Bill Text: CA AB78 | 2019-2020 | Regular Session | Amended
Bill Title: Bergeson-Peace Infrastructure and Economic Development Bank.
Spectrum: Committee Bill
Status: (Passed) 2020-06-29 - Chaptered by Secretary of State - Chapter 10, Statutes of 2020. [AB78 Detail]
Download: California-2019-AB78-Amended.html
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Amended
IN
Senate
June 22, 2020 |
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Amended
IN
Senate
June 18, 2019 |
| Introduced by Committee on Budget (Assembly Members Ting (Chair), Arambula, Bloom, Chiu, Cooper, Frazier, Cristina Garcia, Jones-Sawyer, Limón, McCarty, Medina, Mullin, Muratsuchi, Nazarian, O’Donnell, Ramos, Reyes, Luz Rivas, Blanca Rubio, Mark Stone, Weber, Wicks, and Wood) |
December 03, 2018 |
LEGISLATIVE COUNSEL'S DIGEST
(1)Existing law requires the State Department of Public Health to approve or deny an application submitted by a general acute care hospital or an acute psychiatric hospital to the department’s centralized applications unit within specified deadlines and further requires the department to develop a centralized applications advice program and an automated application system. Existing law provides that the resources necessary to implement these requirements be made available, upon appropriation by the Legislature, from the Internal Departmental Quality Improvement Account.
This bill would delete the provision specifying that the resources necessary to implement these requirements be made available, upon appropriation by the Legislature, from
the Internal Departmental Quality Improvement Account.
(2)Existing law establishes the Office of AIDS in the State Department of Public Health as the lead agency within the state responsible for coordinating state programs, services, and activities relating to the human immunodeficiency virus (HIV), acquired immune deficiency syndrome (AIDS), and AIDS related conditions (ARC), including the CARE Services Program and the AIDS Drug Assistance Program (ADAP). Existing law, to the extent that state and federal funds are appropriated in the annual Budget Act for these purposes, authorizes the Director of Public Health to administer the ADAP to provide drug treatments to persons infected with HIV and AIDS, and to establish uniform standards of financial eligibility for the drugs under the program, in accordance with applicable federal law.
This bill would rename the CARE Services
Program the HIV Care Program. The bill would, commencing April 1, 2020, require the State Department of Public Health to apply the same financial eligibility requirements for the purposes of administering the HIV Care Program as those set forth for the ADAP.
(3)Existing law, the Childhood Lead Poisoning Prevention Act of 1991, requires the State Department of Public Health to adopt regulations establishing a standard of care at least as stringent as the most recent federal Centers for Disease Control and Prevention screening guidelines, whereby all children are evaluated for risk of lead poisoning by health care providers during each child’s periodic health assessment. Existing law requires a laboratory that performs a blood lead analysis on a specimen of human blood drawn in California to report specified information to the State Department of Public Health for each analysis on every person tested. Existing law requires
that all information reported be confidential, except that the department is authorized to share the information for the purpose of surveillance, case management, investigation, environmental assessment, environmental remediation, or abatement with the local health department, environmental health agency, or building department, so long as the entity receiving the information otherwise maintains the confidentiality of the information, as specified.
This bill would allow the State Department of Public Health to also share the information with the State Department of Health Care Services for the purpose of determining whether children enrolled in Medi-Cal are being screened for lead poisoning and receiving appropriate related services. The bill would allow the State Department of Health Care Services to further disclose this information to a managed health care plan in which the beneficiary who is the subject of the information is enrolled, who
the bill would also allow to share the information with the beneficiary’s health care provider.
(4)Existing law establishes the patients’ personal deposit fund at each institution under the jurisdiction of the State Department of State Hospitals for the deposit of patient funds. Whenever the sum in the fund belonging to any one patient exceeds $500, existing law allows the excess to be applied to the payment of care, support, maintenance, and medical attention of the patient.
This bill would prohibit a patient of an institution under the jurisdiction of the State Department of State Hospitals who participates in a sheltered workshop or vocational rehabilitation program from being required to return or remit their earnings to the institution for these purposes.
(5)Existing
law, the Alfred E. Alquist Hospital Facilities Seismic Safety Act of 1983, establishes a program of seismic safety building standards for certain hospitals. Existing law requires all hospitals with buildings subject to a seismic compliance deadline of January 1, 2020, and that are seeking an extension for their buildings to submit an application to the Office of Statewide Health Planning and Development by April 1, 2019, that specifies the seismic compliance method each building will use.
This bill would instead make the application due by September 1, 2019, for Providence Tarzana Medical Center in the City of Los Angeles and UCSF Benioff Children’s Hospital in the City of Oakland.
(6)Existing law requires a hospital granted an extension to provide a quarterly status report to the office, with the first report due on July 1, 2019, until seismic compliance is achieved.
