Today's Law As Amended


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AB-430 Health: budget implementation.(2001-2002)



As Amends the Law Today


SECTION 1.

 Section 95004 of the Government Code, as amended by Section 3 of Chapter 294 of the Statutes of 1997, is amended to read:

95004.
 The early intervention services specified in this title shall be provided as follows:
(a) Direct services for eligible infants and toddlers and their families shall be provided pursuant to the existing regional center system under the Lanterman Developmental Disabilities Services Act (Division 4.5 (commencing with Section 4500) of the Welfare and Institutions Code) and the existing local education agency system under appropriate sections of Part 30 (commencing with Section 56000) of the Education Code and regulations adopted pursuant thereto, and Part C of the Individuals with Disabilities Education Act (20 U.S.C. Sec. 1431 et seq.).
This (b)  (1)   title shall become operative upon the repeal of Title 14  In providing services under this title, regional centers shall comply with the Lanterman Developmental Disabilities Services Act (Division 4.5 (commencing with Section 4500) of the Welfare and Institutions Code, and its implementing regulations (Division 2 (commencing with Section 50201) of Title 17 of the California Code of Regulations) including, but not limited to, those provisions relating to vendorization and ratesetting, except where compliance with those provisions would result in any delays in, or any cost to the families for, the provision of early intervention, or otherwise conflict with this title and the regulations implementing this title (Chapter 2  (commencing with Section 95000) as added by Section  52000) of Division  2 of Chapter 945 Title 17  of the Statutes of 1993. California Code of Regulations), or Part C of the Individuals with Disabilities Education Act (20 U.S.C. Sec. 1431) et seq., and applicable federal regulations contained in Part 303 (commencing with Section 303.1) of Title 34 of the Code of Federal Regulations. 
(2) When compliance with this subdivision would result in any delays in the provision of early intervention services or costs to families for the provision of any of these services, the department may authorize a regional center to use a special service code that allows immediate procurement of the service.
(c) Services shall be provided by family resource centers that provide, but are not limited to, parent-to-parent support, information dissemination and referral, public awareness, family professional collaboration activities, and transition assistance for families.
(d) Existing obligations of the state to provide these services at state expense shall not be expanded.
(e) It is the intent of the Legislature that services be provided in accordance with Sections 303.124, 303.126, and 303.527 of Title 34 of the Code of Federal Regulations.

SEC. 2.

 Section 1395 of the Health and Safety Code is amended to read:

1395.
 (a) Notwithstanding Article 6 (commencing with Section 650) of Chapter 1 of Division 2 of the Business and Professions Code, any health care service plan or specialized health care service plan may, except as limited by this subdivision, solicit or advertise with regard to the cost of subscription or enrollment, facilities and services rendered, provided, however, Article 5 (commencing with Section 600) of Chapter 1 of Division 2 of the Business and Professions Code remains in effect. Any price advertisement shall be exact, without the use of such phrases as “as low as,” “and up,” “lowest prices” or words or phrases of similar import. Any advertisement that refers to services, or costs for the services, and that uses words of comparison must be based on verifiable data substantiating the comparison. Any health care service plan or specialized health care service plan so advertising shall be prepared to provide information sufficient to establish the accuracy of the comparison. Price advertising shall not be fraudulent, deceitful, or misleading, nor contain any offers of discounts, premiums, gifts, or bait of similar nature. In connection with price advertising, the price for each product or service shall be clearly identifiable. The price advertised for products shall include charges for any related professional services, including dispensing and fitting services, unless the advertisement specifically and clearly indicates otherwise.
(b) Plans licensed under this chapter shall not be deemed to be engaged in the practice of a profession, and may employ, or contract with, any professional licensed pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code to deliver professional services. Employment by or a contract with a plan as a provider of professional services shall not constitute a ground for disciplinary action against a health professional licensed pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code by a licensing agency regulating a particular health care profession.
(c) A health care service plan licensed under this chapter may directly own, and may directly operate through its professional employees or contracted licensed professionals, offices and subsidiary corporations, including pharmacies that satisfy the requirements of subdivision (d) of Section 4080.5 of the Business and Professions Code, as are necessary to provide health care services to the plan’s subscribers and enrollees.
(d) A professional licensed pursuant to the provisions of Division 2 (commencing with Section 500) of the Business and Professions Code who is employed by, or under contract to, a plan may not own or control offices or branch offices beyond those expressly permitted by the provisions of the Business and Professions Code.
(e) Nothing in this chapter shall be construed to repeal, abolish, or diminish the effect of Section 129450 of the Health and Safety Code.
(f) Except as specifically provided in this chapter, nothing in this chapter shall be construed to limit the effect of the laws governing professional corporations, as they appear in applicable provisions of the Business and Professions Code, upon specialized health care service plans.
(g) No representative of a participating health, dental, or vision plan or its subcontractor representative shall in any manner use false or misleading claims to misrepresent itself, the plan, the subcontractor, or the Healthy Families or Medi-Cal program while engaging in application assistance activities that are subject to this section. Notwithstanding any other provision of this chapter, any representative of the health, dental, or vision care plan or of the health, dental, or vision care plan’s subcontractor who violates any of the provisions of Section 12693.325 of the Insurance Code shall only be subject to a fine of five hundred dollars ($500) for each of those violations.
(h) A health care service plan shall comply with Section 12693.325 of the Insurance Code and Section 14409 of the Welfare and Institutions Code. In addition to any other disciplinary powers provided by this chapter, if a health care service plan violates any of the provisions of Section 12693.325 of the Insurance Code, the department may prohibit the health care service plan from providing application assistance and contacting applicants pursuant to Section 12693.325 of the Insurance Code.

SEC. 2.3.

 Section 1417.4 of the Health and Safety Code is amended to read:

1417.4.
 (a) There is hereby established in the state department the Quality Awards Program for nursing homes.
(b) The department shall establish criteria under the program, after consultation with stakeholder groups, for recognizing all skilled nursing facilities that provide exemplary care to residents.
(c) (1) Monetary awards shall be made to Quality Awards Program recipients that serve high proportions of Medi-Cal residents to the extent funds are appropriated each year in the annual Budget Act.
(2) Monetary awards presented under this section and paid for by funds appropriated from the General Fund shall be used for staff bonuses and distributed in accordance with criteria established by the department.
(3) Monetary awards presented under this section and paid for from funds from the Federal Citation Penalty Account shall be used to fund innovative facility grants to improve the quality of care and quality of life for residents in skilled nursing facilities, or to fund innovative efforts to increase employee recruitment, or retention, or both, subject to federal approval.
(d) The department shall establish criteria for selecting facilities to receive the quality awards, in consultation with senior advocacy organizations, employee labor organizations representing facility employees, nursing home industry representatives, and other interested parties as deemed appropriate by the department. The criteria established pursuant to this subdivision shall not be considered regulations within the meaning of Section 11342 of the Government Code, and shall not be subject to adoption as regulations pursuant to Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.
(e) The department shall publish an annual listing of the Quality Awards Program recipients with the dollar amount awarded, if applicable. The department shall also publish an annual listing of the Quality Awards Program recipients that receive innovative facility grants with the purpose of the grant and the grant amount.
(f) All of the funds available for the programs described in this section shall be disbursed to qualified facilities by January 1, 2002, and January 1 of each year thereafter.

SEC. 2.5.

 Chapter 3.75 (commencing with Section 1797.198) is added to Division 2.5 of the Health and Safety Code, to read:

CHAPTER  3.75. Trauma Care Fund
1797.198.
 The Legislature finds and declares all of the following:
(a) Trauma centers save lives by providing immediate coordination of highly specialized care for the most life-threatening injuries.
(b) Trauma centers save lives, and also save money, because access to trauma care can mean the difference between full recovery from a traumatic injury and serious disability necessitating expensive long-term care.
(c) Trauma centers do their job most effectively as part of a system that includes a local plan with a means of immediately identifying trauma cases and transporting those patients to the nearest trauma center.
(d) Trauma care is an essential public service.
(e) It is essential for persons in need of trauma care to receive that care within the 60-minute period immediately following injury. It is during this period, referred to as the “golden hour,” when the potential for survival is greatest, and the need for treatment for shock or injury is most critical.
(f) It is the intent of the Legislature in enacting this act to promote access to trauma care by ensuring the availability of services through EMS agency-designated trauma centers.
1797.199.
 (a) There is hereby created in the State Treasury, the Trauma Care Fund, which, notwithstanding Section 13340 of the Government Code, is hereby continuously appropriated without regard to fiscal years to the authority for the purposes specified in subdivision (c).
(b) The fund shall contain any moneys deposited in the fund pursuant to appropriation by the Legislature or from any other source, as well as, notwithstanding Section 16305.7 of the Government Code, any interest and dividends earned on moneys in the fund.
(c) Moneys in the fund shall be expended by the authority to provide for allocations to local EMS agencies, for distribution to local EMS agency-designated trauma centers provided for by this chapter.
(d) Within 30 days of the effective date of this chapter, the authority shall request all local EMS agencies with an approved trauma plan, that includes at least one designated trauma center, to submit within 45 days of the request the total number of trauma patients and the number of trauma patients at each facility that were reported to the local trauma registry for the most recent fiscal year for which data are available, pursuant to Section 100257 of Title 22 of the California Code of Regulations. However, the local EMS agency’s report shall not include any registry entry that is in reference to a patient who is discharged from the trauma center’s emergency department without being admitted to the hospital unless the nonadmission is due to the patient’s death or transfer to another facility. Any local EMS agency that fails to provide these data shall not receive funding pursuant to this section.
(e) Except as provided in subdivisions (j) and (o), the authority shall distribute all funds to local EMS agencies with an approved trauma plan that includes at least one designated trauma center in the local EMS agency’s jurisdiction as of July 1 of the fiscal year in which funds are to be distributed.
(1) The amount provided to each local EMS agency shall be in the same proportion as the total number of trauma patients reported to the local trauma registry for each local EMS agency’s area of jurisdiction compared to the total number of all trauma patients statewide as reported under subdivision (d).
(2) The authority shall send a contract to each local EMS agency that is to receive funds within 30 days of receiving the required data and shall distribute the funds to a local EMS agency within 30 days of receiving a signed contract and invoice from the agency.
(f) Local EMS agencies that receive funding under this chapter shall distribute all those funds to eligible trauma centers, except that an agency may expend 1 percent for administration. It is the intent of the Legislature that the funds distributed to eligible trauma centers be spent on trauma services. The local EMS agency may utilize a grant-based system, a reimbursement-based system, or other appropriate methodology to comply with this section. Local EMS agencies shall take the following factors into consideration when determining the distribution amounts for each trauma center:
(1) The volume of uninsured trauma patients treated at the trauma center.
(2) The existence of a high percentage of uninsured trauma patients relative to the total number of trauma patients treated at the trauma center.
(3) The acuity mix of uninsured trauma patients treated at the trauma center.
(g) A trauma center shall be eligible for funding under this section if it is designated as a trauma center by a local EMS agency pursuant to Section 1798.165 and complies with the requirements of this section. Both public and private hospitals designated as trauma centers shall be eligible for funding.
(h) A trauma center that receives funding under this section shall agree to remain a trauma center through June 30 of the fiscal year in which it receives funding. If the trauma center ceases functioning as a trauma center, it shall pay back to the local EMS agency a pro rata portion of the funding that has been received. If there are one or more trauma centers remaining in the local EMS agency’s service area, the local EMS agency shall distribute the funds among the other trauma centers. If there is no other trauma center within the local EMS agency’s service area, the local EMS agency shall return the moneys to the authority. The authority shall deposit any such funds into the reserve described in subdivision (j). In the case of a local EMS agency that distributes funds using a reimbursement or fee-for-service system, a trauma center that ceases functioning as a trauma center shall only be required to pay back a pro rata portion of the minimum distributed as described in subdivision (i).
(i) Notwithstanding subdivision (f), the local EMS agency shall provide from the funds that the local EMS agency receives from the authority a minimum amount of one hundred fifty thousand dollars ($150,000) to each Level I or Level II trauma center to assist those centers in ensuring trauma center viability. The local EMS agency shall provide a Level III trauma center a minimum amount of fifty thousand dollars ($50,000) for this purpose. If a local EMS agency’s distribution pursuant to subdivision (e) is less than the amount necessary for each trauma center within the local EMS agency’s jurisdiction to receive the minimum amount provided by this subdivision, the authority shall include in its distribution to the agency an additional amount of funds necessary to make up the minimum amount pursuant to paragraph (1) of subdivision (j) plus 1 percent of the added amount for local EMS agency administrative costs. Based upon qualifying patient volume figures and the distribution factors established in subdivision (f), a trauma center designated as a Level IV may receive funding as determined appropriate by the local EMS agency.
(j) Notwithstanding subdivision (e), the authority shall reserve 6 percent of any funds appropriated to the Trauma Care Fund for distribution during the same fiscal year. The authority may spend these funds for the purposes specified in paragraphs (1) to (3), inclusive.
(1) To provide to a local EMS agency, the amount that the agency needs to make up the full minimum amount specified in subdivision (i).
(2) To provide a minimum amount to a trauma center that was not designated on July 1 of the fiscal year as specified in subdivision (e) but which becomes designated by January 1 of any fiscal year in which funds are being distributed pursuant to this section. In the case of such a newly designated center, the minimum distribution shall equal one-half of the minimum distribution described in subdivision (i), provided the local EMS agency makes an application to the authority for this purpose by February 1 of the same fiscal year.
(3) To the extent that there are funds in the reserve after the distributions provided by paragraphs (1) and (2) of this subdivision, to provide additional amounts to a local EMS agency where the distribution under subdivision (f) does not provide an accurate reflection of its total trauma volume. Any local EMS agency that believes the distribution under subdivision (f) does not provide an accurate accounting of its total trauma patient volume may make application to the authority for an adjustment.
(A) The application shall state the reason for the request and shall include supporting data.
(B) The authority shall consider all applications submitted pursuant to this paragraph and received by February 1 of the fiscal year.
(C) Based on the application and its supporting information, the authority shall determine the amount, if any, that the local agency should receive in addition to the amounts specified in subdivision (e) and shall allocate an appropriate amount of the reserve in accordance with its determination.
(k) In order to receive funds pursuant to this section, an eligible trauma center shall submit, pursuant to a contract between the trauma center and the local EMS agency, relevant and pertinent data requested by the local EMS agency. A trauma center shall demonstrate that it is appropriately submitting data to the local EMS agency’s trauma registry and a local EMS agency shall audit the data annually within two years of a distribution from the local EMS agency to a trauma center. Any trauma center receiving funding pursuant to this section shall report to the local EMS agency how the funds were used to support trauma services.
(l) It is the intent of the Legislature that all moneys appropriated to the fund be distributed to local EMS agencies during the same year the moneys are appropriated. To the extent that any moneys are not distributed by the authority during the fiscal year in which the moneys are appropriated, the moneys shall remain in the fund and be eligible for distribution pursuant to this section during subsequent fiscal years, except that the minimum distribution specified in subdivision (i) shall be provided to the extent that moneys are available in the fund.
(m) By October 31, 2002, the authority shall develop criteria for the standardized reporting of trauma patients to local trauma registries. The authority shall seek input from local EMS agencies to develop the criteria. All local EMS agencies shall utilize the trauma patient criteria for reporting trauma patients to local trauma registries by July 1, 2003.
(n) By December 31 of the fiscal year following any fiscal year in which funds are distributed pursuant to this section, a local EMS agency that has received funds from the authority pursuant to this chapter shall provide a report to the authority that details the amount of funds distributed to each trauma center, the amount of any balance remaining, and the amount of any claims pending, if any, and describes how the respective centers used the funds to support trauma services. The report shall also describe the local EMS agency’s mechanism for distributing the funds to trauma centers, a description of their audit process and criteria, and a summary of the most recent audit results.
(o) The authority may retain from any appropriation to the fund an amount sufficient to implement this section, up to two hundred eighty thousand dollars ($280,000). This amount may be adjusted to reflect any increases provided for wages or operating expenses as part of the authority’s budget process.

SEC. 3.

 Section 1799.204 of the Health and Safety Code is amended to read:

1799.204.
 (a) For purposes of this chapter, the following definitions apply:
(1) “EMSC Program” means the Emergency Medical Services For Children Program administered by the authority.
(2) “Technical advisory committee” means a multidisciplinary committee with pediatric emergency medical services, pediatric critical care, or other related expertise.
(3) “EMSC component” means the part of the local agency’s EMS plan that outlines the training, transportation, basic and advanced life support care requirements, and emergency department and hospital pediatric capabilities within a local jurisdiction.
(b) Contingent upon available funding, an Emergency Medical Services For Children Program is hereby established within the authority.
(c) The authority shall do the following to implement the EMSC Program:
(1) Employ or contract with professional, technical, research, and clerical staff as necessary to implement this chapter.
(2) Provide advice and technical assistance to local EMS agencies on the integration of an EMSC Program into their EMS system.
(3) Oversee implementation of the EMSC Program by local EMS agencies.
(4) Establish an EMSC technical advisory committee.
(5) Facilitate cooperative interstate relationships to provide appropriate care for pediatric patients who must cross state borders to receive emergency and critical care services.
(6) Work cooperatively and in a coordinated manner with the State Department of Health Services and other public and private agencies in the development of standards and policies for the delivery of emergency and critical care services to children.
(7) On or before March 1, 2000, produce a report for the Legislature describing any progress on implementation of this chapter. The report shall contain, but not be limited to, a description of the status of emergency medical services for children at both the state and local levels, the recommendation for training, protocols, and special medical equipment for emergency services for children, an estimate of the costs and benefits of the services and programs authorized by this chapter, and a calculation of the number of children served by the EMSC system.

SEC. 4.

 Section 102247 of the Health and Safety Code is amended to read:

102247.
 (a) There is hereby created in the State Treasury the Health Statistics Special Fund. The fund shall consist of revenues, revenues  including, but not limited to, all of the following:
(1) Fees or charges remitted to the State Registrar for record search or issuance of certificates, permits, registrations, or other documents pursuant to Chapter 3 (commencing with Section 26801) 26800)  of Part 3 of Division 2 of Title 3 of the Government Code, and Chapter 4 (commencing with Section 102525), Chapter 5 (commencing with Section 102625), Chapter 8 (commencing with Section 103050), and Chapter 15 (commencing with Section 103600) 103600),  of Part 1 1,  of Division 102 of this code. 102. 
(2) Funds remitted to the State Registrar by the federal Social Security Administration for participation in the enumeration at birth program.
(3) Funds remitted to the State Registrar by the National Center for Health Statistics pursuant to the federal Vital Statistics Cooperative Program.
(4) Any other funds collected by the State Registrar, except Children’s Trust Fund fees collected pursuant to Section 18966 of the Welfare and Institutions Code and  Code,  fees allocated to the Judicial Council pursuant to Section 1852 of the Family Code, and fees collected pursuant to Section 103645,  all of which shall be deposited into the General Fund.
(b) Moneys in the Health Statistics Special Fund shall be expended by the State Registrar for the purpose of funding its existing programs and programs that may become necessary to carry out its mission, upon appropriation by the Legislature.
(c) Health Statistics Special Fund moneys shall be expended only for the purposes set forth in this section and Section 102249, and shall not be expended for any other purpose or for any other state program.
(d) It is the intent of the Legislature that the Health Statistics Special Fund provide for the following:
(1) Registration and preservation of vital event records and dissemination of vital event information to the public.
(2) Data analysis of vital statistics for population projections, health trends and patterns, epidemiologic research, and development of information to support new health policies.
(3) Development of uniform health data systems that are integrated, accessible, and useful in the collection of information on health status.
(e) This section shall become operative on January 1, 2023.

SEC. 5.

 Section 102250 of the Health and Safety Code is repealed.

SEC. 6.

 Section 103625 of the Health and Safety Code is amended to read:

103625.
 (a) A fee of twelve three  dollars ($12) ($3)  shall be paid by the applicant for a certified copy of a fetal death or death record.
(b) (1) A fee of twelve three  dollars ($12) ($3)  shall be paid by a public agency or licensed private adoption agency applicant for a certified copy of a birth certificate that the agency is required to obtain in the ordinary course of business. A fee of eighteen seven  dollars ($18) ($7)  shall be paid by any other applicant for a certified copy of a birth certificate. Four dollars ($4) of any eighteen-dollar ($18) seven-dollar ($7)  fee is exempt from subdivision (e) and shall be paid either to a county children’s trust fund or to the State Children’s Trust Fund, in conformity with Article 5 (commencing with Section 18965) of Chapter 11 of Part 6 of Division 9 of the Welfare and Institutions Code. Two dollars ($2) of any eighteen-dollar ($18) fee is exempt from subdivision (e) and shall be paid to the Umbilical Cord Blood Collection Program Fund in conformity with Section 1628. 
(2) The board of supervisors of any county that has established a county children’s trust fund may increase the fee for a certified copy of a birth certificate by up to three dollars ($3) for deposit in the county children’s trust fund in conformity with Article 5 (commencing with Section 18965) of Chapter 11 of Part 6 of Division 9 of the Welfare and Institutions Code.
(3) The board of supervisors of any county may increase the fee for a certified copy of a birth certificate by up to three dollars ($3) through June 30, 1999, or until any earlier date upon which the board of supervisors finds that the fee is no longer necessary for dependency mediation funding, the proceeds of which shall be used solely for the purpose of providing dependency mediation services in the juvenile court. Public agencies shall be exempt from paying this portion of the fee. However, if a county increases this fee, neither the revenue generated from the fee increase nor the increased expenditures made for these services shall be considered in determining the court’s progress towards achieving its cost reduction goals pursuant to Section 68113 of the Government Code if the net effect of the revenue and expenditures is a cost increase. In each county that increases the fee pursuant to this paragraph, up to 5 percent of the revenue generated from the fee increase may be apportioned to the county recorder for the additional accounting costs of the program.
(c) A fee of three dollars ($3) shall be paid by a public agency applicant for a certified copy of a marriage record, that has been filed with the county recorder or county clerk, that the agency is required to obtain in the ordinary course of business. A fee of six dollars ($6) shall be paid by any other applicant for a certified copy of a marriage record that has been filed with the county recorder or county clerk. Three dollars ($3) of any six-dollar ($6) fee is exempt from subdivision (e) and shall be transmitted monthly by each local registrar, county recorder, and county clerk to the state for deposit into the General Fund as provided by Section 1852 of the Family Code.
(d) A fee of three dollars ($3) shall be paid by a public agency applicant for a certified copy of a marriage dissolution record obtained from the State Registrar that the agency is required to obtain in the ordinary course of business. A fee of six dollars ($6) shall be paid by any other applicant for a certified copy of a marriage dissolution record obtained from the State Registrar.
(e) Each local registrar, county recorder, or county clerk collecting a fee pursuant to subdivisions (a) to (d), inclusive, shall do the following:
(1) (e)  Transmit  Each local registrar, county recorder, or county clerk collecting a fee pursuant to subdivisions (a) to (d), inclusive, shall transmit  15 percent of the fee for each certified copy to the State Registrar by the 10th day of the month following the month in which the fee was received.
(2) Retain 85 percent of the fee for each certified copy solely to support the issuing agency for all activities related to the issuance of certified copies of records pursuant to subdivisions (a) to (d), inclusive.
(f) In addition to the fees prescribed pursuant to subdivisions (a) to (d), inclusive, all applicants for certified copies of the records described in those subdivisions shall pay an additional fee of three dollars ($3), that shall be collected by the State Registrar, the local registrar, county recorder, or county clerk, as the case may be.
(g) The local public official charged with the collection of the additional fee established pursuant to subdivision (f) may create a local vital and health statistics trust fund. The fees collected by local public officials pursuant to subdivision (f) shall be distributed as follows:
(1) Forty-five percent of the fee collected pursuant to subdivision (f) shall be transmitted to the State Registrar.
(2) The remainder of the fee collected pursuant to subdivision (f) shall be deposited into the collecting agency’s vital and health statistics trust fund, except that in any jurisdiction in which a local vital and health statistics trust  fund has not been established, the entire amount of the fee collected pursuant to subdivision (f) shall be transmitted to the State Registrar.
(3) Moneys transmitted to the State Registrar pursuant to this subdivision shall be deposited in accordance with Section 102247.
(h) Moneys in each local vital and health statistics trust fund shall be available to the local official charged with the collection of fees pursuant to subdivision (f) for the applicable jurisdiction for the purpose of defraying the administrative costs of collecting and reporting with respect to those fees and for other costs as follows:
(1) Modernization of vital record operations, including improvement, automation, and technical support of vital record systems.
(2) Improvement in the collection and analysis of health-related birth and death certificate information, and other community health data collection and analysis, as appropriate.
(i) Funds collected pursuant to subdivision (f) shall not be used to supplant funding in existence on January 1, 2002, that is necessary for the daily operation of vital record systems. It is the intent of the Legislature that funds collected pursuant to subdivision (f) be used to enhance service to the public, to improve analytical capabilities of state and local health authorities in addressing the health needs of newborn children and maternal health problems, and to analyze the health status of the general population.
(j) Each county shall annually submit a report to the State Registrar by March 1 containing information on the amount of revenues collected pursuant to subdivision (f) in the previous calendar year and on how the revenues were expended and for what purpose.
(k) Each local registrar, county recorder, or county clerk collecting the fee pursuant to subdivision (f) shall transmit 45 percent of the fee for each certified copy to which subdivision (f) applies to the State Registrar by the 10th day of the month following the month in which the fee was received.
(l) ( l)  The nine dollar ($9) increase to the base fee authorized in subdivision (a) for a certified copy of a fetal death record or death record and subdivision (b) for a certified copy of a birth certificate shall be applied incrementally as follows: additional three dollars ($3) authorized to be charged to applicants other than public agency applicants for certified copies of marriage records by subdivision (c) may be increased pursuant to Section 114. 
(1) A five dollar ($5) increase applied as of January 1, 2012.
(2) An additional two dollar ($2) increase applied as of January 1, 2013.
(3) An additional two dollar ($2) increase applied as of January 1, 2014.
(m) In providing for the expiration of the surcharge on birth certificate fees on June 30, 1999, the Legislature intends that juvenile dependency mediation programs pursue ancillary funding sources after that date.
(n) This section shall remain in effect only until January 1, 2027, and as of that date is repealed.

