This page archives recently chaptered and dead legislation from the 2016 session.
Children
AB 1576: Assemblymember Eggman (District 13)
Mental Health Delivery Demonstration Project: Early Diagnosis and Psychosis Treatment Program.
Summary: This bill would, commencing July 1, 2017, authorize health care service plans that offer health care services within the greater Sacramento area to require enrollees seeking services for a mental health condition to participate in a Mental Health Delivery Demonstration Project through an Early Diagnosis and Psychosis Treatment (EDAPT) program, as defined. The bill would require plans that choose to participate to develop clinical guidelines for enrollees and to make those guidelines available as part of their evidence of coverage and to primary care providers and specialty mental health providers in their contracted network. The bill would allow an enrollee to opt out of the EDAPT program if a psychiatrist notifies the plan that the enrollee is under his or her care. These provisions would be repealed on January 1, 2020. Because a willful violation of these provisions would be a crime, this bill would impose a state-mandated local program.
Last Action: 4/12/2016 First hearing canceled at the request of the author.
AB 2782: Assemblymember Richard Bloom (District 50), Chiu (District 17) and Wood (District 2)
Healthy California Fund: For our Families and Children
Summary: This bill seeks to address Type 2 diabetes, dental disease, heart disease, stroke – debilitating epidemics in California – by creating a dedicated revenue source for prevention and care. The Healthy California Fund will be funded through a two cent per fluid ounce health impact fee on sugar sweetened beverages. CPCA is a proud member of the Coalition for a Healthy California who is sponsoring this legislation.
Last Action: 04/12/2016 Hearing canceled at the request of the author.
Clinician
AB 1917: Assembly member Obernolte (District 33)
Mental Health care professionals: qualifications
Summary: This bill would, require the board to accept specified education an applicant gained from an out-of-state school. This bill would specify that the face-to-face counseling requirement of the practicum coursework be face-to-face counseling of individuals, couples, families, or groups. This bill would require that this counseling be supervised for applicants seeking licensure as a professional clinical counselor. This bill would require that the degree’s practicum and field study experience involve direct client contact. This bill would prohibit remediation of the core content area of assessment, appraisal, and testing of individuals, as specified. The bill also would prohibit the remediation of the core content area of the principles of the diagnostic process and the use of diagnostic tools, as specified.
Last Action: 07/22/2016 Approved by the Governor and chaptered by the Secretary of State
Facilities/Licensing
AB 1947: Assembly member Chiu (District 17)
Health facilities: affiliate clinic: licensing
Summary: This bill would require the centralized application unit to publish on the department’s Internet Web site current checklists and instructions concerning how to complete an application for a new affiliate clinic license, as well as how to report changes to an existing affiliate primary care clinic.
Last Action: 06/13/2016 Hearing canceled at the request of the author
AB 1177: Assemblymembers Gomez (District 51), Burke (District ), and Low (District 28)
Primary care clinics: written transfer agreements
Summary: Existing law requires primary care clinics (PCCs) to obtain and submit a written hospital transfer agreement (HTA) with one or more nearby hospitals and other facilities to meet medical emergencies, to the State Department of Public Health (DPH).
The California Family Health Council, The Community Clinic Association of Los Angeles County, and Planned Parenthood Affiliates of California feel that this bill expands access to essential services by barriers for PPCS to obtain licensure to operate.
Last Action: 10/09/2015 -Chaptered by Secretary of State – Chapter 704, Statutes of 2015.
Insurance and Exchange
AB 41: Assemblymember Richard Pan (D-Sacramento)
Health care coverage: discrimination
Summary: Prohibits a health care service plan or health insurer from discriminating against any health care provider who is acting within the scope of that provider’s license or certification.
According to the author, with the passage of the ACA, an influx of newly insured people will engage with an overburdened health care system that faces severe shortages of health care practitioners. The author states that we must utilize our health care practitioners whose scope of practice and training will allow them to perform more vital functions. The author states that while federal law bans discrimination against whole classes of health care providers, plans and insurers commonly limit the types of health care providers allowed to provide services. The author cites an example of optometrists who are permitted to provide routine vision care under a health plan or insurance contract are often prohibited from treating other conditions that are within their scope of practice. The author asserts that provider discrimination is wrong in principle, anti-competitive, limits or denies patient choice and access to a range of beneficial providers, and results in a less than optimal health care delivery system. The author concludes by stating that this bill will help eliminate provider discrimination which will lead to lower health care costs, improve quality, increase access, and mitigate provider shortages.
Last Action Date: 01/31/2016 Died pursuant to Article IV, Sec. 10(c) of the Constitution.
