Bill Text: CA AB184 | 2021-2022 | Regular Session | Amended
Bill Title: Health.
Spectrum: Committee Bill
Status: (Engrossed - Dead) 2022-08-01 - Re-referred to Com. on B. & F.R. [AB184 Detail]
Download: California-2021-AB184-Amended.html
Amended
IN
Senate
June 26, 2022 |
Amended
IN
Assembly
February 18, 2021 |
Introduced by Committee on Budget (Assembly Members Ting (Chair), Arambula, Bennett, Bloom, Carrillo, |
January 08, 2021 |
LEGISLATIVE COUNSEL'S DIGEST
This bill would express the intent of the Legislature to enact statutory changes, relating to the Budget Act of 2021.
Digest Key
Vote: MAJORITY Appropriation:Bill Text
The people of the State of California do enact as follows:
SECTION 1.
Section 12534 is added to the Government Code, to read:12534.
(a) The Opioid Settlements Fund is hereby created in the State Treasury.SEC. 2.
Section 15432 of the Government Code is amended to read:15432.
As used in this part, the following words and terms shall have the following meanings, unless the context clearly indicates or requires another or different meaning or intent:SEC. 3.
Section 15451.5 of the Government Code is amended to read:15451.5.
A participating health institution that is a private nonprofit corporation or association and that borrows money to finance working capital pursuant to this part, other than as part of the cost of a project, shall be required to repay and discharge the loan withinSEC. 4.
Section 100800 of the Government Code is amended to read:100800.
(a) The Exchange shall administer a program of financial assistance to help low-income and middle-income Californians access affordable health care coverage through the Exchange.SEC. 5.
Section 100820 of the Government Code is amended to read:100820.
(a) The Exchange may, in consultation with the Franchise Tax Board, promulgate rules and regulations as necessary to implement this title that are consistent with the program design adopted pursuant to Section 100800.SEC. 6.
Section 100825 of the Government Code is amended to read:100825.
(b)(1)This title shall remain in effect only until January 1, 2023, and as of that date is repealed.
(2)New financial assistance or other subsidies shall not be provided for periods after coverage year 2022.
SEC. 7.
Section 1385.035 is added to the Health and Safety Code, to read:1385.035.
(a) It is the intent of the Legislature in enacting this section to ensure that enrollees and subscribers benefit from reductions in the rate of growth in health care costs as a result of the establishment of the Office of Health Care Affordability.SEC. 8.
Section 104395 of the Health and Safety Code is amended to read:104395.
The department shall expand the Child Health and Disability Prevention (CHDP) Program contained in Article 6 (commencing with Section 124025) of Chapter 3 of Part 2 of Division 106 as follows:SEC. 9.
Section 11831.1 is added to the Health and Safety Code, to read:11831.1.
(a) No sooner than July 1, 2022, alcohol and other drug programs that are certified in accordance with Section 11831.5 shall either offer medications for addiction treatment (MAT) directly to clients, or have an effective referral process in place with narcotic treatment programs, community health centers, or other MAT providers.SEC. 10.
Section 11834.28 is added to the Health and Safety Code, to read:11834.28.
(a) No sooner than July 1, 2022, an alcoholism or drug abuse recovery or treatment facility shall either offer medications for addiction treatment (MAT) directly to clients, or have an effective referral process in place with narcotic treatment programs, community health centers, or other MAT providers.SEC. 11.
Section 11839.6.1 is added to the Health and Safety Code, to read:11839.6.1.
(a) No sooner than July 1, 2022, the department shall establish a program for the operation and regulation of mobile narcotic treatment programs. A mobile narcotic treatment program established pursuant to this section shall do all of the following:SEC. 12.
Article 7 (commencing with Section 101320) is added to Chapter 3 of Part 3 of Division 101 of the Health and Safety Code, to read:Article 7. Support for Vital Public Health Activities
101320.
(a) Upon appropriation by the Legislature for this purpose, the department shall develop and implement a program to fund and support vital public health activities and services provided by the 61 local health jurisdictions in California.101320.3.
(a) On or before February 1 of every other year, beginning in calendar year 2024, the State Public Health Officer shall submit a written report to the Governor and the Legislature on the state of public health in California. The State Public Health Officer shall present an update annually to the Assembly Committee on Budget and Senate Committee on Budget and Fiscal Review, or relevant subcommittees, during legislative budget hearings.101320.5.
(a) As a condition of the funding authorized pursuant to subdivision (a) of Section 101320, a local health jurisdiction administered by a city shall annually present updates on the public health status to its city council on the state of the city’s public health. The presentation shall identify the city’s most prevalent current causes of morbidity and mortality, causes of morbidity and mortality with the most rapid three-year growth rate, and health disparities. The presentation shall also provide an update on progress addressing these issues through the strategies and programs identified in the local health jurisdiction’s triennial public health planning document, as well as identify policy recommendations for addressing these issues.SEC. 13.
Section 120475 of the Health and Safety Code is amended to read:120475.
On or before March 15 on a biennial basis, the department shall submit a report to the Legislature on all of the following issues:SEC. 14.
Section 120511 of the Health and Safety Code is amended to read:120511.
(a) The department shall allocate funds to local health jurisdictions for sexually transmitted disease prevention and control activities in accordance, to the extent possible, with the following:(c)
(d)
(e)
SEC. 15.
Section 122440 of the Health and Safety Code is amended to read:122440.
(a) (1) (A) The State Department of Public Health shall allocate funds to local health jurisdictions to provide hepatitis C virus (HCV)(b)
(c)
(d)
(e)
(f)
SEC. 16.
Article 2.3 (commencing with Section 123451) is added to Chapter 2 of Part 2 of Division 106 of the Health and Safety Code, to read:Article 2.3. Abortion Practical Support Fund
123451.
(a) As used in this article, the following definitions apply:123452.
(a) The department, or its contracted vendor, shall use moneys in the fund to administer grants to nonprofit organizations in California that are exempt from taxation under Section 501(c) of the Internal Revenue Code and that either specialize in assisting pregnant people who are low income, or who face other financial barriers, with direct practical support services to access and obtain an abortion or that provide abortion services to those persons. Grants awarded pursuant to this subdivision shall be used for activities that increase patient access to abortion in California, including, but not limited to, any of the following:SEC. 17.
Section 124024 is added to the Health and Safety Code, immediately preceding Section 124025, to read:124024.
(a) Before July 1, 2024, the department shall take the following steps:SEC. 18.
Section 124110.5 is added to the Health and Safety Code, to read:124110.5.
This article shall become inoperative on July 1, 2024, or on the date certified by the department pursuant to subdivision (d) of Section 124024, whichever date is later, and shall be repealed on January 1 of the year following the inoperative date.SEC. 19.
Chapter 2.6 (commencing with Section 127500) is added to Part 2 of Division 107 of the Health and Safety Code, to read:CHAPTER 2.6. Health Care Affordability
Article 1. General Provisions and Definitions
127500.
This chapter shall be known, and may be cited, as the California Health Care Quality and Affordability Act.127500.2.
As used in this chapter, the following definitions apply:127500.5.
(a) The Legislature finds and declares all of the following:Article 2. Office of Health Care Affordability
127501.
(a) There is hereby established, within the Department of Health Care Access and Information, the Office of Health Care Affordability. The Director of the Department of Health Care Access and Information shall be the director of the office and shall carry out all functions of that position, including enforcement.127501.2.
(a) Until January 1, 2027, any necessary rules and regulations for the purpose of implementing this chapter may be adopted as emergency regulations in accordance with the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code). The adoption of emergency regulations pursuant to this section shall be deemed to be an emergency and necessary for the immediate preservation of the public peace, health and safety, or general welfare.127501.3.
(a) The office shall be responsive to requests for additional information from the Legislature, including providing testimony during hearings and commenting on proposed legislation or policy issues.127501.4.
(a) (1) Notwithstanding any other state or local law, the office shall collect data and other information it determines necessary from health care entities, except exempted providers, to carry out the functions of the office. To the extent consistent with federal law and to the greatest extent possible, the office may use existing and emerging public and private data sources to minimize administrative burdens and duplicative reporting, including data or information from federal agencies as well as state agencies. The office may request data and information from, or enter into a data sharing agreement with, the State Department of Health Care Services, Covered California, the Department of Managed Health Care, the Department of Insurance, the Labor and Workforce Development Agency, the Business, Consumer Services, and Housing Agency, and other relevant state agencies that monitor compliance of plans and providers with access standards, including timely access, language access, geographic access, and other access standards as provided by law and regulation. The office may also enter into a data sharing agreement with these state agencies that collect payer and provider financial data or other data or information about the health care workforce.127501.6.
(a) For data submitted to the office under paragraph (1) of subdivision (d) of Section 127501.4, the office shall prepare a report on baseline health care spending consistent with subparagraph (A) of paragraph (2) of subdivision (b) on or before June 1, 2025.127501.7.
(a) (1) Notwithstanding any other law regarding the confidentiality of data submitted by health care service plans or other entities to the Department of Managed Health Care, the office and the Department of Managed Health Care may enter into an interagency agreement for the transfer of data pursuant to Section 127501.4 and any other data maintained by the Department of Managed Health Care deemed necessary by the office to implement this chapter.127501.8.
(a) There is hereby established in the State Treasury the Health Care Affordability Fund for the purpose of receiving and expending revenues collected pursuant to this chapter. This fund is subject to appropriation by the Legislature.127501.10.
(a) There is hereby established, within the office, the Health Care Affordability Board. The board shall be composed of eight members, as follows:127501.11.
(a) After receiving input, including recommendations, from the office and the advisory committee, and receiving public comments, the board shall establish all of the following:127501.12.
(a) (1) The board shall establish a Health Care Affordability Advisory Committee to provide input, including recommendations, to the board and the office on a range of areas, including, but not limited to, all of the following:Article 3. Health Care Cost Targets
127502.
(a) The board shall establish a statewide health care cost target.127502.5.
(a) The director shall enforce the cost targets established by this chapter against health care entities in a manner that ensures compliance with targets, allows each health care entity opportunities for remediation, and ensures health care entities do not implement performance improvement plans in ways that are likely to erode access, quality, equity, or workforce stability. The director shall consider each entity’s contribution to cost growth in excess of the applicable target and any actions by the entity that have eroded, or are likely to erode, access, quality, equity, or workforce stability, factors that contribute to spending in excess of the applicable target, and the extent to which each entity has control over the applicable components of its cost target. The director shall review information and other relevant data from additional sources, as appropriate, including data from the Health Care Payments Data Program, to determine the appropriate health care entity that may be subject to enforcement actions under this section. Commensurate with the health care entity’s offense or violation, the director may take the following progressive enforcement actions:Article 4. Quality and Equity Performance
127503.
