Bill Text: CA AB39 | 2013-2014 | Regular Session | Amended


Bill Title: Medi-Cal: designated public hospitals.

Spectrum: Partisan Bill (Democrat 3-0)

Status: (Engrossed - Dead) 2014-08-21 - Read second time. Ordered to third reading. Re-referred to Com. on RLS. pursuant to Senate Rule 29.10(c). [AB39 Detail]

Download: California-2013-AB39-Amended.html
BILL NUMBER: AB 39	AMENDED
	BILL TEXT

	AMENDED IN SENATE  AUGUST 20, 2014
	AMENDED IN SENATE  JUNE 24, 2013
	AMENDED IN ASSEMBLY  MAY 24, 2013
	AMENDED IN ASSEMBLY  MAY 8, 2013
	AMENDED IN ASSEMBLY  APRIL 24, 2013
	AMENDED IN ASSEMBLY  APRIL 9, 2013
	AMENDED IN ASSEMBLY  FEBRUARY 27, 2013

INTRODUCED BY   Assembly Member Skinner
    (   Principal coauthor:   Senator 
 Hancock   ) 
    (   Coauthor:   Senator   De
Saulnier   ) 

                        DECEMBER 3, 2012

    An act to amend Section 25421 of the Public Resources
Code, relating to energy, and making an appropriation therefor.
  An act to amend Section 14166.1 of, and to add Section
14182.6 to, the Welfare and Institutions Code, relating to Medi-Cal,
making an appropriation therefor, and declaring the urgency thereof,
to take effect immediately. 


	LEGISLATIVE COUNSEL'S DIGEST


   AB 39, as amended, Skinner.  Energy: conservation:
financial assistance.   Medi-Cal: designated public
hospitals.  
   Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Care Services, under
which qualified low-income individuals receive health care services.
The Medi-Cal program is, in part, governed and funded by federal
Medicaid Program provisions.  
   Existing law establishes the Medi-Cal Hospital/Uninsured Care
Demonstration Project Act, which revises hospital supplemental
payment methodologies under the Medi-Cal program in order to maximize
the use of federal funds consistent with federal Medicaid law and to
stabilize the distribution of funding for hospitals that provide
care to Medi-Cal beneficiaries and uninsured patients. Existing law
requires the department to seek a successor demonstration project or
federal waiver of Medicaid law to implement specified objectives,
which may include better care coordination for seniors, persons with
disabilities, and children with special health care needs. Existing
law provides that to the extent the provisions under the Medi-Cal
Hospital/Uninsured Care Demonstration Project Act do not conflict
with the provisions of, or the Special Terms and Conditions of, this
demonstration project, the provisions of the Medi-Cal
Hospital/Uninsured Care Demonstration Project Act apply. Existing law
also defines designated public hospital for purposes of these
provisions and requires that designated public hospitals be eligible
for specified payments under the demonstration project.  
   This bill would require the department to seek federal approval to
add Doctors Medical Center, operated by West Contra Costa Healthcare
District, to the list of designated public hospital for purposes of
the demonstration project. The bill would provide that it is the
intent of the Legislature that Doctors Medical Center be eligible for
any funding available to designated public hospitals under the
demonstration project.  
   The bill would appropriate $3,000,000 from the General Fund to the
West Contra Costa Healthcare District for support of the Doctors
Medical Center.  
   This bill would make legislative findings and declarations as to
the necessity of a special statute relating to the Doctors Medical
Center, operated by the West Contra Costa Healthcare District. 

   This bill would declare that it is to take effect immediately as
an urgency statute.  
   The Energy Conservation Assistance Act of 1979 requires, until
January 1, 2018, the State Energy Resources Conservation and
Development Commission to administer the State Energy Conservation
Assistance Account, a continuously appropriated account to provide
grants and loans to local governments and public institutions to
maximize energy use savings.  
   This bill would extend the operation of the act to January 1,
2020, and would thereby make an appropriation by extending the time
during which the funds in a continuously appropriated account are
made available. 
   Vote: 2/3. Appropriation: yes. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