SB 43: Assemblymember Hernandez (District 48)
Essential health benefits
Summary: Existing law requires an individual or small group health care service plan contract or insurance policy issued, amended, or renewed on or after January 1, 2014, to cover essential health benefits. These essential benefits must include rehabilitative and habilitative (medically necessary health services and devices) services as well as the health benefits covered by benchmark plans. Habilitative services are covered under the same terms and conditions as rehabilitative services.
AB 1046: Assemblymember Dababneh (District 45)
Hospitals: Community Benefits
Summary: Existing law requires certain private not-for-profit hospitals to complete a community needs assessment every 3 years, and adopt/update a community benefits plan every year. Certain hospitals, including small and rural hospitals are exempt from these requirements. However, all hospitals must file a report on and make public its community benefits plan and initiatives to address community needs with the Statewide Office of Health Planning and Development.
Last Action Date: 01/31/2016 Died pursuant to Article IV, Sec. 10(c) of the Constitution.
AB 1460: Assemblymember Thurmond (District 15)
Hospitals: Community Benefit Plans
Summary: Existing law requires all hospitals to annually adopt and update a community benefit plan, either alone or in conjunction with other health care providers and organizations. Each hospital must include a description of the actions it has taken to address community needs, along with its financial abilities, within its updated plan that it submits annual to the Office of Statewide Health Planning and Development. Until enacted by the Legislature, the community benefit plans do not have to follow any specific format.
This bill would make technical, non substantive changes to this provision.
Last Action: 02/01/2016 Died at desk.
SB 137: Assemblymember Hernandez (District 48)
Health care coverage: provider directories
Summary: Currently, Medi-Cal services can be provided pursuant to contracts with various managed health care plans.
This bill would require health care service plans and insurers, (collectively referred to as carriers), subject to regulation by the commissioner, to make a provider directory accessible on its website and to update it weekly. The Department of Managed Health Care and the Department of Insurance would have to jointly develop uniform provider directory standards to showcase on the site. The provider directory would include information on contracting health providers, specifically those that accept new patients.
If a patient relied on the provider directory to receive services, the carrier would have to reimburse them for any amount beyond what they would have paid for in-network services. According to the author, it is important that Californians shopping for health insurance have confidence in the provider directory upon which they are basing their decisions.
This bill would provide that no reimbursement for local agencies and school districts by the state is required by this act for a specified reason. One time costs are estimated to be around $160,000 in 2015-16 and $200,000 in 2016-17 for the Insurance Fun and between $150,000 and $300,000 for the Managed Care Fund.
Last Action Date: 10/08/2015 Approved by the Governor. Chaptered by the Secretary of the State – Chapter 649, Statutes 2015.
AB 339: Assemblymember Gordon (District 24)
Outpatient Prescription Drugs
Summary: This bill would prohibit formularies for outpatient prescription drugs administered by a health care service plan or health insurer (collectively known as carriers), from discouraging the enrollment of individuals or from reducing the benefit coverage granted to patients. Until January 1, 2021, the bill would require that all forms of cost sharing for individual prescription drugs that constitute essential health benefits, not exceed $250 for a the first 30 days of supply.
The bill would require a plan contract or policy to cover all single-tablet prescription drugs that are medically necessary for treatment of AIDS/HIV. The bill would prohibit a plan contract or policy from placing more than 50% of drugs within the same class, that are approved by the US FDA, into the 2 highest cost tiers of a drug formulary. As such, a plan contract or policy would have to create definitions for each tier of a drug formulary.
This bill would require a carrier to provide coverage for medically necessary prescription drugs, especially those that lack a therapeutic equivalent. Otherwise, all other cost sharing for outpatient prescription drugs would have to be reasonably priced. These provisions would be applicable to non grandfathered provider plans that are offered, renewed, or amended on or after July 1, 2016, and applicable to non grandfathered provider plans that are offered, renewed, or amended on or after January 1, 2017.
According to the author, Californians with cancer, HIV/AIDS, hepatitis, multiple sclerosis, epilepsy, lupus, and other serious conditions need high cost specialty drugs. This bill will help ensure access to vital medications and remove the patient from negotiations between health plans and pharmaceutical manufacturers. Ongoing fiscal costs are estimated to be around $450,000 on the Managed Care Fund and $80,000 on the Insurance Fund.
Last Action Date: 10/08/2015 Approved by the Governor. Chaptered by the Secretary of State – Chapter 619, Statutes 2015.