(a) (1) The office shall adopt a single set of standard measures for assessing health care quality and equity across payers, fully integrated delivery systems, hospitals, and physician organizations. Performance on quality and health equity measures shall be included in the annual report required in Section 127501.6.Article 5. Alternative Payment Models
127504.
(a) The office shall promote the shift from payments based on fee-for-service to alternative payment models that provide financial incentive for equitable high-quality and cost-efficient care. In furtherance of this goal, the office shall convene health care entities and organize an alternative payment model working group, set statewide goals for the adoption of alternative payment models, and measure the state’s progress toward those goals. With input from the working group, the office shall set benchmarks that include, but are not limited to, increasing the percentage of total health care expenditures delivered through alternate payment models or the percentage of membership covered by an alternative payment model.Article 6. Primary Care and Behavioral Health Investments
127505.
(a) (1) The office shall measure and promote a sustained systemwide investment in primary care and behavioral health. In furtherance of this goal, the office shall measure the percentage of total health care expenditures allocated to primary care and behavioral health and set spending benchmarks. Spending benchmarks for primary care shall consider current and historic underfunding of primary care services.Article 7. Health Care Workforce Stability
127506.
(a) The intent of this section is to monitor the effects of cost targets on health care workforce stability, high-quality jobs, and training needs of health care workers, in addition to adjustments to cost targets pertaining to nonsupervisory employee organized labor costs pursuant to paragraph (7) of subdivision (d) of Section 127502. The Legislature intends that the office use a transparent process that allows for public input to monitor how health care entities achieve the cost targets and highlight best practices and discourage practices harmful to workers and patients.Article 8. Health Care Market Trends
127507.
(a) The office shall monitor cost trends, including conducting research and studies on the health care market, including, but not limited to, the impact of consolidation, market power, venture capital activity, profit margins, and other market failures on competition, prices, access, quality, and equity. In a manner supportive of the efforts of the Attorney General, the Department of Managed Health Care, and the Department of Insurance, as appropriate, the office shall promote competitive health care markets by examining mergers, acquisitions, corporate affiliations, or other transactions that entail a material change to ownership, operations, or governance structure involving health care service plans, health insurers, hospitals or hospital systems, physician organizations, providers, pharmacy benefit managers, and other health care entities. The office shall prospectively analyze those transactions likely to have significant effects, seek input from the parties and the public, and report on the anticipated impacts to the health care market. The role of the office is to collect and report information that is informative to the public.127507.2.
(a) (1) If the office finds that a material change noticed pursuant to Section 127507 is likely to have a risk of a significant impact on market competitions, the state’s ability to meet cost targets, or costs for purchasers and consumers, the office shall conduct a cost and market impact review that examines factors relating to a health care entity’s business and its relative market position, including, but not limited to, changes in size and market share in a given service or geographic region, prices for services compared to other providers for the same services, quality, equity, cost, access, or any other factors the office determines to be in the public interest. The office also may conduct cost and market impact reviews on any health care entity based on a determination by the director under subdivision (g) of Section 127502.5, or in association with agreements or transactions referred to the office by a reviewing authority listed in paragraphs (1) to (4), inclusive, of subdivision (d) of Section 127507.127507.4.
In furtherance of this article, the office may do all of the following:127507.6.
In addition to any legal remedies, the office shall be entitled to specific performance, injunctive relief, and other equitable remedies a court deems appropriate for enforcement of any of the requirements of this article and shall be entitled to recover its attorney’s fees and costs incurred in remedying each violation.SEC. 20.
Section 127691 of the Health and Safety Code is amended to read:127691.
For purposes of this chapter, the following definitionsSEC. 21.
Section 127692 of the Health and Safety Code is amended to read:127692.
(a) The California Health and Human Services Agency (CHHSA) or its departments shall enter into partnerships, consistent with subdivision (b) of Section 127693, in consultation with other state departments as necessary, to increase competition, lower prices, and address shortages in the market for generic prescription drugs, to reduce the cost of prescription drugs for public and private purchasers, taxpayers, and consumers, and to increase patient access to affordable drugs.(b)
SEC. 22.
Section 127694 of the Health and Safety Code is amended to read:127694.
(a) On or beforeSEC. 23.
Section 127695 of the Health and Safety Code is amended to read:127695.
(a) On or beforeSEC. 24.
Section 127696 of the Health and Safety Code, as added by Section 1 of Chapter 207 of the Statutes of 2020, is amended to read:127696.
In order to protect proprietary, confidential information regarding manufacturer or distribution costs and drug pricing, utilization, and rebates, it is necessary that this act limit the public’s right of access to that information. Notwithstanding any other provision of law, all nonpublic information and documents obtained or prepared under thisSEC. 25.
Section 127696 of the Health and Safety Code, as amended by Section 289 of Chapter 615 of the Statutes of 2021, is amended to read:127696.
In order to protect proprietary, confidential information regarding manufacturer or distribution costs and drug pricing, utilization, and rebates, it is necessary that this act limit the public’s right of access to that information. Notwithstanding any other provision of law, all nonpublic information and documents obtained or prepared under thisSEC. 26.
Section 128205 of the Health and Safety Code is amended to read:128205.
As used in this article, and Article 2 (commencing with Section 128250), the following terms have the following meanings:(i)
SEC. 27.
Section 128210 of the Health and Safety Code is amended to read:128210.
There is hereby created a state medical contract program with accredited medical schools, teaching health centers, programs that train primary care physician’s assistants, programs that train primary care nurse practitioners, programs that train registered nurses, programs that train midwives, hospitals, and other health care delivery systems to increase the number of students and residents receiving quality education and training in the primary care specialties of family medicine, internal medicine, obstetrics and gynecology, midwifery, and pediatrics, or in nursing and to maximize the delivery of primary care and family physician services to specific areas of California where there is a recognized unmet priority need for those services.SEC. 28.
Section 128215 of the Health and Safety Code is repealed.(a)There is hereby created a California Health Workforce Education and Training Council that shall be responsible for helping coordinate California’s health workforce education and training to develop a health workforce that meets California’s health care needs. The council shall be composed of 17 members who, together, represent various graduate medical education and training programs, health professions, including, but not limited to, specialties for primary care and behavioral health, and consumer representatives who shall serve at the pleasure of their appointing authorities, as follows:
(1)Six members appointed by the Governor.
(2)One member who shall be the Director of the Department of Health Care Services, or the director’s designee.
(3)One member who shall be the Director of the Department of Health Care Access and Information, or the director’s designee.
(4)Three members appointed by the Speaker of the Assembly.
(5)Three members appointed by the Chairperson of the Senate Committee on Rules.
(6)One member who shall be the President of the University of California, or the president’s designee.
(7)One member who shall be the Chancellor of the California State University, or the chancellor’s designee.
(8)One member who shall be the Chancellor of the California Community Colleges, or the chancellor’s designee.
(b)Members of the council appointed under paragraphs (1), (4), and (5) of subdivision (a) shall be appointed for a term of four years, except that the term of office of the initial members appointed under paragraph (1) shall expire at the end of two years.
SEC. 29.
Section 128220 of the Health and Safety Code is repealed.The members of the council, other than state employees, shall receive compensation of twenty-five dollars ($25) for each day’s attendance at a council meeting, in addition to actual and necessary travel expenses incurred in the course of attendance at a council meeting.
SEC. 30.
Section 128225 of the Health and Safety Code is repealed.(a)The council shall have the powers and authority necessary to carry out the duties imposed upon it by this chapter, including, but not limited to, the following:
(1)Develop graduate medical education and workforce training and development priorities for the state.
(2)Discuss and make recommendations to the Department of Health Care Access and Information regarding the use of health care education and training funds appropriated by the Legislature for programs administered by the department under this part.
(3)Develop standards and guidelines for residency and health professions education and training programs funded under this part.
(4)Review outcomes data from funded programs, as provided to the council by the department, to reprioritize and reassess the graduate medical education and health professions education and training needs of California’s communities.
(5)Explore options for developing a broad graduate medical education and health professions education and training funding strategy.
(6)Advocate for additional funds and additional sources of funds to stimulate expansion of graduate medical education and health professions education and training in California.
(7)Provide technical assistance and support for establishing new graduate medical education and health professions education and training programs in California.
(8)Review and recommend health professions career pathways or ladders.
(b)The council shall carry out the duties imposed upon it by this chapter with primary consideration given to increasing workforce diversity and furthering improved access, quality, and equity of health care for underserved, underrepresented, and Medi-Cal populations. Further, the council shall carry out the duties imposed upon it by this chapter with a primary focus on primary care, behavioral health, oral health, and allied health.
SEC. 31.
Section 128230 of the Health and Safety Code is amended to read:128230.
When funding primary care and family medicine programs or departments, primary care and family medicine residencies, and programs for the training of primary care physician assistants, primary care nurse practitioners, certified nurse-midwives, licensed midwives, or registered nurses, the department shall give priority to programs that have demonstrated success in the following areas:SEC. 32.
Section 128235 of the Health and Safety Code is amended to read:128235.
Pursuant to this article and Article 2 (commencing with Section 128250), the Director of the Department of Health Care Access and Information shall do all of the following:(f)Instruct the council to create subcommittees as may be required from time to time in the discretion of the Director of the Department of Health Care Access and Information.
SEC. 33.
Article 2 (commencing with Section 128250) is added to Chapter 4 of Part 3 of Division 107 of the Health and Safety Code, to read:Article 2. California Health Workforce Education and Training Council
128250.
(a) The terms used in this article have the same meaning as in Section 128205.128251.
The members of the council, other than state employees, shall receive compensation of twenty-five dollars ($25) for each day’s attendance at a council meeting, in addition to actual and necessary travel expenses incurred in the course of attendance at a council meeting.128252.
(a) The council shall have the powers and authority necessary to carry out the duties imposed upon it by this chapter, including, but not limited to, the following:SEC. 34.
Section 10181.35 is added to the Insurance Code, to read:10181.35.
(a) It is the intent of the Legislature in enacting this section to ensure that insureds benefit from reductions in the rate of growth in health care costs as a result of the establishment of the Office of Health Care Affordability.SEC. 35.
Section 12693.74 of the Insurance Code is amended to read:12693.74.