SEC. 7.

 Section 103640 of the Health and Safety Code is repealed.

SEC. 8.

 Section 103641 of the Health and Safety Code is amended to read:

103641.
 The State Registrar shall annually prepare a summary report of all statewide activities related to revenues collected by the State Registrar pursuant to subdivision (f) of Section 103625. The report shall include, but not be limited to, the following:
(a) A report that combines the information that counties are required to submit pursuant to subdivision (f) of Section 103625.
(b) Information regarding revenues collected by the State Registrar pursuant to subdivision (f) of Section 103625 for the previous calendar year, including, but not limited to, the manner in which, and purpose for which, the revenues were expended.

SEC. 8.5.

 Article 1.3 (commencing with Section 104150) is added to Chapter 2 of Part 1 of Division 103 of the Health and Safety Code, to read:

Article  1.3. Breast and Cervical Cancer Early Detection Program Grant
104150.
 (a) A provider or entity that participates in the grant made to the department by the federal Centers for Disease Control and Prevention breast and cervical cancer early detection program established under Title XV of the Public Health Service Act (42 U.S.C. Sec. 300k et seq.) in accordance with requirements of Section 1504 of that act (42 U.S.C. Sec. 300n) may only render screening services under the grant to an individual if the provider or entity determines that the individual’s family income does not exceed 200 percent of the federal poverty level.
(b) The department shall provide for breast cancer and cervical cancer screening services under the grant at the level of funding budgeted from state and other resources during the fiscal year in which the Legislature has appropriated funds to the department for this purpose. These screening services shall not be deemed to be an entitlement.

SEC. 8.9.

 Article 1.5 (commencing with Section 104160) of Chapter 2 of Part 1 of Division 103 of the Health and Safety Code is repealed.

SEC. 9.

 Article 1.5 (commencing with Section 104160) is added to Chapter 2 of Part 1 of Division 103 of the Health and Safety Code, to read:

Article  1.5. Breast and Cervical Cancer Treatment Program
104160.
 (a) The State Department of Health Services shall develop and maintain the Breast and Cervical Cancer Treatment Program to expand and ensure quality breast and cervical cancer treatment for low-income uninsured and underinsured individuals who are diagnosed with breast or cervical cancer.
(b) To implement the program, the department may contract with public or private entities, or utilize existing health care service provider enrollment and payment mechanisms, including the Medi-Cal program’s fiscal intermediary, only if services provided under the program are specifically identified and reimbursed in a manner that does not claim federal financial reimbursement. The utilization of the Medi-Cal program’s fiscal intermediary shall not be subject to Chapter 3 (commencing with Section 12100) of Part 2 of Division 2 of the Public Contract Code. Contracts to implement the program entered into by the department with entities other than the Medi-Cal program’s fiscal intermediary shall not be subject to Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code.
104161.
 For the purposes of this article, the following definitions shall apply:
(a) “Covered conditions” means breast or cervical cancer.
(b) “Breast cancer” includes primary, recurrent, and metastatic cancers of the breast, including, but not limited to, infiltrating or in situ.
(c) “Cervical cancer” includes all primary, recurrent, and metastatic cancers of the cervix, including, but not limited to, infiltrating or in situ, as well as cervical dysplasia.
(d) “Period of coverage” means the period of time beginning when an individual is made eligible under this article for a covered condition and shall not exceed the period of time the individual’s eligibility for treatment services for a covered condition concludes, as described in Section 104161.1.
(e) “Treatment services” means those health care services, goods, supplies, or merchandise medically necessary to treat the covered condition or conditions with which the individual made eligible under this article has been diagnosed.
(f) “Uninsured” means not covered for breast or cervical cancer treatment services by any of the following:
(1) No cost full scope Medi-Cal.
(2) Medicare.
(3) A health care service plan contract or policy of disability insurance.
(4) Any other form of health care coverage.
(g) “Underinsured” means either of the following:
(1) Covered for breast or cervical cancer treatment services by any health care insurance listed in paragraph (2), (3), or (4) of subdivision (f), but the sum of the individual’s insurance deductible, premiums, and expected copayments in the initial 12-month period that breast or cervical cancer treatment services are needed exceeds seven hundred fifty dollars ($750).
(2) Covered by share-of-cost or limited scope Medi-Cal, if the individual is not otherwise eligible for treatment services under the Medi-Cal program pursuant to Section 14007.71 of the Welfare and Institutions Code.
104161.1.
 (a) When an individual is made eligible for treatment services under this article due to a diagnosis of breast cancer, the period of coverage shall not exceed 18 months. After 18 months, the individual’s eligibility for treatment services for the cancer condition that made this individual eligible concludes.
(b) When an individual is made eligible for treatment services under this article due to a diagnosis of cervical cancer, the period of coverage shall not exceed 24 months. After 24 months, the individual’s eligibility for treatment services for the cancer condition that made this individual eligible concludes.
104162.
 An individual shall be eligible to receive treatment services pursuant to this article provided that all of the following criteria are met:
(a) The individual is a resident of California.
(b) The individual is uninsured or underinsured.
(c) The individual, who meets the income standards described in subdivision (d), was screened for breast or cervical cancer by a provider or entity participating in the Centers for Disease Control and Prevention breast and cervical cancer early detection program established under Title XV of the Public Health Service Act (42 U.S.C. Sec. 300k et seq.) in accordance with requirements of Section 1504 of that act (42 U.S.C. Sec. 300n) and needs treatment for breast or cervical cancer.
(d) As determined by the provider performing the screening and diagnosis, the individual has family income at or below 200 percent of the federal poverty level.
(e) The individual has filed a completed application for eligibility for treatment services under the Medi-Cal program pursuant to Section 14007.71 of the Welfare and Institutions Code, and has been found ineligible for benefits under that section.
104162.1.
 When an individual is underinsured, as defined in subdivision (g) of Section 104161, the department shall be the payer of second resort for treatment services. To the extent necessary for the individual to obtain treatment services under any health care insurance listed in paragraph (2), (3), or (4) of subdivision (f) of Section 104161, the department may do the following:
(a) Pay for the individual’s breast or cervical cancer copayments, premiums, and deductible.
(b) Provide only treatment services not otherwise covered by any health care insurance listed in paragraph (2), (3), or (4) of subdivision (f) of Section 104161.
104162.2.
 For the purposes of establishing eligibility for treatment services under this article, breast or cervical cancer screens performed by providers or entities not described in subdivision (c) of Section 104162 may be used only to the same extent the screens are used by the Medi-Cal program for the purpose of determining eligibility pursuant to Section 14007.71 of the Welfare and Institutions Code, as approved by the federal Health Care Financing Administration.
104163.
 The department shall provide for breast cancer and cervical cancer treatment services pursuant to this article at the level of funding budgeted from state and other resources during the fiscal year in which the Legislature has appropriated funds to the department for this purpose. These treatment services shall not be deemed to be an entitlement.

SEC. 10.

 Part 3.5 (commencing with Section 104896) is added to Division 103 of the Health and Safety Code, to read:

PART 3.5. TOBACCO SETTLEMENT FUND

104896.
 (a) As used in this part, the following definitions shall apply:
(1) “Fund” means the Tobacco Settlement Fund.
(2) “Master Settlement Agreement” means the settlement agreement and related documents entered into on November 23, 1998, by the state and leading United States tobacco product manufacturers.
(3) “State’s share of funds” means that portion of payments received from the Master Settlement Agreement designated for use by the state and shall not include those funds designated for distribution to the counties or other local jurisdictions.
(b) Nothing in this part is intended to limit expenditures for programs to the amount provided by the fund.
104897.
 (a) There is hereby established in the State Treasury the Tobacco Settlement Fund.
(b) In the 2001–02 fiscal year, four hundred one million nine hundred ninety-two hundred thousand dollars ($401,992,000) of the state’s share of funds received pursuant to the Master Settlement Agreement shall be deposited in the fund.
(c) Commencing July 1, 2002, the total amount of the state’s share of moneys received pursuant to the Master Settlement Agreement shall be deposited in the fund.
104898.
 (a) Distribution of moneys from the fund shall be made by annual appropriation of the Legislature consistent with the requirements of this part.
(b) Moneys appropriated from the fund shall be used for health purposes, including all of the following:
(1) Health care expansions in the Medi-Cal program, Healthy Families Program, and other state programs.
(2) Health care education and outreach, including, but not limited to, efforts to help reduce the use of tobacco products.
(3) Smoking cessation services.
(4) Enforcement of tobacco-related statutes.
(5) Expansions to primary care and other state-funded clinics that serve low-income, uninsured, or underinsured Californians.
104898.5.
 (a) Notwithstanding any other provision of law, there shall be transferred annually from the General Fund to the Tobacco Settlement Fund an amount, not to exceed two hundred fifty million dollars ($250,000,000) out of funds not otherwise appropriated, as a loan to cover appropriations from the fund when moneys from the Master Settlement Agreement have not been received by the state.
(b) This loan from the General Fund shall be repaid on or before June 30 of each year, without interest, from the funds received pursuant to the Master Settlement Agreement.
104899.
 Revenue accruing to the Tobacco Settlement Fund pursuant to this part shall be deemed revenue to the General Fund solely for the purpose of certifications of General Fund revenue for purposes of subdivision (e) of Section 12306.1 of the Welfare and Institutions Code with respect to in-home supportive services program and Section 10754 of the Revenue and Taxation Code with respect to vehicle license fees.

SEC. 11.

 Section 116590 of the Health and Safety Code is amended to read:

116590.
 (a) Funds  All funds  received by the state board  department  pursuant to this chapter  chapter, including, but not limited to, all civil penalties collected by the department pursuant to Article 9 (commencing with Section 116650) and Article 11 (commencing with Section 116725),  shall be deposited into the Safe Drinking Water Account, which is hereby established, and shall be available  Account that is hereby established. Funds in the Safe Drinking Water Account may not be expended for any purpose other than as set forth in this chapter. All moneys collected by the department pursuant to Sections 116565 to 116600, inclusive, shall be deposited into the Safe Drinking Water Account  for use by the state board,  department,  upon appropriation by the Legislature, for the purpose of providing funds necessary to administer this chapter and the Water Shutoff Protection Act (Chapter 6 (commencing with Section 116900)). chapter. 
(b) The department’s hourly cost rate used to determine the reimbursement for actual costs pursuant to Sections 116565, 116577, and 116580 shall be based upon the department’s salaries, benefits, travel expense, operating, equipment, administrative support, and overhead costs.
(b) (c)  Notwithstanding Section 6103 of the Government Code, each public water system operating under a permit issued pursuant to this chapter shall pay the fees set forth in this chapter.  A public water system may  shall be permitted to  collect a fee from its customers to recover the fees paid by the public water system  pursuant to this chapter.
(d) The fees collected pursuant to subdivision (b) of Section 116565 and subdivision (b) of Section 116570 shall be adjusted annually pursuant to Section 100425, and the adjusted fee amounts shall be rounded off to the nearest whole dollar.
(e) Fees assessed pursuant to this chapter shall not exceed actual costs to either the department or the local primacy agency, as the case may be, related to the public water systems assessed the fees.
(f) In no event shall the total amount of funds received pursuant to subdivision (a) of Section 116565, and subdivision (a) of Section 116577 from public water systems serving 1,000 or more service connections exceed the following:
(1) For the 2001–02 fiscal year, seven million dollars ($7,000,000).
(c) (2)  The total amount of funds received for state operations program costs to administer this chapter for fiscal year 2016–17 shall not exceed thirty-eight million nine hundred seven thousand dollars ($38,907,000) and  For the 2002–03 fiscal year and subsequent fiscal years,  the total amount of funds received for administering this chapter for each fiscal year thereafter  shall not increase by more than 5 percent of the amount received in collected for  the previous fiscal year plus any changes to salary, benefit, and retirement adjustments contained in each annual Budget Act. year. 
(g) The department shall develop a time accounting standard designed to do all of the following:
(1) Provide accurate time accounting.
(2) Provide accurate invoicing based upon hourly rates comparable to private sector professional classifications and comparable rates charged by other states for comparable services. These rates shall be applied against the time spent by the actual individuals who perform the work.
(3) Establish work standards that address work tasks, timing, completeness, limits on redirection of effort, and limits on the time spent in the aggregate for each activity.
(d) (4)  This section shall become operative on July 1, 2016. Establish overhead charge-back limitations, including, but not limited to, charge-back limitations on charges relating to reimbursement of services provided to the department by other departments and agencies of the state, that reasonably relate to the performance of the function. 
(5) Provide appropriate invoice controls.

SEC. 12.

 Section 116600 of the Health and Safety Code is repealed.

SEC. 12.5.

 Section 124035 of the Health and Safety Code is amended to read:

124035.
 The department shall administer this article and Section 120475 and shall adopt minimum standards for the approval of community child health and disability prevention programs and regulations as necessary. The standards shall allow necessary flexibility in the administration of county programs, taking into account the variability of county needs and resources. Standards shall be adopted for:
(a) Education and experience requirements for directors of community child health and disability prevention programs.
(b) Health screening, evaluation, and diagnostic procedures for child health and disability prevention programs.
(c) Public and private facilities and providers that may participate in community child health and disability prevention programs.
(d) The department shall develop a methodology for allocating child health and disability prevention funds to counties for the administration of this program.

SEC. 12.7.

 Section 124040 of the Health and Safety Code is amended to read:

124040.
 (a)  The governing body of each county or counties shall establish a community child health and disability prevention program for the purpose of providing early and periodic assessments of the health status of children in the county or counties by July 1, 1974. However, this shall be the responsibility of the department for all counties that contract with the state for health services. Contract counties, at the option of the board of supervisors, may provide services pursuant to this article in the same manner as other county programs, if provided  the option is exercised prior to the beginning of each fiscal year. Each plan shall include, but is not limited to, the following requirements:
(1) (a)  Outreach and educational services.
(2) (b)  Agreements with public and private facilities and practitioners to carry out the programs.
(3) (c)  Health screening and evaluation services including,  for all children, including  children eligible for Medi-Cal,  a physical examination, immunizations appropriate for the child’s  their  age and health history, and laboratory procedures appropriate for the child’s  their  age and population group performed by, or under the supervision or responsibility of, a physician licensed to practice medicine in California or by a certified family nurse practitioner or a certified pediatric nurse practitioner. group. 
(4) (d)  Referral for diagnosis or treatment when needed, including, for all children eligible for Medi-Cal, referral for treatment by a provider participating in the Medi-Cal program of the conditions detected, and methods for assuring referral is carried out.
(5) (e)  Recordkeeping and program evaluations.
(6)  The health screening and evaluation part of each community child health and disability prevention program plan shall include, but is not limited to, the following for each child:
(A) (1)  A health and development history.
(B) (2)  An assessment of physical growth.
(C) (3)  An examination for obvious physical defects.
(D) (4)  Ear, nose, mouth, and throat inspection, including inspection of teeth and gums, and for all children one year three years  of age and older who are eligible for Medi-Cal, referral to a dentist participating in the Medi-Cal program.
(E) (5)  Screening tests for vision, hearing, anemia, tuberculosis, diabetes, and urinary tract conditions.
(7) (f)  An assessment of nutritional status.
(8) (g)  An assessment of immunization status.
(9) (h)  If Where  appropriate, testing for sickle-cell  sickle cell  trait, lead poisoning, and other tests that may be necessary to the identification of children with potential disabilities requiring diagnosis and possibly treatment.
(10) (i)  For all children eligible for Medi-Cal, necessary assistance with scheduling appointments for services and with transportation.
(j) The department shall report to the Legislature, by April 15, 1986, on all necessary steps to improve access to preventive dental care for children eligible for Medi-Cal, such as streamlining reimbursement procedures, increasing fees for specific preventive dental procedures, or increasing fees in specific geographic areas.
(b) (k)  Dentists receiving referrals of children eligible for Medi-Cal under this section shall employ procedures to advise the child’s parent or parents of the need for and scheduling of annual appointments.
(c)  Standards for procedures to carry out health screening and evaluation services and to establish the age at which particular tests should be carried out shall be established by the director. At the discretion of the department, these health screening and evaluation services may be provided at the frequency provided under the Healthy Families Program and permitted in managed care plans providing services under the Medi-Cal program, and shall be contingent upon appropriation in the annual Budget Act. Immunizations may be provided at the frequency recommended by the Committee on Infectious Disease of the American Academy of Pediatrics and the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention.
(d)   Each community child health and disability prevention program shall, pursuant to standards set by the director, establish a record system that contains a health case history for each child so that costly and unnecessary repetition of screening, immunization and referral will not occur and appropriate health treatment will be facilitated as specified in Section 124085.

SEC. 13.

 Section 124710 of the Health and Safety Code is amended to read:

124710.
 (a) (1) It is the intent of the Legislature that funds distributed under this section promote stability for participating clinics, as a part of the state’s health care safety net, and at the same time be distributed in a manner that best promotes access to health care to geographically isolated populations.
(2) The department shall grant funds, for a minimum of  up to  three years per grant, retroactive to funds appropriated in the Budget Act of 2002 (Chapter 379 of the Statutes of 2002), to  to  eligible, private, nonprofit, community-based primary care clinics for the purpose of establishing and maintaining rural health services and development projects as specified under this article. The department may continue to pay any grantee whose grant expired on June 30, 2003, until June 30, 2004, as if the grant had been extended, provided that funds are appropriated for this purpose in the Budget Act of 2003 and the grantee agrees in writing to expend the money as if the grant had been extended.  
(b) In order to be eligible to receive funds under this program, a clinic shall, at a minimum, meet all of the following conditions:
(1) The clinic shall be licensed under paragraph (1) or (2) of subdivision (a) of Section 1204.
(2) The clinic shall operate in a “rural” Medical Study Service Area, as defined by the Health Manpower Commission.
(3) The clinic shall operate in a medically underserved area, including a Health Professional Shortage Area, or serve a medically underserved population, as designated by the United States Department of Health and Human Services, or shall be able to demonstrate that at least 50 percent of its patients are persons with incomes at or below 200 percent of the federal poverty level.
(c) The department shall seek input from stakeholders in designing the methodology for distribution of funds under this section.
(d) If the funds that are available for purposes of this section for any fiscal year are greater than funds that were available for the prior fiscal year, the department shall establish a base funding level that is applicable to all sites funded in the prior fiscal year. To the extent that funds are available, the base funding level shall not be less than seventy-five thousand dollars ($75,000) for each site. To implement this section, the department shall not be required to reduce funding for clinics that are above the minimum awards.

SEC. 14.

 Section 12693.325 of the Insurance Code is amended to read:

12693.325.
 (a) (1)  Notwithstanding any provision of this chapter, a participating health, dental, or vision plan that is licensed and in good standing as required by subdivision (b) of Section 12693.36 may provide application assistance directly to an applicant acting on behalf of an eligible person child  who telephones, writes, or contacts the plan in person at the plan’s place of business, or at a community public awareness event that is open to all participating plans in the county, or at any other site approved by the board, and who requests application assistance.
(2) A participating health, dental, or vision plan may also provide application assistance directly to an applicant only under the following conditions:
(A) The assistance is provided upon referral from a government agency, school, or school district.
(B) The applicant has authorized the government agency, school, or school district to allow a health, dental, or vision plan to contact the applicant with additional information on enrolling in free or low-cost health care.
(C) The State Department of Health Care Services approves the applicant authorization form in consultation with the board.
(D) The plan may not actively solicit referrals and may not provide compensation for the referrals.
(E) If a family is already enrolled in a health plan, the plan that contacts the family cannot encourage the family to change health plans.
(F) The board amends its marketing guidelines to require that when a government agency, school, or school district requests assistance from a participating health, dental, or vision plan to provide application assistance, that all plans in the area shall be invited to participate.
(G) The plan abides by the board’s marketing guidelines.
(b) A participating health, dental, or vision plan may provide application assistance to an applicant who is acting on behalf of an eligible or potentially eligible child in any of the following situations:
(1) The child is enrolled in a Medi-Cal managed care plan and the participating plan becomes aware that the child’s eligibility status has or will change and that the child will no longer be eligible for Medi-Cal. In those instances, the plan shall inform the applicant of the differences in benefits and requirements between the Healthy Families Program and the Medi-Cal program.
(2) The child is enrolled in a Healthy Families Program managed care plan and the participating plan becomes aware that the child’s eligibility status has changed or will change and that the child will no longer be eligible for the  Healthy Families Program.  Families.  When it appears a child may be eligible for Medi-Cal benefits, the plan shall inform the applicant of the differences in benefits and requirements between the Medi-Cal program and the Healthy Families Program.
(3) The participating plan provides employer-sponsored coverage through an employer and an employee of that employer who is the parent or legal guardian of the eligible or potentially eligible child.
(4) The child and his or her family are participating through the participating plan in COBRA continuation coverage or other group continuation coverage required by either state or federal law and the group continuation coverage will expire within 60 days, or has expired within the past 60 days.
(5) The child’s family, but not the child, is participating through the participating plan in COBRA continuation coverage or other group continuation coverage required by either state or federal law, and the group continuation coverage will expire within the past  60 days, or has expired within the past 60 days.
(c) A participating health, dental, or vision plan employee or other representative that provides application assistance shall complete a certified application assistant training class approved by the State Department of Health Care  Services in consultation with the board. The employee or other representative shall in all cases inform an applicant verbally of his or her relationship with the participating health plan. In the case of an in-person contact, the employee or other representative shall provide in writing to the applicant the nature of his or her relationship with the participating health plan and obtain written acknowledgment acknowledgement  from the applicant that the information was provided.
(d) A participating health, dental, or vision plan that provides application assistance may not do any of the following:
(1) Directly, indirectly, or through its agents, conduct door-to-door marketing or telephone phone  solicitation.
(2) Directly, indirectly, or through its agents, select a health plan or provider for a potential applicant. Instead, the plan shall inform a potential applicant of the choice of plans available within the applicant’s county of residence and specifically name those plans and provide the most recent version of the program handbook.
(3) Directly, indirectly, or through its agents, conduct mail or in-person solicitation of applicants for enrollment, except as specified in subdivision (b), using materials approved by the board.
(e) A participating health, dental, or vision plan that provides application assistance pursuant to this section is not eligible for an application assistance fee otherwise available pursuant to Section 12693.32, and may not sponsor a person eligible for the program by paying his or her family contribution amounts or copayments, and may not offer applicants any inducements to enroll, including, but not limited to, gifts or monetary payments.
(f) A participating health, dental, or vision plan may assist applicants acting on behalf of subscribers who are enrolled with the participating plan in completing the program’s annual eligibility review package in order to allow those applicants to retain health care coverage.
(g) Each participating health, dental, or vision plan shall submit to the board a plan for application assistance. All scripts and materials to be used during application assistance sessions shall be approved by the board and the State Department of Health Care  Services.
(h) Each participating health, dental, or vision plan shall provide each applicant with the toll-free telephone number for the Healthy Families Program.
(i) When deemed appropriate by the board, the board may refer a participating health, dental, or vision plan to the Department of Managed Health  Care or the State Department of Health Care  Services, as applicable, for the review or investigation of its application assistance practices.
(j) The board shall evaluate the impact of the changes required by this section section,  and shall provide a biennial  report to the Legislature on or before March 1 of every other year.  1, 2002.  To prepare these reports, the State Department of Health Care  Services, in cooperation with the board, shall code all the application packets used by a managed care plan to record the number of applications received that originated from managed care plans. The number of applications received that originated from managed care plans shall also be reported on the board’s Web site.  website.  In addition, the board shall periodically survey those families assisted by plans to determine if the plans are meeting the requirements of this section, and if families are being given ample information about the choice of health, dental, or vision  health  plans available to them. The report shall include any recommended changes to this section. 
(k) Nothing in this the  section shall be seen as mitigating a participating health, dental, or vision plan’s responsibility to comply with all federal and state laws, including, but not limited to, Section 1320a-7b of Title 42 of the United States Code.
(l) This section shall remain in effect only until January 1, 2003, and as of that date is repealed, unless a later enacted statute, that is enacted before January 1, 2003, deletes or extends that date.

