Bill Text: CA AB582 | 2013-2014 | Regular Session | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Palm Drive Health Care District: certificates of participation: lien.

Spectrum: Partisan Bill (Democrat 3-0)

Status: (Passed) 2014-06-16 - Chaptered by Secretary of State - Chapter 23, Statutes of 2014. [AB582 Detail]

Download: California-2013-AB582-Amended.html

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BILL NUMBER: AB 582	AMENDED
	BILL TEXT

	AMENDED IN SENATE  FEBRUARY 12, 2014
	AMENDED IN SENATE  JULY 2, 2013
	AMENDED IN SENATE  JUNE 13, 2013
	AMENDED IN ASSEMBLY  MAY 24, 2013
	AMENDED IN ASSEMBLY  APRIL 1, 2013

INTRODUCED BY   Assembly  Member   Chesbro
  Members   Levine   and Chesbro 

    (   Principal coauthor:   Senator 
 Evans   ) 

                        FEBRUARY 20, 2013

   An act to  repeal and add Section 14105.485 of the Welfare
and Institutions Code, relating to Medi-Cal.   add
Section 5451.7 to the Government Code, relating to local finance, and
declaring the urgency thereof, to take effect immediately. 


	LEGISLATIVE COUNSEL'S DIGEST


   AB 582, as amended,  Chesbro   Levine  .
 Medi-Cal: complex rehabilitation technology.  
Palm Drive Health Care District: certificates of participation:
lien.  
   The Local Health Care District Law authorizes health care
districts in the state to provide for various forms of financing for
the purpose of carrying out their duties under the law, including
financing secured by public revenues.  
   This bill would require that all obligations of the Palm Drive
Health Care District in connection with specified certificates of
participation be secured by a statutory lien on all of the revenues
generated from certain dedicated parcel taxes, according to specified
criteria.  
   This bill would make legislative findings and declarations as to
the necessity of a special statute for the Palm Drive Health Care
District.  
   This bill would declare that it would take effect immediately as
an urgency statute.  
   Existing law provides for 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.
The Medi-Cal program is, in part, governed and funded by federal
Medicaid Program provisions. Existing law requires the department to
establish a list of covered services and maximum allowable
reimbursement rates for durable medical equipment and requires the
list to be published in provider manuals. Existing law requires a
provider of custom rehabilitation equipment and custom rehabilitation
technology services, as defined, to have a qualified rehabilitation
professional on staff, as prescribed, and requires a medical provider
to conduct a physical examination of an individual before
prescribing a motorized wheelchair or scooter for a Medi-Cal
beneficiary.  
   This bill would, until January 1, 2019, recast these provisions to
apply to complex rehabilitation technology, as defined. The bill
would require that complex rehabilitation technology be recognized as
a separate benefit by the Medi-Cal program in both fee-for-service
and managed care delivery systems. The bill would require complex
rehabilitation technology be subject to a prior authorization
process, as specified, and would authorize the department to adopt
additional utilization controls, as appropriate, and additional
requirements for Medi-Cal coverage, as specified. 
   Vote:  majority  2/3  . Appropriation:
no. Fiscal committee:  yes   no  .
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

   SECTION 1.    Section 5451.7 is added to the 
 Government Code   , to read:  
   5451.7.  (a) All obligations of the Palm Drive Health Care
District in connection with any and all certificates of participation
executed and delivered, or revenue bonds issued, by or on behalf of
the district between August 15, 2005, and December 31, 2014,
including certificates of participation executed and delivered or
revenue bonds issued before 2035 to refund the revenue bonds or
certificates of participation, shall be secured by a statutory lien
on all of the revenues generated from parcel taxes levied pursuant to
Measure W, approved by the voters of the district at the general
election held on November 2, 2004.
   (b) This lien shall arise automatically without the need for any
action or authorization by the district or the board of directors of
the district. The lien shall be valid and binding from the time the
certificates of participation are executed and delivered or the
revenue bonds are issued.
   (c) The parcel tax revenue shall immediately be subject to this
lien, and the lien shall immediately attach to the parcel tax revenue
and be effective, binding, and enforceable against the district, its
successors, purchasers of those revenues, creditors, and all others
asserting rights therein, irrespective of whether those parties have
notice of the lien and without the need for any physical delivery,
recordation, filing, or further act. 
   SEC. 2.    The Legislature finds and declares that a
special law is necessary and that a general law cannot be made
applicable within the meaning of Section 16 of Article IV of the
California Constitution because of the unique circumstances regarding
financing obligations of the Palm Drive Health Care District. 
   SEC. 3.    This act is an urgency statute necessary
for the immediate preservation of the public peace, health, or safety
within the meaning of Article IV of the Constitution and shall go
into immediate effect. The facts constituting the necessity are:
 
