Department of Health Care Services Begins Work on Medi-Cal Function Transfer from the Departments of Mental Health and Alcohol and Drug Programs

The California Department of Health Care Services (DHCS) convened the first in a series of stakeholder meetings to discuss the transfer of Department of Mental Health (DMH) Medi-Cal related mental health functions and Department of Alcohol and Drug Programs (DADP) Drug Medi-Cal functions to DHCS. 

These transfers were authorized in two of last month’s 2011-12 budget trailer bills: AB 102 (Chapter 29, Statutes of 2011) authorizes the transfer of Medi-Cal related mental health functions to DHCS, while AB 106 (Chapter 32, Statutes of 2011), authorizes the transfer of the Drug Medi-Cal program to DHCS. 

Both new laws require DHCS to convene a series of stakeholder meetings to create a state administrative and programmatic transition plan for the transfers. That transition plan is due to the Legislature on October 1 of this year, and the transfers are supposed to occur by the spring of 2012. 

Medi-Cal functions that will be transferred from DMH to DHCS include Medi-Cal Program Policy Support; Medi-Cal Program Compliance; County Medi-Cal Program Technical Assistance; Administrative and Financial Services in Support of Medi-Cal Program; IT Support for Medi-Cal Systems and Subsystems; and Data Management and Support for the Medi-Cal Program. 

Besides the stakeholder meetings, DHCS is soliciting written comments and recommendations on the transfers, which may be sent to a new DHCS email address set up especially for this purpose. A website with meeting materials is under construction; CSAC will report when it is in use.

Service Coordination

SB 557 (Kehoe) – Support
As Amended on July 7, 2011

SB 557, by Senator Christine Kehoe, would establish two-year pilot programs for family justice centers in Alameda and Sonoma Counties, as well as the cities of San Diego and Anaheim, and require the National Justice Center Alliance to report to the Legislature on the effectiveness, possible legislation, and best practices of those centers. 

The family justice center concept is simple: co-locate a multi-disciplinary team of professionals in a single location to coordinate services for victims of family violence. This model ensures service coordination but also enhances the safety and well-being of victims of violence and their families. 

Both the counties of Alameda and Sonoma also currently operate acclaimed family justice centers. These county centers focus on victims of domestic violence and human trafficking. Senator Kehoe’s SB 557 supports the family justice center concept by authorizing Alameda and Sonoma counties, as well as two cities (San Diego and Anaheim) to establish or continue to operate family justice centers to assist victims of domestic violence, sexual assault, stalking, cyberstalking, cyberbullying, human trafficking, and elder or dependent adult abuse. 

SB 557 also outlines clear confidentiality and professional practice guidelines, and mandates collaboration with local community-based advocates, survivors, and service providers. 

In short, SB 557 will build upon the progress made by Alameda and Sonoma County by creating a structure for the National Justice Center Alliance to examine the success of the model. To do this, the bill also contains a sunset clause of January 1, 2014, and counties believe that the results of the pilot participants will encourage California to continue to build upon the family justice center model. It is for these reasons that CSAC supports SB 557, which is on the Assembly Floor as part of the Consent Calendar.

Adult Protective Services

SB 33 (Simitian) – Support
As Amended on June 15, 2011

SB 33, by Senator Joe Simitian, would repeal the sunset date for statute that designates certain financial institution employees as mandated reporters for suspected financial abuse of elder or dependent adults. 

Senator Simitian authored SB 1018 in 2007 to expand the definition of mandated reporters of elder or dependent adult abuse to those who work at financial institutions. SB builds that statute by removing the January 1, 2013 sunset date. 

The Assembly Public Safety Committee passed the bill on July 1 and it is now on the Assembly Floor.

Health and Public Health

AB 300 (Ma) – Support
As Amended on June 30, 2011

AB 300, by Assembly Member Fiona Ma, would establish clear standards for the tattoo, piercing and permanent cosmetics industry in California.

AB 300 establishes a clear scope of local authority, clear requirements for registration of body art practitioners and consistent enforcement of mobile and fixed body art sites. The bill also requires body art practitioners, as a provision of registration, to complete courses on the transmission of blood borne pathogens and first aid.

