CSAC Bulletin Article

Health and Human Services 08/26/2011

California Health Benefit Exchange Board Names Executive Director

The California Health Benefit Exchange Board unanimously voted to appoint Peter V. Lee as its first Executive Director. 

Mr. Lee comes from Washington, D.C, where he currently serves as the Deputy Director for the Center for Medicare and Medicaid Innovation at the Centers for Medicare and Medicaid Services (CMS). He previously served as the Director of Delivery System Reform at the federal Health and Human Services’ Office of Health Reform, and spent eight years in San Francisco as Executive Director of the Pacific Business Group on Health. Mr. Lee returns to California with more than 25 years of health policy experience, and it is considered a coup for California to have hired a key figure in President Obama’s administration who is knowledgeable about health care reform and the Affordable Care Act. 

California has led the nation by establishing the first Health Benefit Exchange in the wake of the Affordable Care Act. The California Health Benefit Exchange Board was formed earlier this year and is tasked with building a new insurance marketplace for businesses and individuals to purchase health insurance using federal tax subsidies and credits beginning in 2014. For more information about the Exchange, including a meeting calendar, visit www.HealthExchange.ca.gov.

California Nets $1.7 Million for Prevention and Public Health Projects

The federal Health and Human Services Agency has announced that California will receive $1.7 million for public health infrastructure as part of the Affordable Care Act grant structure. Nationwide, the federal agency will distribute $137 million. 

The grants are intended to enhance state and local efforts to provide tobacco cessation services, support public health laboratory services, prevent healthcare infections, and provide comprehensive substance abuse treatment. 

California received four grants from the Centers for Disease Control and Prevention:

  • CDC Tobacco Quitlines $340,245
  • CDC Strengthen Public Health immunization $765,000
  • CDC Emerging Infections Program $216,151
  • CDC Vaccine Effectiveness Monitoring $381,103

Emergency Medical Services

AB 210 (Solorio) – Request to Make it a Two-Year Bill
As Amended on August 15, 2011

AB 210, by Assembly Member Jose Solorio, would amend what is commonly known as Section 201 (Health and Safety Code Section 1797.201-224) of the Emergency Medical Services (EMS) System and the Pre-Hospital Emergency Medical Care Personnel Act (EMS Act) to require grandfathered EMS transportation providers to enter into a written agreement with their respective Local Emergency Medical Services Agency (LEMSA) by 2014.

AB 210 is intended to address Section 201 issues surrounding regulatory authority, local control, and operational control in local EMS systems. The bill also includes an attempt to create a standard set of definitions for Section 201. AB 210 was originally envisioned as a vehicle for the recommendations of a state Emergency Medical Services Commission subcommittee, but that committee has not fully reached consensus on its provisions. However, a stakeholder group comprised of the California Professional Firefighters, ambulance services, fire chiefs, cities and local EMS administrators has continued to meet as the bill moves through the legislative process. CSAC is maintaining a pending position while stakeholders continue their work on reaching a consensus, but counties have serious and significant concerns with the bill as written and with proposed amendments.

At the August 15 Senate Appropriations hearing, the counties of San Joaquin and Tulare maintained their oppose positions, while the county of Mono stated their concerns for the record. MontereyCounty also has concerns about the bill, as does the state Emergency Medical Services Authority (EMSA). CSAC has maintained a “pending” position on AB 210 and joined with the Regional Council of Rural Counties, Urban Counties Caucus, and the County Health Executives Association of California asking Assembly Member Solorio to make AB 210 a two-year bill. This would give the stakeholders more time to develop mutually agreeable language and address our specific county issues. 

However, AB 210 was passed by the Senate Appropriations Committee on August 25 and now goes to the Senate Floor. CSAC will continue to work with counties, county organizations, the author and sponsors to address our concerns. Should the bill continue to move forward as currently drafted, CSAC will adopt an oppose position.

CalFresh (Food Stamps)

AB 402 (Skinner) – Support
As Amended on August 17, 2011

AB 402, by Assembly Member Nancy Skinner, would help combat child hunger by making it easier to coordinate outreach efforts for the School Meal and CalFresh Programs. 