   In order to enable the Palm Drive Health Care District to complete
its financing, and meet its obligations to employees, vendors, and
other creditors in a timely manner, it is necessary for this act to
take effect immediately.  
  SECTION 1.   It is the intent of the Legislature
to do all of the following:
   (a) Provide the support necessary for patients with complex
rehabilitation technology needs to stay in their homes or community
settings, prevent avoidable institutionalization, and reduce
secondary medical complications.
   (b) Ensure adequate access to appropriate complex rehabilitation
technology and support services for complex needs patients.
   (c) Recognize the value of preventive and specialized services in
the treatment of complex needs patients.
   (d) Acknowledge the importance of the hands-on professional
resources required for effective evaluation and configuration of
complex rehabilitation technology.
   (e) Establish or improve safeguards related to the delivery of
complex rehabilitation technology.
   (f) Ensure cost efficiency in the provision of complex
rehabilitation technology.  
  SEC. 2.    Section 14105.485 of the Welfare and
Institutions Code is repealed.  
  SEC. 3.    Section 14105.485 is added to the
Welfare and Institutions Code, to read:
   14105.485.  (a) For purposes of this section, the following
definitions apply:
   (1) "Complex rehabilitation technology" means any item, piece of
equipment, or product system, whether modified or customized, that is
used to increase, maintain, or improve functional capabilities with
respect to mobility and reduce anatomical degradation and
complications of individuals with disabilities. Complex
rehabilitation technology includes, but is not limited to,
nonstandard manual wheelchairs, power wheelchairs, seating systems
that are specially configured, ordered, and measured based on patient
height, weight, and disability, specialized wheelchair electronics
and cushions, custom bath equipment, standers, gait trainers, and
specialized strollers.
   (2) "Complex rehabilitation technology services" includes the
application of enabling systems designed and assembled to meet the
needs of a patient experiencing any permanent or long-term loss or
abnormality of physical or anatomical structure or function with
respect to mobility. These services include, but are not limited to,
the evaluation of the needs of a patient with a disability, including
an assessment of the patient for the purpose of ensuring that the
proposed equipment is appropriate; the documentation of medical
necessity; the selection, fit, customization, maintenance, assembly,
repair, replacement, pick up and delivery, and testing of equipment
and parts; and the training of an assistant caregiver and of the
patient who will use the technology or individuals who will assist
the complex needs patient in using the technology.
   (3) "Complex rehabilitation technology provider" means a company
or entity that complies with all of the following:
   (A) Meets the supplier and quality standards established for a
durable medical equipment supplier under the Medicare Program and is
enrolled as a provider in the Medi-Cal program.
   (B) Is accredited by a recognized accrediting organization as a
supplier of complex rehabilitation technology.
   (C) Employs or contracts with at least one qualified
rehabilitation technology professional for each distribution
location.
   (D) Has the qualified rehabilitation technology professional
physically present for the evaluation and determination of the
complex rehabilitation technology provided.
   (E) Maintains a reasonable supply of parts, adequate physical
facilities, and qualified service or repair technicians, and provides
patients with prompt services and repair for all complex
rehabilitation technology supplied.
   (4) "Qualified rehabilitation technology professional" means an
individual to whom either one of the following applies:
   (A) The individual is a registered member in good standing of the
National Registry of Rehabilitation Technology Suppliers (NRRTS), and
holds the designation of Certified Complex Rehabilitation Technology
Specialist.
   (B) The individual has successfully passed the credentialing
examination and received the credential of Assistive Technology
Professional (ATP) from the Rehabilitation Engineering and Assistive
Technology Society of North America (RESNA), or other credentialing
organization recognized by the department.
   (b) Complex rehabilitation technology shall be recognized as a
separate benefit by the Medi-Cal program in both fee-for-service and
managed care delivery systems.
   (c) Any provider of complex rehabilitation technology to a
Medi-Cal beneficiary shall have on staff, either as an employee or
independent contractor, or have a contractual relationship with, a
qualified rehabilitation technology professional who is directly
involved in determining the specific complex rehabilitation
technology needs of the patient and is directly involved with, or
closely supervised in, the final fitting and delivery of the complex
rehabilitation technology.
    (d) A medical provider shall conduct a physical examination of a
patient who is a Medi-Cal beneficiary before prescribing complex
rehabilitation technology. The medical provider shall complete a
certificate of medical necessity, developed by the department, that
documents the medical condition that necessitates the technology and
verifies that the patient is capable of using the technology safely.
   (e) The department may adopt additional requirements for Medi-Cal
coverage, including a speciality evaluation by a physical therapist
licensed pursuant to Chapter 5.7 (commencing with Section 2600) of
Division 2 of the Business and Professions Code, an occupational
therapist licensed pursuant to Chapter 5.6 (commencing with Section
2570) of Division 2 of the Business and Professions Code, or other
licensed health care professional approved by the department. The
licensed health professional performing the specialty evaluation may
not have a financial relationship with the complex rehabilitation
technology provider.
   (f) Notwithstanding Section 14133.05, complex rehabilitation
technology shall be subject to a prior authorization process in which
services are approved based on the medical, physical, and functional
needs of the patient, as demonstrated in documents prescribed by the
department. Prior authorization may be obtained through the
treatment authorization request process set forth in Section 51321 of
Title 22 of the California Code of Regulations. The department may
adopt additional utilization controls for complex rehabilitation
technology, as appropriate.
   (g) Contracts initiated by the department with managed care plans
shall be consistent with the requirements of this section.
   (h) This section shall remain in effect only until January 1,
2019, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2019, deletes or extends
that date.  
  SEC. 4.    Section 14105.485 is added to the
Welfare and Institutions Code, to read:
   14105.485.  (a) Any provider of custom rehabilitation equipment
and custom rehabilitation technology services to a Medi-Cal
beneficiary shall have on staff, either as an employee or independent
contractor, or have a contractual relationship with, a qualified
rehabilitation professional who was directly involved in determining
the specific custom rehabilitation equipment needs of the patient and
was directly involved with, or closely supervised, the final fitting
and delivery of the custom rehabilitation equipment.
   (b) A medical provider shall conduct a physical examination of an
individual before prescribing a motorized wheelchair or scooter for a
Medi-Cal beneficiary. The medical provider shall complete a
certificate of medical necessity, developed by the department, that
documents the medical condition that necessitates the motorized
wheelchair or scooter, and verifies that the patient is capable of
using the wheelchair or scooter safely.
   (c) For purposes of this section, the following definitions apply:

