This bill would express the intent of the Legislature to enact statutory changes relating to the Budget Act of 2019.

 THIRD READING  

Bill No: AB 80

Author: Committee on Budget

Amended: 6/22/20 in Senate

Vote: 21

PRIOR VOTES NOT RELEVANT

SENATE BUDGET & FISCAL REVIEW COMMITTEE: 13-5, 6/24/20

AYES: Mitchell, Beall, Caballero, Durazo, Hurtado, Leyva, McGuire, Monning, Pan, Roth, Skinner, Stern, Wieckowski

NOES: Nielsen, Dahle, Melendez, Moorlach, Morrell

SUBJECT: Public health omnibus

SOURCE: Author

DIGEST:

1. This bill is an omnibus health trailer bill, and contains changes to implement the 2020-21 Budget.

ANALYSIS: This bill makes technical and clarifying statutory revisions affecting health programs necessary to implement the Budget Act of 2020. Specifically, this bill:

1. Establishes the Health Care Payments Data Program, which will collect data on health care expenditures for inclusion in a Health Care Payments Data System. The data system will collect information regarding health care costs, utilization, quality, and equity to provide greater transparency to inform public policy decisions.
2. Prohibits termination of Medi-Cal eligibility for incarcerated juveniles to comply with provisions of the federal Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act.
3. Changes the name of the Electronic Health Record Incentive Program to the Medi-Cal Promoting Interoperability Program and extends the program sunset date from July 1, 2021, to January 1, 2024.
4. Prioritizes full-scope Medi-Cal expansion to undocumented seniors in the upcoming budget if the Department of Finance determines there are sufficient General Fund revenues for that fiscal year and the ensuing three fiscal years to support the expansion.
5. Authorizes the Department of Health Care Services (DHCS) to reimburse for medication assisted treatment (MAT) services in the Drug-Medi-Cal program.
6. Adjusts rate reviews for physician and dental reimbursable services to more closely align with federal access-to-care requirements.
7. Amends the definition of “best price” to allow DHCS to negotiate prescription drug rebates for Medi-Cal beneficiaries using the best international price, rather than the best domestic price.
8. Authorizes DHCS to negotiate prescription drug rebates on behalf of non-Medi-Cal populations.
9. Eliminates the monthly limit of six prescriptions and the one dollar copayment for prescriptions for Medi-Cal beneficiaries in the fee-for-service delivery system.
10. Requires DHCS to implement any approved federal Medicaid waiver or flexibility related to the novel coronavirus 2019 (COVID-19) public health emergency.
11. Authorizes DHCS to extend coverage for COVID-19 to uninsured individuals for the duration of the COVID-19 emergency period, pursuant to the option afforded to states in the federal Families First Coronavirus Response Act (FFCRA).
12. Requires DHCS to maximize federal financial participation for Medi-Cal expenditures to respond to the COVID-19 public health emergency, including the temporary increase granted in the FFCRA, and to comply with any conditions placed on receipt of those funds.
13. Authorizes DHCS, in consultation with stakeholders, to seek federal approval for a temporary extension of all or select components of the state’s 1115 Waiver Demonstration project, Medi-Cal 2020, which is scheduled to expire on December 31, 2020.
14. Suspends the Value-Based Payments program and supplemental payments to providers in Medi-Cal from Proposition 56 tobacco tax revenue effective July 1, 2021, unless the Department of Finance estimates that General Fund revenues exceed expenditures for the 2021-22 and 2022-23 fiscal years by an amount sufficient to support these programs and payments.
15. Authorizes DHCS to reduce applicable capitation rate increments for Medi-Cal managed care plans by up to 1.5 percent for the July 1, 2019, to December 31, 2020, rating period to account for reduced utilization related to the COVID-19 public health emergency.
16. Authorizes DHCS, in consultation with affected Medi-Cal managed care plans, to develop and implement a risk corridor to limit the financial risk of either overpayments or underpayments of capitation rates during the July 1, 2019, to December 31, 2020, rating period.
17. Authorizes the Department of Public Health (DPH) to allow the Pre-Exposure Prophylaxis (PrEP) Assistance Program to pay for an initial 30-day supply of PrEP and post-exposure prophylaxis (PEP) medication.
18. Authorizes the Franchise Tax Board to provide electronic retrieval of modified adjusted gross income data for the purposes of determining eligibility for the AIDS Drug Assistance Program.
19. Exempts the Lead-Related Construction Program from the Administrative Procedures Act for the purposes of addressing funding issues through fees established through the fee report authorized in the 2018 Budget Act.
20. Extends the authority for Patton State Hospital to house up to 1,530 patients from September 2020 until September 2030.
21. Authorizes the Governor, upon recommendation of the director, to appoint medical directors for the Department of State Hospitals and each of the individual state hospitals. Also allows the director to designate other hospital employees as officers.
22. Allows the board and staff members of Covered California to provide volunteer professional services if certain conditions are met.
23. Revises the actuarial value of Bronze-level health plans offered in Covered California to comply with new federal rules.
24. Extends the program period and reappropriates and extends availability of funding for the Medically-Tailored Meals pilot program authorized in the 2017 Budget Act.
25. Removes statutory language authorized in the 2019 Budget Act that would have suspended funding for DPH programs for the prevention of human immunodeficiency virus, hepatitis C, and sexually transmitted diseases.
26. Authorizes DHCS to establish, implement, and maintain a supplemental payment pool for nonhospital community clinics participating in the federal 340B program.

General Fund expenditure authority of $1.4 million approved in the 2017 Budget Act for a medically tailored meals pilot program and makes those funds available for encumbrance or expenditure until June 30, 2023.

FISCAL EFFECT: Appropriation: Yes Fiscal Com.: Yes Local: Yes

According to the Senate Budget and Fiscal Review Committee, this bill reappropriates General Fund expenditure authority of $1.4 million approved in the 2017 Budget Act for a medically tailored meals pilot program and makes those funds available for encumbrance or expenditure until June 30, 2023.

SUPPORT: (Verified 6/23/20)

None received

OPPOSITION: (Verified 6/23/20)

None received

Prepared by: Scott Ogus / B. & F.R. / 916-651-4103

6/25/20 0:46:57

**** END ****

CONCURRENCE IN SENATE AMENDMENTS

CSA1 Bill Id:AB 80

Author:(Committee on Budget)

As Amended Ver:June 22, 2020

Majority vote. Budget Bill Appropriation Takes Effect Immediately

SUMMARY:

This is the Omnibus Health Trailer Bill for 2020-21. It contains necessary changes related to the Budget Act of 2020. This bill makes various statutory changes to implement the 2020-21 budget.

The Senate Amendments:

