BILL ANALYSIS �
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|SENATE RULES COMMITTEE | AB 357|
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THIRD READING
Bill No: AB 357
Author: Pan (D)
Amended: 8/5/14 in Senate
Vote: 21
SENATE HEALTH COMMITTEE : 8-0, 6/25/14
AYES: Hernandez, Morrell, Beall, De Le�n, DeSaulnier, Evans,
Monning, Nielsen
NO VOTE RECORDED: Wolk
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
ASSEMBLY FLOOR : 78-0, 1/29/14 (Consent) - See last page for
vote
SUBJECT : Medi-Cal Childrens Health Advisory Panel
SOURCE : Author
DIGEST : This bill renames the Healthy Families Advisory Board
as the Medi-Cal Childrens Health Advisory Panel (Panel),
transfers the new entity to the Department of Health Care
Services (DHCS), requires the Panel to be an independent
statewide advisory board that advises DHCS on matters relevant
to children enrolled in Medi-Cal and their families, and
requires DHCS to provide general support and staff assistance to
the Panel.
ANALYSIS : Existing law:
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1.Establishes, under federal law, the Medicaid Program (Medi-Cal
in California), administered by DHCS, to provide comprehensive
health care services to low income individuals, including
children.
2.Establishes the Healthy Families Program (HFP) Advisory Board,
a 15-member advisory panel appointed by the Managed Risk
Medical Insurance Board (MRMIB).
3.Requires the transition of children from HFP to the Medi-Cal
Program.
This bill:
1.Renames the HFP Advisory Board as the Panel, transfers the new
entity to DHCS, and requires the Panel to be an independent
statewide advisory board that advises DHCS on matters relevant
to children enrolled in Medi-Cal and their families,
including, but not limited to, emerging trends in the care of
children, quality measurements, communications between DHCS
and Medi-Cal families, provider network issues, and Medi-Cal
enrollment issues.
2.Requires the Panel to elect, from among its members, its
chair. Requires, in order to coordinate the activities of the
Panel with other advisory bodies whose scope includes children
enrolled in Medi-Cal, the chair to keep apprised of relevant
Medi-Cal stakeholder meetings by communicating with DHCS staff
assisting the Panel.
3.Requires the Panel's powers and duties to include, but not be
limited to, both of the following:
A. To advise the DHCS Director on all policies,
regulations, and operations of the Medi-Cal program related
to providing health care services to children; and
B. To meet at least quarterly, unless deemed unnecessary by
the chair.
1.Requires DHCS' powers and duties to include, but not be
limited to, all of the following:
A. To provide general support and staff assistance to the
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advisory panel;
B. To convene and attend meetings of the Panel at least
quarterly, unless deemed unnecessary by the chair, at
locations that are easily accessible to the public and
Panel members, are of sufficient duration for presentation,
discussion, and public comment on each agenda item, and are
open in accordance with the Bagley-Keene Open Meeting Act;
C. To reimburse the members of the Panel for all necessary
travel expenses associated with the activities of the
Panel, and to provide a stipend of $100 per meeting
attended to each panel member who is a Medi-Cal enrollee or
a parent of a Medi-Cal enrollee;
D. To maintain an Internet Web page on DHCS' Internet Web
site dedicated to the Panel that includes specified
information.
E. To inform Panel members when new information is posted
to the Internet Web page dedicated to the Panel; and
F. To report to the Legislature, by January 1, 2018, on the
Panel's accomplishments, effectiveness, efficiency, and any
recommendations for statutory changes needed to improve the
ability of the Panel to fulfill its purpose.
1.Makes the following changes to the composition of the Panel as
compared to the HFP Advisory Board by requiring the following:
A. A current or former foster youth, an attorney, social
worker, probation officer, or court appointed special
advocate who currently represents one or more foster youth,
a foster care service provider, or a child welfare
advocate.
B. A parent of a Medi-Cal enrollee who has received
treatment services under the California Children's Services
Program within the past six months.
C. A Medi-Cal enrollee who has received services under the
Access for Infants and Mothers Program within the past six
months.
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D. A parent or legal guardian of a Medi-Cal enrollee under
21 years of age who has received mental health services
under the Early and Periodic Screening, Diagnostic, and
Treatment Program within the past six months.
1.Makes various legislative declarations and findings related to
the health and well-being of California's children, including
that children enrolled in Medi-Cal and their families should
benefit from the Panel eventually adopting changes that would
allow the panel to better function in its new environment at
DHCS and within the changing landscape of the Medi-Cal program
and its stakeholder and advisory processes.
Background
The HFP Advisory Board was established statutorily to advise
MRMIB on HFP policies, regulations, operation, and
implementation. It is comprised of 15 members, appointed by
MRMIB, who serve three year terms, and consists of subject
matter experts such as providers, health care delivery
organizations, medical and dental providers, a business
representative, and subscriber parents. AB 1494 (Budget
Committee, Chapter 28, Statutes of 2012) required the Health and
Human Services Agency to provide the legislative fiscal and
policy committees with a strategic plan for the transition for
the HFP no later than October 1, 2012. This strategic plan is
required to include a time certain for the transfer of the HFP
Advisory Board to DHCS.
