Bill Text

PDF |Add To My Favorites |Track Bill | print page

SB-207 Elections: voter registration: partisan primary elections.(2019-2020)

SHARE THIS:share this bill in Facebookshare this bill in Twitter
Date Published: 01/07/2020 09:00 PM
SB207:v94#DOCUMENT

Amended  IN  Assembly  January 07, 2020
Amended  IN  Assembly  August 15, 2019
Amended  IN  Assembly  July 02, 2019
Amended  IN  Senate  April 08, 2019
Amended  IN  Senate  March 20, 2019

CALIFORNIA LEGISLATURE— 2019–2020 REGULAR SESSION

Senate Bill
No. 207


Introduced by Senator Hurtado
(Principal coauthor: Assembly Member Chiu)(Coauthors: Assembly Members Nazarian and Reyes)(Principal coauthor: Assembly Member Gonzalez)

February 04, 2019


An act to add Sections 14132.08, 14132.085, and 14132.09 to the Welfare and Institutions Code, relating to Medi-Cal. An act to amend Section 2152 of, and to add Section 2119.5 to, the Elections Code, relating to elections.


LEGISLATIVE COUNSEL'S DIGEST


SB 207, as amended, Hurtado. Medi-Cal: asthma preventive services. Elections: voter registration: partisan primary elections.
Existing law requires a county elections official to accept affidavits of registration received on or before the 15th day before an election and to accept conditional voter registration affidavits received during the 14 days immediately preceding an election and on election day. Existing law establishes procedures for a voter to change the voter’s residence address by executing a new affidavit of registration or a notice or letter of the change of address, or for a voter to change the voter’s political party preference by executing a new affidavit of registration.
This bill would permit a voter, from the 14th day immediately preceding an election until the close of polls on election day, in lieu of executing a new affidavit of registration, to change the voter’s residence address or political party preference by submitting to the voter’s county elections official a written request containing the new residence address or political party preference and signed under penalty of perjury. The bill would require a ballot or provisional ballot to be provided to the voter, as specified, and would require that the registration of the voter be immediately updated.
By imposing additional duties on local elections officials and expanding the scope of crimes, this bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that with regard to certain mandates no reimbursement is required by this act for a specified reason.
With regard to any other mandates, this bill would provide that, if the Commission on State Mandates determines that the bill contains costs so mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.

Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income persons receive health care benefits. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing federal law authorizes, at the option of the state, preventive services, as defined, to be provided by practitioners other than physicians or other licensed practitioners.

This bill would include asthma preventive services, as defined, as a covered benefit under the Medi-Cal program, no later than July 1, 2021, if the Legislature appropriates funds for that purpose. The bill would require the department, in consultation with external stakeholders, to approve 2 accrediting bodies with expertise in asthma to review and approve training curricula for asthma preventive services providers, and would require the curricula to be consistent with specified federal and clinically appropriate guidelines. The bill would require a supervising licensed Medi-Cal provider and the Medi-Cal asthma preventive services provider to satisfy specified requirements, including the Medi-Cal asthma preventive services provider’s completion of a training program approved by one of the accrediting bodies. The bill would authorize the department to implement, interpret, or make specific these provisions without taking regulatory action until regulations are adopted. The bill would require the department to adopt regulations by July 1, 2023, and to provide semiannual status reports to the Legislature until regulations have been adopted. The bill would require the department to seek any federal waivers or other state plan amendments as necessary, and would require these provisions to be implemented if federal approvals are obtained, as specified.

Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NOYES  

The people of the State of California do enact as follows:


SECTION 1.

 Section 2119.5 is added to the Elections Code, to read:

2119.5.
 (a) From the 14th day immediately preceding an election until the close of polls on election day, in lieu of executing a new affidavit of registration for a change of address within the same county, the county elections official shall accept a written request by a voter that contains all of the following:
(1) The voter’s printed name.
(2) The voter’s former residence address.
(3) The voter’s new residence address.
(4) A certification by the voter of the content of the written request as to its truthfulness and correctness, under penalty of perjury.
(5) The voter’s signature and date of execution.
(b) The written request shall be delivered to the county elections official’s office or to any location that offers conditional voter registration and at which a ballot can be issued. Following delivery to such a location, the county elections official shall issue a ballot in accordance with the following:
(1) A nonprovisional ballot shall be issued to the voter if either of the following applies:
(A) The voter appears at the voter’s precinct, the voter’s name is found on the roster, and the voter either has not been issued a vote by mail ballot or the conditions set forth in subdivision (a) of Section 3015 are satisfied.
(B) The voter appears at a location that is equipped with an electronic poll book or other means to determine the voter’s precinct, the location can provide the voter with a ballot for the voter’s precinct, the entire county has established connectivity between locations, and the location at which the voter appears verifies that the voter has not cast a ballot at another location for the election and notes in the voter’s record that the voter cast a ballot.
(2) A provisional ballot shall be issued to the voter if either of the following applies:
(A) The voter appears at the voter’s precinct, the voter’s name is found on the roster, the voter has been issued a vote by mail ballot, and the conditions set forth in subdivision (a) of Section 3015 are not satisfied.
(B) The voter appears at a location, other than the voter’s precinct, that is equipped with an electronic poll book or other means to determine the voter’s precinct, but the entire county has not established connectivity between locations such that the location is unable to verify that the voter has not cast a ballot at another location for the election.
(c) Upon receipt of a properly executed written request described in subdivision (a), the registration of the voter shall be immediately updated and the written request shall be maintained with the voter’s record.

SEC. 2.

 Section 2152 of the Elections Code is amended to read:

2152.
 (a) Whenever any voter has declined to disclose or has changed his or her the voter’s party preference prior to the close of registration for an election, he or she the voter may either so disclose or have a change recorded by executing a new affidavit of registration and completing the prior registration portion of the affidavit.
(b) From the 14th day immediately preceding an election until the close of polls on election day, in lieu of executing a new affidavit of registration to disclose or have a change recorded for a voter’s political party preference, the county elections official shall accept a written request by a voter that discloses or changes the voter’s political party preference and that contains all of the following:
(1) The voter’s printed name.
(2) The voter’s current residence address.
(3) The voter’s new political party preference.
(4) A certification by the voter of the content of the written request as to its truthfulness and correctness, under penalty of perjury.
(5) The voter’s signature and date of execution.
(c) The written request shall be delivered to the county elections official’s office or to any location that offers conditional voter registration and at which a ballot for the political party for which the voter disclosed a preference can be issued. Following delivery to such a location, the county elections official shall issue a ballot in accordance with the following:
(1) A nonprovisional ballot shall be issued to the voter if either of the following applies:
(A) The voter appears at the voter’s precinct, the voter’s name is found on the roster, and the voter either has not been issued a vote by mail ballot or the conditions set forth in subdivision (a) of Section 3015 are satisfied.
(B) The voter appears at a location that is equipped with an electronic poll book or other means to determine the voter’s precinct, the location can provide the voter with a ballot for the voter’s precinct, the entire county has established connectivity between locations, and the location at which the voter appears verifies that the voter has not cast a ballot at another location for the election and notes in the voter’s record that the voter cast a ballot.
(2) A provisional ballot shall be issued to the voter if either of the following applies:
(A) The voter appears at the voter’s precinct, the voter’s name is found on the roster, the voter has been issued a vote by mail ballot, and the conditions set forth in subdivision (a) of Section 3015 are not satisfied.
(B) The voter appears at a location, other than the voter’s precinct, that is equipped with an electronic poll book or other means to determine the voter’s precinct, but the entire county has not established connectivity between locations such that the location is unable to verify that the voter has not cast a ballot at another location for the election.
(d) Upon receipt of a properly executed written request described in subdivision (b), the registration of the voter shall be immediately updated and the written request shall be maintained with the voter’s record.

SEC. 3.

 No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution for certain costs that may be incurred by a local agency or school district because, in that regard, this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.
However, if the Commission on State Mandates determines that this act contains other costs mandated by the state, reimbursement to local agencies and school districts for those costs shall be made pursuant to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of the Government Code.
SECTION 1.

The Legislature finds and declares all of the following:

(a)Asthma is a significant public health problem with notable disparities by race, ethnicity, and income.

