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SB-338 Health care service plans: health equity and quality.(2023-2024)

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Date Published: 03/16/2023 09:00 PM
SB338:v98#DOCUMENT

Amended  IN  Senate  March 16, 2023

CALIFORNIA LEGISLATURE— 2023–2024 REGULAR SESSION

Senate Bill
No. 338


Introduced by Senator Nguyen

February 07, 2023


An act to amend Section 120125 1399.870 of the Health and Safety Code, relating to communicable disease prevention and control. health equity and quality.


LEGISLATIVE COUNSEL'S DIGEST


SB 338, as amended, Nguyen. Communicable disease prevention Health care service plans: health equity and quality.
Existing law, the Knox-Keene Health Service Plan Act of 1975, establishes the Department of Managed Health Care to ensure that health care service plans provide enrollees with access to quality health care services and to protect and promote the interests of enrollees.
Existing law requires the department to convene a Health Equity and Quality Committee to recommend quality and benchmark standards for reviewing the equity and quality in health care delivery. Existing law permits the department to contract with consultants who will assist the committee with the implementation and administration of its duties. Existing law exempts these contracts from review and approval, as specified, until January 1, 2024. Existing law requires the director, as part of the committee appointment process, to consider the relevant experience or expertise of appointees, including, but not limited to, racial, ethnic, or sexual orientation. Existing law required the department, on or before September 30, 2022, to make quality and benchmark recommendations.
This bill would require the director to appoint to the committee at least one individual with an intellectual or developmental disability, or the parent or guardian of such an individual. This bill would also require the department to reconvene the committee at least once annually to review and revisit quality and benchmark standards. This bill would also exempt contracts entered into pursuant to these provisions from the review and approval processes, as specified, until January 1, 2026.

Existing law requires the State Department of Health Services to, among other requirements, examine the causes of communicable diseases occurring or likely to occur in the State of California.

This bill would make a technical, nonsubstantive change to those provisions.

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

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


SECTION 1.

 Section 1399.870 of the Health and Safety Code is amended to read:

1399.870.
 (a) (1) On or before March 1, 2022, the department shall convene a Health Equity and Quality Committee to make recommendations to the department for standard health equity and quality measures, including annual benchmark standards for assessing equity and quality in health care delivery. The department may contract with consultants to assist the committee with the implementation and administration of its duties.
(2) The committee shall provide initial recommendations, as well as recommendations on updating and revising standard health equity and quality measures and annual benchmark standards, consistent with this article. These recommendations shall consider the interaction of multiple characteristics in determining where disparate outcomes exist, including, but not limited to, race, ethnicity, gender, sexual orientation, language, age, income, and disability.
(3) Meetings of the committee shall be subject to the Bagley-Keene Open Meeting Act (Article 9 (commencing with Section 11120) of Chapter 1 of Part 1 of Division 3 of Title 2 of the Government Code).
(4) The department may contract with consultants to assist the committee with the implementation and administration of its duties.
(b) In appointing members to the committee, the director shall consider all of the following:
(1) The expertise of each committee member so that the committee’s composition reflects a diversity of relevant expertise.
(2) The racial, cultural, ethnic, sexual orientation, gender, economic, linguistic, age, disability, and geographical diversity of the state so that the committee’s composition reflects the communities of California.
(3) The expertise of representatives from other state agencies that are engaged in the work of setting quality and equity goals or standards for health care entities.
(4) The representation of consumer stakeholders that serve diverse populations.
(5) Inclusion of experts, researchers, and community members who are engaged in the development of alternative approaches to measuring health equity, consumer experience, and health outcomes.
(c) The director shall appoint to the committee at least one individual with an intellectual or developmental disability, or the parent or guardian of such an individual.

(c)

(d) On or before September 30, 2022, the committee shall provide the recommendations described in subdivision (a), which may consider and may include all of the following:
(1) Quality measures, including, but not limited to, Healthcare Effectiveness Data and Information Set (HEDIS) measures and the federal Centers for Medicare and Medicaid Services Child and Adult Core Set measures.
(2) Surveys or other measures to assess consumer experience and satisfaction, including alternative approaches that take into account cultural competence, health literacy, exposure to discrimination, and social and cultural connectedness, such as connection to community, identity, traditions, and spirituality.
(3) Other child and adult quality or outcome measures that the committee determines are appropriate, including establishing new measures for patient-reported outcomes.
(4) Effective ways to measure health outcomes in the absence of quality measures, including both of the following:
(A) Demographic data or other data related to race, ethnicity, or socioeconomic variables that are currently collected by health care service plans.
(B) Other data sources, including the Health Care Payments Data Program established pursuant to Section 127671.1, the health evidence initiative of Covered California for the individual and small group markets, and other statistically valid and reliable sources of data.
(5) Approaches to stratifying reporting of results by factors, including, but not limited to, age, sex, geographic region, race, ethnicity, language, sexual orientation, gender identity, and income to the extent health plans or public programs have data on these factors and that the results are statistically valid and reliable.
(6) Alternative methods to measure health outcomes that permit sufficient stratification to determine impacts on health equity and quality that are not subject to the methodological limitations of current measurement approaches.
(7) Alternative methods to measure physical and behavioral health outcomes, including, but not limited to, measures to assess social and cultural connectedness, such as connection to community, identity, traditions, and spirituality. The department shall consult with the Office of Health Equity in identifying these alternative methods.
(8) Measures of social determinants of health, such as housing security, food insecurity, caregiving, and other nonmedical determinants of health.

(d)

(e) The committee’s recommendations shall include setting annual health equity and quality benchmarks.

(e)

(f) The department shall consider the committee’s recommendations in establishing the standard measures and annual benchmarks pursuant to Section 1399.871. The department shall enforce the established set of standard health equity and quality measures and applicable annual benchmarks consistent with Section 1399.872.

(f)

(g) The department shall reconvene the committee at least once annually following the establishment of the standard measures and annual benchmarks pursuant to Section 1399.871 for the purpose of reviewing or revisiting the standard measures and annual benchmarks after the department has received data from health care service plans pursuant to Section 1399.872.

(g)

(h) Contracts entered into pursuant to this article are exempt from Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code, Section 19130 of the Government Code, and Chapter 6 (commencing with Section 14825) of Part 5.5 of Division 3 of Title 2 of the Government Code, and are exempt from the review or approval of any division of the Department of General Services, until January 1, 2024. 2026.

SECTION 1.Section 120125 of the Health and Safety Code is amended to read:
120125.

The department shall examine into the causes of communicable disease in people and domestic animals occurring or likely to occur in this state.