Bill Text: CA SB1308 | 2015-2016 | Regular Session | Amended

California Senate Bill 1308 (Prior Session Legislation)

Bill Title: Medi-Cal: county organized health systems.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Failed) 2016-11-30 - From committee without further action. [SB1308 Detail]

Download: California-2015-SB1308-Amended.html

BILL NUMBER: SB 1308	AMENDED
	BILL TEXT

	AMENDED IN SENATE  MARCH 28, 2016

INTRODUCED BY   Senator Nguyen

                        FEBRUARY 19, 2016

   An act to amend Section  14087.8 of   14087.6
of, and to add Section 14087.65 to,  the Welfare and
Institutions Code, relating to Medi-Cal.



	LEGISLATIVE COUNSEL'S DIGEST


   SB 1308, as amended, Nguyen. Medi-Cal: county  organized 
health systems.
   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 authorizes the department
to negotiate exclusive contracts with any county  which
  that  seeks to provide, or arrange for the
provision  of   of,  the Medi-Cal services
to Medi-Cal beneficiaries, as specified. Existing law 
requires that when the department has entered into a contract with a
county, that the department, at a minimum, monitor the level and
quality of services provided in the county and the county's
expenditures pursuant to the contract, as specified.  
authorizes a county that has contracted for the provision of services
to   arrange for any or all of the services to be provided
by subcontracting with primary care providers, health maintenance
organizations, insurance carriers, or other entities or individuals.

   This bill would  require the department to additionally
report to the Legislature annually on the level and quality of
services provided in the county and the county's expenditures
pursuant to the contract.   prohibit a county organized
health system that has contracted with the department as described
above from utilizing funds intended for administrative and
operational expenses for staff retreats, promotional giveaways,
excessive executive compensation, or promotion of federal or state
legislative or regulatory modifications. The bill would prohibit a
media campaign or paid advertising purchased by the county organized
health system from featuring the image or voice of an elected public
official or candidate for elected office, or directly represent the
views of an official or candidate. The bill would permit the media
campaign or paid advertising to reference an official or candidate if
the name appears in a roster listing containing the names of all
officers of the purchasing agency, as specified. The bill would 
 make related legislative findings and declarations. 
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


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

   SECTION 1.    The Legislature finds and declares all
of the following:  
   (a) County organized health systems together serve 2.2 million
enrollees in the Medi-Cal program.  
   (b) Recent increases in enrollment in the Medi-Cal program have
stretched available resources and have the potential to limit access
to vital medical care.  
   (c) County organized health system resources should be directed to
providing direct care to the maximum extent possible.  
   (d) The California Health Benefit Exchange has operated with
limitations on how taxpayer funding can be used in an effort to
direct more resources into direct patient services.  
   (e) All advertisement and promotional material produced by county
organized health systems should be used to promote access to health
care and not to promote board members.  
   (f) County organized health systems are responsible for
billion-dollar annual contracts, which potentially creates perceived
or real conflicts of interest. 
   SEC. 2.    Section 14087.6 of the   Welfare
and Institutions Code   is amended to read: 
   14087.6.   (a)    A county that has contracted
for the provision of services pursuant to this article may provide
the services directly to recipients, or arrange for any or all of the
services to be provided by subcontracting with primary care
providers, health maintenance organizations, insurance carriers, or
other entities or individuals. The subcontracts may utilize a
prospectively negotiated reimbursement rate, fee-for-service,
retainer, capitation, or other basis for payment. The rate of payment
established under the contract shall not exceed the total per capita
amount that the department estimates would be payable for all
services and requirements covered under the contract if all these
services and requirements were to be furnished to Medi-Cal
beneficiaries under the Medi-Cal fee-for-service program. 
    Counties
    (b)     Counties  that are responsible
for providing health care under this chapter shall make efforts to
utilize existing health service resources if these resources can be
estimated by the county to result in lower total long-term costs and
accessible quality care to persons served under this chapter. The
granting of a certificate of need pursuant to the criteria set forth
in Section 127200 of the Health and Safety Code or a certificate of
exemption pursuant to the criteria set forth in Section 127175 of the
Health and Safety Code shall satisfy the intent of this provision.

   (c) A county organized health system that has contracted for the
provision of services pursuant to this article shall not utilize any
funds intended for administrative and operational expenses for staff
retreats, promotional giveaways, excessive executive compensation, or
promotion of federal or state legislative or regulatory
modifications. 
   SEC. 3.    Section 14087.65 is added to the 
 Welfare and Institutions Code   , to read:  
   14087.65.  (a) A media campaign or paid advertising purchased by a
county organized health system that contracts for the provision of
services pursuant to this article shall not feature in any manner the
image or voice of an elected public official or candidate for
elected office, or directly represent the views of an elected public
official or candidate for elected office.
   (b) A media campaign or paid advertising purchased by a county
organized health system that contracts for the provision of services
pursuant to this article may include a reference to an elected public
official or candidate for elected office if the name appears in a
roster listing containing the names of all officers of the purchasing
agency and all names in the roster appear in the same type size,
typeface, type color, and location.  
  SECTION 1.    Section 14087.8 of the Welfare and
Institutions Code is amended to read:
   14087.8.  When the department has entered into a contract with a
county pursuant to this article, the department shall, at a minimum,
through a method independent of any agency of the county, monitor and
report to the Legislature annually on the level and quality of
services provided in a county, as well as a county's expenditures
pursuant to the contract, and shall ensure conformity with federal
law.