Bill Text: CA SB492 | 2015-2016 | Regular Session | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Coordinated Care Initiative: consumer educational and informational guide.

Spectrum: Partisan Bill (Democrat 3-0)

Status: (Failed) 2016-11-30 - Died at Desk. [SB492 Detail]

Download: California-2015-SB492-Introduced.html

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BILL NUMBER: SB 492	INTRODUCED
	BILL TEXT


INTRODUCED BY   Senator Liu
   (Principal coauthor: Assembly Member Brown)

                        FEBRUARY 26, 2015

   An act to add Section 14132.279 to the Welfare and Institutions
Code, relating to Medi-Cal.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 492, as introduced, Liu. Coordinated Care Initiative: Consumer
Bill of Rights.
   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. One of the methods by which these
services are provided is pursuant to contracts with various types of
managed care health plans. Existing federal law provides for the
federal Medicare Program, which is a public health insurance program
for persons 65 years of age and older and specified persons with
disabilities who are under 65 years of age.
   Existing law, the Coordinated Care Initiative (CCI), requires the
department to seek federal approval pursuant to a Medicare or a
Medicaid demonstration project or waiver, or a combination thereof,
to establish a demonstration project that enables beneficiaries
dually eligible for the Medi-Cal program and the Medicare Program to
receive a continuum of services that maximizes access to, and
coordination of, benefits between the programs.
   This bill would establish the Coordinated Care Initiative Consumer
Bill of Rights, which would set forth rights to which an individual
receiving care under the CCI would be entitled, including, but not
limited to, rights to self-direction and choice, quality,
flexibility, and accessibility of service, cultural competence, and
an appropriate grievance and appeal process, as specified. The bill
would require the department to make the information available to the
public, as specified.
   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.  Section 14132.279 is added to the Welfare and
Institutions Code, to read:
   14132.279.  (a) This section shall be known, and may be cited, as
the Coordinated Care Initiative Consumer Bill of Rights.
   (b) A consumer under the Coordinated Care Initiative shall have
all of the following rights:
   (1) The right to self-direction. The individual shall have the
option to coordinate his or her care and services. If due to
cognitive impairment the individual is unable to do so, a statutory
option should be made available to allow for a surrogate or informal
caregiver chosen by the individual to coordinate care.
   (2) The right to choice. Plan networks should ensure that
individuals have access to, and choice of, a range of providers and
settings across the continuum of care, including health care
services, behavioral health services, and long-term services and
supports.
   (3) The right to coordination. An individual shall have access to
care coordination, in accordance with his or her needs and
preferences.
   (4) The right to integration of services. Services shall be
delivered to the individual in an integrated manner, regardless of
the source of payment.
   (5) The right to flexibility. Services within a plan's contracted
services shall meet the individual's changing needs and incorporate
new modes of service and supports.
   (6) The right to quality. All services and supports shall be of
high quality and shall be personcentered. Statutory standards be
established should to provide a mechanism for enforcement.
   (7) The right to cultural competence. Individuals shall have
access to threshold language services. Services should be appropriate
and responsive to the needs of all populations.
   (8) The right to accessibility. Services and information shall be
easy to access. In accordance with the federal Americans with
Disabilities Act, services shall be delivered in a manner that is
physically, cognitively, and programmatically accessible.
   (9) The right to personal assistants and caregivers. The system of
care shall support the role of quality paid and unpaid caregivers,
including family caregivers, and shall recognize the importance of
workforce development, caregiver needs assessment, and the
availability of training.
   (10) The right to independence. Services across the continuum
shall support maximum independence, full social integration, and
quality of life.
   (11) The right to grievances and appeals. Participants shall have
access to an independent grievance and appeals process. Access and
resolution shall be prompt, without disruption in service delivery.
   (12) The right to timeliness. All services and supports shall be
delivered in a timely manner, in order to ensure the individual's
optimal health and functioning.
   (c) The department shall post the Coordinated Care Initiative
Consumer Bill of Rights on its Internet Website, and shall also
provide copies to members or the public upon request. The department
shall make the bill of rights available to the public in prevalent
languages.