SEC. 14.5.

 Section 12693.70 of the Insurance Code is amended to read:

12693.70.
 To be eligible to participate in the program, an applicant shall meet all of the following requirements:
(a) Be an applicant applying on behalf of an eligible child, which means a child who is all of the following:
(1) Less than 19 years of age. An application may be made on behalf of a child not yet born up to three months prior to the expected date of delivery. Coverage shall begin as soon as administratively feasible, as determined by the board, after the board receives notification of the birth. However, no child less than 12 months of age shall be eligible for coverage until 90 days after the enactment of the Budget Act of 1999.
(2) Not eligible for no-cost full-scope Medi-Cal or Medicare coverage  at the time of application.
(3) In compliance with Sections 12693.71 and 12693.72.
(4) A child who meets citizenship and immigration status requirements that are applicable to persons participating in the program established by Title XXI of the Social Security Act, except as specified in Section 12693.76.
(5) A resident of the State of California pursuant to Section 244 of the Government Code; or, if not a resident pursuant to Section 244 of the Government Code, is physically present in California and entered the state with a job commitment or to seek employment, whether or not employed at the time of application to or after acceptance in, the program.
(6) (A) In either of the following:
(i) (6)  (A)  In a family with an annual or monthly household income equal to or less than 200 percent of the federal poverty level.
(ii) (I) When implemented by the board, subject to subdivision (b) of Section 12693.765 and pursuant to this section, a child under the age of two years who was delivered by a mother enrolled in the Access for Infants and Mothers Program as described in Part 6.3 (commencing with Section 12695). Commencing July 1, 2007, eligibility under this subparagraph shall not include infants during any time they are enrolled in employer-sponsored health insurance or are subject to an exclusion pursuant to Section 12693.71 or 12693.72, or are enrolled in the full scope of benefits under the Medi-Cal program at no share of cost. For purposes of this clause, any infant born to a woman whose enrollment in the Access for Infants and Mothers Program begins after June 30, 2004, shall be automatically enrolled in the Healthy Families Program, except during any time on or after July 1, 2007, that the infant is enrolled in employer-sponsored health insurance or is subject to an exclusion pursuant to Section 12693.71 or 12693.72, or is enrolled in the full scope of benefits under the Medi-Cal program at no share of cost. Except as otherwise specified in this section, this enrollment shall cover the first 12 months of the infant’s life. At the end of the 12 months, as a condition of continued eligibility, the applicant shall provide income information. The infant shall be disenrolled if the gross annual household income exceeds the income eligibility standard that was in effect in the Access for Infants and Mothers Program at the time the infant’s mother became eligible, or following the two-month period established in Section 12693.981 if the infant is eligible for Medi-Cal with no share of cost. At the end of the second year, infants shall again be screened for program eligibility pursuant to this section, with income eligibility evaluated pursuant to clause (i), subparagraphs (B) and (C), and paragraph (2) of subdivision (a).
(II) Effective on October 1, 2013, or when the State Department of Health Care Services has implemented Chapter 2 (commencing with Section 15810) of Part 3.3 of Division 9 of the Welfare and Institutions Code, whichever is later, eligibility for coverage in the program pursuant to this clause shall terminate. The board shall coordinate with the State Department of Health Care Services to implement Chapter 2 (commencing with Section 15810) of Part 3.3 of Division 9 of the Welfare and Institutions Code, including transition of subscribers to the AIM-Linked Infants Program. The State Department of Health Care Services shall administer the AIM-Linked Infants Program, pursuant to Chapter 2 (commencing with Section 15810) of Part 3.3 of Division 9 of the Welfare and Institutions Code, to address the health care needs of children formerly covered pursuant to this clause.
(B) All income over 200 percent of the federal poverty level but less than or equal to 250 percent of the federal poverty level shall be disregarded in calculating annual or monthly household income.
(C) In a family with an annual or monthly household income greater than 250 percent of the federal poverty level, any income deduction that is applicable to a child under Medi-Cal shall be applied in determining the annual or monthly household income. If the income deductions reduce the annual or monthly household income to 250 percent or less of the federal poverty level, subparagraph (B) shall be applied.
(b) The applicant shall  If the applicant is applying for the purchasing pool, and does not have a family contribution sponsor the applicant shall pay the first month’s family contribution and  agree to remain in the program for six months, unless other coverage is obtained and proof of the coverage is provided to the program.
(c) An applicant shall enroll all of the applicant’s eligible children in the program.
(d) In filing documentation to meet program eligibility requirements, if the applicant’s income documentation cannot be provided, as defined in regulations promulgated by the board, the applicant’s signed statement as to the value or amount of income shall be deemed to constitute verification.
(e) An applicant shall pay in full any family contributions owed in arrears for any health, dental, or vision coverage provided by the program within the prior 12 months.
(f) By January 2008, the board, in consultation with stakeholders, shall implement processes by which applicants for subscribers may certify income at the time of annual eligibility review, including rules concerning which applicants shall be permitted to certify income and the circumstances in which supplemental information or documentation may be required. The board may terminate using these processes not sooner than 90 days after providing notification to the Chair of the Joint Legislative Budget Committee. This notification shall articulate the specific reasons for the termination and shall include all relevant data elements that are applicable to document the reasons for the termination. Upon the request of the Chair of the Joint Legislative Budget Committee, the board shall promptly provide any additional clarifying information regarding implementation of the processes required by this subdivision.

SEC. 15.

 Section 12693.755 of the Insurance Code is amended to read:

12693.755.
 (a) Subject to subdivision (b), commencing four months after the initial federal approval is obtained pursuant to the waiver described in subdivision (b), the board shall expand eligibility under this part to uninsured parents of, and as defined by the board, adults responsible for, children enrolled to receive coverage under this part or who are enrolled to receive the full scope of Medi-Cal services with no share of cost and whose income does not exceed 250 percent of the federal poverty level, before applying the income disregard provided for in subparagraph (B) of paragraph (6) of subdivision (a) of Section 12693.70.
(b) (1) The board shall implement a program to provide coverage under this part to any uninsured parent or responsible adult who is eligible pursuant to subdivision (a), pursuant to the waiver identified in paragraph (2).
(2) The program shall be implemented only in accordance with a State Child Health Insurance Program waiver pursuant to Section 1397gg(e)(2)(A) of Title 42 of the United States Code, to provide coverage to uninsured parents and responsible adults, and shall be subject to the terms, conditions, and duration of the waiver. The services shall be provided under the program only if the waiver is approved by the federal Centers for Medicare and Medicaid Services, and, except as provided under the terms and conditions of the waiver, only to the extent that federal financial participation is available and funds are appropriated specifically for this purpose.

SEC. 16.

 Section 12693.76 of the Insurance Code is amended to read:

12693.76.
 (a) Notwithstanding any other provision of law, a child who meets the definition of the term defined in subsection (b) or (c) of  is a qualified alien as defined in  Section 1641 of Title 8 of the United States Code Annotated  shall not be determined ineligible solely on the basis of the child’s  his or her  date of entry into the United States.
(b) Notwithstanding any other provision of law, subdivision (a) may only be implemented to the extent provided in the annual Budget Act.  
(c) Notwithstanding any other provision of law, any uninsured parent or responsible adult who meets the definition of the term defined in subsection (b) or (c) of  is a qualified alien, as defined in  Section 1641 of Title 8 of the United States Code Code,  shall not be determined to be ineligible solely on the basis of that person’s  his or her  date of entry into the United States.
(d) Notwithstanding any other provision of law, subdivision (c) may only be implemented to the extent of funding provided in the annual Budget Act.

SEC. 16.5.

 Section 12693.98 of the Insurance Code is amended to read:

12693.98.
 (a) (1) The Medi-Cal-to-Healthy Families Bridge Benefits Program is hereby established to provide any child who meets the criteria set forth in subdivision (b) with a one two  calendar-month period of health care benefits in order to provide the child with an opportunity to apply for the Healthy Families Program established under Chapter 16 (commencing with Section 12693).
(2) The Medi-Cal-to-Healthy Families Bridge Benefits Program shall be administered by the board and the State Department of Health Care Services. board. 
(b) (1) Any child who meets all of the following requirements shall be eligible for one two  calendar month months  of Healthy Families benefits funded by Title XXI of the Social Security Act, known as the State Children’s Health Insurance Program:
(A) He or she has been receiving, but is no longer eligible for, full-scope Medi-Cal benefits without a share of cost.
(B) He or she is eligible for full-scope Medi-Cal benefits with a share of cost.
(C) He or she is under 19 years of age at the time he or she is no longer eligible for full-scope Medi-Cal benefits without a share of cost.
(D) He or she has family income at or below 200 percent of the federal poverty level.
(E) He or she is not otherwise excluded under the definition of “targeted targeted  low-income child” child  under subsections (b)(1)(B)(ii), (b)(1)(C), and (b)(2) of Section 2110 of the Social Security Act (42 U.S.C. Secs. 1397jj(b)(1)(B)(ii), 1397jj(b)(1)(C), and 1397jj(b)(2)).
(2) The one two  calendar month months  of benefits under this chapter shall begin on the first day of the month following the last day of the receipt of benefits without a share of cost.
(c) The income methodology for determining a child’s family income, as required by paragraph (1) of subdivision (b) shall be the same methodology used in determining a child’s eligibility for the full scope of Medi-Cal benefits.
(d) The one calendar-month  two calendar month  period of Healthy Families benefits provided under this chapter shall be identical to the scope of benefits that the child was receiving under the Medi-Cal program without a share of cost.
(e) The one calendar-month  two calendar month  period of Healthy Families benefits provided under this chapter shall only be made available through a Medi-Cal provider or under a Medi-Cal managed care arrangement or contract.
(f) Except as provided in subdivision (j), nothing in  Nothing in  this section shall be construed to provide Healthy Families benefits for more than a one two  calendar-month period under any circumstances, including the failure to apply for benefits under the Healthy Families Program or the failure to be made aware of the availability of the Healthy Families Program, unless the circumstances described in subdivision (b) reoccur.
(g) (1) This section shall become operative on the first day of the second month following the effective date of this section, subject to paragraph (2).
(2) Under no circumstances shall this section become operative until, and shall be implemented only to the extent that, all necessary federal approvals, including approval of any amendments to the State Child Health Plan have been sought and obtained and federal financial participation under the federal State Children’s Health Insurance Program, as set forth in Title XXI of the Social Security Act, has been approved.
(h) This section shall become inoperative if an unappealable court decision or judgment determines that any of the following apply:
(1) The provisions of this section are unconstitutional under the United States Constitution or the California Constitution.
(2) The provisions of this section do not comply with the State Children’s Health Insurance Program, as set forth in Title XXI of the Social Security Act.
(3) The provisions of this section require that the health care benefits provided pursuant to this section are required to be furnished for more than two two-  calendar months. -months. 
(i) If the State Child Health Insurance Program waiver described in Section 12693.755 is approved, and at the time the waiver is implemented, the benefits described in this section shall also be available to persons who meet the eligibility requirements of the program and are parents of, or, as defined by the board, adults responsible for, children enrolled to receive coverage under this part or enrolled to receive full-scope  full scope  Medi-Cal services with no share of cost.
(j) The one month of benefits provided in this section shall be increased to two months commencing on implementation of the waiver referred to in Section 12693.755.
(k) This section shall cease to be implemented on the date that the Director of Health Care Services executes a declaration stating that implementation of the Healthy Families Presumptive Eligibility Program established pursuant to Section 12693.98a has commenced, and as of that date is repealed.

SEC. 16.7.

 Section 12693.981 is added to the Insurance Code, to read:

12693.981.
 (a) (1) The Healthy Families-to-Medi-Cal Bridge Benefits Program is hereby established to provide any person enrolled for coverage under this part who meets the criteria set forth in subdivision (b) with a two calendar-month period of health care benefits in order to provide the person with an opportunity to apply for Medi-Cal.
(2) The Healthy Families-to-Medi-Cal Bridge Benefits Program shall be administered by the board.
(b) (1) Any person who meets all of the following requirements shall be eligible for two additional calendar months of Healthy Families benefits:
(A) He or she has been receiving, but is no longer eligible for, benefits under the program.
(B) He or she appears to be income eligible for full-scope Medi-Cal benefits without a share of cost.
(2) The two additional calendar months of benefits under this chapter shall begin on the first day of the month following the last day of the person’s eligibility for benefits under the program.
(c) The two-calendar-month period of Healthy Families benefits provided under this chapter shall be identical to the scope of benefits that the child was receiving under the program.
(d) Nothing in this section shall be construed to provide Healthy Families benefits for more than a two calendar-month period under any circumstances, including the failure to apply for benefits under the Medi-Cal program or the failure to be made aware of the availability of the Medi-Cal program unless the circumstances described in subdivision (b) reoccur.
(e) This section shall be implemented only if the State Child Health Insurance Program waiver described in Section 12693.755 is approved, and at the time the waiver is implemented.
(f) This section shall become inoperative if an unappealable court decision or judgment determines that any of the following apply:
(1) The provisions of this section are unconstitutional under the United States Constitution or the California Constitution.
(2) The provisions of this section do not comply with the State Children’s Health Insurance Program, as set forth in Title XXI of the federal Social Security Act.
(3) The provisions of this section require that the health care benefits provided pursuant to this section are required to be furnished for more than two calendar months.

SEC. 17.

 Section 12693.982 is added to the Insurance Code, to read:

12693.982.
 For purposes of this chapter, “Medi-Cal” means the state health care program established pursuant to Chapter 14 (commencing with Section 14000) of Part 3 of Division 9 of the Welfare and Institutions Code.

SEC. 18.

 Section 4094.2 of the Welfare and Institutions Code is amended to read:

4094.2.
 (a) For the purpose of establishing payment rates for community treatment facility programs, the private nonprofit agencies selected to operate these programs shall prepare a budget that covers the total costs of providing residential care and supervision and mental health services for their proposed programs. These costs shall include categories that are allowable under California’s Foster Care program and existing programs for mental health services. They shall not include educational, nonmental health medical, medical  and dental costs.
(b) Each agency operating a community treatment facility program shall negotiate a final budget with the local mental health department in the county in which its facility is located (the host county) and other local agencies, agencies  as appropriate. This budget agreement shall specify the types and level of care and services to be provided by the community treatment facility program and a payment rate that fully covers the costs included in the negotiated budget. All counties that place children in a community treatment facility program shall make payments using the budget agreement negotiated by the community treatment facility provider and the host county.
(c) A foster care rate shall be established for each community treatment facility program by the State Department of Social Services.
(1) (c)  (A) A   foster care rate shall be established for each community treatment facility program by the State Department of Social Services.  These rates shall be established using the existing foster care rate for a short-term residential therapeutic program, as defined in subdivision (ad) of Section 11400,  ratesetting system for group homes,  with modifications designed as necessary. It is anticipated that all community treatment facility programs will offer the level of care and services required to receive the highest foster care rate provided for under the current group home  ratesetting system.
(B) Beginning July 1, 2027, or the date specified in paragraph (9) of subdivision (h) of Section 11461, in accordance with the schedules provided in paragraph (4) of subdivision (h) of Section 11461 and Sections 16562 and 16565, whichever is later, the rate paid on behalf of a child or nonminor dependent placed in a community treatment facility shall be equivalent to the Tiered Rate Structure described in paragraphs (1) to (3), inclusive, of subdivision (e) of Section 11462.
(2) Except as otherwise provided in paragraph (3), commencing January 1, 2017, the program shall have accreditation from a nationally recognized accrediting entity identified by the State Department of Social Services pursuant to the process described in paragraph (4) of subdivision (b) of Section 11462.
(3) Any community treatment facility shall be reclassified and paid at the appropriate program rate for which it is qualified if it fails to timely obtain or maintain accreditation as required by state law or fails to provide proof of that accreditation to the State Department of Social Services upon request.
(d) For the 2001–02 fiscal year, the 2002–03 fiscal year, the 2003–04 fiscal year, and the 2004–05 fiscal year,  community treatment facility programs shall also be paid a community treatment facility supplemental rate of up to two thousand five hundred dollars ($2,500) per child per month on behalf of children eligible under the foster care program and children placed out of home pursuant to an individualized education program developed under former  Section 7572.5 of the Government Code. Subject to the availability of funds, the supplemental rate shall be shared by the state and the counties. Counties shall be responsible for paying a county share of cost equal to 60 percent of the community treatment rate for children placed by counties in community treatment facilities and the state shall be responsible for 40 percent of the community treatment facility supplemental rate. The community treatment facility supplemental rate is intended to supplement, and not to supplant, the payments for which children placed in community treatment facilities are eligible to receive under the foster care program and the existing programs for mental health services.
(e) For initial ratesetting purposes for community treatment facility funding, the cost of mental health services shall be determined by deducting the foster care rate and the community treatment facility supplemental rate from the total allowable cost of the community treatment facility program. Payments to certified providers for mental health services shall be based on eligible services provided to children who are Medi-Cal beneficiaries, up to the approved federal rate statewide maximum allowances  for these services.
(f) Although there is statutory authorization for up to 400 community treatment facility beds statewide, it is anticipated that there will be a phased-in implementation of community treatment facilities, and that the average monthly community treatment facility caseload during the 2001–02 fiscal year will be approximately 100.
(f) (g)  The State Department of Health Care Services  department  shall provide the community treatment facility supplemental rates to the counties for advanced payment to the community treatment facility providers in the same manner as the regular foster care payment and within the same required payment time limits.
(g) (h)  In order to facilitate the a  study of the costs of community treatment facilities, licensed community treatment facilities shall provide all documents regarding facility operations, treatment, and placements requested by the department.
(h) (i)  It is the intent of the Legislature that the State Department of Health Care Services  department  and the State Department of Social Services work to maximize federal financial participation in funding for children placed in community treatment facilities through funds available pursuant to Titles IV-E and XIX of the federal Social Security Act (42  (Title 42  U.S.C. Sec. 670 et seq. and following  and Sec. 1396 et seq.) and following)  and other appropriate federal programs.
(i) (j)  The State Department of Health Care Services  department  and the State Department of Social Services may adopt emergency regulations necessary to implement joint protocols for the oversight of community treatment facilities, to modify existing licensing regulations governing reporting requirements and other procedural and administrative mandates to take into account the seriousness and frequency of behaviors that are likely to be exhibited by the  seriously emotionally disturbed children placed in community treatment facility programs, to modify the existing foster care ratesetting regulations, and to pay the community treatment facility supplemental rate. The adoption of these regulations shall be deemed to be an emergency and necessary for the immediate preservation of the public peace, health and safety, and general welfare. The regulations shall become effective immediately upon filing with the Secretary of State. The regulations shall not remain in effect more than 180 days unless the adopting agency complies with all the provisions of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, as required by subdivision (e) of Section 11346.1 of the Government Code.
(j) Notwithstanding the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), the State Department of Social Services may implement, interpret, or make specific changes made to this section by the act that added this subdivision through and by means of all-county letters or similar written directives, which shall be exempt from submission to or review by the Office of Administrative Law. These all-county letters or similar written directives shall have the same force and effect as regulations until the adoption of regulations no later than January 1, 2030.

SEC. 19.

 Section 4107 of the Welfare and Institutions Code is amended to read:

4107.
 (a) The security of patients committed pursuant to Section 1026 of, and Chapter 6 (commencing with Section 1367) of Title 10 of Part 2 of, the Penal Code, and former Sections 6316 and 6321,  6321 of the Welfare and Institutions Code,  at Patton State Hospital shall be the responsibility of the Secretary Director  of the Department of Corrections and Rehabilitation. Corrections. 
(b) The Department of Corrections and Rehabilitation and  the State Department of Mental Health shall jointly develop a plan to transfer all patients committed to Patton State Hospital pursuant to the provisions in subdivision (a) from Patton State Hospital no later than January 1, 1986, and shall transmit this plan to the Senate Committee on Judiciary and to the Assembly Committee on Criminal Justice, and to the Senate Health and Welfare Committee and Assembly Health Committee by June 30, 1983. The plan shall address whether the transferred patients shall be moved to other state hospitals or to correctional facilities, or both, for commitment and treatment.
(c) Notwithstanding any other provision of  law, the State Department of State Hospitals Mental Health  shall house no more than 1,336 patients at Patton State Hospital. However, until September 2030, up to 1,530 one year after the activation of the Coalinga Secure Treatment Facility, up to 1,670  patients may be housed at the hospital.
(d) The Department of Corrections and the State Department of Mental Health shall jointly develop a plan for ensuring the external and internal security of the hospital during the construction of additional beds at Patton State Hospital and the establishment of related modular program space for which funding is provided in the Budget Act of 2001. No funds shall be expended for the expansion project until 30 days after the date upon which the plan is submitted to the fiscal committees of the Legislature and the Chair of the Joint Legislative Budget Committee.
(e) The Department of Corrections and the State Department of Mental Health shall also jointly develop a plan for ensuring the external and internal security of the hospital upon the occupation of the additional beds at Patton State Hospital. These beds shall not be occupied by patients until the later of the date that is 30 days after the date upon which the plan is submitted to the Chair of the Joint Legislative Budget Committee or the date upon which it is implemented by the departments.
(d) (f)  This section shall remain in effect only until all patients committed, pursuant to the provisions enumerated in subdivision (a), have been removed from Patton State Hospital and shall have no force or effect on or after that date.

SEC. 20.