(a) Subscribers shall continue to be eligible for the program for a period of 12 months from the month eligibility is established.SEC. 36.
Section 12693.74 is added to the Insurance Code, to read:12693.74.
(a) To the extent federal financial participation is available, and subject to subdivision (e), the child shall remain continuously eligible for the program up to five years of age. The department shall seek any federal approvals that may be necessary to implement this subdivision.SEC. 37.
Part 4.6 (commencing with Section 1490) is added to Division 2 of the Labor Code, to read:PART 4.6. Hospital and Skilled Nursing Facility COVID-19 Worker Retention Pay
1490.
(a) The Legislature finds and declares that stability in the California health care workforce will further its efforts to manage the COVID-19 pandemic and address other public health issues that face Californians.1491.
For purposes of this part, the following definitions apply:1492.
(a) Upon appropriation by the Legislature, the department shall provide funding to participant covered entities, covered services employers, and physician entities to make retention payments to their eligible employees or eligible physicians, and shall make retention payments directly to eligible physicians who are not employees of a covered entity or physician entity, for the public purposes specified in Section 1490. The department may provide up to one thousand five hundred dollars ($1,500) for each eligible full-time employee, one thousand two hundred and fifty dollars ($1,250) for each eligible part-time employee, or one thousand dollars ($1,000) for each eligible physician, subject to the methodology described in subdivision (d) and the aggregate amount of funding available for this purpose.1493.
(a) In the event of a dispute about the status of an employee as a full-time eligible employee, part-time eligible employee, the retention payment amount, or the covered entity’s or covered service employer’s failure to make a retention payment, the employee or a labor organization that represents the employee may write to the employer and request a review of the employee’s eligibility status, retention payment amount, or the employer’s failure to make a retention payment. The employer shall have 30 days to review the employee’s request, disclose to the employee the amount received from the department subject to the methodology described in subdivision (d) of Section 1492, and cure any alleged deficiency without damages.1494.
(a) In the event of a dispute about the status of an eligible physician, the retention payment amount, or the physician entity’s failure to make a retention payment, the physician may write to the physician entity and request a review of the physician’s eligibility status, retention payment amount, or the physician entity’s failure to make a retention payment. The physician entity shall have 30 days to review the physician’s request, disclose to the physician the amount received from the department subject to the methodology described in subdivision (d) of Section 1492, and cure any alleged deficiency without penalty.1495.
(a) In serving as a conduit for the retention payments under this part, covered entities, covered services employers, and physician entities are carrying out a state program. This part does not create a private right of action in any civil litigation against covered entities, covered services employers, and physician entities regarding the administration of the retention payment program and in the receipt and transmittal of retention payment program funds.SEC. 38.
Section 1001.36 of the Penal Code is amended to read:1001.36.
(a) On an accusatory pleading alleging the commission of a misdemeanor or felony offense, the court may, after considering the positions of the defense and prosecution, grant pretrial diversion to a defendant pursuant to this section if the defendant meets all of the requirements specified in paragraph (1) of subdivision (b).SEC. 39.
Section 1026 of the Penal Code is amended to read:1026.
(a) If a defendant pleads not guilty by reason of insanity, and also joins with it another plea or pleas, the defendant shall first be tried as if only the other plea or pleas had been entered, and in that trial the defendant shall be conclusively presumed to have been sane at the time the offense is alleged to have been committed. If the jury finds the defendant guilty, or if the defendant pleads only not guilty by reason of insanity, the question whether the defendant was sane or insane at the time the offense was committed shall be promptly tried, either before the same jury or before a new jury in the discretion of the court. In that trial, the jury shall return a verdict either that the defendant was sane at the time the offense was committed or was insane at the time the offense was committed. If the verdict or finding is that the defendant was sane at the time the offense was committed, the court shall sentence the defendant as provided by law. If the verdict or finding is that the defendant was insane at the time the offense was committed, the court, unless it appears to the court that the sanity of the defendant has been recovered fully, shall direct that the defendant be committed to the State Department of State Hospitals for the care and treatment of persons with mental health disorders or any other appropriate public or private treatment facility approved by the community program director, or the court may order the defendant placed on outpatient status pursuant to Title 15 (commencing with Section 1600) of Part 2.SEC. 40.
Section 1026.2 of the Penal Code is amended to read:1026.2.
(a) An application for the release of a person who has been committed to a state hospital or other treatment facility, as provided in Section 1026, upon the ground that sanity has been restored, may be made to the superior court of the county from which the commitment was made, either by the person, or by the medical director of the state hospital or other treatment facility to which the person is committed or by the community program director where the person is on outpatient status under Title 15 (commencing with Section 1600). The court shall give notice of the hearing date to the prosecuting attorney, the community program director or a designee, and the medical director or person in charge of the facility providing treatment to the committed person at least 15 judicial days in advance of the hearing date.During
SEC. 41.
Section 1369 of the Penal Code is amended to read:1369.
Except as stated in subdivision (g), a trial by court or jury of the question of mental competence shall proceed in the following order:SEC. 42.
Section 1369.1 of the Penal Code is repealed.(a)As used in this chapter, “treatment facility” includes a county jail. Upon the concurrence of the county board of supervisors, the county mental health director, and the county sheriff, the jail may be designated to provide medically approved medication to defendants found to be mentally incompetent and unable to provide informed consent due to a mental disorder, pursuant to this chapter. In the case of Madera, Napa, and Santa Clara Counties, the concurrence shall be with the board of supervisors, the county mental health director, and the county sheriff or the chief of corrections. The provisions of Sections 1370, 1370.01, and 1370.02 shall apply to antipsychotic medications provided in a county jail, provided, however, that the maximum period of time a defendant may be treated in a treatment facility pursuant to this
section shall not exceed six months.
(b)This section does not abrogate or limit any law enacted to ensure the due process rights set forth in Sell v. United States (2003) 539 U.S. 166.
SEC. 43.
Section 1370 of the Penal Code is amended to read:1370.
(a) (1) (A) If the defendant is found mentally competent, the criminal process shall resume, the trial on the offense charged or hearing on the alleged violation shall proceed, and judgment may be pronounced.(ii)If the court finds any of the conditions described in clause (i) to be true, the court shall issue an
(iii)
(iv)
(v)
(vi)
(E)
(F)
(G)
(H)
(I)
SEC. 44.
Section 1370.6 of the Penal Code is amended to read:1370.6.
(a) If a mentally incompetent defendant is admitted to a county jail treatment facility pursuant to Section 1370, the department shall provide restoration of competency treatment at the county jail treatment facility and shall provide payment to the county jail treatment facility for the reasonable costs of the bed during the restoration of competency treatment as well as for the reasonable costs of any necessary medical treatment not provided within the county jail treatment facility, unless otherwise agreed to by the department and the facility.(4)The six-month limitation in Section 1369.1 shall not apply to individuals deemed incompetent to stand trial who are being treated to restore competency within a county jail treatment facility pursuant to this section.
SEC. 45.
Section 1372 of the Penal Code is amended to read:1372.
(a) (1) If the medical director of a state hospital, a person designated by the State Department of State Hospitals at an entity contracted by the department to provide services to a defendant prior to placement in a treatment program or other facility to which the defendant is committed, or the community program director, county mental health director, or regional center director providing outpatient services, determines that the defendant has regained mental competence, the director or designee shall immediately certify that fact to the court by filing a certificate of restoration with the court by certified mail, return receipt requested, or by confidential electronic transmission. This shall include any certificate of restoration filed by the State Department of State Hospitals based on an evaluation conducted pursuant to Section 4335.2 of the Welfare and Institutions Code. For purposes of this section, the date of filing shall be the date on the return receipt.SEC. 46.
Section 1602 of the Penal Code is amended to read:1602.
(a) Before any person subject to the provisions of subdivision (b) of Section 1601 may be placed on outpatient status, the court shall consider all of the following criteria:SEC. 47.
Section 1603 of the Penal Code is amended to read:1603.
(a) Before any person subject to subdivision (a) of Section 1601 may be placed on outpatient status the court shall consider all of the following criteria:SEC. 48.
Section 1604 of the Penal Code is amended to read:1604.
(a) Upon receipt by the committing court of the recommendation of the director of the state hospital or other treatment facility to which the person has been committed that the person may be eligible for outpatient status as set forth in subdivision (a)(1) of Section 1602 or 1603, the court shall immediately forward such recommendation to theSEC. 49.
Section 2603 of the Penal Code, as amended by Section 11 of Chapter 434 of the Statutes of 2021, is amended to read:2603.
(a) Except as provided in subdivision (b), an inmate confined in a county jail shall not be administered any psychiatric medication without their prior informed consent.SEC. 50.
Section 4019 of the Penal Code, as amended by Section 4 of Chapter 599 of the Statutes of 2021, is amended to read:4019.
(a) This section applies in all of the following cases:SEC. 51.
Section 18914 of the Revenue and Taxation Code is amended to read:18914.
(a) An individual may designate on the tax return that a contribution in excess of the personal income tax liability, if any, be made to the Suicide Prevention Voluntary Tax Contribution Fund established by Section 18915. That designation is to be used as a voluntary contribution on the tax return.(1)Programs designed to prevent suicide in rural and desert communities located in the state.
(2)Crisis centers located in the state that are active members of the National Suicide Prevention Lifeline.
SEC. 52.
Section 18916 of the Revenue and Taxation Code is amended to read:18916.
(a) Notwithstanding Section 13340 of the Government Code, all money transferred to the Suicide Prevention Voluntary Tax Contribution Fund shall be continuously appropriated and allocated as follows:(A)Fifty percent of the funds disbursed pursuant to this paragraph shall be awarded through a project-specific grant process to crisis centers to fund programs that are designed to provide suicide prevention services to rural and desert communities. Crisis centers applying for the grants shall submit an application to the Mental Health Services Oversight and Accountability Commission in the manner prescribed by the commission.
(B)Fifty percent of the funds disbursed pursuant to this paragraph shall be disbursed to crisis centers for the sole purpose of providing suicide prevention services. When disbursing funds pursuant to this subparagraph, the Mental Health Services Oversight and Accountability Commission shall, to the extent feasible, consult with Didi Hirsch Mental Health Services. The Mental Health Services Oversight and Accountability Commission shall disburse to each crisis center, from the disbursements required by this subparagraph, an amount proportional to the proportion that the annual number of calls the crisis center answers bears to the annual number of calls answered by all crisis centers located in the state that are active members of the National Suicide Prevention Lifeline.
