BILL ANALYSIS                                                                                                                                                                                                    �






                             SENATE COMMITTEE ON HEALTH
                          Senator Ed Hernandez, O.D., Chair

          BILL NO:       AB 2266
          AUTHOR:        Mitchell
          AMENDED:       May 25, 2012
          HEARING DATE:  June 20, 2012
          CONSULTANT:    Bain

           SUBJECT  :  Medi-Cal: Enhanced Health Homes for Frequent Hospital 
          Users with Chronic Conditions.
           
          SUMMARY  :  Requires the Department of Health Care Services (DHCS) 
          to establish a program to provide health home services designed 
          to reduce a participating individual's avoidable use of 
          hospitals when more effective care can be provided in less 
          costly settings. Defines the population of individuals eligible 
          to receive health home services, the required services, and the 
          criteria for health care providers selected through a request 
          for proposal (RFP) process. Requires DHCS to prepare or contract 
          for an evaluation of the program, to complete the evaluation, 
          and to submit a report to the appropriate policy and fiscal 
          committees of the Legislature. Implements this bill only if 
          federal financial participation (FFP) is available and the 
          federal Centers for Medicare and Medicaid Services (CMS) 
          approves the State Plan Amendment (SPA) to implement this bill.

          Existing law:
          1.Establishes the Medi-Cal program, administered by DHCS, under 
            which qualified low-income individuals receive health care 
            services. 

          2.Authorizes, under the federal Patient Protection and 
            Affordable Care Act (ACA) (Public Law 111-148), as amended by 
            the Health Care Education and Reconciliation Act of 2010 
            (Public Law 111-152), states to offer health home services, as 
            defined, to eligible individuals with chronic conditions who 
            select a designated provider, a team of health care 
            professionals operating with such a provider, or a health team 
            as the individual's health home for purpose of providing the 
            individual with health home services.

          3.Provides, under the ACA, 90 percent federal matching funds for 
            the first 8 quarters the health home option is in effect. 
            Thereafter, the state's regular federal matching rate would be 
            in effect (typically 50 percent in California).
                                                         Continued---



          AB 2266 | Page 2




          
          This bill:
          1.Requires DHCS, no later than January 1, 2014, to do all of the 
            following:
             a.   Design, with opportunity for public comment, a program 
               to provide enhanced health home services to persons at high 
               risk of avoidable and frequent use of hospital services due 
               to complex co-occurring health and behavioral health 
               conditions. 
             b.   Upon a RFP process, select providers as designated 
               providers working in coordination with health care 
               providers under the Health Homes option SPA.
             c.   Submit any necessary applications to CMS for a SPA under 
               the Health Homes option to provide enhanced health home 
               services to Medi-Cal beneficiaries, to newly eligible 
               Medi-Cal beneficiaries upon Medicaid expansion under the 
               ACA, and to Low Income Health Program (LIHP) enrollees, if 
               applicable, in counties with LIHPs willing to match federal 
               funds.

          2.Requires the program established to provide services to 
            Medi-Cal beneficiaries, to newly enrolled Medi-Cal 
            beneficiaries upon implementation of Medicaid expansion under 
            the ACA, and, if applicable, in counties with a LIHP, willing 
            to match federal funds, to enrollees of the LIHP. Requires the 
            program to be designed to reduce a participating individual's 
            avoidable use of hospitals when more effective care, including 
            primary and specialty care, and social services can be 
            provided in less costly settings.

          3.Requires DHCS to seek, to the extent permitted by federal law 
            and to the extent federal approval is obtained, to define the 
            population of eligible individuals as individuals experiencing 
            two or more specified diagnoses (mental health disorder, 
            substance abuse disorder, chronic or life-threatening 
            condition, or significant cognitive impairment) and two or 
            more specified indicators of severity (inpatient 
            hospitalizations, excessive use of crisis or emergency 
            services, failed linkages to primary care, chronic 
            homelessness, inadequate follow-through, two or more episodes 
            of detoxification services, medication resistance, 
            self-harm/threats of harm to others, or significant 
            complications in health conditions).

          4.Permits DHCS to develop a payment methodology other than a 
            fee-for-service payment, including a per member, per month 




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            payment to designated providers.