 Section 4136 of the Welfare and Institutions Code is amended to read:

4136.
 (a)  Each patient in a state hospital for the mentally disordered  who has resided in the state hospital for a period of at least 30 days shall be paid an amount of aid for his or her personal and incidental needs that, when added to his or her income, equals twelve dollars and fifty cents ($12.50) per month. If a patient elects to do so, a patient may save all or any portion of his or her monthly amount of aid provided for personal and incidental needs for expenditure in subsequent months.
(b) Each indigent patient in a state hospital shall be allotted sufficient materials for one letter each week, including postage in an amount not to exceed the cost of one stamp for first-class mail for a one-ounce letter, at no cost to the patient.
(c) Each newly admitted patient, for the first 30 days after his or her initial admission, shall be allotted sufficient materials for two letters each week, including postage for first-class mail for up to two one-ounce letters per week. The hospital administrator shall ensure that additional writing materials and postage are available for purchase by patients at the store or canteen on hospital grounds.
(d) For purposes of this section, “indigent patient” means a patient whose income is no more than twelve dollars and fifty cents ($12.50) per month.

SEC. 20.5.

 Section 4356 of the Welfare and Institutions Code is amended to read:

4356.
 (a) The department shall provide support to the four original pilot sites.
(b) (1) The department shall award and administer grants to four additional sites, to be selected through a competitive bidding process. One site shall be within each of the regions listed in Section 4357.2. It is the intent of the Legislature that one site be located in a rural area. Implementation of new project sites shall be contingent upon the availability of funds, and new project sites shall be selected on an incremental basis as funds become available.
(2) Priority shall be given to applicants that have proven experience in providing services to persons with an acquired traumatic brain injury including, but not limited to, supported living services, community reintegration services, vocational support services, caregiver support, and family and community education.
Using (3)   data collected consistent with requirements  The department shall convene a working group,  established pursuant to subdivision (a) of Section 4355,  Section 4357.1, to assist them in developing requests for proposals and evaluating bids. In addition,  the department shall monitor and evaluate the performance of service providers. use this working group as an advisory committee in accordance with requirements of Part J of Subchapter II of the Public Health Service Act (42 U.S.C. Sec. 280b et seq.) in order to pursue available federal funds including, but not limited to, Section 300d-52 of Title 42 of the United States Code. 
(4) Each new site shall be in operation within six months following the grant award.
(5) The four additional sites prescribed by this subdivision shall be established to the extent that the availability of federal funds or other appropriate funds permit.
(c) (1) The department, with the advice and assistance of the working group, shall develop an independent evaluation and assist sites in collecting uniform data on all clients.
(2) The evaluation shall test the efficacy, individually and in the aggregate, of the existing and new project sites in the following areas:
(A) The degree of community reintegration achieved by clients, including their increased ability to independently carry out activities of daily living, increased participation in community life, and improved living arrangements.
(B) The improvements in clients’ prevocational and vocational abilities, educational attainment, and paid and volunteer job placements.
(C) Client and family satisfaction with services provided.
(D) Number of clients, family members, health and social service professionals, law enforcement professionals, and other persons receiving education and training designed to improve their understanding of the nature and consequences of traumatic brain injury, as well as any documented outcomes of that training and education.
(E) The extent to which participating programs result in reduced state costs for institutionalization or higher levels of care, if such an estimate can be obtained within the 10 percent of funds allowed for the evaluation.
(3) The department shall expend not more than 10 percent of the annual program amount on the evaluation. The evaluator shall be chosen by means of competitive bid and shall report to the department.
(4) The evaluator shall make a final report to the Legislature by January 1, 2005.

SEC. 20.7.

 Section 4359 of the Welfare and Institutions Code is amended to read:

4359.
 This chapter shall remain in effect until July 1, 2007, and as of that date is repealed, unless a later enacted statute enacted prior to that date extends or deletes that date.

SEC. 21.

 Section 4427.5 is added to the Welfare and Institutions Code, to read:

4427.5.
 (a) A developmental center shall immediately report all resident deaths and serious injuries of unknown origin to the appropriate law enforcement agency that may, at its discretion, conduct an independent investigation.
(b) The department shall do both of the following:
(1) Annually provide written information to every developmental center employee regarding all of the following:
(A) The statutory and departmental requirements for mandatory reporting of suspected or known abuse.
(B) The rights and protections afforded to individuals’ reporting of suspected or known abuse.
(C) The penalties for failure to report suspected or known abuse.
(D) The telephone numbers for reporting suspected or known abuse to designated investigators of the department and to local law enforcement agencies.
(2) On or before August 1, 2001, in consultation with employee organizations, advocates, consumers, and family members, develop a poster that encourages staff, residents, and visitors to report suspected or known abuse and provides information on how to make these reports.

SEC. 22.

 Section 4598.5 of the Welfare and Institutions Code is amended to read:

4598.5.
 If, in the unforeseen event that federal funds are not available for appropriation or transfer to Item 4110-001-0001 of Section 2.00 of the annual Budget Act for support of the Organization of Area Boards on Developmental Disabilities, from Item 4100-001-0890 of Section 2.00 of the annual Budget Act based on a determination by the Department of Finance, the Department of Finance shall notify the appropriate fiscal and policy committees of the Legislature and the Joint Legislative Budget Committee within 15 calendar days of this determination. This notification shall specify the dollar amount needed to fully continue operations of the Organization of Area Boards on Developmental Disabilities, and this amount is hereby appropriated from the General Fund for those purposes, commencing 10 days after the receipt of the notification by the Legislature.

SEC. 23.

 Section 4631 of the Welfare and Institutions Code is amended to read:

4631.
 (a) In order to provide to the greatest extent practicable a larger degree of uniformity and consistency in the services, funding, and administrative practices of regional centers throughout the state, the State Department of Developmental Services shall, in consultation with the regional centers, adopt regulations prescribing a uniform accounting system, a uniform budgeting and encumbrancing system, a systematic approach to administrative practices and procedures, and a uniform reporting system which shall include:
(1) Number and costs of diagnostic services provided by each regional center.
(2) Number and costs of services by service category purchased by each regional center.
(3) All other administrative costs of each regional center.
(b) The department’s contract with a regional center shall require strict accountability and reporting of all revenues and expenditures, and strict accountability and reporting as to the effectiveness of the regional center in carrying out its program and fiscal responsibilities as established herein.
(c) The Director of Developmental Services shall publish a report of the financial status of all regional centers and their operations by February 28 of each year. At a minimum, the report shall include each regional center’s budget and actual expenditures for the previous fiscal year and each center’s budget and projected expenditures for the current fiscal year.

SEC. 24.

 Section 4640.6 of the Welfare and Institutions Code is amended to read:

4640.6.
 (a) In approving regional center contracts, the department shall ensure that regional center staffing patterns demonstrate that direct service coordination are the highest priority.
(b) Contracts between the department and regional centers shall require that regional centers implement an emergency response system that ensures that a regional center staff person will respond to a consumer, or individual acting on behalf of a consumer, within two hours of the time an emergency call is placed. This emergency response system shall be operational 24 hours per day, 365 days per year.
(c) Contracts between the department and regional centers shall require regional centers to have service coordinator-to-consumer ratios, as follows:
(1) An average service coordinator-to-consumer  coordinator to consumer  ratio of 1 one  to 62 for all consumers who have not moved from the developmental centers to the community since April 14, 1993. In no case shall a service coordinator for these consumers have an assigned caseload in excess of 79 consumers for more than 60 days.
(2) An average service coordinator-to-consumer ratio of 1 one  to 45 for all consumers who have moved from a developmental center to the community since April 14, 1993. In no case shall a service coordinator for these consumers have an assigned caseload in excess of 59 consumers for more than 60 days.
(3) The following coordinator-to-consumer ratios shall apply:
(A) All consumers enrolled in the Home and Community-based Services Waiver program for persons with developmental disabilities, an average service coordinator-to-consumer ratio of 1 to 62.
(B) All consumers who have moved from a developmental center to the community since April 14, 1993, and have lived continuously in the community for at least 12 months, an average service coordinator-to-consumer ratio of 1 to 62.
(C) All consumers who have not moved from the developmental centers to the community since April 14, 1993, and who are not described in subparagraph (A), an average service coordinator-to-consumer ratio of 1 to 66.
(4) Notwithstanding paragraphs (1) to (3), inclusive, an average service coordinator-to-consumer ratio of 1 to 40 for all consumers five years of age and younger.
(5) (A) Notwithstanding paragraphs (1) to (3), inclusive, enhanced service coordination, including a service coordinator-to-consumer ratio of 1 to 40, shall be available to consumers identified as having low or no purchase-of-service expenditures, as identified in the annual Budget Act.
(B) Enhanced service coordination, including the coordinator-to-consumer ratio specified in this paragraph shall be available to specified consumers until one of the following criteria are met:
(i) The family or consumer is no longer interested in receiving enhanced service coordination.
(ii) (d)  All of the consumer’s identified service needs have been thoroughly explored and offered. For purposes of this section, “service coordinator” means a regional center employee whose primary responsibility includes preparing, implementing, and monitoring consumers’ individual program plans, securing and coordinating consumer services and supports, and providing placement and monitoring activities. 
(iii) All information and training were provided to the family and consumer and the consumer’s focused support goals were completed.
(iv) The family or consumer feels confident that they can continue to receive the assistance they need to be successful without receiving enhanced service coordination.
(C) (e)  For the purposes of this paragraph, “enhanced service coordination” may include, but is not  By December 15, 1999, the department shall make recommendations to the Legislature and the Governor regarding the core staffing formula used to allocate operations funding to regional centers. These recommendations shall include consideration of, and public comments related to, the Regional Center Core Staffing Study, and shall include, but not be  limited to, all of the following:
(i) (1)  Regular contact, via telephone or video, with consumers or their families. Salary and wage levels for positions deemed necessary to retain and maintain qualified staff. 
(ii) (2)  Maintaining no less than quarterly contact with consumers or their families. Regional center staff positions that should be mandated. 
(iii) Having annual individual program plan or individual family service plan meetings.
(6) (A) Notwithstanding paragraphs (1) to (3), inclusive, an average service coordinator-to-consumer ratio of 1 to 25 for all consumers with complex needs.
(B) The coordinator-to-consumer ratio specified in this paragraph shall not be authorized for a consumer for more than 12 months after the consumer is no longer receiving the services described in clause (i) or (ii) of subparagraph (C), after the consumer is no longer placed in a facility described in clause (iii), (iv), (v), (vi), (vii), or (viii) of subparagraph (C), or after the department has made the determination described in clause (ix) of subparagraph (C), unless an extension is granted. An extension shall be based on a new and complete comprehensive assessment of the consumer’s needs. An extension may be granted one time, and shall not exceed six months.
(C) For the purposes of this paragraph, a “consumer with complex needs” means a consumer who is any of the following:
(i) Receiving regional center-funded mobile crisis services by a department-approved vendor, or has received those services within the past six months.
(ii) Receiving state-operated crisis assessment stabilization team services, or has received those services within the past six months.
(iii) Placed in a community crisis home, as defined in Section 4698.
(iv) Placed in an acute crisis home operated by the department, pursuant to Section 4418.7.
(v) Placed in a locked psychiatric setting or has been placed in a locked psychiatric setting in the past six months.
(vi) Placed in an institution for mental disease, as described in Part 5 (commencing with Section 5900) of Division 5.
(vii) Placed out of state as a result of appropriate services being unavailable within the state, pursuant to Section 4519.
(viii) Placed in a county jail and eligible for diversion pursuant to Chapter 2.8 (commencing with Section 1001.20) of Title 6 of Part 2 of the Penal Code or found incompetent to stand trial as described in Section 1370.1 of the Penal Code.
(ix) A person the department has determined cannot be safely served in a developmental center, as described in Section 6510.5.
(7) (3)  For purposes of paragraph (3), service coordinators may have a mixed caseload of consumers  Staffing ratios necessary to meet the requirements of this chapter, including a service coordinator-to-consumer ratio necessary to appropriately meet the needs of consumers who are younger than  three years of age and younger, consumers enrolled in the Home and Community-based Services Waiver program for persons with developmental disabilities, and other consumers if the overall average caseload is weighted proportionately to ensure that overall regional center average service coordinator-to-consumer ratios as specified in paragraph (3) are met. For purposes of paragraph (3), in no case shall a service coordinator have an assigned caseload in excess of 84 for more than 60 days. their families. 
(d) (4)  For purposes of this section, “service coordinator” means a regional center employee whose primary responsibility includes preparing, implementing, and monitoring consumers’ individual program plans, securing and coordinating consumer services and supports, and providing placement and monitoring activities. Funding methodologies. 
(5) Indicate the impact to staffing ratios implemented pursuant to subdivision (c).
(e) (f)  In order to ensure that caseload ratios are maintained pursuant to this section, each regional center shall provide service coordinator caseload data to the department, annually for each fiscal  department in September and March of each fiscal year, commencing in the 1999–2000 fiscal  year. The data shall be submitted in the format, including the content,  a format  prescribed by the department. Within 30 days of receipt of data submitted pursuant to this subdivision, the department shall make a summary of the data available to the public upon request. The department shall verify the accuracy of the data when conducting regional center fiscal audits. Data submitted by regional centers pursuant to this subdivision shall:
(1) Only include data on service coordinator positions as defined in subdivision (d). Regional centers shall identify the number of positions that perform service coordinator duties on less than a full-time basis. Staffing ratios reported pursuant to this subdivision shall reflect the appropriate proportionality of these staff to consumers served.
(2) Be reported separately for service coordinators whose caseload primarily  includes any of the following:
(A) Consumers who are three years of age and older and who have not moved from the developmental center to the community since April 14, 1993.
(B) Consumers who have moved from a developmental center to the community since April 14, 1993.
(C) Consumers who are younger than three years of age.
(D) Consumers enrolled in the Home and Community-based Services Waiver program.
(3) Not include positions that are vacant for more than 60 days or new positions established within 60 days of the reporting month that are still vacant. days. 
(4) For purposes of calculating caseload ratios for consumers enrolled in the Home and Community-based Services Waiver program, vacancies shall not be included in the calculations.
(f) (g)  The department shall provide technical assistance and require a plan of correction for any regional center that, for two consecutive reporting periods, fails to maintain service coordinator caseload ratios required by this section or otherwise demonstrates an inability to maintain appropriate staffing patterns pursuant to this section. Plans of correction shall be developed following input from the state council, local  local area board, local  organizations representing consumers, family members, regional center employees, including recognized labor organizations, and service providers, and other interested parties.
(g) Each time that new funds are appropriated in the annual Budget Act to the department for allocation to regional centers with the stated purpose of reducing caseload ratios, both of the following shall occur:
(1) Each regional center shall hold at least one public meeting during that year to receive stakeholder input to help inform the way the regional center allocates new positions funded through the allocation to that regional center. Stakeholders may include the state council, local organizations representing consumers, family members, community-based organizations that represent the ethnic and language diversity of the regional center catchment area, regional center employees, including recognized labor organizations and service providers, and other interested parties. The public meeting required by this paragraph fulfills a regional center’s requirement under subdivision (f) to gather input regarding its plan of correction if the plan of correction is discussed during the meeting.
(2) On or before October 10 of the year of the appropriation of funds, and again by March 10 of that fiscal year, and in a format prescribed by the department, each regional center shall report the following information to the department:
(A) The number of new service coordinator positions created with the funds allocated to reduce caseload ratios.
(B) Data on current caseload ratios as of March 1 and October 1, respectively.
(C) Any other information determined by the department.
(3) The department shall post the information required to be reported by a regional center pursuant to paragraph (2) on its internet website.
(h) Contracts between the department and regional center shall require the regional center to have, or contract for, all of the following areas:
(1) Criminal justice expertise to assist the regional center in providing services and supports support  to consumers involved in the criminal justice system as a victim, defendant, inmate, or parolee.
(2) Special education expertise to assist the regional center in providing advocacy and support to families seeking appropriate educational services from a school district.
(3) Family support expertise to assist the regional center in maximizing the effectiveness of support and services provided to families.
(4) Housing expertise to assist the regional center in accessing affordable housing for consumers in independent or supportive living arrangements.
(5) Community integration expertise to assist consumers and families in accessing integrated services and supports and improved opportunities to participate in community life.
(6) Quality assurance expertise, to assist the regional center to provide the necessary coordination and cooperation with the state council, area board  in conducting quality-of-life assessments and coordinating coordinate  the regional center quality assurance efforts.
(7) Each regional center shall employ at least one consumer advocate who is a person with developmental disabilities.
(8) Other staffing arrangements related to the delivery of services that the department determines are necessary to ensure maximum cost-effectiveness and to ensure that the service needs of consumers and families are met.
(9) Implicit bias training, pursuant to Section 4511.1, to increase service access and equity in the developmental services system.
(10) Language access and cultural competency services and support, pursuant to Section 4620.4, to allow consistent access to information and services and to advance person-centered health and human services equity outcomes toward the diminishment of racial, ethnic, and other disparities.
(i) Any regional center proposing a staffing arrangement that substantially deviates from the requirements of this section shall request a waiver from the department. Prior to granting a waiver, the department shall require a detailed staffing proposal, including, but not limited to, how the proposed staffing arrangement will benefit consumers and families served, and shall demonstrate clear and convincing support for the proposed staffing arrangement from constituencies served and impacted, that include, but are not limited to, consumers, families, providers, advocates, and recognized labor organizations. In addition, the regional center shall submit to the department any written opposition to the proposal from organizations or individuals, including, but not limited to, consumers, families, providers, and advocates, including recognized labor organizations. The department may grant waivers to regional centers that sufficiently demonstrate that the proposed staffing arrangement is in the best interest of consumers and families served, complies with the requirements of this chapter, and does not violate any contractual requirements. A waiver shall be approved by the department for up to 12 months, at which time a regional center may submit a new request pursuant to this subdivision.
(j) From February 1, 2009, to June 30, 2010, inclusive, the following shall not apply:
(1) (j)  The service coordinator-to-consumer ratio  requirements of paragraph (1), and subparagraph (C) of paragraph (3), of subdivision (c). subdivisions (c), (g), and (i) shall not apply when a regional center is required to develop an expenditure plan pursuant to Section 4791, and when the expenditure plan addresses the specific impact of the budget reduction on staffing requirements and the expenditure plan is approved by the department. 
(2) The requirements of subdivision (e). The regional centers shall, instead, maintain sufficient service coordinator caseload data to document compliance with the service coordinator-to-consumer ratio requirements in effect pursuant to this section.
(3) The requirements of paragraphs (1) to (6), inclusive, of subdivision (h).
(k) From July 1, 2010, until June 30, 2013, the following shall not apply:
(1) The service coordinator-to-consumer ratio requirements of paragraph (1), and subparagraph (C) of paragraph (3), of subdivision (c).
(2) The requirements of paragraphs (1) to (6), inclusive, of subdivision (h).
( (k) 
l
)  (1) Any contract between the department and a regional center entered into on and after January 1, 2003, 2002,  shall require that all employment contracts entered into with regional center staff or contractors be available to the public for review, upon request. For purposes of this subdivision, an no  employment contract or portion thereof thereof,  may not  be deemed confidential nor or  unavailable for public review.
(2) Notwithstanding paragraph (1), the no  social security number of the contracting party may not  be disclosed.
(3) The term of the employment contract between the regional center and an employee or contractor shall not exceed the term of the state’s contract with the regional center.
SEC. 25.
 The Legislature finds and declares all of the following:
(a) Autism disorder is the only disability under the Lanterman Developmental Disabilities Services Act for which there is no biological marker upon which to base a diagnosis.
(b) Persons with autism disorder and other pervasive developmental disorders exhibit similar core deficits in social interaction, communication, and restricted and repetitive behaviors or interests.
(c) The only method currently available to diagnose autism disorder and other pervasive developmental disorders is observation and evaluation of behavior.
(d) Given the method by which autism disorder and other pervasive developmental disorders are currently diagnosed, the opportunity for misdiagnosis occurs when clinicians are not properly trained in the utilization of diagnostic tools, including diagnostic parental interviews and questionnaires and diagnostic observation instruments.
(e) There is consensus among the appropriate medical disciplines regarding the most effective methods of diagnosing autism disorder and other autistic spectrum disorders.
(f) All regional centers serving persons with developmental disabilities should utilize the same diagnostic tools and employ the same diagnostic methods for which clinical staff have been appropriately trained to ensure consistency and accuracy of diagnosis of autism disorder and other pervasive developmental disorders throughout California.

SEC. 26.

 Section 4643.3 is added to the Welfare and Institutions Code, to read:

4643.3.
 (a) (1) On or before April 1, 2002, the department shall develop evaluation and diagnostic procedures for the diagnosis of autism disorder and other autistic spectrum disorders.
(2) The department shall publish or arrange for the publication of the evaluation and diagnostic procedures required by paragraph (1). The published evaluation and diagnostic procedures shall be available to the public.
(b) The department shall develop a training program for regional center clinical staff in the utilization of diagnostic procedures for the diagnosis of autism disorder. The training program shall be implemented on or before July 1, 2002.

SEC. 27.

 Section 4685.5 of the Welfare and Institutions Code is amended to read:

4685.5.
 (a) Notwithstanding any other provision of law, commencing January 1, 1999, the department shall conduct a pilot project under which funds shall be allocated for local self-determination pilot programs that will enhance the ability of a consumer and his or her family to control the decisions and resources required to meet all or some of the objectives in his or her individual program plan.
(b) Local self-determination pilot programs funded pursuant to this section may include, but not be limited to, all of the following:
(1) Programs that provide for consumer and family control over which services best meet their needs and the objectives in the individual program plan.
(2) Programs that provide allowances or subsidies to consumers and their families.
(3) Programs providing for the use of debit cards.
(4) Programs that provide for the utilization of parent vendors, direct pay options, individual budgets for the procurement of services and supports, alternative case management, and vouchers.
(5) Wraparound programs.
(c) The department shall allocate funds for pilot programs in three regional center catchment areas and shall, to the extent possible, test a variety of mechanisms outlined in subdivision (b).
(d) Funds allocated to implement this section may be used for administrative and evaluation costs. Purchase-of-services costs shall be based on the estimated annual service costs associated with each participating consumer and family. Each proposal shall include a budget outlining administrative, service, and evaluation components.
(e) Pilot projects shall be conducted in the following regional center catchment areas:
(1) Tri-Counties Regional Center.
(2) Eastern Los Angeles Regional Center.
(3) Redwood Coast Regional Center.
(f) If any of the regional centers specified in subdivision (e) do not submit a proposal meeting the requirements set forth in this section or by the department, the department may select another regional center to conduct a pilot project.
(g) The department shall develop and issue a request for proposals soliciting regional center participation in the pilot program. Consumers, families, regional centers, advocates, and service providers shall be consulted during the development of the request for proposal and selection of the pilot areas.
(h) Each area receiving funding under this section shall demonstrate joint regional center and area board support for the local self-determination pilot program, and shall establish a local advisory committee, appointed jointly by the regional center and area board, made up of consumers, family members, advocates, and community leaders and that shall reflect the multicultural diversity and geographic profile of the catchment area. The local advisory committee shall review the development and ongoing progress of the local self-determination pilot program and may make ongoing recommendations for improvement to the regional center. By September 1, 2000, the local advisory committee shall submit to the department recommendations for the continuation and expansion of the program.
(i) The department shall issue a report to the Legislature no later than January 1, 2001, on the status of each pilot program funded by this section and recommendations with respect to continuation and expansion.
(j) Notwithstanding any other provision of law, as of January 1, 1999, of the balances available pursuant to Item 4300-490 of the Budget Act of 1998 for regional centers, the first seven hundred fifty thousand dollars ($750,000) is reappropriated for the purposes of implementing this section, and shall be available for expenditure until January 1, 2002.
(k) This section shall remain in effect only until January 1, 2004, and as of that date is repealed, unless a later enacted statute, that becomes effective on or before January 1, 2004, extends or deletes that date.

SEC. 28.

