Amended in Assembly January 6, 2014

Amended in Assembly March 19, 2013

California Legislature—2013–14 Regular Session

Assembly Bill No. 175

Introduced by Assembly Member V. Manuel Pérez

January 24, 2013

An act to add Section 124557 to the Health and Safety Code, relating to health care coverage begin insert , and making an appropriation therefor end insert .

LEGISLATIVE COUNSEL’S DIGEST

AB 175, as amended, V. Manuel Pérez. Health care coverage.

Existing law requires the State Department of Health Care Services to maintain a program for seasonal agricultural and migratory workers and their families that includes technical and financial assistance to local agencies concerned with the health of seasonal agricultural and migratory workers and their families in coordination with similar programs of the federal government, other states, and voluntary agencies, and to grant funds to eligible private, nonprofit, community-based primary care clinics for the purpose of establishing and maintaining a health services program for seasonal agricultural and migratory workers and their families. Existing federal law, the federal Patient Protection and Affordable Care Act (PPACA), enacts various health care coverage market reforms that take effect January 1, 2014.

This bill would establish the Uncovered begin insert Worker end insert Health Trust Fund for the purpose of providing begin delete health care coverage end delete begin insert comprehensive primary health care services end insert to workers ineligible for health care coverage under federal and state programs, including the PPACA. This bill would authorize voluntary contributions to be deposited into the trust.

begin delete

The

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begin insert This end insert bill would require that trust moneys, as specified, be distributed by the begin delete Primary Health Care Services Branch end delete begin insert Primary, Rural, and Indian Health Division end insert of the department through begin delete its end delete begin insert the authority of the end insert Rural Health Clinic Program. begin delete The bill would require the department to publish a list of employers who contributed to the trust and make that list available to nonprofit community health centers. end delete begin insert Because the bill would create a continuously appropriated fund, it would make an appropriation. end insert The bill would also require the department to provide begin delete those end delete employers begin insert contributing to the trust end insert with a list of nonprofit community health centers begin insert , as defined, end insert accessible to begin insert uncovered end insert workers.

This bill would require the department, on or before begin delete January 1, 2015, end delete begin insert March 1, 2015, end insert to prepare begin insert and make available end insert an application form, as specified, for nonprofit community health centers to use to apply for moneys from the trust. The bill would require a nonprofit community begin insert health end insert center applying for trust moneys to submit the application to the department. The bill would begin insert also end insert require the department to distribute trust moneys according to specified begin delete criteria. The bill end delete begin insert criteria, and end insert would begin delete require end delete begin insert authorize end insert nonprofit community health centers to utilize mobile medical units and provide transportation to begin insert uncovered end insert workers who reside or are employed in geographical areas that make access to clinic sites difficult.

This bill would require that the costs to the department of administering the trust be provided from the trust, and would prohibit begin delete these end delete begin insert administrative end insert costs from exceeding 10% of the total trust moneys.

Vote: majority. Appropriation:  begin delete no end delete begin insert yes end insert . Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

SECTION 1.  

The Legislature hereby finds and declares the
following:

(a) An analysis of data collected by the United States
government in March 2008, about insurance coverage in the prior
calendar year, found that 33.2 percent of all immigrants did not
have health insurance compared to 12.7 percent of native-born
Americans.

(b) Immigrants account for 27.1 percent of all those without
health insurance. Immigrants are 12.5 percent of the nation’s total
population.

(c) Lack of health insurance is a significant problem, even for
long-time immigrant residents. Among immigrants who arrived
in the country in the 1980s, 28.7 percent lacked health insurance
in 2007.

(d) The high level of uninsured amongst the immigrant
population means that they often have jobs that do not provide
insurance while their low incomes make private insurance too
expensive.

(e) California is home to almost one-third of all immigrants in
the United States.

(f) Many of these immigrants are much more likely to work in
small business, agriculture, labor, cleaning or repair, and sales,
technology, and administration industries.

(g) In 2010, 7 million individuals or 21.5 percent of California’s
population was uninsured, with adults comprising 86 percent of
the uninsured.

(h) Based on an analysis by the University of California, Los
Angeles, Center for Health Policy Research, the federal Patient
Protection and Affordable Care Act begin delete (PPACA), end delete begin insert (PPACA) end insert will
reduce California’s eligible uninsured population to 2.72 million
by 2019.