The bill builds on the eligibility similarities of the School Meal and CalFresh programs by giving school districts the option to help initiate a confidential CalFresh application for students enrolled in the School Meal program. AB 402 will allow, at the option of the local school district and CalFresh administering agency, the confidential School Meal application to be utilized to initiate a confidential CalFresh application. 

Assembly Bill 402 will build a bridge between two federal programs to help feed our youngest and most vulnerable residents throughout the year, not just on school days. It is for these reasons that CSAC supports AB 402.

The Assembly concurred in the Senate amendments and sent AB 402 to the Governor.

Adult Protective Services

AB 1288 (Gordon) – Support
As Amended on July 13, 2011

AB 1288, by Assembly Member Rich Gordon, would protect the assets of vulnerable seniors or dependent adults from misuse and fraud while a conservatorship petition is pending in court. 

Assembly Bill 1288 specifically would extend the period of time in which a public guardian or conservator may petition to protect the assets of seniors and dependent adults from 15 to 30 days. The bill also would expand the scope of the possession or control of property by the guardian to include assets held in the name of a proposed conservatee’s trust, and recent amendments protect the rights of spouses of the wards or proposed conservatees. AB 1288 was also recently amended to include direction on Certificates of Authority, which, if enacted, will provide financial institutions with written recordable certification of the conservator’s intent to protect real property from being transferred, encumbered, or disposed of during the petition period. 

Counties often encounter these issues during Adult Protective Services investigations, and it is challenging to complete a petition for conservatorship within 15 days. AB 1288 is a common sense, simple measure to provide appointed guardians a suitable amount of time and authority to protect the assets of vulnerable seniors and dependent adults. It is for these reasons that CSAC supports the bill. 

The Assembly concurred in the Senate amendments and sent AB 1288 to the Governor.

Service Coordination

SB 557 (Kehoe) – Support
As Amended on July 7, 2011

SB 557, by Senator Christine Kehoe, would establish two-year pilot programs for family justice centers in Alameda and SonomaCounties, as well as the cities of San Diego and Anaheim, and require the National Justice Center Alliance to report to the Legislature on the effectiveness, possible legislation, and best practices of those centers. 

The family justice center concept is simple: co-locate a multi-disciplinary team of professionals in a single location to coordinate services for victims of family violence. This model ensures service coordination but also enhances the safety and well-being of victims of violence and their families. 

Both the counties of Alameda and Sonoma also currently operate acclaimed family justice centers. These county centers focus on victims of domestic violence and human trafficking. Senator Kehoe’s SB 557 supports the family justice center concept by authorizing Alameda and Sonoma counties, as well as two cities (San Diego and Anaheim) to establish or continue to operate family justice centers to assist victims of domestic violence, sexual assault, stalking, cyberstalking, cyberbullying, human trafficking, and elder or dependent adult abuse. 

SB 557 also outlines clear confidentiality and professional practice guidelines, and mandates collaboration with local community-based advocates, survivors, and service providers. 

In short, SB 557 will build upon the progress made by Alameda and SonomaCounty by creating a structure for the National Justice Center Alliance to examine the success of the model. To do this, the bill also contains a sunset clause of January 1, 2014, and counties believe that the results of the pilot participants will encourage California to continue to build upon the family justice center model. It is for these reasons that CSAC supports SB 557, which was passed by the Senate on August 22 and sent to the Governor.

In-Home Supportive Services

SB 930 (Evans) – Support
As Amended on August 15, 2011

SB 930, by Senator Noreen Evans, would eliminate the requirements for counties to collect the fingerprints of each IHSS consumer and have both providers and consumers to submit fingerprints on each IHSS timesheet (a provision of current law that is scheduled to go into effect on July 1 of this year). The bill would also repeal statute that prohibits providers from using a Post Office Box (P.O. Box) for IHSS forms, including for paychecks. A final amendment will increase communication between the state Department of Social Services and the public authorities when a prospective provider is denied employment. 

