AB 1613

Bill Subjects

Abstract

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 provisions. Pursuant to a federal waiver, the Medi-Cal program administers a program known as the Family Planning, Access, Care, and Treatment (Family PACT) Waiver Program, under which comprehensive clinical family planning services, as defined, are provided to any person who has a family income at or below 200% of the federal poverty level and who is eligible to receive those services pursuant to the terms of the waiver. Existing law requires the program to be operated only in accordance with the waiver and certain statutes and regulations and subject to the terms, conditions, and duration of the waiver. This bill would rename the program as the Family PACT Program. The bill would provide that in addition to being operated in accordance with the waiver, the program may be operated in accordance with a state plan amendment adopted pursuant to federal law, as specified, known as the Family PACT successor state plan amendment and would make conforming changes. The bill would expand the definition of comprehensive clinical family planning services to include services, drugs, devices, and supplies deemed by the federal Centers for Medicare and Medicaid Services to be appropriate for the Family PACT Program. The bill would permit the Director of Health Care Services to implement the state plan amendment retroactively to July 1, 2010. Existing law authorizes the Director of Health Care Services to limit the rates of payment for health care services provided under the Medi-Cal program. This bill would require the director to reduce rates applicable to radiology services so that they do not exceed 80% of the lowest maximum allowance established under the federal Medicare program for the same or similar services with dates of service on or after October 1, 2010. This bill would require the director to implement these provisions only to the extent that the director determines that the rates will comply with applicable federal Medicaid requirements and that federal financial participation is available. This bill would require the department to develop and implement a payment methodology based on diagnosis-related groups, subject to federal approval, that reflects the costs and staffing levels associated with quality of care for patients in all general acute care hospitals, with certain exceptions, in state and out of state, as specified. The bill would provide that the diagnosis-related group-based payments apply to all claims, except as specified. The bill would require the department to submit to the Legislature annual status reports, commencing on April 1, 2011, and ending on April 1, 2014, on the implementation of the above-described provisions. This bill would require, in order to enable the department to develop and implement the above-mentioned payment methodology, the Director of Health Care Services, subject to federal approval, to freeze rates applicable to inpatient hospital services, as specified. It would permit the department to modify this rate-freeze in order to comply with federal Medicaid requirements. The bill would require the department, within 90 days of the above-described provisions becoming effective, to develop and provide to all hospitals the methodology that will be utilized to implement the rate freeze for noncontract hospitals. 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, until January 1, 2011, requires the State Department of Health Care Services, subject to any necessary federal approval, to take all appropriate steps to amend the Medicaid state plan, to implement a requirement that any hospital that does not have in effect a contract with a Medi-Cal managed health care plan that establishes payment amounts for services furnished to a beneficiary enrolled in that plan shall accept, as payment in full, prescribed payment amounts. This bill would extend the duration of these provisions until January 1, 2012. Under existing law, the California Medical Assistance Commission is authorized to negotiate contracts with managed health care plans and other entities in clearly defined geographic areas for the provision of Medi-Cal services, with these contracts being binding upon the department. This bill would, instead, provide that the department, rather than the commission, has the exclusive authority to negotiate these contracts, and would make conforming changes. It would provide that contracts or contract amendments negotiated pursuant to the bill are public records for purposes of the California Public Records Act. Existing law specifies the procedures by which the State Department of Health Care Services determines prospective capitation rates to health plans participating in the Medi-Cal managed care program, and permits the department to utilize a county and health plan specific rate methodology to develop Medi-Cal managed care capitation rates for contracts between the department and case management plans, county health systems, and a geographic managed care pilot project. This bill would provide that, prior to October 1, 2011, the risk-adjusted countywide capitation rate shall comprise no more than 20% of the total capitation rate paid to each Medi-Cal managed care plan. Existing law imposes various taxes, including a tax at a specified rate on the gross premiums of an insurer, as defined, and, until January 1, 2011, on the total operating revenue, as specified, of a Medi-Cal managed care plan, as defined. Existing law provides that the tax on Medi-Cal managed care plans would have no force or effect if any of specified conditions apply. This bill would extend the imposition of the tax on the total operating revenue of Medi-Cal managed care plans until July 1, 2011, and make other conforming changes. Existing law continuously appropriates the proceeds from the tax on Medi-Cal managed care plans (1) to the department for purposes of the Medi-Cal program in an amount equal to 38.41% of the proceeds from the tax and (2) to the Managed Risk Medical Insurance Board for purposes of the Healthy Families Program in an amount equal to 