Bill Text: CA AB2535 | 2019-2020 | Regular Session | Introduced


Bill Title: Denti-Cal provider pilot program.

Spectrum: Partisan Bill (Republican 2-0)

Status: (Introduced - Dead) 2020-03-17 - In committee: Hearing postponed by committee. [AB2535 Detail]

Download: California-2019-AB2535-Introduced.html


CALIFORNIA LEGISLATURE— 2019–2020 REGULAR SESSION

Assembly Bill
No. 2535


Introduced by Assembly Members Mathis and Lackey

February 19, 2020


An act to add and repeal Section 14132.916 of the Welfare and Institutions Code, relating to Medi-Cal.


LEGISLATIVE COUNSEL'S DIGEST


AB 2535, as introduced, Mathis. Denti-Cal provider pilot program.
Under existing law, the Lanterman Developmental Disabilities Services Act, the State Department of Developmental Services is responsible for providing various services and supports to individuals with developmental disabilities, and for ensuring the appropriateness and quality of those services and supports. Under existing law, the department contracts with regional centers to provide services and supports to persons with developmental disabilities.
Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services, including dental services that are provided under a fee-for-service system, which is referred to as Denti-Cal program, and managed care in the Counties of Los Angeles and Sacramento. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law establishes various pilots and programs, including the Caries Risk Assessment and Disease Management Pilot, a dental integration pilot program in County of San Mateo, and a dental outreach and education program, which address dental services provided under the Medi-Cal program.
This bill would require the department to establish and administer a 5-year pilot program to educate and train Denti-Cal providers on how to effectively serve Medi-Cal beneficiaries with intellectual or developmental disabilities who are regional center consumers, to contract with an independent evaluator, and to utilize an expert to perform specified duties, including advising on the design of the pilot program. The bill would require a Denti-Cal provider who participates in the pilot program to complete continuing education hours and clinical hours working with Medi-Cal beneficiaries who are regional center consumers, and would require the department to determine the number of continuing education and clinical hours, in collaboration with the Dental Board of California and the Dental Hygiene Board of California within the Department of Consumer Affairs. The bill would require the department to establish a supplemental provider payment under the Denti-Cal program for any dental provider who renders dental services to regional center consumers and has completed the continuing education and clinical hours, and to issue, no later than one year after the initial funding of the pilot program, a report to the Legislature on the evaluation of the pilot program. The bill would repeal those provisions on January 1, 2027.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

The people of the State of California do enact as follows:


SECTION 1.

 Section 14132.916 is added to the Welfare and Institutions Code, immediately following Section 14132.915, to read:

14132.916.
 (a) (1) Upon appropriation by the Legislature for this purpose, the department shall establish and administer a comprehensive five-year pilot program, to educate and train Denti-Cal providers on how to effectively serve Medi-Cal beneficiaries with intellectual or developmental disabilities who are regional center consumers. The pilot program shall include an evaluation component to determine whether the pilot program increases the number of Denti-Cal providers who are willing and able to serve those consumers on a statewide basis.
(2) (A) The department shall contract with an independent evaluator, at the beginning of the pilot program, to ensure that the pilot program includes components that appropriately measure its success.
(B) The department shall utilize an expert with experience in the subject matter of the pilot program to do both of the following:
(i) Advise on the design of the pilot program and evaluation.
(ii) Conduct an evaluation of the pilot program.
(b) A Denti-Cal provider who participates in the pilot program shall complete continuing education hours and perform clinical hours working with Medi-Cal beneficiaries who are regional center consumers, and, upon completing those hours, they shall qualify for the payment described in subdivision (c). The department shall determine, in collaboration with the Dental Board of California and the Dental Hygiene Board of California within the Department of Consumer Affairs, the number of continuing education and clinical hours specified in this subdivision.
(c) The department shall establish a supplemental provider payment under the Denti-Cal program for any dental provider who renders dental services to Medi-Cal beneficiaries who are regional center consumers and has completed the requisite continuing education and clinical hours.
(d) The department shall issue a report to the Legislature, in compliance with Section 9795 of the Government Code, on the evaluation of the pilot program. This report shall be completed no later than one year after the initial funding of the pilot program.
(e) This section shall remain in effect only until January 1, 2027, and as of that date is repealed.

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