1. Health Benefit Exchange Bronze Plan Actuarial Value
   1. Approve the current federal upper de minimis range of +5% for all nongrandfathered bronze level health plans and health insurance policies starting in 2021 as compared to current state law which sets the de minimis range for Bronze plans at a narrower +4/-2%.
2. Health Benefit Exchange Clinical Volunteering
   1. Authorize Health Benefit Exchange board members and staff to perform clinical volunteer services if the following conditions are met: 1) the board member or staff is a health care professional who was actively participating in that profession prior to appointment to the Exchange; 2) the board member does not receive compensation for the services and does not have an ownership interest in the entity where the volunteering is occurring; and 3) the services are performed at the University of California or a nonprofit educational institution, or a facility operated by a state or county agency not in contract with the Exchange. Exempts liability insurance, space, equipment and other supports form the definition of compensation.
3. Health Care Payments Data System
   1. Change the name of the Health Care Cost Transparency Database to the Health Care Payments Data Program which shall administer the Health Care Payments Data System. Establish this program at the Office of Statewide Health Planning and Development (OSHPD), and require the program to collect data on all California residents to the extent feasible.
   2. Make findings and declarations related to the public interest in the price, cost, utilization, equity, and quality of health care services.
   3. Clarify the intent of the Legislature with regard to the purpose and goals of this program, including improving public health, advancing health coverage, reducing health care costs, preserving consumer privacy, and more.
   4. Require OSHPD to establish an advisory committee, and specify that the director of the State Department of Health Care Services (DHCS), and the executive director of the California Health Benefit Exchange (HBEX), or their representatives, shall be nonvoting ex officio members of the advisory committee. Require each appointed member to serve a term of two years, and serve at the discretion of the director. Require that the advisory committee elect a chairperson. Require the advisory committee to meet at least quarterly. Stipulate the functions of the advisory committee.
   5. Require, on or before July 1, 2024, the advisory committee to make recommendations to OSHPD on public health data functions and integration, and require OSHPD to publish these recommendations on their website.
   6. Require OSHPD to establish a data release committee to make recommendations about applications seeking either program data with direct personal identifiers or the transmission of standardized datasets, except for data requests from other state agencies.
   7. Authorize OSHPD to convene other committees or workgroups as necessary. Authorize OSHPD to enter into contracts for purposes of operating this program, until January 1, 2026.
   8. Require OSHPD to ensure that the program can map to other datasets.
   9. Require health care service plans, health insurers, a city or county that offers self-insured or multiemployer-insured plans, and other specified mandatory and voluntary entities to submit health care data to this program.
   10. Require the Department of Managed Health Care and the Department of Insurance to take appropriate action to bring a plan or insurer into compliance if OSHPD notifies the department of a plan’s failure to submit required data. Exempt specified multiple employer welfare arrangements. Impose civil penalties on a health insurer that fails to comply with the data submission requirements.
   11. Authorize the department director to suspend or revoke any license to a health care service plan or assess penalties if the plan violates various legal requirements, including data submission requirements of the Health Care Payments Data System.
   12. Require OSHPD to use the data to produce publicly available information, including summaries, analyses, studies, and reports that support the goals of improving public health, reducing disparities, and reducing health care costs.
   13. Require OSHPD to submit a report to the Legislature on or before March 1, 2024 that includes claims data reported by mandatory and voluntary submitters.
   14. Require the System to protect the confidentiality of personally identifiable data and exempts it from disclosure. Authorize OSHPD to provide controlled access to such data by outside data analysts, researchers, and other qualified applicants, as defined.
   15. Define “qualified applicants” to include state agencies, mandatory submitters, established nonprofit research institutions, the University of California, nonprofit educational institutions, providers, suppliers, labor unions, self-insured multiemployer plans that submit data, and specified consumer organizations.
   16. Authorize OSHPD to establish pricing mechanisms for data products, custom reports, and the use of nonpublic data, and require such revenue to be deposited into the Health Care Payments Data Fund to be used for this program.
   17. Make findings to demonstrate the interest protected by limitations on the public’s right of access to public meetings and documents in order to protect confidential proprietary information submitted for inclusion in the Health Care Payments Data System.
4. Lead-Related Construction Fee APA Exemption
   1. Exempt from the Administrative Procedures Act (APA) the adjustment of fees and publication of the final fee for the Lead-Related Construction Program and require that modifications to fees be implemented without being adopted as a regulation. Require that the revised list of fees be filed with the Secretary of State and printed in the California Code of Regulations.
5. Removal of Suspension Language from Infectious Disease Control Statutes
   1. Remove language that requires, under specified circumstances, the suspension of programs that seek to prevent the spread of HIV, Hepatitis C, and sexually transmitted diseases on December 31, 2021.
6. AIDS Drug Assistance Program Modified Adjusted Gross Income (MAGI) Information
   1. Authorize the Department of Public Health (DPH) to electronically retrieve AIDS Drug Assistance Program (ADAP) clients’ modified adjusted gross income (MAGI) data from the California Franchise Tax Board (FTB) and require the FTB to provide this data to DPH. Add to the statute the federal definitions of “household” and “family size.” Change references to “taxpayer” to “taxpayer household.”
7. Pre-Exposure Prophylaxis Assistance Program – Initial 30-day Supply of PrEP and PEP
   1. Authorize the Office of AIDS to subsidize the costs of up to 30 days of Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP) medications for prevention of HIV infection.
8. Patton State Hospital Over-Bedding Sunset Extension
   1. Extend the authorization for the Department of State Hospitals to house up to 1,530 patients at Patton State Hospital from September 2020 until September 2030.
9. Department of State Hospitals Medical Director Exempt Positions
   1. Require the Governor, upon the recommendation of the Director of State Hospitals, to appoint one medical director for the department and one medical director for each state hospital. Require the department and hospital medical directors to be physicians and specify the directors’ responsibilities.
   2. Require the Director of State Hospitals to appoint the following officers: 1) a hospital administrator; 2) a hospital director; 3) a chief of police services; and 4) any other hospital employee to be an officer.
   3. Require a hospital administrator to be selected based on their overall knowledge of the hospital and the operation of its administrative, business, and life-support functions.
   4. Provide for various updates to statutory provisions that govern State Hospital leadership.
10. Full-Scope Medi-Cal for Undocumented Seniors
    1. Require that full scope Medi-Cal coverage for individuals who are 65 years of age or older, and who do not have satisfactory immigration statuses or are unable to establish satisfactory immigration status, be prioritized for inclusion in the budget for the upcoming fiscal year, if the Department of Finance projects a positive ending balance in the Special Fund for Economic Uncertainties, for the upcoming fiscal year and each of the ensuing three fiscal years, that exceeds the cost of providing full scope benefits to this population.
11. Conforms Inmate Eligibility to Federal Law
    1. Bring state law into compliance with the federal “Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act,” which, in part, requires states to no longer terminate Medicaid eligibility for juveniles who are incarcerated and allows states to adopt indefinite Medi-Cal suspension for eligible incarcerated juveniles, beginning October 1, 2020. Eliminate the current limit of one year for Medi-Cal suspensions for incarcerated juveniles.
    2. Require DHCS, in consultation with stakeholders, including the County Welfare Directors Association of California and advocates, to develop and implement a redetermination of eligibility for incarcerated juveniles whose Medi-Cal eligibility is suspended.
12. Drug Medi-Cal Reimbursement of Medication Assisted Treatment for Opioid Use Disorders
    1. Add Medication Assisted Treatment (MAT) services as a reimbursable Drug Medi-Cal (DMC) Treatment Program benefit for all DMC provider types, which includes all medications approved by the Food and Drug Administration to treat opioid use disorders, counseling services and behavioral therapy in accordance with the SUPPORT for Patients and Communities Act.
    2. Authorize DHCS to implement these sections by means of bulletin or similar instructions until any necessary regulations are adopted and require DHCS to adopt any regulations necessary to implement the sections by July 1, 2023.
    3. Make technical corrections to the statute, remove references to the obsolete MAT medication levoalphacetylmethadol, also known as LAAM, and replace “day care rehabilitative” with “intensive outpatient treatment services” to align with what is listed in the Medicaid State Plan.
13. Medically Tailored Meals Pilot Program Extension
    1. Extend the length of the Medically Tailored Meals pilot program from three to four years.
    2. Delay the due date of the program evaluation from January 1, 2021 to within 12 months after the end of the four-year pilot.
    3. Delay the statutory sunset from “January 1, 2021 or six months following the end of the program,” to “the date the department submits its report containing its evaluation of the program to the Legislature or 12 months after the end of the program.”
14. Electronic Health Record Incentive Program Name Change and Extension
    1. Change the name of the Electronic Health Record Incentive Program to be the Medi-Cal Promoting Interoperability Program, in compliance with new federal Centers for Medicare and Medicaid Services (CMS) requirements and extend the sunset date for the program from July 1, 2021 to January 1, 2024.
15. Aligning Rate Review with the Access Monitoring Review Plan
    1. Require DHCS Director to periodically, rather than annually, review reimbursement levels for physician and dental services to align with federal requirements, which require reviews every three years.
    2. Clarify that the review of rates pertain to the Medi-Cal Fee-For-Service delivery system since the existing statute predates the managed care delivery system.
    3. Require DHCS to revise reimbursement rates to the extent the Director deems necessary to comply with applicable federal Medicaid requirements.
    4. Specify that when DHCS performs its review of the rate, it is consistent with DHCS’ federally approved access monitoring plan, or any successor methodology for monitoring reasonable access to Medi-Cal covered services.
    5. Eliminate obsolete requirements when DHCS performs rate reviews for physician and dental reimbursable services to more closely align with federal access-to-care requirements. Remove obsolete and inaccessible data elements.
    6. Align the intent with current federally-mandated access-to-care requirements and to more accurately reflect current practices
16. COVID-19 Medi-Cal Response
    1. Allow DHCS to be responsive to the COVID-19 public health emergency by codifying any related, federally-approved waivers or flexibilities into State law.
    2. Require DHCS to implement any federal Medicaid waiver or flexibility approved by CMS related to the COVID-19 public health emergency, notwithstanding any existing State law to the contrary.
    3. Allow DHCS to extend coverage for the treatment of COVID-19 to uninsured individuals for the duration of the COVID-19 emergency period pursuant to the option afforded to states in the federal Families First Coronavirus Response Act.
    4. Require DHCS to maximize federal financial participation for applicable Medi-Cal expenditures available to respond to the COVID-19 public health emergency, including the temporary increase in the Federal Medical Assistance Percentage granted under the federal Families First Coronavirus Response Act, and to comply with any conditions placed on receipt of such federal funds.
    5. Allow DHCS, in consultation with stakeholders, to seek federal approval for a temporary extension, or multiple temporary extensions, of all or select components of the California Medi-Cal 2020 Demonstration that will otherwise expire on December 31, 2020.
    6. Require DHCS to seek any federal approvals deemed necessary to implement these statutory changes or to maintain sufficient access to covered Medi-Cal benefits during the COVID-19 emergency period.
17. Pharmacy Proposals
    1. Expand the definition of “Best Price” to include foreign, in addition to domestic, prices, effective January 1, 2021.
    2. Require DHCS, upon approval of the Department of Finance, to seek federal approvals to establish and administer a drug rebate program to collect rebate payments from drug manufacturers with respect to drugs furnished to selected populations of California residents that are ineligible for full-scope Medi-Cal benefits. Require DHCS to administer this program consistent with the federal Medicaid Drug Rebate Program.
    3. Sunset a statutory limit of six prescriptions drugs per month for Medi-Cal patients on January 1, 2021.
    4. Sunset the statute that requires Medi-Cal patients to make copayments on prescription drugs, on January 1, 2021.
    5. Make findings to demonstrate the interest protected by limitations on the public’s right of access to public meetings and documents in order to facilitate manufacturer participation and delivery of affordable prescription drugs to low-income Californians and to protect the confidentiality of trade secrets and pricing information.
18. Managed Care Efficiencies
    1. Require DHCS, in consultation with affected Medi-Cal managed care plans, to develop and implement a risk corridor that is symmetrical to risk and profit to limit the financial risk of either significant capitation rate overpayments or underpayments. Stipulate that the risk corridor shall apply from July 1, 2019 to December 31, 2020. Authorize DHCS to continue to apply the risk corridor past January 1, 2021 if deemed actuarially appropriate to account for the impacts of the COVID-19 public health emergency.
    2. Require DHCS to reduce capitation rate increments by up to 1.5 percent, if determined to be appropriate, for capitation rates associated with the July 1, 2019 to December 31, 2020 time period. Authorize DHCS to continue this reduction beyond January 1, 2021 if deemed actuarially appropriate and necessary to account for the impacts of the COVID-19 public health emergency.
19. Supplemental Payment Pool Allocations
    1. Require DHCS, contingent on an appropriation by the Legislature, to make available fee-for-service-based supplemental payments from a fixed-amount payment pool to qualifying nonhospital 340B community clinics, beginning January 1, 2021. Require DHCS to establish a stakeholder process on or before July 15, 2020, to develop and implement the methodology for distribution of payments, including the eligibility criteria for receipt of payments, the aggregate amount of pool funding, the criteria for apportioning the funding, and timing of payments.
20. Proposition 56 Suspensions
    1. Find and declare that these provisions are consistent with the California Healthcare, Research and Prevention Tobacco Tax Act of 2016.
    2. Suspend the Proposition 56-funded Value Based Payment (VBP) program on July 1, 2021, unless either of the following conditions are met: 1) if the estimates (contained in the 2021 May Revision) of General Fund revenues and expenditures for the 2021-22 and 2022-23 fiscal years contain estimated annual General Fund revenues that exceed estimated annual General Fund expenditures for 2021-22 and 2022-23 fiscal years by an amount equal to or greater than the sum total of all General Fund appropriations for all programs subject to suspension; or 2) if the suspension takes effect, but the Legislature finds alternative solutions to restore this program, consistent with Legislative intent established by this bill.
    3. Suspend Proposition 56-funded Medi-Cal provider supplemental payments on July 1, 2021, unless either of the following conditions are met: 1) if the estimates (contained in the 2021 May Revision) of General Fund revenues and expenditures for the 2021-22 and 2022-23 fiscal years contain estimated annual General Fund revenues that exceed estimated annual General Fund expenditures for 2021-22 and 2022-23 fiscal years by an amount equal to or greater than the sum total of all General Fund appropriations for all programs subject to suspension; or 2) if the suspension takes effect, but the Legislature finds alternative solutions to restore this program, consistent with Legislative intent established by this bill. Apply this section to all Medi-Cal provider types that currently receive Proposition 56-funded supplemental payments, with the exception of women’s health services.
21. General Provisions
    1. Re-appropriate $1,430,000 to support the Medically Tailored Meals Pilot Program and make this funding available for encumbrance and expenditure until June 30, 2022.
    2. Declare that the provisions of this measure are severable, such that if any provision of this measure is held invalid, that invalidity shall not affect other provisions.
    3. Declare that this bill creates a new crime and imposes a state-mandated local program.
    4. Declare that this bill provides for appropriations related to the Budget Bill, is related to the budget in the Budget Bill and shall take effect immediately.