SB 1305: Assemblymember Bonta (District 18)
Limitations on cost sharing: family coverage
Summary: Existing law requires that all nongrandfathered products in individual or small group markets, a health care service plan contract or health insurance policy, issued, amended or renewed on or after January 1, 2015, include a limit on annual out-of-pocket expenses on essential health benefits.
Last Action Date: 10/08/2015 Approved by the Governor. Chaptered by the Secretary of State – Chapter 641, Statutes 2015.
Medi-Cal
SB 1308: Senator Nguyen (District 17)
Health care coverage: State Innovation Waiver
Summary: This bill would prohibit a county organized health system 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.
Last Action: 4/5/16 Hearing canceled at the request of the author
Mental Health
AB 1917: Assembly member Obernolte (District 33)
Mental Health care professionals: qualifications
Summary: This bill would, require the board to accept specified education an applicant gained from an out-of-state school. This bill would specify that the face-to-face counseling requirement of the practicum coursework be face-to-face counseling of individuals, couples, families, or groups. This bill would require that this counseling be supervised for applicants seeking licensure as a professional clinical counselor. This bill would require that the degree’s practicum and field study experience involve direct client contact. This bill would prohibit remediation of the core content area of assessment, appraisal, and testing of individuals, as specified. The bill also would prohibit the remediation of the core content area of the principles of the diagnostic process and the use of diagnostic tools, as specified.
Last Action: 07/22/2016 Approved by the Governor and chaptered by the Secretary of State
AB 1576: Assemblymember Eggman (District 13)
Mental Health Delivery Demonstration Project: Early Diagnosis and Psychosis Treatment Program.
Summary: This bill would, commencing July 1, 2017, authorize health care service plans that offer health care services within the greater Sacramento area to require enrollees seeking services for a mental health condition to participate in a Mental Health Delivery Demonstration Project through an Early Diagnosis and Psychosis Treatment (EDAPT) program, as defined. The bill would require plans that choose to participate to develop clinical guidelines for enrollees and to make those guidelines available as part of their evidence of coverage and to primary care providers and specialty mental health providers in their contracted network. The bill would allow an enrollee to opt out of the EDAPT program if a psychiatrist notifies the plan that the enrollee is under his or her care. These provisions would be repealed on January 1, 2020. Because a willful violation of these provisions would be a crime, this bill would impose a state-mandated local program.
Last Action: 04/12/2016 Hearing canceled at the request of the author.
AB 847: Assemblymember Mullin (District 22)
Mental health: community-based services
Summary:This bill would require the department to develop a proposal for the United States Secretary of Health and Human Services to be selected as a participating state in the time-limited demonstration program described above to receive enhanced federal matching funds for mental health services provided by certified community behavioral health clinics to Medi-Cal beneficiaries. The bill would appropriate $1,000,000 from the Mental Health Services Act Fund to the State Department of Health Care Services to develop that proposal. The bill would make findings and declarations of the Legislature, including that the changes the bill would make are consistent with and further the intent of the act. This bill contains other related provisions and other existing laws.
Last Action: 04/11/2016 Approved by the Governor. Chaptered by the Secretary of State – Chapter 6, Statutes of 2016.
AB 847: Assemblymembers Mullin (District 22), and Ridley-Thomas (District 54)
Mental Health: Community Based Services
Summary: Existing law provides Medi-Cal program provides for specified services, including various mental health services. The Protecting Access to Medicare Act of 2014, requires the United States Secretary of Health and Human Services to award, no later than January 1, 2016, planning grants to states to assist with the development of their proposals to demonstrate their mental health services improvement plan.
According to the Assembly Appropriations Committee, this bill would bring administrative costs to DHCS estimated at under $100,000 (General Fund/federal) to support the application process. However, if the grant is received, it would pay for the development of the demonstration program.
Last Action Date: 04/11/2016 Approved by the Governor and chaptered by the Secretary of State – Chapter 6, Statutes 2016.
AB 858: Assemblymember Wood (District 2)
Improving Access to Behavioral Health Services in Primary Care (Same Day Billing)
Summary: This bill allows federally qualified health centers (FQHCs) and rural health clinics (RHCs) to provide and be reimbursed for both medical and mental health services to Medi-Cal beneficiaries on the same day, in the same location. Currently, an outdated provision of law prohibits “same day billing” for medical services and mental health services, even though it does allow for medical and dental services to be delivered and paid for on the same day.
Last Action Date: 10/10/2015 Vetoed by the Governor.
AB 690: Assemblymember Wood (District 2)
Improving Access to Behavioral Health Services in Primary Care (MFT Providers)
Summary: Adds marriage and family therapists (MFTs) as health care professionals whose services may be reimbursed by Medi-Cal when provided at a federally qualified health center (FQHC) or rural health clinic (RHC). According to 2012 OSHPD data, 41.5 percent of community clinics and health centers provide behavioral health services in 50 of California’s 58 Counties.