(b)Asthma is of particular concern for low-income Californians enrolled in Medi-Cal. Low-income populations have higher asthma severity, poorer asthma control, and higher rates of asthma emergency department visits and hospitalizations. When uncontrolled, patients with asthma may seek care in more expensive settings.

(c)Patient asthma education and environmental asthma trigger assessments and remediation may reduce more costly emergency department visits and hospitalizations, improve asthma control, decrease the frequency of symptoms, decrease work and school absenteeism, and improve quality of life.

(d)Providing access to asthma education and environmental asthma trigger assessments and remediation will help fulfill California’s quadruple aim goal of strengthening health care quality, improving health outcomes, reducing health care costs, and advancing health equity.

SEC. 2.Section 14132.08 is added to the Welfare and Institutions Code, to read:
14132.08.

(a)The department shall develop and implement asthma preventive services to assist Medi-Cal beneficiaries in asthma management and prevention.

(b)The following definitions apply for purposes of this section:

(1)“Asthma education” means providing information to a patient about basic asthma facts, the use of medications, self-management techniques and self-monitoring skills, and actions to mitigate or control environmental exposures that exacerbate asthma symptoms, consistent with the National Institutes of Health’s 2007 Guidelines for the Diagnosis and Management of Asthma (EPR-3), any future updates of those guidelines, and other clinically appropriate guidelines.

(2)“Asthma preventive services” means asthma education, environmental asthma trigger assessments, and environmental asthma trigger remediation, as defined in this subdivision.

(3)“Asthma preventive services provider” means an individual who renders evidence-based asthma preventive services, including asthma education, environmental asthma trigger assessments, and environmental asthma trigger remediation for a Medi-Cal beneficiary with asthma, and who meets all of the requirements described in subdivision (a) of Section 14132.09.

(4)“Environmental asthma trigger assessment” means the identification of environmental asthma triggers commonly found in and around the home, including allergens and irritants. This assessment shall guide the asthma education about actions to mitigate or control environmental exposures.

(5)“Minor to moderate environmental asthma trigger remediation” means conducting specific actions to mitigate or control environmental exposures, such as providing and putting on dust-proof mattress and pillow covers, providing low-cost products, such as high-efficiency particulate air vacuums, asthma-friendly cleaning products, dehumidifiers and small air filters, and utilizing integrated pest management, including performing or referring for the provision of minor repairs to the home’s structure, such as patching cracks and small holes through which pests can enter.

(6)“Supervision,” “supervising,” or “supervise” means the supervision of an asthma preventive services provider who is providing asthma preventive services by any of the following licensed, enrolled Medi-Cal providers acting within the scope of their respective practices:

(A)A licensed physician.

(B)A licensed nurse practitioner.

(C)A licensed physician assistant.

(c)An asthma preventive services provider shall provide asthma education, environmental trigger assessments, and, as appropriate, provide or refer for the provision of minor to moderate environmental asthma trigger remediation to Medi-Cal beneficiaries in order to manage asthma and prevent asthma exacerbations that may result in hospitalization or death.

(d)(1)No later than July 1, 2021, asthma preventive services, as defined in paragraph (2) of subdivision (b), shall be a covered benefit under the Medi-Cal program to Medi-Cal beneficiaries with poorly controlled asthma for whom a licensed provider has recommended the provision of these services.

(2)Paragraph (1) shall be implemented only to the extent that the Legislature makes an appropriation in the annual Budget Act or other measure for this purpose.

SEC. 3.Section 14132.085 is added to the Welfare and Institutions Code, to read:
14132.085.

The department shall approve at least two governmental or nongovernmental accrediting bodies with expertise in asthma to review and approve training curricula for asthma preventive services providers rendering services in the Medi-Cal program. In approving the accrediting bodies, the department shall consult with external stakeholders. The accrediting bodies shall approve training curricula that align with the National Institutes of Health’s 2007 Guidelines for the Diagnosis and Management of Asthma (EPR-3) and any future updates of the guidelines. The curricula shall be, at a minimum, 16 hours, and shall include, but not be limited to, all of the following:

(a)Basic facts about asthma, including contrasts between airways of a person who has and a person who does not have asthma, airflow obstruction, and the role of inflammation.

(b)Roles of medications, including the differences among long-term control medication, quick-relief medications, any other medications demonstrated to be effective in asthma management or control, medication skills, and device usage.