(b)The Mental Health Services Oversight and Accountability Commission shall report on its internet website information on the process for awarding money, the amount of money spent on administration, and an itemization of how program
funds were awarded, including, but not limited to, the recipients of grants made with funds.
SEC. 53.
Section 4335.2 of the Welfare and Institutions Code is amended to read:4335.2.
(a) As used in this section, “department” means the State Department of State Hospitals.(d)
(e)
(f)
(g)
(h)
SEC. 54.
Section 4336 is added to the Welfare and Institutions Code, to read:4336.
(a) As used in this section, “department” means the State Department of State Hospitals.SEC. 55.
Section 4360.5 is added to the Welfare and Institutions Code, to read:4360.5.
(a) The State Department of State Hospitals shall establish a statewide panel of independent evaluators responsible for Forensic Conditional Release Program placement determinations for patients committed to the department and transitioning to community treatment settings for services pursuant to Section 4360.SEC. 56.
Section 4361 of the Welfare and Institutions Code is amended to read:4361.
(a) As used in this section, “department” means the State Department of State Hospitals.(2)The number of individuals originally declared incompetent to stand trial on felony charges that the court ultimately ordered to diversion.
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(i)(1)In order to receive funds pursuant to this chapter, a county’s proposal shall demonstrate a 20-percent match of county funds toward the total cost of diversion to be funded through the contract.
(2)Notwithstanding paragraph (1), a proposal from a small county shall demonstrate a 10-percent match of county funds toward the total cost of diversion to be funded through the contract. For purposes of this paragraph, “small county” means a county with a population of 200,000 or less based on the most recent available estimates of population data determined by the Demographic Research Unit of the Department of Finance.
(3)
SEC. 57.
Section 4361.7 is added to the Welfare and Institutions Code, to read:4361.7.
(a) Subject to an appropriation by the Legislature for this express purpose, the department may contract for medical, evaluation, and other services as necessary to facilitate early access to treatment for individuals in county jails who have been deemed incompetent to stand trial on a felony charge.SEC. 58.
Section 5325.3 is added to the Welfare and Institutions Code, to read:5325.3.
(a) For purposes of administering antipsychotic medications to a person admitted as a voluntary patient, as described in Section 850 of Title 9 of the California Code of Regulations, or any successor regulation, who consents to receiving those medications, as part of specialty mental health services covered under Medi-Cal or as part of community mental health services, a health facility, or a facility that has a community residential treatment program pursuant to Article 1 (commencing with Section 5670) of Chapter 2.5 of Part 2, shall not be required to obtain the signature of that patient.SEC. 59.
Section 5328 of the Welfare and Institutions Code is amended to read:5328.
(a) All information and records obtained in the course of providing services under Division 4 (commencing with Section 4000), Division 4.1 (commencing with Section 4400), Division 4.5 (commencing with Section 4500), Division 5 (commencing with Section 5000), Division 6 (commencing with Section 6000), or Division 7 (commencing with Section 7100), to either voluntary or involuntary recipients of services are confidential. Information and records obtained in the course of providing similar services to either voluntary or involuntary recipients before 1969 are also confidential. Information and records shall be disclosed only in any of the following cases:Date |
(b)
(c)
SEC. 60.
Section 5848.5 of the Welfare and Institutions Code is amended to read:5848.5.
(a) The Legislature finds and declares all of the following:(7)The commission shall provide a status report to the fiscal and policy committees of the Legislature on the progress of implementation no later than March 1, 2014.
(h)Funds appropriated by the Legislature to the commission pursuant to paragraph (8) of subdivision (b) for the purposes of addressing children’s crisis services shall be allocated to support triage personnel and family supportive training and related services. These funds shall be made available to selected counties, counties acting jointly, or city mental health departments, as determined by the commission through a selection process. The commission may, at its discretion, also give consideration to private nonprofit corporations and public agencies in an area or region of the state if a county, or counties acting jointly, affirmatively supports this designation and collaboration in lieu of a county government directly receiving grant funds.
(1)These funds may provide for a range of crisis-related services for a child in need of assistance, or his or her parent, guardian, or caregiver. These service activities may include, but are not limited to, the following:
(A)Intensive coordination of care and services.
(B)Communication, coordination, and referral.
(C)Monitoring service delivery to the child or youth.
(D)Monitoring the child’s progress.
(E)Providing placement service assistance and service plan development.
(F)Crisis or safety planning.
(2)The commission shall take into account at least the following criteria and factors when selecting recipients and determining the amount of grant awards for these funds, as follows:
(A)Description of need, including potential gaps in local service connections.
(B)Description of funding request, including personnel.
(C)Description of how personnel and other services will be used to facilitate linkage and access to services, including objectives and anticipated outcomes.
(D)Ability to obtain federal Medicaid reimbursement, when applicable.
(E)Ability to provide a matching contribution of local funds.
(F)Ability to administer an effective service program and the degree to which local agencies and service providers will support and collaborate with the triage personnel effort.
(G)Geographic areas or regions of the state to be eligible for grant awards, which shall include rural, suburban, and urban areas, and may include use of the five regional designations utilized by the County Behavioral Health Directors Association of California.
(3)The commission shall determine maximum grant awards, and shall take into consideration the level of need, population to be served, and related criteria, as described in paragraph (2), and shall reflect reasonable costs.
(4)Funds awarded by the commission for purposes of this section may be used to supplement, but not supplant, existing financial and resource commitments of the county, counties acting jointly, or a city mental health department that received the grant.
(5)Notwithstanding any other law, a county, counties acting jointly, or a city mental health department that receives an award of funds for the purpose of this section is not required to provide a matching contribution of local funds.
(6)Notwithstanding any other law, the commission, without taking any further regulatory action, may implement, interpret, or make specific this section by means of informational letters, bulletins, or similar instructions.
(7)The commission may waive requirements in this section for counties with a population of 100,000 or less, if the commission determines it is in the best interest of the state and meets the intent of the law.
(8)The commission shall provide a status report to the fiscal and policy committees of the Legislature on the progress of implementation no later than January 10, 2018, and annually thereafter.
SEC. 61.
Section 5961.5 of the Welfare and Institutions Code is amended to read:5961.5.
(a) As a component of the initiative, the State Department of Health Care Services shall develop and select evidence-based interventions and community-defined promising practices to improve outcomes for children and youthSEC. 62.
Section 7276 of the Welfare and Institutions Code is amended to read:7276.
(a) The charge for the care and treatment of all persons who have mental health disorders at state hospitals for whom there is liability to pay therefor shall be determined pursuant to Section 4025. The Director of State(b)If the Director of State Hospitals delegates to the county the responsibility for determining the ability of a minor child and their parents to pay for state hospital services, the requirements of Sections 5710 and 7275.1 and the
policies and procedures established and maintained by the director, including those relating to the collection and accounting of revenue, shall be followed by each county to which that responsibility is delegated.
SEC. 63.
Section 7279 of the Welfare and Institutions Code is amended to read:7279.
(b)If at any time there is not sufficient money on hand in the estate of a committed person to pay the claim of a state mental hospital for his or her care, support, maintenance, and expenses therein, the court may, on petition of the guardian or conservator of the estate, or if the guardian or conservator fails, refuses, or neglects to apply, on the petition of the department, make an order directing the guardian or conservator to sell so much of the other personal or real property or both, of the person as is necessary to pay for the care, support, maintenance, and expenses of the person at the mental hospital. From the proceeds of such sale, the guardian or conservator shall pay the amount due for the care, support, maintenance, and expenses at the mental hospital, and also such other charges as are allowed by law.
(c)Payment for the care, support, maintenance, and expenses shall not be extracted, however, from a person who has no more than five hundred dollars ($500) of assets.
SEC. 64.
Section 7281 of the Welfare and Institutions Code is amended to read:7281.
There is at each institution under the jurisdiction of the State Department of State Hospitals and at each institution under the jurisdiction of the State Department of Developmental Services, a fund known as the patients’ personal deposit fund. Any funds coming into the possession of the superintendent, belonging to any patient in that institution, shall be deposited in the name of that patient in the patients’ personal deposit fund, except that if a guardian or conservator of the estate is appointed for the patient thenSEC. 65.
Section 7284 of the Welfare and Institutions Code is repealed.(a)If a person who lacks legal capacity to make decisions, who has no guardian or conservator of the estate, and who has been admitted or committed to the State Department of State Hospitals for placement in a state hospital, is the owner of any property, the State Department of State Hospitals, acting through its designated officer, may apply to the superior court of the proper county for its appointment as guardian or conservator of the person’s estate.
(b)For the purposes of this section, the State Department of State Hospitals is hereby made a corporation and may act as executor, administrator, guardian or conservator of estates, assignee, receiver, depositary, or trustee, under appointment of any court or by authority of any law of this state, and may transact
business in that capacity in like manner as an individual, and for this purpose may sue and be sued in any of the courts of this state.
(c)If a person admitted or committed to the State Department of State Hospitals dies, leaving an estate, and having no relatives at the time residing within this state, the State Department of State Hospitals may apply for letters of administration of his or her estate and, in the discretion of the court, letters of administration may be issued to the department. When the State Department of State Hospitals is appointed as guardian, conservator, or administrator, the department shall be appointed as guardian, conservator, or administrator without bond. The officer designated by the department shall be required to give a surety bond in an amount deemed necessary from time to time by the director, but in no event shall the initial bond be less than ten thousand dollars ($10,000), which bond shall be for the
joint benefit of the several estates and the State of California. The State Department of State Hospitals shall receive any reasonable fees for its services as the guardian, conservator, or administrator as the court allows. The fees paid to the State Department of State Hospitals for its services as guardian, conservator, or administrator of the various estates may be used as a trust account from which may be drawn expenses for filing fees, bond premiums, court costs, and other expenses required in the administration of the various estates. Whenever the balance remaining in the trust fund account shall exceed a sum deemed necessary by the department for the payment of expenses, the excess shall be paid quarterly by the department into the State Treasury to the credit of the General Fund.
SEC. 66.
Section 7285 of the Welfare and Institutions Code is repealed.The State Department of State Hospitals may invest funds held as executor, administrator, guardian or conservator of estates, or trustee, in bonds or obligations issued or guaranteed by the United States or the State of California. Such investments may be made and such bonds or obligations may be sold or exchanged for similar bonds or obligations without notice or court authorization.
SEC. 67.
Section 7286 of the Welfare and Institutions Code is repealed.The State Department of State Hospitals may establish one or more common trusts for investment of funds held as executor, administrator, guardian or conservator of estates, or trustee and may designate from time to time the amount of participation of each estate in such trusts. The funds in such trusts may be invested only in bonds or obligations issued or guaranteed by the United States or the State of California.