 Section 4731 of the Welfare and Institutions Code is amended to read:

4731.
 (a) Each consumer or any representative acting on behalf of any consumer or consumers, who believes that any right to which a consumer is entitled has been abused, punitively withheld, or improperly or unreasonably denied by a regional center, state-operated facility, developmental center,  or service provider, may pursue a complaint as provided in this section.
(b) Initial referral of any complaint taken pursuant to this section shall be to the director of the regional center from which the consumer receives case management services. If the consumer resides in a state-operated facility,  state developmental center,  the complaint shall be made to the director of the state-operated facility.  that state developmental center.  The director shall, within 20 working days of receiving a complaint, investigate the complaint and send a written proposed resolution to the complainant and, if applicable, to the service provider. The written proposed resolution shall include a telephone number and mailing address for referring the proposed resolution in accordance with subdivision (c).
(c) If the complainant is not satisfied with the proposed resolution, the complainant may refer the complaint, in writing, to the Director of Developmental Services within 15 working days of receipt of the proposed resolution. The director shall, within 45 days of receiving a complaint, issue a written administrative decision and send a copy of the decision to the complainant, the director of the regional center or state-operated facility,  state developmental center,  and the service provider, if applicable. If there is no referral to the department, the proposed resolution shall become effective on the 20th working day following receipt by the complainant.
(d) The department shall annually compile the number of complaints filed, by each regional center and state-operated facility,  state developmental center catchment area,  the subject matter of each complaint, and a summary of each decision. Copies shall be made available to any person upon request.
(e) This section shall not be used to resolve disputes concerning the nature, scope, or amount of services and supports that should be included in an individual program plan, for which there is an appeals appeal  procedure established in this division, or disputes regarding rates or audit appeals for which there is an appeals appeal  procedure established in regulations. Those disputes shall be resolved through the appeals procedure established by this division or in regulations.
(f) All consumers or, if where  appropriate, their parents, legal guardian, conservator, or  authorized representative, shall be notified in writing in their preferred language  a language which they comprehend,  of the right to file a complaint pursuant to this section when they apply for services from a regional center or a state-operated facility, are admitted to a developmental center,  and at each regularly scheduled planning meeting.

SEC. 29.

 Section 5675 of the Welfare and Institutions Code is amended to read:

5675.
 (a) (1) Subject  Mental health rehabilitation centers shall only be licensed by the State Department of Health Care Services subsequent to application by counties, county contract providers, or other organizations.  to Section 5768, Placer County and up to 15 other counties may establish a pilot project for up to six years, to develop a shared mental health rehabilitation center for the provision of community care and treatment for persons with mental disorders who are placed in a state hospital or another health facility because no community placements are available to meet the needs of these patients. Participation in this pilot project by the counties shall be on a voluntary basis. 
(b) (1) The department shall establish, by emergency regulation, the standards for the pilot project, and monitor the compliance of the counties with those standards. Participating counties, in consultation with the department, shall be responsible for program monitoring.
(2) In the application for a mental health rehabilitation center, program evaluation measures The department, in conjunction with the county mental health directors, shall provide an interim report to the Legislature within three years of the commencement of operation of the facilities authorized pursuant to this section regarding the progress and cost effectiveness demonstrated by the pilot project. The department, in conjunction with the county mental health directors, shall report to the Legislature within five years of the commencement of operation of the facilities authorized pursuant to this section regarding the progress and cost effectiveness demonstrated by the pilot project. The report shall evaluate whether the pilot project is effective based on clinical indicators, and is successful in preventing future placement of its clients in state hospitals or other long-term health facilities, and shall report whether the cost of care in the pilot facilities is less than the cost of care in state hospitals or in other long-term health facility options. The evaluation report  shall include, but not be limited to, an evaluation of the selected method and the effectiveness of the pilot project staffing, and an analysis of the effectiveness of the pilot project at meeting  all of the following: following objectives: 
(A) That the clients placed in the facilities show improved global assessment scores scores,  as measured by preadmission and postadmission tests.
(B) That the clients placed in the facilities demonstrate improved functional behavior as measured by preadmission and postadmission tests.
(C) That the clients placed in the facilities have reduced medication levels as determined by comparison of preadmission and postadmission records.
(b) (3)  The State Department of Health Care Services shall conduct annual licensing inspections of mental health rehabilitation centers. pilot project shall be deemed successful if it demonstrates both of the following: 
(A) The costs of the program are no greater than public expenditures for providing alternative services to the clients served by the project.
(B) That the benefit to the clients, as described in this subdivision, is improved by the project.
(c) (1) The  All regulations relating to the licensing of mental health rehabilitation centers, heretofore adopted by  project shall be subject to existing regulations of the State Department of Health Services applicable to health facilities that  the State Department of Mental Health, or its successor, shall remain in effect and shall be fully enforceable by the State Department of Health Care Services with respect to any facility or program required to be licensed as a mental health rehabilitation center, unless and until readopted, amended, or repealed by the Director of Health Care Services. Health deems necessary for fire and life safety of persons with mental illness. 
(2) The State Department of Health Care Services shall succeed to and be vested with all duties, powers, purposes, functions, responsibilities, and jurisdiction of the State Department of Mental Health, and its successor, if any, as they relate to licensing mental health rehabilitation centers.
(d) (1) The  Notwithstanding subdivision (c), pursuant to Section 5963.05, the State Department of Health Care Services may develop and revise documentation standards for individual service plans to be consistent with the standards developed pursuant to paragraph (3) of subdivision (h) of Section 14184.402.  department shall consider projects proposed by other counties under Section 5768. 
(e) (1) Clients served by the project shall have all of the protections and rights guaranteed to mental health patients pursuant to the following provisions of law:
(A) Part 1 (commencing with Section 5000) and this part.
(B) Article 5 (commencing with Section 835), Article 5.5 (commencing with Section 850), and Article 6 (commencing with Section 860) of Chapter 4 of Title 9 of the California Code of Regulations.
(2) The department shall require mental health rehabilitation centers to implement these documentation standards and shall conduct annual licensing inspections and investigations to determine compliance with these standards. Clients shall have access to the services of a county patients’ rights advocates as provided in Chapter 6.2 (commencing with Section 5500) of Part 1. 

SEC. 29.3.

 Section 5839 of the Welfare and Institutions Code is amended to read:

5839.
 This part shall become inoperative on July 1 2004, and as of January 1, 2005, is repealed, unless a later enacted statute, that is enacted before January 1, 2005, deletes or extends the dates on which it becomes inoperative and is repealed.

SEC. 29.5.

 Section 6600.05 of the Welfare and Institutions Code is amended to read:

6600.05.
 (a)  Coalinga  Until a permanent housing and treatment facility is available, Atascadero  State Hospital shall be used whenever a person is committed to a secure facility for mental health treatment pursuant to this article and is placed in a state hospital under the direction of the State Department of State Hospitals Mental Health  unless there are unique circumstances that would preclude the placement of a person at that facility. If a state hospital is not used, the facility to be used shall be located on a site or sites determined by the Secretary of the Department of  Director of  Corrections and Rehabilitation and  the Director of State Hospitals. Mental Health.  In no case shall a person committed to a secure facility for mental health treatment pursuant to this article be placed at Metropolitan State Hospital or Napa State Hospital.
(b) A permanent facility for the housing and treatment of persons committed pursuant to this article shall be located on a site or sites determined by the Director of Corrections and the Director of Mental Health, with approval by the Legislature through a trailer bill or other legislation.  The State Department of State Hospitals Mental Health  shall be responsible for operation of the facility, including the provision of treatment.

SEC. 30.

 Section 14005.7 of the Welfare and Institutions Code is amended to read:

14005.7.
 (a) Medically needy persons and medically needy family persons are entitled to health care services under Section 14005 providing all eligibility criteria established pursuant to this chapter are met.
(b) Except as otherwise provided in this chapter or in Title XIX of the federal Social Security Act, no medically needy family person, medically needy person or state-only Medi-Cal persons shall be entitled to receive health care services pursuant to Section 14005 during any month in which their spend down of excess income  his or her share of cost  has not been met.
(c) In the case of a medically needy person, monthly income, as determined, defined, counted, and valued, in accordance with Title XIX of the federal Social Security Act, in excess of the amount required for maintenance established pursuant to Section 14005.12, exclusive of any amounts considered exempt as income under Chapter 3 (commencing with Section 12000), less amounts paid for Medicare and other health insurance premiums shall be the spend down of excess income  share of cost  to be met under Section 14005.9.
(d) In the case of a medically needy family person or state-only Medi-Cal person, monthly income, as determined, defined, counted, and valued, in accordance with Title XIX of the federal Social Security Act, in excess of the amount required for maintenance established pursuant to Section 14005.12, exclusive of any amounts considered exempt as income under Chapter 2 (commencing with Section 11200), less amounts paid for Medicare and other health insurance premiums shall be the spend down of excess income  share of cost  to be met under Section 14005.9.
(e) In determining the income of a medically needy person residing in a licensed community care facility, income shall be determined, defined, counted, and valued, in accordance with Title XIX of the federal Social Security Act, any amount paid to the facility for residential care and support that exceeds the amount needed for maintenance shall be deemed unavailable for the purposes of this chapter.
(f) (1) For purposes of this section the following definitions apply:
(A) “SSI” means the federal Supplemental Security Income program established under Title XVI of the federal Social Security Act.
(B) “MNL” means the income standard of the Medi-Cal medically needy program defined in Section 14005.12.
(C) Board and care “personal care services” or “PCS” deduction means the income disregard that is applied to a resident in a licensed community care facility, in lieu of the board and care deduction specified in subdivision (e) of Section 14005.7, when the PCS deduction is greater than the board and care deduction.
(2) (A) For purposes of this section, the SSI recipient retention amount is the amount by which the SSI maximum payment amount to an individual residing in a licensed community care facility exceeds the maximum amount that the state allows community care facilities to charge a resident who is an SSI recipient.
(B) For purposes of this section, the personal and incidental needs deduction for an individual residing in a licensed community care facility is either of the following:
(i) If the deduction specified in subdivision (e) is applicable to the individual, the amount, not to exceed the amount by which the SSI recipient retention amount exceeds twenty dollars ($20), nor to be less than zero, by which the sum of the amount that the individual pays to their  his or her  licensed community care facility and the SSI recipient retention amount exceed the sum of the individual’s MNL, the individual’s board and care deduction, and twenty dollars ($20).
(ii) If the deduction specified in paragraph (1) is applicable to the individual, an amount, not to exceed the amount by which the SSI recipient retention amount exceeds twenty dollars ($20), nor to be less than zero, by which the sum of the amount that which  the individual pays to their  his or her  community care facility and the SSI recipient retention amount exceed the sum of the individual’s MNL, the individual’s PCS deduction and twenty dollars ($20).
(3) In determining the countable income of a medically needy individual residing in a licensed community care facility, the individual shall have deducted from their  his or her  income the amount specified in subparagraph (B) of paragraph (2).
(g) No later than one month after the effective date of subparagraph (B) of paragraph (2) of subdivision (f), the department shall submit to the federal medicaid administrator a state plan amendment seeking approval of the income deduction specified in subdivision (f), and of federal financial participation for the costs resulting from that income deduction.
(h) The deduction prescribed by paragraph (3) of subdivision (f) shall be applied no later than the first day of the fourth month after the month in which the department receives approval for the federal financial participation specified in subdivision (g). Until approval for federal financial participation is received by the department, there shall be no deduction under paragraph (3) of subdivision (f).

SEC. 31.

 Section 14005.30 of the Welfare and Institutions Code is amended to read:

14005.30.
 (a) (1)  To the extent that federal financial participation is available,  Medi-Cal benefits under this chapter shall be provided to individuals eligible for services under Section 1396u-1 of Title 42 of the United States Code with family incomes that do not exceed 109 percent of the federal poverty level. Code, including any options under Section 1396u-1(b)(2)(C) made available to and exercised by the state. 
(2) The department shall exercise its option under Section 1396u-1(b)(2)(C) of Title 42 of the United States Code to adopt less restrictive income and resource eligibility standards and methodologies to the extent necessary to allow all recipients of benefits under Chapter 2 (commencing with Section 11200) to be eligible for Medi-Cal under paragraph (1).
(3) To the extent federal financial participation is available, the department shall exercise its option under Section 1396u-1(b)(2)(C) of Title 42 of the United States Code authorizing the state to disregard all changes in income or assets of a beneficiary until the next annual redetermination under Section 14012. The department shall implement this paragraph only if, and to the extent that the State Child Health Insurance Program waiver described in Section 12693.755 of the Insurance Code extending Healthy Families Program eligibility to parents and certain other adults is approved and implemented.
(b) (1) To  Except as provided for in paragraph (3), when determining eligibility under this section, an applicant’s or beneficiary’s income and resources shall be determined, counted, and valued in accordance with the requirements of Section 1396a(e)(14)  the extent that federal financial participation is available, the department shall exercise its option under Section 1396u-1(b)(2)(C)  of Title 42 of the United States Code, as added by the ACA. Code as necessary to expand eligibility for Medi-Cal under subdivision (a) by establishing the amount of countable resources individuals or families are allowed to retain at the same amount medically needy individuals and families are allowed to retain, except that a family of one shall be allowed to retain countable resources in the amount of three thousand dollars ($3,000). 
(2) When determining eligibility under this section, an applicant’s or beneficiary’s assets shall not be considered and deprivation shall not be a requirement for eligibility.
(3) (c)  The department shall seek federal approval to use the determination of eligibility for the CalWORKs program as a determination of eligibility for Medi-Cal benefits under this section. The department’s use of the CalWORKs eligibility determination to determine eligibility for Medi-Cal benefits under this section shall be consistent, and in conformity, with the terms  To the extent federal financial participation is available, the department shall, commencing March 1, 2000, adopt an income disregard for applicants equal to the difference between the income standard under the program adopted pursuant to Section 1931(b) of the federal Social Security Act (42 U.S.C. Sec. 1396u-1) and the amount equal to 100 percent  of the federal approval. poverty level applicable to the size of the family. A recipient shall be entitled to the same disregard, but only to the extent it is more beneficial than, and is substituted for, the earned income disregard available to recipients. 
(c) (d)  For purposes of calculating income under this section during any calendar year, increases in social security benefit payments under Title II of the federal Social Security Act (42 U.S.C. Sec. 401 et seq.) and following)  arising from cost-of-living adjustments shall be disregarded commencing in the month that these social security benefit payments are increased by the cost-of-living adjustment through the month before the month in which a change in the federal poverty level requires the department to modify the income disregard pursuant to subdivision (c)  and in which new income limits for the program established by this section are adopted by the department.
(d) The MAGI-based income eligibility standard applied under this section shall conform with the maintenance of effort requirements of Sections 1396a(e)(14) and 1396a(gg) of Title 42 of the United States Code, as added by the ACA.
(e) For purposes of this section, the following definitions shall apply: Subdivision (b) shall be applied retroactively to January 1, 1998. 
(1)  “ACA” means the federal Patient Protection and Affordable Care Act (Public Law 111-148), as originally enacted and as amended by the federal Health Care and Education Reconciliation Act of 2010 (Public Law 111-152) and any subsequent amendments.
(2) “MAGI-based income” means income calculated using the financial methodologies described in Section 1396a(e)(14) of Title 42 of the United States Code, as added by the federal Patient Protection and Affordable Care Act (Public Law 111-148) and as amended by the federal Health Care and Education Reconciliation Act of 2010 (Public Law 111-152) and any subsequent amendments.
(f) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement, interpret, or make specific  shall implement, without taking regulatory action, subdivisions (a) and (b) of  this section by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions until the time any necessary regulations are adopted. The  an all county letter or similar instruction. Thereafter, the  department shall adopt regulations by July 1, 2018,  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. Commencing Beginning  six months after the effective date of this section, and notwithstanding Section 10231.5 of the Government Code, the  the  department shall provide a status report to the Legislature on a semiannual basis, in compliance with Section 9795 of the Government Code,  basis  until regulations have been adopted.
(g) This section shall be implemented only if and to the extent that federal financial participation is available and any necessary federal approvals have been obtained.

SEC. 32.

 Section 14005.40 of the Welfare and Institutions Code is amended to read:

14005.40.
 (a) To the extent federal financial participation is available, the department shall exercise its option under Section 1902(a)(10)(A)(ii)(X) of the federal Social Security Act (42 U.S.C. Sec. 1396a(a)(10)(A)(ii)(X)), 1396a(a)(10)(A)(ii)(X),  to implement a program for aged and disabled persons as described in Section 1902(m) of the federal Social Security Act (42 U.S.C. Sec. 1396a(m)(1)).
(b) To the extent federal financial participation is available, the blind shall be included within the definition of disabled for the purposes of the program established in this section.
(c) An individual shall satisfy the financial eligibility requirement of this program if all both  of the following conditions are met:
(1) Countable income, as determined in accordance with Section 1902(m) of the federal Social Security Act (42 U.S.C. Sec. 1396a(m)), does not exceed an income level standard  equal to 100 percent of the applicable federal poverty level. level, plus two hundred thirty dollars ($230) for an individual or, in the case of a couple, three hundred ten dollars ($310), provided that the income standard so determined shall not be less than the SSI/SSP payment level for a disabled individual or, in the case of a couple, the SSI/SSP payment level for a disabled couple. 
(2) (A) Until such time as the department obtains federal approval for the income disregard described in paragraph (3), countable income shall include an additional two hundred thirty dollars ($230) for an individual or, in the case of a couple, three hundred ten dollars ($310).
(B) Upon receipt of federal approval for, and implementation of, paragraph (3), this paragraph shall become inoperative. The director shall execute a declaration, which shall be retained by the director, stating that federal approval for paragraph (3) has been obtained and the date upon which paragraph (3) will be implemented. The director shall post the declaration on the department’s internet website.
(3) (A) Pursuant to Section 1902(r)(2) of the federal Social Security Act (42 U.S.C. Sec. 1396a(r)(2)), all countable income over 100 percent of the federal poverty level, up to 138 percent of the federal poverty level, shall be disregarded, after taking all other disregards, deductions, and exclusions into account for those persons eligible pursuant to this section.
(B) The department shall seek federal approval to implement this paragraph.
(4) (A) For the purposes of calculating countable income under this section, an income exemption shall be applied as necessary to adjust the SSI/SSP payment level as used in this section so that it is the same as the SSI/SSP payment level that was in place on May 1, 2009.
(B) This additional income exemption shall cease to be implemented when the SSI/SSP payment levels increase beyond those in effect on May 1, 2009.
(C) The income level determined pursuant to paragraphs (1) and (2) shall not be less than the SSI/SSP payment level the individual receives or would receive as a disabled or blind individual or, in the case of a couple, the SSI/SSP payment level the couple receives or would receive as a disabled or blind couple.
(5) (2)  Countable resources, as determined in accordance with Section 1902(m) of the federal Social Security Act (42 U.S.C. Sec. 1396a(m)), do not exceed the maximum levels established in that section.
(d) The financial eligibility requirements provided in subdivision subdivisions  (c) may be adjusted upwards to reflect the cost of living in California, contingent upon appropriation in the annual Budget Act.
(e) (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  department shall implement  this section by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions until regulations are adopted. letters or similar instructions, and without taking regulatory action. Thereafter, the department 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. 
(2) The department shall adopt regulations by July 1, 2023, 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. The department shall provide a status report to the Legislature on a semiannual basis, in compliance with Section 9795 of the Government Code, until regulations are adopted.
(f) For purposes of calculating income under this section during any calendar year, increases in social security benefit payments under Title II of the federal Social Security Act (42 U.S.C. Sec. 401 et seq.) arising from cost-of-living adjustments shall be disregarded commencing in the month that these social security benefit payments are increased by the cost-of-living adjustment through the month before the month in which a change in the federal poverty level requires the department to modify the income level standard  described in subdivision (c).
(g) (1) For purposes of this section, section  the following definitions apply:
(A) “SSI” means the federal Supplemental Security Income program established under Title XVI of the federal Social Security Act.
(B) “Income level” standard”  means the applicable income level  standard including the augmentations  specified in paragraph (1) of  subdivision (c).
(C) The board and care “personal care services” or “PCS” deduction refers to an income disregard that is applied to a resident in a licensed community care facility in lieu of the board and care deduction (equal to the amount by which the basic board and care rate exceeds the income level in subparagraph (B))  standard in subparagraph (B), of paragraph (1) of subdivision (g))  when the PCS deduction is greater than the board and care deduction.
(2) (A) For purposes of this section, the SSI recipient retention amount is the amount by which the SSI maximum payment amount to an individual residing in a licensed community care facility exceeds the maximum amount that the state allows community care facilities to charge a resident who is an SSI recipient.
(B) For the purposes of this section, the personal and incidental needs deduction for an individual residing in a licensed community care facility is either of the following:
(i) If the board and care deduction is applicable to the individual, the amount, not to exceed the amount by which the SSI recipient retention amount exceeds twenty dollars ($20), nor to be less than zero, by which the sum of the amount that which  the individual pays to the individual’s  his or her  licensed community care facility and the SSI recipient retention amount exceed the sum of the individual’s income level, standard,  the individual’s board and care deduction, and twenty dollars ($20).
(ii) If the PCS deduction specified in paragraph (1) of subdivision (g) is applicable to the individual, an amount, not to exceed the amount by which the SSI recipient retention amount exceeds twenty dollars ($20), nor to be less than zero, by which the sum of the amount that which  the individual pays to the individual’s  his or her  community care facility and the SSI recipient retention amount exceed the sum of the individual’s income level, standard,  the individual’s PCS deduction, deduction  and twenty dollars ($20).
(3) In determining the countable income under this section of an individual residing in a licensed community care facility, the individual shall have deducted from the individual’s  his or her  income the amount specified in subparagraph (B) of paragraph (2).
(h) No later than one month after the effective date of subdivision (g), the department shall submit to the federal Medicaid program  medicaid  administrator a state plan amendment seeking approval of the income deduction specified in paragraph (3) of subdivision (g), and of federal financial participation for the costs resulting from that income deduction.
(i) The deduction prescribed by paragraph (3) of subdivision (g) shall be applied no later than the first day of the fourth month after the month in which the department receives approval for the federal financial participation specified in subdivision (h). Until approval for federal financial participation is received, there shall be no deduction under paragraph (3) of subdivision (g).
(j) This section shall be implemented only if, and to the extent that, any necessary federal approvals have been obtained.
(k) Paragraph (3) of subdivision (c) shall be implemented after the director determines, and communicates that determination in writing to the Department of Finance, that systems have been programmed for implementation of paragraph (3) of subdivision (c), but no sooner than January 1, 2020.
(l) This section shall become inoperative on the later of either January 1, 2024, or the date on which the determination of the Director of Health Care Services is communicated in writing to the Department of Finance pursuant to paragraph (2) of subdivision (b) of Section 14005.62, and subject to implementation of Section 14005.62 pursuant to subdivision (d) of that section, and shall remain inoperative for time periods in which the department has obtained the necessary federal approvals to implement paragraph (2) of subdivision (b) of Section 14005.62 for the applicable population.

SEC. 32.5.