61.59% of the proceeds from the tax. This bill, from July 1, 2010, to June 1, 2011, inclusive, would, instead, continuously appropriate (1) a percentage of the revenues from the tax on Medi-Cal managed care plans equal to the difference between 100% and the applicable federal medical assistance percentage (FMAP) to the department for purposes of the Medi-Cal program and (2) the remaining revenues to the Managed Risk Medical Insurance Board for purposes of the Healthy Families Program. The bill would make an appropriation by extending the continuous appropriation. Existing law requires every return required to be filed with the State Insurance Commissioner pursuant to provisions governing taxes on the gross premiums of insurers and, until January 1, 2011, on the total operating revenue of Medi-Cal managed care plans, to be signed by the insurer or an executive officer of the insurer and to be made under oath or contain a written declaration that it is made under penalty of perjury. This bill would, instead, require every return required to be filed with the State Insurance Commissioner pursuant to provisions governing taxes on the total operating revenue of Medi-Cal managed care plans until July 1, 2011. By expanding the crime of perjury, this bill would impose a state-mandated local program. Existing law requires the department to impose a uniform quality assurance fee on each skilled nursing facility, with certain exceptions, in accordance with a prescribed formula. The formula is based on the determination of the projected net revenues of skilled nursing facilities. The fee will cease to be assessed and collected on and after July 31, 2011, and these provisions will be repealed on January 1, 2012. This bill would provide that, beginning in the 2010–11 rate year, specified multilevel facilities will no longer be exempt from the quality assurance fee. However, the bill would provide that a multilevel facility shall not be required to pay the quality assurance fee until changes to the quality assurance fee and the rate methodology enacted in the 2010 portion of the 2009–10 Regular Session of the Legislature are approved by the federal Centers for Medicare and Medicaid Services and the State Department of Health Care Services has increased the Medi-Cal rates and the increased rates are paid to facilities. This bill would also extend the assessment and collection of the uniform quality assurance fee through July 31, 2012. The bill provides for the collection of all quality assurance fees and penalties, including interest, that have been assessed, even after the quality assurance fee ceases to be assessed and would modify the remedies for collection of these fees. The bill would extend the repeal date for these provisions until January 1, 2013. This bill would require the State Department of Public Health, in consultation with stakeholders, to develop recommendations, as prescribed, to address the findings published in a specified report and would require the State Department of Public Health to provide the recommendations to the fiscal and policy committees of the Legislature no later than March 1, 2011. Existing law, the Medi-Cal Long-Term Reimbursement Act, requires the department to implement a facility-specific reimbursement ratesetting system for certain freestanding skilled nursing facilities. Reimbursement rates for these facilities are funded by a combination of federal funds and moneys collected pursuant to the above-described uniform quality assurance fee. Existing law provides that this rate methodology shall cease to be implemented on July 1, 2011, with these provisions to be repealed on January 1, 2012. This bill would extend the implementation date of the freestanding skilled nursing facility rate reimbursement provisions through July 31, 2012, would make various conforming changes in these provisions, and would extend the repeal date for all of these provisions until January 1, 2013. It would also modify, for the 2010–11 and 2011–12 rate years, the facility reimbursement formula to be used under these provisions. This bill would also require the department, by August 1, 2011, to develop the Skilled Nursing Facility Quality and Accountability Supplemental Payment System, as specified, subject to federal approval and the availability of federal, state, or other funds. The bill would provide that the system shall be utilized for providing supplemental payments to skilled nursing facilities that improve the quality and accountability of care rendered to residents and penalizing those facilities that do not meet measurable standards, in accordance with prescribed requirements. The bill would provide specific methodologies to be used in calculating the supplemental payments to be made and the penalties to be imposed. The bill would create in the State Treasury the Skilled Nursing Facility Quality and Accountability Special Fund and continuously appropriate the moneys in the fund, without regard to fiscal year, to the department to make the above-described supplemental payments. The bill would provide that, upon appropriation of the Legislature, the moneys in the fund may also be used to cover administrative costs incurred by the State Department of Public Health and the State Department of Health Care Services, for positions and contract funding to implement the above-described provisions, and to provide funding assistance for Long-Term Care Ombudsman program activities. This bill would appropriate, for the 2010–11 fiscal year, $1.9 million from the Skilled Nursing Quality and Accountability Special Fund to the California Department of Aging to fund Long-Term Care Ombudsman program activities. This bill would create in the Special Deposit Fund, the Skilled Nursing Facility Minimum Staffing Penalty Account, and would require the State Department of Public Health to deposit penalty payments collected into the account. This bill would require the State Department of Public Health to transfer, on a monthly basis, moneys in the Skilled Nursing Facility Minimum Staffing Penalty Account to the Skilled Nursing Quality and Accountability Special