BILL ANALYSIS                                                                                                                                                                                                    �



                                                                            



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                                    THIRD READING


          Bill No:  AB 505
          Author:   Nazarian (D)
          Amended:  5/19/14 in Senate
          Vote:     21


           SENATE HEALTH COMMITTEE  :  6-2, 6/12/13
          AYES:  Hernandez, Beall, De Le�n, DeSaulnier, Monning, Wolk
          NOES:  Anderson, Nielsen
          NO VOTE RECORDED:  Pavley

           SENATE APPROPRIATIONS COMMITTEE  :  7-0, 6/24/13
          AYES:  De Le�n, Walters, Gaines, Hill, Lara, Padilla, Steinberg

           ASSEMBLY FLOOR  :  72-0, 5/16/13 - See last page for vote


           SUBJECT :    Medi-Cal:  managed care:  language assistance  
          services

           SOURCE  :     California Pan-Ethnic Health Network


           DIGEST  :    This bill requires all managed care plans contracting  
          with the Department of Health Care Services (DHCS) to provide  
          Medi-Cal services, except as specified, to provide language  
          assistance services, which includes oral interpretation and  
          translation services, to limited-English-proficient (LEP)  
          Medi-Cal beneficiaries, as defined.  Requires DHCS to determine  
          when a LEP population meets the requirement for translation  
          services, as prescribed.

           Senate Floor Amendments  of 5/19/14 change the threshold for when  
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          translation services are required for Medi-Cal beneficiaries.

           ANALYSIS  :    

          Existing law:

          1.Establishes the Medi-Cal program, which is administered by  
            DHCS, under which qualified low-income individuals receive  
            health care services.

          2.Permits the Director of DHCS to contract, on a bid or non-bid  
            basis, with any qualified individual, organization, or entity  
            to provide services to, arrange for or case manage the care of  
            Medi-Cal beneficiaries; permits, at the Director's discretion,  
            the contract to be exclusive or non-exclusive, statewide or on  
            a more limited geographic basis, and includes provisions to  
            provide for delivery of services in a manner consistent with  
            managed care principles, techniques, and practices directed at  
            ensuring the most cost-effective and appropriate scope,  
            duration, and level of care.

          3.Prohibits, under Title VI of the Civil Rights Act of 1964, a  
            person in the United States, on the grounds of race, color, or  
            national origin, from being excluded from participation in,  
            denied the benefits of, or subjected to discrimination under  
            any program or activity receiving federal financial  
            assistance.

          This bill:

          1.Requires DHCS to require all managed care plans contracting  
            with DHCS that provide Medi-Cal services to provide language  
            assistance services to LEP beneficiaries who are mandatorily  
            enrolled in managed care in the following manner:

             A.   Oral interpretation services in any language on a  
               24-hour basis at key points of contact.

             B.   Translation services to the language groups identified  
               by DHCS.

          1.Requires DHCS to determine when an LEP population meets the  
            requirement for translation services using one of the  
            following numeric thresholds:

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             A.   A population group of at least 3,000 or 5% of the  
               beneficiary population whichever is fewer, mandatory  
               Medi-Cal beneficiaries, residing in the service area, and  
               who indicate their primary language as other than English;  
               or

             B.   A population group of mandatory Medi-Cal beneficiaries,  
               residing in the service area, who indicate their primary  
               language as other than English, and that meet a  
               concentration standard of 1,000 beneficiaries in a single  
               ZIP Code or 1,500 beneficiaries in two contiguous ZIP  
               Codes.

          1.Requires DHCS to make this determination if any of the  
            following occurs:

             A.   A nonmanaged care county becomes a new managed care  
               county;

             B.   A new population group becomes a mandatory Medi-Cal  
               managed care beneficiary population; or

             C.   A period of three years has passed since the last  
               determination.

          1.Requires DHCS to instruct managed care plans of the language  
            groups that meet the numeric threshold by means of  
            incorporating this requirement into plan contracts, all-plan  
            letters or similar instructions.

          2.Designates a person as "LEP" if an individual speaks English  
            less than very well.

          3.Clarifies that these provisions do not apply to mental health  
            plans contracting with DHCS.

           Background
           
           Percentage of Californians who are LEP and current DHCS  
          standards  .  According to the U.S. Census Bureau 2010 American  
          Community Survey, 43.7% of Californians over the age of five  
          speak a language other than English, and 19.9% of Californians  
          over the age of five speak English "less than very well."  DHCS'  

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          Medi-Cal Managed Care Division is responsible for determining  
          statewide translation threshold languages and their numeric  
          estimate for Medi-Cal managed care counties.  DHCS establishes  
          the thresholds through its contractual language with plans and  
          through DHCS-issued All Plan Letters (APLs).  Through contract,  
          DHCS requires its Medi-Cal managed care plans to ensure equal  
          access to health care services for its members without regards  
          to a member's proficiency in the English language.

          A June 2002 APL, requires plans to provide 24-hour interpreter  
          service for all LEP members at all provider sites within the  
          plans' service areas.  In addition, plans are required to  
          provide translation services to their Medi-Cal LEP members based  
          on certain population levels, which this bill codifies.  Plans  
          must provide interpreter and translation services when a LEP  
          member population meets a numeric threshold of 3,000 members  
          residing in its service area.  Both services must be provided to  
          LEP member populations meeting concentration standards of 1,000  
          members in a single Zip Code, or 1,500 members in two contiguous  
          Zip Codes.  There are currently 13 Medi-Cal threshold languages  
          (English, Arabic, Armenian, Cambodian, Cantonese, Farsi, Hmong,  
          Korean, Mandarin, Russian, Spanish, Tagalog, and Vietnamese).