COMMENTS:

This bill is a budget trailer bill within the overall 2020-21 budget package to implement actions taken affecting the Departments of Health Care Services, Insurance, Managed Health Care, Public Health, State Hospitals, the California Health Benefit Exchange, and the Office of Statewide Health Planning and Development.

According to the Author:

None

Arguments in Support:

None on file.

Arguments in Opposition:

None on file.

FISCAL COMMENTS:

This is a budget trailer bill to implement appropriations in the Budget Act of 2020.

VOTES:

ASSEMBLY FLOOR: 54-13-13

YES: Aguiar-Curry, Bauer-Kahan, Bloom, Boerner Horvath, Bonta, Burke, Calderon, Carrillo, Cervantes, Chau, Chu, Cooper, Daly, Eggman, Frazier, Friedman, Gabriel, Cristina Garcia, Gipson, Gloria, Gonzalez, Gray, Grayson, Holden, Irwin, Jones-Sawyer, Kalra, Kamlager-Dove, Limón, Maienschein, McCarty, Medina, Mullin, Muratsuchi, Nazarian, O'Donnell, Petrie-Norris, Quirk, Quirk-Silva, Ramos, Reyes, Luz Rivas, Robert Rivas, Rodriguez, Blanca Rubio, Salas, Santiago, Smith, Mark Stone, Ting, Weber, Wicks, Wood, Rendon

NO: Bigelow, Brough, Dahle, Flora, Fong, Gallagher, Kiley, Mathis, Melendez, Obernolte, Patterson, Voepel, Waldron

ABS, ABST OR NV: Arambula, Berman, Chen, Chiu, Choi, Cooley, Cunningham, Diep, Eduardo Garcia, Lackey, Levine, Low, Mayes

UPDATED:

VERSION: June 22, 2020

CONSULTANT: Andrea Margolis / BUDGET / (916) 319-2099 FN: 0003151

SENATE COMMITTEE ON

Senator Holly Mitchell, Chair

2019 - 2020 Regular

Bill No: Hearing Date: June 24, 2020

Subject:

Summary:

This bill is an omnibus health trailer bill, and contains changes to implement the 2020-21 budget.

