CSAC Bulletin Article

Health and Human Services

Senate Special Session Bills with Active CSAC Positions

SBX2 2 (Hernandez) – Pending
As Amended on September 4, 2015

SBX2 2, by Senator Ed Hernandez, was voted on the Senate Floor last night. It received a single yes vote, which allows it to be referred to the newly formed Health Special Session Conference Committee.

SBX2 14 (Hernandez) – Pending
As Introduced on September 9, 2015

SBX2 14, by Senator Hernandez, would: 1) change the definition of tobacco products to include electronic cigarettes; 2) impose a $2 tobacco tax on cigarettes and an equivalent tax on electronic cigarettes; 3) repeal the 7 percent reduction in in-home supportive services (IHSS) service hours; and 4) impose a tiered MCO tax on all managed care organizations.

This measure was heard by the Senate Public Health and Developmental Services Committee on Thursday morning, where the Health Plans conveyed their opposition to the measure. It was also taken up and passed by the Senate Appropriations Committee on Thursday and is now heading to the Senate Floor for a vote.

Assembly Special Session Bills with Active CSAC Positions

ABX2 6 (Cooper) – SUPPORT
As Amended on August 27, 2015

ABX2 6 by Assembly Member Jim Cooper, would expand the STAKE Act’s definition of tobacco products to include electronic devises that deliver nicotine or vaporized liquids and make it illegal to furnish such products to minors.

This bill is similar to SB 140 introduced by Senator Leno during the regular session. Senator Leno was forced to abandon the bill in Assembly Government and Finance Committee due to significant amendments that stripped the bill of its intended purpose.

ABX2 6 was passed by the Assembly Finance Committee and now resides on the Assembly Floor awaiting a vote.

ABX2 8 (Wood) – SUPPORT
As Amended

ABX2 8, by Assembly Member Wood would raise the age for restricted access to tobacco products from 18 to 21.

The bill was originally introduced by Senator Hernandez during the regular session – SB 151 – however, the bill was pulled from at the request of the author.

ABX2 8 was passed by the Assembly Finance Committee and will be heard on the Assembly Floor.

ABX2 15 (Eggman) – Watch
As Amended on September 3, 2015

ABX2 15 would enact the End of Life Option Act authorizing an adult who meets certain qualifications, and who has been determined by his or her attending physician to be suffering from a terminal disease, as defined, to make a request for a drug prescribed pursuant to these provisions for the purpose of ending his or her life.

This bill is a reintroduction of the regular session’s SB 128, by Senator Wolk, which failed to meet the deadline in the Assembly Health Committee and is now a 2-year measure.

ABX2 15 is being heard on the Senate Floor today. CSAC did not take a position on this measure but is including it in the interest of informing our members.

ABX2 19 (Bonta) – Pending
As Introduced on September 8, 2015

Assembly Member Rob Bonta’s MCO tax proposal included in ABX2 19 would generate an equivalent amount of nonfederal funds as the current MCO tax. The legislation would set a tax methodology for FY 16-17, which includes two sets of tiers – one for Medi-Cal managed care plans and another for non-Medi-Cal managed care plans. For FY 17-18 and future years, ABX2 19 gives the Department of Health Care Services and the Department of Managed Health Care the authority to determine tax methodologies.

The measure has not yet been heard by a policy committee.
 

Other Legislation

Child Welfare

SB 238 (Mitchell) – SUPPORT
As Amended on September 4, 2015

SB 238, sponsored by the County Welfare Directors Association of California and supported by CSAC, seeks to increase communication and training amongst all parties serving foster youth through requiring four key aspects:

1. The Department of Social Services and the Department of Health Care Services to develop monthly data reports that match prescription and claims data with child welfare services records;

2. The development of a system that triggers alerts to child welfare social workers and others serving the child such as attorneys and courts, when medications that could have dangerous interactions with psychotropic medications have been prescribed or when foster youth are prescribed unusual dosages;

3. An update to the JV-220 court form to allow key stakeholders to provide information, feedback and details on the overall mental health and treatment plan for the child; and

4. Training for child welfare social workers, foster children, caregivers and attorneys, Court-Appointed Special Advocates and foster care public health nurses regarding psychotropic medications.

SB 238 is enrolled and is awaiting the Governor’s action.
 

Medi-Cal

AB 858 (Wood) – SUPPORT
As Amended on September 4, 2015

AB 858, by Assembly Member Wood, would allow federally qualified health centers (FQHCs) and rural health clinics (RHCs) to draw down federal funding for patient visits with marriage and family therapists. CSAC supports AB 858 which was heard on the Assembly Floor, where they concurred with the Senate amendments. It will be headed to the Governor’s desk for action.

SB 33 (Hernandez) – Support
As Amended on August 28, 2015

SB 33 by Senator Ed Hernandez, would 1) limit estate recovery for those ages 55 and over to only the health care services required to be recovered under federal law; 2) eliminate recovery against the estate of a surviving spouse of a deceased beneficiary; and 3) require DHCS to provide notice of total Medi-Cal expenses paid on behalf of the beneficiary that are subject to recovery and post notice on how to request this information on the website. CSAC along with the County Health Executives Association of California and the County Welfare Directors Association of California have taken a support position on this measure; however the measure was sent to the Assembly Floor’s inactive file and will be a 2-year bill.
 

Medi-Cal Demonstration Bills

SB 36 (Hernandez) – SUPPORT
As Amended on September 4, 2015

SB 36 currently serving as the sole legislative vehicle for California’s successor Section 1115 Medicaid Waiver. As amended, the bill would allow the Department of Health Care Services to seek an extension of the current 1115 Waiver, given the anticipated delays in obtaining CMS approval of California’s successor Section 1115 Waiver.

