Health Care Special Session

The Health Care Special Session remains open after efforts to pass a MCO tax during the last few days of the regular session fell short. The Administration was disappointed that they could not reach agreement with the health plans and legislature and released a formal statement. The Legislature did convene a conference committee for the health special session, and as 2016-17 budget discussions gain momentum this fall, the fate of the Medi-Cal services that it helps fund hang in the balance.

CSAC is tracking several special session bills, including the MCO tax and other tobacco related legislation, which have not moved since Friday’s bulletin report. However, ABX2 15 – the ‘End of Life Act’ by Assembly Member Susan Eggman – which CSAC does not have a formal position on – passed both houses and is now awaiting the Governor’s action.

CSAC will continue to monitor the Health Care Special Session and the new conference committee.

Legislation

Medi-Cal Demonstration Bills

SB 36 (Hernandez) – SUPPORT
As Amended on September 4, 2015

SB 36 currently serving as the sole legislative vehicle for California’s successor Section 1115 Medicaid Waiver. As amended, the bill would allow the Department of Health Care Services to seek an extension of the current 1115 Waiver, given the anticipated delays in obtaining CMS approval of California’s successor Section 1115 Waiver.

DHCS and CMS are actively engaged in Waiver discussions. Last week, DHCS provided an update to interested parties, noting that CMS had rejected the shared savings proposal and that they would be looking creatively for non-federal match.

CSAC supports SB 36 (Hernandez), which was passed after a unanimous vote on the Senate Floor in the waning hours of the session. It will now head to the Governor’s desk for action.

Mental Health

AB 193 (Maienschein) – OPPOSE
As Amended on September 2, 2015

AB 193, by Assembly Member Brian Maienschein, 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 and continues to advocate against it. Unfortunately, the Assembly concurred with the Senate amendments with 79 ‘aye’ votes and only 1 ‘no’ vote. We urge counties to send in letters of opposition to the Governor’s office urging his veto on this measure.

SB 804 (Senate Health Committee) – Support
As Amended on September 4, 2015

SB 804, the Senate Health Committee’s omnibus bill, updates obsolete references to California Mental Health Directors Association and the County Alcohol and Drug Program Administrators Association of California to reflect the County Behavioral Health Directors Association (CBHDA).

SB 804 is now enrolled and is awaiting the Governor’s action.

IHSS

AB 1436 (Burke) – SUPPORT
As Amended on September 4, 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 is enrolled and awaits the Governor’s action.