Proposed Law:

This bill makes technical and clarifying statutory revisions affecting health programs necessary to implement the Budget Act of 2020. Specifically, this bill:

1. Establishes the Health Care Payments Data Program, which will collect data on health care expenditures for inclusion in a Health Care Payments Data System. The data system will collect information regarding health care costs, utilization, quality, and equity to provide greater transparency to inform public policy decisions.
2. Prohibits termination of Medi-Cal eligibility for incarcerated juveniles to comply with provisions of the federal Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act.
3. Changes the name of the Electronic Health Record Incentive Program to the Medi-Cal Promoting Interoperability Program and extends the program sunset date from July 1, 2021, to January 1, 2024.
4. Prioritizes full-scope Medi-Cal expansion to undocumented seniors in the upcoming budget if the Department of Finance determines there are sufficient General Fund revenues for that fiscal year and the ensuing three fiscal years to support the expansion.
5. Authorizes the Department of Health Care Services (DHCS) to reimburse for medication assisted treatment (MAT) services in the Drug-Medi-Cal program.
6. Adjusts rate reviews for physician and dental reimbursable services to more closely align with federal access-to-care requirements.
7. Amends the definition of “best price” to allow DHCS to negotiate prescription drug rebates for Medi-Cal beneficiaries using the best international price, rather than the best domestic price.
8. Authorizes DHCS to negotiate prescription drug rebates on behalf of non-Medi-Cal populations.
9. Eliminates the monthly limit of six prescriptions and the one dollar copayment for prescriptions for Medi-Cal beneficiaries in the fee-for-service delivery system.
10. Requires DHCS to implement any approved federal Medicaid waiver or flexibility related to the novel coronavirus 2019 (COVID-19) public health emergency.
11. Authorizes DHCS to extend coverage for COVID-19 to uninsured individuals for the duration of the COVID-19 emergency period, pursuant to the option afforded to states in the federal Families First Coronavirus Response Act (FFCRA).
12. Requires DHCS to maximize federal financial participation for Medi-Cal expenditures to respond to the COVID-19 public health emergency, including the temporary increase granted in the FFCRA, and to comply with any conditions placed on receipt of those funds.
13. Authorizes DHCS, in consultation with stakeholders, to seek federal approval for a temporary extension of all or select components of the state’s 1115 Waiver Demonstration project, Medi-Cal 2020, which is scheduled to expire on December 31, 2020.
14. Suspends the Value-Based Payments program and supplemental payments to providers in Medi-Cal from Proposition 56 tobacco tax revenue effective July 1, 2021, unless the Department of Finance estimates that General Fund revenues exceed expenditures for the 2021-22 and 2022-23 fiscal years by an amount sufficient to support these programs and payments.
15. Authorizes DHCS to reduce applicable capitation rate increments for Medi-Cal managed care plans by up to 1.5 percent for the July 1, 2019, to December 31, 2020, rating period to account for reduced utilization related to the COVID-19 public health emergency.
16. Authorizes DHCS, in consultation with affected Medi-Cal managed care plans, to develop and implement a risk corridor to limit the financial risk of either overpayments or underpayments of capitation rates during the July 1, 2019, to December 31, 2020, rating period.
17. Authorizes the Department of Public Health (DPH) to allow the Pre-Exposure Prophylaxis (PrEP) Assistance Program to pay for an initial 30-day supply of PrEP and post-exposure prophylaxis (PEP) medication.
18. Authorizes the Franchise Tax Board to provide electronic retrieval of modified adjusted gross income data for the purposes of determining eligibility for the AIDS Drug Assistance Program.
19. Exempts the Lead-Related Construction Program from the Administrative Procedures Act for the purposes of addressing funding issues through fees established through the fee report authorized in the 2018 Budget Act.
20. Extends the authority for Patton State Hospital to house up to 1,530 patients from September 2020 until September 2030.
21. Authorizes the Governor, upon recommendation of the director, to appoint medical directors for the Department of State Hospitals and each of the individual state hospitals. Also allows the director to designate other hospital employees as officers.
22. Allows the board and staff members of Covered California to provide volunteer professional services if certain conditions are met.
23. Revises the actuarial value of Bronze-level health plans offered in Covered California to comply with new federal rules.
24. Extends the program period and reappropriates and extends availability of funding for the Medically-Tailored Meals pilot program authorized in the 2017 Budget Act.
25. Removes statutory language authorized in the 2019 Budget Act that would have suspended funding for DPH programs for the prevention of human immunodeficiency virus, hepatitis C, and sexually transmitted diseases.
26. Authorizes DHCS to establish, implement, and maintain a supplemental payment pool for nonhospital community clinics participating in the federal 340B program.

Fiscal Effect:

Reappropriates General Fund expenditure authority of $1.4 million approved in the 2017 Budget Act for a medically tailored meals pilot program and makes those funds available for encumbrance or expenditure until June 30, 2023.

Support:

None on file.

Opposed:

None on file.

-- END --

(Without Reference to File)

CONCURRENCE IN SENATE AMENDMENTS

CSA1 Bill Id:AB 80

Author:(Committee on Budget)

As Amended Ver:June 14, 2019

Majority vote. Budget Billl Appropriation Takes Effect Immediately

SUMMARY:

Provides for statutory changes necessary to enact human services related provisions of the Budget Act of 2019. As part of the 2019-20 budget package, Assembly Bill 80 makes statutory changes to implement the budget act.