The income and profits of each trust shall be the property of the estates participating and shall be distributed, when received, in proportion to the amount of participation of each estate in such trust. The losses of each trust shall be the losses of the estates participating and shall be apportioned, as the same
occur, upon the same basis as income and profits.
SEC. 68.
Section 7287 of the Welfare and Institutions Code is repealed.Upon the death of an incompetent person over whom the State Department of State Hospitals has obtained jurisdiction pursuant to Section 7284, the department may make proper disposition of the remains, and pay for the disposition of the remains together with any indebtedness existing at the time of the death of the person from the assets of the guardianship or conservatorship estate, and thereupon it shall file its final account with the court or otherwise close its administration of the estate of the person.
SEC. 69.
Section 7290 of the Welfare and Institutions Code is amended to read:7290.
TheSEC. 70.
Section 7291 of the Welfare and Institutions Code is repealed.The county from which each person has been committed to an institution for defective or psychopathic delinquents shall pay the state the cost of the care of such person, for the time the person committed remains a patient of the institution, at the monthly rate therefor fixed as provided in Section 7292.
SEC. 71.
Section 7292 of the Welfare and Institutions Code is repealed.The cost of such care shall be determined and fixed from time to time by the Director of State Hospitals, but in no case shall it exceed the rate of forty dollars ($40) per month.
SEC. 72.
Section 14005.12 of the Welfare and Institutions Code is amended to read:14005.12.
(a) For the purposes of Sections 14005.4 and 14005.7, the department shall establish the income levels for maintenance need at the lowest levels that reasonably permit medically needy persons to meet their basic needs for food, clothing, and shelter, and for which federal financial participation will still be provided under Title XIX of the federal Social Security Act. It is the intent of the Legislature that the income levels for maintenance need for medically needy aged, blind, and disabled adults, in particular, shall be based upon amounts that adequately reflect their needs.SEC. 73.
Section 14005.12 is added to the Welfare and Institutions Code, to read:14005.12.
(a) For the purposes of Sections 14005.4 and 14005.7, the department shall establish the income levels for maintenance need at the lowest levels that reasonably permit medically needy persons to meet their basic needs for food, clothing, and shelter, and for which federal financial participation will still be provided under Title XIX of the federal Social Security Act. It is the intent of the Legislature that the income levels for maintenance need for medically needy aged, blind, and disabled adults, in particular, shall be based upon amounts that adequately reflect their needs.SEC. 74.
Section 14005.13 of the Welfare and Institutions Code is amended to read:14005.13.
(a) Notwithstanding Section 14005.12, when an individual residing in a long-term care facility would incur a share of cost for services under this chapter due to incomeSEC. 75.
Section 14005.13 is added to the Welfare and Institutions Code, to read:14005.13.
(a) Notwithstanding Section 14005.12, when an individual residing in a long-term care facility would incur a share of cost for services under this chapter due to income that exceeds that allowed for the incidental and personal needs of the individual, a specified portion of the individual’s earned income from therapeutic wages shall be exempt. Therapeutic wages are wages earned by the individual under all of the following conditions:SEC. 76.
Section 14005.22 of the Welfare and Institutions Code is amended to read:14005.22.
(a) ASEC. 77.
Section 14005.225 of the Welfare and Institutions Code is repealed.(a)The department shall seek any state plan amendments or federal waivers necessary to provide pregnant women whose income is over 109 percent of, and is up to and including 138 percent of, the federal poverty level as determined, counted, and valued in accordance with the requirements of Section 1396a(e)(14) of Title 42 of the United States Code, as added by the federal Patient Protection and Affordable Care Act (Public Law 111-148) and as amended by the federal
Health Care and Education Reconciliation Act of 2010 (Public Law 111-152) and any subsequent amendments, with full scope Medi-Cal benefits without a share of cost during their pregnancy and through the end of the calendar month in which the 60th day after the end of their pregnancy falls.
(b)To the extent permitted by state and federal law, a woman eligible under this section shall be required to enroll in a Medi-Cal managed care health plan in those counties in which a Medi-Cal managed care health plan is available.
(c)Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department, without taking any further regulatory action, shall implement, interpret, or make specific this section by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions until the time regulations
are adopted. The department shall adopt regulations by July 1, 2017, in accordance with the requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code. Notwithstanding Section 10231.5 of the Government Code, beginning six months after the effective date of this section, the department shall provide a status report to the Legislature on a semiannual basis, in compliance with Section 9795 of the Government Code, until regulations have been adopted.
(d)This section shall be implemented only if and to the extent that federal financial participation is available and any necessary federal approvals have been obtained.
SEC. 78.
Section 14005.255 is added to the Welfare and Institutions Code, to read:14005.255.
(a) (1) Notwithstanding Section 14005.25, subject to paragraph (2) and subdivision (d), a child shall be continuously eligible for Medi-Cal up to, five years of age.SEC. 79.
Section 14005.26 of the Welfare and Institutions Code is amended to read:14005.26.
(a) (1) Except as provided in subdivision (b), the department shall exercise the option pursuant to Section 1902(a)(l0)(A)(ii)(XIV) of the federal Social Security Act (42 U.S.C. Sec. 1396a(a)(10)(A)(ii)(XIV)) to provide full-scope benefits with no share of cost under this chapter and Chapter 8 (commencing with Section 14200) to optional targeted low-income children pursuant to Section 1905(u)(2)(B) of the federal Social Security Act (42 U.S.C. Sec. 1396d(u)(2)(B)), with family incomes up to and including 200 percent of the federal poverty level. The department shall seek federal approval of a state plan amendment to implement this subdivision.SEC. 80.
Section 14005.37 of the Welfare and Institutions Code is amended to read:14005.37.
(a) Except as provided in Section 14005.39, a county shall perform redeterminations of eligibility for Medi-Cal beneficiaries every 12 months and shall promptly redetermine eligibility whenever the county receives information about changes in a beneficiary’s circumstances that may affect eligibility for Medi-Cal benefits. The procedures for redetermining Medi-Cal eligibility described in this section shall apply to all Medi-Cal beneficiaries.(A)
(B)
SEC. 81.
Section 14005.64 of the Welfare and Institutions Code is amended to read:14005.64.
(a) Effective January 1, 2014, and notwithstanding any other law, when determining eligibility for Medi-Cal benefits, an applicant’s or beneficiary’s income and resources shall be determined, counted, and valued in accordance with the requirements of Section 1902(e)(14) of the federal Social Security Act (42 U.S.C. Sec. 1396a(e)(14)), as added by the ACA, which prohibits the use of an assets or resources test for individuals whose income eligibility is determined based on modified adjusted gross income.SEC. 82.
Section 14007.8 of the Welfare and Institutions Code is amended to read:14007.8.
(a) (1) An individual who is 25 years of age or younger, and who does not have satisfactory immigration status or is unable to establish satisfactory immigration status as required by Section 14011.2, shall be eligible for the full scope of Medi-Cal benefits, if they are otherwise eligible for benefits under this chapter.(B)
(C)
SEC. 83.
Section 14007.9 of the Welfare and Institutions Code, as amended by Section 32 of Chapter 5 of the 4th Extraordinary Session of the Statutes of 2009, is amended to read:14007.9.
(a) The department shall adopt the option made available under Section 1902(a)(10)(A)(ii)(XIII) of the federal Social Security Act (42 U.S.C. Sec. 1396a(a)(10)(A)(ii)(XIII)). In order to be eligible for benefits under this section, an individual shall be required to meet all of the following requirements:SEC. 84.
Section 14007.9 of the Welfare and Institutions Code, as amended by Section 91 of Chapter 3 of the Statutes of 2011, is amended to read:14007.9.
(a) (1) The department shall adopt the option made available under Section 1902(a)(10)(A)(ii)(XIII) of the federal Social Security Act (42 U.S.C. Sec. 1396a(a)(10)(A)(ii)(XIII)). In order to be eligible for benefits under this section, an individual shall be required to meet all of the following requirements:SEC. 85.
Section 14011.10 of the Welfare and Institutions Code is amended to read:14011.10.
(a) Except as provided in Sections 14053.7, 14053.8, and 14184.800, benefits provided under this chapter to an individual who is an inmate of a public institution shall be suspended in accordance with Section(e)
(f)
(g)
(h)
(i)
(j)
(k)
(l)
SEC. 86.
Section 14011.66 of the Welfare and Institutions Code is amended to read:14011.66.
(a) Effective January 1, 2014, the department shall provide Medi-Cal benefits during a presumptive eligibility period to individuals who have been determined eligible on the basis of preliminary information by a qualified hospital in accordance with Section 1396a(a)(47)(B) of Title 42 of the United States Code and as set forth in this section.SEC. 87.
Section 14011.7 of the Welfare and Institutions Code is amended to read:14011.7.
(a) To the extent allowed under federal law and only if federal financial participation is available, the department shall exercise the option provided in Section 1396r-1a of Title 42 of the United States Code and(f)The scope and delivery of benefits provided to a child who is preenrolled for the Healthy Families Program pursuant to this section shall be identical to the scope and delivery of benefits received by a child who is preenrolled for the Medi-Cal program pursuant to this section.
(g)
(h)Upon the implementation of this section, this section shall control in the event of a conflict with any provision of Article 6 (commencing with Section 124025) of Chapter 3 of Part 2 of Division 106 of the Health and Safety Code governing the Child Health and Disability Prevention program.
(i)
(j)
(k)Notwithstanding subdivision (g), in no event shall this section be implemented before April 1, 2003.
SEC. 88.
Section 14087.46 of the Welfare and Institutions Code is amended to read:14087.46.
(a) The department shall implement a dental managed care program for Medi-Cal beneficiaries to achieve major cost savings, while ensuring access and quality of care, pursuant to this section.(3)
SEC. 89.
Section 14105.075 of the Welfare and Institutions Code is amended to read:14105.075.
(a) (1) Notwithstanding any other law, for dates of service on or after August 1, 2016, payments to intermediate care facilities for the developmentally disabled that are licensed pursuant to subdivision (e), (g), or (h) of Section 1250 of the Health and Safety Code, and to facilities providing continuous skilled nursing care to developmentally disabled individuals pursuant to the pilot project established by Section 14132.20, as determined by the applicable methodology for setting reimbursement rates for those facilities, shall be the reimbursement rates that were applicable to those facilities in the 2008–09 rate year, increased by 3.7 percent. Payments to the facilities pursuant to this section shall also include the projected cost of complying with new state or federal mandates to the extent applicable to the reimbursement methodology associated with the type of facility.SEC. 90.
