Today's Law As Amended


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AB-318 Medi-Cal materials: readability.(2019-2020)



As Amends the Law Today


SECTION 1.
 The Legislature finds and declares all of the following:
(a) Low health literacy and low reading literacy are barriers to meaningful access and equal opportunity to fully participate in one’s health care services.
(b) One-third of Medi-Cal beneficiaries speak a language other than English as their primary language. In comparison to their English-speaking counterparts, limited-English-proficient (LEP) individuals are more likely to have low reading literacy or low health literacy, which leads to lower quality health care and poorer health outcomes.
(c) Using plain and simple language will increase the readability of materials, improving access for Medi-Cal beneficiaries with varying reading or health literacy levels.
(d) By improving the readability of key Medi-Cal documents and ensuring that translated materials are field tested, the State Department of Health Care Services can empower consumers and help safeguard the health care rights of Medi-Cal beneficiaries.

SEC. 2.

 Section 14029.93 is added to the Welfare and Institutions Code, to read:

14029.93.
 (a) Commencing January 1, 2020, all Medi-Cal beneficiary materials translated into threshold languages and released by the department, and informing materials as defined in subdivision (e) that are translated into threshold languages and released by managed care plans contracting with the department, shall be field tested as part of the translation process, except as described in subdivisions (c) and (d).
(b) (1) For purposes of this section, “field testing” means a review of translations for accuracy, cultural appropriateness, and readability.
(2) Field testing shall be conducted by a focus group, or another form of review, involving native speakers of the applicable language or community-based organizations with an understanding of the linguistic needs of the targeted population.
(3) Field testing may be administered internally by the department or the managed care plan, or by a third-party contractor, including, but not limited to, an entity already contracted for translation.
(c) Information contained in a material on an individualized, nonstandard basis for a Medi-Cal beneficiary, including, but not limited to, personal identifying information or specific information regarding a Medi-Cal beneficiary’s medical condition, shall not be field tested.
(d) Information released to Medi-Cal beneficiaries during a state of emergency or a local emergency, as defined in Section 8558 of the Government Code, that cannot be written before the state of emergency or local emergency, including information required pursuant to Section 1368.7 of the Health and Safety Code or Section 8594.16 of the Government Code, is exempt from the field testing requirement described in this section.
(e) For purposes of this section, “informing materials” means documents that provide Medi-Cal managed care members with essential information about access to, and usage of, plan services, including only the following:
(1) Plan termination notices.
(2) New member welcome packets.
(3) Member handbooks.
(4) Forms and information regarding grievance or complaint procedures and information regarding external review of plan decisions.
(5) Forms and information regarding appeals and adverse benefit determinations.
(f) For purposes of this section, “managed care plan” refers to any individual, organization, or entity that enters into a contract with the department to provide services to enrolled Medi-Cal beneficiaries pursuant to any of the following:
(1) Article 2.7 (commencing with Section 14087.3).
(2) Article 2.8 (commencing with Section 14087.5).
(3) Article 2.81 (commencing with Section 14087.96).
(4) Article 2.82 (commencing with Section 14087.98).
(5) Article 2.91 (commencing with Section 14089).
(6) Chapter 8 (commencing with Section 14200).
(7) Chapter 8.9 (commencing with Section 14700).
(8) A county Drug Medi-Cal organized delivery system authorized under the California Medi-Cal 2020 Demonstration, Number 11-W-00193/9, as approved by the federal Centers for Medicare and Medicaid Services and described in the Special Terms and Conditions. For purposes of this paragraph, “Special Terms and Conditions” has the same meaning as set forth in subdivision (o) of Section 14184.10.

SEC. 3.

 Section 14029.94 is added to the Welfare and Institutions Code, to read:

14029.94.
 (a) The department shall consult with stakeholders to identify at least 10 documents released by the department to Medi-Cal beneficiaries, and shall designate a readability expert to revise those documents. In identifying those documents, the department and the stakeholders shall consider the number of Medi-Cal beneficiaries who use the document and whether the document is needed to determine eligibility for benefits, to describe the availability of services, or to describe a Medi-Cal beneficiary’s rights.
(1) For the purposes of this section, the department shall consult with interested stakeholders, including, but not limited to, consumer advocates and managed care plans as defined in Section 14029.93, and the State Department of Social Services State Hearings Division.
(2) The readability expert shall have demonstrated expertise in improving the readability and visual layout of consumer documents intended for populations with low reading or health literacy.
(3) The readability expert shall consult with the department and the stakeholders to ensure that essential messages are preserved through the translation process.
(4) The list of documents shall include, as part of the minimum 10 documents, the most recently updated versions of all of the following documents:
(A) California Medi-Cal Dental Services Beneficiary Handbook, as released by the department.
(B) Medi-Cal Managed Care Model Member Handbook, as released by the department.
(C) Rights and Responsibilities Form, known as MC 219 Form, as released by the department and cited in Medi-Cal Eligibility Division Information Letter No. I 16-05.
(D) Medi-Cal Request for Information Form, known as MC 355 Form, as released by the department and cited in All County Welfare Directors Letter No. 18-25.
(E) Medi-Cal Annual Redetermination Form, known as MC 210 RV Form, as released by the department and cited in All County Welfare Directors Letter No. 11-23.
(b) After revising the documents, the readability expert shall present to the stakeholders and department employees preparing consumer materials on best practices in readability and the principles used to revise the documents, and shall demonstrate the improvements in readability.
(c) The readability expert and the stakeholders shall provide the department with specific recommendations for revising the selected documents to improve the readability of the documents.
(d) The department shall rerelease the selected documents with revisions based on the recommendations from the readability expert and the stakeholders.
(e) After the department completes the revisions to the documents, the documents shall be translated into all threshold languages and field tested pursuant to Section 14029.93.
(f) This section shall be implemented no later than January 1, 2021.