BILL ANALYSIS Ó
AB 2392
Page 1
ASSEMBLY THIRD READING
AB 2392 (John A. Pérez)
As Amended May 25, 2012
Majority vote
HEALTH 14-5 APPROPRIATIONS 12-5
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|Ayes:|Monning, Ammiano, Atkins, |Ayes:|Fuentes, Blumenfield, |
| |Bonilla, Eng, Gordon, | |Bradford, Charles |
| |Hayashi, | |Calderon, Campos, Davis, |
| |Roger Hernández, Bonnie | |Gatto, Ammiano, Hill, |
| |Lowenthal, Mitchell, | |Lara, Mitchell, Solorio |
| |Nestande, Pan, | | |
| |V. Manuel Pérez, Williams | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Logue, Garrick, Mansoor, |Nays:|Harkey, Donnelly, |
| |Silva, Smyth | |Nielsen, Norby, Wagner |
| | | | |
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SUMMARY : Requires the Department of Health Care Services (DHCS)
to seek federal funding to establish a program to provide and
reimburse certified medical interpretation services to Medi-Cal
beneficiaries with limited English proficiency (LEP).
Specifically, this bill :
1)Requires the program to offer medical interpreter services to
Medi-Cal providers serving Medi-Cal beneficiaries in
fee-for-service (FFS) or Medi-Cal managed care (MCMC) and
allows Medi-Cal approved providers and MCMC contracting and
subcontracting plans to utilize the program to provide
interpreter services to Medi-Cal beneficiaries.
2)Requires all contracts between MCMC plans and subcontractors,
including those with providers and other plans, to include
provisions describing access to medical interpreter services
under this program.
3)Requires DHCS to pursue all available sources of funding to
establish and administer this program, to develop a mechanism
to leverage existing sources of funding associated with
medical interpretation services in order to offset state
General Fund (GF) costs and to seek any federal approvals
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necessary.
4)Specifies legislative intent including: to create a program
to provide reliable access to language interpretation to
Medi-Cal beneficiaries who are LEP; to enable trained and
qualified interpreters to meet the demand for language
services; and, to facilitate accurate and timely communication
between LEP patients and their health care providers.
FISCAL EFFECT : According to the Assembly Appropriations
Committee:
1)Costs for a number of activities as noted below. Costs would
generally be at a 50% GF, 50% federal funds matching rate
except for costs associated with services used by children,
subject to federal approval. Pursuant to the Children's
Health Insurance Program Reauthorization Act of 2010 and
subsequent federal guidance, language services for children
can be claimed at a 25% GF, 75% federal funds matching rate.
Children comprise approximately half of the Medi-Cal
population.
2)This bill requires the department to develop a mechanism to
leverage existing funding associated with medical
interpretation services, in order to fully offset increased
state GF costs. Thus, the only net state costs are the
following:
a) One-time administrative costs in the range of $1 million
(50% GF, 50% federal funds) to DHCS to seek federal
approvals, create system protocols, develop an information
technology or 'IT' infrastructure, design communications
and guidance, promulgate regulations, consult with
stakeholders, and other initial program development
activities.
b) If DHCS establishes an accreditation system for
qualifying language providers as stated in the intent
language of this bill, one-time costs of $100,000 (50% GF,
50% federal funds) to develop standards and promulgate
regulations, as well as $50,000 or more ongoing to
credential these providers.
3)The extent to which a centralized medical interpretation
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system would increase the number of medical interpretation
visits, given that the program would have to rely on
leveraging existing funding for these purposes, is unknown.
The availability of enhanced 75% federal match for services
provided to children through a centrally administered system,
and the potential for increased cost efficiency of such a
system, suggests it may be possible to increase the number and
quality of visits provided, with negligible additional state
costs.
4)Potential impact on medical services used is also difficult to
estimate, but improved access to high-quality interpretive
services is likely to improve access to care and, on balance,
increase overall medical costs to the Medi-Cal program for LEP
beneficiaries.
COMMENTS : According to the author, this bill is to require DHCS
to explore options for obtaining federal matching funds in the
Medi-Cal program for the reimbursement of medical interpretation
services to beneficiaries who are LEP. The author points out
that more than 40% of Californians speak a language other than
English at home. Furthermore, almost seven million Californians
are estimated to speak English "less than very well." The
author states that research has found that language barriers can
contribute to inadequate patient evaluation and diagnosis, lack
of appropriate and/or timely treatment, or other medical errors
that can jeopardize patient safety and lead to unnecessary
procedures and costs. The author further points out that
currently language assistance in medical settings is provided by
trained or untrained staff or in an informal manner by family
members or friends. The author argues that with this bill,
California has an opportunity to develop a more comprehensive
language assistance program by seeking additional federal
funding for medical interpreter services in the Medi-Cal
program.
In 2002, the federal Centers for Medicare and Medicaid Services
released a letter to all state Medicaid directors reminding
states that federal matching funds are available for states'
expenditures related to the provision of oral and written
translation administrative activities and services provided for
Medicaid recipients. According to the letter, federal financial
participation is available for such activities or services
whether provided by staff interpreters, contract interpreters,
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or through a telephone service. Nonetheless, in California
there is no mechanism to reimburse for language services in the
FFS system as there is no billing code.
Analysis Prepared by : Marjorie Swartz / HEALTH / (916)
319-2097
FN: 0003953