The Senate Public Safety Committee passed the bill on June 29 and it is now on the Senate Floor. 

AB 581 (Pérez) – Support
As Amended on July 11, 2011

AB 581, as amended on July 11 by Assembly Speaker John Pérez, would create the California Healthy Food Financing Imitative. 

Assembly Bill 581 specifically establishes the California Healthy Food Financing Initiative Fund at the State Treasury and positions the state to access these federal funds. The bill also requires a stakeholder process through the Department of Food and Agriculture to develop recommendations on promoting healthy food and accessing federal funding that will be presented to the Legislature.

Counties support efforts to increase the number of fresh grocery stores, urban and rural farm stands, farmers’ markets, and community gardens in underserved communities. It is for these reasons that CSAC supports AB 581. 

The Senate Health Committee passed AB 581 on July 7, and it will be heard next by the Senate Appropriations Committee on August 15.

Mental Health

AB 1297 (Chesbro) – Support
As Amended on July 11, 2011

AB 1297, a bill by Assembly Member Wesley Chesbro, would ensure timely federal reimbursement to counties for providing Specialty Mental Health Managed Care services provided by counties. 

Specifically, AB 1297 would align the state’s requirements for the Specialty Medi-Cal Mental Health Managed Care program with existing federal requirements, which will help maximize federal reimbursements for these services. AB 1297 would accomplish this by requiring the state and the California Mental Health Directors Association to develop a reimbursement methodology that conforms to federal Medicaid requirements and approved Medicaid state plan and waivers. 

Counties believe that AB 1297 will both streamline and enhance our ability to draw down timely federal reimbursements for Specialty Medi-Cal Mental Health Managed Care services – all at no cost to the state’s General Fund. It is for these reasons that CSAC supports AB 1297. The Senate Health Committee passed AB 1297 with amendments on July 6, and it will be heard next in the Senate Appropriations Committee on August 15.

CalFresh (Food Stamps)

AB 402 (Skinner) – Support
As Amended on June 30, 2011

AB 402, by Assembly Member Nancy Skinner, would help combat child hunger by making it easier to coordinate outreach efforts for the School Meal and CalFresh Programs. 

The bill builds on the eligibility similarities of the School Meal and CalFresh programs by giving school districts the option to help initiate a confidential CalFresh application for students enrolled in the School Meal program. AB 402 will allow, at the option of the local school district and CalFresh administering agency, the confidential School Meal application to be utilized to initiate a confidential CalFresh application. 

Assembly Bill 402 will build a bridge between two federal programs to help feed our youngest and most vulnerable residents throughout the year, not just on school days. It is for these reasons that CSAC supports AB 402.

The Senate Human Services Committee passed the bill on June 28 and it is now on the Senate Floor. 

Child Welfare Services/Foster Care

AB 212 (Beall) – Support
As Amended on June 21, 2011

AB 212, by Assembly Member Jim Beall, would implement technical provisions related to last year’s landmark foster care legislation, the California Fostering Connections to Success Act of 2010 (AB 12). 

AB 212 is the result of efforts by counties, stakeholders, and Department of Social Services staff to “clean up” some provisions of AB 12. To that end, AB 212 mostly focuses on implementing KinGAP eligibility for young adults aged 18 to 21, and streamlining the assessment portion of the legal guardianship and adoptions process. 

The Senate Judiciary Committee passed AB 212 on July 5, and it is now scheduled to be heard by the Senate Appropriations Committee on August 15. 

SB 578 (Negrete McLeod) – Support
As Amended on June 29, 2011

SB 578, a bill by Senator Gloria Negrete McLeod, would help foster children graduate from high school by establishing a system to recognize and properly classify previous coursework or credit from other schools and institutions. 

Counties believe that SB 578 will give foster youth the opportunity to apply prior satisfactorily completed work toward a high school diploma and thereby increase the population of foster youth who are able to satisfactorily complete educational requirements and graduate from high school. The Assembly Education Committee passed the SB 578 on July 6, and it now goes to the Assembly Appropriations Committee with a recommendation to be placed on that committee’s consent calendar. It has not yet been set for hearing. 

