BILL ANALYSIS �
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THIRD READING
Bill No: AB 2612
Author: Dababneh (D), et al.
Amended: 8/19/14 in Senate
Vote: 21
SENATE HEALTH COMMITTEE : 6-1, 6/18/14
AYES: Hernandez, Beall, DeSaulnier, Evans, Monning, Wolk
NOES: Morrell
NO VOTE RECORDED: De Le�n, Nielsen
SENATE APPROPRIATIONS COMMITTEE : 5-0, 8/14/14
AYES: De Le�n, Hill, Lara, Padilla, Steinberg
NO VOTE RECORDED: Walters, Gaines
ASSEMBLY FLOOR : 69-1, 5/28/14 - See last page for vote
SUBJECT : Medi-Cal
SOURCE : Californians for Safety and Justice
DIGEST : This bill requires the Department of Health Care
Services (DHCS), in implementing the California Health Home
Program (Health Home Program) authorized under federal health
care reform, to request a waiver of federal law to authorize the
state to claim the federal financial participation (FFP) for
health home services provided to individuals, who are otherwise
eligible to receive health home services and who are state or
county inmates in their last 30 days in custody.
ANALYSIS :
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Existing law:
1.Establishes the Medi-Cal program, administered by DHCS, under
which qualified low-income individuals receive health care
services. The Medi-Cal program is, in part, governed and
funded by federal Medicaid provisions.
2.Authorizes, under the Affordable Care Act (ACA), states to
offer health home services, as defined, to eligible
individuals with chronic conditions who select a designated
provider, a team of health care professionals operating with
such a provider, or a health team as the individual's health
home for purpose of providing the individual with health home
services. Provides, under the ACA, 90% federal matching funds
for the first eight quarters the health home option is in
effect. Thereafter, the state's regular federal matching rate
would be in effect (typically 50% in California).
3.Authorizes DHCS to take specified actions in creating a Health
Home Program, as authorized under the ACA, including designing
a program, contracting with providers, defining the eligible
populations, developing a payment methodology, identifying the
specific health home services needed for each population, and
submitting any State Plan Amendments or waivers to the federal
government.
This bill:
1.Requires DHCS, in implementing the Health Home Program, to
request a waiver of federal law to authorize the state to
claim FFP for health home services provided to individuals,
who are otherwise eligible to receive health home services
under the program and who are state or county inmates in their
last 30 days in custody, by a provider or team of providers,
to ensure coordination of care and reduce gaps in care.
Limits pre-release health home services to case management,
care coordination and health promotion, comprehensive
transitional care, individual and family support, referral to
community and social services supports, and health information
technology, and excludes health care services.
2.Makes legislative findings regarding the ACA, the Medi-Cal
expansion under the ACA, the additional substance use disorder
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benefits under Medi-Cal and associated federal funding, and
the substance use disorder treatment needs of individuals
being released from jails.
3.States legislative intent to encourage appropriate use of
health homes for people in the criminal justice system and to
increase access to primary care, mental health treatment, and
substance use disorder treatment for individuals in the
criminal justice system, and that Medi-Cal eligible
individuals are eligible for Medi-Cal benefits, including
individuals in formal or informal diversion or deferred entry
of judgment programs, individuals on probation, individuals on
parole, individuals on post-release community supervision, and
individuals on mandatory supervision.
Background
Federal Health Homes for Enrollees with Chronic Conditions . The
ACA contains several provisions to support and advance the
medical home model of care. One of these was entitled "State
Option to Provide Health Homes for Enrollees with Chronic
Conditions," which established a waiver program to give states
the option of enrolling Medicaid beneficiaries with chronic
conditions into a health home. States electing the health home
option in their Medicaid program would receive a 90% federal
matching rate for two years for these services. Federal law
defines the individuals eligible for health home services as
individuals meeting specified conditions.
Medicaid waivers . When DHCS wants to make significant changes
to its Medicaid program, it must amend its state Medicaid Plan
(the state's contract with the federal government), and (if
needed) receive an exemption or Medicaid waiver from portions of
federal Medicaid law. California has used Medicaid waivers to
provide additional services to specific groups of individuals
who were not eligible for FFP, to limit services to specific
geographic areas of the state, and provide medical coverage to
individuals who may not otherwise be eligible under Medicaid
rules. An example of a provision of Medicaid law that is waived
is the federal "freedom of choice" requirements. Waiving this
requirement allows California to require Medi-Cal beneficiaries
to receive benefits through managed care plans.
The criteria used by the federal government for approval of
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Medicaid waivers are generally based upon policy, rather than
solely on federal law. The most significant federal requirement
is that of cost-effectiveness or budget neutrality. The
proposed waiver changes must not cost the federal government
more than the expected Medicaid costs for the traditional
Medicaid population under the same time period.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
SUPPORT : (per Senate Health Committee analysis of 6/18/14 -
unable to reverify at time of writing)
Californians for Safety and Justice (source)
ARGUMENTS IN SUPPORT : According to the author, "This bill
will help to alleviate barriers to treatment by requiring DHCS
to include provisions in pending waiver requests to the federal
government to allow health home coordination of care during the
last 30 days of a jail or prison sentence."
ASSEMBLY FLOOR : 69-1, 5/28/14
AYES: Achadjian, Alejo, Allen, Ammiano, Bigelow, Bloom,
Bocanegra, Bonilla, Bonta, Bradford, Brown, Buchanan, Ian
Calderon, Campos, Chau, Chesbro, Cooley, Dababneh, Daly,
Dickinson, Eggman, Fong, Fox, Beth Gaines, Garcia, Gatto,
Gomez, Gonzalez, Gordon, Gray, Grove, Hagman, Hall, Roger
Hern�ndez, Holden, Jones, Jones-Sawyer, Levine, Linder, Logue,
Lowenthal, Maienschein, Medina, Mullin, Muratsuchi, Nazarian,
Nestande, Olsen, Pan, Patterson, Perea, John A. P�rez, V.
Manuel P�rez, Quirk, Quirk-Silva, Rendon, Ridley-Thomas,
Rodriguez, Salas, Skinner, Stone, Ting, Wagner, Weber,
Wieckowski, Wilk, Williams, Yamada, Atkins
NOES: Harkey
NO VOTE RECORDED: Ch�vez, Conway, Dahle, Donnelly, Frazier,
Gorell, Mansoor, Melendez, Waldron, Vacancy
JL/AL:k 8/19/14 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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