AltaMed Government Relations
 2003-04
Legislative Session
Federal
Immigrant Children’s Health Improvement Act (H.R. 1689
and S.845) –This bill would give states the option
of providing federal Medicaid and SCHIP coverage to legal immigrant
children and pregnant women and allow states to receive a federal
match for this coverage. Supported by AltaMed, CCALAC, CPCA and
NACHC.
Health Care Equality and Accountability Act (H.R. 3459 and
S. 1833) – This bill would give preference to community
health centers (CHCs) in the placement of National Health Service
Corps (NHSC) clinicians that have a majority of patients that are
members of health disparity populations. Such a preference would further
help ensure that CHCs have adequate access to needed health professionals.
Supported by AltaMed, CCALAC, CPCA and NACHC.
Patient Navigator, Outreach and Chronic Disease Prevention
Act (H.R. 918 and S.453) This bill will allow CHCs and other
health care providers to establish and expand community-based patient
navigator programs aimed at improving the health and quality of acre
received by individuals. Patient navigators serve as a link between
their communities and providers to increase utilization of available
preventive health services to use existing health services appropriately.
Patient navigators are an effective way to increase access to already
existing health care programs, improve health outcomes and reduce
health disparities.
Building Better Health Centers Act of 2003 (H.R.1386 and
S.673) This bill would create a competitive grant program
for CHC facility construction. Under current law, CHCs are not
able to use Federal grant dollars for construction, modernization,
or expansion of facilities. In order to meet increasing demand,
CHCs need dollars for construction, modernization, or expansion
of their facilities. A recent survey by NACHC revealed that
the average age of CHC facilities is about 30 years old. Without
enactment of a competitive grant program for facility construction
and improvement, the only remaining source of federal funds
is through the annual appropriation process.
California
Federally-Qualified Health Centers & Rural Health Centers
Reimbursement (SB 1187 Chesbro) While last year’s passage
of SB 36 (Chesbro) culminated three years of work surrounding the
statutory implementation of the prospective payment system (PPS) in
California, outstanding issues remain. This measure will provide technical
clean up to SB 36 while seeking to resolve the following issues: (1)
the “four walls” issue; (2) reimbursement for same-day
visits; and (3) adjusting the threshold necessary to qualify for scope
of service changes. Supported by AltaMed, CCALAC, and CPCA.
Provider Enrollment Streamlining (AB 2307 Richman)
– This bill streamlines the enrollment of primary care clinics
as providers in California’s public programs. CPCA is sponsoring
AB 2307. The current primary care clinic licensure process largely
overlaps the provider enrollment process for various public health
programs, including Child Health and Disability Prevention Program,
the Medi-Cal Program, the Perinatal Services Program, and comprehensive
clinical family planning services. AB 2307 would combine the licensure
and enrollment process, eliminating costly duplicative requirements.
Supported by AltaMed, CCALAC, and CPCA.
Licensing Streamlining (SB 1824 Ducheny) Last year,
CPCA co-sponsored SB 937 (Ducheny) to standardize and streamline the
licensing process for California’s non-profit primary care clinics.
As part of the negotiations that led to SB 937’s enactment,
the Department of Health Services (DHS) requested technical language
clarifying that in the expedited processing of an application, DHS
has 30 days to approve or deny the application. SB 1824 was introduced
to address this request of DHS. Supported by AltaMed, CCALAC,
and CPCA.
Volunteer Health Care Professionals (AB 2510 Nakanishi)
With the persistent problems of the uninsured and access to care for
underserved populations, CPCA is sponsoring this legislation as a
means of removing obstacles to health care professionals volunteering
their services for no reimbursement. Modeled after a program in Florida
that in 2000 achieved $66 million in free health care services, AB
2510 would enable a health care professional to contract with a government
agency to provide free services. The government agency would then
pay for the contracting professionals liability insurance. Supported
by AltaMed, CCALAC, and CPCA.
Vision Care Benefits (AB 1927 Cohn) This bill would
require a health plan that offers vision care benefits to contract
with optometrists and physicians and surgeons. It would also prevent
a health plan, that offers vision services, from discriminating or
refusing to contract with a primary care clinic. Supported by
AltaMed, CCALAC, and CPCA.
Primary Care Clinic Rx Program (SB 1563 Escutia)
Rising prescription drug prices continue to be a major element driving
health care costs higher. The federal 340B Program enables covered
entities (including FQHCs, Title X clinics, and Ryan White clinics)
to obtain discounted drug prices, with studies indicating savings
on drug prices ranging from 25-50%. This measure creates a state-version
of the 340B Program that would enable non-profit and public primary
care clinics not covered by the federal program to realize similar
savings. The bill will be introduced during March. Supported by
AltaMed, CCALAC, and CPCA.
