Tobacco Tax Introduced in Health Special Session 

Senator Richard Pan and Assembly Member Rob Bonta released identical tobacco tax legislation in the Second Extraordinary Special Session on Health – SBX2 13 and ABX2 16 respectively. The bills would expand the definition of tobacco products to include electronic cigarettes and would impose the same licensing requirements on electronic cigarette manufactures, importers, distributers, wholesalers and retailers.

Most importantly, the bills would impose a tax of .10 cents per cigarette, or $2 per pack, and would place a tax on electronic cigarettes that would be equivalent to the cigarette tax rate. The bills indicate that funds raised through this tax would be used for state health care and prevention programs, but provide no additional clarity or specificity.

The director of the Department of Health Care Services, Jennifer Kent, indicated initial support for the measure, and said she hoped the funding could be used to increase Medi-Cal fee-for-service provider rates.

The special session tobacco bills are backed by the Save Lives California coalition, which includes labor (SEIU), health care (California Medical Association, the California Dentists Association, the California Hospital Association) , some health plans, and the American Cancer Society and American Lung Association.

CSAC is examining the measures and seeking more clarity on how any potential revenue would be directed before taking a position.

Final Actions in Senate and Assembly Appropriations Committees

As the deadline for fiscal bills to be hear in appropriations committees approached, the Senate and Assembly acted on all remaining bills with a fiscal impact yesterday, including those that remained on the Committees’ Suspense Files. Several HHS bills were heard by the Appropriations Committees and the actions are noted below.

Child Welfare
SB 478 (Huff) – SUPPORT
As Amended August 18, 2015

SB 478, by Senator Bob Huff and co-sponsored by the County Welfare Directors Association of California and the Los Angeles County Board of Supervisors, seeks to authorize county welfare agencies that choose to opt in to develop a pilot program for internet-based reporting of child abuse and neglect, increase efficiency and reduce costs related to the transmission of written reports. Recent amendments would require participating counties to develop outcome measures and to report to the Legislature on the effectiveness of the program by January

The measure was unanimously passed by the Assembly Appropriations Committee and is now awaiting a vote by the full Assembly.

Organized Camps
SB 476 (Mendoza) – Oppose Unless Amended
As Amended – July 16, 2015

SB 476, by Senator Tony Mendoza, would expand the definition of organized recreational camps and create a new mandate on local health departments.

The measure was held on Suspense by the Assembly Appropriations Committee and will likely be a two-year bill.

Peer Certification
SB 614 (Leno) – SUPPORT
As Amended July 16, 2015

Senator Mark Leno’s SB 614, sponsored by the County Behavioral Health Directors Association, would establish a statewide peer and family support specialist certification program to be administered by the Department of Health Care Services.

SB 614 was passed off of Suspense and is now moving to the Assembly floor for a vote.

Health Care Coverage for Undocumented Individuals

SB 4 (Lara) – NO POSITION 
As Amended on July 16, 2015

Senator Ricardo Lara’s SB 4, originally sought to extend full-scope Medi-Cal benefits to low-income undocumented immigrants under age 19, however, this was granted with passage of the 2015-16 Budget.

SB 4 now seeks to require the California Health and Human Services Agency to apply for a federal waiver to allow individuals not able to obtain health coverage due to their immigration status to obtain coverage from the California Exchange.

The Assembly Appropriations Committee passed SB 4, which is now headed to the Assembly Floor.

CalWORKs

AB 702 (Maienschein) – SUPPORT 
As Introduced on February 25, 2015

AB 702 by Assembly Member Brian Maienschein, seeks to eliminate the requirement that temporary housing assistance be provided during one period of consecutive days up to 16 days. Instead, it would limit temporary housing assistance to a maximum of 16 calendar days. The bill was deemed to increase costs because currently families under-utilize the number of days they can receive the benefit.

CSAC supported the measure to allow counties to better target the intermittent cycle of homelessness by increasing flexibility for the recipient. Unfortunately, AB 702 was held on Suspense by the Senate Appropriations Committee.

SB 23 (Mitchell) – Pending
As Introduced on December 1, 2015

Senate Bill 23, by Senator Holly Mitchell, would repeal the exclusion of an additional child born into a family that has been on CalWORKs for ten consecutive months prior to the birth of the child, for purposes of determining a family’s maximum aid payment. It would also prohibit the conditioning of applicant or recipient’s eligibility for aid on their disclosure of information regarding rape, incest and contraception.

The County Welfare Director’s Association is a cosponsor of SB 23, which was passed off of the Suspense File by the Assembly Appropriations Committee.

Medi-Cal

SB 33 (Hernandez) – Support
As Amended on June 1, 2015

SB 33 by Senator Ed Hernandez, would 1) limit estate recovery for those ages 55 and over to only the health care services required to be recovered under federal law; 2) eliminate recovery against the estate of a surviving spouse of a deceased beneficiary; and 3) require DHCS to provide notice of total Medi-Cal expenses paid on behalf of the beneficiary that are subject to recovery and post notice on how to request this information on the website. CSAC along with the County Health Executives Association of California and the County Welfare Directors Association of California have taken a support position on this measure, which was passed by the Assembly Appropriations Committee with technical amendments.

AB 858 (Wood) – SUPPORT
As Amended July 1, 2015

AB 858, by Assembly Member Wood, initially sought to allow Federally Qualified Health Centers and Rural Health Clinics to be reimbursed by Medi-Cal for two visits by a patient with a single or different health care professional on the same day at a single location. On May 28 the bill was amended to added provisions from Assembly Wood’s AB 690, which sought to allow federally qualified health centers (FQHCs) and rural health clinics (RHCs) to draw down federal funding for patient visits with marriage and family therapists.