This bill would instead make the first report due on October 1, 2019, for the above-described 2 facilities if they are granted an extension based on an application submitted on or after April 1, 2019.
This bill would make legislative findings and declarations as to the necessity of a special statute for those 2 facilities.
(7)Existing law establishes the Medi-Cal program, administered by the State Department of Health Care Services and 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, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care, and makes a willful violation
of the act a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law establishes the California Health Benefit Exchange (Exchange), also known as Covered California. Existing law specifies the powers and duties of the board governing the Exchange, and requires the board to facilitate the purchase of qualified health plans by qualified individuals and qualified small employers. Existing law establishes the California Health Trust Fund and continuously appropriates moneys in the fund for these purposes.
Existing federal law, the Patient Protection and Affordable Care Act (PPACA), enacts various health care coverage market reforms as of January 1, 2014. PPACA generally requires an individual, and any dependents of the individual, to maintain minimum essential coverage, as defined, and, if an individual fails to maintain minimum essential coverage, PPACA imposes on the individual taxpayer a penalty. This provision
is referred to as the individual mandate.
This bill would create the Minimum Essential Coverage Individual Mandate to require an individual who is a California resident to ensure that the individual, and any spouse or dependent of the individual, is enrolled in and maintains minimum essential coverage for each month beginning on and after January 1, 2020, except as specified. The bill would require the Exchange to grant exemptions from the mandate for reason of hardship or religious conscience, and would require the Exchange to establish a process for determining eligibility for an exemption. The bill would impose the Individual Shared Responsibility Penalty for the failure to maintain minimum essential coverage, as determined and collected by the Franchise Tax Board, in collaboration with the Exchange, as specified. The bill would require the Franchise Tax Board to provide specified information to the Exchange regarding individuals who do not maintain minimum
essential coverage, and would require the Exchange to conduct annual outreach and enrollment efforts with those individuals. The bill would require an applicable entity, as defined, that provides minimum essential coverage to an individual to file specified returns to the Franchise Tax Board regarding that coverage, as prescribed.
Until January 1, 2023, the bill would create Individual Market Assistance, which would be authorized to provide health care coverage financial assistance to California residents with household incomes at or below 600% of the federal poverty level, including advanced premium assistance subsidies. The bill would authorize a health care service plan or health insurer to cancel a contract or policy for nonpayment after a 3-month grace period if the individual receives that advanced premium assistance subsidy or advance payments of the federal premium tax credit, but would require a plan or insurer to provide health care coverage for the first
month of the grace period and to return the subsidy and tax credit for the 2nd and 3rd months of the grace period if the outstanding premiums are not paid. Because a willful violation of the bill’s requirements relative to health care service plans would be a crime, the bill would impose a state-mandated local program. The bill would also expand the purposes of the California Health Trust Fund to include the Exchange’s operational costs of the Minimum Essential Coverage Individual Mandate and Individual Market Assistance. By expanding the purposes of a continuously appropriated fund, the bill would make an appropriation.
(8)Existing law provides for a schedule of benefits under the Medi-Cal program, which includes specified outpatient services, including, among others, chiropractic services and audiology services, subject to utilization controls. Notwithstanding this provision, existing law excludes certain optional Medi-Cal benefits,
including, among others, audiology services and speech therapy services, podiatric services, psychology services, and incontinence creams and washes, from coverage under the Medi-Cal program, except for specified beneficiaries. Existing law provides for the restoration of optometric and optician services, as described.
This bill would require the coverage of optometric and optician services to be suspended on December 31, 2021, unless specified circumstances apply. This bill would restore coverage of optional benefits for audiology services and speech therapy services, podiatric services, psychology services, and incontinence creams and washes no sooner than January 1, 2020, and would require these services to be suspended on December 31, 2021, unless specified circumstances apply.
(9)Existing law creates the California Health and Human Services Agency for
the implementation and oversight of human services and health care programs.
This bill would, within the California Health and Human Services Agency, establish the Office of the Surgeon General to raise public awareness, coordinate policies, and advise policymakers on topics of health, including toxic stress and adverse childhood events. The bill would establish the Surgeon General as the director of the office, to be appointed by the Governor with the confirmation of the Senate for appointments after July 1, 2019.
(10)Existing law establishes the Office of AIDS in the State Department of Public Health. That office, among other functions, provides funding for AIDS prevention and education.
This bill would authorize the department, contingent upon a specific appropriation in the annual Budget Act, to award grant
funding to specified entities on a competitive basis to provide comprehensive HIV prevention and control activities, as described.
(11)Existing law established a 3-year demonstration pilot project for the 2015–16 to 2018–19 fiscal years, inclusive, that required the State Department of Public Health to award funding, on a competitive basis, for innovative, evidence-based approaches to provide outreach, hepatitis C screening, and linkage to and retention in quality health care for the most vulnerable and underserved individuals living with, or at high risk for, hepatitis C viral infection (HCV).