Section 14105.192 of the Welfare and Institutions Code is amended to read:14105.192.
(a) The Legislature finds and declares all of the following:SEC. 91.
Section 14105.197 is added to the Welfare and Institutions Code, to read:14105.197.
(a) For dates of service on and after July 1, 2022, or the effective date of any necessary federal approvals as required by subdivision (b), whichever is later, the reimbursement rates or payments for all of the following services and providers may be maintained, using General Fund or other state funds appropriated to the department as the state share, at the payment levels in effect on December 31, 2021, including supplemental payments or rate increases, or both, as applicable, under the California Healthcare, Research and Prevention Tobacco Tax Act of 2016 (Proposition 56, an initiative measure approved at the November 8, 2016, statewide general election) that were implemented with funds from the Healthcare Treatment Fund, as established pursuant to subdivision (a) of Section 30130.55 of the Revenue and Taxation Code:SEC. 92.
Section 14105.2 of the Welfare and Institutions Code is amended to read:14105.2.
(a) The allowable markup payable for the dispensing of medical supplies by assistive device and sickroom supply dealers and pharmacies shall not exceed 23 percent of the estimated acquisition cost of the item dispensed, as defined by the department.SEC. 93.
Section 14105.2 is added to the Welfare and Institutions Code, to read:14105.2.
(a) The allowable markup payable for the dispensing of medical supplies, including diabetic supplies except as indicated in subdivision (b), by assistive device and sickroom supply dealers and pharmacies shall not exceed 23 percent of the estimated acquisition cost of the item dispensed, as defined by the department.SEC. 94.
Section 14105.48 of the Welfare and Institutions Code is amended to read:14105.48.
(a) The department shall establish a list of covered services and maximum allowable reimbursement rates for durable medical equipment, as defined in Section 51160 of Title 22 of the California Code of Regulations, and the list shall be published in provider manuals. The list shall specify utilization controls to be applied to each type of durable medical equipment.SEC. 95.
Section 14124.12 of the Welfare and Institutions Code is amended to read:14124.12.
(a) (1) Notwithstanding any other law, for the duration of the COVID-19 emergency period, the department shall implement any federal Medicaid program waiver or flexibility approved by the federal Centers for Medicare and Medicaid Services related to the COVID-19 public health emergency. This includes, but is not limited to, any waiver or flexibility approved pursuant to Sections 1315, 1320b-5, or 1396n of Title 42 of the United States Code, or the Medi-Cal state plan. Any request for a federal Medicaid program waiver or flexibility shall be subject to Department of Finance approval before the department submits that request to the federal Centers for Medicare and Medicaid Services.(h)
(i)
SEC. 96.
Section 14132.100 of the Welfare and Institutions Code is amended to read:14132.100.
(a) The federally qualified health center services described in Section 1396d(a)(2)(C) of Title 42 of the United States Code are covered benefits.SEC. 97.
Section 14132.57 is added to the Welfare and Institutions Code, to read:14132.57.
(a) (1) The department shall seek all necessary federal approvals to exercise the option described in Section 1396w-6 of Title 42 of the United States Code, to provide qualifying community-based mobile crisis intervention services to eligible Medi-Cal beneficiaries experiencing a mental health or substance use disorder crisis.SEC. 98.
Section 14132.725 of the Welfare and Institutions Code is repealed.(a)To the extent that federal financial participation is available, face-to-face contact between a health care provider and a patient is not required under the Medi-Cal program for health care services provided by asynchronous store and forward, as defined in subdivision (a) of Section 2290.5 of the Business and Professions Code. Services appropriately provided through the store and forward process are subject to billing and reimbursement policies developed by the department.
(b)Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement, interpret, and make specific this section by means
of all-county letters, provider bulletins, and similar instructions.
SEC. 99.
Section 14132.725 is added to the Welfare and Institutions Code, to read:14132.725.
(a) For purposes of this section, the following definitions apply:SEC. 100.
Section 14132.731 of the Welfare and Institutions Code is repealed.(a)A Drug Medi-Cal certified provider shall receive reimbursement for individual counseling services provided through telehealth, as defined in Section 2290.5 of the Business and Professions Code, by a licensed practitioner of the healing arts or a registered or certified alcohol or other drug counselor, when medically necessary and in accordance with the Medicaid state plan.
(b)This section shall be implemented only to the extent federal financial participation is available and only if any necessary federal approvals have been obtained.
(c)The department shall adopt regulations by July 1, 2022, to implement this section in accordance with the Administrative Procedure Act
(Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code).
(d)Notwithstanding the rulemaking provisions of the Administrative Procedure Act, the department may, if it deems it appropriate, implement, interpret, or make specific this section by means of provider bulletins, written guidelines, or similar instructions from the department, until regulations are adopted.
SEC. 101.
Section 14132.731 is added to the Welfare and Institutions Code, to read:14132.731.
(a) A county that enters into a Drug Medi-Cal Treatment Program contract with the department in accordance with Section 14124.20, or the department if entering into a Drug Medi-Cal Treatment Program contract directly with providers or as otherwise described in Section 14124.21, shall reimburse Drug Medi-Cal certified providers for medically necessary Drug Medi-Cal reimbursable services, as defined in Section 14124.24, provided by a licensed practitioner of the healing arts, or a registered or certified alcohol or other drug counselor or other individual authorized by the department to provide Drug Medi-Cal reimbursable services when those services meet the standard of care, meet the requirements of the service code being billed, and are delivered through video synchronous interaction or audio-only synchronous interaction.SEC. 102.
Section 14132.88 of the Welfare and Institutions Code is amended to read:14132.88.
(a) Notwithstanding subdivision (h) of Section 14132 and to the extent funds are made available in the annual Budget Act for this purpose, the following are covered benefits for beneficiaries 21 years of age or older under this chapter:(e)The department shall reduce the rate of subgingival curettage and root planing by 41 percent for all beneficiaries except those residing in a skilled nursing
facility or an intermediate care facility for the developmentally disabled. Notwithstanding Section 14105 and Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement this subdivision by means of a provider bulletin or similar instruction, without taking regulatory action.
SEC. 103.
Section 14132.98 of the Welfare and Institutions Code is amended to read:14132.98.
(a) For a beneficiary diagnosed with cancer and accepted into a phase I, phase II, phase III, or phase IV clinical trial for(c)The treatment shall be provided in a clinical trial that either:
(1)Involves a drug that is exempt under federal regulations from a new drug application.
(2)Is approved by one of the following:
(A)One of the National Institutes of Health.
(B)The federal Food and Drug Administration, in the form of an investigational new drug application.
(C)The United States Department of Defense.
(D)The United States Veterans’ Administration.
SEC. 104.
The heading of Article 4.1 (commencing with Section 14138.1) of Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions Code is amended to read:
Article
4.1. Payment Reform Pilot Program for Federally Qualified Health Centers Federally Qualified Health Center Alternative Payment Model Project
SEC. 105.
Section 14138.1 of the Welfare and Institutions Code is amended to read:14138.1.
For purposes of this article, the following definitions apply:(a)
(b)
(c)
(d)
(e)
(f)
(g)
(h)
(i)
(j)
(k)
(l)“Principal health plan” means an organization or entity that enters into a contract with the department pursuant to Article 2.7 (commencing with Section 14087.3), Article 2.8 (commencing with Section 14087.5), Article 2.81 (commencing with Section 14087.96), Article 2.82 (commencing with Section 14087.98), Article 2.91 (commencing with Section 14089), or Chapter 8 (commencing with Section 14200), to provide or arrange for the care of Medi-Cal beneficiaries
(m)
(n)
(o)
SEC. 106.
Section 14138.10 of the Welfare and Institutions Code is repealed.The Legislature finds and declares all of the following:
(a)The federal Patient Protection and Affordable Care Act has made and continues to make significant progress in driving health care delivery system reforms that emphasize health outcomes, efficiency, patient satisfaction, and value.
(b)California has expanded Medi-Cal to cover more than 12 million residents, roughly one-third of the state’s population. To meet the needs of the state’s growing patient population, California must continue to explore new strategies to expand access to high quality and cost-effective primary care services.
(c)With such a large portion of the state’s population receiving health care services through Medi-Cal, it is imperative that patient-centered innovations drive Medi-Cal reforms.
(d)Health care today is more than a face-to-face visit with a provider, but rather a whole-person approach, often including a physician, a care team of other health care providers, technology inside and outside of a health center, and wellness activities including nutrition and exercise classes, all of which are designed to be more easily incorporated into a patient’s daily life.
(e)Accessible health care in a manner that fits a patient’s needs is important for improving patient satisfaction, building trust, and ultimately improving health outcomes.
(f)In an attempt to invest up front in health care services that can prevent
longer term avoidable high-cost services, the federal Patient Protection and Affordable Care Act made a significant investment in FQHCs.
(g)FQHCs are essential community providers, providing high quality, cost-effective comprehensive primary care services to underserved communities.
(h)Today FQHCs face certain restrictions because the current payment structure reimburses an FQHC only when there is a traditional encounter with a provider. Current law prohibits payment for both a primary care visit and mental health visit on the same day.
(i)A more practical approach financially incentivizes FQHCs to provide the right care at the right time. Restructuring the current visit based, fee-for-service model with a capitated equivalent affords FQHCs the assurance of payment and the flexibility to deliver care in the most
appropriate patient-centered manner.
(j)A reformed payment methodology will enable FQHCs to take advantage of alternative encounters. Alternative encounters, such as group visits, same-day mental health services, and telephone and email consultations, are effective care delivery methods and contribute to a patient’s overall health and well-being.
SEC. 107.
Section 14138.10 is added to the Welfare and Institutions Code, to read:14138.10.
The Legislature finds and declares all of the following:SEC. 108.
Section 14138.11 of the Welfare and Institutions Code is repealed.It is the intent of the Legislature to test an alternative payment methodology for FQHCs, as permitted by federal law, and to design and implement the APM to do all of the following:
(a)Provide patient-centered care delivery options to California’s expansive Medi-Cal population.
(b)Promote cost efficiencies, and improve population health and patient satisfaction.
(c)Improve the capacity of FQHCs to deliver high-quality care to a population growing in numbers and in complexity of needs.