Effective January 1, 2014, HFP Advisory Board transitioned to
DHCS along with the rest of HFP. Stakeholders and members of
the Advisory Board itself have made suggestions regarding its
future role. These suggestions include monthly meetings, direct
reporting to the Director of DHCS, advising on both children and
families covered by Medi-Cal, that the Advisory Board be
provided designated DHCS staff, to require written responses to
recommendations of the Advisory Board if its recommendations are
not implemented by DHCS, and advising on all policies,
regulations and operations relating to the administration and
provision of health care services in the Medi-Cal program.
Comments
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According to the author's office, as implementation of the
Patient Protection and Affordable Care Act (ACA) moves forward,
HFP participants transition to Medi-Cal, and Medi-Cal enrollment
increases, it is critical that we have a process for providing
stakeholder feedback regarding Medi-Cal services provided to
California's children. Following the transition of all children
in the HFP, nearly five million children are expected to be
enrolled in Medi-Cal. Additionally, many of the approximately
460,000 children who are currently eligible but not enrolled in
Medi-Cal are expected to enroll as outreach efforts associated
with ACA implementation increase. Once the transition of
children from HFP into Medi-Cal is complete, close to 50% of all
children under the age of 18 in California will be enrolled in
Medi-Cal. Given the unique health needs of children and in light
of recent and impending changes to the Medi-Cal program, the
need is greater than ever for children in Medi-Cal to benefit
from an effective and efficient stakeholder advisory process so
that California can ensure that they are receiving the best
possible care.
Prior legislation
AB 1494 (Budget Committee, Chapter 28, Statutes of 2012)
provides for the transition of children from HFP to Medi-Cal in
four phases, starting no earlier than January 1, 2013.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
SUPPORT : (Verified 8/6/14)
American Academy of Pediatrics, California
California Academy of Child and Adolescent Psychiatry
California Academy of Family Physicians
California Academy of Physician Assistants
California Children's Hospital Association
California Coverage and Health Initiatives
California Dental Association
California Federation of Teachers
California Hospital Association
California Medical Association
California Optometric Association
California Primary Care Association
California Psychological Association
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California Teachers Association
Child Abuse Prevention Center
Children Now
Children's Defense Fund-California
Children's Partnership
Community Clinic Association of Los Angeles County
First 5 LA
PICO California
The Arc and United Cerebral Palsy California
United Ways of California
OPPOSITION : (Verified 8/6/14)
California Right to Life Committee, Inc.
Department of Health Care Services
ARGUMENTS IN SUPPORT : This bill is supported by the
children's advocacy groups, including the Children's
Partnership, Children Now, Children's Defense Fund-California,
PICO California, the California Coverage and Health Initiatives,
and United Ways of California to rename the HFP Advisory Board
as the Medi-Cal Children's Health Advisory Panel, keep its
composition intact, move the body's advisory capacity from MRMIB
to DHCS, and require DHCS to provide staff assistance to the
Advisory Panel. Supporters argue that, in the 15 years the HFP
Advisory Board has been operating, it has made recommendations
that have helped to improve the quality of care for children in
HFP, and has been an important space for parents of enrollees
and other experts to discuss ways to improve the program. The
transition from HFP to Medi-Cal coverage requires an update to
the Advisory Board in its current statutorily-defined capacity,
and supporters argue the ongoing need for and recognized value
of the Advisory Panel role is more important than ever as DHCS
is responsible for providing health coverage to nearly half of
California's children through Medi-Cal.
ARGUMENTS IN OPPOSITION : The California Right to Life
Committee writes in opposition that it has grave concerns that
the membership of the Panel will include agencies with a vested
interest in promoting "reproductive health care," which would
include abortifacients and abortion services for minors and
without parental notification or consent.
DHCS opposes this bill because they believe that adding an
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independent advisory board specific to children's health issues
is unnecessary and believes this group should be a component of
an existing DHCS stakeholder group and not structured as a
formal advisory panel, in statute or otherwise. DHCS states this
is consistent with their approach to restructuring stakeholder
groups and having the flexibility to modify groups as needed.
ASSEMBLY FLOOR : 78-0, 01/29/14
AYES: Achadjian, Alejo, Allen, Ammiano, Atkins, Bigelow, Bloom,
Bocanegra, Bonilla, Bonta, Bradford, Brown, Buchanan, Ian
Calderon, Campos, Chau, Ch�vez, Chesbro, Conway, Cooley,
Dababneh, Dahle, Daly, Dickinson, Donnelly, Eggman, Fong, Fox,
Frazier, Beth Gaines, Garcia, Gatto, Gomez, Gonzalez, Gordon,
Gorell, Gray, Grove, Hagman, Hall, Harkey, Roger Hern�ndez,
Holden, Jones, Jones-Sawyer, Levine, Linder, Lowenthal,
Maienschein, Mansoor, Medina, Melendez, Morrell, Mullin,
Muratsuchi, Nazarian, Nestande, Olsen, Pan, Patterson, V.
Manuel P�rez, Quirk, Quirk-
Silva, Rendon, Ridley-Thomas, Rodriguez, Salas, Skinner,
Stone, Ting, Wagner, Waldron, Weber, Wieckowski, Wilk,
Williams, Yamada, John A. P�rez
NO VOTE RECORDED: Logue, Perea
JL:nl 8/6/14 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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