          5.Requires services provided under the program to include all of 
            the following:
             a.   Comprehensive and individualized case management;
             b.   Care coordination and health promotion, including 
               connection to medical, mental health, and substance abuse 
               care;
             c.   Comprehensive transitional care from inpatient to other 
               settings, including appropriate follow-up;
             d.   Individual and family support, including authorized 
               representatives;
             e.   Referral, if relevant, to other community and social 
               services supports, including transportation to appointments 
               needed to manage health needs, connection to housing for 
               participants who are homeless or unstably housed, and peer 
               and recovery support; and
             f.   Health information technology to identify eligible 
               individuals and link services, if feasible and appropriate. 

           
           6.Permits the state to limit the availability of services 
            geographically, provided that providers meet criteria 
            identified below in each county designated. 
           
           7.Requires DHCS to select designated providers operating with a 
            team of health care professionals that have all of the 
            following:
             a.   A designated lead provider that is a community clinic, a 
               provider of mental health services pursuant to the Adult 
               and Older Adult Mental Health System of Care Act, or a 
               hospital;
             b.   Demonstrated experience working with frequent hospital 
               users and with documentation of experience reducing 
               emergency department (ED) visits and hospital inpatient 
               days among the population served;
             c.   Demonstrated experience working with people experiencing 
               chronic homelessness;
             d.   The capacity and administrative infrastructure to 
               participate in the program, including the ability to meet 
               requirements of federal guidelines;
             e.   Documented ability to provide or to link clients with 
               appropriate community-based services, including intensive 
               individualized face-to-face care coordination, primary 
               care, specialty care, mental health treatment, substance 




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               abuse treatment, peer and recovery support, permanent or 
               transitional housing, and transportation;
             f.   Experience working with supportive or other permanent 
               housing providers;
             g.   Current partnership with essential community hospitals, 
               particularly the hospital or hospitals serving a high 
               proportion of Medi-Cal patients, such as disproportionate 
               share hospitals; and
             h.   A viable plan, with roles identified among providers of 
               the enhanced health home, to do all of the following:
                 i.           Reach out to and engage frequent hospital 
                  users and chronically homeless eligible individuals;
                 ii.          Connect eligible individuals who are 
                  homeless or experiencing housing instability to 
                  permanent housing, including supportive housing;
                 iii.         Ensure eligible individuals receive whatever 
                  integrated services are needed to access and maintain 
                  health stability, including medical, mental health, and 
                  substance abuse care and social services to address 
                  social determinants of health;
                 iv.          Track, maintain, and provide outcome data to 
                  the evaluator;
                 v.           Identify appropriate funding sources for the 
                  nonfederal share of costs of services for the first 
                  eight quarters of implementation of the program; and
                 vi.          Identify appropriate funding sources for the 
                  nonfederal share of costs of services to sustain program 
                  funding beyond the first eight quarters of 
                  implementation of the program, which may include a plan 
                  to partner with managed care organizations, counties, 
                  hospitals, private funders, or others. 

          8.Permits DHCS to designate providers working under a managed 
            care organization contract or as a fee-for-service provider. 

          9.Prohibits a specified provision of this bill from being 
            construed to preclude local entities, health plans, or 
            foundations from contributing the nonfederal share of costs 
            for services provided under this program, as specified.

          10.          Prohibits this bill from being construed to limit 
            DHCS in targeting additional populations or creating 
            additional programs under the Health Homes option.

          11.          Permits DHCS to implement this bill through 
            provider bulletins or similar instructions, without taking 




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            regulatory action under the Administrative Procedure Act. 

          12.          Requires DHCS, if FFP is available, to prepare, or 
            contract for the preparation of, an evaluation of the program 
            identified in this bill. Requires DHCS to seek out and utilize 
            only non-state public funds or private funds to fund the 
            nonfederal share of costs of the evaluation. Requires DHCS, 
            within 18 months after designated providers have been selected 
            and have begun to seek payment, to complete the evaluation and 
            submit a report to the appropriate policy and fiscal 
            committees of the Legislature.

          13.          Requires this bill to be implemented only if 
            non-state public funds or private funds are available to fully 
            fund the creation, implementation, administration, and service 
            costs during the first eight quarters of implementation, and 
            thereafter. Allows DHCS to use state funds to fund the program 
            costs if, after the first eight quarters of implementation, 
            DHCS finds that Medi-Cal costs avoided by the participants of 
            the program are adequate to fully fund the program costs.