Fund. The bill would make the above-described supplemental payment provisions subject to federal approval and would provide that in the event of a final judicial determination that these provisions are unlawful, they shall become inoperative. Existing law, subject to federal approval, imposes, as a condition of participation in state-funded health insurance programs other than the Medi-Cal program, a quality assurance fee, as specified, on certain general acute care hospitals through and including December 31, 2010. Existing law creates the Hospital Quality Assurance Revenue Fund in the State Treasury and requires that the money collected from the quality assurance fee be deposited into the fund. Existing law provides that the moneys in the fund shall, upon appropriation by the Legislature, be available only for certain purposes, including health care coverage for children. This bill would provide that it is the intent of the Legislature that the moneys in the fund for health care coverage for children be used to expand and enhance health services for children when the health of the economy and state budget are strong enough to allow for program expansions, and strong enough to ensure that the funds supplement, rather than supplant, existing funding for children's health services during the time that the above-described provisions are in effect. Existing law requires the department to establish and maintain a plan, known as the County Administrative Cost Control Plan, for the purpose of effectively controlling costs related to the county administration of the determination of eligibility for benefits under the Medi-Cal program within the amounts annually appropriated for that administration. This bill would require the plan to delineate processes for determining county administration base costs and funding for caseload changes, cost-of-living adjustments, and program and other changes. The bill would require the department and county welfare departments to develop procedures to ensure the data clarity, consistency, and reliability of information contained in the county budget survey documents utilized under the plan that is submitted by counties to the department, including the format of the budget survey documents and use of the documents for the development of determining county administration costs. By requiring county welfare departments to develop the above-described procedures, this bill would impose a state-mandated local program. The bill would require any changes developed pursuant to the above-described provisions to be incorporated within the state's annual budget process by not later than the 2011–12 fiscal year. Under existing law, the Legislature finds and declares that linking appropriate funding for county Medi-Cal administrative operations, including annual cost-of-doing-business adjustments, with performance standards will give counties the incentive to meet the performance standards and enable them to continue to do the work they do on behalf of the state. Existing law provides that it is the intent of the Legislature to provide appropriate funding to the counties for a cost-of-doing-business adjustment, except for the 2008–09 and 2009–10 fiscal years. This bill would additionally provide that it is the intent of the Legislature to not appropriate funds for the cost-of-doing-business adjustment for the 2010–11 fiscal year. Existing law requires the State Department of Health Care Services, to the extent required by federal law, for Medi-Cal recipients who are qualified Medicare beneficiaries, to pay the Medicare premiums, deductibles, and coinsurance for elderly and disabled persons whose income does not exceed the federal poverty level or 200% of a specified Supplemental Security Income program standard. For beneficiaries with a share of cost at or below $500 who do not qualify for assistance because their income exceeds the above-described income requirements and they are not eligible for any other federally funded assistance for the payment of their Medicare Part B premium, existing law requires the State Department of Health Care Services to pay the beneficiary's Medicare Part B premium on a monthly basis regardless of whether the beneficiary's share of cost has been met. This bill would delete the requirement that the State Department of Health Care Services pay the beneficiary's Medicare Part B premium on a monthly basis regardless of whether the beneficiary's share of cost has been met for the above-described beneficiaries with a share of cost at or below $500. Existing law, until July 1, 2012, requires the department, subject to the availability of federal financial participation, to exercise a federal option to expand continuous eligibility to children 19 years of age and younger for 6 months, after which date the continuous eligibility period shall be from the date of a determination of eligibility to the earlier of either the end of a 12-month period following the eligibility determination or the date the child exceeds 19 years of age. Existing law provides that the provisions limiting continuous eligibility to 6 months shall be inoperative from March 27, 2009, until the date the Director of Health Care Services executes a declaration specifying that increased federal financial participation is no longer available pursuant to the federal American Recovery and Reinvestment Act of 2009 (ARRA) . Existing law provides that during period in which the provisions limiting continuous eligibility to 6 months are inoperative, the continuous eligibility period shall be from the date of a determination of eligibility to the earlier of either the end of a 12-month period following the eligibility determination or the date the child exceeds 19 years of age. This bill would delete the above-described provisions in effect until July 1, 2012. This bill would delete the delayed operative date of July 1, 2012, for the above-described provisions that provide that the continuous eligibility period shall be from the date of a determination of eligibility to the earlier of either the end of a 12-month period following the eligibility