CSAC Bulletin Article

Health and Human Services update 5/19/2014

Human Services

AB 2547 (Gaines) – Support
As Amended on May 15, 2014

AB 2547, by Assembly Member Beth Gaines, would allow Placer County to continue to operate their successful integrated, coordinated, and seamless approach to health and human services delivery in the County for another five years. 
Sponsored by the Placer County Board of Supervisors, AB 2547 extends the sunset date to January 1, 2022 for the County’s innovative Health and Human Services blended pilot program. Operated in conjunction with the State, Placer County’s Integrated Health and Human Services Pilot Program serves as a model of family centered and needs-based delivery of services to children and families by providing blended education, mental health, probation, and child welfare services in a seamless team approach. 
The Assembly Human Services Committee passed AB 2547 on April 29 on their consent calendar, with the recommendation to the Assembly Appropriations Committee to also place it on consent. On May 14, the Assembly Appropriations Committee passed AB 2547 with amendments on a 17 to 0 vote. The amendments remove the sunset date and make the Placer County Integrated Health and Human Services Pilot Program permanent. Additionally, they removed obsolete evaluation and reporting requirements.

AB 1733 (Quirk-Silva, Maienschein, Atkins) – Support
As Amended on April 21, 2014

AB 1733, by Assembly Members Sharon Quirk-Silva, Brian Maienshcein and Assembly Speaker Toni Atkins, allows a fee waiver for a homeless person to obtain a certified certificate of live birth from the county registrar or recorder or an identification card from the Department of Motor Vehicles (DMV). 
CSAC supports AB 1733. As the service provider of last resort for indigent Californians, counties deal with the effects of homelessness across our systems, including health, human services and public safety. AB 1733 will facilitate access for homeless people to services that are critical to helping them move towards self-sufficiency. Government and non-governmental entities fund a variety of services that help ensure the health and safety of homeless and low-income people. However, eligibility must be established in order to access these services, which often requires proof of identity with a birth record or valid identification card. Providing these services to homeless persons reduce costs to government and society overall, but particularly counties. 
This bill passed both Assembly Health and Transportation Committees; AB 1733 is currently on the Assembly Appropriations Suspense file. 

Emergency Medical Services

AB 1975 (Hernández) – Oppose
As Amended on May 7, 2014

AB 1975, by Assembly Member Roger Hernández, was amended this week, but the changes have failed to allay county concerns about the bill. 
AB 1975 would originally have required Local Emergency Medical Services Agencies (LEMSAs) which are implementing a trauma care system to commission the American College of Surgeons (ACS) to conduct a comprehensive assessment periodically of equitability and access to its trauma system. 
After the amendments on May 7, this bill would require local EMS agencies (LEMSAs) to commission regional assessments by an independent entity of their trauma systems. This bill would also require LEMSAs to incorporate regional trauma coordinating committee (RTCC) recommendations into their local trauma care plans. 
Counties oppose AB 1975. Local EMS agencies, with the oversight of the EMS Authority and the Commission on EMS, currently perform objective and independent trauma planning and system evaluation. While there may be value on a case-by-case basis for a local EMS agency voluntarily choosing to contract with an independent entity, counties oppose the significant increase in authority and roles for RTCC’s in the development of local trauma care plans. 
CSAC, along with the Emergency Medical Administrators Association of California (EMSAAC) and the Emergency Medical Directors Association of California (EMDAC), are currently in talks with the Author’s office to address our ongoing concerns. CSAC continues to oppose the measure based on the May 7 amendments. The Assembly Health Committee passed the measure on May 7 on an 11 to 6 vote; it goes next to the Assembly Appropriations Committee. 

Mental Health 

SB 1054 (Steinberg) – Support
As Amended on April 7, 2014

SB 1054, by Senate President pro Tempore Darrell Steinberg, would resurrect the Mentally Ill Offender Crime Reduction (MIOCR) grant program by providing $25 million for juvenile offenders and $25 million for adult offenders in 2014-15. 
The competitive grant program would be administered by the Board of State and Community Corrections and disbursements would be made from the Recidivism Reduction Fund to counties that expand or establish a continuum of swift, certain, and graduated responses to reduce crime and criminal justice costs related to mentally ill offenders over four years. 
CSAC strongly supports Senator Steinberg’s efforts to target funding for intensive services to those who suffer from mental illness in the criminal justice system. The Senate Public Safety Committee passed SB 1054 on April 22 with strong county and law enforcement support. It has been referred to the Senate Budget and Fiscal Review Committee. 

