BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 357
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          CONCURRENCE IN SENATE AMENDMENTS
          AB 357 (Pan)
          As Amended  August 5, 2014
          Majority vote
           
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          |ASSEMBLY:  |78-0 |(January 29,    |SENATE: |34-0 |(August 25,    |
          |           |     |2014)           |        |     |2014)          |
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           Original Committee Reference:   HEALTH  

           SUMMARY  :  Renames the Healthy Families Advisory Board to the  
          Children's Health Advisory Board (CHAB) and transfers the  
          panel's advisory and reporting capacity from Managed Risk  
          Medical Insurance Board (MRMIB) to the Director of the  
          Department of Health Care Services (DHCS) on matters relevant to  
          all children enrolled in Medi-Cal and their families, as  
          specified.

           The Senate amendments  clarify that the CHAB maintain a  
          membership of 15 individuals, remove requirements for DHCS to  
          respond to panel recommendations and feedback in writing, and  
          add intent language.

           FISCAL EFFECT  :  According to the Senate Appropriations  
          Committee, pursuant to Senate Rule 28.8, negligible state costs.

           COMMENTS  :  According to the author, as implementation of the  
          Patient Protection and Affordable Care Act (ACA) moves forward,  
          Healthy Families Program (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.

          The author further states that, given the unique health needs of  
          children and in light of recent and impending changes to the  








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          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 insure that they are  
          receiving the best possible care.

          The HFAB 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.  Effective January 1, 2014, HFAB transitioned to DHCS  
          along with the rest of HFP.  The role of HFAB after transition  
          is currently unclear.  Stakeholders and the Advisory Board  
          itself have made suggestions regarding the future role.  These  
          include more frequent meetings, direct reporting to the Director  
          of DHCS and expansion of the role, to advise on all children in  
          Medi-Cal.  The HFAB also recommends maintaining the existing  
          scope which includes advising on all policies, regulations and  
          operations, submitting recommendations formally in writing and a  
          written response, when not implemented on the reasoning for the  
          non-implementation.  In addition HFAB would have  
          responsibilities with regard to monitoring and performance  
          reports including evaluating aspects of the program and making  
          recommendations.

          Recent United States Census Bureau numbers show there were about  
          9.3 million children under the age of 18 in California during  
          July 2012.  During the same month there were 3.6 million  
          children enrolled in the Medi-Cal program, accounting for  
          roughly 39% of all children under the age of 18 in the state.

          The California children's health coverage coalition, comprised  
          of the Children's Partnership, Children Now, Children's Defense  
          Fund-California, PICO California, the California Coverage and  
          Health Initiatives, and United Ways of California support this  
          bill, stating that in the 15 years that the HFAB 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, and that this bill is a  
          means to ensure that children and families will continue to have  
          a strong voice at DHCS.
          
           The California Medical Association supports this bill writing  








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          that given the significant programmatic and eligibility changes  
          currently underway in Medi-Cal, a strong stakeholder advisory  
          group process is vital to ensure access and quality of care is  
          not compromised.  The California Teachers Association also  
          writes in support, stating that there is a lack of focus on the  
          health of children, and this important legislation shines the  
          spotlight on a vulnerable population.

          This bill has no known opposition.

           
          Analysis Prepared by  :    Paula Villescaz / HEALTH / (916)  
          319-2097 


          FN:  
          0004910