determination or the date the child exceeds 19 years of age, thereby making those provisions operative on the date this bill becomes effective. Existing law requires reimbursement to Medi-Cal pharmacy providers of legend and nonlegend drugs, as defined, to consist of the estimated acquisition cost of the drug, as defined, plus a professional fee for dispensing. This bill, commencing January 1, 2011, and subject to federal approval, would permit the department to reimburse Medi-Cal providers for physician-administered drugs, as defined, using either the Healthcare Common Procedure Coding System code rate or the National Drug Code rate, as specified, except that the reimbursement rate shall not be less than the Medicare reimbursement rate. This bill would provide that nonlegend acetaminophen-containing products, with the exception of children's Tylenol, selected by the department are not covered benefits. Existing law authorizes the State Department of Health Care Services to enter into nonexclusive contracts with entities to provide fiscal intermediary services in order to administer and disburse funds available for Medi-Cal services to health care providers in accordance with the provisions of the contract and any schedule of charges or formula for determining payments established pursuant to the contract. This bill would require the department to provide the appropriate fiscal and policy committees of the Legislature, the Legislative Analyst's Office, the Office of the State Chief Information Officer (OCIO) , and the Bureau of State Audits (BSA) with quarterly reports on the transition and takeover process efforts of the Medi-Cal fiscal intermediary contract, as specified, including copies of any oversight reports developed by contractors of the department for the California Medicaid Management Information System (CA-MMIS) project and any subsequent responses from the department. The bill would provide that the reports be provided within 30 days of the close of each quarter, commencing July 1, 2010, and continuing through the life of the contract. Upon request from the Chair of the Joint Legislative Budget Committee (JLBC) , this bill would require the department to provide updates on the Implementation Advanced Planning Document provided to the federal Centers for Medicare and Medicaid Services pertaining to the CA-MMIS project. This bill would require the CA-MMIS project to be subject to reviews and recommendations of the OCIO and would require the OCIO to submit a copy of those reviews and recommendations to the JLBC. The bill would require the BSA to review the appropriate project documents and quarterly reports and make recommendations about the new system implementation project, as necessary, and would require the BSA to submit a copy of any reviews and recommendations to the JLBC. This bill would authorize the Chair of the JLBC to request an audit of the progress of the transition, development, and implementation of the CA-MMIS. Existing law provides that a person with private health care coverage is not entitled to receive health care items or services furnished or paid for by a publicly funded health care program, as defined, if covered by that private health care coverage. Existing law entitles a publicly funded health care program that furnishes or pays for designated services to be subrogated to the rights that person has against the carrier of the coverage, to the extent of the health care items provided or services rendered. Under existing law, an entity providing private health care coverage, as defined, is required to respond to inquiries of, and agree not to deny claims submitted by, the state, in connection with the provision of a health care item or service, as specified. Existing law requires a claim for payment to be made within 3 years after provision of the relevant health care item or service. This bill would extend the above requirements imposed upon an entity providing private health care coverage to include inquiries and claims submitted by providers, as defined. Under existing law, the State Department of Developmental Services contracts with the regional centers to provide services and supports to persons with developmental disabilities. The services and supports to be provided to a regional center consumer are contained in an individual program plan (IPP) , developed in accordance with prescribed requirements. Under existing law, Medi-Cal benefits include intermediate care facility services for persons with developmental disabilities. This bill, effective July 1, 2007, would require certain types of licensed intermediate care facilities for persons with developmental disabilities (ICF-DDs) , as specified, to be responsible for providing day treatment and transportation services that are selected and authorized through an IPP, as specified, for each beneficiary receiving those services who resides in that licensed ICF-DD. The bill would require the regional centers to arrange the day treatment and transportation services and would require the licensed ICF-DDs to reimburse the regional center for the full costs of making disbursements to day treatment and transportation service providers. This bill would require the State Department of Developmental Services to be responsible for reimbursing a licensed ICF-DD for the costs of reimbursing the regional center for the full cost of making disbursements for day treatment and transportation services, plus a coordination fee which will include an administrative fee and reimbursement for increased costs associated with the quality assurance fee. This bill, effective July 1, 2007, would authorize the State Department of Developmental Services to make a supplemental payment to an enrolled Medi-Cal provider that is a licensed ICF-DD for day treatment and transportation services provided to Medi-Cal beneficiaries residing in the ICF-DDs. This bill would require the State Department of Developmental Services to amend the regional center contracts for the 2007–08 fiscal year to extend the contract liquidation period until June 30, 2011. This bill would require the State Department of