Mobile Dental Van (AB 2390 Reyes/Chan) Clarifies
that mobile health vans providing dental services and that operated
by non-profit and government operated clinics, are not subject to
the registration requirements of the Dental Practices Act. It also
provides that the limitation applicable dentist-owned mobile clinics
are not applicable to mobile health vans operated by open-door private,
non-profit and government operated clinics. Supported by AltaMed,
CCALAC, and CPCA.
ADHC Managed Growth (SB 1845 Perata) This bill contains
important policy changes for the adult day health care program that
were supported by the Legislature last year as an alternative
to the Governor’s budget proposals. SB 1845 contains the following
changes to current law:
- Structural Reform for the certification and
licensing process including a new “pre-application”
step, and a required 8-hour orientation class for new providers;
- Moratorium on new initial certification applications
for one year (6 months total moratorium and 6 months with exception
for underserved areas) to allow the Department of Aging to re-tool
the initial application process. PACE, FQHC, RHC and relocations
would be exempt;
- Fee increases to support the new pre-application
process. Application fees are established at $5,000, (this fee is
more than offset by the deferral of facility costs resulting from
the change in the application process that no longer would require
the licensee to show possession of a facility until after
the pre-application is approved. Annual licensing renewal fees will
be $20 times the licensed capacity. Supported by AltaMed, CAADS,
and CPCA
Prescription Drugs (AB 1957 Frommer) This bill would
require the department to establish a Web site on or before July 1,
2005, to facilitate the safe purchase by California residents of prescription
drugs at reduced prices. It would require that the website establish
electronic links to pharmacies that are located in Canada and that
meet specified requirements. The bill would also require the department's
website to include price comparisons of prescription drugs, including
prices charged by licensed pharmacies in the state and Canadian pharmacies
that provide mail order service to the United. Supported by AltaMed
and SCHAC.
Comparative Benefit Matrix (AB 1596 Frommer) This
bill would require a health care service plan and a health insurer
to make these matrixes available through a link on their Internet
websites to the sites of the Department of Managed Health Care and
the Department of Insurance. Because the bill would impose a different
requirement on a health care service plan, the violation of which
would be a crime, it would impose a state-mandated local program.
This bill contains other related provisions and other existing laws.
Supported by AltaMed and SCHAC.
Health Care (AB 1959 Chu) This bill would require
the State Auditor to conduct an audit of the state's procurement and
reimbursement practices as they relate to the purchase of drugs for
or by state agencies, as specified, and issue and provide to the Legislature
the first audit report no later than May 31, 2005, and a subsequent
audit report no less than every 2 years thereafter, until May 31,
2009. Supported by AltaMed and SCHAC.
Public Health Outreach (AB 1963 Salinas) This bill
would include within the duties of the Office of Multicultural Health,
encouragement of the use of promotores de salud, as defined, and community
health workers to provide better health outcomes for rural and underserved
communities through the various public health programs, and would
make conforming changes in various public health programs to include
their use. Supported by AltaMed and SCHAC.
Clean Needle and Syringe Exchange: AIDS and Hepatitis (AB
2871 Berg) This bill would instead authorize cities, counties,
or cities and counties to have a clean needle and syringe exchange
project that, in consultation with the State Department of Health
Service, authorizes such exchange, as recommended by the United States
Secretary of Health and Human Services and as part of a network of
comprehensive services. This bill contains other existing laws. Supported
by AltaMed and SCHAC.
Omnibus Labor and Employment Non-Discrimination Act (AB 2900
Laird) This bill would amend existing law prohibit discrimination
on the same bases of race, religious creed, color, national origin,
ancestry, physical disability, mental disability, medical condition,
marital status, sex, age, or sexual orientation. Because existing
law makes a violation of certain of those nondiscrimination provisions
a misdemeanor, this bill, by expanding the bases on which discrimination
is prohibited, would impose a state-mandated local program. This bill
would also make technical, non-substantive changes to those provisions.
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 no reimbursement is required by this
act for a specified reason. Supported by AltaMed and SCHAC.
Prescription Drugs (AJR 61 Ridley-Thomas) This measure
would memorialize the United States Secretary of Health and Human
Services to certify to the Congress of the United States that implementation
of provisions of the Medicare Prescription Drug, Improvement and Modernization
Act of 2003, permitting the importation of prescription drugs from
Canada into the United States, will pose no additional risk to the
public's health and safety and will result in a significant reduction
in the cost of prescription drugs to the American consumer. Supported
by AltaMed and SCHAC.