          14.          Permits DHCS to revise or terminate the enhanced 
            health home program any time after the first eight quarters of 
            implementation if DHCS finds that the program fails to result 
            in improved health outcomes or fails to decrease total 
            Medi-Cal costs, including managed care organization costs, if 
            applicable, for the population it is serving. Permits DHCS to 
            also designate additional providers, with federal approval, or 
            remove providers operating under the program if those 
            providers are unable to provide the nonfederal matching funds 
            or do not meet DHCS' guidelines. 

           FISCAL EFFECT  : According to the Assembly Appropriations 
          Committee:
          1.This bill specifies that funding sources for the nonfederal 
            share of Health Home services costs for the first eight 
            quarters must be identified by participating providers, and 
            requires the continued provision of these services to be 
            cost-neutral to the state after eight quarters. 

          2.Direct costs to DHCS include: 
             a.   Program development. One-time administrative costs to 
               DHCS in the hundreds of thousands of dollars or more, 
               depending upon the ultimate size and scope of the program.  
               DHCS has applied for and received a total of $1 million for 




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               planning (50 percent federal, 50 percent matching funds 
               from The California Endowment).  
             b.   Program administration. This annual cost could be up to 
               the low millions of dollars, depending on the scope of the 
               program, the number and type of providers, and other 
               factors.  
             c.   Evaluation. DHCS indicates evaluations for similar 
               projects generally cost upwards of $1 million.

          3.This bill specifies it is only to be implemented if non-state 
            public or private funds are available to fully fund the 
            creation, implementation, administration, and evaluation 
            costs.   Thus, the impact to the General Fund is projected to 
            be minimal.   

          4.Limited DHCS resources. This project will compete with other 
            projects for limited administrative resources for developing 
            and implementing health home pilots

          5.Savings. Significant medical cost savings may be possible. 
            Similar projects targeting frequent hospital users have 
            demonstrated dramatic reductions in costs over a two-year 
            period. However, cost savings may also be realized by other 
            Health Home options DHCS is already considering.

          6.Societal benefit. Enhanced services to stabilize high-needs, 
            high-cost Medi-Cal beneficiaries could have positive spillover 
            effects in local communities through reduced demand on social, 
            public health, and public safety services.

           PRIOR VOTES  :  
          Assembly Health:    14- 5
          Assembly Appropriations:12- 5
          Assembly Floor:     53- 25
           

          COMMENTS  :  
           1.Author's statement.  Frequent users of emergency department 
            hospital care who are homeless face significant difficulties 
            accessing regular or preventive care and complying with 
            treatment protocols. Without a home, frequent users cannot 
            improve health outcomes or reduce their costly use of acute 
            care services, with no place to store medications, an 
            inability to adhere to a healthy diet or maintain appropriate 
            hygiene, and an inability to rest sufficiently to recover from 
            illness. Homeless Medi-Cal enrollees will in fact, continue to 




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            use costly acute care services and actually increase their 
            inpatient days, even if receiving medical home services to 
            reduce their return to the hospital.

          2.Federal law and guidance on State Option to Provide Health 
            Homes for Enrollees with Chronic Conditions. Section 2703 of 
            the ACA allows states to elect the Health Home option in their 
            Medicaid program and receive a 90 percent federal matching 
            rate for 2 years for these services. Federal law defines the 
            individuals eligible for health home services as individuals 
            meeting one of the following: (a) having at least two chronic 
            conditions; (b) having one chronic condition and are at risk 
            of having a second chronic condition; or (c) having one 
            serious and persistent mental health condition. 

          Federal law defines "health home services" as services provided 
            by a designated provider, a team of health care professionals 
            operating with such a provider, or a health team that 
            provides:
             �    Comprehensive care management;
             �    Care coordination and health promotion;
             �    Comprehensive transitional care, including appropriate 
               follow-up, from inpatient to other settings;
             �    Patient and family support (including authorized 
               representatives);
             �    Referral to community and social support services, if 
               relevant; and
             �    Use of health information technology to link services, 
               as feasible and appropriate.

            In preliminary guidance provided to State Medicaid Directors 
            in November 2010, CMS stated that this ACA provision is an 
            important opportunity for states to address and receive 
            additional federal support for the enhanced integration and 
            coordination of primary, acute, behavioral health (mental 
            health and substance use), and long-term services and supports 
            for persons across the lifespan with chronic illness. CMS 
            stated that the health home provision provides an opportunity 
            to build a person-centered system of care that achieves 
            improved outcomes for beneficiaries and better services and 
            value for Medicaid programs. CMS indicated it expects that use 
            of the health home service delivery model will result in lower 
            rates of ED use, reduction in hospital admissions and 
            re-admissions, reduction in health care costs, less reliance 
            on long-term care facilities, and improved experience of care 




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            and quality of care outcomes for the individual.