Last Action Date: 01/31/2016 Died pursuant to Article IV, Sec. 10(c) of the Constitution.
SB 291: Senator Vidak
Mental Health
Summary: Existing law contains provisions over the community mental health services provided to the mentally disordered by locally administered and controlled community health programs in each county. This bill would make technical, nonsubstantive changes to the latter provisions.
Last Action Date: 10/07/2015 Vetoed by the Governor
AB 1254: Assemblymember Grove (District 24)
Health care service Plans: abortion coverage
Summary: The federal Patient Protection and Affordable Care Act (PPACA), enacted January 1, 2014, requires a health insurer in the individual or small group market to ensure coverage for essential health benefits. PPACA does not require that a qualified health plan provide coverage for abortion.
The Knox-Keene Health Care Service Plan Act of 1975 permits the Director of Managed Health Care to oversee a hearing by ordering or suspending a license, or assessing administrative penalties.
This bill permits a health care service plan to exclude abortion as a covered benefit. However, this bill would prohibit the director of Managed Health Care from denying a license or from disciplining a license on the basis that the plan excludes coverage for abortions. According to the author, this bill lifts the requirement on those with religious or moral objections to support abortions by paying for the in their health care plan.
Last Action: 01/31/2016 Died pursuant to to Article IV, Sec. 10(c) of the Constitution.
Miscellaneous
SB 876: Senator Liu (District 15 )
Homelessness
Summary: This bill would afford persons experiencing homelessness the right to use public spaces without discrimination based on their housing status and describe basic human and civil rights that may be exercised without being subject to criminal or civil sanctions, including the right to use and to move freely in public spaces, the right to rest in public spaces and to protect oneself from the elements, the right to eat in any public space in which having food is not prohibited, and the right to perform religious observances in public spaces, as specified. The bill would state the intent of the Legislature that these provisions be interpreted broadly so as to prohibit policies or practices that are discriminatory in either their purpose or effect.
Last Action: 04/11/2016 Hearing canceled at the request of the author
AB 2782: Assemblymember Richard Bloom (District 50), Chiu (District 17) and Wood (District 2)
Healthy California Fund: For our Families and Children
Summary: This bill seeks to address Type 2 diabetes, dental disease, heart disease, stroke – debilitating epidemics in California – by creating a dedicated revenue source for prevention and care. The Healthy California Fund will be funded through a two cent per fluid ounce health impact fee on sugar sweetened beverages. Some of the funds created through this impact fee will go towards the State’s Indian Health Program.
Last Action: 04/12/2016 Hearing canceled at the request of the author
AB 374: Assemblymember Nazarian (District 46)
Health care coverage: Prescription drugs
Summary: Step Therapy is a process that requires patients to try a first-line medication before receiving coverage for a second-line medication. A patient can be required to try several medications before receiving coverage for the medication that best treats their unique condition. This bill would require the Department of Managed Health Care and the Department of Insurance to develop a step therapy override determination request form by July, 2016. “Step therapy override determination” is the ability to determine whether the step therapy protocol should be overridden due to a patient’s unique situation, in order to allow for immediate coverage of the provider’s prescription. The prescribing provider would submit the request form to the health care service plan or health insurer (collectively known as carriers), who would then have to answer the provider’s request within 72 hours for non-urgent requests, and within 24 hours for urgent requests. If the carrier denies the request, it can be appealed through a medical review process. If the carrier approves of the override form, they are prohibited from requiring a patient to undergo step therapy or fail-first protocol.
According to the author, this bill establishes a process that facilitates greater balance between a provider’s medical judgment and the carrier’s business practice. With step therapy based on solely on costs, it does not take into account an individual’s unique needs for medication.
Last Action Date: Chaptered by Secretary of State – Chapter 621, Statutes of 2015. 10/9/15
AB 383: Assemblymember Gipson (District 54)
Summary: The existing Hepatitis C Education, Screening, and Treatment Act helps regulate hepatitis C virus (HCV) education and outreach. The act also requires the Director of Public Health to develop a public education and outreach program aimed at increasing awareness of the HCV among high-risk groups, physician’s offices, health care workers, and health care facilities.
This bill would, until January 1, 2023 require a primary care clinic to provide primary care for patients, and conduct a HCV screening or diagnostic test. The clinic is not required to provide primary care nor screening services for a patient who has already taken a HCV screening or diagnostic test, who is receiving services in an emergency care setting, or who has declined the test within the previous 12 months.
