BILL ANALYSIS                                                                                                                                                                                                    �



                                                                AB 2608
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        CONCURRENCE IN SENATE AMENDMENTS
        AB 2608 (Bonilla)
        As Amended August 23, 2012
        Majority vote
         
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        |ASSEMBLY:  |74-0 |(May 30, 2012)  |SENATE: |36-0 |(August 28,    |
        |           |     |                |        |     |2012)          |
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         Original Committee Reference:    HEALTH  

         SUMMARY  :  Eliminates the January 1, 2013, sunset clause and revises 
        existing provisions implementing the Medicaid local billing option 
        (LBO) that allows local educational agencies (LEAs) to obtain 
        federal matching funds for health care services provided by schools 
        to Medi-Cal eligible students.

         The Senate amendments  :  

         1)Delete the requirement that Department of Health Care Services 
          (DHCS) to seek a state plan amendment (SPA) and to revise 
          applicable regulatory requirements pertaining to medical 
          transportation services provided by LEAs so that LEAs may seek 
          reimbursement for services as allowed under federal law

        2)Delete the requirement that DHCS include, in the annual report 
          filed with the Legislature, an accounting of funds withheld from 
          federal matching funds by DHCS to fund staff and administer the 
          LEA billing option.  Require instead, no later than July 1, 2013, 
          and every year thereafter, DHCS to make publicly accessible an 
          annual accounting of all funds collected by DHCS from Medicaid 
          payments allocable to LEAs, including those used to fund DHCS 
          administrative activities.  Require the accounting to detail 
          amounts withheld from each LEA.  Allows one-time costs for the 
          development of the accounting of up to $250,000.

        3)State that regulations relating to reimburse of Medi-Cal medical 
          transportation services shall not apply to medical transportation 
          eligible to be billed by LEAs.  Provide that this exception shall 
          become inoperative on January 1, 2018, or when the regulations 
          have been updated. 

         AS PASSED BY THE ASSEMBLY  , this bill:









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        1)Eliminated the January 1, 2013, sunset clause and revised existing 
          provisions implementing the Medicaid LBO that allows LEAs to 
          obtain federal matching funds for health care services provided by 
          schools to Medi-Cal eligible students.  

        2)Required DHCS to seek a SPA and to revise applicable regulatory 
          requirements pertaining to medical transportation services 
          provided by LEAs so that LEAs may seek reimbursement for services 
          as allowed under federal law.  

        3)Added a requirement that DHCS include, in the annual report filed 
          with the Legislature, an accounting of funds that are withheld 
          from federal matching funds and used by DHCS to fund staff and 
          administer the LEA billing option.  

        4)Required funds withheld from the federal matching funds due to 
          each LEA be collected by reducing payments to all participating 
          LEAs proportionately and deleted a requirement that these funds be 
          derived only from an amount that exceeds the baseline amount as 
          set by LEA billing revenues for the 2000-01 fiscal year (FY).

        5)Required the report to detail the amounts withheld from funds that 
          would otherwise be due to each participating LEA.  

         FISCAL EFFECT  :  According to the Senate Appropriations Committee 
        this bill would result in millions of dollars in additional federal 
        funds reimbursing LEAs for 50% of specified expenses they 
        mandatorily incur under existing law.

         COMMENTS  :  According to Los Angeles Unified School District (LAUSD), 
        many of the responsibilities of DHCS related to the LBO program are 
        set to expire in 2013.  According to the author, eliminating this 
        sunset is necessary to prevent school districts from losing federal 
        matching funds through the Medi-Cal program for health services that 
        school districts are required to provide.  This bill will also align 
        allowable transportation services with federal rules to allow for 
        reimbursement for transportation of students with disabilities and 
        could generate millions of dollars statewide for necessary school 
        transportation for students with disabilities.  For example, LAUSD 
        currently spends $77 million on transportation for 13,000 students 
        with disabilities.  However, under the current state rules, LAUSD is 
        only able to receive $2 million in federal reimbursement.  
        Currently, state rules do not allow reimbursement for a child who 
        requires transportation in a vehicle adapted to serve the needs of 
        the disabled such as a specially adapted school bus unless the child 








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        is in a wheel chair or a gurney.  According to the author, federal 
        rules are not so restrictive.  In addition, this bill increases 
        transparency and accountability in the work performed by DHCS.  
        According to LAUSD, DHCS is able to withhold certain amounts from 
        the federal reimbursement dollars that go to schools in order to 
        offset the costs to DHCS for administering the LBO program.  LAUSD 
        states that protecting and properly accounting for these withhold 
        amounts ensures that schools are receiving the federal money they 
        are due.

        DHCS also proposed to delete the January 1, 2013, LBO program sunset 
        date.  The DHCS proposal was through the FY 2012-13 Budget as budget 
        trailer bill language (TBL).  The TBL also proposed to eliminate the 
        requirement that a baseline LBO funding amount must be met prior to 
        funding LBO contractor costs, and removed the maximum annual funding 
        limit of $1.5 million for DHCS administrative and contractor costs.  
        According to DHCS, eliminating the baseline requirement prior to 
        funding the LBO administrative costs would allow DHCS to reduce 
        federal Medicaid payments to fund contractor costs without delay.  
        Not acting could potentially restrict DHCS from generating 
        sufficient funds to cover all necessary contractor costs.  The LBO 
        program baseline funding level for FY 2000-01 was approximately $60 
        million.  Currently, DHCS monitors reimbursements to the LEAs to 
        ensure the baseline requirement is met prior to funding contractor 
        costs required for the LBO program.  Unlike this bill, however, the 
        TBL proposed to set the annual funding as an amount that would be 
        agreed upon between DHCS and the LEA Committee.  DHCS argued that 
        this would allow sufficient flexibility to accommodate reasonable 
        cost increases associated with contract services.  The current 
        amount has remained static since 2001.  The Assembly and Senate 
        Budget subcommittees that have considered this issue rejected the 
        TBL proposal and deferred to the policy committees and this bill.

         Analysis Prepared by  :    Marjorie Swartz / HEALTH / (916) 319-2097  
         
        FN: 0005662