Health Care Services to request approval from the federal Centers for Medicare and Medicaid Services for the implementation of the above-described provisions. The bill would provide that if after seeking federal approval, federal approval is not obtained or federal financial participation is no longer available, the above-described provisions shall not be implemented or shall become inoperative. This bill would provide that due to a change in the availability of federal funding that addresses the ability of California to capture additional federal financial participation for day treatment and transportation services provided to a Medi-Cal beneficiary residing in a licensed ICF-DD, certain funds appropriated in the Budget Act of 2007 shall be available for liquidation until June 30, 2011, which would extend the term for which existing appropriation is available, thereby making an appropriation. Existing law requires that, as a condition of participation in the Medi-Cal program, there be imposed a quality assurance fee each state fiscal year upon the entire gross receipts, as defined, of a designated intermediate care facilities, as defined. Existing law requires that the fee be placed in the General Fund and allocated to intermediate care facilities to support their quality improvement efforts, and distributed to each facility based on the number of Medi-Cal patients at the eligible facility. Existing law requires the department to seek federal approval for the implementation of the fee. This bill would provide that upon approval of the above-described state plan amendment authorizing reimbursement for day treatment and transportation services provided on or after July 1, 2007, the reimbursement payments made by the State Department of Developmental Services to the ICF-DDs shall be subject to the above-described quality assurance fee. Existing law requires regional centers, in order to implement changes in the level of funding for regional center purchase of services, from February 1, 2009, to June 30, 2011, inclusive, to reduce certain payments for services delivered on or after February 1, 2009, by 3%, except as specified. This bill would, instead, require regional centers to reduce the payments for those services by 3% from February 1, 2009, to June 30, 2010, inclusive, and by 4.25% from July 1, 2010, to June 30, 2011, inclusive. This bill would, between July 1, 2010, and June 30, 2011, subject to certain conditions, permit a regional center, for providers who are subject to the 4.25% payment reduction, with certain exceptions, to temporarily modify personnel requirements, functions, or qualifications, or staff training requirements. This bill would, from July 1, 2010, to June 30, 2011, inclusive, suspend prescribed annual review and reporting requirements that are imposed on providers whose payment is reduced by 4.25% pursuant to the above-described provisions. Existing law establishes various state developmental centers, including the Agnews Developmental Center and the Lanterman Developmental Center, for the care of developmentally disabled persons. Existing law contains various provisions concerning the closure of the Agnews Developmental Center, including a provision authorizing the State Department of Developmental Services to operate any facility, provide its employees to assist in the operation of any facility, or provide other necessary services and supports if, in the discretion of the department, it determines that the activity will assist in meeting the goal of an orderly closure of Agnews Developmental Center. This bill would extend many of the above-described provisions concerning the closure of the Agnews Developmental Center to the Lanterman Developmental Center. This bill would provide that for the Lanterman Developmental Center, the use of department employees is in effect for up to 2 years following the transfer of the last resident of Lanterman Developmental Center, as specified. Additionally, this bill would require the State Department of Developmental Services to prepare a report on the use of the department's employees in providing services in the community to assist in the orderly closures of Agnews Developmental Center and Lanterman Developmental Center. The bill would require the report to be submitted with the Governor's proposed budget for the 2012–13 fiscal year to the fiscal committees of both houses of the Legislature and annually thereafter. Existing law requires a service agency, which is defined as a developmental center or regional center that receives state funds to provide services to persons with developmental disabilities, to provide adequate notice, as defined, to an applicant for, or recipient of, services from the service agency, and to the applicant's or recipient's authorized representative, if any, prior to the agency making a decision without the mutual consent of the service recipient or authorized representative to reduce, terminate, or change services set forth in an IPP or prior to a recipient being determined to be no longer eligible for agency services. This bill would require the notice to inform the recipient and authorized representative of whether or not the individual is eligible for an exemption or exception to the action the service agency proposes to take, as specified, and the specific law supporting the exemption or exception. Existing law, until January 1, 2011, authorizes the State Department of Social Services and the State Department of Developmental Services, to jointly establish and administer a pilot project for licensing and regulating Adult Residential Facilities for Persons with Special Health Care Needs (ARFPSHN) , to the extent that funds are appropriated for this purpose in the annual Budget Act. Existing law authorizes the State Department of Social Services to, subject to certain conditions, license an ARFPSHN to provide 24-hour services to up to 5 adults with developmental disabilities who have special health care and intensive support needs, as defined. This bill would indefinitely extend the duration of the above-described program and would make conforming