For these reasons, CSAC supports SB 930. The Assembly Appropriations Committee passed the bill on August 25, and it now goes to Assembly Floor.

Child Welfare Services/Foster Youth

AB 194 (Beall) – Support
As Amended on June 16, 2011

AB 194, a bill by Assembly Member Jim Beall, would grant foster youth priority enrollment in a public university or community college system. 

AB 194 specifically would allow foster youth and former foster youth to receive priority enrollment in the CaliforniaStateUniversity and community college system, if the specific campus utilizes the required technology to grant priority enrollment. AB 194 also requests the participation of the University of California system. 

Counties support efforts to ensure the long-term success of foster youth and former foster youth and therefore support AB 194. The Senate Appropriations Committee passed AB 194 on August 25 and it now goes to the Senate Floor. 

AB 212 (Beall) – Support
As Amended on August 15, 2011

AB 212, by Assembly Member Jim Beall, would implement technical provisions related to last year’s landmark foster care legislation, the California Fostering Connections to Success Act of 2010 (AB 12). 
AB 212 is the result of efforts by counties, stakeholders, and Department of Social Services staff to “clean up” some provisions of AB 12. To that end, AB 212 mostly focuses on implementing KinGAP eligibility for young adults aged 18 to 21, and streamlining the assessment portion of the legal guardianship and adoptions process, as well as KinGAP payments. 
The Senate Appropriations Committeepassed AB 212 on August 25, and it now goes to the Senate Floor. 

AB 709 (Brownley) – Support
As Amended on August 15, 2011

AB 709, by Assembly Member Julia Brownley, would ensure the timely enrollment of foster youth who must transfer to a new school. 

Existing law requires a school to immediately enroll a foster child, even if the child is unable to produce the records normally required for enrollment. This includes previous academic records, proof of residency, and medical records. However, existing law does not address the requirement to produce proof of immunization or a vaccination history prior to enrollment. AB 709 addresses this discrepancy by allowing schools to waive the vaccination record requirement for foster youth. 

CSAC supports the bill, which was passed by the Assembly on August 25 and sent to the Governor. 

AB 717 (Ammiano) – Support
As Amended June 29, 2011

AB 717, by Assembly Member Tom Ammiano, would improve the use and operation of the Child Abuse Central Index (CACI).

The CACI is a tool used by county child welfare agencies when conducting investigations and hiring of staff. However, because of the sensitive information within the system, CACI has been the target of litigation throughout the years. A result of some of that litigation is a due process structure for persons listed on the CACI. AB 717, as amended, will improve due process by, among other things, affording all persons listed in CACI the right to request a due process hearing if they have not already had the opportunity to do so. AB 717 would also help streamline the system by permitting “inconclusive” reports to be purged. Also, AB 717 would allow the Department of Justice to purge all reports in CACI where the person listed has reached 100 years of age. 

CSAC has changed our position to support due to the recent amendments clarifying the due process and “inconclusive” report process. The Senate Appropriations Committee passed AB 717 on August 25 and it now goes to the Senate Floor.

Medi-Cal

AB 396 (Mitchell) – Support
As Amended on August 15, 2011

AB 396, by Assembly Member Holly Mitchell, would provide the opportunity for counties to receive federal funding for the inpatient medical costs of juvenile detainees. 

Specifically, AB 396 would allow counties to draw down federal matching funds for the inpatient medical treatment provided to minors who are outside of a county detention facility for more than 24 hours. Recent amendments also specify that the counties which elect to participate and the state negotiate administrative costs associated with obtaining the federal funding annually. 

The Senate Appropriations Committee passed AB 396 on August 25 and it now goes to the Senate Floor.

CalWORKs

AB 959 (Jones) – Support
As Amended on August 15, 2011

AB 959, by Assembly Member Brian Jones, will increase efficiency in the CalWORKs and CalFresh programs by allowing for a one-month grace period during the discontinuance process. 

Assembly Bill 959 is a San Diego county-sponsored measure that is aimed at increasing efficiency at the county level by allowing county eligibility staff to restore eligibility for cases that have been discontinued due to missing information. 

