BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                      



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                                 THIRD READING


          Bill No:  AB 2392
          Author:   John A. Pérez (D)
          Amended:  8/21/12 in Senate
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  6-3, 6/27/12
          AYES:  Hernandez, Alquist, De León, DeSaulnier, Rubio, Wolk
          NOES:  Harman, Anderson, Blakeslee
           
          SENATE APPROPRIATIONS COMMITTEE  :  5-2, 8/16/12
          AYES:  Kehoe, Alquist, Lieu, Price, Steinberg
          NOES:  Walters, Dutton
           
          ASSEMBLY FLOOR  :  52-24, 5/30/12 - See last page for vote


           SUBJECT  :    Medi-Cal:  interpreter services

           SOURCE  :     Author


           DIGEST  :    This bill requires the Department of Health Care 
          Services (DHCS) to seek federal funding to establish a 
          program to provide and reimburse for certified medical 
          interpretation services to Medi-Cal beneficiaries who are 
          limited English proficient (LEP).

           Senate Floor Amendments  of 8/21/12 establish the State 
          Personnel Board (SPB) as the certifying body for the 
          CommuniCal certified medical interpreter (CCMI) program 
          established by this bill, and require the DHCS to establish 
          the CommuniCal program to provide and reimburse for 
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          certified medical interpretation services to Medi-Cal 
          beneficiaries who are LEP.

           ANALYSIS  :    

          Existing law:

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

          2. Provides, under federal law, increased federal matching 
             funding for translation and interpretation services 
             provided in connection with the enrollment, retention, 
             and use of services under Medicaid (Medicaid is known as 
             Medi-Cal in California) and the Children's Health 
             Insurance Program (CHIP is known as the Healthy Families 
             Program in California).

          3. Prohibits, under Title VI of the Civil Rights Act of 
             1964, a person in the United States, on the grounds of 
             race, color, or national origin, from being excluded 
             from participation in, denied the benefits of, or 
             subjected to discrimination under any program or 
             activity receiving federal financial assistance.

          This bill:

          1. Requires DHCS to seek federal funding to establish a 
             program to provide and reimburse for certified medical 
             interpretation services to Medi-Cal beneficiaries who 
             are LEP.

          2. Requires the program to offer medical interpreter 
             services to Medi-Cal providers serving Medi-Cal 
             beneficiaries on either a fee-for-service (FFS) or 
             managed care basis, pursuant to this bill.

          3. Permits a health care provider or entity entering into a 
             Medi-Cal provider agreement or a Medi-Cal managed care 
             contract with the state, including Medi-Cal managed care 
             organizations (MMCOs), MMCO subcontracting plans, and 
             FFS providers, to utilize the program to provide medical 
             interpreter services to Medi-Cal beneficiaries.

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          4. Requires all contracts between MMCOs and their 
             subcontractors, including health providers and other 
             health plans, to include provisions describing access to 
             medical interpreter services under this program.

          5. Requires DHCS to pursue all available sources of federal 
             funding to establish and administer the medical 
             interpretation program and to seek any federal approvals 
             necessary to implement this bill.

          6. Requires DHCS to develop a mechanism to leverage 
             existing sources of funding associated with medical 
             interpretation services, in order to fully offset state 
             General Fund (GF) costs for the provision of medical 
             interpretation services and program administration. 

          7. Establishes the SPB as the certifying body for the CCMI 
             program established by this bill, and requires the DHCS 
             to establish the CommuniCal program to provide and 
             reimburse for certified medical interpretation services 
             to Medi-Cal beneficiaries who are LEP.

          8. States legislative intent to do all of the following: 

             A.    Create a program that provides reliable access to 
                language interpretation for Medi-Cal beneficiaries 
                who are LEP;

             B.    Establish a mechanism for accessing federal 
                Medicaid matching funds to provide funding for the 
                program;

             C.    Enable trained and qualified interpreters to meet 
                the demand for language services for a significant 
                portion of LEP Medi-Cal beneficiaries; and

             D.    Facilitate accurate and timely communication 
                between LEP patients and their health care providers, 
                which will improve quality of care, reduce medical 
                errors, increase patient understanding and compliance 
                with health diagnoses and care plans, and reduce the 
                cost of health care by eliminating unnecessary tests 
                and other care.

