BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  SB 1081
                                                                  Page  1

          Date of Hearing:   August 8, 2012

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Felipe Fuentes, Chair

                    SB 1081 (Fuller) - As Amended:  June 20, 2012 

          Policy Committee:                             HealthVote:19-0

          Urgency:     Yes                  State Mandated Local Program: 
          No     Reimbursable:              No

           SUMMARY  

          This bill adds Non-Designated Public Hospitals (NDPHs) to the 
          list of eligible entities authorized to operate a Low-Income 
          Health Program (LIHP), if the hospital is located in a county 
          that does not have a designated public hospital and the county 
          does not intend to operate a local LIHP.  

          This bill also requires the Department of Health Care Services 
          (DHCS) to seek federal approval, and makes implementation of the 
          bill contingent on receipt of federal approval.

           FISCAL EFFECT  

          1)Minor administrative costs to DHCS to seek federal approval 
            for this change and review applications from hospitals to 
            operate LIHPs.  These administrative costs are funded by 50% 
            federal funds, 50% local funds from participating entities.  
            Given the short time frame and unique circumstances, only one 
            county (Tulare County) is expected to apply pursuant to this 
            bill.   

          2)If an NDPH operated a LIHP pursuant to this bill, local funds 
            for health care services would also be matched by new federal 
            funds. According to the District Hospital Leadership Forum, 
            the sponsor of this bill, this could result in an estimated 
            increase in federal funds in Tulare County of $2.7 million.   

           COMMENTS  

           1)Rationale .   According to the author, this bill is needed to 
            allow a public district hospital to become a LIHP contractor, 
            in counties that do not operate hospitals and are not 








                                                                  SB 1081
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            interested in becoming LIHP contractors.  

           2)Background  . California's "Bridge to Reform" Section 1115 
            federal waiver set up the LIHP, which allows local public 
            entities to access federal matching funds to provide a 
            Medi-Cal-like set of benefits at local option and costs.  
            Currently, 13 counties, as well as a consortium of 34 
            counties, are operating LIHPs.  A number of applications from 
            other eligible entities are pending.  Some counties, including 
            Tulare and Santa Barbara, have decided not to pursue a LIHP.  
            LIHPs are designed to provide health care benefits to 
            individuals who will become eligible for Medi-Cal or for 
            subsidized private coverage in 2014.  

           3)Urgency  . This bill states an urgency clause is necessary in 
            order to improve access to health care services for patients 
            in underserved areas at the earliest possible time.  LIHPs are 
            only expected to operate through 2013.  An urgency bill would 
            allow a hospital to apply to operate a LIHP and potentially 
            begin operation this year.  

           Analysis Prepared by  :    Lisa Murawski / APPR. / (916) 319-2081