(d)Transition away from a payment system
that rewards volume with a flexible alternative that recognizes the value added when Medi-Cal beneficiaries are able to more easily access the care they need and when providers are able to deliver care in the most appropriate manner to patients.
(e)Track alternative encounters at FQHCs in order to establish a data set from which alternative encounters may be assigned a value that can be used in future ratesetting.
(f)Implement the APM where the FQHC receives at least the same amount of funding it would receive under the current payment system, and in a manner that does not disrupt patient care or threaten FQHC viability.
SEC. 109.
Section 14138.12 of the Welfare and Institutions Code is amended to read:14138.12.
(a) (1) The department shall authorize a payment reform(3)The department shall authorize implementation of an APM pilot project with respect to a county for a period of up to three years.
(6)The APM pilot project for a participating FQHC site in a county shall begin no sooner than the first day of the month following the month in which the department received federal approval of the principal health plan’s specific APM supplemental capitation rates.
SEC. 110.
Section 14138.13 of the Welfare and Institutions Code is amended to read:14138.13.
(a) The department shall notify every FQHC in the state of the APM(1)A Medi-Cal beneficiary who receives services from any FQHC to which the beneficiary is not assigned for primary care services under the APM pilot project by a principal health plan or subcontracting payer.
(2)A person who is a Medi-Cal beneficiary, but who is not a Medi-Cal beneficiary within a designated APM aid category.
(e)A
SEC. 111.
Section 14138.14 of the Welfare and Institutions Code is amended to read:14138.14.
(a) A participating FQHC shall be compensated for the APM scope of services provided to its APM enrollees pursuant to this section.(3)
SEC. 112.
Section 14138.15 of the Welfare and Institutions Code is amended to read:14138.15.
(a) A principal health plan shall be compensated by the department for the APM scope of services provided to its APM enrollees pursuant to this section.SEC. 113.
Section 14138.16 of the Welfare and Institutions Code is amended to read:14138.16.
(a) For the duration of the APM(1)The principal health plan is fully responsible for all costs up to one-half of 1 percent in excess of the APM supplemental capitation amounts.
(2)The principal health plan shall fully retain the revenues paid through the APM supplemental capitation amounts in excess of the costs incurred up to one-half of 1 percent below the APM supplemental capitation amounts.
(3)The principal health plan and the department shall share equally in the responsibility for costs in excess of the APM supplemental capitation amounts that are greater than one-half of 1 percent but less than 1 percent above the APM supplemental capitation amounts.
(4)The principal health plan and the department shall share equally the benefit of the revenues paid through the APM supplemental capitation amounts in excess of the costs incurred that are greater than one-half of 1 percent but less than 1 percent below the APM supplemental capitation amounts.
(5)The department shall be fully responsible for all costs in excess of the APM supplemental capitation amounts that are more than 1 percent above the APM supplemental capitation amounts.
(6)The department shall fully retain the revenues paid through the APM supplemental capitation amounts in excess of the costs incurred greater than 1 percent below the supplemental capitation amounts.
(c)The department shall develop specific contract language to implement the requirements of this section that shall be incorporated into the contracts of each affected principal health plan.
(d)This section shall be implemented only to the extent that any necessary federal approvals or waivers are obtained.
SEC. 114.
Section 14138.17 of the Welfare and Institutions Code is amended to read:14138.17.
(a) In order to ensure participating FQHCs have an incentive to manage visits and costs, while at the same time exercising a reasonable amount of flexibility to deliver care in the most efficient and quality driven manner, for the duration of the APM(i)Multiplied by 1.05 for year one.
(ii)Multiplied by 1.075 for year two.
(iii)Multiplied by 1.1 for year three.
(D)The amount in subparagraph (C) shall be subtracted from the amount in subparagraph (A).
(E)
(2)(A)To incentivize care delivery in ways that may vary from traditional delivery of care, participating FQHCs shall have the flexibility to experience a lower than expected visit utilization of up to 30 percent of projected utilization. If an FQHC site’s actual utilization is at a level that is more than 30 percent lower than the projected utilization, the department shall review, in consultation with the principal health plan, or subcontracting payer, as applicable, the FQHC site’s relevant data to identify the cause or causes of the difference, including, but not limited to, its volume of alternative encounters. If the department is able to determine that all or part of the lower than expected utilization was due to objective factors developed by the department in consultation with the principal health plans and FQHCs that are related to delivery system transformation and enhancements, such as alternative encounters, the department shall allow the participating FQHC site to retain all or a portion of the payments attributable to the utilization decrease that exceeds 30 percent lower than the projected utilization. If the department is unable to determine that all or a portion of the utilization decrease in excess of 30 percent was related to delivery system transformation and enhancements according to the objective criteria developed pursuant to this subparagraph, the participating FQHC site shall be required to refund the applicable payment amount to the principal health plan or subcontracting payer pursuant to subparagraph (B).
(B)The total amount refunded by the participating FQHC site to the principal health plan or subcontracting payer shall be limited to an amount calculated as follows:
(i)The actual total utilization, expressed as traditional encounters, for the applicable year shall be determined.
(ii)The projected total utilization contained in the clinic-specific PMPMs for the actual APM enrollees for the applicable year shall be determined and multiplied by 70 percent.
(iii)The amount in clause (i) shall be subtracted from the amount in clause (ii).
(iv)The amount in clause (iii) shall be multiplied by the participating FQHC site’s per-visit rate that was determined pursuant to Section 14132.100, yielding the maximum amount of the refund to be made by the participating FQHC site. The refund shall be paid in one aggregate payment.
(C)Any adjustment made pursuant to this paragraph shall be requested by a principal health plan, subcontracting payer, or FQHC, no later than 90 days after that determination by the department pursuant to subparagraph (A).
SEC. 115.
Section 14138.18 of the Welfare and Institutions Code is repealed.(a)The department, in consultation with interested FQHCs and principal health plans, may modify any methodology, process, or provision specified in this article to the extent necessary to comply with federal law or to obtain any necessary federal approvals.
(b)This article shall be implemented only to the extent that federal financial participation is available and any necessary federal approvals have been obtained.
(c)In the event of a conflict between a provision in this article and the terms of a federally approved APM, the terms of the federally approved APM shall control.
SEC. 116.
Section 14138.18 is added to the Welfare and Institutions Code, to read:14138.18.
(a) This article shall be implemented only to the extent that any necessary federal approvals have been obtained and federal financial participation is available and not otherwise jeopardized.SEC. 117.
Section 14138.19 of the Welfare and Institutions Code is repealed.In the event of an epidemic, or similar catastrophic occurrence that the department determines is likely to result in at least a 30 percent increase in actual utilization per member per month within the APM scope of services for one or more APM aid categories at a participating FQHC site, the department may adjust, or require the adjustment of, payments made pursuant to this article as it deems necessary to account for the utilization increase at the affected participating FQHC site. The department shall make the determination described in this section upon written request of a participating FQHC site.
SEC. 118.
Section 14138.21 of the Welfare and Institutions Code is repealed.(a)This article shall not be deemed to affect the amounts paid or the reimbursement methodology applicable to FQHCs for dental services that are provided outside the scope of a contract between the department and an applicable principal health plan that is in effect as of July 1, 2015.
(b)The department shall contract with an independent entity to perform an evaluation of the APM pilot project authorized pursuant to this article. To the extent practicable, the evaluation shall be completed and provided to the appropriate fiscal and policy committees of the Legislature within six months of the conclusion of the pilot project in those counties that are included in the initial pilot project implementation authorized pursuant to paragraph (2) of subdivision (a) of
Section 14138.12. The department shall carry out the duty imposed pursuant to this subdivision only if there are sufficient private foundation or nonprofit foundation funds available for this purpose. A report submitted pursuant to this subdivision shall be submitted in compliance with Section 9795 of the Government Code.
(c)The evaluation by the independent entity shall assess and report on whether the APM pilot project produced improvements in access to primary care services, care quality, patient experience, and overall health outcomes for APM enrollees. The evaluation shall include existing FQHC required quality metrics and an assessment of how the changes in financing allowed for alternative types of primary care visits and alternative encounters between the participating FQHC and the patient and how those changes affected volume of same-day visits for mental and physical health conditions. The evaluation shall also assess whether the APM
pilot project’s efforts to improve primary care resulted in changes to patient service utilization patterns, including the reduced utilization of avoidable high-cost services and services provided outside the FQHC. The evaluation shall also identify any administrative and financial implementation issues for FQHCs that may arise if subsequent legislation makes the pilot program operative statewide.
SEC. 119.
Section 14138.21 is added to the Welfare and Institutions Code, to read:14138.21.
This article shall not be deemed to affect the amounts paid or the reimbursement methodology applicable to FQHCs for dental services and for services that are provided outside the scope of a contract between the department and an applicable principal health plan that is in effect as of January 1, 2024, or for any other amounts for which the FQHC may be eligible outside of the prospective payment rate, including, but not limited to, incentives or supplemental payments.SEC. 120.
Section 14138.22 of the Welfare and Institutions Code is repealed.(a)Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement, interpret, or make specific this article by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions, without taking regulatory action.
(b)Beginning January 1, 2017, and notwithstanding Section 10231.5 of the Government Code, the department shall provide a status report to the Legislature regarding any instruction issued by the department pursuant to subdivision (a) on a semiannual basis until six months after implementation of the pilot project authorized pursuant to this article.
(c)It is the intent of the Legislature, if the scope of the pilot project authorized by this article is extended, that the department adopt regulations to implement this article.
SEC. 121.
Section 14138.22 is added to the Welfare and Institutions Code, to read:14138.22.
Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement, interpret, or make specific this article by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions, without taking any further regulatory action.SEC. 122.
Section 14138.23 of the Welfare and Institutions Code is amended to read:14138.23.
For purposes of implementing this article, the department may enter into exclusive or nonexclusive contracts on a bid or negotiated basis,SEC. 123.
Section 14148 of the Welfare and Institutions Code is amended to read:14148.
(a) (1) (A) Except as provided in subparagraph (B), the department shall adopt the federal option provided under Section 4101 of the Omnibus Budget Reconciliation Act of 1987 (Public Law 100-203) to extend eligibility for medical assistance under Medicaid to all pregnantSEC. 124.
Section 14148.8 of the Welfare and Institutions Code is amended to read:14148.8.