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           Background
           
           Enhanced federal matching funds for translation and 
          interpretation services  .  Children's Health Insurance 
          Program Reauthorization Act of 2009 (CHIPRA), Public Law 
          111-3, enacted on February 4, 2009, contains provisions 
          that affect both CHIP and Medicaid.  In July 2010, the 
          Centers for Medicare and Medicaid Services (CMS) provided 
          guidance on the implementation of Section 201(b) of CHIPRA, 
          which provides increased administrative funding for 
          translation or interpretation services provided under CHIP 
          and Medicaid.  Under Medicaid, increased federal funding 
          for translation and interpretation services available under 
          CHIPRA is limited to children and family members of those 
          children.  Under CHIP, increased federal funding for 
          translation and interpretation services is not just limited 
          to children, and includes pregnant women receiving CHIP 
          coverage.

          Prior to CHIPRA, states could claim federal matching funds 
          for translation or interpretation costs as either an 
          administration expense or as a medical assistance-related 
          expense, and were reimbursed at the standard Federal 
          Medical Assistance Percentage (regular FMAP) rate (which is 
          typically 50% in California for Medi-Cal and 65% for the 
          Healthy Families Program). 

          CHIPRA provides increased federal matching funding for 
          translation or interpretation services provided to eligible 
          individuals for whom English is not their primary language. 
           The increased federal match for translation or 
          interpretation services differs for Medicaid and CHIP.  For 
          Medicaid, the increased match is 75% of allowable 
          expenditures.  For CHIP, the increased match is 75%, or the 
          state's enhanced FMAP plus 5%, whichever is higher (in 
          California, it would be 75%).  However, the increased 
          federal match is only available for eligible expenditures 
          claimed as administration of the Medicaid or CHIP plan, not 
          expenditures claimed for benefits (which are matched at the 
          state's usual FMAP rate of 50% for Medi-Cal and 65% for 
          CHIP).  In addition, the expenditures that qualify for the 
          increased match under CHIP are subject to the 10% cap on 
          administrative expenditures.

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           Federal anti-discrimination law  .  Title VI of the Civil 
          Rights Act of 1964 and its implementing regulations provide 
          that no person shall be subject to discrimination on the 
          basis of race, color, or national origin under any program 
          or activity that receives federal financial assistance.  
          Each federal department has a civil rights office that is 
          charged with ensuring that its programs are free of 
          discrimination.  The federal Department of Health and Human 
          Services (HHS) Office for Civil Rights (OCR) 
          responsibilities include enforcing the Civil Rights Act, 
          the Americans with Disabilities Act, and the Age 
          Discrimination Act.  Any organization or individual who 
          receives monies through HHS-health departments, health 
          plans, social service agencies, nonprofits, hospitals, 
          clinics, and physicians-is subject to OCR oversight.  The 
          OCR has the authority to investigate complaints related to 
          linguistic barriers, to initiate its own reviews, and to 
          withhold federal funds for noncompliance. 

           OCR policy guidance  .  CMS issued a State Medicaid Director 
          letter on August 31, 2000, that informed states of the 
          policy guidance that the OCR had issued on the prohibition 
          against national origin discrimination as it affects 
          persons with LEP, pursuant to Title VI of the Civil Rights 
          Act of 1964. 

          OCR Policy Guidance requires recipients of federal 
          assistance to take reasonable steps to ensure meaningful 
          access to their programs and activities by LEP persons.  
          The Guidance explains that the obligation to provide 
          meaningful access is fact-dependent and starts with an 
          individualized assessment that balances four factors:  (1) 
          the number or proportion of LEP persons eligible to be 
          served or likely to be encountered by the program or 
          grantee; (2) the frequency with which LEP individuals come 
          into contact with the program; (3) the nature and 
          importance of the program, activity or service provided by 
          the recipient to its beneficiaries; and (4) the resources 
          available to the grantee/recipient and the costs of 
          interpretation/ translation services.  CMS states there is 
          no "one size fits all" solution for Title VI compliance 
          with respect to LEP persons, and what constitutes 
          "reasonable steps" for large providers may not be 

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          reasonable where small providers are concerned.