changes. This bill would impose a state-mandated local program by changing the definition of crimes provided for under the California Community Care Facilities Act. Existing law provides that an ARFPSHN may be established in a facility financed pursuant to certain provisions under which the State Department of Developmental Services approves a regional center proposal to provide for housing for persons eligible for regional center services. This bill would, instead, provide that an ARFPSHN may only be established in a facility approved by the State Department of Developmental Services to provide for housing for persons eligible for regional center services or through an approved regional center community placement plan, as specified. However, this bill would provide that the State Department of Developmental Services shall only approve the development of ARFPSHNs that are directly associated with the orderly closure of the Lanterman Developmental Center. Existing law prohibits a regional center from paying a rate to any ARFPSHN for any consumer that exceeds the average annual cost of serving a consumer at Agnews Developmental Center, as determined by the State Department of Developmental Services. This bill would, instead, prohibit a regional center from paying a rate to any ARFPSHN for any consumer that exceeds the rate in the State Department of Developmental Services approved community placement plan for that facility unless the regional center demonstrates that a higher rate is necessary to protect a consumer's health and safety and the department has granted prior written authorization. Under existing law, the State Department of Mental Health operates and maintains state institutions for the mentally disordered. This bill would allow the State Department of Mental Health to contract with providers of health care services and health care network providers for the provision of emergency health care services, as specified. The bill would also specify maximum rates of payment for services received from health care providers either under contract, or that do not contract, with the department. Existing law requires the State Department of Mental Health to contract with a single nonprofit agency, as specified, for the provision of mental health patients' rights and advocacy services on a multiyear basis for a contract term of up to 3 years. This bill would, instead, require the State Department of Mental Health to contract on a multiyear basis for a contract term of up to 5 years. Existing law, the Mental Health Services Act, was approved by the voters in November 2004 as Proposition 63, an initiative measure. Under the act, the State Department of Mental Health is required to, among other things, distribute funds for local assistance for designated mental health programs. Existing law requires the Director of Mental Health, at the time of the release of the January 10 budget plan and the May Revision, to submit information to the Legislature regarding the expenditure of Proposition 63 funding for each state department and each major program category. This bill would require the information submitted to the Legislature to include a complete listing of state support expenditures for the current year and for the budget year by the State Department of Mental Health, including the number of state positions and any contract funds. Existing law, the federal Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) requires state child health plans to provide certain disenrollment rights and to establish sanctions against managed care organizations, as specified. The act also, among other things, requires state child health plans to convert to the Medicaid prospective payment system for services provided by federally qualified health centers and rural health clinics. Existing law creates the Healthy Families Program, administered by the Managed Risk Medical Insurance Board (MRMIB) , to arrange for the provision of health, vision, and dental benefits to children less than 19 years of age who meet certain criteria, including having a limited household income. Existing law requires MRMIB to negotiate separate contracts with participating health, dental, and vision plans for specified benefit packages. This bill would, on and after January 1, 2011, authorize MRMIB to impose sanctions on participating health, dental, and vision plans by applying a specified Medicaid managed care provision imposed under CHIPRA. The bill would, on and after January 1, 2011, also authorize MRMIB to enter into contracts with entities other than participating health, dental, or vision plans in order to provide or pay benefits to Healthy Families Program subscribers for certain purposes, including ensuring that Healthy Families Program subscribers have adequate access to benefits. The bill would exempt any interagency agreement entered into pursuant to these provisions, and any contract or contract amendment necessary to implement that agreement, from competitive bidding laws and review or approval of the Department of General Services. The bill would authorize MRMIB to adopt emergency regulations for purposes of implementing these requirements or any other provision of CHIPRA not addressed by those requirements. 