SB 1161 (Beall) – Support
As Amended on April 29, 2014

SB 1161, by Senator Jim Beall, would require the Department of Health Care Services to expand substance use disorder (SUD) residential treatment capacity and medical detoxification services in California by pursuing a federal Medicaid waiver with the Center for Medicare and Medicaid Services.
SB 1161 seeks to ensure that residential care facilities for substance use disorder and medical detoxification services are available to Medi-Cal beneficiaries. Expansion of provider capacity is a critical component of ensuring that the Medi-Cal expansion meets the needs of those seeking substance use disorder treatment. As California looks to expand treatment capacity, it should partner with the federal government in seeking flexibility in the models for delivering care that will allow for the most cost effective expenditure of public funds. 
CSAC is also supportive of DHCS’s pursuit of a broad federal waiver to test a new model for better access and care coordination within the Drug Medi-Cal program and SUD services at the county level. The Senate Appropriations Committee heard the bill on May 12 and placed it on the suspense file with a 7 to 0 vote.

Public Guardian

AB 1725 (Maienschein) – Oppose
As Amended on April 30, 2014

AB 1725, by Assembly Member Brian Maienschein, remains a concern for counties as it will increase costs and workload levels and hasten the erosion of county authority in conservatorship investigations should this measure move forward.
AB 1725 was amended April 30, and while the amendments reflect an improvement in the bill, counties remain opposed to the remaining provisions that would allow a Probate Court to make a recommendation of conservatorship to the county Conservatorship Officer (CO) and require the CO to conduct the investigation and file a report within 30 days of the probate court recommendation.
While the proposed language does not require the CO to recommend conservatorship to the Superior Court, it does compel the CO to conduct a conservatorship investigation. This is contrary to current law, whereby a CO retains the authority to determine whether an investigation is warranted upon receiving a referral by a medical professional. 
Should the mandate in AB 1725 become law, counties anticipate a significant increase in workload and county costs for conservatorship investigations. Further, the measure would also impose an arbitrary and frankly unrealistic 30-day mandated timeline for the investigation and submission of a report to the Superior Court. 
CSAC urges counties to oppose AB 1725, which has been referred to the Assembly Appropriations Committee but not yet set for hearing. 

General Assistance

AB 2311 (Bradford) – Oppose
As Introduced on February 21, 2014

AB 2311, by Assembly Member Steven Bradford, would alter locally-established General Assistance (GA) eligibility to allow honorably discharged veterans to receive GA benefits for a longer period of time. 
Each county establishes GA benefit eligibility and award levels to best serve the needs of their communities. While counties strive to serve veteran populations, AB 2311 would increase county-funded benefits for a specific population and remove local authority to set GA levels that meets the needs of each community. 
AB 2311 is currently on the Assembly Appropriations Committee’s suspense file. CSAC urges counties to weigh in on this issue. 

Medi-Cal

SB 1341 (Mitchell) – Support
As Amended on May 6, 2014

SB 1341, by Senator Holly Mitchell, would codify the existing agreement between the Administration, Covered California, and the counties regarding the respective roles of the State Automated Welfare System (SAWS) and the California Health Eligibility Enrollment and Retention System (CalHEERS). 
Specifically, SB 1341:

  • Specifies SAWS as the system of record for Medi-Cal and that SAWS shall contain all Medi-Cal eligibility rules and case management functionality. The bill permits the MAGI rules for Medi-Cal to continue to be housed in CalHEERS as they currently are; and, 
  • Requires that Notices of Action (NOAs) for Medi-Cal be programmed into the Medi-Cal system of record: the SAWS systems.

The Senate Appropriations Committee will hear SB 1341 on May 19.

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