           Data on language in California  .  According to the U.S. 
          Census' 2010 American Community Survey, 43.7% of 
          Californians over the age of five speak a language other 
          than English, and 19.9% of Californians over the age of 
          five speak English "less than very well."  According to the 
          California Health Interview Survey, of the 3.5 million 
          adults in the Medi-Cal program, about 281,000 (8.1%) had 
          difficulty understanding their doctor and/or needed another 
          person to help them understand their doctor.  Among the 
          parents of 1.8 million children under age 12 in the 
          Medi-Cal program, about 135,000 (7.4%) had difficulty 
          understanding the child's doctor and/or needed another 
          person's help to understand the doctor.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes   
          Local:  No

           SUPPORT  :   (Verified  6/27/12)(per Senate Health Committee 
          analysis)

          AFSCME, AFL-CIO
          California Academy of Family Physicians
          California Communities United Institute
          California Pan-Ethnic Health Network (in concept)
          Children Now
          Children's Defense Fund - California
          Congress of California Seniors
          Disability Rights California
          Health Access California
          Latino Coalition for a Healthy California
          National Association of Social Workers - California Chapter
          The Children's Partnership
          Western Center on Law and Poverty

           ARGUMENTS IN SUPPORT  :    Western Center on Law and Poverty 
          states this bill assists California in drawing down 
          additional federal funds for the interpreter services 
          Medi-Cal providers and plans are required to provide.  
          While Medi-Cal managed care plan rates include funds for 
          interpreter services and some providers draw down federal 
          funds for language services (such as hospitals), California 
          is leaving federal dollars on the table that it could use 

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          to provide these critical services. 

          AFSCME, AFL-CIO writes that, with the expansion of Medi-Cal 
          and the implementation of the California Health Benefit 
          Exchange under federal health care reform, the state has a 
          clear opportunity to create an interpreters' program that 
          will allow patients and providers to clearly communicate 
          with each other.  AFSCME states that, during these 
          difficult fiscal times, the state should seek to maximize 
          all federal dollars to help the Medi-Cal program, and 
          matching funds for health care interpretation will help our 
          state respond to the needs of LEP Californians. 

          Health Access California writes that professional 
          interpreters trained in medical interpretation are critical 
          as medical terminology is not readily translated, cultural 
          sensitivity is lost, and avoidable medical errors occur.


           ASSEMBLY FLOOR  :  52-24, 5/30/12
          AYES:  Alejo, Allen, Ammiano, Atkins, Beall, Block, 
            Blumenfield, Bonilla, Bradford, Brownley, Buchanan, 
            Butler, Charles Calderon, Campos, Carter, Cedillo, 
            Chesbro, Dickinson, Eng, Feuer, Fong, Fuentes, Furutani, 
            Galgiani, Gatto, Gordon, Hall, Hayashi, Roger Hernández, 
            Hill, Huber, Hueso, Huffman, Lara, Bonnie Lowenthal, Ma, 
            Mendoza, Mitchell, Monning, Nestande, Pan, Perea, V. 
            Manuel Pérez, Portantino, Skinner, Solorio, Swanson, 
            Torres, Wieckowski, Williams, Yamada, John A. Pérez
          NOES:  Achadjian, Bill Berryhill, Conway, Cook, Donnelly, 
            Beth Gaines, Garrick, Gorell, Grove, Hagman, Harkey, 
            Jeffries, Jones, Knight, Logue, Mansoor, Miller, Morrell, 
            Nielsen, Norby, Olsen, Silva, Smyth, Wagner
          NO VOTE RECORDED:  Davis, Fletcher, Halderman, Valadao


          CTW:k  8/22/12   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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