Major Provisions

1. Continues to suspend the payment of child support incentive payments administered by the Department of Child Support Services (DCSS) for the 2019–20 and 2020–21 fiscal years, pending implementation of a new funding methodology for local child support agencies (LCSAs).
2. Requires the DCSS to implement a revised local child support agency funding methodology in the 2019–20 fiscal year. This is supported with a General Fund appropriation of $19 million ($56 million total funds) in 2019-20, increasing as implementation continues in future years.
3. Requires the DCSS to convene a series of stakeholder working sessions to establish an ongoing local child support agency funding methodology to commence in the 2020–21 fiscal year, and requires DCSS to recommend changes to the 2019–20 funding methodology to the Legislature on February 1, 2020.
4. Increases the DCSS administrative service fee, effective October 1, 2019, from $25 to $35 on a never-assisted custodial party who received child support collection services from the state and increases the disbursement threshold to which this would apply from an annual amount of $500 to $550 or more in collected child support payments. This state law change conforms to requirements in federal law.
5. Continues to suspend the fee exemption in existing law, requiring the Department of Justice (DOJ) or the State Department of Social Services (DSS) to charge a reasonable fee for fingerprinting or obtaining a criminal record for a license applicant who will provide services to 6 or fewer children.
6. States the intent of the Legislature to achieve annual inspections for licensed child day care centers and licensed family day care homes and facilities on or before July 1, 2021.
7. Requires, to the extent required by federal law, a child care provider who receives compensation, in whole or in part, under the Emergency Child Care Bridge Program for Foster Children to be registered as a Trustline provider, at no cost to the provider, unless the provider has a criminal conviction for which the DSS has not granted a criminal conviction exemption.
8. Deletes the authorization to conduct specified pilot programs and demonstration projects related to certain public social services programs where the statute is obsolete or the program was not launched. Deletes various obsolete reporting requirements.
9. Specifies that Office of the State Long-Term Care Ombudsman shall provide residents with regular and timely access to the services provided by the office through quarterly facility visits to skilled nursing facilities and residential care facilities for the elderly. This is supported with a General Fund appropriation of $4.2 million ($5.2 million total funds) in 2019-20 and $5.2 million General Fund in 2020-21 and on-going.
10. Requires the California Department of Aging (CDA) to administer the Aging and Disability Resource Connection (ADRC) Infrastructure Grants Program for the purpose of implementing a No Wrong Door System. Requires funds to be awarded pursuant to the grant program to interested and qualified area agencies on aging and independent living centers to complete the planning and application process for designation and approval to operate as an ADRC program. Authorizes grant funds to be awarded to aid designated ADRC programs operated by area agencies on aging and independent living centers in expanding or strengthening the services that they provide. This is supported with a General Fund appropriation of $5 million in 2019-20 and on-going, subject to suspension of the implementation on December 31, 2021, unless the Department of Finance makes a specified determination.
11. Deletes a July 1, 2024 sunset date for the Traumatic Brain Injury program, administered by the Department of Rehabilitation (DOR), which facilitates the provision of services for persons with acquired traumatic brain injury, utilizing an individual service plan to identify the needs of consumers and deliver, either directly or by arrangement, coordinated services designed to meet those needs.
12. Requires, to the extent possible within the technology, the development of the California Statewide Automated Welfare System (CalSAWS) enrollment and eligibility functionality, case management systems, ancillary services, public portals, and mobile applications to have the goals of minimizing the burden of the overall eligibility process for enrollment and retention of benefits for low-income Californians, streamlining interactions for both clients and eligibility workers, and facilitating applicant and client submission of feedback. Requires the participants in quarterly stakeholder meetings to jointly update the Legislature at least twice per year through existing processes as to how the CalSAWS development, implementation, and maintenance minimizes client burden in order to improve access to safety net programs and incorporates ongoing applicant and client feedback toward continuous improvement.
13. Removes obsolete references to a nonbiometric identity verification method in the CalWORKs program and removes obsolete references to former statewide fingerprint imaging system requirements with reference to identity verification requirements for the CalWORKs program.
14. Effective October 1, 2019, increases the maximum aid payment amounts for CalWORKs recipients, based on the number of people in the assistance unit, whether the assistance unit includes a recipient who is exempt from participating in welfare-to-work activities, and the region in which the family resides. This grant increase is intended to be the next step toward alleviating the condition of deep child poverty, defined as living with a subsistence level less than 50% of the Federal Poverty Level, for children in the CalWORKs program. This is supported with a General Fund appropriation of $333.7 million in 2019-20 and $444.7 million in 2020-21.
15. Renames the CalWORKs Home Visiting Initiative the CalWORKs Home Visiting Program, recognizing its permanent program nature, and makes various technical, nonsubstantive changes to the program’s provisions. Revises program eligibility requirements, including by making eligible for the home visiting program an individual who is apparently eligible for CalWORKs aid and a pregnant individual who has applied for CalWORKs aid within 60 calendar days prior to reaching the 2nd trimester of pregnancy and would be eligible for CalWORKs aid other than not having reached the 2nd trimester of pregnancy. Authorizes a county and the home visiting program to incorporate participation of the noncustodial parent of a child who is a member of a CalWORKs assistance unit into home visiting services.
16. Changes the requirement in the CalWORKs Homeless Assistance Program (HAP) for eligibility for temporary shelter assistance limited to one period of up to 16 consecutive days every 12 months to instead 16 cumulative days every 12 months. Conforming changes are made for cases where homelessness is a direct result of domestic violence by a spouse, partner, or roommate, physical or mental illness. This change is supported with a General Fund appropriation of $14.7 million in 2019-20 and $27.6 million in 2020-21 and on-going.
17. Provides that, commencing with the 2020–21 fiscal year, the funding provided for stage one child care be allocated to counties separately from the CalWORKs Single Allocation. Requires the State Department of Social Services to work with representatives of county human services agencies and the County Welfare Directors Association of California to develop recommendations for revising the methodology used for development of the CalWORKs single allocation annual budget.
18. Requires, when CalSAWS is able to produce a report identifying overpayment and when the individual responsible for the overpayment has not received aid under CalWORKs for 36 consecutive months or longer, that the overpayment, then deemed to be uncollectible, be discharged, rather than expunged. This is a terminology change conforming to recent state law changes.
19. Requires the DSS to facilitate a workgroup that includes counties, advocates for the poor, organizations that represent workers, CalWORKs recipients, staff of the appropriate fiscal and policy committees of the Legislature, and other stakeholders in a review of the CalWORKs welfare-to-work laws and regulations. Requires the workgroup to develop a set of immediate, near-term, and long-term recommendations focused on eliminating policy barriers that would prohibit the successful implementation of the CalWORKs Outcomes and Accountability Review (Cal-OAR), as influenced by a welfare-to-work model known locally as CalWORKs 2.0. Requires the DSS to update the Joint Legislative Budget Committee on the recommendations of the workgroup by February 1, 2020, and would repeal these provisions on January 1, 2021.
20. Extends and revises the policy for emergency caregiver payments in the 2019-20 fiscal year, continuing to make these payments ineligible for the federal or state share of payment upon approval or denial of the resource family application or beyond 120 days, whichever comes first, subject to an extension beyond those payments, for up to 365 days of payments, if certain conditions are met by the county, including, among others, the provision of monthly documentation showing good cause for the delay in approving the resource family application that is outside the control of the county. This is supported with a one-time General Fund appropriation of $4.1 million in 2019-20.
21. Requires each county, on and after July 1, 2019, to provide a payment equivalent to the resource family basic level rate of the home-based family care rate structure on behalf of an Indian child placed in the home of the caregiver who is pending approval as a tribally approved home if specified criteria are met.
22. Authorizes the DSS to grant an additional extension to a group home until December 31, 2020, upon a county child welfare agency submitting a written request on behalf of a provider that includes an update to the previously submitted documentation. Requires the county child welfare and mental health agencies, in order to maintain the placement of foster youth placed in a group home that receives this extension, to submit a collaborative plan to the DSS and the State Department of Health Care Services (DHCS) that includes specified components. Requires the DSS, the DHCS, and stakeholders to develop a collaborative plan to address barriers to building high-quality services in residential treatment programs and in family-based settings.
23. Requires, commencing July 1, 2019, the rates paid to foster family agencies to be increased by 4.15%, except for the rate paid to a certified family home or resource family agency. This is supported with a General Fund appropriation of $6.5 million in 2019-20 and on-going, subject to suspension of the rate increase on December 31, 2021, unless the Department of Finance makes a specified determination.
24. Requires the DSS, with the advice and assistance of the County Welfare Directors Association of California and other specified stakeholders, to establish a working group to develop performance standards and outcome measures for providers of out-of-home care placements made under the AFDC-FC program.
25. Requires the DSS, in collaboration with the County Welfare Directors Association of California, to track the utilization, workload, and costs associated with implementing any specific tool developed to identify the child’s strengths and needs and determine the most appropriate out-of-home placement.
26. Provides that when a child receiving benefits under the Approved Relative Caregiver Funding Program (ARC) or AFDC-FC program becomes eligible for benefits under the state-funded or federally funded Kin-GAP Program, respectively, the child shall continue to receive ARC or AFDC-FC benefits through the day that the juvenile court dismisses the dependency or terminates the wardship, and Kin-GAP payments shall begin the following day.
27. Establishes a rebased County In-Home Supportive Services (IHSS) Maintenance of Effort (MOE), reducing the base for the 2019–20 fiscal year to $1,563,282,000 from that which was established in the 2017–18 fiscal year at $1,769,443,000, commencing July 1, 2019. Makes additional adjustments to the County IHSS MOE relating to, among other things, benefits that are locally negotiated, mediated, or imposed, and administration expenditures. Once the state minimum wage reaches $15 per hour, requires the state to pay 35%, and the county 65%, of the nonfederal share of an increase in provider wages or health benefits locally negotiated, mediated, imposed, or adopted by ordinance, or of increases to rates in contracts. Changes the inflation factor applied to the County IHSS MOE to 4% beginning on July 1, 2020, and annually thereafter. Current law sets, beginning on July 1, 2019, an inflation factor of 7%.
28. Repeals offsetting provisions related to a combination of General Fund moneys appropriated in the annual Budget Act and redirected 1991 Realignment funds, based on specified formulas, for purposes of the 2019–20, 2020–21, 2021–22, and subsequent fiscal years. Redirect moneys from specified accounts of the Local Revenue Fund to the mental health account, health account, and family support account, of each county or city and county and to the continuously appropriated County Medical Services Program Growth Subaccount. Makes other revisions relating to the distribution of 1991 Realignment funds.
29. Require the DSS to develop and implement the federally-required electronic visit verification system (EVV system), the purpose of which is to electronically verify specified information with respect to Medicaid-funded personal care services and home health care services provided by the state, in accordance with specified principles, including compliance with specified federal statutory and case law, the capabilities of the system, the rights of IHSS program consumers and providers, and development and implementation of the EVV system in a manner and timeframe that avoids payment of federal financial participation penalties.
30. Requires the DSS to work with the County Welfare Directors Association of California to determine the actual one-time and ongoing county workload and costs to implement the EVV system and to consider the information for annual budget changes and county workload requirements related to implementation. Makes this provision inoperative on July 1, 2020, and repeals it on January1, 2021.