          1.Related legislation. SB 393 (Hernandez) would enact the 
            Patient-Centered Medical Home (PCMH) Act of 2011 and would 
            define "medical home," "patient-centered medical home," 
            "advanced practice primary care," "health home," 
            "person-centered-health care home," and "primary care home" to 
            mean a health care delivery model using the definition in a 
            specified provision of the ACA and any federal rules or 
            regulations issued pursuant to that ACA provision. SB 393 is 
            pending in the Assembly Health Committee.
          
          2.Prior legislation.  AB 1542 (Jones) of 2009 would have defined 
            a PCMH to mean, in part, a health care delivery model in which 
            a patient establishes an ongoing relationship with a physician 
            or other licensed health care provider, working in a 
            physician-directed practice team to provide comprehensive, 
            accessible and continuous evidence-based primary care and 
            coordinate the patient's health care needs across the health 
            care system.  AB 1542 failed passage on the Assembly Floor on 
            concurrence.

            SB 1738 (Steinberg) of 2008 would have required DHCS to 
            establish a three-year pilot program to provide intensive 
            multidisciplinary services to Medi-Cal beneficiaries 
            identified as frequent users of health care.  SB 1738 was 
            vetoed by Governor Schwarzenegger who stated in his veto 
            message that he could not support the bill because of the 
            state's ongoing fiscal challenges and asked the author and 
            stakeholders to work with his Administration to identify 
            strategies to ensure these beneficiaries receive the right 
            care, at the right time, in the right setting.

          3.Support.  The Corporation for Supportive Housing (CSH) argues 
            overwhelming data show that the services this bill would fund 
            could save Medi-Cal significant costs, and most importantly, 
            would save the lives of potentially thousands of Californians, 
            getting people off the streets, out of hospitals and into 
            decent, appropriate care. CSH states using 90 percent federal 
            Medi-Cal funding through the ACA option, this bill would fund 
            health home services to coordinate and integrate the medical, 
            behavioral health, and social services needed to reduce 
            avoidable hospitalizations. CSH states it administered the 
            Frequent Users of Health Services Initiative, a 
            foundation-funded five-year program, supporting six projects 
            throughout California that offered community-based 




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            multidisciplinary services to people who frequently incur 
            inpatient stays or ED visits for avoidable reasons. Frequent 
            users experience psychosocial complexities, like chronic 
            disease, mental disability, substance abuse, or homelessness 
            (often a combination of these conditions). Intensive 
            face-to-face services that coordinate and help beneficiaries 
            manage their care not only improve health outcomes among these 
            individuals but decrease hospital costs. Medi-Cal 
            beneficiaries participating in the Frequent Users of Health 
            Services Initiative programs experienced a 60 percent decrease 
            in ED visits and a 69 percent decrease in inpatient days. The 
            state incurred significant cost savings as a result. In fact, 
            data from similar programs across the country show these 
            services save between $7,500 and $29,000 per year, per 
            beneficiary in Medicaid costs. CSH states this bill 
            complements the state's health reform goals and promotes 
            easy-to-implement proven strategies. 

          4.Technical amendments. On page 8, line 34, the reference to 
            "section" should instead be a reference to "article." 

           SUPPORT AND OPPOSITION  :
          Support:  California Association for Health Services at Home
                    California Association of Alcohol and Drug Programs 
               Executives, Inc. 
                    California Center for Rural Policy
                    California Chapter of the American College of 
               Emergency Physicians
                    California Council of Community Mental Health Agencies
                    California Primary Care Association 
                    Century Housing 
                    Compass Family Services
                    Corporation for Supportive Housing
                    Disability Rights California
                    Health Access California
                    Homeward Bound of Marin
                    Housing California
                    LifeSTEPS
                    Mental Health America of California
                    National Association of Social Workers, California 
               Chapter
                    The Non-Profit Housing Association of Northern 
               California
                    Santa Clara County Board of Supervisors
                    Western Center on Law and Poverty




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                    One individual

          Oppose:   None received.

                                      -- END --