   (1) "Custom rehabilitation equipment" means any item, piece of
equipment, or product system, whether modified or customized, that is
used to increase, maintain, or improve functional capabilities with
respect to mobility and reduce anatomical degradation and
complications of individuals with disabilities. Custom rehabilitation
equipment includes, but is not limited to, nonstandard manual
wheelchairs, power wheelchairs and seating systems, power scooters
that are specially configured, ordered, and measured based on patient
height, weight, and disability, specialized wheelchair electronics
and cushions, custom bath equipment, standers, gait trainers, and
specialized strollers.
   (2) "Custom rehabilitation technology services" means the
application of enabling technology systems designed and assembled to
meet the needs of a specific person experiencing any permanent or
long-term loss or abnormality of physical or anatomical structure or
function with respect to mobility. These services include, but are
not limited to, the evaluation of the needs of a patient with a
disability, including an assessment of the patient for the purpose of
ensuring that the proposed equipment is appropriate, the
documentation of medical necessity, the selection, fit,
customization, maintenance, assembly, repair, replacement, pick up
and delivery, and testing of equipment and parts, and the training of
an assistant caregiver and of a patient who will use the equipment
or individuals who will assist the client in using the equipment.
   (3) "Qualified rehabilitation professional" means an individual to
whom any one of the following applies:
   (A) The individual is a physical therapist licensed pursuant to
the Business and Professions Code, occupational therapist licensed
pursuant to the Business and Professions Code, or other qualified
health care professional approved by the department.
   (B) The individual is a registered member in good standing of the
National Registry of Rehabilitation Technology Suppliers, or other
credentialing organization recognized by the department.
   (C) The individual has successfully passed one of the following
credentialing examinations administered by the Rehabilitation
Engineering and Assistive Technology Society of North America:
   (i) The Assistive Technology Supplier examination.
   (ii) The Assistive Technology Practitioner examination.
   (iii) The Rehabilitation Engineering Technologist examination.
   (d) This section shall become operative on January 1, 2019.