31. Requires the DSS, the DHCS, the California State Association of Counties, the County Welfare Directors Association of California, the County Behavioral Health Directors Association of California, and the Chief Probation Officers of California to provide quarterly in-person updates to the Legislature on progress toward the implementation of the Continuum of Care Reform (CCR) effort. Requires the updates to include specified information on, among other topics, the transition of providers to the CCR program models, the capacity to provide mental health services, tracking child outcomes over time, the CCR-related costs and savings, system changes, and county recruitment and retention efforts.
32. Exempts certain contracts or grants, necessary for DSS to implement or evaluate the CCR from various laws and procedures, including the Public Contract Code and the State Contracting Manual and review by either the Department of General Services or the Department of Technology. Makes these provisions inoperative on July 1, 2021, and would repeal them as of January 1, 2022.
33. Establishes a child welfare public health nursing early intervention program in the County of Los Angeles to improve outcomes for youth who are at risk of entering the foster care system, by maximizing access to health care, health education, and connection to safety net services. The program would be administered by the Los Angeles County Department of Public Health (DPH), in cooperation with the county’s Department of Children and Family Services (DCFS). Specifies the duties of a county public health nurse participating in the pilot program, including conducting emergency and routine home visits with social workers and providing parents and guardians with educational tools and resources to ensure their child’s physical, mental, and behavioral health needs are being met. Requires DPH and DCFS to develop appropriate outcome measures to determine the effectiveness of the program in achieving its objectives and report its findings and recommendations to the Legislature. Requires the DHCS and the county to seek any federal approvals necessary to implement the program and seek to maximize federal financial participation. This is supported with a General Fund appropriation of $8.3 million in 2019-20 and on-going, subject to suspension of the implementation on December 31, 2021, unless the Department of Finance makes a specified determination.
34. Requires the DSS to establish a statewide hotline, operational no sooner than January 1, 2021, and on the same date as the county-based mobile response systems described below, as the entry point for a Family Urgent Response System (FURS), to respond to calls from caregivers or current or former foster children or youth during moments of instability, as specified. Requires the hotline to include, among other things, referrals to a county-based mobile response system, for further support and in-person response. Requires the DSS to ensure that deidentified, aggregated data are collected regarding individuals served through the hotline and the county-based mobile response system and to publish a report on the DSS internet website by January 1, 2022, and annually thereafter.
35. Requires, no sooner than January 1, 2021, and on the same date as the statewide hotline described above, county child welfare, probation, and behavioral health agencies, in each county or region of counties, as specified, to establish a joint county-based mobile response system that includes a mobile response and stabilization team for the purpose of providing supportive services to, among other things, address situations of instability, preserve the relationship of the caregiver and the child or youth, and stabilize the situation. Requires those agencies to submit a single, coordinated plan to the DSS, describing how the system would meet specified requirements. Authorizes those agencies to implement these provisions on a per-county basis or by collaborating with other counties to establish regional, cross-county mobile response systems.
36. Requires the DSS, in collaboration with the DHCS, to issue all necessary guidance for county-based mobile response systems. Requires the DSS, in collaboration with specified entities, on an annual basis beginning on January 1, 2022, to assess utilization and workload associated with implementation of the statewide hotline and mobile response system and provide an update to the Legislature during budget hearings.
37. Makes FURS inoperative in any fiscal year for which funding is not appropriated in the annual Budget Act for the purpose of complying with its requirements. This is supported with a General Fund appropriation of $15 million in 2019-20 and $30 million in 2020-21 and on-going, subject to suspension of the implementation on December 31, 2021, unless the Department of Finance makes a specified determination.
38. Amends statute to recognize the permanent nature of the program that makes a recipient of Supplemental Security Income/State Supplementary Payment Program (SSI/SSP) benefits eligible for CalFresh benefits, enabled by current law that establishes the SSI/SSP Cash-In Supplemental Nutrition Benefit (SNB) Program and the SSI/SSP Cash-In Transitional Nutrition Benefit (TNB) Program to provide nutrition benefits to a CalFresh household that had its benefits reduced or became ineligible when a previously excluded SSI/SSP recipient was added to the household under the new eligibility provisions.
39. Makes the SNB and TNB benefits available without regard to an appropriation in the annual Budget Act.
40. Makes SSI/SSP-equivalent benefits available in the Cash Assistance Program for Immigrants (CAPI) program, retroactive to June 1, 2019, without regard to an appropriation in the annual Budget Act.
41. Requires the DSS to establish a Work Incentive Nutritional Supplement (WINS) program, under which each county is required to provide a $10 monthly additional food assistance benefit for each eligible CalFresh household.
42. Deletes the requirement that the state use funds that qualify for the state’s Temporary Assistance for Needy Families (TANF) program maintenance of effort requirements to pay for the cost of Work Incentive Nutritional Supplement (WINS) benefits.
43. Requires the DSS to work with representatives for county human services agencies and the County Welfare Directors Association of California to update the budgeting methodology used to determine the annual funding for county administration of the CalFresh program beginning with the 2020–21 fiscal year.
44. Increases from 10% to 15% the annual budget limitation on storage and transportation expenditures associated with the CalFood Program, commencing on July 1, 2019.
45. Makes tribes and combinations of counties or tribes eligible for funding under the Housing and Disability Income Advocacy Program as grantees. Requires grantees to use the funding for the provision of certain services, including housing assistance, and to make a reasonable effort to place a client who receives subsidies in housing that the client can sustain without a subsidy upon approval of disability benefits or consider providing limited housing assistance until an alternative subsidy, affordable housing voucher, or other sustainable housing option is secured. Requires the DSS to annually inform the Legislature of the implementation progress and to submit an annual report to the Legislature on the implementation of the program. This program is supported with a General Fund appropriation of $25 million in 2019-20 and on-going.
46. Expands the scope of the Bringing Families Home Program to also apply to tribal governments and would make conforming changes. Makes certain changes to the criteria for housing-related supports, requiring, among other things, the use of an assessment tool. Requires a participating county or tribe to utilize a cross-agency liaison to coordinate activities. This is supported with a one-time General Fund appropriation of $25 million in 2019-20.
47. Requires the DSS to administer a rapid response program to award grants or contracts to entities that provide critical assistance to immigrants during times of need. Prescribes requirements for the grants or contracts, including that the grants or contracts provide critical funding for immigrants, including medical treatment, temporary shelter, food, and clothing. Requires the DSS to provide an update to the Legislature regarding any entity receiving funds and would require the update to contain specified information, including the name of the entity or entities that will receive the funding, a timeline for implementation of the services, and the approximate number of persons that will be served per month by the funds. The bill’s provisions would be inoperative on July 1, 2022, and would be repealed on January 1, 2023. States that these provisions are severable. These activities are supported with a one-time General Fund appropriation of $25 million in 2019-20.
48. Repeal provisions related to a Refugee Targeted Assistance program, pursuant to and conforming with changes in federal law. Authorizes the DSS, to the extent permitted by federal law, to contract with, or award grants to, qualified nonprofit organizations for the administration of refugee social services and refugee cash assistance.
49. Expands the purposes of the appropriation associated with refugee pupils through the DSS to provide additional services for pupils who are unaccompanied undocumented minors. Requires the DSS to allocate funding to school districts impacted by significant numbers of refugee pupils, other eligible populations served by the federal Office of Refugee Resettlement, and unaccompanied undocumented minors using a formula to be developed by the DSS based upon the refugee and unaccompanied undocumented minor arrivals in a school district during the preceding 60-month period for which the DSS has data.
50. Authorizes the Department of Housing and Community Development (HCD) to provide funding to counties for allocation to child welfare services agencies to help young adults who are 18 to 24 years of age secure and maintain transitional housing, with priority given to young adults formerly in the state’s foster care or probation systems. Requires the HCD to consult with the DSS, the Department of Finance, and the County Welfare Directors Association to develop an allocation schedule for purposes of distributing funds. This is supported with a General Fund appropriation of $8 million in 2019-20 and on-going, subject to suspension of the implementation on December 31, 2021, unless the Department of Finance makes a specified determination.
51. Authorizes twelve months of continuous eligibility for CalWORKs stage one child care. Requires a county welfare department to provide a monthly report to stage two contractors to facilitate the continuity of care across the stages. This is supported with a General Fund appropriation of $56.4 million, $4.2 million of which for one-time automation purposes, in 2019-20 and $70.5 million annually on-going.
52. Increases the CalWORKs asset limitation to $10,000 and the motor vehicle exemption to $25,000, effective June 1, 2020, or upon a specified notification regarding the completion of automation necessary to implement these changes from the DSS, whichever is later. Requires the amount of the asset limitation and the motor vehicle exemption to be adjusted annually. Deletes the amount likely to render a CalWORKs recipient ineligible for CalWORKs benefits from the income reporting threshold, also effective June 1, 2020, or upon a specified notification regarding the completion of automation necessary to implement these changes from the DSS, whichever is later. This is supported with a General Fund appropriation of $7.5 million in 2019-20, $27.8 million in 2020-21, and $29.9 million in 2021-22 and on-going.
53. Incrementally increases the amount of exempted income on an annual basis, also known as the CalWORKs Earned Income Disregard, beginning on June 1, 2020, or upon a specified notification regarding the completion of automation necessary to implement these changes from the DSS, whichever is later. This is supported with a General Fund appropriation of $6.8 million in 2019-20, $74.4 million in 2020-21, $85.7 million in 2021-22, and $99 million in 2022-23 and on-going.
54. Requires that In-Home Supportive Services providers receive payment of wages only by direct deposit or provider card either by July 1, 2021 or an alternative date identified by DSS, relative to statewide implementation of the federal electronic visit verification requirement, whichever is later and upon notification to the Legislature. Provides for a request for proposal process for the provider card vendor, with specified criteria, and delineates qualifications and requirements for how the provider card should function.
55. Requires, until January 1, 2021, a specified mediation process to be held if a public authority or nonprofit consortium and the employee organization fail to reach an agreement on a bargaining contract or after October 1, 2019. Requires the mediation process to also include the county board of supervisors holding a public hearing after the factfinding panel’s public release of its findings of fact and recommended settlement terms. Subjects a county to a withholding of a specified amount of 1991 Realignment funds if the parties have completed the mediation process and if the factfinding panel has issued findings of fact and recommended settlement terms that are more favorable to the employee
56. Provides authority to the state to implement and administer specified changes to law through all-county letters or similar instructions until regulations are adopted, and provides authority for emergency regulations with specified dates and conditions for adoption.
57. Specifies that to the extent that this act has an overall effect of increasing the costs already borne by a local agency for programs or levels of services mandated by the 2011 Realignment Legislation, Section 36 of Article XII of the California Constitution shall govern this act's application to local agencies and the state's funding of those programs or levels of service.
58. Designates this act as a bill providing for appropriations related to the Budget Act and that it is identified as such in the Budget Bill, and shall take effect immediately.

