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:
AB 2608
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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