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 requires health care service plans to pay specified assessments each fiscal year as a reimbursement of their share of the costs and expenses reasonably incurred in the administration of the act. This bill would authorize the Director of the Department of Managed Health Care, by notice to all licensed health care service plans on or before October 15, 2010, to require health care service plans to pay an additional assessment, which is separate and independent of the above-described assessment, to provide the department with sufficient revenues to support costs and expenses of the department, as specified, for the 2010–11 fiscal year. The bill would require the additional assessment to be paid in full by December 1, 2010. By expanding the definition fo a crime, this bill would impose a state-mandated local program. Existing law limits the amount of the assessments paid by health care service plans. This bill would, on and after July 1, 2011, and until August 31, 2015, authorize the director to raise the assessment limit to incorporate annual expenditure levels as set forth by the above-described provisions relating to the additional assessment. Existing law, the Confidentiality of Medical Information Act, prohibits a health care provider, a contractor, or a health care service plan from disclosing medical information, as defined, regarding a patient of the provider or an enrollee or subscriber of the health care service plan without first obtaining an authorization, except as specified. This bill would also exempt certain medical information and records disclosed to, and their use by, MRMIB, as specified. Existing law requires the department to submit an application to the federal Centers for Medicare and Medicaid Services for a waiver or demonstration project that would implement specified objectives. This bill would require the State Department of Health Care Services to enter into an interagency agreement with the Department of Managed Health Care to have the Department of Managed Health Care, on behalf of the State Department of Health Care Services, conduct financial audits, medical surveys, and a review of the provider networks of the managed care health plans participating in the above-described demonstration project. Existing law establishes the California Discount Prescription Drug Program, which is administered by the State Department of Health Care Services. Existing law provides that the program shall become operative on or after July 1, 2010. This bill would require the program to be implemented only if, and to the extent that, a Budget Act or other statute that is enacted on or before February 1, 2015, includes or makes an appropriation to implement the program. Existing law requires, on August 1, 2013, the department to determine whether pharmaceutical manufacturer participation in the program has been sufficient to meet certain benchmarks. It also requires the department, on and after August 10, 2013, to reassess program outcomes, at least once every year, consistent with the benchmarks. This bill would, if the program is implemented, extend the above-described requirement dates to August 1, 2017. Existing law establishes the Office of Health Information Integrity within the California Health and Human Services Agency to ensure the enforcement of state law mandating confidentiality of medical information and to impose administrative fines for the unauthorized use of medical information. Existing law authorizes the California Health and Human Services Agency, or one of the departments under its jurisdiction, to apply for federal funds made available through the federal American Recovery and Reinvestment Act of 2009 (ARRA) for health information technology and exchange, and establishes the California Health Information Technology and Exchange Fund for these purposes. Existing law provides that if the agency or one of the departments under its jurisdiction, elects not to submit an application for federal funds, the Governor shall designate a qualified nonprofit entity to be the state-designated entity for the purposes of establishing health information exchange. This bill would, if the agency or one of its departments applies for federal funds, authorize the agency or department to later choose to subgrant, in whole or in part, portions of the federal grant to a qualified nonprofit entity, which would be designated as the state governance entity, for the purposes of establishing health information exchange. This bill would specify the duties of the agency, the state-designated entity, or state governance entity in performing these functions, and would modify the membership of the initial governing board of the entity. The bill would require the agency to develop a detailed implementation plan and to submit it to the Legislature by November 1, 2010. The bill would, commencing October 1, 2010, require the agency to report, by October 1 and April 1 of each year, to the Legislature regarding expenditures and the status of health information technology and exchange activities funded through the fund. This bill would specify that the agency, state-designated entity, or state governance entity shall establish and begin providing health information exchange services no later than January 1, 2012. This bill would provide that all deliverables, as defined in the scope of work originated or prepared by the state-designated entity or state governance entity, as specified, shall, upon delivery and acceptance by the agency, become the exclusive property of the state, and may be copyrighted by the state under the oversight of the agency, as prescribed. This bill would require the agency to require the state-designated entity or state governance entity to develop specified policies and procedures to provide the public with transparency of the actions of the entity. Existing law authorizes the State Public Health Officer, to the extent that state and federal funds are appropriated in the annual Budget Act for these purposes, to establish and administer a program to provide drug treatments to persons infected with the human immunodeficiency virus (HIV) , the etiologic agent of acquired immune deficiency syndrome (AIDS) . Under the program, known as the AIDS Drug Assistance Program (ADAP) , the State Department of Public Health subsidizes the cost of drugs for the treatment of persons infected with HIV. Under existing law, moneys from the AIDS Drug Assistance Program Rebate Fund, a continuously appropriated fund, are used to cover costs related to the purchase of drugs and services provided through the ADAP. This bill would require the State Department of Health Care Services and the State Department of Public Health, in the event state expenditures for the ADAP are identified by California to be used for a certified public expenditure for the purpose of obtaining federal financial participation under the Medi-Cal program for any purpose, to ensure the integrity of the ADAP in