          DHCS' APL and contract does not define LEP.  This bill defines  
          LEP as an individual who speaks English less than very well,  
          which is the definition used by the United States Census.

           Prior Legislation
           
          AB 2392 (John A. P�rez, 2012) was substantially similar to AB  
          1263.  The bill died on the Assembly Inactive File.

          SB 442 (Calderon, 2011) would have required general acute care  
          hospital policies for the provision of language assistance to  
          patients with language or communication barriers to include  
          procedures for discussing with the patient any cultural,  
          religious, or spiritual beliefs or practices that may influence  
          care, and to increase the ability of hospital staff to  
          understand and respond to the cultural needs of patients.   
          Additionally, would have required hospitals' policies on  
          language assistance services to include criteria on proficiency  
          similar to those that apply to health plans.  The bill was  
          vetoed by Governor Brown.


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          SB 1405 (Soto, 2006) would have required the Department of  
          Health Services (now DHCS) to create the Task Force on  
          Reimbursement for Language Services, as specified, to develop a  
          mechanism for seeking federal matching funds from federal  
          Centers for Medicare and Medicaid Services to pay for language  
          assistance services, as specified.  The bill died on the Senate  
          Inactive File.

          AB 800 (Yee, Chapter 313, Statutes of 2005) requires all health  
          facilities (hospitals, skilled nursing facilities, intermediate  
          care facilities, correctional treatment centers) and all primary  
          care clinics to include a patient's principal spoken language on  
          the patient's health records.

          SB 853 (Escutia, Chapter 713, Statutes of 2003) requires the  
          Department of Managed Health Care and the Department of  
          Insurance to adopt regulations to ensure enrollees have access  
          to language assistance in obtaining health care services.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No

          According to the Senate Appropriations Committee:

           Ongoing costs likely between $40,000 and $75,000 every three  
            years to determine the thresholds for translating documents by  
            Medi-Cal managed care plans by DHCS (50% General Fund, 50%  
            federal funds).

           No significant increased costs for providing interpretation  
            and translation services are expected.  This bill essentially  
            recodifies existing law and practice.

           SUPPORT  :   (Verified  5/20/14)

          California Pan-Ethnic Health Network (source)
          100% Campaign
          American Civil Liberties Union of California
          American Federation of State, County and Municipal Employees,  
          AFL-CIO
          California Association of Public Authorities
          California Coverage and Health Initiatives
          California Immigrant Policy Center
          Children Now

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          Children's Defense Fund - California
          Children's Partnership
          Health Access California
          National Association of Social Workers
          National Health Law Program
          PICO California
          Southeast Asia Resource Action Center
          Street Level Health Project
          United Ways of California
          Western Center on Law and Poverty

           ARGUMENTS IN SUPPORT  :    This bill is sponsored by the  
          California Pan-Ethnic Health Network (CPEHN) to strengthen  
          consumer protections for Medi-Cal managed care enrollees who  
          speak English less than very well, by codifying existing  
          language assistance requirements in Medi-Cal managed care.   
          According to CPEHN, an estimated 6 to 7 million Californians are  
          LEP and over 1.4 million individuals will be newly eligible for  
          Medi-Cal, over one-third of whom will speak English less than  
          very well.

          According to the author, this bill achieves the goals of the  
          federal Affordable Care Act (ACA) to increase access and  
          availability of health care options and strengthens consumer  
          protections for Medi-Cal managed care LEP enrollees by codifying  
          in state law the language assistance requirements in Medi-Cal  
          managed care.  The author's office states language barriers  
          limit access to health care at every level, from scheduling an  
          appointment to receiving a medical diagnosis.  This bill ensures  
          that necessary protections for LEP individuals are not lost in  
          the process of implementing the changes made by the ACA.

           ASSEMBLY FLOOR  :  72-0, 5/16/13
          AYES:  Achadjian, Alejo, Ammiano, Atkins, Bigelow, Bloom,  
            Blumenfield, Bocanegra, Bonilla, Bonta, Bradford, Brown,  
            Buchanan, Ian Calderon, Campos, Chau, Ch�vez, Chesbro, Conway,  
            Cooley, Dahle, Daly, Dickinson, Eggman, Fong, Fox, Frazier,  
            Beth Gaines, Garcia, Gatto, Gomez, Gordon, Gorell, Gray,  
            Hagman, Hall, Harkey, Roger Hern�ndez, Jones, Jones-Sawyer,  
            Levine, Linder, Logue, Lowenthal, Maienschein, Mansoor,  
            Medina, Mitchell, Mullin, Muratsuchi, Nazarian, Nestande,  
            Olsen, Pan, Patterson, Perea, V. Manuel P�rez, Quirk,  
            Quirk-Silva, Rendon, Salas, Skinner, Ting, Torres, Wagner,  
            Waldron, Weber, Wieckowski, Wilk, Williams, Yamada, John A.  

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            P�rez
          NO VOTE RECORDED:  Allen, Donnelly, Grove, Holden, Melendez,  
            Morrell, Stone, Vacancy


          JL:e  5/21/14   Senate Floor Analyses 

                           SUPPORT/OPPOSITION:  SEE ABOVE

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