   SECTION 1.    Section 14166.1 of the  
Welfare and Institutions Code   is amended to read: 
   14166.1.  For purposes of this article, the following definitions
shall apply:
   (a) "Allowable costs" means those costs recognized as allowable
under Medicare reasonable cost principles and additional costs
recognized under the demonstration project and successor
demonstration project, including those expenditures identified in
Appendix D to the Special Terms and Conditions for the demonstration
project and successor demonstration project. Allowable costs under
this subdivision shall be determined in accordance with the Special
Terms and Conditions and implementation documents for the
demonstration project and successor demonstration project approved by
the federal Centers for Medicare and Medicaid Services.
   (b) "Base year private DSH hospital" means a nonpublic hospital,
nonpublic-converted hospital, or converted hospital, as those terms
are defined in paragraphs (26), (27), and (28), respectively, of
subdivision (a) of Section 14105.98, that was an eligible hospital
under paragraph (3) of subdivision (a) of Section 14105.98 for the
2004-05 state fiscal year.
   (c) "Demonstration project" means the Medi-Cal Hospital/Uninsured
Care Demonstration, Number 11-W-00193/9, as approved by the federal
Centers for Medicare and Medicaid Services, effective for the period
of September 1, 2005, through October 31, 2010.
   (d) "Designated public hospital" means any one of the following
hospitals to the extent identified in Attachment C,
"Government-operated Hospitals to be Reimbursed on a Certified Public
Expenditure Basis," to the Special Terms and Conditions for the
demonstration project and successor demonstration project, as
applicable, issued by the federal Centers for Medicare and Medicaid
Services:
   (1) UC Davis Medical Center.
   (2) UC Irvine Medical Center.
   (3) UC San Diego Medical Center.
   (4) UC San Francisco Medical Center.
   (5) UC Los Angeles Medical Center, including Santa Monica/UCLA
Medical Center.
   (6) LA County Harbor/UCLA Medical Center.
   (7) LA County Martin Luther King Jr.-Harbor Hospital.
   (8) LA County Olive View UCLA Medical Center.
   (9) LA County Rancho Los Amigos National Rehabilitation Center.
   (10) LA County University of Southern California Medical Center.
   (11) Alameda County Medical Center.
   (12) Arrowhead Regional Medical Center.
   (13) Contra Costa Regional Medical Center.
   (14) Kern Medical Center.
   (15) Natividad Medical Center.
   (16) Riverside County Regional Medical Center.
   (17) San Francisco General Hospital.
   (18) San Joaquin General Hospital.
   (19) San Mateo Medical Center.
   (20) Santa Clara Valley Medical Center.
   (21) Tuolumne General Hospital.
   (22) Ventura County Medical Center. 
   (23) Doctors Medical Center. 
   (e) "Federal medical assistance percentage" means the federal
medical assistance percentage applicable for federal financial
participation purposes for medical services under the Medi-Cal state
plan pursuant to Section 1396b(a) of Title 42 of the United States
Code.
   (f) "Nondesignated public hospital" means a public hospital
defined in paragraph (25) of subdivision (a) of Section 14105.98,
excluding designated public hospitals.
   (g) "Project year" means the applicable state fiscal year of the
Medi-Cal Hospital/Uninsured Care Demonstration Project through
October 31, 2010.
   (h) "Project year private DSH hospital" means a nonpublic
hospital, nonpublic-converted hospital, or converted hospital, as
those terms are defined in paragraphs (26), (27), and (28),
respectively, of subdivision (a) of Section 14105.98, that was an
eligible hospital under paragraph (3) of subdivision (a) of Section
14105.98, for the particular project year.
   (i) "Prior supplemental funds" means the Emergency Services and
Supplemental Payments Fund, the Medi-Cal Medical Education
Supplemental Payment Fund, the Large Teaching Emphasis Hospital and
Children's Hospital Medi-Cal Medical Education Supplemental Payment
Fund, and the Small and Rural Hospital Supplemental Payments Fund,
established under Sections 14085.6, 14085.7, 14085.8, and 14085.9,
respectively.
   (j) "Private hospital" means a nonpublic hospital,
nonpublic-converted hospital, or converted hospital, as those terms
are defined in paragraphs (26) to (28), inclusive, respectively, of
subdivision (a) of Section 14105.98.
   (k) "Safety net care pool" means the federal funds available under
the Medi-Cal Hospital/Uninsured Care Demonstration Project and the
successor demonstration project to ensure continued government
support for the provision of health care services to uninsured
populations.
   (  l  ) "Uninsured" shall have the same meaning as that
term has in the Special Terms and Conditions issued by the federal
Centers for Medicare and Medicaid Services for the demonstration
project and the successor demonstration project.
   (m) "Successor demonstration project" means the Medicaid
demonstration project entitled "California's Bridge to Reform," No.
11-W-00193/9, as approved by the federal Centers for Medicare and
Medicaid Services, effective for the period of November 1, 2010,
through October 31, 2015.
   (n) "Successor demonstration year" means the demonstration year as
identified in the Special Terms and Conditions for the successor
demonstration project that corresponds to a specific period of time
as follows:
   (1) Successor demonstration year 6 corresponds to the period of
November 1, 2010, through June 30, 2011.
   (2) Successor demonstration year 7 corresponds to the period of
July 1, 2011, through June 30, 2012.
   (3) Successor demonstration year 8 corresponds to the period of
July 1, 2012, through June 30, 2013.
   (4) Successor demonstration year 9 corresponds to the period of
July 1, 2013, through June 30, 2014.
   (5) Successor demonstration year 10 corresponds to July 1, 2014,
through October 31, 2015.
   (o) "Low Income Health Program" means the county-based elective
program to provide benefits for low-income individuals that is
authorized by the successor demonstration project and implemented by
Part 3.6 (commencing with Section 15909).
   (p) "Delivery system reform incentive pool" means the separate
federal funding pool created within the safety net care pool under
the successor demonstration project that is available to support
programs of activity to enhance the quality of care and health of
patients served by designated public hospitals and nonhospital
clinics and other provider types with which they are affiliated, and,
under specified conditions and approval of the federal Centers for
Medicare and Medicaid Services, to private disproportionate share
hospitals and nondesignated public hospitals.
   SEC. 2.    Section 14182.6 is added to the  
Welfare and Institutions Code   , to read:  
   14182.6.  (a) The department shall seek federal approval to amend
the demonstration project described in Section 14180 to add the
Doctors Medical Center, operated by the West Contra Costa Healthcare
District, to the list of designated public hospitals identified in
Attachment C, "Government Hospitals to be Reimbursed on a Certified
Public Expenditure Basis," to the Special Terms and Conditions for
the demonstration project.
   (b) It is the intent of the Legislature that Doctors Medical
Center be eligible for any funding available to designated public
hospitals under the demonstration project, including payments
described in subdivision (b) of Section 14166.35. 
   SEC. 3.    The sum of three million dollars
($3,000,000) is hereby appropriated from the General Fund to the West
Contra Costa Healthcare District for support of the Doctors Medical
Center. 
   SEC. 4.    The Legislature finds and declares that a
special law is necessary and that a general law cannot be made
applicable within the meaning of Section 16 of Article IV of the
California Constitution because of the unique circumstances regarding
financing of the West Contra Costa Healthcare District. 
   SEC. 5.    This act is an urgency statute necessary
for the immediate preservation of the public peace, health, or safety
within the meaning of Article IV of the Constitution and shall go
into immediate effect. The facts constituting the necessity are:
 
