BILL ANALYSIS �
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|SENATE RULES COMMITTEE | SB 946|
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THIRD READING
Bill No: SB 946
Author: Senate Health Committee
Amended: 5/10/11
Vote: 21
SENATE HEALTH COMMITTEE : 9-0, 5/4/11
AYES: Hernandez, Strickland, Alquist, Anderson, Blakeslee,
De Le�n, DeSaulnier, Rubio, Wolk
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
SUBJECT : Public health
SOURCE : Author
DIGEST : This bill makes various technical and
substantive changes in provisions of law regarding
telemedicine, Emergency Medical Services funds, food
handling, HIV reporting, the Office of HIPAA
Implementation, health insurance, and mental health
services payments.
ANALYSIS :
Telemedicine
Existing law:
1. For the purpose of health practitioner requirements,
community college training programs, health plan
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requirements, and medical payments, defines
"telemedicine" to mean the practice of health care
delivery, diagnosis, consultation, treatment, transfer
of medical data, and education using interactive audio,
video, or data communications.
2. Requires that the Department of Health Care Services
(DHCS) report to the Legislature by January 1, 2008, on
the number and type of services provided and the
Medi-Cal payments made related to the application of
store-and-forward telemedicine.
This bill:
1. Replaces references to "telemedicine" with "telehealth."
2. Deletes the reporting requirement.
Emergency Medical Services
Existing law:
1. Authorizes counties to establish a Maddy Emergency
Medical Services (EMS) fund and to deposit specified
penalties, forfeitures, and fines into the fund to
reimburse physicians and hospitals for losses from
providing uncompensated emergency care, and for other
EMS purposes as determined by each county.
2. Requires each county establishing a Maddy EMS fund
(Maddy fund) to report to the Legislature on the
implementation and status of the Maddy fund beginning
January 1, 1989 and on each April 15 thereafter. The
report must include the total amount of fines and
forfeitures collected, the total amount of penalty
assessments collected, the total amount of penalty
assessments deposited into the Maddy fund, the fund
balance, and the amount of moneys disbursed under the
program to physicians and surgeons, to hospitals and to
other emergency purposes.
This bill requires county Maddy fund reports to include
additional information on the types of funds received,
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administrative costs, fee schedules and methodologies for
reimbursing physicians and hospitals, and contact
information for county personnel involved in administration
of the fund, as specified.
Retail Food
Existing law, under the California Retail Food Code
(CalCode), provides for the regulation of health and
sanitation standards for retail food facilities by the
Department of Public Health (CDPH) and vests local health
agencies with primary responsibility for enforcing this
code. Specifies hand-washing procedures and glove usage
guidelines for food handlers.
This bill:
1. Specifies that hands must be washed by employees prior
to donning gloves for working with food or replacing
gloves that were changed or replaced due to specified
circumstances. Prohibits single-use gloves from being
washed.
2. Provides that an employee with a lesion or wound that is
open or draining is prohibited from handling food.
Specifies precautions that an employee with a cut, sore,
rash, lesion or wound must take when contacting food and
food-contact surfaces.
HIV Reporting
Existing law requires health care providers and clinical
laboratories to report HIV infection by patient name to the
local health officer, and mandates local health officers to
report unduplicated HIV cases by patient name to CDPH.
Existing regulations mandate the use of CDPH HIV/AIDS
Confidential Case Report form, Adult (CDPH 8641A (05/07))
or Pediatric (CDPH 8641P (05/07).
This bill authorizes CDPH to develop a form to be used to
report cases of HIV infection to the local health
department and to the department, and allows the form to be
implemented without promulgating new regulations.
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Office of HIPAA Implementation
Existing law:
1. Establishes the federal Health Insurance Portability and
Accountability Act (HIPAA).
2. Establishes the Office of HIPAA Implementation within
the Health and Human Services Agency (HHSA).
Establishes a Director of the Office and requires the
Director to establish an advisory committee to obtain
information on statewide HIPAA implementation activities
that must meet at least twice per year. Requires all
state entities subject to HIPAA to complete an
assessment by January 1, 2001, to determine the impact
of HIPAA on their operations.
This bill renames the office the Office of Health
Information Integrity. Deletes a redundant code section
that specifies that the Office be under supervision of a
director appointed by the Secretary of HHSA. Deletes the
outdated requirement to complete the assessment. Revises
the frequency with which the advisory committee meets to as
needed.
