BILL ANALYSIS                                                                                                                                                                                                    Ó




                   Senate Appropriations Committee Fiscal Summary
                            Senator Kevin de León, Chair


          AB 2325 (J. Pérez) - Medi-Cal: CommuniCal.
          
          Amended: June 12, 2014          Policy Vote: Health 6-2
          Urgency: No                     Mandate: No
          Hearing Date: August 4, 2014                            
          Consultant: Brendan McCarthy    
          
          This bill meets the criteria for referral to the Suspense File.
          
          
          Bill Summary: AB 2325 would require the Department of Health  
          Care Services to establish a program to provide for and  
          reimburse for medical interpretation services provided to  
          Medi-Cal enrollees with limited English proficiency. The bill  
          would grant collective bargaining rights to interpreters  
          providing services through the program.

          Fiscal Impact: 
              One-time costs of $1.4 million to develop program  
              guidelines, seek necessary federal approvals, and develop  
              billing systems (50% General Fund, 50% federal funds).

              One-time costs of about $50,000 to develop regulations  
              relating to collective bargaining of translators by the  
              Public Employment Relations Board (General Fund).

              One-time costs of about $90,000 and ongoing costs of about  
              $50,000 per year to oversee an election by translators to  
              choose a collective bargaining agent by the Public  
              Employment Relations Board (General Fund).

              Periodic costs up to $1 million for negotiating a  
              memorandum of understanding with the established bargaining  
              unit and overseeing the implementation by the Department of  
              Human Resources (General Fund).

              Ongoing costs of about $37 million per year to provide  
              translation services in fee-for-service Medi-Cal, based on  
              estimates of the existing Medi-Cal fee-for-service  
              population with limited English proficiency (General Fund  
              and federal funds).









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              Unknown costs in Medi-Cal managed care (General Fund and  
              federal funds). Under current law, health plans are required  
              to provide interpretation services, including managed care  
              plans that contract with the Department of Health Care  
              Services. It is unclear whether the bill's requirement to  
              provide "certified medical interpretation services" at  
              reimbursement rates subject to collective bargaining would  
              increase costs for translation services, above the costs  
              already being incurred. Similarly, the bill requires  
              in-person translation to be the preferred method of  
              communication in many instances. Under current practice,  
              many providers in the managed care system make use of  
              telephone interpretation services. To the extent that  
              providers switch to in-person translation services, costs  
              are likely to increase.

              The federal financial participation rate for the costs  
              above may vary. Generally, the federal government pays for  
              50% of Medi-Cal costs. However, the federal government pays  
              an increase reimbursement rate the former Health Families  
              population is 65%. Finally, for the Medi-Cal expansion  
              population, the federal government pays 100% of the cost,  
              declining to 90% by 2020. (Federal law allows for a 75%  
              match for certain costs of interpretation that are  
              considered administrative costs. However, the Department  
              indicates that the provision of interpretation services  
              under the bill would be considered Medi-Cal benefits and  
              would be subject to the normal federal match.)

          Background: Under state and federal law, the Department of  
          Health Care Services operates the Medi-Cal program, which  
          provides health care coverage to pregnant women, children and  
          their parents with low incomes, as well as blind, disabled, and  
          certain other populations. Pursuant to the federal Affordable  
          Care Act, California has opted to expand eligibility for  
          Medi-Cal up to 138 percent of the federal poverty level and to  
          include childless adults.  

          With the exception of certain populations (for example,  
          individuals eligible for limited scope Medi-Cal benefits or  
          individuals dually eligible for Medi-Cal and Medicare in most  
          counties), managed care is the primary system for providing  
          Medi-Cal benefits. The Department estimates that in 2014-15, 7.5  
          million Medi-Cal beneficiaries (73 percent of total enrollment)  








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          will receive care through the managed care system. 

          The federal Civil Rights Act of 1964 and implementing  
          regulations prohibit the discrimination against any person based  
          on race, color, or national origin by entities that receive  
          federal assistance. The federal Office for Civil Rights enforces  
          these requirements and has indicated through guidance that  
          entities receiving federal funding may be required to provide  
          access to translation services for limited English-speaking  
          program beneficiaries.

          Current state law requires all licensed managed care plans to  
          provide interpretation services to enrollees who are limited  
          English proficient. Current law also requires all licensed  
          managed care plans to provide translation services based on the  
          concentration of non-English speaking enrollees. These  
          requirement apply to Medi-Cal managed care plans, but allow the  
          regulatory agencies to deem Medi-Cal managed care plans in  
          compliance if they meet more stringent requirements through  
          contractual requirements.

          Despite these requirements in law, there are indications that  
          not all Medi-Cal beneficiaries are receiving care in a  
          linguistically appropriate manner. According to the California  
          Health Interview Survey, about 8% of adults in Medi-Cal had  
          difficulty understanding their doctor or required another person  
          to help them understand their doctor. Similarly, about 7% of the  
          parents of children enrolled in Medi-Cal had difficulty  
          understanding their doctor or needed another person to help them  
          understand their doctor.

          Proposed Law: AB 2325 would require the Department of Health  
          Care Services to establish a program to provide for and  
          reimburse for medical interpretation services provided to  
          Medi-Cal enrollees with limited English proficiency. The bill  
          would grant interpreters providing services through the program  
          with collective bargaining rights.

          Major provisions of the bill would:
              Require the Department of Health Care Services to establish  
              the "CommuniCal"  program for interpretation services to  
              Medi-Cal beneficiaries;
              Permit Medi-Cal health care providers, in both  
              fee-for-service and managed care, to use CommuniCal;








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              Require CommuniCal to be administered by an independent  
              broker;
              Require participating interpreters to be certified by the  
              Department;
              Require certified interpreters to have specified  
              qualifications;
              Grant CommuniCal interpreters the right to be represented  
              by a labor organization, which would be responsible for  
              state-wide collective bargaining for the interpreters;
              Provide the procedures under which interpreters may select  
              a labor organization and the responsibilities of the  
              Department of Human Resources and the Public Employment  
              Relations Board in bargaining with such a labor  
              organization.

          Related Legislation: AB 1263 (J. Perez , 2013) and AB 2392 (J.  
          Perez, 2012) were substantially similar to this bill. AB 1263  
          was vetoed by Governor Brown and AB 2392 was moved to the  
          Assembly Inactive File on concurrence in Senate amendments.

          Staff Comments: The availability of enhanced federal financial  
          participation for translation services indicates that there may  
          be opportunities to improve access to care for non-English  
          proficient Medi-Cal beneficiaries at a reduced cost to the  
          state. On the other hand, it is not clear whether the program to  
          provide certified translation services, as required under the  
          bill, would be a more economical method of providing translation  
          services than the current methods used by health care providers.  
          If a centralized system managed by the Department is more costly  
          than the methods currently in use, cost savings may be minimal.

          Improving translation services for people with limited English  
          proficiency would likely have mixed impacts on Medi-Cal costs.  
          By improving enrollees' ability to communicate with providers,  
          the bill is likely to enable enrollees to more easily access  
          care, increasing utilization and costs. On the other hand,  
          better communication between a patient and a provider may  
          improve the patient and the provider's ability to manage the  
          patient's health, potentially reducing long-term costs.













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