Prescription Drugs (AJR 62 Ridley-Thomas) This measure
would call upon the California delegation of the United States Senate
and House of Representatives to sponsor and support legislation to
repeal any Medicare provision that would prohibit the federal government
from negotiating fair drug prices as contained in a section of the
federal Medicare Prescription Drug, Improvement, and Modernization
Act of 2003 (Public Law 108-173). Supported by AltaMed and SCHAC.
Medi-Cal: Plan Enrollment Eligibility (SB 831 Perata)
This bill would authorize the department to undertake efforts to provide
opportunities for voluntary enrollment in managed care plans and primary
care case management plans for any individual who is eligible for
benefits under the Medi-Cal program and who has an obligation to pay
a share of the cost of the benefits. The bill would authorize the
department to pursue all federal waivers and state medicaid plan amendments
necessary to implement the plan, and, upon creation of an option for
those beneficiaries to enroll in managed care plans, to take all necessary
actions to inform beneficiaries of their right to enroll in managed
care plans. Supported by AltaMed and SCHAC.
Prescription Drug Reimbursement: Pharmacy Purchases From
Canadian Sources: Medi-Cal: AIDS Drug Assistance Program (SB 1333
Perata) This bill would authorize, notwithstanding any other
provision of law, the department to reimburse a pharmacy that provides
to a Medi-Cal beneficiary a prescription drug that was purchased from
a Canadian pharmacy. This bill would provide that reimbursement for
that prescription drug may be in an amount up to an established percentage
less than the most recent allowable drug product price, not to exceed
50% of the difference between the purchase price from the Canadian
pharmacy and the purchase price the pharmacy would have paid to a
pharmaceutical wholesaler. This bill would also authorize, notwithstanding
any other provision of law, the department to reimburse, in the same
manner a pharmacy that has provided to a person eligible for benefits
under ADAP a prescription drug that was purchased from a Canadian
pharmacy. Supported by AltaMed and SCHAC.
Single Payor Health Care Coverage (SB 921 Kuehl Principal
- coauthor: Assembly Member Goldberg Coauthors: Senators Alarcon,
Cedillo, Florez, Perata, Romero, and Soto Coauthors: Assembly Members
Chan, Diaz, Hancock, Koretz, Levine, Lieber, Longville, Lowenthal,
Pavley, Steinberg, and Wiggins) This bill would establish
the California Health Care System to be administered by the newly
created California Health Care Agency under the control of an elected
Health Care Commissioner. The bill would make all California residents
eligible for specified health care benefits under the California Health
Care System, which would, on a single-payer basis, negotiate for or
set fees for health care services provided through the system and
pay claims for those services. The bill would prohibit deductibles
or co payments during the initial first 2 years of operation of the
health care system, but would authorize the commissioner to establish
deductibles and co payments thereafter. The bill would require the
health care system to be operational by January 1, 2006, and would
enact various transition provisions. The bill would require the commissioner
to seek all necessary waivers, exemptions, agreements, or legislation
to allow various existing federal, state, and local health care payments
to be paid to the California Health Care System, which would then
assume responsibility for all benefits and services previously paid
for with those funds. The bill would create a Health Policy Board
to establish policy on medical issues and various other matters relating
to the health care system. The bill would create the Office of Consumer
Advocacy within the agency to represent the interests of health care
consumers relative to the health care system. The bill would create
the Office of Medical Practice Standards within the agency, headed
by the chief medical officer, to establish standards of best medical
practice, including evaluation of pharmaceuticals and medical and
surgical treatment, and in conjunction with that office, would create
the Medical Practice Standards Advisory Board with specified advisory
duties. The bill would create the Office of Inspector General for
the California Health Care System within the Attorney General's office,
which would have various oversight powers. The bill would extend the
application of certain insurance fraud laws to providers of services
and products under the health care system, thereby imposing a state-mandated
local program by revising the definition of a crime. The bill would
enact other related provisions relative to budgeting, federal preemption,
subrogation, collective bargaining agreements, and associated matters.
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 no reimbursement is required by this
act for a specified reason. Supported by AltaMed and SCHAC.
Budget Act Appropriations: Excess Revenues: Funding Priorities
(SB 1270 Ortiz) Existing law provides for various public
social services programs under which health care services, cash assistance,
and other benefits are provided to qualified low-income families and
individuals and qualified aged, blind, and disabled persons. This
bill would require the Joint Legislative Budget Committee and the
Governor to jointly develop a plan that outlines by agency and strategy
the allocation, as proposed by the bill, of any revenues deposited
in the General Fund for any fiscal year that exceed the amount appropriated
from the General Fund for that fiscal year, excluding any revenues
the expenditure of which would be restricted by law. Supported
by AltaMed and SCHAC.
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