Bill Text: CA SB1004 | 2013-2014 | Regular Session | Chaptered
Bill Title: Health care: palliative care.
Spectrum: Partisan Bill (Democrat 2-0)
Status: (Passed) 2014-09-25 - Chaptered by Secretary of State. Chapter 574, Statutes of 2014. [SB1004 Detail]
Download: California-2013-SB1004-Chaptered.html
BILL NUMBER: SB 1004 CHAPTERED
BILL TEXT
CHAPTER 574
FILED WITH SECRETARY OF STATE SEPTEMBER 25, 2014
APPROVED BY GOVERNOR SEPTEMBER 25, 2014
PASSED THE SENATE AUGUST 27, 2014
PASSED THE ASSEMBLY AUGUST 26, 2014
AMENDED IN ASSEMBLY AUGUST 22, 2014
AMENDED IN ASSEMBLY AUGUST 18, 2014
AMENDED IN SENATE MAY 5, 2014
INTRODUCED BY Senator Hernandez
(Coauthor: Senator Wolk)
FEBRUARY 13, 2014
An act to add Section 14132.75 to the Welfare and Institutions
Code, relating to health care.
LEGISLATIVE COUNSEL'S DIGEST
SB 1004, Hernandez. Health care: palliative care.
Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Care Services and
under which qualified low-income persons receive health care
benefits, including hospice benefits. The Medi-Cal program is, in
part, governed and funded by federal Medicaid provisions. One of the
methods by which Medi-Cal services are provided is pursuant to
contracts with various types of managed health care plans.
Existing law requires the department to develop, as a pilot
project, a pediatric palliative care benefit to evaluate whether, and
to what extent, such a benefit should be offered under the Medi-Cal
program. Existing law requires that the pilot project be implemented
only to the extent that federal financial participation is available,
and requires the department to submit a waiver application for
federal approval.
Existing law requires that beneficiaries eligible to receive the
pediatric palliative care benefit be under 21 years of age, and
allows the department to further limit the population served by the
project to make the above evaluation. Existing law requires that the
services available under the project include those types of services
that are available through the Medi-Cal hospice benefit, and certain
other services.
This bill would require the department to establish standards and
provide technical assistance for Medi-Cal managed care plans to
ensure delivery of palliative care services, which would include
specified hospice services and any other services determined
appropriate by the department. The bill would require that authorized
providers include licensed hospice agencies and home health agencies
licensed to provide hospice care that are contracted with Medi-Cal
managed care plans to provide palliative care services. This bill
would require the department, to the extent practicable, to ensure
that the delivery of palliative care services under these provisions
is provided in a manner that is cost neutral to the General Fund on
an ongoing basis. This bill would authorize the department to
implement these provisions through all plan letters or similar
instructions.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 14132.75 is added to the Welfare and
Institutions Code, to read:
14132.75. (a) In enacting this section, it is the intent of the
Legislature that palliative care include, but not be limited to, all
of the following:
(1) Specialized medical care and emotional and spiritual support
for people with serious advanced illnesses.
(2) Relief of symptoms, pain, and stress of serious illness.
(3) Improvement of quality of life for both the patient and
family.
(4) Appropriate care for any age and for any stage of serious
illness, along with curative treatment.
(b) The department, in consultation with interested stakeholders,
shall establish standards and provide technical assistance for
Medi-Cal managed care plans to ensure delivery of palliative care
services.
(c) Covered services shall include, but are not limited to, those
types of services that are available through the Medi-Cal hospice
benefit. These services shall include the following, regardless of
whether these services are covered under the Medi-Cal hospice
benefit:
(1) Hospice services that are provided at the same time that
curative treatment is available, to the extent that the services are
not duplicative.
(2) Hospice services provided to individuals whose conditions may
result in death, regardless of the estimated length of the individual'
s remaining period of life.
(3) Any other services that the department determines to be
appropriate.
(d) The department, in consultation with interested stakeholders,
shall establish guidance on the medical conditions and prognoses that
render a beneficiary eligible for the palliative care services.
(e) Providers authorized to provide services shall include
licensed hospice agencies and home health agencies licensed to
provide hospice care that are contracted with Medi-Cal managed care
plans to provide palliative care services.
(f) The department shall, to the extent practicable, ensure that
the delivery of palliative care services under this section is
provided in a manner that is cost neutral to the General Fund on an
ongoing basis.
(g) 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 the provisions of this section by means of
all plan letters or similar instructions, without the adoption of
regulations. The department shall notify stakeholders and the fiscal
and appropriate policy committees of the Legislature of its intent to
issue all plan letters or other similar instructions prior to
issuance.
(h) (1) Nothing in this section shall result in the elimination or
reduction of any covered benefits or services under the Medi-Cal
program.
(2) This section shall not affect an individual's eligibility to
receive, concurrently with the services provided for in this section,
any services, including home health services, for which the
individual would have been eligible in the absence of this section.
