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AB-11 Early and Periodic Screening, Diagnosis, and Treatment Program: screening services.(2017-2018)

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Date Published: 07/03/2018 09:00 PM
AB11:v94#DOCUMENT

Amended  IN  Senate  July 03, 2018
Amended  IN  Senate  June 18, 2018
Amended  IN  Assembly  January 10, 2018
Amended  IN  Assembly  January 03, 2018
Amended  IN  Assembly  March 23, 2017

CALIFORNIA LEGISLATURE— 2017–2018 REGULAR SESSION

Assembly Bill No. 11


Introduced by Assembly Members McCarty and Bonta
(Coauthors: Assembly Members Carrillo, Kamlager-Dove, Nazarian, and Mark Stone)

December 05, 2016


An act to add Section 14132.195 to to, and to add and repeal Section 14197.07 of, the Welfare and Institutions Code, relating to Medi-Cal.


LEGISLATIVE COUNSEL'S DIGEST


AB 11, as amended, McCarty. Early and Periodic Screening, Diagnosis, and Treatment Program: screening services.
Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services, including Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) for any individual under 21 years of age who is covered under Medi-Cal consistent with the requirements under federal law. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.
Existing federal law provides that EPSDT services include periodic screening services, vision services, dental services, hearing services, and other necessary services to correct or ameliorate defects and physical and mental illnesses and conditions discovered by the screening services, whether or not the services are covered under the state plan.
This bill would require, consistent with federal law, that screening services under the EPSDT program include developmental screening services for individuals zero to 3 years of age, inclusive, and be in compliance with the periodicity schedule and the standardized and validated developmental screening tools that are established by the Bright Futures/American Academy of Pediatrics Recommendations for Preventive Pediatric Health Care and by any future updates to those recommendations. The bill would require that screening tools be administered in their entirety and in adherence to the specific tools’ recommended guidelines. inclusive. Until July 1, 2023, the bill would require an external quality review organization entity to annually review, survey, and report on managed care plan reporting and compliance with specified developmental screening tools and schedules. The bill would also make legislative findings and declarations relating to child development.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

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


SECTION 1.

 The Legislature finds and declares all of the following:
(a) Not all children experience a clear path toward healthy development, making the early identification of developmental concerns and the timely connection to appropriate intervention essential to a child’s well-being.
(b) Despite the prevalence of developmental delays and disorders, the overall rate of developmental screening remains low and the use of validated screening tools is often inconsistent.
(c) Many children at risk for developmental delays or disabilities due to environmental or biological factors are not identified in a timely fashion, greatly reducing the effectiveness of applied intervention.
(d) The Bright Futures Guidelines by the American Academy of Pediatrics provide evidence-driven guidance for all preventive care screenings and well-child visits, recommending that developmental surveillance include the periodic administration of a standardized developmental screening test.
(e) Early access to appropriate intervention for children with developmental delays and disabilities is critically important for healthy and optimal development.

SEC. 2.

 Section 14132.195 is added to the Welfare and Institutions Code, immediately following Section 14132.19, to read:

14132.195.
 Consistent with federal law, screening services provided under the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) benefit pursuant to subdivision (v) of Section 14132 shall include developmental screening services for individuals zero to three years of age, inclusive. These developmental screening services shall be in compliance with the periodicity schedule and the standardized and validated developmental screening tools that are established by the Bright Futures/American Academy of Pediatrics Recommendations for Preventive Pediatric Health Care and by any future updates to those recommendations. Developmental screening tools shall be administered in their entirety and in adherence to the specific tools’ recommended guidelines.

SEC. 3.

 Section 14197.07 is added to the Welfare and Institutions Code, to read:

14197.07.
 (a) As part of the federally required external quality review organization (EQRO) review of Medi-Cal managed care plans in the annual detailed technical report required by Section 438.364 of Title 42 of the Code of Federal Regulations, effective for contract periods commencing on or after July 1, 2018, the EQRO entity shall annually review, survey, and report on managed care plan reporting and compliance with the use of the validated developmental screening tools and periodicity schedule recommended by the American Academy of Pediatrics for children zero to three years of age, inclusive.
(b) This section shall remain in effect only until July 1, 2023, and as of that date is repealed.