AB 204

Bill Subjects

Abstract

Existing law establishes the Federal Trust Fund, consisting of all money received by the state from the United States. Existing law also establishes the California Health Trust Fund as a continuously appropriated fund to provide for the administration of the California Patient Protection and Affordable Care Act, as specified. This bill would authorize, to the extent permitted by federal law, the transfer of funds from the Federal Trust fund to the California Health Trust Fund, if the money is made available by the United States for consistent purposes. Because the California Health Trust Fund is continuously appropriated, this bill would make an appropriation by authorizing the transfer of additional moneys into the fund. Existing law establishes the Abortion Practical Support Fund, a continuously appropriated fund, for the purpose of providing grants to nonprofit organizations that either specialize in assisting pregnant people who are low income, or who face other financial barriers, with direct practical support services to access and obtain an abortion or that provide abortion services to those persons. This bill would specify that grant funds are required to be used to fund a new program or support an existing program that increases patient access to abortion. The bill would also expand the definition of "practical support" and therefore make an appropriation by expanding the use of moneys in a continuously appropriated fund. Existing law establishes the Health Care Affordability Board, which is tasked with establishing a statewide health care cost target and specific targets by specified categories, such as health care sector. Existing law requires that these specific targets and the methodology for setting them be adjusted for a provider or fully integrated delivery system's cost target, subject to projected labor costs. This bill would make clarifying changes to these provisions. Existing law establishes the Office of Health Care Affordability, within the Department of Health Care Access and Information, responsible for analyzing the health care market for cost trends and drivers of spending to develop data-informed policies for lowering health care costs. Existing law requires the office to adopt a set of standard measures for assessing care quality and equity across payers and requires that it be annually reviewed and updated. This bill would instead require that the office review and update the standard measures periodically. Existing law, the Song-Brown Health Care Workforce Training Act, establishes a state medical contract program with accredited medical schools, hospitals, and other programs and institutions to increase the number of students and residents receiving quality education and training in specified primary care specialties and maximize the delivery of primary care and family physician services to underserved areas of the state. The bill would add programs that train postgraduate physician assistants and nurse practitioners to the list of programs eligible to contract with the state under the Song-Brown Health Care Workforce Training Act, and would make conforming changes. Existing law prohibits a person from being tried or adjudged to punishment while that person is mentally incompetent, establishes a process by which a defendant's mental competency is evaluated, and requires a court, before ordering a defendant to be committed to the State Department of State Hospitals or other treatment facility, to hear and determine whether the defendant lacks the capacity to make decisions regarding the administration of antipsychotic medication, as specified. Existing law requires the department, within 90 days after a commitment, to make a written report to the court and the community program director for the county or region of commitment, or a designee, concerning the defendant's progress toward recovery of mental competence and whether the administration of antipsychotic medication remains necessary. Existing law specifies what is required to be considered in that report, such as whether the defendant presents a danger to others, and whether the defendant has a mental disorder for which medications are the only effective treatment, among others. This bill would instead make the contents of the reports permissive, among other conforming changes. Existing law authorizes the department to conduct reevaluations of mentally incompetent defendants awaiting admission to the department any time after commitment has been ordered. Existing law authorizes a court to order the involuntary administration of antipsychotic medication based upon a reevaluation, as specified. This bill would clarify that a court is required to base its determination on the recommendation made by a department clinician. Existing law authorizes the State Department of State Hospitals to contract with private or public entities to house and treat individuals committed to the department, under certain circumstances. Existing law authorizes the use of contracted funds for program implementation costs, including projects to modify, expand, or retrofit a space, among other things. This bill would expand the authorized use of these funds to include building of new facilities. Existing law authorizes the State Department of State Hospitals to provide patient information and records to district attorneys for specified purposes, under certain circumstances. This bill would instead require the department to provide patient information and records to district attorneys under these circumstances, unless otherwise prohibited by law. Existing law, to the extent federal financial participation is available, requires the State Department of Health Care Services to exercise its option under federal law to implement a program for individuals who are 65 years of age or older or are disabled, without a share of cost, if they meet certain financial eligibility criteria, including not exceeding 138% of the federal poverty level in their countable income or as specified. Under existing law, certain medically needy persons with higher incomes qualify for Medi-Cal with a share of cost, if they meet specified criteria. Existing law requires the department to establish income levels for maintenance at the lowest levels that reasonably permit a medically needy person to meet their basic needs for food, clothing, and shelter, and for which federal financial participation will still be provided under applicable federal law. Existing law, to the extent that any necessary federal authorization is obtained, increases the above-described income level for maintenance per month to be equal to the income limit for Medi-Cal without a share of cost for individuals who are 65 years of age or older or are disabled, generally totaling 138% of