   In order to prevent the imminent closure of a critical component
of the West Contra Costa County safety net by providing funding
comparable to other safety net hospitals, it is necessary that this
act take effect immediately.  
  SECTION 1.    Section 25421 of the Public
Resources Code is amended to read:
   25421.  (a) Except as provided in subdivision (b), this chapter
shall remain in effect only until January 1, 2020, and as of that
date is repealed, unless a later enacted statute, which is enacted
before January 1, 2020, deletes or extends that date.
   (b) Except as specified in subdivisions (c) and (d), all loans
outstanding as of January 1, 2020, shall continue to be repaid on a
semiannual basis, as specified in Section 25415, until paid in full.
All unexpended funds in the State Energy Conservation Assistance
Account on January 1, 2020, and thereafter shall revert to the
General Fund.
   (c) To the extent required under applicable bond obligations,
unexpended funds from the proceeds of bonds sold pursuant to Section
25417.5 that remain in the State Energy Conservation Assistance
Account on January 1, 2020, shall remain in the account. These funds
shall be expended pursuant to the applicable requirements for bond
proceeds. Once all applicable bond obligations have been satisfied,
unexpended funds shall revert to the General Fund.
   (d) Unexpended funds from the federal American Recovery and
Reinvestment Act of 2009 (Public Law 111-5) remaining in the State
Energy Conservation Assistance Account on January 1, 2020, shall
revert to the Federal Trust Fund. 
      
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