AB 709 (Brownley) – Support
As Amended on April 6, 2011

AB 709, by Assembly Member Julia Brownley, would ensure the timely enrollment of foster youth who must transfer to a new school. 

Existing law requires a school to immediately enroll a foster child, even if the child is unable to produce the records normally required for enrollment. This includes previous academic records, proof of residency, and medical records. However, existing law does not address the requirement to produce proof of immunization or a vaccination history prior to enrollment. AB 709 addresses this discrepancy by allowing schools to waive the vaccination record requirement for foster youth. 

CSAC supports the bill, which was passed unanimously by the Senate Education Committee on June 22 and is now on the Senate floor. 

AB 717 (Ammiano) – Support
As Amended on June 29, 2011

AB 717, by Assembly Member Tom Ammiano, provides clean-up language regarding the Child Abuse Central Index (CACI), a statewide Department of Justice index of reports related to child abuse. 

The CACI index, while a useful tool in the child welfare services arena, has been the subject of substantial litigation over the years. Because of this, stakeholders, including the Departments of Justice and Social Services and counties have worked to improve the due process aspects of utilizing the CACI. AB 717 will, among other things, afford all persons listed in CACI the right to request a due process hearing if they have not already had the opportunity to do so. AB 717 would also take the important step of purging “inconclusive” reports from the CACI system and would purge all reports where the person listed has reached 100 years of age. 

Counties and the County Welfare Directors Association worked extensively with the author to ensure that the June 29 version of the bill is acceptable for counties and on solid legal ground. It is for this reason that CSAC has now taken a support position. 

The Senate Judiciary Committee passed AB 717 on June 28, and it will be heard next in the Senate Appropriations Committee on August 15. 

AB 823 (Dickinson) – Support
As Amended on July 12, 2011

AB 823, by Assembly Member Roger Dickinson, would create a California Children’s Cabinet tasked with ensuring better coordination and delivery of services to our children and their families. 

The bill would specifically create the Children’s Cabinet of California and give Governor Jerry Brown the authority to appoint the members. All state agencies that have jurisdiction over the well-being of children and families would be included, and the Cabinet must meet by March 1, 2012. This model is similar to Children’s Cabinets in approximately 20 states throughout the country, and will expand the existing Child Welfare Council (CWC) and State Interagency Team (SIT) models to align public resources for the healthy growth and development of all children and youth in California. 

Recent amendments require the Cabinet to report to the Legislature every odd-numbered year, and also stipulate that the Cabinet will not be formed until there are sufficient funds within the State Treasury to do so. 

By coordinating the continuum of children’s services in California and working to streamline and maximize available private and federal funding, counties believe that the creation of a California Children’s Cabinet will have long-term social and economic benefits for all residents. It is for these reasons that CSAC supports the bill. The Senate Human Services Committee passed the bill on July 5, and it will be heard next in the Senate Appropriations Committee on August 15. 

Adult Protective Services

AB 1288 (Gordon) – Support
As Amended on July 1, 2011

AB 1288, by Assembly Member Rich Gordon, would protect the assets of vulnerable seniors or dependent adults from misuse and fraud while a conservatorship petition is pending in court. 

Assembly Bill 1288 specifically would extend the period of time in which a public guardian or conservator may petition to protect the assets of seniors and dependent adults from 15 to 30 days. The bill also would expand the scope of the possession or control of property by the guardian to include assets held in the name of a proposed conservatee’s trust, and recent amendments protect the rights of spouses of the wards or proposed conservatees. AB 1288 was also recently amended to include direction on Certificates of Authority, which, if enacted, will provide financial institutions with written recordable certification of the conservator’s intent to protect real property from being transferred, encumbered, or disposed of during the petition period. 

Counties often encounter these issues during Adult Protective Services investigations, and it is challenging to complete a petition for conservatorship within 15 days. AB 1288 is a common sense, simple measure to provide appointed guardians a suitable amount of time and authority to protect the assets of vulnerable seniors and dependent adults. It is for these reasons that CSAC supports the bill. 