(a) (1) The State Department of Health Care Services shall provide Medi-Cal reimbursements to alternative birth centers for facility-related delivery costs at a statewide all-inclusive rate per delivery that shall not exceed 80 percent of the average Medi-Cal reimbursement received by general acute care hospitals with Medi-Cal contracts and shall be based on an average hospital length of stay of 1.7 days. The reimbursement rate shall be updated annually and shall be based on the California Medical Assistance Commission’s annually published legislative report of average contract rates for general acute care hospitals with Medi-Cal contracts. However, the reimbursement shall not exceed the alternative birth center’s charges to any non-Medi-Cal patient for similar services. This paragraph shall apply to Medi-Cal reimbursement for facility-related delivery costs of alternative birth centers until the effective date of any necessary federal approval obtained by the department pursuant to paragraph (2).SEC. 125.
Section 14170.8 of the Welfare and Institutions Code is amended to read:14170.8.
(a) Notwithstanding any other provision of law, every primary supplier of pharmaceuticals, medical equipment, or supplies shall maintain accounting records to demonstrate the manufacture, assembly, purchase, or acquisition and subsequent sale, of any pharmaceuticals, or medical equipment, or supplies to providers, as defined in Section 14043.1. Accounting records shall include, but not be limited to, inventory records, general ledgers, financial statements, purchase and sales journals and invoices, prescription records, bills of lading, and delivery records. For purposes of this section the term “primary suppliers” shall mean any manufacturer, principal labeler, assembler, wholesaler, or retailer.SEC. 126.
Section 14184.201 of the Welfare and Institutions Code is amended to read:14184.201.
(a) Notwithstanding any other law, the department shall standardize those applicable covered Medi-Cal benefits provided by Medi-Cal managed care plans under comprehensive risk contracts with the department on a statewide basis and across all models of Medi-Cal managed care in accordance with this section and the CalAIM Terms and Conditions.(c)
(d)
(e)
(f)
SEC. 127.
Section 14184.206 of the Welfare and Institutions Code is amended to read:14184.206.
(a) Commencing January 1, 2022, and subject to subdivision (f) of Section 14184.102, a Medi-Cal managed care plan may elect to cover those(1)
(2)“In lieu of services” has the same meaning as set forth in paragraph (2) of subsection (e) of Section 438.3 of Title 42 of the Code of Federal Regulations.
SEC. 128.
Section 14184.400 of the Welfare and Institutions Code is amended to read:14184.400.
(a) Commencing January 1, 2022, subject to subdivision (f) of Section 14184.102, the department shall continue to implement the Specialty Mental Health Services Program described in part in Chapter 8.9 (commencing with Section 14700), as a component of CalAIM and in accordance with this article and the CalAIM Terms and Conditions.SEC. 129.
Section 14184.405 of the Welfare and Institutions Code is amended to read:14184.405.
(a) Subject toSEC. 130.
Section 14184.800 of the Welfare and Institutions Code is amended to read:14184.800.
(a) Notwithstanding any other law, commencing no sooner than January 1, 2023, a qualifying inmate of a public institution shall be eligible to receive targeted Medi-Cal services for 90 days, or the number of days approved in the CalAIM Terms and ConditionsSEC. 131.
Section 14186.3 of the Welfare and Institutions Code is amended to read:14186.3.
(a) (1) No sooner than July 1, 2012, Community-Based Adult Services (CBAS) shall be a Medi-Cal benefit covered under every managed care health plan contract and available only through managed care health plans. Medi-Cal beneficiaries who are eligible for CBAS shall enroll in a managed care health plan in order to receive those services, except for beneficiaries exempt under subdivision (c) of Section 14186.2 or in counties or geographic regions where Medi-Cal benefits are not covered through managed care health plans. Notwithstanding subdivision (a) of Section 14186.2 and pursuant to the provisions of an approved federal waiver or plan amendment, the provision of CBAS as a Medi-Cal benefit through a managed care health plan shall not be limited to Coordinated Care Initiative counties.SEC. 132.
Section 14197 of the Welfare and Institutions Code is amended to read:14197.
(a) It is the intent of the Legislature that the department implement and monitor compliance with the time(e)(1)
(2)
(3)
(4)The department may authorize a Medi-Cal managed care plan to use clinically appropriate telecommunications technology as a means of determining annual compliance with the time and distance standards established pursuant to this section or may approve alternative access to care, including telehealth consistent with the requirements of Section 2290.5 of the Business and Professions Code, e-visits, or other evolving and innovative technological solutions that are used to provide care from a distance.
(f)
(g)
(h)
(i)
(j)
(k)
SEC. 133.
Section 14197.04 of the Welfare and Institutions Code is amended to read:14197.04.
(a) (1) A Medi-Cal managed care plan that has received approval from the department to utilize an alternative access standard pursuant to subdivisionSEC. 134.
Section 14197.2 of the Welfare and Institutions Code is amended to read:14197.2.
(a) This section implements the state option inSEC. 135.
Section 15826 of the Welfare and Institutions Code is amended to read:15826.
(a) The department shall administer the program and may do all of the following:SEC. 136.
Section 15832 of the Welfare and Institutions Code is amended to read:15832.
(a) To be eligible to participate in the program, a person shall meet all of the requirements in either paragraph (1) or (2):(b)This section shall become operative on July 1, 2014.
SEC. 137.
Section 15832 is added to the Welfare and Institutions Code, to read:15832.
(a) To be eligible to participate in the program, a person shall meet all of the requirements in either paragraph (1) or (2):SEC. 138.
Section 15840 of the Welfare and Institutions Code is amended to read:15840.
(a) (1) At a minimum, coverage provided pursuant to this chapter shall be provided to subscribers during one pregnancy, and until the end of the month in which the 60th day after pregnancy occurs, and to eligible children less than two years of age who were born of a pregnancy covered under this program or the Access for Infants and Mothers program under former Part 6.3 (commencing with Section 12695) of Division 2 of the Insurance Code to a woman enrolled in the Access for Infants and Mothers program.SEC. 139.
Section 15840 is added to the Welfare and Institutions Code, to read:15840.
(a) (1) At a minimum, coverage provided pursuant to this chapter shall be provided to subscribers during one pregnancy, and until the end of the month in which the 60th day after pregnancy occurs, and to eligible children less than two years of age, or less than five years of age pursuant to Section 15832, who were born of a pregnancy covered under this program or the Access for Infants and Mothers program under former Part 6.3 (commencing with Section 12695) of Division 2 of the Insurance Code to a person enrolled in the Access for Infants and Mothers program.SEC. 140.
Section 15849 is added to the Welfare and Institutions Code, to read:15849.
(a) Effective July 1, 2022, to the extent allowable under federal law, notwithstanding the provisions of this chapter to the contrary, the department may elect not to impose subscriber contributions for purposes of coverage as described in this chapter, including, but not limited to, subscriber contributions for Access-linked infants, for an applicable coverage period.SEC. 141.
Section 15854 of the Welfare and Institutions Code is amended to read:15854.
(a) The department, in consultation with other appropriate parties, shall establish the criteria for evaluating an applicant’s proposal, which shall include, but not be limited to, the following:SEC. 142.
Section 15854.5 is added to the Welfare and Institutions Code, to read:15854.5.
(a) Effective July 1, 2022, to the extent allowable under federal law, and notwithstanding the provisions of this chapter to the contrary, the department may elect not to impose subscriber contributions for purposes of coverage as described in this chapter for an applicable coverage period.SEC. 143.
Section 16501.3 of the Welfare and Institutions Code is amended to read:16501.3.
(a) The State Department of Social Services shall establish and maintain a program of public health nursing in the child welfare services program that meets the federal requirements for the provision of health care to minor and nonminor dependents in foster care consistent with Section 30026.5 of the Government Code. The purpose of the public health nursing program shall be to promote and enhance the physical, mental, dental, and developmental well-being of children in the child welfare system.(f)
(g)
SEC. 144.
Chapter 16.5 (commencing with Section 18998) is added to Part 6 of Division 9 of the Welfare and Institutions Code, to read:CHAPTER 16.5. Community Health Workers
18998.
For purposes of this chapter, the following terms have the following meanings:18998.1.
On or before July 1, 2023, the department shall do all of the following:18998.2.
(a) An organization may seek approval of a community health worker certificate program in accordance with this chapter and any standards approved by the department. In administering an approved community health worker certificate program, the organization shall oversee and enforce the requirements developed pursuant to this chapter.18998.3.
(a) The department, in consultation with stakeholders, may request that an individual who is either enrolled in, or who has completed, a community health worker certificate program submit data consistent with Section 502 of the Business and Professions Code.18998.4.
The department may contract with a vendor or vendors to implement this chapter.18998.5.
Except as provided in Section 18998.3, and notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement, interpret, or make specific this chapter by means of policy letters, provider bulletins, or other similar instructions, without taking regulatory action. The department shall consult with affected stakeholders before acting pursuant to this section.SEC. 145.
The provisions of this measure are severable. If any provision of this measure or its application is held invalid, that invalidity shall not affect other provisions or applications that can be given effect without the invalid provision or application.SEC. 146.
The Legislature finds and declares that Section 16 of this act, which adds Section 123452 to the Health and Safety Code, imposes a limitation on the public’s right of access to the meetings of public bodies or the writings of public officials and agencies within the meaning of Section 3 of Article I of the California Constitution. Pursuant to that constitutional provision, the Legislature makes the following findings to demonstrate the interest protected by this limitation and the need for protecting that interest:SEC. 147.
The Legislature finds and declares that Section 19 of this act, which adds Chapter 2.6 (commencing with Section 127500) to Part 2 of Division 107 of the Health and Safety Code, imposes limitations on the public’s right of access to the meetings of public bodies or the writings of public officials and agencies within the meaning of Section 3 of Article I of the California Constitution. Pursuant to that constitutional provision, the Legislature makes the following findings to demonstrate the interest protected by this limitation and the need for protecting that interest:SEC. 148.
The Legislature finds and declares that Sections 24 and 25 of this act, which amend Section 127696 of the Health and Safety Code, impose a limitation on the public’s right of access to the meetings of public bodies or the writings of public officials and agencies within the meaning of Section 3 of Article I of the California Constitution. Pursuant to that constitutional provision, the Legislature makes the following findings to demonstrate the interest protected by this limitation and the need for protecting that interest:SEC. 149.
No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution for certain costs that may be incurred by a local agency or school district because, in that regard, this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.SEC. 150.
This act is a bill providing for appropriations related to the Budget Bill within the meaning of subdivision (e) of Section 12 of Article IV of the California Constitution, has been identified as related to the budget in the Budget Bill, and shall take effect immediately.It is the intent of the Legislature to enact statutory changes, relating to the Budget Act of 2021.