This bill would, contingent upon a specific appropriation in the annual Budget Act, require the department to allocate funds to local health jurisdictions to provide HCV activities, including monitoring, prevention, testing, and linkage to and retention in care activities for the most vulnerable and underserved
individuals living with, or at high risk for, HCV.
(12)Existing law requires the State Department of Public Health to develop and review plans and participate in a program for the prevention and control of venereal disease.
This bill would also require the department, contingent upon a specific appropriation in the annual Budget Act, to allocate grants to local health jurisdictions for sexually transmitted disease control and prevention activities, as prescribed.
This bill would suspend the above programs as of December 31, 2021, unless projected General Fund revenues exceed the projected annual General Fund expenditures in the 2021–22 and 2022–23 fiscal years by a specified amount.
(13)Existing law authorizes the State Department of Public Health to establish, maintain, and subsidize clinics,
dispensaries, and prophylactic stations for the diagnosis, treatment, and prevention of venereal disease, and authorizes the department to provide medical, advisory, financial, or other assistance to those clinics, dispensaries, and stations, as may be approved by the department.
The bill would delete this authority to establish, maintain, and subsidize clinics, dispensaries, and prophylactic stations and, instead, would authorize the department to provide medical, advisory, financial, or other assistance to organizations, funded by the sexually transmitted disease control and prevention program.
(14)Existing federal law, the PPACA, established annual limits on deductibles and defining bronze, silver, gold, and platinum levels of coverage for the nongrandfathered individual and small group markets.
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, which provides for the licensure and regulation of health care service plans by the Department of Managed Health Care, and makes a willful violation of the act a crime, and similar provisions of the Insurance Code, which provide for the regulation of health insurers by the Department of Insurance, prohibit the actuarial value for a nongrandfathered individual or small employer health plan or health insurance policy from varying by more than plus or minus 2%.
This bill would instead authorize the actuarial value for a nongrandfathered bronze level high deductible health plan or health insurance policy to range from plus 4% to minus 2%. Because a willful violation of the bill’s requirements relative to health care service plans would be a crime, the bill would impose a state-mandated local program.
(15)Existing law vests the State Department of State Hospitals with jurisdiction over state hospitals, and defines state hospital to include, among others, the Atascadero State Hospital, Napa State Hospital, and county jail treatment facilities under contract with the department to provide competency restoration services.
Existing law establishes a workers’ compensation system, administered by the Administrative Director of the Division of Workers’ Compensation, that generally requires employers to secure the payment of workers’ compensation for injuries incurred by their employees that arise out of, or in the course of, employment. Existing law provides that each inmate of a state penal or correctional institution is entitled to workers’ compensation benefits for injury arising out of, and in the course of, assigned employment, and for the death of the inmate if the injury proximately causes the death.
Existing law provides counsel to an inmate under the workers’ compensation system for an appeal and generally provides that an employee who is an inmate, or their family on behalf of that inmate, is not entitled to compensation for psychiatric injury, except with respect to an injury sustained prior to incarceration. With respect to temporary disability payments, existing law requires the deposit of those payments into the Uninsured Employers Benefits Trust Fund, a continuously appropriated fund, for the payment of nonadministrative expenses of the workers’ compensation program, if the inmate has no dependents.
This bill would similarly provide that each patient in a State Department of State Hospitals facility is entitled to workers’ compensation benefits for injury arising out of, and in the course of, a vocational rehabilitation work assignment, and for the death of the patient if the injury proximately causes the death. The bill would provide counsel to a
patient under the workers’ compensation system for an appeal and provide that an employee who is a patient committed to a state hospital facility under the State Department of State Hospitals, or their family on behalf of the patient, is not entitled to compensation for psychiatric injury while working in a vocational rehabilitation program, except as specified with respect to an injury sustained prior to commitment. With respect to any temporary disability payments incurred prior to commitment under that provision, if the patient has no dependents, the bill would require the deposit of those payments into the Uninsured Employers Benefits Trust Fund, a continuously appropriated fund, thereby making an appropriation.
(16)Subject to rules and regulations adopted by the State Department of State Hospitals, a hospital director is authorized to establish sheltered workshops at a state hospital to provide patients with remunerative work.
This bill would similarly authorize a hospital director to establish other vocational rehabilitation programs for state hospital patients, and would specify that patients who participate in a sheltered workshop or other vocational rehabilitation program under these provisions are not employees for purposes of state civil service, minimum wage, and contracts of employment.
(17)Under existing law, one of the methods by which Medi-Cal services are provided is pursuant to contracts with various types of managed care plans. Existing law imposes a managed care organization provider tax, which is administered by the State Department of Health Care Services, on licensed health care service plans, managed care plans contracted with the department to provide Medi-Cal services, and alternate health care service plans, as defined. Existing law terminates that tax on July 1, 2019.