 Section 14007.45 is added to the Welfare and Institutions Code, to read:

14007.45.
 (a) To the extent federal financial participation is available, the department shall exercise the option provided in Section 1920A of the federal Social Security Act (42 U.S.C. Sec. 1396r-1a) to the extent necessary to implement a program for accelerated eligibility for children who are in the process of entering the foster care system.
(b) The department shall designate county foster care workers, public health nurses, or other staff who are involved in the children’s removal from the home as a qualified entity capable of making an eligibility determination under Section 1920A of the federal Social Security Act (42 U.S.C. Sec. 1396r-1a).
(c) The qualified entity shall have access to the Medi-Cal Eligibility Data System to determine whether the child for whom the petition of dependency was filed is eligible for Medi-Cal. If the child is not currently eligible for Medi-Cal, the qualified entity shall have the authority to enter the child’s information into the Medi-Cal Eligibility Data System to ensure timely issuance of either a Medi-Cal card or Medi-Cal Benefits Identification Card thereby ensuring immediate proof of or access to proof of Medi-Cal eligibility.
(d) The department shall seek any state plan amendments necessary to implement this section. Once federal approval of all necessary state plan amendments is received, implementation shall begin on the first day of the month that follows the full calendar month after the month federal approval is received.
(e) In the event that the state plan amendment necessary to implement this section is disapproved by the federal government, the department shall instruct counties on all available procedures for expediting eligibility applications for children described in subdivision (a) and for immediately issuing sufficient proof of eligibility to ensure that eligibility of children entering the foster care system can be immediately confirmed by providers.
(f) If the federal waiver described in Section 12693.755 of the Insurance Code for covering parents under the State Children’s Health Insurance Program is approved, and if the option under Section 1920A of the federal Social Security Act (42 U.S.C. Sec. 1396r-1a) is exercised to extend accelerated eligibility to all children as part of implementation of that waiver, and if the state plan amendment for implementation of this section is disapproved, then the department shall have discretion to determine whether and under what circumstances foster care workers who complete the application form described in subdivision (e) shall submit that form to the qualified entity for accelerated eligibility rather than to the county Medi-Cal eligibility worker.
(g) This section shall be implemented only if and to the extent that federal financial participation is available.
(h) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department shall implement, without taking any regulatory action, this section by means of all-county letters or similar instructions. Thereafter, the department 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.

SEC. 33.

 Section 14007.71 is added to the Welfare and Institutions Code, to read:

14007.71.
 (a) The department shall adopt the option made available under Section 1396a(a)(10)(A)(ii)(XVIII) of Title 42 of the United States Code, to provide medical assistance during the period in which an individual described in subdivision (c) of Section 104162 of the Health and Safety Code requires treatment for breast or cervical cancer. In addition, to assist in the delivery of timely and continuing breast cancer and cervical cancer treatment, a state benefits identification card shall be issued by the department within four working days of the date in which the individual submits application information that demonstrates to the provider, as described in subdivision (c) of Section 104162 of the Health and Safety Code, that the individual meets the federal criteria described in Section 1902a(aa) of the federal Social Security Act (Section 1396a(aa) of Title 42 of the United States Code).
(b) Notwithstanding any other provision of law, an individual who is a qualified alien as defined in Section 1641 of Title 8 of the United States Code shall not be determined ineligible for services under this section solely on the basis of the individual’s date of entry into the United States.
(c) The department shall file all necessary state plan amendments to implement the requirements of this section.
(d) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department shall implement this section, and Article 1.3 (commencing with Section 104150) and Article 1.5 (commencing with Section 104160) of Chapter 2 of Part 1 of Division 103 of the Health and Safety Code, by means of an all-county letter or similar instruction, without taking any further regulatory action. Thereafter, the department shall adopt regulations to implement this section 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.
(e) Notwithstanding any other provision of law, the department shall make eligibility determinations and redeterminations necessary for applicants and beneficiaries to obtain services pursuant to this section as provided under Title XIX of the federal Social Security Act (42 U.S.C. Sec. 1396 et seq.).
(f) Except for those individuals described in subdivision (b) and notwithstanding any other provision of law, this section shall be implemented only if, and to the extent that, the department determines that federal financial participation, as provided under Title XIX of the federal Social Security Act (42 U.S.C. Section 1396a, et seq.), is available.
(g) The department shall implement this section on January 1, 2002, if a state plan amendment adopting the option described in subdivision (a), has been approved by the federal Centers for Medicare and Medicaid Services, or at the time state plan amendment is approved, if a later date.

SEC. 34.

 Section 14011.2 is added to the Welfare and Institutions Code, to read:

14011.2.
 To the extent federal financial participation is available, the department shall take all steps necessary to comply with the terms and conditions of the State Child Health Insurance Program waiver described in Section 12693.755 of the Insurance Code extending eligibility under the Healthy Families Program to parents and certain other adults. The department shall seek any state plan amendments or other waivers under Title XIX of the Social Security Act (42 U.S.C. Sec. 1396 et seq.) necessary to implement this section.

SEC. 35.

 Section 14011.6 is added to the Welfare and Institutions Code, to read:

14011.6.
 (a) To the extent federal financial participation is available, the department shall exercise the option provided in Section 1920a of the federal Social Security Act (42 U.S.C. Sec. 1396r-1a) to implement a program for accelerated enrollment of children.
(b) The department shall designate the single point of entry, as defined in subdivision (c), as the qualified entity for determining eligibility under this section.
(c) For purposes of this section, “single point of entry” means the centralized processing entity that accepts and screens applications for benefits under the Medi-Cal Program for the purpose of forwarding them to the appropriate counties.
(d) The department shall implement this section only if, and to the extent that, federal financial participation is available.
(e) The department shall seek federal approval of any state plan amendments necessary to implement this section. When federal approval of the state plan amendment or amendments is received, the department shall commence implementation of this section on the first day of the second month following the month in which federal approval of the state plan amendment or amendments is received.
(f) Notwithstanding any other provision of law, the department shall implement this section only if, and to the extent that, the federal State Children’s Health Insurance Program waiver described in Section 12693.755 of the Insurance Code is approved by the Federal Government.
(g) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department shall, without taking any regulatory action, implement this section by means of all-county letters. Thereafter, the department 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.

SEC. 36.

 Section 14017.6 is added to the Welfare and Institutions Code, to read:

14017.6.
 For the purposes of this chapter, all references to “the Medi-Cal card,” identified in Section 14017.8, shall be deemed to also be a reference to the benefits identification card, identified in Section 14017.7.

SEC. 37.

 Section 14017.7 is added to the Welfare and Institutions Code, to read:

14017.7.
 (a) In addition to the issuance of Medi-Cal cards, pursuant to Section 14017.8, the department may issue a benefits identification card for the purpose of identifying an individual who has been determined eligible for health care benefits under this chapter or health care benefits under another health care program administered by the department, or both.
(b) In no event shall a benefits identification card be issued to an individual described in subdivision (a) unless appropriate and adequate safeguards have been implemented to ensure all of the following:
(1) If the individual has been determined eligible for health care benefits under another health care program administered by the department, that health care program pays for any and all health care benefits delivered to the individual by that health care program.
(2) State funds appropriated to or federal medicaid financial participation claimed by the Medi-Cal program shall only be used for the delivery of health care benefits authorized pursuant to this chapter.
(c) The individual described in subdivision (a) may present the benefits identification card to obtain health care benefits for which that individual has been determined eligible under this chapter, or health care benefits under another health care program administered by the department, or both.
(d) Where applicable, all laws, regulations, restrictions, conditions, and terms of participation regarding the possession, billing, and use of Medi-Cal cards shall also apply to a benefits identification card.
(e) For the purposes of this section, “benefits” includes medically necessary services, goods, supplies, or merchandise.

SEC. 38.

 Section 14053.1 of the Welfare and Institutions Code is amended to read:

14053.1.
 Notwithstanding Section 14053, ancillary outpatient services, pursuant to Section 14132, for any eligible individual who is 21 years of age or over, and has not attained 65 years of age and who is a patient in an institution for mental diseases shall be covered regardless of the availability of federal financial participation.

SEC. 39.

 Section 14087.325 of the Welfare and Institutions Code is amended to read:

14087.325.
 (a) The department shall require, as a condition of obtaining a contract with the department, that a any  local initiative, as defined in subdivision (w) (v)  of Section 53810 of Title 22 of the California Code of Regulations, offer a subcontract to an any  entity defined in Section 1396d(l)(2)(B) of Title 42 of the United States Code providing services as defined in Section 1396d(a)(2)(C) of Title 42 of the United States Code and operating in the service area covered by the local initiative’s contract with the department. These entities are also known as federally qualified health centers.
(b) Except as otherwise provided in this section, managed care subcontracts offered to a federally qualified health center or a rural health clinic, as defined in Section 1396d(l)(1) of Title 42 of the United States Code, by a local initiative, county organized health system, as defined in Section 12693.05 of the Insurance Code, commercial plan, as defined in subdivision (i) (h)  of Section 53810 of Title 22 of the California Code of Regulations, or a health plan contracting with a geographic managed care program, as defined in subdivision (g) of Section 53902 of Title 22 of the California Code of Regulations, shall be on the same terms and conditions offered to other subcontractors providing a similar scope of service. A beneficiary, subscriber, or enrollee of a program or plan who affirmatively selects, or is assigned by default to, a federally qualified health center or rural health clinic under the terms of a contract between a plan, government program, or a subcontractor of a plan or program, and a federally qualified health center or rural health clinic, shall be assigned directly to the federally qualified health center or rural health clinic, and not to an individual provider performing services on behalf of the federally qualified health center or rural health clinic. 
(c) The department shall provide incentives in the competitive application process described in paragraph (1) of subdivision (b) of Section 53800 of Title 22 of the California Code of Regulations, to encourage potential commercial plans as defined in subdivision (i) (h)  of Section 53810 of Title 22 of the California Code of Regulations to offer subcontracts to these federally qualified health centers.
(d) Reimbursement to federally qualified health centers and rural health centers for services provided pursuant to a subcontract with a local initiative, a commercial plan, geographic managed care program health plan, or a county organized health system, shall be paid in a manner that is not less than the level and amount of payment that the plan would make for the same scope of services if the services were furnished by a provider that is not a federally qualified health center or rural health clinic.
(e) (1) The department shall administer a program to ensure that total payments to federally qualified health centers and rural health clinics operating as managed care subcontractors pursuant to subdivision (d) comply with applicable federal law pursuant to Sections 1902(aa) and 1903(m)(2)(A)(ix) of the Social Security Act (42 U.S.C. U.S.C.A.  Secs. 1396a(aa) and 1396b(m)(2)(A)(ix)). Under the department’s program, federally qualified health centers and rural health clinics subcontracting with local initiatives, commercial plans, county organized health systems, and geographic managed care program health plans shall seek supplemental reimbursement from the department through a per visit fee-for-service billing system utilizing the state’s Medi-Cal fee-for-service claims processing system contractor. To carry out this per visit payment process, each federally qualified health system and rural health clinic shall submit to the department for approval a rate differential calculated to reflect the amount necessary to reimburse the federally qualified health center or rural health clinic for  the difference between the payment the center or clinic received from the managed care health plan and either the interim rate established by the department based on the center’s or clinic’s reasonable cost or the center’s or clinic’s prospective payment rate. The department shall adjust the computed rate differential as it deems necessary to minimize the difference between the center’s or clinic’s revenue from the plan and the center’s or clinic’s cost-based reimbursement or the center’s or clinic’s prospective payment rate.
(2) In addition, to the extent feasible, within six months of the end of the center’s or clinic’s fiscal year, the department shall perform an annual reconciliation to reasonable cost, and make payments to, or obtain a recovery from, the center or clinic.
(f) In calculating the capitation rates to be paid to local initiatives, commercial plans, geographic managed care program health plans, and county organized health systems, the department shall not include the additional dollar amount applicable to cost-based reimbursement that would otherwise be paid, absent cost-based reimbursement, to federally qualified health centers and rural health clinics in the Medi-Cal fee-for-service program.
(g) (1) A federally qualified health center or rural health clinic may voluntarily agree to enter into a capitated or other at-risk contract with a managed care program health plan if the clinic agrees to all of the following:
(A) Reimbursement by the health plan under the contract is payment in full for the services provided under the contract and the costs and revenues experienced by the clinic under the contract shall not be subjected to reconciliation to reasonable cost.
(B) The clinic shall not seek supplemental reimbursement from the department, as provided in paragraph (1) of subdivision (e), or seek reconciliation to reasonable cost with the department, as provided in paragraph (2) of subdivision (e).
(2) The existence of a contract specified in paragraph (1) shall not void the center’s or clinic’s right to reconciliation to reasonable cost for those services that are not part of the center’s or clinic’s capitated or other at-risk contract with a health plan.
(3) A federally qualified health center or rural health clinic that agrees to enter into a capitated or at-risk contract shall, in writing to the department, affirmatively waive its right to supplemental reimbursement as provided in paragraph (1) of subdivision (e), and reconciliation to reasonable cost as provided in paragraph (2) of subdivision (e) for services provided pursuant to the subcontract with the health plan. Nothing in this paragraph shall restrict a center or clinic that waives its right to cost-based reimbursement from reinstating that right, in writing to the department, if the capitation or at-risk contract between the center or clinic and the health plan that prompted the waiver terminates.
(g) (h)  On or before September 30, 2002, the director shall conduct a study of the actual and projected impact of the transition from a cost-based reimbursement system to a prospective payment system for federally qualified health centers and rural health clinics. In conducting the study, the director shall evaluate the extent to which the prospective payment system stimulates expansion of services, including new facilities to expand capacity of the centers, and the extent to which actual and estimated prospective payment rates of federally qualified health centers and rural health clinics for the first five years of the prospective payment system are reflective of the cost of providing services to Medi-Cal beneficiaries. Clinics may submit cost reporting information to the department to provide data for the study.
(h) (i)  The department shall approve all contracts between federally qualified health centers or rural health clinics and a any  local initiative, commercial plan, geographic managed care program health plan, or county organized health system system,  in order to ensure compliance with this section.
(i) (j)  This section shall not preclude the department from establishing pilot programs pursuant to Section 14087.329.

SEC. 40.

 Section 14089.7 of the Welfare and Institutions Code is repealed.

14089.7.
 (a)  The department may adopt emergency regulations to implement this article in accordance with the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code). The initial adoption of emergency regulations and one readoption of the initial regulations shall be deemed to be an emergency and necessary for the immediate preservation of the public peace, health and safety, or general welfare. Initial emergency regulations and the first readoption of those regulations shall be exempt from review by the Office of Administrative Law. The initial emergency regulations and the first readoption of those regulations authorized by this section shall be submitted to the Office of Administrative Law for filing with the Secretary of State and publication in the California Code of Regulations and each shall remain in effect for no more than 180 days.
(b)  All regulations adopted pursuant to this section prior to the repeal and addition of this section by the act adding this section shall remain in full force and effect unless they are repealed or amended by the department in accordance with the Administrative Procedure Act.

SEC. 41.

 Section 14089.7 is added to the Welfare and Institutions Code, to read:

14089.7.
 (a) The department may adopt emergency regulations to implement this article in accordance with the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code). The initial adoption of emergency regulations and one readoption of the initial regulations shall be deemed to be an emergency and necessary for the immediate preservation of the public peace, health and safety, or general welfare. Initial emergency regulations and the first readoption of those regulations shall be exempt from review by the Office of Administrative Law. The initial emergency regulations and the first readoption of those regulations authorized by this section shall be submitted to the Office of Administrative Law for filing with the Secretary of State and publication in the California Code of Regulations and each shall remain in effect for no more than 180 days.
(b) All regulations adopted pursuant to this section prior to the repeal and addition of this section by the act adding this section shall remain in full force and effect unless they are repealed or amended by the department in accordance with the Administrative Procedure Act.

SEC. 41.5.

 Section 14105.27 is added to the Welfare and Institutions Code, to read:

14105.27.
 (a) Each eligible facility, as described in subdivision (b) may, in addition to the rate of payment that the facility would otherwise receive for skilled nursing services, receive supplemental Medi-Cal reimbursement to the extent provided in this section.
(b) A facility shall be eligible for supplemental reimbursement only if the facility has all of the following characteristics continuously during the department’s rate year beginning August 1, 2001, and subsequent rate years:
(1) Provides services to Medi-Cal beneficiaries.
(2) Is a distinct part of an acute care hospital providing skilled nursing services. For purposes of this section, “acute care hospital” means the facilities described by subdivision (a) or (b), or both, of Section 1250 of the Health and Safety Code.
(3) Is owned or operated by a county, city, city and county, or health care district organized pursuant to Chapter 1 (commencing with Section 32000) of Division 23 of the Health and Safety Code.
(c) An eligible facility’s supplemental reimbursement pursuant to this section shall be calculated and paid as follows:
(1) The supplemental reimbursement to an eligible facility, as described in paragraph (4), shall be equal to the amount of federal financial participation received as a result of the claims submitted pursuant to paragraph (2) of subdivision (g).
(2) In no instance shall the amount certified pursuant to paragraph (1) of subdivision (e), when combined with the amount received from all other sources of reimbursement from the Medi-Cal program, exceed 100 percent of projected costs, as determined pursuant to the Medi-Cal State Plan, for distinct part skilled nursing services at each facility.
(3) Costs associated with the provision of subacute services pursuant to Section 14132.25 shall not be certified for supplemental reimbursement pursuant to this section.
(4) The supplemental Medi-Cal reimbursement provided by this section shall be distributed under a payment methodology based on skilled nursing services provided to Medi-Cal patients at the eligible facility, either on a per diem basis, a per discharge basis, or any other federally permissible basis. The department shall seek approval from the federal Centers for Medicare and Medicaid Services for the payment methodology to be utilized, and shall not make any payment pursuant to this section prior to obtaining that approval.
(d) (1) It is the Legislature’s intent in enacting this section to provide the supplemental reimbursement described in this section without any expenditure from the General Fund.
(2) The state share of the supplemental reimbursement submitted to the federal Centers for Medicare and Medicaid Services for purposes of claiming federal financial participation shall be paid only with funds from the governmental entities described in paragraph (3) of subdivision (b) and certified to the state as provided in subdivision (e).
(e) The particular governmental entity, described in paragraph (3) of subdivision (b), on behalf of any eligible facility shall do all of the following:
(1) Certify, in conformity with the requirements of Section 433.51 of Title 42 of the Code of Federal Regulations, that the claimed expenditures for distinct part nursing facility services are eligible for federal financial participation.
(2) Provide evidence supporting the certification as specified by the department.
(3) Submit data as specified by the department to determine the appropriate amounts to claim as expenditures qualifying for federal financial participation.
(4) Keep, maintain, and have readily retrievable, any records specified by the department to fully disclose reimbursement amounts to which the eligible facility is entitled, and any other records required by the federal Centers for Medicare and Medicaid Services.
(f) The department may require that any governmental entity, described in paragraph (3) of subdivision (b), seeking supplemental reimbursement under this section enter into an interagency agreement with the department for the purpose of implementing this section.
(g) (1) The department shall promptly seek any necessary federal approvals, including a federal medicaid waiver, for the implementation of this section. If necessary to obtain federal approval, the department may limit the program to those costs that are allowable expenditures under Title XIX of the federal Social Security Act (Subchapter 19 (commencing with Section 1396) of Chapter 7 of Title 42 of the United States Code). If federal approval is not obtained for implementation of this section, this section shall become inoperative.
(2) The department shall submit claims for federal financial participation for the expenditures for the services described in subdivision (e) that are allowable expenditures under federal law.
(3) The department shall, on an annual basis, submit any necessary materials to the federal government to provide assurances that claims for federal financial participation will include only those expenditures that are allowable under federal law.
(h) In the event there is a final judicial determination by any court of appellate jurisdiction or a final determination by the administrator of the federal Centers for Medicare and Medicaid Services that the supplemental reimbursement provided in this section must be made to any facility not described in this section, this section shall become immediately inoperative.
(i) All funds expended pursuant to this section are subject to review and audit by the department.

SEC. 42.

 Section 14105.8 of the Welfare and Institutions Code is repealed.

14105.8.
 (a) The department may enter into contracts with manufacturers of enteral nutrition products that can be used as a therapeutic regimen to prevent serious disability or death in patients with medically diagnosed conditions that preclude the full use of regular food, on a bid or nonbid basis. The department shall maintain a list of those products for which contracts have been executed. For those contracts that generate rebates, those rebates shall be managed through the department’s drug rebate accounting system.
(b) (1) To ensure that the health needs of Medi-Cal beneficiaries are met, the department shall, when evaluating a decision to execute a contract, and when evaluating enteral nutrition products for retention on, addition to, or deletion from, the list of enteral nutrition products, consider all of the following criteria:
(A) The safety of the product.
(B) The effectiveness of the product.
(C) The essential need for the product.
(D) The potential for misuse of the product.
(E) The immediate or long-term cost effectiveness of the product.
(2) The deficiency of a product when measured by one of the criteria specified in paragraph (1) may be sufficient to support a decision that the product should be deleted from, should not be added to, or should not be retained on, the list of medical supplies. However, the superiority of a product under one criterion may be sufficient to warrant the addition or retention of the product, notwithstanding a deficiency in another criterion.
(c) In order that Medi-Cal beneficiaries may have access to a comprehensive range of enteral nutrition products pursuant to subdivision (a), the department shall ensure that there is representation on the list of both general use and specialized use enteral nutrition products. The department deems all products designed to meet the normal needs of infants, and all products that are an incomplete source of nutrition, including modular products, and all products intended for use in weight loss, are not benefits of the Medi-Cal program. The department may deem an incomplete product a benefit for patients with diagnoses, including, but not limited to, malabsorption and inborn errors of metabolism, when the product either appropriately lacks only an offending nutrient, or has been shown to not be investigational nor experimental when used as part of a therapeutic regimen to prevent serious disability or death, or when both conditions apply.
(d) In order to achieve maximum cost savings, the Legislature declares that an expedited process for contracts under this section is necessary. Therefore, contracts entered into on a nonbid basis shall be exempt from Chapter 2 (commencing with Section 10290) of Part 2 of Division 2 of the Public Contract Code.
(e) Deletions made to the list of enteral nutrition products shall become effective no sooner than 30 days after publication of the changes in provider bulletins.
(f) Changes made to the list of enteral nutrition products under this or any other section are exempt from the requirements of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340), Chapter 4 (commencing with Section 11370), and Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code), and shall not be subject to the review and approval of the Office of Administrative Law.
(g) The department may provide beneficiaries continuing care for products deleted from the list of enteral nutrition products. The department shall assess the need for continuing care based on the criteria in subdivision (b) and the potential impact on beneficiary access to appropriate therapy. To be eligible for continuing care status under this subdivision, a beneficiary must be taking the enteral nutrition product when the product is deleted. Additionally, the department shall have received a claim for the enteral nutrition product with a date of service that is within 100 days prior to the date the product was deleted. A beneficiary shall remain eligible for continuing care status provided that a claim is submitted for the enteral nutrition product in question at least every 100 days and the date of service of the claim is within 100 days of the date of service of the last claim submitted for the same enteral nutrition product.
(h) The department shall provide individual notice to Medi-Cal beneficiaries at least 60 calendar days prior to the effective date of the deletion of any enteral nutrition product from the list of enteral nutrition products. The notice shall include a description of the beneficiary’s right to a fair hearing and shall encourage the beneficiary to consult a physician to determine if an appropriate substitute enteral nutrition product is available from Medi-Cal.
(i) Enteral nutrition products authorized pursuant to subdivision (a) shall be available only through prior authorization. The department may designate those enteral nutrition products that are without a contract as not being a benefit of the Medi-Cal program, except in the case of continuing care as described in subdivision (h) of this section.
(j) Contracts executed pursuant to this section shall be confidential and shall be exempt from disclosure under the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code).
(k) (1) Manufacturers shall calculate and pay interest on late or unpaid rebates.
(2) Interest pursuant to paragraph (1) shall begin accruing 38 calendar days from the date of mailing of the quarterly invoice, including supporting utilization data sent to the manufacturer. Interest shall continue to accrue until the date of mailing of the manufacturer’s payment.
(3) Interest rates and calculations pursuant to paragraph (1) shall be identical and shall be equal to the drug rebate interest rates as determined by the federal Centers for Medicare and Medicaid Services’ Medicaid Drug Rebate Program Releases or regulations.
(4) If the date of mailing of a state rebate payment is 69 days or more from the date of mailing of the invoice, including supporting utilization data sent to the manufacturer, the interest rate shall be as specified in paragraph (3), however the interest rate shall be increased by 10 percentage points.
(l) The department may adopt emergency regulations to implement this section in accordance with the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code).

SEC. 43.