DHCS and CMS are actively engaged in Waiver discussions. Last week, DHCS provided an update to interested parties, noting that CMS had rejected the shared savings proposal and that they would be looking creatively for non-federal match.

CSAC is in SUPPORT of SB 36 – which the Assembly passed with a 61 to 0 vote – and will continue to provide updates as Waiver discussions progress.
 

Child Support

AB 610 (Jones Sawyer) – SUPPORT
As Amended on August 31, 2015

AB 610, by Assembly Member Reginald Jones-Sawyer, would expand an existing pilot program to apply to all child support cases and would authorize the local child support agency to administratively adjust account balances for cases if the agency verifies that the obligator is unable to pay due to incarceration.

On Thursday, the Assembly concurred with the Senate amendments to AB 610. CSAC supports this measure which is now headed to the Governor for action.

Adult Protective Services

SB 196 (Hancock) – SUPPORT
As Amended on August 27, 2015

Senate Bill 196, by Senator Hancock, would authorize a county adult protective services agency to file a petition for a protective order on behalf of elder or dependent adults if the adult has been identified as lacking the capacity and a conservatorship is being sought.

Current law authorizes the following persons to seek an order: a conservator or trustee, an attorney-in-fact, a person appointed as a guardian ad litem, or other person legally authorized to seek the order. SB 196 seeks to add a county adult protective services agency as an authorized entity.

CSAC supports SB 196, which was signed into law by Governor Brown on Wednesday, September 9. It was sponsored by the County Welfare Directors Association and we commend them for their good work on elder protection issues.
 

Mental Health

AB 193 (Maienschein) – OPPOSE
As Amended on September 2, 2015

AB 193, by Assembly Member Brian Mainschein, would authorize a Probate Court judge to recommend a Lanterman-Petris-Short Act (LPS) conservatorship to the county officer providing conservatorship investigations. Essentially, AB 193 assumes that because a Probate conservatorship has been established, a person should also qualify for involuntary mental health treatment or a conservatorship. The LPS Act was created so that individuals could not be indiscriminately placed in involuntary settings without due process, which includes the involuntary hold process and LPS conservatorship. It is a very high bar that is in place to protect the patients, and AB 193 erodes this due process.

AB 193 would also result in significant county General Fund costs due to increased investigations and potentially increased LPS conservatorships. CSAC, along with Los Angeles County, the Urban Counties Caucus and the County Behavioral Health Directors Association, all OPPOSE AB 193 and continues to advocate against it. Unfortunately, the Assembly concurred with the Senate amendments with 79 ‘aye’ votes and only 1 ‘no’ vote. We urge counties to send in letters of opposition to the Governor’s office urging his veto on this measure.
 

SB 804 (Senate Health Committee) – Support
As Amended on September 4, 2015

SB 804, the Senate Health Committee’s omnibus bill, updates obsolete references to California Mental Health Directors Association and the County Alcohol and Drug Program Administrators Association of California to reflect the County Behavioral Health Directors Association (CBHDA). The bill was passed by the Assembly Floor and is awaiting the Senate’s concurrence on amendments taken in the Assembly.
 

Peer Certification

SB 614 (Leno) – SUPPORT
As Amended on August 31, 2015

Senator Mark Leno’s SB 614, sponsored by the County Behavioral Health Directors Association (CBHDA), would establish a statewide peer and family support specialist certification program to be administered by the Department of Health Care Services.

SB 614 has been moved to the inactive file; however, the author, the Department of Health Care Services, and CBHDA are committed to moving this legislation early next year.
 

Continuum of Care Reform

AB 403 (Stone) – SUPPORT IN CONCEPT
As Amended on July 16, 2015

AB 403, by Assembly Member Mark Stone and sponsored by the Department of Social Services (DSS), reflects DSS’ attempt to reform the continuum of care group home system for foster youth. In January, DSS released their Continuum of Care Report to the Legislature, which outlined a comprehensive approach to improving the experience and outcomes of children and youth in foster care.

AB 403 reclassifies juvenile treatment facilities and the transition from the use of group homes for children in foster care and on probation to the use of short-term residential treatment centers (STRTCs) – defined in the amendments. AB 403 revises foster parent training requirements and provides for the development of Child-Family Teams to inform the process of placement and services to children. Additionally, the bill seeks to develop a new group home rate payment structure to fund placement options for children in foster care.

CSAC, along with our county affiliates – CWDA, CBHDA and CPOC – continue to work closely with the Department of Social Services on this significant measure, including on both the potential fiscal and policy impacts. CSAC continues to maintain a SUPPORT IN CONCEPT position on AB 403, which was passed by the Assembly this morning and is now enrolled.
 

IHSS

AB 1436 (Burke) – SUPPORT
As Amended on September 4, 2015

AB 1436 by Assembly Member Autumn Burke creates an authorized representative structure for the In-Home Supportive Services (IHSS) Program – which enables adults and children who need help with daily living activities remain in their own home rather than being institutionalized. Other county-administered programs, including Medi-Cal, CalWORKs and CalFresh, have statutory or regulator procedures for applicants and recipients to designate an authorized representative to act on their behalf in signing up for the program, receiving services and participating in the appeal process.

AB 1436 would create a statutory authority for an IHSS recipient or applicant to name an authorized representative, which would be completely optional to them.

AB 1436 will be taken up by the Assembly for concurrence with the Senate’s amendments.

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