This bill would declare the intent of the Legislature to enact a managed care organization provider tax in California. The bill would make collection of the tax and the associated revenue contingent upon receipt of approval from the federal Centers for Medicare and Medicaid Services.
(18)Existing law requires the Director of Health Care Services to develop and implement standards, for purposes of the Medi-Cal program, for the timely processing and payment of each claim type. Existing law authorizes the State Department of Health Care Services to enter into various contracts with fiscal intermediaries to provide claims processing services.
This bill would authorize the department to make a contingency payment, as part of the claims processing services, which is also referred to as the Medi-Cal Checkwrite Schedule, to an identified provider
during an identified service period to ensure continued access to healthcare services, subject to approval of the Department of Finance. The bill would authorize the department to implement these provisions without taking regulatory action, and would require the department to implement these provisions only to the extent that necessary federal approvals are obtained and federal financial participation is not jeopardized.
(19)Existing law requires the State Department of Health Care Services to license and regulate alcoholism or drug abuse recovery or treatment facilities serving adults.
This bill would require the State Department of Health Care Services to seek federal approval, to the extent it deems necessary, to expand the Medi-Cal benefit for adult Alcohol Misuse Screening and Behavioral Counseling Interventions in Primary Care to include screening for
misuse of opioids and other illicit drugs. The bill would suspend implementation of these provisions on December 31, 2021, unless specified circumstances apply.
(20)Existing law authorizes the State Department of Health Care Services, among other things, to enter into contracts with certain drug manufacturers that provide for state rebates for purposes of the Medi-Cal program. Under existing law, the department is entitled to various drug rebates, including federal rebates in accordance with certain conditions, and drug manufacturers are required to calculate and pay interest on late or unpaid rebates.
This bill would establish the Medi-Cal Drug Rebate Fund in the State Treasury, and would provide that nonfederal moneys collected by the department and deposited into the account be continuously appropriated for purposes of funding the nonfederal share of health care services
provided under the Medi-Cal program. The bill would authorize the Controller to use any money in the fund for cashflow loans to the General Fund, as specified. By establishing a continuously appropriated fund, the bill would make an appropriation.
(21)Existing law requires the State Department of Health Care Services to consult with the Medi-Cal Contract Drug Advisory Committee regarding contract drugs under the Medi-Cal program.
This bill would require the department to convene an advisory group to receive feedback on the changes, modifications, and operational timeframes regarding the implementation of pharmacy benefits offered in the Medi-Cal program.
(22)Existing law, the California Healthcare, Research, and Prevention Tobacco Tax Act of 2016, or Proposition 56, which was approved by voters at the November 8,
2016, statewide general election, increases taxes imposed on distributors of cigarettes and tobacco products and allocates a specified percentage of those revenues to the department to increase funding for the Medi-Cal program, in a manner that, among other things, ensures timely access, limits specific geographic shortages of services, or ensures quality care. Existing law establishes the Healthcare Treatment Fund for this purpose.
This bill would require the State Department of Health Care Services to develop value-based payment (VBP) programs that would require designated Medi-Cal managed care plans to make incentive payments to qualified network providers, aimed at improving behavioral health integration, prenatal and postpartum care, chronic disease management, and quality and outcomes for children, for the purpose of improving care for some of the most vulnerable or at-risk populations in the Medi-Cal managed care delivery system. The bill would require the
department to implement the VBP programs for a period no shorter than 3 fiscal years, effective no earlier than July 1, 2019.
The bill would condition program implementation on receipt of any necessary federal approvals, availability of federal financial participation, and an appropriation of moneys to the department in the annual Budget Act from the Healthcare Treatment Fund in accordance with Proposition 56.
The bill would authorize the department to implement these provisions by means of plan letters or other similar instructions, and by entering into exclusive or nonexclusive contracts, or amending existing contracts, on a bid or negotiated basis.
(23)Existing law authorizes the State Department of Health Care Services, subject to federal approval, to create the Health Home Program (program) for enrollees with chronic conditions, as
authorized under federal law.
Existing law creates the Health Home Program Account in the Special Deposit Fund within the State Treasury in order to collect and allocate non-General Fund public or private grant funds, to be expended, upon appropriation by the Legislature, for the purposes of implementing the program. Existing law appropriates $50,000,000 from the account to the department for the purposes of implementing the program. Under existing law, the appropriation is available for encumbrance or expenditure until June 30, 2020.
This bill would extend the availability of those funds for encumbrance or expenditure to June 30, 2024, and would also specify state administration as a component of the program implementation for which those funds may be expended, thereby making an appropriation.
(24)The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
(25)This bill would declare that it is to take effect immediately as a bill providing for appropriations related to the Budget Bill.