The most recent amendments removed the original provisions of AB 858 that would allow for reimbursement of two visits in a single day, which mirrors AB 690 – which died in the Assembly Appropriations Committee.

Despite the recent amendments, CSAC supports AB 858 which was passed off of the Senate Appropriations Committee’s Suspense File with amendments.

Child Welfare

SB 238 (Mitchell) – SUPPORT
As Amended on July 1, 2015

SB 238, sponsored by the County Welfare Directors Association of California and supported by CSAC, seeks to increase communication and training amongst all parties serving foster youth through requiring four key aspects:

1. The Department of Social Services and the Department of Health Care Services to develop monthly data reports that match prescription and claims data with child welfare services records;

2. The development of a system that triggers alerts to child welfare social workers and others serving the child such as attorneys and courts, when medications that could have dangerous interactions with psychotropic medications have been prescribed or when foster youth are prescribed unusual dosages;

3. An update to the JV-220 court form to allow key stakeholders to provide information, feedback and details on the overall mental health and treatment plan for the child; and

4. Training for child welfare social workers, foster children, caregivers and attorneys, Court-Appointed Special Advocates and foster care public health nurses regarding psychotropic medications.

SB 238 was passed off of the Assembly Appropriations Suspense File and is now heading to the Assembly floor.

Mental Health

AB 193 (Maienschein) – OPPOSE
As Amended on July 6, 2015

AB 193, by Assembly Member Brian Mainschein, would authorize a Probate Court judge to recommend a Lanterman-Petris-Short Act (LPS) conservatorship to the county officer providing conservatorship investigations. Essentially, AB 193 assumes that because a Probate conservatorship has been established, a person should also qualify for involuntary mental health treatment or a conservatorship. The LPS Act was created so that individuals could not be indiscriminately placed in involuntary settings without due process, which includes the involuntary hold process and LPS conservatorship. It is a very high bar that is in place to protect the patients, and AB 193 erodes this due process.

AB 193 would also result in significant county General Fund costs due to increased investigations and potentially increased LPS conservatorships. CSAC, along with Los Angeles County, the Urban Counties Caucus and the County Behavioral Health Directors Association, all OPPOSE AB 193, which was passed unanimously off of the Senate Appropriations Committee’s Suspense File. CSAC will continue to oppose AB 193 as it nears a vote on the Senate Floor.

AB 1299 (Ridley-Thomas) – SUPPORT IF AMENDED
As Amended on July 16, 2015

AB 1299, by Assembly Member Sebastian Ridley -Thomas, would make changes to how foster children placed outside of their county of original jurisdiction are able to access mental health services. It would require the Department of Health Care Services to issue policy guidance that establishes the presumptive transfer of responsibility for mental health services from the county of original jurisdiction to the foster child’s county of residence.

CSAC has taken a SUPPORT IF AMENDED on AB 1299, as it seeks to ensure foster children receive services mental health services in a timely manner. However, CSAC continues to work with the author’s office and the sponsors – the California Alliance of Child and Family Services – to address county concerns regarding the bill language and implementation. It is unclear as of this writing if the county concerns regarding the July 16 version of the bill will be addressed. AB 1299 was held on the Senate Appropriations Committee’s Suspense File and will not be moving forward this legislative year.

Continuum of Care Reform

AB 403 (Stone) – SUPPORT IN CONCEPT
As Amended on July 16, 2015

AB 403, by Assembly Member Mark Stone and sponsored by the Department of Social Services (DSS), reflects DSS’ attempt to reform the continuum of care group home system for foster youth. In January, DSS released their Continuum of Care Report to the Legislature, which outlined a comprehensive approach to improving the experience and outcomes of children and youth in foster care.

AB 403 reclassifies juvenile treatment facilities and the transition from the use of group homes for children in foster care and on probation to the use of short-term residential treatment centers (STRTCs) – defined in the amendments. AB 403 revises foster parent training requirements and provides for the development of Child-Family Teams to inform the process of placement and services to children. Additionally, the bill seeks to develop a new group home rate payment structure to fund placement options for children in foster care.

CSAC, along with our county affiliates – CWDA, CBHDA and CPOC – continue to work closely with the Department of Social Services on this significant measure, including on both the potential fiscal and policy impacts. CSAC continues to maintain a SUPPORT IN CONCEPT position on AB 403, which was passed off of the Senate Appropriations Committee’s Suspense File and now headed to the Senate floor.

Child Support

AB 610 (Jones Sawyer) – SUPPORT
As Amended on July 16, 2015

AB 610, by Assembly Member Reginald Jones-Sawyer, would expand an existing pilot program to apply to all child support cases and would authorize the local child support agency to administratively adjust account balances for cases if the agency verifies that the obligator is unable to pay due to incarceration.

The measure was heard by the Senate Appropriations Committee and placed on the Suspense file on August 19. It is likely a two-year bill.

IHSS

AB 1436 (Burke) – SUPPORT 
As Amended on May 6, 2015

AB 1436 by Assembly Member Autumn Burke creates an authorized representative structure for the In-Home Supportive Services (IHSS) Program – which enables adults and children who need help with daily living activities remain in their own home rather than being institutionalized. Other county-administered programs, including Medi-Cal, CalWORKs and CalFresh, have statutory or regulator procedures for applicants and recipients to designate an authorized representative to act on their behalf in signing up for the program, receiving services and participating in the appeal process.

AB 1436 would create a statutory authority for an IHSS recipient or applicant to name an authorized representative, which would be completely optional to them.

AB 1436 was passed off of the Senate Appropriations Committee Suspense File and is headed to the Senate Floor.