The author contends that HCV is the most common bloodborne pathogen in the United States, and is a leading cause of complications from chronic liver disease. This bill requires primary care clinics to increase HCV tests for high risk patients and generate community awareness. The bill would result in cost pressure of around $4.5 million to increase hepatitis C testing in primary care clinics, $1-2 million for counseling and care, and $340 million for increased drug treatment on Medi-Cal.
Last Action: 01/31/2016 Died pursuant to Article IV, Sec. 10(c) of the Constitution.
SB 591: Senator Pan
Summary: This bill, beginning January 1, 2016, would impose an additional tax on the distribution of cigarettes at the rate of $0.10 per cigarette, or $2.00 per pack. The wholesaler would have to file a return that reveals the number of cigarettes in its possession to date with the State Board of Equalization and pay a cigarette indicia adjustment tax at the rate equal to the difference between the existing tax rate and the bill’s tax rate for cigarette tax stamps.
AB 414: Assemblymemebr Chávez (District 76)
Office of Rural Health
Summary: Existing law requires the Secretary of the California Health and Human Services Agency to establish an Office of Rural Health, or an alternative organizational structure. The Office of Rural Health serves as a source of information and referral, which helps to promote coordinated planning for the delivery of health services in rural California.
Last Action: 02/01/16 Died at the desk.
AB 1238: Assemblymember Linder
Summary: Under existing law, a certified copy of a birth, death, marriage, or military service record may only be supplied by the State Registrar, local registrar, or county recorder to an authorized person, who submits a written, faxed, or digitized image request.
Women and Girls
SB 464: Senator Hernandez
Healing Arts: Self Reported Tools
Summary: This bill would authorize a physician, surgeon, registered nurse, certified nurse-midwife, nurse practitioner, physician assistant, or a pharmacist, all acting within the scope of existing law relating to their profession, to utilize a self screening tool to better identify risk factors that might result from the use of self-administered hormonal contraceptives. Additionally, all such professions mentioned above will be authorized to after an appropriate prior examination, prescribe, furnish, or dispense self-administered hormonal contraceptives. The bill would authorize blood pressure, weight, height, and patient health history to be self-reported through use of the self-screening tool.
According to the author, hormonal contraception is a proven safe method for preventing pregnancy. The author further states that existing law is unclear as to whether self-screening tools can be used to transmit relevant medical and family history information between patient and provider. Thus, enabling the use of self-screening tools will allow healthcare providers to make greater use of existing and developing technology, and will increase access to oral contraception.
Last Action Date: 9/30/2015 Approved by the Governor and chaptered by the Secretary of State – Chapter 387, Statutes of 2015
Workforce
SB 1204: Senator Hernandez (District 22)
Health professionals: loan repayment
Summary: The bill would increase the monetary limits for loan repayment and would expand the eligibility for loan repayment funds to include those physicians providing psychiatric services.
Last Action: 3/15/2016 April 4th hearing canceled at the request of author
Nurse Practitioners: Scope of Practice
Summary: Under the Nursing Practice Act, nurse practitioners licensed by the Board of Registered Nurses are required to consult with a physician or surgeon prior to ordering medical equipment or certifying a disability for insurance purposes, along with a variety of other services including approving, signing, modifying or adding a treatment plan for a patient.
This bill permits nurse practitioners with certification from a national body recognized by the board of practice to complete the actions listed above without supervision of or adherence to standardized procedures of a surgeon or physician. The bill requires the nurse practitioner to instead refer a patient to a physician, surgeon, or licensed health care provider if the situation is beyond their scope of practice. The bill requires that a nurse practitioner must also refer a client to a surgeon or practitioner for services such as laboratory, diagnostic, nuclear medicine, radiation oncology, physical therapy, physical rehabilitation, psychometric testing, home infusion therapy, as well as diagnostic imaging goods or services if the licensee or licensee’s family member has a financial interest in the patient. Any violation of this is punishable as a misdemeanor after review by the Medical Board of California.
This bill would also expand the definition of a “licensee” to include nurse practitioners, effectively expanding the scope of an existing crime and requiring implementation a state-mandated local program. Along with the Medical Board of California, the bill would require the Board of Registered Nursing to review the case before imposing disciplinary action.
Additionally, while existing law requires that specified healing arts licentiates undergo a peer review, the bill would expand the definition of “licentiates” to include nurse practitioners. The Board of Registered Nursing, would again have to submit reviews for this purpose.
This bill requires no reimbursements from the state.
Last Action: 06/28/2016 Hearing canceled at the request of the author.
