BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 916|
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THIRD READING
Bill No: AB 916
Author: V. Manuel Pérez (D)
Amended: 7/5/12 in Senate
Vote: 21
SENATE HEALTH COMMITTEE : 8-0, 6/27/12
AYES: Hernandez, Harman, Alquist, Anderson, Blakeslee,
DeSaulnier, Rubio, Wolk
NO VOTE RECORDED: De León
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
ASSEMBLY FLOOR : Not relevant
SUBJECT : Health: underserved communities
SOURCE : Author
DIGEST : This bill requires federally qualified health
centers (FQHCs), as described, operated by a county to file
a specified report with the Office of Statewide Health
Planning and Development (OSHPD) reflecting patient
demographic data, among other information.
ANALYSIS : Existing law:
1.Establishes FQHCs, under federal law, to include all
organizations receiving grants under Section 330 of the
Public Health Service Act, and makes FQHCs eligible to
qualify for enhanced reimbursement from Medicare and
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Medicaid, as well as other benefits.
2.Allows individual counties to establish systems to
provide for the health of their indigent populations,
including licensing their own county-run clinics.
3.Establishes the Licensing and Certification Division of
the Department of Public Health (DPH) to license health
facilities and non-county clinics, with certain
exceptions.
4.Requires all clinics licensed by DPH to file a verified
report with OSHPD showing specified information for the
previous calendar year. This information includes the (a)
number of patients served and descriptive information,
including age, gender, race, and ethnic background of
patients; (b) number of patient visits by type of
service, including child health and disability prevention
screenings, medical and dental services, among others;
(c) total clinic operating expenses; (d) gross patient
charges by payer category; (e) deductions from revenue;
and (f) additional information as may be required by
OSHPD or DPH Licensing and Certification.
5.Establishes the California State Office of Rural Health
within the Department of Health Care Services (DHCS) to
collaborate with public and private entities statewide,
and at the regional and national levels to increase rural
access to health care. Establishes the Seasonal
Agricultural and Migratory Workers (SAMW) Advisory
Committee within DHCS to advise DHCS on the level of
resources, priorities, criteria, and guidelines necessary
to address the health of seasonal and migratory
agricultural workers.
This bill requires FQHCs operated by a county, as
described, to file a report with OSHPD showing patient
demographic and payer information, as specified. Exempts
clinics conducted, operated or maintained as outpatient
departments of hospitals, and licensed health facilities,
as defined, from this requirement.
Background
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Farmworker health. A policy brief from the Central Coast
Health Network on the status of farmworkers claims that
despite the fact that California's agricultural industry
continues to generate well over $20 billion annually ($27
billion in 2000), farmworkers continue to lag well behind
the rest of society in terms of income, health, housing,
education, and other socio-economic conditions.
Farmworkers continue to live in poverty or near poverty,
suffer from chronic health conditions at higher rates than
the general public, have little access to health insurance,
and are often undereducated and speak little English. Data
from 2000 show that 18% of male farmworkers had at least
two of three risk factors for chronic disease, 81% of men
and 76% of women had unhealthy weight, men suffer from iron
deficiency anemia at a rate of four times greater than U.S.
men. Also, nearly 70% lacked any form of health insurance,
32% of males reported they'd never been to a doctor or
clinic in their lives, 50% of males and 40% of females had
never been to a dentist, and over two-thirds never had an
eye-care visit.
Farms present many unique health and safety hazards for
workers, including: exposure to chemicals and pesticides;
machinery, tools and equipment that can be dangerous;
hazardous areas, such as grain bins, silos and wells; and
livestock that can spread diseases or cause injuries.
Farmworkers are also likely to be exposed to extreme heat,
and many have suffered heat strokes. United Farm Workers
claims that at least 16 farmworkers have died due to heat
illness since 2005, including the widely known 2008 death
of 17-year-old Maria Isabel Vasquez Jimenez.
State actions related to farmworker health. The SAMW
Program was developed to study the health and health
services for seasonal agricultural and migratory workers
and their families throughout the state; provide financial
and technical assistance to primary care clinics serving
this target population; and, coordinate similar programs of
the federal government and other state and voluntary
agencies. The SAMW Advisory Committee was also established
to advise DHCS on guidelines necessary to address the
health of seasonal and migratory workers. The SAMW Program
awarded grants to community-based, private, nonprofit,
licensed primary health care clinics throughout California
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for the provision of comprehensive primary and preventive
health care services. During Fiscal Year 1997-2000, the
SAMW Program funded 45 clinics to support or enhance the
delivery of primary health care to seasonal agricultural
workers, migratory workers, and their families. The
California State Office of Rural Health was established in
statute in 1995 to promote a relationship between state
government and local and federal agencies, universities,
private and public interest groups, rural consumers, health
care providers, foundations, and other offices of rural
health, as well as to develop health initiatives and
maximize the use of existing resources without duplicating
existing effort.
FQHCs. FQHCs are expected to focus on providing care to
the populations whose needs are not met by private
providers such as uninsured or publicly insured
individuals. Each FQHC tailors its services and patient
base according to the unmet need in its community. FQHCs
are strongly encouraged to collaborate with other health
care providers in the area and to focus on filling service
gaps rather than duplicating services. FQHC funding must be
used for the purpose of increasing access to the
underserved patients in the community.
In order to become an FQHC, a clinic has to:
Be located in an area designated as a Medically
Underserved Area/Population;
Be or become a 501(c)3 nonprofit organization or a public
entity;
Have a governing board with at least 51percent of members
being consumers;
Provide comprehensive primary care including dental
health and mental health; and
Serve patients without regard to their ability to pay
(using a sliding fee scale).
FQHCs can be nonprofits or county-run. Unlike nonprofit
clinics in California, county-run FQHCs are licensed by
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their respective counties, and are therefore excluded from
the requirement on clinics in existing law to report data
to OSHPD.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
SUPPORT : (Verified 8/8/12)
National Association of Social Workers, California Chapter
OPPOSITION : (Verified 8/8/12)
California Right to Life Committee, Inc.
ARGUMENTS IN SUPPORT : The National Association of Social
Workers, California Chapter (NASW-CA) supports this bill,
which NASW-CA believes will address the ongoing health
disparities afflicting California farmworkers by creating
an entity to take a leadership role in identifying viable
strategies for improving their health status. NASW-CA
advocates for the implementation and improvement of
programs and policies designed to enhance human well-being
and help meet the basic needs of all people.
ARGUMENTS IN OPPOSITION : The California Right to Life
Committee, Inc. opposes this bill and considers it as one
additional bureaucracy dependent on federal and private
dollars, not one which would significantly increase health
care services in the long run to those farmworkers in our
state.
CTW:n 8/8/12 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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