Counties believe that AB 959 will simply reduce the number of CalWORKs and CalFresh applications processed at the local level, help avoid duplication of applications and overlapping eligibility, and save the time and effort of both county staff and program recipients. The Senate Appropriations Committeepassed AB 959 on August 25 and it now goes to the Senate Floor. 

AB 1182 (R. Hernández) – Support
As Introduced on August 22, 2011

AB 1182, by Assembly Member Roger Hernández, would allow CalWORKs applicants and recipients to own reliable cars. 

AB 1182 would specifically delete the requirement that counties assess the value of a motor vehicle when determining or redeterminingCalWORKs eligibility. 

AB 1182 would increase the opportunities for recipients to find and maintain stable employment, while also increasing the state’s work participation rate, reducing grant costs in the long run and helping to avoid federal penalties. It is for these reasons that CSAC supports AB 1182. The Senate Appropriations Committee passed AB 1182 on August 25, and it now goes to the Senate Floor.

Health and Public Health

SB 335 (Hernandez) – Watch
As Amended on August 18, 2011

SB 335, by Senator Ed Hernandez, O.D., extends the hospital quality assurance fee for Medi-Cal and children’s health until December 31, 2013.

SB 335 specifically authorizes the collection of fees from private hospitals for Medi-Cal payments and grants to other hospitals, as well as children’s health care coverage. The bill also creates an additional pool of funds for county Low Income Health Programs (LIHPs) to pay for out-of-network-care for enrollees and some grants to hospitals. 

The Assembly Health Committee passed SB 335 on August 23 and will be heard next in the Assembly Appropriations Committee. 

AB 581 (Pérez) – Support
As Amended on July 11, 2011

AB 581, as amended on July 11 by Assembly Speaker John Pérez, would create the California Healthy Food Financing Imitative. 

Assembly Bill 581 specifically establishes the California Healthy Food Financing Initiative Fund at the State Treasury and positions the state to access these federal funds. The bill also requires a stakeholder process through the Department of Food and Agriculture to develop recommendations on promoting healthy food and accessing federal funding that will be presented to the Legislature.

Counties support efforts to increase the number of fresh grocery stores, urban and rural farm stands, farmers’ markets, and community gardens in underserved communities. It is for these reasons that CSAC supports AB 581. 

The Senate Appropriations Committee passed AB 581 on August 25 and it now goes to the Senate Floor. 

Health Care Reform

AB 1296 (Bonilla) – Support 
As Amended on July 13, 2011

AB 1296, by Assembly Member Susan Bonilla, is a vehicle to attempt to streamline the eligibility and application process for the Medi-Cal, Healthy Families Program, and the new Health Care Exchange. It is being developed with the goal of meeting the requirements of the federal Affordable Care Act (ACA) in 2014, and was last amended on July 13. 

The Senate Appropriations Committee passed AB 1296 on August 25 and it now goes to the Senate Floor.

Mental Health

AB 1297 (Chesbro) – Support
As Amended on July 11, 2011

AB 1297, a bill by Assembly Member Wesley Chesbro, would ensure timely federal reimbursement to counties for providing Specialty Mental Health Managed Care services provided by counties. 

Specifically, AB 1297 would align the state’s requirements for the Specialty Medi-Cal Mental Health Managed Care program with existing federal requirements, which will help maximize federal reimbursements for these services. AB 1297 would accomplish this by requiring the state and the California Mental Health Directors Association to develop a reimbursement methodology that conforms to federal Medicaid requirements and approved Medicaid state plan and waivers. 

Counties believe that AB 1297 will both streamline and enhance our ability to draw down timely federal reimbursements for Specialty Medi-Cal Mental Health Managed Care services – all at no cost to the state’s General Fund. It is for these reasons that CSAC supports AB 1297. The Senate Appropriations Committee passed AB 1297 on August 25 and it now goes to the Senate Floor. The Appropriations Committee adopted amendments to delay implementation of the measure to July 1, 2012.

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