AB 1288 is currently on the Senate floor. 

Medi-Cal

AB 396 (Mitchell) – Support
As Amended on May 12, 2011

AB 396, by Assembly Member Holly Mitchell, would provide the opportunity for counties to receive federal funding for the inpatient medical costs of juvenile detainees. 

Specifically, AB 396 would allow counties to draw down federal matching funds for the inpatient medical treatment provided to minors who are outside of a county detention facility for more than 24 hours. 

AB 396 has been referred to both the Senate Health Committee and the Senate Public Safety Committee. The Senate Public Safety Committee passed the measure on July 6, and it will be heard next in the Senate Appropriations Committee on August 15.

AB 540 (Beall) – Support
As Amended on April 7, 2011

AB 540, by Assembly Member Jim Beall, would allow California to draw down federal funding for providing confidential alcohol and drug screening and brief intervention services to pregnant women and women of childbearing age who also qualify for Medi-Cal benefits. 

By implementing the Medi-Cal Alcohol and Drug Screening and Brief Intervention Services Program, AB 540 would create a voluntary-participation program for the counties to provide the non-federal match. The bill would then enable the state to draw down federal revenue for counties that are already providing these services. For every local dollar invested, California could receive a dollar match from the federal government. Furthermore, the bill clarifies that SBI services would be targeted to pregnant women and women of childbearing age, and all participation would be both voluntary and confidential. 

AB 540 would provide counties with a much-needed federal revenue stream – at no cost to the state – for these valuable services, and this is why CSAC supports the bill. The Senate Health Committee passed AB 540 on July 6, and it will be heard next in the Senate Appropriations Committee on August 15. 

CalWORKs

AB 959 (Jones) – Support
As Amended on July 5, 2011

AB 959, by Assembly Member Brian Jones, will increase efficiency in the CalWORKs and CalFresh programs by allowing for a one-month grace period during the discontinuance process. 

Assembly Bill 959 is a San Diego county-sponsored measure that is aimed at increasing efficiency at the county level by allowing county eligibility staff to restore eligibility for cases that have been discontinued due to missing information if that information is received within 30 days of the discontinuance notice. 

Counties believe that AB 959 will simply reduce the number of CalWORKs and CalFresh applications processed at the local level, help avoid duplication of applications and overlapping eligibility, and save the time and effort of both county staff and program recipients. The Senate Human Services Committee passed the bill on June 28, and it will be heard next in the Senate Appropriations Committee on August 15. 

Health Care Reform

AB 1296 (Bonilla) – Support 
As Amended on July 13, 2011

AB 1296, by Assembly Member Susan Bonilla, is a vehicle to attempt to streamline the eligibility and application process for the Medi-Cal, Healthy Families Program, and the new Health Care Exchange. It is being developed with the goal of meeting the requirements of the federal Affordable Care Act (ACA) in 2014, and was last amended on July 13. 

The broad concept of AB 1296 is to ensure that California’s health care enrollment system is well-positioned to implement the ACA requirements, while also creating a system that works for individuals and families across the spectrum of income and needs. Counties have supported the bill in concept throughout 2011, and have changed our position to straight support of the bill, including these provisions: 

• Creation of a “no wrong door” system.
• Streamlining eligibility rules among Medi-cal, premium subsidies in the Exchange, Healthy Families and county programs.
• Coordinating and simplifying citizenship and identity verification at application and renewal.
• Requiring the creation of a single statewide application – paper and electronic – for all systems and entities accepting and processing applications and eligibly.
• Maximizing coordination and enrollment in other public programs, such as CalWORKs and CalFresh.

Despite our support for AB 1296, we remain aware that there are numerous technical issues to work through as California contemplates an integrated approach to enroll health care consumers. For example, the federal government will be issuing guidance that will impact how to incorporate county-based programs in the enrollment provisions. 

CSAC, the Urban Counties Caucus, County Welfare Directors Association, County Health Executives Association of California, and County Mental Health Directors Association have now taken a support position on AB 1296. 

The Senate Health Committee passed the amended version of the bill on July 12, and it now goes to the Senate Appropriations Committee, but has not yet been set for hearing.