 Section 14105.33 of the Welfare and Institutions Code is amended to read:

14105.33.
 (a) The department may enter into contracts with manufacturers of single-source and multiple-source drugs, on a bid or nonbid basis, for drugs from each major therapeutic category, and shall maintain a list of those drugs for which contracts have been executed.
(b) (1) Contracts executed pursuant to this section shall be for the manufacturer’s best price, as defined in Section 14105.31, which shall be specified in the contract, and subject to agreed-upon  agreed upon  price escalators, as defined in that section. The contracts shall provide for a state rebate,  an equalization payment amount,  as defined in Section 14105.31, to be remitted to the department quarterly. The department shall submit an invoice to each manufacturer for the state rebate,  equalization payment amount,  including supporting utilization data from the department’s prescription drug paid claims tapes within 30 days of receipt of the federal  Centers for Medicare and Medicaid Services’ file of manufacturer rebate information. In lieu of paying the entire invoiced amount, a manufacturer may contest the invoiced amount pursuant to procedures established by the federal Centers for Medicare and Medicaid Services’ Medicaid Drug Rebate Program Releases or regulations by mailing a notice, that shall set forth its grounds for contesting the invoiced amount, to the department within 38 days of the department’s mailing of the state invoice and supporting utilization data. For purposes of state accounting practices only, the contested balance shall not be considered an accounts receivable amount until final resolution of the dispute pursuant to procedures established by the federal Centers for Medicare and Medicaid Services’ Medicaid Drug Rebate Program Releases or regulations that results in a finding of an underpayment by the manufacturer. Manufacturers may request, and the department shall timely provide, at cost, Medi-Cal provider level drug utilization data, and other Medi-Cal utilization data necessary to resolve a contested department-invoiced rebate amount.
(2) The department shall provide for an annual audit of utilization data used to calculate the state rebate equalization amount  to verify the accuracy of that data. The findings of the audit shall be documented in a written audit report to be made available to manufacturers within 90 days of receipt of the report from the auditor. Any manufacturer may receive a copy of the audit report upon written request. Contracts between the department and manufacturers shall provide for any equalization payment adjustments determined necessary pursuant to an audit.
(3) (A)  Utilization data used to determine the state rebate  an equalization payment amount  shall exclude data from both of the following:
(i) (A)  Health maintenance organizations, as defined in Section 300e(a) of Title 42 of the United States Code, including those organizations that contract under Section 1396b(m) of Title 42 of the United States Code.
(ii) (B)  Capitated plans that include a prescription drug benefit in the capitated rate, and that have negotiated contracts for rebates or discounts with manufacturers.
(B) This paragraph shall become inoperative on July 1, 2014.
(4) Commencing July 1, 2014, utilization data used to determine the state rebate shall include data from all programs, including, but not limited to, fee-for-service Medi-Cal, and utilization data, as limited in paragraph (5), from health plans contracting with the department to provide services to beneficiaries pursuant to this chapter, Chapter 8 (commencing with Section 14200), or Chapter 8.75 (commencing with Section 14591), that qualify for federal drug rebates pursuant to Section 1927 of the federal Social Security Act (42 U.S.C. Sec. 1396r-8) or that otherwise qualify for federal funds under Title XIX of the federal Social Security Act (42 U.S.C. Sec. 1396 et seq.) pursuant to the Medicaid state plan or waivers.
(5) Health plan utilization data shall be limited to those drugs for which a health plan is authorizing a prescription drug described in subparagraph (A), and pursuant to the coverage policies established in subparagraph (B):
(A) A prescription drug for which the department reimburses the health plan through a separate capitated payment or other supplemental payment. Payment shall not be withheld for decisions determined pursuant to Section 1374.34 of the Health and Safety Code.
(B) The department shall develop coverage policies, consistent with the criteria set forth in paragraph (1) of subdivision (c) of Section 14105.39 and in consultation with clinical experts, Medi-Cal managed care plans, and other stakeholders, for prescription drugs described in subparagraph (A). These coverage policies shall apply to the entire Medi-Cal program, including fee-for-service and Medi-Cal managed care, through the Medi-Cal List of Contract Drugs or through provider bulletins, all plan letters, or similar instructions. Coverage policies developed pursuant to this section shall be revised on a semiannual basis or upon approval by the Food and Drug Administration of a new drug subject to subparagraph (A). For the purposes of this section, “coverage policies” include, but are not limited to, clinical guidelines and treatment and utilization policies.
(6) For prescription drugs not subject to the requirements of paragraph (5), utilization data used to determine the state rebate shall include all data from health plans, except for health maintenance organizations, as defined in Section 300e(a) of Title 42 of the United States Code, including those organizations that contract pursuant to Section 1396b(m) of Title 42 of the United States Code.
(7) 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 paragraph (5) by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions, until the time regulations are adopted. The department shall adopt regulations by October 1, 2017, 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. Notwithstanding Section 10231.5 of the Government Code, beginning six months after the effective date of this section, the department shall provide a status report to the Legislature on a semiannual basis, in compliance with Section 9795 of the Government Code, until regulations have been adopted.
(c) In order that Medi-Cal beneficiaries may have access to a comprehensive range of therapeutic agents, the department shall ensure that there is representation on the list of contract drugs in all major therapeutic categories. Except as provided in subdivision (a) of Section 14105.35, the department shall not be required to contract with all manufacturers who negotiate for a contract in a particular category. The department shall ensure that there is sufficient representation of single-source and multiple-source drugs, as appropriate, in each major therapeutic category.
(d) The department shall select the therapeutic categories to be included on the list of contract drugs, and the order in which it seeks contracts for those categories. The department may establish different contracting schedules for single-source and multiple-source drugs within a given therapeutic category.
(e) (1) In order to fully implement subdivision (d), the department shall, to the extent necessary, negotiate or renegotiate contracts to ensure there are as many single-source drugs within each therapeutic category or subcategory as the department determines necessary to meet the health needs of the Medi-Cal population. The department may determine in selected therapeutic categories or subcategories that no single-source drugs are necessary because there are currently sufficient multiple-source drugs in the therapeutic category or subcategory on the list of contract drugs to meet the health needs of the Medi-Cal population. However, in no event shall a beneficiary be denied continued use of a drug that which  is part of a prescribed therapy in effect as of September 2, 1992, until the prescribed therapy is no longer prescribed.
(2) In the development of decisions by the department on the required number of single-source drugs in a therapeutic category or subcategory, and the relative therapeutic merits of each drug in a therapeutic category or subcategory, the department shall consult with the Medi-Cal Contract Drug Advisory Committee. The committee members shall communicate their comments and recommendations to the department within 30 business days of a request for consultation, and shall disclose any associations with pharmaceutical manufacturers or any remuneration from pharmaceutical manufacturers.
(f) In order to achieve maximum cost savings, the Legislature declares that an expedited process for contracts under this section is necessary. Therefore, contracts entered into on a nonbid basis shall be exempt from Chapter 2 (commencing with Section 10290) of Part 2 of Division 2 of the Public Contract Code.
(g) In no event shall a beneficiary be denied continued use of a drug that is part of a prescribed therapy in effect as of September 2, 1992, until the prescribed therapy is no longer prescribed.
(h) Contracts executed pursuant to this section shall be confidential and shall be exempt from disclosure under the California Public Records Act (Division 10 (Chapter 3.5  (commencing with Section 7920.000) of  6250) of Division 7 of  Title 1 of the Government Code).
(i) The department shall provide individual notice to Medi-Cal beneficiaries at least 60 calendar days prior to the effective date of the deletion or suspension of any drug from the list of contract drugs. The notice shall include a description of the beneficiary’s right to a fair hearing and shall encourage the beneficiary to consult a physician to determine if an appropriate substitute medication is available from Medi-Cal.
(j) In carrying out the provisions of this section, the department may contract either directly, or through the fiscal intermediary, for pharmacy consultant staff necessary to initially accomplish the treatment authorization request reviews.
(k) (1) Manufacturers shall calculate and pay interest on late or unpaid rebates. The interest shall not apply to any prior period adjustments of unit rebate amounts or department utilization adjustments.
(2) For state rebate payments, manufacturers shall calculate and pay interest on late or unpaid rebates for quarters that begin on or after the effective date of the act that added this subdivision.
(3) Following final resolution of any dispute pursuant to procedures established by the federal Centers for Medicare and Medicaid Services’ Medicaid Drug Rebate Program Releases or regulations regarding the amount of a rebate, any underpayment by a manufacturer shall be paid with interest calculated pursuant to subdivisions (m) and (n), and any overpayment, together with interest at the rate calculated pursuant to subdivisions (m) and (n), shall be credited by the department against future rebates due.
(l) Interest pursuant to subdivision (k) shall begin accruing 38 calendar days from the date of mailing of the invoice, including supporting utilization data sent to the manufacturer. Interest shall continue to accrue until the date of mailing of the manufacturer’s payment.
(m) Except as specified in subdivision (n), interest rates and calculations pursuant to subdivision (k) for Medicaid medicaid  rebates and state rebates shall be identical and shall be determined by the federal Centers for Medicare and Medicaid Services’ Medicaid  Health Care Financing Administration’s Medicaid  Drug Rebate Program Releases or regulations.
(n) If the date of mailing of a state rebate payment is 69 days or more from the date of mailing of the invoice, including supporting utilization data sent to the manufacturer, the interest rate and calculations pursuant to subdivision (k) shall be as specified in subdivision (m), however the interest rate shall be increased by 10 percentage points. This subdivision shall apply to payments for amounts invoiced for any quarters that begin on or after the effective date of the act that added this subdivision.
(o) If the rebate payment is not received, the department shall send overdue notices to the manufacturer at 38, 68, and 98 days after the date of mailing of the invoice, and supporting utilization data. If the department has not received a rebate payment, including interest, within 180 days of the date of mailing of the invoice, including supporting utilization data, the manufacturer’s contract with the department shall be deemed to be in default and the contract may be terminated in accordance with the terms of the contract. For all other manufacturers, if the department has not received a rebate payment, including interest, within 180 days of the date of mailing of the invoice, including supporting utilization data, all of the drug products of those manufacturers shall be made available only through prior authorization effective 270 days after the date of mailing of the invoice, including utilization data sent to manufacturers.
(p) If the manufacturer provides payment or evidence of payment to the department at least 40 days prior to the proposed date the drug is to be made available only through prior authorization pursuant to subdivision (o), the department shall terminate its actions to place the manufacturers’ drug products on prior authorization.
(q) The department shall direct the state’s fiscal intermediary to remove prior authorization requirements imposed pursuant to subdivision (o) and notify providers within 60 days after payment by the manufacturer of the rebate, including interest. If a contract was in place at the time the manufacturers’ drugs were placed on prior authorization, removal of prior authorization requirements shall be contingent upon good faith negotiations and a signed contract with the department.
(r) A beneficiary may obtain drugs placed on prior authorization pursuant to subdivision (o) if the beneficiary qualifies for continuing care status. To be eligible for continuing care status, a beneficiary must be taking the drug when its manufacturer is placed on prior authorization status. Additionally, the department shall have received a claim for the drug with a date of service that is within 100 days prior to the date the manufacturer was placed on prior authorization.
(s) A beneficiary may remain eligible for continuing care status, provided that a claim is submitted for the drug in question at least every 100 days and the date of service of the claim is within 100 days of the date of service of the last claim submitted for the same drug.
(t) Drugs covered pursuant to Sections 14105.43 and 14133.2 shall not be subject to prior authorization pursuant to subdivision (o), and any other drug may be exempted from prior authorization by the department if the director determines that an essential need exists for that drug, and there are no other drugs currently available without prior authorization that meet that need.
(u) It is the intent of the Legislature in enacting subdivisions (k) to (t), inclusive, that the department and manufacturers shall cooperate and make every effort to resolve rebate payment disputes within 90 days of notification by the manufacturer to the department of a dispute in the calculation of rebate payments.
(v) This section shall remain in effect only until January 1, 2003, and as of that date is repealed, unless a later enacted statute, which is enacted before January 1, 2003, deletes or extends that date.

SEC. 43.5.

 Section 14110.65 is added to the Welfare and Institutions Code, to read:

14110.65.
 (a) (1) The department shall, upon federal approval of a federal Medicaid State Plan amendment authorizing federal financial participation, provide a supplemental rate adjustment to the Medi-Cal reimbursement rate for specific nursing facilities, intermediate care facilities/developmentally disabled, intermediate care facilities/developmentally disabled-habilitative, intermediate care facilities/developmentally disabled-nursing, and pediatric subacute units which have a collectively bargained contract or a comparable, legally binding, written commitment to increase salaries, wages, or benefits for nonmanagerial, nonadministrative, noncontract staff. It is the intent of this section to make this supplemental rate adjustment available to both facilities with collective bargaining agreements and facilities without collective bargaining agreements that meet the requirements of this section. The supplemental rate adjustment shall be sufficient to fund the Medi-Cal portion of each facility’s commitment that exceeds the labor cost adjustment for the covered employees that is already included in the Medi-Cal base reimbursement rate. Starting on the date of federal approval of the Medicaid State Plan amendment and at the start of each rate year thereafter, the supplemental rate adjustments made pursuant to this section shall occur for the commitments that increase salaries, wages, or benefits during the rate year as compared to the salaries, wages, or benefits paid in the preceding year. These supplemental rate adjustments shall be subject to certification of the availability of funds by the Department of Finance on May 15 of each year for the following fiscal year, and subject to the extent funds are appropriated for this purpose in the annual Budget Act. Authorization for the supplemental rate adjustments shall terminate on the date of implementation by the department of a Medi-Cal reimbursement system that uses facility-specific rates for nonhospital based nursing facilities covered by this section.
(2) For a specific facility to be eligible for the supplemental rate adjustment, the facility shall submit the following to the department:
(A) Proof of a legally binding, written commitment to increase the salaries, wages, or benefits of existing and newly hired employees, excluding managers, administrators, and contract employees, during the rate year.
(B) Proof of the existence of a method of enforcement of the commitment, such as arbitration, that is available to the employees or their representative, and all of the following apply.
(i) It is expeditious.
(ii) It uses a neutral decisionmaker.
(iii) It is economical for the employees.
(C) Proof that the specific facility has provided written notice of the terms of the commitment and the availability of the enforcement mechanism to the relevant employees or their recognized representatives.
(3) For purposes of this section, a supplemental rate adjustment shall equal the Medi-Cal portion of the total amount of any increase in salaries, wages, and benefits provided in the enforceable written agreement minus any increase provided to that facility during that rate year provided in the standardized rate methodology (Medi-Cal base reimbursement rate) for labor related costs attributable to the employees covered by the commitment. Any supplemental rate adjustment made pursuant to this section shall only cover the period of the nonexpired, enforceable, written agreement. The department shall adjust the methodology for determining costs in the future rate determinations.
(4) Any supplemental rate adjustment for any facility under this section shall be no more than the greater of either of the following:
(A) Eight percent of that portion of the facility’s per diem labor costs, prior to the rate year, attributable to employees covered by the commitment.
(B) Eight percent of the facility’s peer group’s per diem labor costs multiplied by the percentage of the facility’s per diem labor costs attributable to employees covered by the commitment.
(5) The department shall terminate the adjustment for the specific facility if it finds the binding written commitment has expired and does not otherwise remain enforceable.
(6) The department may inspect relevant payroll and personnel records of facilities receiving funds pursuant to this section in order to ensure that the salary, wage, and benefit increases provided for in this section have been implemented. In addition to the remedies provided in subdivision (b), the department may retroactively recover funds provided to a facility for labor costs incurred after expiration of the commitment or due to the failure of the facility to comply with the commitment.
(7) An employees enforcement or attempted enforcement of the written commitment pursuant to paragraph (2) of subdivision (a) shall not constitute a basis for adverse action against that employee.
(b) The department shall provide instructions on facility requirements by November 1, 2001, or at least 60 days before implementation of this section, whichever is earlier. In developing these instructions, the department shall consult with provider and employee representatives. Audit, exit conference, and other review protocol for determining facility compliance with this section shall be developed by the department after consulting with provider and employee representatives. Any facility that is paid under the supplemental rate adjustment provided for in this section that the director finds has not provided the salary, wage, and benefit increases provided for shall be liable for the amount of funds paid to the facility by this section but not distributed to employees for salary, wage, and benefit increases, plus a penalty equal to 10 percent of the funds not so distributed. Recoupment of funds from any facility that disagrees with the findings of the director specific to this section and has filed a request for hearing pursuant to Section 14171, shall be deferred until the request for hearing is either rejected or the director’s final administrative decision is rendered. Interest shall be applied to any recoupment amount at the interest rate and timeframes specified in subdivision (h) of Section 14171. The facility shall be subject to Section 14107.

SEC. 44.

 Section 14126.02 of the Welfare and Institutions Code is amended to read:

14126.02.
 (a) It is the intent of the Legislature to devise a Medi-Cal long-term care reimbursement methodology that more effectively ensures individual access to appropriate long-term care services, promotes quality resident care, advances decent wages and benefits for nursing home workers, supports provider compliance with all applicable state and federal requirements, and encourages administrative efficiency.
(b) (1)  The department shall implement a facility-specific ratesetting system, subject to federal approval and the availability of federal funds, that reflects the costs and staffing levels associated with quality of care for residents in nursing facilities, as defined in subdivision (c) of Section 1250 of the Health and Safety Code, except that the ratesetting system shall not apply to a unit that provides pediatric subacute services in a skilled nursing facility, or to a skilled nursing facility that is designated as an institution for mental diseases, as defined in Section 1396d(i) of Title 42 of the United States Code. The facility-specific ratesetting system shall be effective commencing on August 1, 2005, and shall be implemented commencing on the first day of the month following federal approval. The department may retroactively increase and make payment of rates to facilities. review the current Medi-Cal reimbursement system to evaluate the extent to which the methodology supports the objectives stated in subdivision (a). The scope of the review shall encompass the structure currently used for peer groups, audits, projections, updates and other rate development factors that have an impact on the quality of care. 
(2) The department shall examine several alternative rate methodology models for a new Medi-Cal reimbursement system for skilled nursing facilities to include, but not be limited to, consideration of the following:
(A) Classification of residents based on the resource utilization group system or other appropriate acuity classification system.
(B) Facility specific case mix factors.
(C) Direct care labor based factors.
(D) Geographic or regional differences in the cost of operating facilities and providing resident care.
(c) On or before April 1, 2002, the department shall submit to the Legislature a formal report and proposal for any statutory changes necessary to implement recommendations related to best meeting the objectives stated in subdivision (a) and the costs associated with any changes.
(d) The alternatives for a new system described in paragraph (2) of subdivision (b) shall be developed in consultation with recognized experts with experience in long-term care reimbursement, economists, the Attorney General, the federal Centers for Medicare and Medicaid Services, and other interested parties.
(c) (e)  In implementing this section, the department may contract as necessary, on a bid or nonbid basis, for professional consulting services from nationally recognized higher education and research institutions, or other qualified individuals and entities not associated with a skilled nursing facility, with demonstrated expertise in long-term care reimbursement systems. The ratesetting system  review  specified in subdivision (b) shall be developed conducted  with all possible expedience. This subdivision establishes an accelerated process for issuing contracts pursuant to this section and contracts entered into pursuant to this subdivision shall be exempt from the requirements of Chapter 1 (commencing with Section 10100) and Chapter 2 (commencing with Section 10290) of Part 2 of Division 2 of the Public Contract Contracts  Code.
(d) The department shall implement a facility-specific ratesetting system by August 1, 2004, subject to federal approval and availability of federal or other funds, that reflects the costs and staffing levels associated with quality of care for residents in hospital-based nursing facilities.

SEC. 45.

 Section 16809 of the Welfare and Institutions Code, as amended by Section 99 of Chapter 93 of the Statutes of 2000, is amended to read:

16809.
 (a) (1) The board of supervisors of a county that which  contracted with the department pursuant to former  Section 16709 during the 1990–91 fiscal year and any county with a population under 300,000, as determined in accordance with the 1990 decennial census, by adopting a resolution to that effect, may elect to participate in the County Medical Services Program. The governing board  County Medical Services Program  shall have responsibilities for specified health services to county residents certified eligible for those services by the county.
(2) The board of supervisors of a county that has contracted with the governing board pursuant to paragraph (1) may also contract with the governing board for the delivery of health care and health-related services to county residents other than under the County Medical Services Program by adopting a resolution to that effect. The governing board shall have responsibilities for the delivery of specified health services to county residents as agreed upon by the governing board and the county. Participation by a county pursuant to this paragraph shall be voluntary, and funds shall be provided solely by the county.
(b) The governing board may contract with the department or any other person or entity to administer the County Medical Services Program.
(1) (2)  If the governing board  County Medical Services Program Governing Board  contracts with the department to administer the County Medical Services Program, that contract shall include, but need not be limited to, all of the following:
(A) Provisions for the payment to participating counties for making eligibility determinations as determined by the governing board. based on the formula used by the County Medical Services Program for the 1993–94 fiscal year. 
(B) Provisions for payment of expenses of the governing board. County Medical Services Program Governing Board. 
(C) Provisions relating to the flow of funds from counties’ vehicle license fees, sales taxes, and participation fees and the procedures to be followed if a county does not pay those funds to the program.
(D) Those provisions, as applicable, contained in the 1993–94 fiscal year contract with counties under the County Medical Services Program.
(E) (3)  Provisions for the department to administer  The contract between the department and the County Medical Services Program Governing Board shall require that the state maintain at least the level of administrative support provided to  the County Medical Services Program pursuant to regulations adopted  for the 1993–94 fiscal year. The department may decline to implement decisions made  by the governing board or as otherwise determined  that would require a greater level of administrative support than that for the 1993–94 fiscal year. The department may implement decisions upon compensation  by the governing board. board to cover that increased level of support. 
(F) (4)  Provisions requiring that the governing board reimburse the state costs of providing administrative support to the  The contract between the department and the  County Medical Services Program in accordance with amounts determined between the governing board and the department. Governing Board may include provisions for the administration of a pharmacy benefit program and, pursuant to these provisions, the department may negotiate, on behalf of the County Medical Services Program, rebates from manufacturers that agree to participate. The governing board shall reimburse the department for staff costs associated with this paragraph. 
(2) (5)  If the governing board does not  The department shall administer the County Medical Services Program pursuant to the provisions of the 1993–94 fiscal year  contract with the department for administration of the County Medical Services Program, the governing board may contract with the department for specified services to assist in the administration of that program. Any contract with the department under this paragraph shall require that the governing board reimburse the state costs of providing administrative support. counties and regulations relating to the administration of the program until the County Medical Services Program Governing Board executes a contract for the administration of the County Medical Services Program and adopts regulations for that purpose. 
(3) (6)  The department shall not be liable for any costs related to decisions of the governing board  County Medical Services Program Governing Board  that are in excess of those set forth in the contract between the department and the governing board. County Medical Services Program Governing Board. 
(c) (b)  Each county intending to participate in the County Medical Services Program pursuant to this section shall submit to the governing board  Governing Board of the County Medical Services Program  a notice of intent to contract adopted by the board of supervisors no later than April 1 of the fiscal year preceding the fiscal year in which the county will participate in the County Medical Services Program.
(d) (c)  A county participating in the County Medical Services Program pursuant to this section, or a county contracting with the governing board pursuant to paragraph (2) or (3) of subdivision (a), or participating in a pilot project or contracting with the governing board for an alternative product pursuant to Section 16809.4,  section  shall not be relieved of its indigent health care obligation under Section 17000.
(e) (d)  (1) The County Medical Services Program Account is established in the County Health Services Fund. The County Medical Services Program Account is continuously appropriated, notwithstanding Section 13340 of the Government Code, without regard to fiscal years. The  following amounts may be deposited in the account:
(A) Any interest earned upon moneys money  deposited in the account.
(B) Moneys provided by participating counties or appropriated by the Legislature to the account.
(C) Moneys loaned pursuant to subdivision (n). (q). 
(2) The methods and procedures used to deposit funds into the account shall be consistent with the methods used by the program during the 1993–94 fiscal year, unless otherwise determined by the governing board. year. 
(f) (e)  Moneys in the program account shall be used by the governing board, or by the department if the department contracts with the governing board for this purpose,  department, pursuant to its contract with the County Medical Services Program Governing Board,  to pay for health care services provided to the persons meeting the eligibility criteria established pursuant to subdivision (j) and to pay the governing board expenses and program administrative costs. In addition, moneys in this account may be used to reimburse the department for state costs pursuant to subparagraph (F) of paragraph (1) of subdivision (b). for the expense of the governing board as set forth in the contract between the board and the department. 
(g) (f)  (1) Moneys in this account shall be administered on an accrual basis and notwithstanding any other provision of  law, except as provided in this section and Section 17605.051,  section,  shall not be transferred to any other fund or account in the State Treasury except for purposes of investment as provided in Article 4 (commencing with Section 16470) of Chapter 3 of Part 2 of Division 4 of Title 2 of the Government Code.
(2) (A) All interest or other increment resulting from the investment shall be deposited in the program account, at the end of the 1982–83 fiscal year and every six months thereafter,  notwithstanding Section 16305.7 of the Government Code.
(B) All interest deposited pursuant to subparagraph (A) shall be available to reimburse program-covered services, governing board expenses, and program administrative costs. County Medical Services Program Governing Board expenses, or for expenditures to augment the program’s rates, benefits, or eligibility criteria pursuant to subdivision (j). 
(h) (g)  The governing board shall establish a reserve account for the purpose of depositing funds for the payment of claims and unexpected contingencies. Funds  A separate County Medical Services Program Reserve Account is established in the County Health Services Fund. Six months after the end of each fiscal year, any projected savings in the program account shall be transferred to the reserve account, with final settlement occurring no more than 12 months later. Moneys in this account shall be utilized when expenditures for health services made pursuant to subdivision (j) for a fiscal year exceed the amount of funds available in the program account for that fiscal year. When funds  in the reserve account in excess of the amounts the governing board determines necessary for these purposes  are estimated to exceed 10 percent of the budget for health services for all counties electing to participate in the County Medical Services Program under this section for the fiscal year, the additional funds  shall be available for expenditures in years when program expenditures exceed program funds, and  expenditure  to augment the rates, benefits, or eligibility criteria under the program. pursuant to subdivision (j) or for reducing the participation fees as determined by the County Medical Services Program Governing Board pursuant to subdivision (i). Nothing in this section shall preclude the CMSP Governing Board from establishing other reserves. 
(h) Moneys in the program account and the reserve account, except for moneys provided by the state in excess of the amount required to fund the state risk specified in subdivision (j), and any funds loaned pursuant to subdivision (p) shall not be transferred to any other fund or account in the State Treasury except for purposes of investment as provided in Article 4 (commencing with Section 16470) of Chapter 3 of Part 2 of Division 4 of Title 2 of the Government Code. All interest or other increment resulting from investment shall be deposited in the program account, notwithstanding Section 16705.7 of the Government Code.
(i) (1) Counties shall pay participation fees as established by the governing board  County Medical Services Program Governing Board  and their jurisdictional risk amount in a method that is consistent with that established in the 1993–94 fiscal year.
(2) A county may request, due to financial hardship, the payments under paragraph (1) be delayed. The request shall be subject to approval by the governing board. CMSP Governing Board. 
(3) Payments made pursuant to this subdivision shall be deposited in the program account, unless otherwise directed by the governing board. account. 
(4) Payments may be made as part of the deposits authorized by the county pursuant to Sections 17603.05 and 17604.05.
(j) (1) (A) For the 1991–92 fiscal year and all preceding fiscal years, the state shall be at risk for any costs in excess of the amounts deposited in the reserve fund.
(j) (B)  (1) (i)  (A)  Beginning in the 1992–93 fiscal year and for each fiscal year thereafter, counties and the state shall share the risk for cost increases of the County Medical Services Program not funded through other sources. The state shall be at risk for any cost that exceeds the cumulative annual growth in dedicated sales tax and vehicle license fee revenue, up to the amount of twenty million two hundred thirty-seven thousand four hundred sixty dollars ($20,237,460) per fiscal year, except for the 1999–2000, 2000–01, 2001–02, 2002–03, 2003–04, 2004–05, 2005–06, 2006–07, and 2007–08 fiscal years, and all fiscal years thereafter.  and 2001–02 fiscal years.  Counties shall be at risk up to the cumulative annual growth in the Local Revenue Fund created by Section 17600, according to the table specified in paragraph (2), to the County Medical Services Program, plus the additional cost increases in excess of twenty million two hundred thirty-seven thousand four hundred sixty dollars ($20,237,460) per fiscal year, except for the 1999–2000, 2000–01, 2001–02, 2002–03, 2003–04, 2004–05, 2005–06, 2006–07, and 2007–08 fiscal years, and all fiscal years thereafter. and 2001–02 fiscal years. In the 1994–95 fiscal year, the amount of the state risk shall be twenty million two hundred thirty-seven thousand four hundred sixty dollars ($20,237,460) per fiscal year, in addition to the cost of administrative support pursuant to paragraph (3) of subdivision (a). 
(B) (ii)  For the 1999–2000, 2000–01, 2001–02, 2002–03, 2003–04, 2004–05, 2005–06, 2006–07, and 2007–08 fiscal years, and all fiscal years thereafter,  and 2001–02 fiscal years,  the state shall not be at risk for any cost that exceeds the cumulative annual growth in dedicated sales tax and vehicle license fee revenue. Counties shall be at risk up to the cumulative annual growth in the Local Revenue Fund created by Section 17600, according to the table specified in paragraph (2), to the County Medical Services Program, plus any additional cost increases for the 1999–2000, 2000–01, 2001–02, 2002–03, 2003–04, 2004–05, 2005–06, 2006–07, and 2007–08 fiscal years, and all fiscal years thereafter. and 2001–02 fiscal years. 
(C) (i)  The governing board  CMSP Governing Board, after consultation with the department,  shall establish uniform eligibility criteria and benefits among all counties participating in  for  the County Medical Services Program listed in paragraph (2). For counties that are not listed in paragraph (2) and that elect to participate pursuant to paragraph (1) of subdivision (a), the eligibility criteria and benefit structure may vary from those of counties participating pursuant to paragraph (2) of subdivision (a). Program. 
(ii) Notwithstanding clause (i), the governing board may establish and maintain pilot projects to identify or test alternative approaches for determining eligibility or for providing or paying for benefits under the County Medical Services Program, and may develop and implement alternative products with varying levels of eligibility criteria and benefits outside of the County Medical Services Program.
(2) For the 1991–92 fiscal year, and each fiscal year thereafter,  jurisdictional risk limitations shall be as follows:
Jurisdiction
 Amount
Jurisdiction
 Amount
 Alpine ........................
$  13,150
 Amador ........................
 620,264
 Butte ........................
 5,950,593
 Calaveras ........................
 913,959
 Colusa ........................
 799,988
 Del Norte ........................
 781,358
 El Dorado ........................
 3,535,288
 Glenn ........................
 787,933
 Humboldt ........................
 6,883,182
 Imperial ........................
 6,394,422
 Inyo ........................
 1,100,257
 Kings ........................
 2,832,833
Lake  ........................
1,022,963
 Lassen ........................
 687,113
 Madera ........................
 2,882,147
 Marin ........................
 7,725,909
 Mariposa ........................
 435,062
Mendocino  ........................
1,654,999
 Modoc ........................
 469,034
 Mono ........................
 369,309
 Napa ........................
 3,062,967
 Nevada ........................
 1,860,793
 Plumas ........................
 905,192
 San Benito ........................
 1,086,011
 Shasta ........................
 5,361,013
 Sierra ........................
 135,888
 Siskiyou ........................
 1,372,034
 Solano ........................
 6,871,127
 Sonoma ........................
 13,183,359
 Sutter ........................
 2,996,118
 Tehama ........................
 1,912,299
 Trinity ........................
 611,497
 Tuolumne ........................
 1,455,320
 Yuba ........................
 2,395,580
(3) Beginning in the 1991–92 fiscal year and in subsequent fiscal years, the jurisdictional risk limitation for the counties that did not contract with the department pursuant to former  Section 16709 during the 1990–91 fiscal year shall be the amount specified in subparagraph paragraph  (A) plus the amount determined pursuant to subparagraph paragraph  (B), minus the amount specified by the governing board  County Medical Services Program Governing Board  as participation fees.

(A) 
 Jurisdiction
 Amount
Lake ........................
$1,022,963 
Mendocino ........................
1,654,999
 Merced ........................
 2,033,729
 Placer ........................
 1,338,330
 San Luis Obispo ........................
 2,000,491
 Santa Cruz ........................
 3,037,783
 Yolo ........................
 1,475,620
(B) The amount of funds necessary to fully fund the anticipated costs for the county shall be determined by the governing board  CMSP Governing Board  before a county is permitted to participate in the County Medical Services Program.
(4) The  For the 1994–95 and 1995–96 fiscal years, the  specific amounts and method of apportioning risk to each participating county may be adjusted by the governing board. CMSP Governing Board. 
(k) The Legislature hereby determines that an expedited contract process for contracts under this section is necessary. Contracts under this section shall be exempt from Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code. Contracts of the department pursuant to this section shall have no force or effect unless they are approved by the Department of Finance.
(l) ( l)  The state shall not incur any liability except as specified in this section.
(m) Third-party recoveries for services provided under this section pursuant to Article 3.5 (commencing with Section 14124.70) of Chapter 7 of Part 3  may be pursued.
(n) Under the program provided for in this section, the department may reimburse hospitals for inpatient services at the rates negotiated for the Medi-Cal program by the California Medical Assistance Commission, pursuant to Article 2.6 (commencing with Section 14081) of Chapter 7 of Part 3, if the California Medical Assistance Commission determines that reimbursement to the hospital at the contracted rate will not have a detrimental fiscal impact on either the Medi-Cal program or the program provided for in this section. In negotiating and renegotiating contracts with hospitals, the commission may seek terms which allow reimbursement for patients receiving services under this section at contracted Medi-Cal rates.
(o) Any hospital which has a contract with the state for inpatient services under the Medi-Cal program and which has been approved by the commission to be reimbursed for patients receiving services under this section shall not deny services to these patients.
(p) Participating counties may conduct an independent program review to identify ways through which program savings may be generated. The counties and the department may collectively pursue identified options for the realization of program savings.
(n) (q)  The Department of Finance may authorize a loan of up to thirty million dollars ($30,000,000) for deposit into the program account to ensure that there are sufficient funds available to reimburse providers and counties pursuant to this section.
(r) Regulations adopted by the department pursuant to this section shall remain operative and shall be used to operate the County Medical Services Program until a contract with the County Medical Services Program Governing Board is executed and regulations, as appropriate, are adopted by the County Medical Services Program Governing Board. Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, those regulations adopted under the County Medical Services Program shall become inoperative until January 1, 1998, except those regulations that the department, in consultation with the County Medical Services Program Governing Board, determines are needed to continue to administer the County Medical Services Program. The department shall notify the Office of Administrative Law as to those regulations the department will continue to use in the implementation of the County Medical Services Program.
(o) (s)  Moneys appropriated from the General Fund to meet the state risk, risk  as set forth in subparagraph (A) (B)  of paragraph (1) of subdivision (j), (j)  shall not be available for those counties electing to disenroll from the County Medical Services Program.
(p) (t)  Notwithstanding any other law, the Controller may use the moneys in the County Medical Services Program Account for loans to the General Fund as provided in Sections 16310 and 16381 of the Government Code. However, interest shall be paid on all moneys loaned to the General Fund from the County Medical Services Program Account. Interest payable shall be computed at a rate determined by the Pooled Money Investment Board to be the current earning rate of the fund from which loaned. This subdivision does not authorize any transfer that will interfere with the carrying out of the object for which the County Medical Services Program Account was created. This section shall remain in effect only until January 1, 2003, and as of that date is repealed, unless a later enacted statute, that is enacted on or before January 1, 2003, deletes or extends that date. 

SEC. 46.

 Section 147 of Chapter 722 of the Statutes of 1992 is repealed.

SEC. 47.
 The repeal of Section 147 of Chapter 722 of the Statutes of 1992, contained in this act, is declarative of existing law and reconfirms that it was the intent of the Legislature that the emergency regulatory authority contained in Section 147 of Chapter 722 of the Statutes of 1992 only applied to the initial adoption of emergency regulations immediately implementing that act. It was the intent of the Legislature that any regulations subsequently adopted comply with the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code). Notwithstanding that legislative intent, all department actions to adopt, amend, or repeal regulations pursuant to Section 147 of Chapter 722 of the Statutes of 1992 that are in effect on the effective date of this act are hereby deemed valid and shall remain in force and effect unless and until amended or repealed pursuant to the Administrative Procedure Act.
SEC. 48.
 (a) The State Department of Health Services shall issue an all-county letter (ACL) to prescribe procedures for removing any indication of other health coverage, other than Medi-Cal, from a foster child’s Medi-Cal eligibility information. The ACL shall clarify that the department shall remove any indication of other health coverage from a foster child’s eligibility information as soon as there is an indication that the other health coverage is a barrier to timely access to any Medi-Cal eligible benefit. Once removed, all eligible physical health, mental health, and other benefits offered under Medi-Cal may be billed directly to Medi-Cal.
(b) The ACL shall state that a foster care worker, eligibility worker, or provider may request that the department remove any indication of other health coverage. The ACL shall also state that this request shall be granted if there is written documentation or documented oral communication from the other health coverage that the other health coverage does not cover the specific provider requested, the specific service requested, the specific frequency requested, or the specific location requested.
(c) A request by the foster care worker, eligibility worker, or provider to the department to remove any indication of other health coverage shall be granted by the department if there is no response from the other health coverage to the documented written or oral communication from the foster care worker, eligibility worker, or provider to the liable third party within 15 days.
SEC. 49.
 (a) It is the intent of the Legislature to urge the State Department of Health Services to create a process by which noncervical gynecological cancers, including uterine and ovarian cancers, can be included in the California Breast and Gynecological Cancer Treatment Program.
(b) The Director of Health Services shall report to the Legislature on or before March 31, 2002, regarding any changes in federal law permitting the state to expand the state program for ensuring cancer treatment availability for low-income uninsured women, specifically as it relates to treatment for noncervical gynecological cancers pursuant to state-funded programs. This report shall include, but not be limited to, the following:
(1) The extent to which low-income uninsured women with noncervical gynecological cancers are currently receiving medical treatment.
(2) The institutional mechanism or mechanisms by which access to treatment could be expanded under current State Department of Health Services programs, as well as programs administered by the Managed Risk Medical Insurance Board.
(3) A comprehensive fiscal analysis by the State Department of Health Services for the expansion of treatment for patients who are diagnosed with noncervical gynecological cancers under the California Breast and Gynecological Cancer Treatment Program.
(c) In order to develop the options for ensuring noncervical gynecological cancer treatment is available for low-income uninsured women, the director may consult with representatives of health care consumers, providers, insurers, health care workers, advocates, counties, and all other interested parties. Any changes in federal law shall be reported to the policy and fiscal committees of the Legislature with recommendations on implementation of an expansion of services to this patient population.
SEC. 50.
 Notwithstanding any other provision of law, the funds appropriated by the Budget Act of 2001 for the Preventing Youth Tobacco Use Program, the tobacco use competitive grant program provided for in Section 104385 of the Health and Safety Code, the tobacco prevention media campaign provided for in subdivision (e) of Section 104375 of the Health and Safety Code, the evaluation of the tobacco use prevention and education program set forth in subdivisions (b) and (c) of Section 104375 of the Health and Safety Code, the school-based tobacco use prevention program pursuant to Sections 104420, 104425, 104430, and 104435 of the Health and Safety Code, and local lead agency tobacco use prevention programs set forth in Section 104400 of the Health and Safety Code, shall be available for encumbrance and expenditure without regard to fiscal years for two years beyond the date of the appropriation, or until June 30, 2003, whichever is later.
SEC. 50.5.
 (a) Local emergency medical services agencies that do not have existing trauma care system plans may submit proposals for funding for their preparation of a trauma care system plan to the Emergency Medical Services Authority by January 15, 2002. Upon receipt of all of the local EMS agency proposals, the authority shall establish an appropriate funding level for a one-time payment to fund preparation and implementation of their initial trauma care system plans, contingent upon funding for this purpose in the Budget Act or another statute.
(b) The authority may retain from any state appropriation for the purpose of this section an amount sufficient to implement this section, up to one hundred seven thousand dollars ($107,000), subject to approval in the budget process.
SEC. 51.
 The State Department of Health Services shall provide the fiscal and policy committees of the Legislature and the local Los Angeles County 1115 Waiver Oversight Committee, upon their individual request, with copies of all reports and updates provided to the federal Centers for Medicare and Medicaid Services as contained in the Los Angeles County waiver document, including the state’s monitoring plan, the annual administrative budget report, quarterly status reports, independent audits, the worker retraining plan, and the quality assurance and improvement plan.
SEC. 52.
 (a) Commencing August 1, 2001, local educational agencies (LEAs) participating in the LEA Medi-Cal billing option may contribute funds to the State Department of Health Services in order to fund a contract for a rate study for the LEA Medi-Cal billing option. In order to fund the contract for the rate study, the funds contributed by the LEAs shall total five hundred thousand dollars ($500,000). The funds contributed by the LEAs shall not contain federal money and may be paid from any other fund allowed under federal law and regulation. Funds received from the LEAs shall be deposited in the Special Deposit Fund described in Section 16370 of the Government Code and used for the purpose specified in this section. The department shall collect funds from the LEAs and match the funds contributed by the LEAs with the appropriate share of federal funds solely for the purpose of subsidizing a contract to complete a rate study to evaluate cost-based rates and to develop a rate methodology mechanism for the LEA Medi-Cal billing option. When sufficient funding for the contract has been collected, the department shall initiate the contract process for the rate study.
(b) The department shall have sole source authority to contract for the LEA Medi-Cal billing option rate study. If, for any reason, sufficient funds for the rate study are not received by the department by June 30, 2004, the contract shall not be entered into and the rate study shall not be undertaken, and the funds shall be returned to the contributing LEAs.
SEC. 53.
 The State Department of Developmental Services shall provide the fiscal committees of the Legislature with copies of finalized data analyses, including statistical analyses of variances and results of data survey work, conducted as part of the second phase of the Purchases of Services Study to be completed in 2002.
SEC. 53.5.
 The State Department of Health Services shall convene a workgroup with the Department of Insurance, the Office of Statewide Health Planning and Development, and the Department of Finance and shall submit a report by March 1, 2002, to the appropriate committees of the Legislature, on the availability and cost trends for general liability and professional liability insurance for long term care providers in California. This report should focus on elements that include, but are not limited to, all of the following:
(a) The number and cost of claims and trends.
(b) Trends in average long-term care liability premiums.
(c) Projections on future cost of claims and premiums based on past and current loss experience.
(d) Identification of the factors contributing to trends in claims, costs, and premiums related to general liability and professional liability insurance for long-term care providers.
(e) A review of actions taken in other states related to general liability and professional liability insurance for long-term care providers.
(f) Policy recommendations related to the availability and cost of general liability and professional liability insurance for long-term care providers.
SEC. 54.
 The State Department of Health Services shall provide the fiscal and policy committees of the Legislature with a copy of the independent assessment of the state’s Home and Community Based Waiver, as administered by the State Department of Health Services and the State Department of Developmental Services, upon its completion and submission to the federal Centers for Medicare and Medicaid Services and by no later than September 1, 2001.
SEC. 55.
 The State Department of Developmental Services shall provide the fiscal and policy committees of the Legislature with an annual update regarding special incident information, as collected and developed by the department at the request of the federal Centers for Medicare and Medicaid Services.
SEC. 56.
 All emergency regulations adopted for the implementation of Article 2.7 (commencing with Section 14087), 2.8 (commencing with Section 14087.5), 2.81 (commencing with Section 14087.96), 2.9 (commencing with Section 14088), 2.91 (commencing with Section 14089), 2.95 (commencing with Section 14092), and 2.98 (commencing with Section 14094), of Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions Code including any emergency regulation adopted pursuant to the authority of provisions that were amended or repealed after the adoption of those regulations, shall remain in effect unless they are amended or repealed in accordance with the Administrative Procedure Act, Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.
SEC. 57.
 The State Department of Health Services may adopt emergency regulations to implement the applicable provisions of this act in accordance with the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code). The initial adoption of emergency regulations and one readoption of the initial regulations shall be deemed to be an emergency and necessary for the immediate preservation of the public peace, health and safety, or general welfare. Initial emergency regulations and the first readoption of those regulations shall be exempt from review by the Office of Administrative Law. The initial emergency regulations and the first readoption of those regulations authorized by this section shall be submitted to the Office of Administrative Law for filing with the Secretary of State and publication in the California Code of Regulations and each shall remain in effect for no more than 180 days.
SEC. 58.
 (a) Of the amount appropriated in Item 4260-111-0001 of the Budget Act of 2001 from the Cigarette and Tobacco Products Surtax Fund, twenty-four million eight hundred three thousand dollars ($24,803,000) shall be allocated in accordance with subdivision (b) for the 2001–02 fiscal year from the following accounts:
(1) Nine million fifteen thousand dollars ($9,015,000) from the Hospital Services Account.
(2) Two million three hundred twenty-eight thousand dollars ($2,328,000) from the Physician Services Account.
(3) Thirteen million four hundred sixty thousand dollars ($13,460,000) from the Unallocated Account.
(b) Funds appropriated pursuant to subdivision (a) shall be allocated proportionately as follows:
(1) Twenty-two million three hundred twenty-four thousand dollars ($22,324,000) shall be administered and allocated for distribution through the California Healthcare for Indigents Program (CHIP), Chapter 5 (commencing with Section 16940) of Part 4.7 of Division 9 of the Welfare and Institutions Code, as provided in this act.
(2) Two million four hundred seventy-nine thousand dollars ($2,479,000) shall be administered and allocated through the rural health services program, Chapter 4 (commencing with Section 16930) of Part 4.7 of Division 9 of the Welfare and Institutions Code, as provided in this act.
(c) Funds appropriated by this act from the Physician Services Account and the Unallocated Account in the Cigarette and Tobacco Product Surtax Fund shall be used only for the reimbursement of uncompensated emergency services as defined in Section 16953 of the Welfare and Institutions Code. Funds shall be transferred to the Physician Services Account in the county Emergency Medical Services Fund established pursuant to Sections 16951 and 16952 of the Welfare and Institutions Code.
(d) Funds appropriated by this act from the Hospital Services Account in the Cigarette and Tobacco Products Surtax Fund shall be used only for reimbursement of uncompensated emergency services, as defined in Section 16953 of the Welfare and Institutions Code, provided in general acute care hospitals providing basic, comprehensive, or standby emergency services. Reimbursement for emergency services shall be consistent with the provisions of Section 16952 of the Welfare and Institutions Code.
SEC. 59.
 (a) The addition of Article 1.3 (commencing with Section 104150) to Chapter 2 of Part 1 of Division 103 of the Health and Safety Code by Section 8.5 of this act shall become operative on January 1, 2002.
(b) The repeal and addition of Article 1.5 (commencing with Section 104160) of Chapter 2 of Part 1 of Division 103 of the Health and Safety Code made by Sections 8.9 and 9 of this act shall become operative on January 1, 2002.
SEC. 60.
 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, notwithstanding Section 17610 of the Government Code, 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. If the statewide cost of the claim for reimbursement does not exceed one million dollars ($1,000,000), reimbursement shall be made from the State Mandates Claims Fund.
SEC. 61.
 This act is an urgency statute necessary for the immediate preservation of the public peace, health, or safety within the meaning of Article IV of the Constitution and shall go into immediate effect. The facts constituting the necessity are:
In order to provide for the administration of this act relating to health for the entire 2001–02 fiscal year, it is necessary that this act go into immediate effect.