(i) A report by the Central Coast Health Network in 2012 found
that between 300,000 and 1 million farmworkers in California will
remain uninsured under the PPACA because of their ineligibility
to participate in the program and their lack of sufficient income.

(j) Based on the annual income earned by many workers in
small business, agriculture, restaurants, sales, and service industries
in California, these workers will not be covered by the PPACA
and expansion of Medicaid.

SEC. 2.  

Section 124557 is added to the Health and Safety Code,
to read:

124557.  

(a) The following definitions apply for purposes of
this section:

(1) “Contributing employer” means a person who employs an
individual who is ineligible to receive health care coverage under
state or federal programs and contributes money to the Uncovered
Worker Health Trust Fund.

begin insert

(2) “Nonprofit community health center” means a community
clinic or free clinic, as defined in subdivision (a) of Section 1204.

end insert begin delete

(2)

end delete

begin insert (3) end insert  “Trust” means the Uncovered Worker Health Trust Fund.

begin delete

(3)

end delete

begin insert (4) end insert  “Uncovered worker” means an individual who begin insert does not have
health care coverage and end insert is ineligible to receive health care
coverage begin insert beyond emergency and pregnancy services end insert under state
or federal programs begin insert , including, but not limited to, Medi-Cal or
other coverage under the federal Patient Protection and Affordable
Care Act (Public Law 111-148), end insert and is working in the state for
an employer who contributes money to the Uncovered Worker
Health Trust Fund.

(b) There is hereby created the Uncovered Worker Health Trust
Fund for the purpose of providing comprehensive begin delete health insurance
coverage end delete begin insert primary health care services end insert to uncovered workers.
Voluntary contributions may be deposited into the trust from the
following sources:

(1) Private donors.

(2) Charitable and philanthropic organizations.

(3) Contributing employers.

(c) The department shall, on or before begin delete January 1, 2015, end delete begin insert March
1, 2015, end insert prepare and make available an application form for
nonprofit community health centers to use in requesting moneys
from the trust. The department shall include in the application form
a memorandum of understanding that contains space for the
following information, in addition to any other data the department
deems relevant:

(1) The name of the contributing employer.

(2) The number of uncovered workers that will be employed
by the contributing employer.

(3) The length of time that uncovered workers will be employed
by the contributing employer and the time that those workers will
continue to require health care services.

(4) The estimated cost of providing health care services to the
contributing employer’s uncovered workers.

(d) Nonprofit community health centers applying for moneys
from the trust shall submit the application to the department.

(e)  begin delete Moneys from the trust end delete begin insert Notwithstanding Section 13340 of
the Government Code, moneys from the trust are continuously
appropriated to the department, and end insert shall be allocated to
participating nonprofit community health centers no later than July
1, 2015, unless the department determines that the trust has an
insufficient balance to carry out the requirements of this section,
in which case the department may delay implementation until the
trust has a balance of one million dollars ($1,000,000) or more.

(1) The begin delete Primary Health Care Services Branch end delete begin insert Primary, Rural,
and Indian Health Division end insert of the department, through begin delete its end delete begin insert the
authority of the end insert Rural Health Clinic Program, shall distribute
moneys from the trust to nonprofit community health centers to
provide comprehensive primary health care services, including
begin insert preventive end insert mental health and dental care, to uncovered workers.

(2) The department shall allocate moneys from the trust to
nonprofit community health centers based on the number of
uncovered workers to be served, the length of time the uncovered
worker will be employed by the contributing employer,
geographical location, and any other criteria developed by the
department in consultation with contributing employers and
nonprofit community health centers.

begin delete

(f) (1) The department shall publish a list of contributing
employers and shall make that list available to nonprofit
community health centers that serve uncovered workers.

end delete begin delete

(2)

end delete

begin insert (f) end insert  The department shall publish a list of nonprofit community
begin delete clinics end delete begin insert health centers end insert located in the proximity of, and accessible
to, uncovered workers and shall provide that list to contributing
employers.

(g) Nonprofit community health centers begin delete shall end delete begin insert may end insert utilize mobile
medical units or provide transportation to uncovered workers who
reside or are employed in geographical areas that make access to
clinic sites difficult.

(h) The cost to the department of administering the trust shall
be provided from the trust. Administrative costs shall not exceed
10 percent of the total moneys in the trust.

begin delete

(i) Nothing in this act shall detract, impede, or violate any
provision of the PPACA.

end delete