Bill Text: CA AB2299 | 2017-2018 | Regular Session | Amended
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Medi-Cal: managed care plans: informational materials.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Vetoed) 2018-09-19 - Vetoed by Governor. [AB2299 Detail]
Download: California-2017-AB2299-Amended.html
Bill Title: Medi-Cal: managed care plans: informational materials.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Vetoed) 2018-09-19 - Vetoed by Governor. [AB2299 Detail]
Download: California-2017-AB2299-Amended.html
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Amended
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Assembly
May 21, 2018 |
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Amended
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April 23, 2018 |
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Amended
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April 10, 2018 |
CALIFORNIA LEGISLATURE—
2017–2018 REGULAR SESSION
| Assembly Bill | No. 2299 |
| Introduced by Assembly Member Chu |
February 13, 2018 |
An act to add Section 14029.93 to the Welfare and Institutions Code, relating to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
AB 2299, as amended, Chu.
Medi-Cal: managed care plans: informational materials.
Existing law establishes the Medi-Cal program, administered by the State Department of Health Care Services, under which health care services are provided to qualified, low-income persons. The Medi-Cal program is, in part, governed and funded by federal Medicaid Program provisions. Existing law requires the department to notify Medi-Cal beneficiaries, prospective beneficiaries, and members of the public about the program, including the availability of language assistance services and the availability of the grievance procedure.
This bill would require the department to ensure that all written health education and informing materials, as defined, in English and those translated into threshold languages by managed care plans are at or below the equivalent of 6th grade reading level. The bill would require the department to require managed care
plans or other contractors to conduct conduct, by January 1, 2020, a one-time, targeted community review of health education and informing materials in English and each threshold language, in order for members to ensure the cultural and linguistic appropriateness of materials in community-based settings. The bill would require the managed care plans to adopt additional readability and suitability standards developed by the community-review process by July 1, 2020. The bill would require managed care plans to report the findings of the community review process, and would require the department to publish those findings and develop recommendations for additional readability and suitability standards based on the
findings. The bill would include a statement of legislative findings and declarations.
Digest Key
Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NOBill Text
The people of the State of California do enact as follows:
SECTION 1.
The Legislature finds and declares all of the following:(a) Low health literacy and low reading literacy are barriers to meaningful access and equal opportunity to fully participate in one’s health care services.
(b) A significant number of Medi-Cal managed care plan members speak a language other than English as their primary language. In comparison to their English-speaking counterparts, limited-English-proficient (LEP) individuals are more likely to have low literacy levels or low health literacy, which leads to lower quality health care and poorer health care outcomes.
(c) Informing materials provide essential information to members regarding their health care rights, plan benefits, and access to services. Using plain and simple language will increase the readability of materials, improving access for members with varying health literacy levels.
(d) By applying reading level, readability, and suitability requirements to informing materials, the State Department of Health Care Services can empower and help safeguard the health care rights of its most vulnerable members.
(e) The individuals for whom plan documents are designed are best equipped to assess the cultural and linguistic suitability of the materials. Targeted community review is the most effective process to engage these
consumers of particular cultural and linguistic groups.
SEC. 2.
Section 14029.93 is added to the Welfare and Institutions Code, to read:14029.93.
(a) The department shall ensure that all written health education and informing materials developed by managed care plans are at or below the equivalent of sixth grade reading level in English.(1) Written health education in English shall meet the readability and suitability checklists established by the department by means of all-county letters, plan letters, including All Plan Letter 11-018, plan or provider bulletins, or similar instructions.
(2) Written informing materials in English shall meet the readability and suitability checklists established through the department’s contracts with
managed care plans.
(3) Managed care plans shall adopt any additional readability and suitability standards developed by the community review process described in subdivision (c) and recommended by the department in subdivision (d).
(b) The department shall ensure that all written health education and informing materials translated into threshold languages by managed care plans are at or below the equivalent of sixth grade reading level.
(1) For each threshold language for which an equivalent sixth grade reading level cannot be determined, the department shall require managed care plans to establish a process for Medi-Cal beneficiaries, advocates, and stakeholders to review existing and new materials through a
one-time community review described in subdivision (c), with sufficient time to provide meaningful feedback. This review shall be completed by January 1, 2020.