The Senate Amendments:

COMMENTS:

According to the Author:

Arguments in Support:

Arguments in Opposition:

FISCAL COMMENTS:

VOTES:

ASSEMBLY FLOOR: 54-13-13

YES: Aguiar-Curry, Bauer-Kahan, Bloom, Boerner Horvath, Bonta, Burke, Calderon, Carrillo, Cervantes, Chau, Chu, Cooper, Daly, Eggman, Frazier, Friedman, Gabriel, Cristina Garcia, Gipson, Gloria, Gonzalez, Gray, Grayson, Holden, Irwin, Jones-Sawyer, Kalra, Kamlager-Dove, Limón, Maienschein, McCarty, Medina, Mullin, Muratsuchi, Nazarian, O'Donnell, Petrie-Norris, Quirk, Quirk-Silva, Ramos, Reyes, Luz Rivas, Robert Rivas, Rodriguez, Blanca Rubio, Salas, Santiago, Smith, Mark Stone, Ting, Weber, Wicks, Wood, Rendon

NO: Bigelow, Brough, Dahle, Flora, Fong, Gallagher, Kiley, Mathis, Melendez, Obernolte, Patterson, Voepel, Waldron

ABS, ABST OR NV: Arambula, Berman, Chen, Chiu, Choi, Cooley, Cunningham, Diep, Eduardo Garcia, Lackey, Levine, Low, Mayes

UPDATED:

VERSION: June 14, 2019

CONSULTANT: Nicole Vazquez / BUDGET / (916) 319-2099 FN: 0001125

 THIRD READING  

Bill No: AB 80

Author: Committee on Budget

Amended: 6/14/19 in Senate

Vote: 21

SENATE BUDGET & FISCAL REVIEW COMMITTEE: 11-3, 6/19/19

AYES: Mitchell, Beall, Hurtado, Leyva, McGuire, Monning, Pan, Roth, Skinner, Umberg, Wieckowski

NOES: Nielsen, Moorlach, Stone

NO VOTE RECORDED: Durazo, Jones, Morrell, Stern

ASSEMBLY FLOOR: Not relevant

SUBJECT: Human services omnibus

SOURCE: Author

DIGEST:

This bill provides for statutory changes necessary to enact human-services related provisions of the Budget Act of 2019.

ANALYSIS: This bill, as part of the 2019-20 budget package, makes statutory changes to implement the Budget Act. Specifically, this bill:

Department of Social Services (DSS)

1. Includes provisions pertaining to the CalWORKs program, including:
   1. Ending Childhood Deep Poverty. Increases the maximum aid payment (MAP) amounts for CalWORKs recipients in order to increase grants to no less than 50 percent of the Federal Poverty Level for assistance units (AU) of one, effective October 1, 2019. Grant amounts for all other AU sizes will be increased to no less than 47 percent. The Budget Act includes $348 million General Fund ongoing for this purpose.
   2. Home Visiting Program. Makes the Home Visiting Program permanent and allows for the inclusion of all young children ages 0-2.
   3. Homeless Assistance Program. Allows the use of temporary assistance for up to 16 cumulative days, instead of consecutive days, in a 12-month period. The Budget Act includes $14.7 million in 2019-20 for this purpose.
   4. Earned Income Disregard (EID) and Income Reporting Threshold (IRT). Updates the EID to $500 and 50 percent of income with a June 1, 2020 effective date and subsequent adjustments in future fiscal years. Also removes the amount likely to render a recipient ineligible for CalWORKs benefits from the IRT. The Budget Act includes $6.8 million in 2019-20 for these purposes.
   5. 12-month Continuous Eligibility for CalWORKs Stage One Childcare. Amends the CalWORKs Stage one child care program to provide full time continuous child care to families in Stage one for twelve months or until families are transferred to Stage two. Expands the definition of program activities that make families eligible for child care. Provides for a data sharing system between county welfare departments and child care contractors to ensure that child care is not disrupted during the transfer from Stage one to Stage two.
   6. Asset Limits. Increases the CalWORKs asset limit to $10,000 and the motor vehicle exemption to $25,000 and ties inflation factors to these limits. The Budget Act includes $7.5 million in 2019-20 for this purpose.
2. Includes provisions pertaining to Child Welfare Services, including:
   1. Family Urgent Response System. Establishes a statewide hotline for caregivers and youth who experience emotional, behavioral, or other difficulties and are in need of immediate help. Also allows counties to establish or expand mobile response teams to provide in-home response on a 24/7 basis to stabilize situations and assess needs. The Budget Act includes $15 million in 2019-20 for this purpose. The program would be subject to suspension on December 31, 2021, if certain conditions are met.
   2. Foster Family Agency (FFA) Rates - Cost-of-Living Adjustment (COLA). Provides a one-time COLA, based on the California Necessities Index, to the rates paid to FFAs, subject to suspension on December 31, 2021, if certain conditions are met. The Budget Act includes $6.8 million for this purpose.
   3. Continued Emergency Caregiver Funding at Time of Placement. Allows for continued payment for emergency caregivers prior to approval for up to 365 days if the delay in the Resource Family Approval process is found to be neither the fault of the county nor the family. The Budget Act includes $4.1 million for this purpose.
3. Includes provisions pertaining to the Supplemental Security Income/State Supplemental Payment (SSI/SSP) program, including:
   1. Supplemental Nutrition Benefit (SNB) and Transitional Nutrition Benefit (TNB) Programs. Makes the SNB and TNB programs, both designed to hold harmless households that would have been negatively affected by the expansion of CalFresh benefits to SSI/SSP recipients, permanent. Also makes these benefits available without regard to an appropriation in the annual Budget Act.
4. Includes provisions pertaining to the In-Home Supportive Services (IHSS) program, including:
   1. Maintenance-of-Effort (MOE). Resets the base for counties’ share of program costs and adjusts the IHSS MOE inflation factor, among other provisions.
   2. Electronic Visit Verification (EVV) Protections. Codifies consumer and provider protections that were included in budget bill language in the 2018 Budget Act.
   3. Wage Agreements. Subjects counties to financial penalties when agreements on wage increases with IHSS services providers cannot be reached following a fact-finding process.
   4. Provider Cards. Allows providers to receive payment of wages through a provider card, such as a prepaid account or prepaid card.
5. Includes, additionally, for DSS:
   1. Rapid Response Program. Requires DSS to administer a rapid response program to award grants to entities that provide critical assistance to immigrants during times of need.