meeting its maintenance of effort requirements to receive federal funds and to obtain all ADAP drug rebates to support the ADAP. Existing law establishes the Office of AIDS in the State Department of Public Health. Existing law authorizes HIV counselors trained by the Office of AIDS and working in an HIV counseling and testing site funded by the State Department of Public Health through a local health jurisdiction, or its agents, to perform skin punctures for purposes of withdrawing blood for HIV test purposes. This bill would additionally authorize HIV counselors to perform skin punctures for purposes of withdrawing blood for HIV test purposes if the HIV counselor is working at an HIV counseling and testing site that utilizes HIV counseling staff who are trained by the Office of AIDS, or its agents, and has a quality assurance plan approved by the local health department, as specified, and staff who comply with certain quality assurance requirements required by regulation. The bill would authorize the Office of AIDS, or its agents, to charge a fee for training HIV counselors. The bill would authorize the local health department to charge a fee for the quality assurance plan approval. Existing law, the California Special Supplemental Food Program for Women, Infants, and Children (WIC) , authorizes establishment of a statewide program, administered by the State Department of Public Health, for providing nutritional food supplements to low-income pregnant women, low-income postpartum and lactating women, and low-income infants and children under 5 years of age, who have been determined to be at nutritional risk. The program, which implements a program authorized under existing federal law, provides for the redemption of nutrition coupons by recipients at any authorized retail food vendor. This bill would, by no later than January 10 and May 14 of each year, require the State Department of Public Health to provide the fiscal committees of the Legislature with an estimate package for WIC that shall include all significant assumptions underlying the estimate for the WIC program's current-year and budget-year proposals and concise information identifying applicable estimate components necessary to support the estimate. Existing law requires the State Department of Public Health to provide breast cancer and cervical cancer screening services under a federal grant made under the federal Centers for Disease Control and Prevention breast and cervical cancer early detection program to eligible low-income individuals. Funding for these services is provided by a combination of federal and state moneys. The above-described provisions are collectively known as the Every Woman Counts program. This bill would, by no later than January 10 and May 14 of each year, require the State Department of Public Health to provide the fiscal committees of the Legislature with an estimate package for the Every Woman Counts program that includes all significant assumptions underlying the estimate for this program, including current-year and budget-year proposals, and that contains concise information identifying applicable estimate components necessary to support the estimate. This bill would require the State Department of Public Health to provide the fiscal and appropriate policy committees of the Legislature with quarterly updates on caseload, estimated expenditures, and related program monitoring data for the Every Woman Counts program by no later than the 15th day of the month following the end of each quarter of the fiscal year. Existing law establishes specified licensing and certification program fees for various health facilities, and contains provisions relating to methodologies for adjustment of those fees. Existing law requires the State Department of Public Health to annually prepare a report of all costs for activities of the Licensing and Certification Program. Existing law requires the report to include, among other things, recommendations for Licensing and Certification Program fees in accordance with specified criteria. This bill would, by no later than January 10 and May 14 of each year, require the State Department of Public Health to provide the fiscal committees of the Legislature with an estimate package for the Licensing and Certification Program that includes all significant assumptions underlying the estimate for this program, including current-year and budget-year proposals, and that contains concise information identifying applicable estimate components, as specified. This bill would, no later than January 20 of each year, require the State Department of Public Health to provide a vacancy report, effective as of December 1 of the previous calendar year, to the Joint Legislative Budget Committee and the chairs of the fiscal committees of both houses of the Legislature that identifies both filled and vacant positions within the department by center, division, branch, and classification. This bill would require the State Department of Health Care Services to seek support from one or more foundations to support and develop a study or studies of the California Children's Services (CCS) Program, to be provided to interested stakeholders and the fiscal and appropriate policy committees of the Legislature by May 2011. It would express the intent of the Legislature concerning the purposes to which the study or studies are to be used. This bill would require the State Department of Health Care Services to provide the fiscal and appropriate policy committees of the Legislature with semiannual updates containing certain information regarding all of California's Medicaid waivers to be provided in March and October of each year. 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 with regard to certain mandates no reimbursement is required by this act for a specified reason. With regard to any other mandates, this bill would provide that, if the Commission on State Mandates determines that the bill contains costs so mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above. This bill would declare that it is to take effect immediately as an urgency statute.