Health Insurance Coverage
Existing law:
1. Licenses and regulates health plans, by the Department
of Managed Health Care (DMHC), and health insurers, by
the Department of Insurance (CDI).
2. Prohibits a carrier or solicitor from encouraging or
directing a child or responsible party for a child from
applying for coverage with a carrier because of health
status, claims experience, industry, occupation, or
geographic location, provided that the location is
within the carrier's approved service area. Prohibits a
carrier from entering into a contract, agreement, or
arrangement with a solicitor that provides for or
results in payment to the solicitor for the sale of a
health benefit plan that is varied because of the health
status, claims experience, industry, occupation, or
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geographic location of the child.
This bill:
1. Replaces references to "solicitor" with "agent or
broker" or "agent or broker of the carrier" in specified
sections of the Insurance Code.
2. Defines "hotdog" to mean "a whole, cured, cooked sausage
that is skinless or stuffed in a casing and that is also
known as a frankfurter, frank, further, wiener, red hot,
Vienna, bologna, garlic bologna, or knockwurst, and that
may be served in a bun or roll."
3. Corrects drafting errors, grammatical errors, and code
references.
Mental Health
Existing law authorizes the Department of Mental Health
(DMH) to approve negotiated rates and incentive payments
for the provision of Short Doyle/Medi-Cal reimbursable
community mental health services (SD/MC services).
This bill conforms state law to existing federal
regulations and current DMH practice by repealing the
authorization to approve negotiated rates and incentive
payments for SD/MC services.
Background
Telehealth provisions . Telemedicine is currently described
in statute as the practice of health care delivery,
diagnosis, consultation, treatment, transfer of medical
data, and education using interactive audio, video, or data
communications. According to the California Telemedicine
and eHealth Center, telemedicine generally refers to the
provision of clinical services from a distance, whereas
telehealth more commonly refers to a broader scope of
services that includes telemedicine, but also includes
other services that can be provided remotely using
communication technologies. To reflect this shift in
terminology used in common practice, SB 946 changes
references in existing law from "telemedicine" to
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"telehealth."
This bill also deletes an outdated requirement that DHCS
report to the Legislature on the number and type of
services provided and the Medi-Cal payments made related to
the application of store-and-forward telemedicine.
Store-and-forward telemedicine is technology that allows a
provider or technician at the patient site to capture
diagnostic information such as medical images, video and
audio clips, and transmits the data to a clinician at a
remote site for assessment. These provisions were requested
by the California State Rural Health Association and the
California Primary Care Association.
Emergency Medical Services Fund provisions . Beginning in
1987, the state enacted a series of bills to compensate
physicians and medical facilities for emergency medical
services provided to patients who do not have health
insurance and cannot pay for their medical care. SB 12
(Maddy), Chapter 1240, Statutes of 1987, allows counties to
establish Maddy EMS funds (also known as Maddy funds).
Revenue sources for Maddy funds are penalty assessments on
certain criminal and traffic violations, and a portion of
the fees from people attending traffic violator schools.
Funds from penalty assessments must be used to reimburse
physicians and hospitals for patients who do not make
payment for EMS services and have no third-party or
government source of payment.
Counties with Maddy funds are required to report specified
information to the Legislature on the status of their
funds. SB 946 requires county Emergency Medical Services
Fund reports to include additional information in these
reports, including:
Reasons for the lack of deposits, if no moneys were
deposited into the fund;
The amount of funds collected from additional assessments
levied by counties on fines, penalties, or forfeitures
imposed and collected by the courts for criminal
offenses, including violations relating to the control of
alcoholic beverages and violations of the Vehicle Code;
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The amount of money disbursed for actual administrative
costs;
Fee schedules and methodologies for reimbursing
physicians and hospitals;
The amount of moneys available to be disbursed to
hospitals, and the amount of claims submitted by
hospitals, along with the percentage of those claims that
were reimbursed; and
The name and contact information for county personnel
involved in the administration of the fund.
The purpose of these provisions is to provide more
transparency and allow a better understanding of how these
funds are collected and distributed at the local level.
This provision was requested by the California Chapter of
the American College of Emergency Physicians (CAL/ACEP).
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
CTW:mw 5/19/11 Senate Floor Analyses
SUPPORT/OPPOSITION: NONE RECEIVED
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