(c)Environmental control measures, including how to identify, avoid, and mitigate environmental exposures, such as allergens and irritants, that worsen the patient’s asthma.

(d)Asthma self-monitoring to assess level of asthma control, monitor symptoms, and recognize the early signs and symptoms of worsening asthma.

(e)Understanding the concepts of asthma severity and asthma control.

(f)Educating patients on how to read an asthma action plan and reinforce the messages of the plan to the patient.

(g)Effective communication strategies, including, at a minimum, cultural and linguistic competency and motivational interviewing.

(h)The roles of various members of the care team and when and how to make referrals to other care providers and services, as appropriate.

SEC. 4.Section 14132.09 is added to the Welfare and Institutions Code, to read:
14132.09.

(a)An enrolled Medi-Cal provider shall supervise, as defined in paragraph (6) of subdivision (b) of Section 14132.08, an asthma preventive services provider, and the supervising Medi-Cal provider shall ensure that an asthma preventive services provider, at minimum, complies with all of the following requirements:

(1)Successfully complete a training program approved by an accrediting body, as described in Section 14132.085.

(2)(A)Successfully complete, at a minimum, 16 hours of face-to-face client interaction training focused on asthma management and prevention within a six-month period. This training shall be overseen and assessed by a licensed physician, nurse practitioner, or physician assistant.

(B)An individual who has completed the minimum face-to-face client contact after 2007, the year of the most recent update of the National Institutes of Health’s Guidelines for the Diagnosis and Management of Asthma (EPR-3), shall be deemed to have satisfied the face-to-face client contact requirement of subparagraph (A).

(3)Successfully complete annually four hours of continuing education that is consistent with the curricula described in Section 14132.085.

(4)Provide asthma preventive services under the supervision of a licensed Medi-Cal provider.

(5)Be employed by or under contract with an entity or a supervising licensed Medi-Cal provider that meets the requirements described in paragraph (6) of subdivision (b) of Section 14132.08.

(6)Be 18 years of age or older and have a high school education or the equivalent.

(b)An entity or supervising licensed Medi-Cal provider who employs or contracts with an asthma preventive services provider shall do all of the following:

(1)Ensure that the asthma preventive services provider meets the requirements of paragraphs (1) to (6), inclusive, of subdivision (a).

(2)Maintain written documentation of services provided by the asthma preventive services provider.

(3)Ensure that documentation of the provision of services is provided to the supervising licensed provider, as defined in paragraph (6) of subdivision (b) of Section 14132.08, the referring licensed medical provider, and, if different, the patient’s licensed primary care provider.

(c)The department shall pursue funding opportunities, including general funds, and develop payment methodologies for minor to moderate remediation when indicated necessary by the asthma preventive services provider that conducted the environmental asthma trigger assessment.

(d)An enrolled Medi-Cal provider shall seek reimbursement from the department for the purchase of products or services, including any referred services, related to minor to moderate environmental asthma trigger remediation, as defined in paragraph (5) of subdivision (b) of Section 14132.08.

(e)(1)Except as provided in paragraph (2), Sections 14132.08, 14132.085, and this section shall be implemented only to the extent that federal financial participation is available and not otherwise jeopardized, and any necessary federal approvals have been obtained.

(2)The implementation of minor to moderate environmental asthma trigger remediation services, as defined in paragraph (5) of subdivision (b) of Section 14132.08, is not subject to the availability of federal financial participation or federal approval.

(f)(1)Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department, without taking any further regulatory action, shall implement, interpret, or make specific in Sections 14132.08 and 14132.085 and this section, policies and procedures pertaining to the asthma preventive services, and applicable waivers and state plan amendments, by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions until the time regulations are adopted.

(2)Thereafter, the department, by July 1, 2023, shall adopt regulations in accordance with the requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.

(3)Beginning six months after the effective date of Sections 14132.08 and 14132.085 and this section, and notwithstanding Section 10231.5 of the Government Code, the department shall provide a status report to the Legislature on a semiannual basis until regulations have been adopted.

(g)This section neither alters the scope of practice for a health care professional nor authorizes the delivery of health care services in a setting or in a manner that is not authorized under the Health and Safety Code or the Business and Professions Code.