the federal poverty level. The bill would make these provisions operative on January 1, 2025, or the date certified by the department, whichever is later. This bill would make conforming changes. Existing law requires Medi-Cal beneficiaries to make set copayments for specified services and prohibits the department from reducing the provider reimbursement as a result of the copayment. Existing law prohibits a provider, except as specified, from denying care or services to an individual eligible for care because of their inability to pay a copayment. This bill would make these provisions inoperative on July 1, 2022, and would repeal them as of January 1, 2023. Existing law establishes the Medi-Cal Physicians and Dentists Loan Repayment Program, which requires the department to develop and administer the program to provide loan assistance payments to qualifying, recent graduate physicians and dentists who serve beneficiaries of the Medi-Cal program and other specified health care programs. Existing law establishes the Medi-Cal Loan Repayment Program Special Fund in the State Treasury and requires the fund to contain funds transferred from the California Electronic Cigarette Excise Tax Fund, as specified, funds collected from remittances by Medi-Cal managed care plans as described below, and any other moneys appropriated to the program. Existing law requires a Medi-Cal managed care plan to comply with a minimum 85% medical loss ratio (MLR) consistent with specified federal regulations. Effective for contract rating periods commencing on or after July 1, 2023, existing law requires a Medi-Cal managed care plan to provide a remittance for noncompliance with the minimum MLR standard. After the department returns the requisite federal share amounts to the federal Centers for Medicare and Medicaid Services, existing law requires the transfer of the remaining remitted amounts to the Medically Underserved Account for Physicians within the Health Professions Education Fund for use, upon appropriation, for the Steven M. Thompson Physician Corps Loan Repayment Program, as specified. This bill would instead require that the remaining remitted amounts be transferred to the Medi-Cal Loan Repayment Program Special Fund for purposes of the above-described Medi-Cal Physicians and Dentists Loan Repayment Program. By creating a new revenue source for a continuously appropriated fund, the bill would make an appropriation. Under existing law, Medi-Cal beneficiaries can receive health care services, including federally qualified health center (FQHC) services and rural health clinic (RHC) services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. This bill would require the department, upon an appropriation by the Legislature, to establish a clinic workforce stabilization retention payment program to provides funds to eligible qualified clinics, including, but not limited to, FQHCs and RHCs. The bill would require those funds to be used to make retention payments to the clinics' eligible employees, for the public purposes of providing stability in the California qualified clinic workforce and retaining qualified health care workers. The bill would require the department to distribute funds to each eligible qualified clinic based on the total number of eligible employees reported as provided in the bill, in an amount up to $1,000 per eligible employee, subject to available funding, and reduced on a pro rata basis if the requests exceed the amount of funds available. The bill would require qualified clinics to pay retention payments to eligible employees within 60 days of receipt from the department. The bill would require a qualified clinic to provide specified information to the department if the clinic intends to request funding under the program and after the payments have been made to eligible employees. Because the bill would require certain information to be attested to under penalty of perjury, the bill would expand the crime of perjury, thereby imposing a state-mandated local program. The bill would exempt payments made pursuant to the program from any adjustments or deductions made to Medi-Cal payments to qualified clinics, except as required by federal law. The bill would provide that its requirements would be implemented only to the extent that the department determines that federal financial participation under the Medi-Cal program is not jeopardized. The bill would establish resolution procedures in the event of a dispute as to the status of an employee as an eligible employee, the retention payment amount, or a qualified clinic's failure to make a retention payment, as prescribed. The bill would not create a private right of action in any civil litigation against a qualified clinic regarding the administration of the retention payment program and in the receipt and transmittal of retention payment program funds, except as specified, or in any civil litigation or administrative proceeding against the state or the department or other state agency or department. Under existing law, beginning no earlier than January 1, 2025, a child under 5 years of age is continuously eligible for Medi-Cal, including without regard to income, until the child reaches 5 years of age, subject to specified circumstances. Existing law makes this provision contingent on obtaining all necessary federal approvals, an appropriation, and a determination by the department that systems have been programmed to implement certain provisions. Existing law establishes the County Health Initiative Matching Fund, administered by the State Department of Health Care Services, through which an applicant county, county agency, a local initiative, or a county organized health system that provides an intergovernmental transfer, as specified, is authorized to submit a proposal to the department for funding for the purpose of providing comprehensive health insurance coverage to certain children, who otherwise do not qualify for Medi-Cal with no share of cost or for other certain Medi-Cal programs. This bill would, no sooner than January 1, 2025, for any child eligible under these provisions, require that they remain continuously eligible until they are 5 years of age and prohibits a redetermination of eligibility prior to that age. The bill would make implementation contingent on receipt of necessary federal approvals and financial participation, upon an appropriation, as specified, and upon a determination that systems have been programmed to implement these changes. Because counties are required to make Medi-Cal eligibility determinations, and to the extent that this bill would expand Medi-Cal eligibility, the bill would impose a state-mandated local program. 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 a bill providing for appropriations related to the Budget Bill.