(2) Plans shall adopt any additional readability and suitability standards developed by the community review process described in subdivision (c) and recommended by the department pursuant to subdivision (d). (e) by July 1, 2020.
(c) The department shall require managed care plans or other contractors to conduct a one-time, targeted community review of health
education and informing materials in English and each threshold language, in order for members to ensure the cultural and linguistic appropriateness of materials in community-based settings. The managed care plans or other contractors shall structure the community review process, as follows:
(1) When determining who shall participate in the community review process, the managed care plans or other contractors shall do all of the following:
(A) Provide background information on plan members, including the ratio of threshold language speakers, and a summary of the plan’s current community review process.
(B) Include current Medi-Cal beneficiaries and community-based organizations that work directly with Medi-Cal beneficiaries
to identify and recruit beneficiaries with varying levels of literacy.
(C) Identify and include native speakers of a specific threshold language to review translated materials in their threshold language. The use of software shall not be used in lieu of a native speaker to evaluate consumer-facing materials.
(2) Outreach methods for participants in the community review process shall include, but not be limited to, e-mail, email, mail, and telephone calls.
(3) When conducting the community review process, the managed care plans or other contractors shall
do all of the following:
(A) Incorporate both quantitative and qualitative approaches, including focus groups and surveys with a minimum of four participants.
(B) Allow 60 days for participants to provide feedback.
(C) Have a native speaker of the threshold language assess, conduct, and evaluate the community review process and provide feedback.
(D) Allow community feedback in both written and oral formats.
(4) Managed care plans or other contractors shall conduct a targeted community review when new informing materials are created.
(5) Managed care plans may aggregate community reviews by threshold language, and need not conduct separate reviews for each county served.
(d) (1) Health education materials produced by a third-party vendor, which have been field tested by a minimum of four native speakers and meet the additional readability and suitability standards developed pursuant to paragraph (2) of subdivision (a), shall be exempt from the community review requirements set forth under subdivision (c).
(2) Health education and informing materials produced by the managed care plan prior to January 1, 2019, which
are field tested by a minimum of four native speakers and meet the additional readability and suitability standards developed pursuant to paragraph (2) of subdivision (b), are exempt from the one-time community review described in subdivision (c). Any material that fails to meet subsequently adopted readability and suitability standards shall be updated accordingly and reviewed pursuant to subdivision (c).
(d)
(e) The managed care plans shall report the findings of the community review process described in subdivision (c). The department shall publish the findings of the community reviews and develop
recommendations for additional readability and suitability standards based on the findings.
(e)
(f) The following definitions apply for purposes of this section:
(1) “Field tested” means a review by a minimum of four native speakers that is conducted by either a third-party vendor, managed care plan, or agent. “Field tested” is distinguished from the community review process described in subdivision (c).
(1)
(2) (A) “Health education materials” means documents that are designed to assist members to modify personal health behaviors, achieve and maintain healthy lifestyles, and promote positive health outcomes, including updates on current health conditions, self-care, and management of health conditions, as detailed in the department’s All Plan Letter 11-018, or subsequently published letters, bulletins, or similar instructions.
(B) Health education materials include, but are not limited to, topics about preventive care, health promotion, screenings, disease management, healthy living, and health communications.
(2)
(3) (A) “Informing materials” means vital documents that provide members with essential information about access to and
usage of plan services, as detailed in the department’s All Plan Letter 11-018, or subsequently published letters, bulletins, or similar instructions.
(B) Informing materials include, but are not limited to, all of the following:
(i) Enrollment and disenrollment forms and information.
(ii) Evidence of coverage (EOC) booklets.
(iii) Facility directories.
(iv) Form letters.
(v) Information regarding members’ rights and grievance procedures.
(vi) Insurance plan
documents.
(vii) New member welcome packets.
(viii) Notices of action.
(3)
(4) “Plans” refers to managed care plans.
(f)
(g) This section does not apply to statements
that are specifically required by law to be included in written materials.