Department of Aging

1. Includes, for the Department of Aging:
   1. Long-Term Care Ombudsman. Specifies that the State Ombudsman should provide residents with regular and timely access to services through quarterly facility visits. The Budget Act includes $5.2 million ongoing for this and other related purposes.
   2. No Wrong Door Model. Requires the department to administer a grant program for the purpose of implementing a No Wrong Door system, subject to suspension on December 31, 2021, if certain conditions are met. Grants would be awarded to qualified Area Agencies on Aging and Independent Living Centers. The Budget Act includes $5 million ongoing for this purpose.

Department of Rehabilitation

1. Includes, for the Department of Rehabilitation:
   1. Traumatic Brain Injury Program. Removes the sunset on the program, extending its operation indefinitely.

Department of Child Support Services

1. Includes, for the Department of Child Support Services:
   1. Local Child Support Agency (LCSA) Funding Methodology. Requires the department to convene a series of stakeholder working sessions to establish an ongoing LCSA funding methodology to begin in the 2020-21 fiscal year.

FISCAL EFFECT: Appropriation: Yes Fiscal Com.: Yes Local: Yes

SUPPORT: (Verified 6/13/19)

None received

OPPOSITION: (Verified 6/13/19)

None received

Prepared by: Renita Polk / B. & F.R. / 916-651-4103

6/19/19 16:38:10

**** END ****

SENATE COMMITTEE ON BUDGET AND FISCAL REVIEW

Senator Holly Mitchell, Chair

2019 - 2020 Regular

Bill No: AB 80 Hearing Date: June 19, 2019

Subject: Human services omnibus

Summary:

Provides for statutory changes necessary to enact human-services related provisions of the Budget Act of 2019.

Background:

As part of the 2019-20 budget package, this bill makes statutory changes to implement the budget act.

Proposed Law:

For the Department of Social Services (DSS):

CalWORKs: This bill includes provisions pertaining to the CalWORKs program, including:

1. Ending Childhood Deep Poverty. Increases the maximum aid payment (MAP) amounts for CalWORKs recipients in order to increase grants to no less than 50 percent of the Federal Poverty Level for assistance units (AU) of one, effective October 1, 2019. Grant amounts for all other AU sizes will be increased to no less than 47 percent. The Budget Act includes $329.8 million General Fund ongoing for this purpose.
2. Home Visiting Program. Makes the Home Visiting Program permanent and allows for the inclusion of all young children ages 0-2.
3. Homeless Assistance Program. Allows the use of temporary assistance for up to 16 cumulative days, instead of consecutive days, in a 12-month period. The Budget Act includes $14.7 million in 2019-20 for this purpose.
4. Earned Income Disregard (EID) and Income Reporting Threshold (IRT). Updates the EID to $500 and 50 percent of income with a June 1, 2020 effective date and subsequent adjustments in future fiscal years. Also removes the amount likely to render a recipient ineligible for CalWORKs benefits from the IRT. The Budget Act includes $6.8 million in 2019-20 for these purposes.
5. 12-month Continuous Eligibility for CalWORKs Stage One Childcare. Amends the CalWORKs Stage one child care program to provide full time continuous child care to families in Stage one for twelve months or until families are transferred to Stage two. Expands the definition of program activities that make families eligible for child care. Provides for a data sharing system between county welfare departments and child care contractors to ensure that child care is not disrupted during the transfer from Stage one to Stage two.
6. Asset Limits. Increases the CalWORKs asset limit to $10,000 and the motor vehicle exemption to $25,000 and ties inflation factors to these limits. The Budget Act includes $7.5 million in 2019-20 for this purpose.

Child Welfare Services: The bill includes provisions pertaining to Child Welfare Services, including:

1. Family Urgent Response System. Establishes a statewide hotline for caregivers and youth who experience emotional, behavioral, or other difficulties and are in need of immediate help. Also allows counties to establish or expand mobile response teams to provide in-home response on a 24/7 basis to stabilize situations and assess needs. The Budget Act includes $15 million in 2019-20 for this purpose. The program would be subject to suspension on December 31, 2021, if certain conditions are met.
2. Foster Family Agency (FFA) Rates - Cost-of-Living Adjustment (COLA). Provides a one-time COLA, based on the California Necessities Index, to the rates paid to FFAs, subject to suspension on December 31, 2021, if certain conditions are met. The Budget Act includes $6.8 million for this purpose.
3. Continued Emergency Caregiver Funding at Time of Placement. Allows for continued payment for emergency caregivers prior to approval for up to 365 days if the delay in the Resource Family Approval process is found to be neither the fault of the county nor the family. The Budget Act includes $4.1 million for this purpose.

Supplemental Security Income/State Supplemental Payment (SSI/SSP) Program: This bill includes provisions pertaining to the SSI/SSP program, including:

1. Supplemental Nutrition Benefit (SNB) and Transitional Nutrition Benefit (TNB) Programs. Makes the SNB and TNB programs, both designed to hold harmless households that would have been negatively affected by the expansion of CalFresh benefits to SSI/SSP recipients, permanent. Also makes these benefits available without regard to an appropriation in the annual Budget Act.

In-Home Supportive Services (IHSS): This bill includes provisions pertaining to the IHSS program, including:

1. Maintenance-of-Effort (MOE). Resets the base for counties’ share of program costs and adjusts the IHSS MOE inflation factor, among other provisions.
2. Electronic Visit Verification (EVV) Protections. Codifies consumer and provider protections that were included in budget bill language in the 2018 Budget Act.
3. Wage Agreements. Subjects counties to financial penalties when agreements on wage increases with IHSS services providers cannot be reached following a fact-finding process.
4. Provider Cards. Allows providers to receive payment of wages through a provider card, such as a prepaid account or prepaid card.

Additionally, for DSS, this bill:

1. Rapid Response Program. Requires the department to administer a rapid response program to award grants to entities that provide critical assistance to immigrants during times of need.

For the Department of Aging:

1. Long-Term Care Ombudsman. Specifies that the State Ombudsman should provide residents with regular and timely access to services through quarterly facility visits. The Budget Act includes $5.2 million ongoing for this and other related purposes.
2. No Wrong Door Model. Requires the department to administer a grant program for the purpose of implementing a No Wrong Door system, subject to suspension on December 31, 2021, if certain conditions are met. Grants would be awarded to qualified Area Agencies on Aging and Independent Living Centers. The Budget Act includes $5 million ongoing for this purpose.

For the Department of Rehabilitation:

1. Traumatic Brain Injury Program. Removes the sunset on the program, extending its operation indefinitely.

For the Department of Child Support Services:

1. Local Child Support Agency (LCSA) Funding Methodology. Requires the department to convene a series of stakeholder working sessions to establish an ongoing LCSA funding methodology to begin in the 2020-21 fiscal year.

Fiscal Effect:

Funding related to the changes in this bill is contained in the 2019-20 budget.

Support: None on file.

Opposition: None on file.

-- END --

ASSEMBLY THIRD READING

ATR Bill Id:AB 80

Author:(Ting)

As Introduced Ver:December 3, 2018

Majority vote. Budget Bill Appropriation Takes Effect Immediately

SUMMARY:

This bill expresses the intent of the Legislature to enact statutory changes relating to the Budget Act of 2019.

Major Provisions

COMMENTS:

According to the Author:

Arguments in Support:

Arguments in Opposition:

FISCAL COMMENTS:

VOTES:

UPDATED:

VERSION: December 3, 2018

CONSULTANT: Christian Griffith / BUDGET / (916) 319-2099 FN: 0000123