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AB-3118 Medically supportive food.(2019-2020)

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Date Published: 05/14/2020 09:00 PM
AB3118:v97#DOCUMENT

Amended  IN  Assembly  May 14, 2020
Amended  IN  Assembly  May 11, 2020

CALIFORNIA LEGISLATURE— 2019–2020 REGULAR SESSION

Assembly Bill
No. 3118


Introduced by Assembly Member Bonta

February 21, 2020


An act to add Section 14132.76 to and repeal Section 14042.15 of the Welfare and Institutions Code, relating to Medi-Cal.


LEGISLATIVE COUNSEL'S DIGEST


AB 3118, as amended, Bonta. Medically supportive food.
Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services, including enteral nutrition products, pursuant to a schedule of benefits, and subject to utilization controls, such as prior authorization. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law, until January 1, 2021, or as otherwise specified, requires the department to establish a 3-year pilot program in specified counties, including the Counties of Alameda and Sonoma, to provide medically tailored meals, as defined, to Medi-Cal participants with specified health conditions, such as cancer and renal disease.
This bill would expand the Medi-Cal schedule of benefits to include require the department to establish, no earlier than January 1, 2021, a pilot program for a 3-year period in the County of Alameda to provide medically supportive food, such as healthy food vouchers or renewable food prescriptions, as a covered benefit for a Medi-Cal beneficiary who has a specified chronic health condition, including diabetes or heart disease, when utilizing evidence-based practices that demonstrate the prevention, reduction, or reversal of those specified diseases. The bill would authorize the department, in consultation with stakeholders, to establish utilization controls, including the limitation on the number of services, and to enter into contracts for purposes of implementing these provisions. the pilot program. The bill would require the department to evaluate the pilot program upon its conclusion, to report to the Legislature on those findings, and to implement these provisions by various means, including provider bulletins, without taking regulatory action, and action. The bill would condition the implementation of these provisions to the extent permitted by federal law, the availability of federal financial participation, and the department securing federal approval. approval, and would repeal these provisions on January 1, 2026.
This bill would make legislative findings and declarations as to the necessity of a special statute for the County of Alameda.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

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


SECTION 1.Section 14132.76 is added to the Welfare and Institutions Code, immediately following Section 14132.75, to read:
14132.76.

SECTION 1.

 Section 14042.15 is added to the Welfare and Institutions Code, immediately following Section 14042.1, to read:

14042.15.
 (a) It is the intent of the Legislature to increase positive health outcomes for Medi-Cal beneficiaries by providing in the County of Alameda by establishing a pilot program to provide medically supportive food to them eligible residents and linking that food to nutritional and behavioral supports, including, but not limited to, nutrition education, group medical visits, cooking education, and behavioral counseling.
(b) For purposes of this section, the following definitions apply:
(1) “Food prescription” means a dosage of medically supportive food approved by a provider enrolled in the Medi-Cal program.
(2) “Healthy food voucher” means a coupon for free or discounted medically supportive food.
(3) “Medically supportive food” means any nutrient rich whole food, including any fruit, vegetable, legume, nut, seed, and whole grain used as a medical treatment to address a specific health condition when utilizing evidence-based practices that demonstrate the prevention, reversal, or management of a specific chronic disease.
(4) “Pilot program” means the three-year pilot program established in the County of Alameda to provide medically supportive food as a covered benefit for a Medi-Cal beneficiary who has a chronic health condition.
(c) To the extent funds are made available in the annual Budget Act for this purpose, and no earlier than January 1, 2021, the department shall establish a pilot program for a three-year period in the County of Alameda to provide medically supportive food is as a covered benefit for a Medi-Cal beneficiary who has a chronic health condition, including prediabetes, diabetes, heart disease, hypertension, kidney disease, or obesity, when utilizing evidence-based practices that demonstrate the prevention, reduction, or reversal of those specified diseases, subject to utilization controls, as described in Section 14133. This benefit Under the pilot program, medically supportive food shall include, but is not limited to, direct medically supportive food assistance, such as all of the following:
(1) Healthy food boxes, groceries, or meals to prevent, reverse, or manage chronic disease.
(2) Healthy food vouchers for food, including fruits and vegetables, to prevent, reverse, or manage chronic disease.
(3) Renewable food prescriptions for food, including fruits and vegetables, to prevent, reverse, or manage chronic disease.
(4) Medically tailored groceries and meals.
(d) The department, in consultation with stakeholders, may establish utilization controls, as described in Section 14133, with respect to the limitation on the number of services, including how these services may be restricted as to a set number within a specified time frame. timeframe. In developing these utilization controls, controls under the pilot program, the department shall consider the nutritional needs of a recipient to prevent, reverse, or manage chronic disease, their acuity, and other selection criteria.
(e) For purposes of implementing this section, the pilot program, the department may enter into exclusive or nonexclusive contracts on a bid or negotiated basis, and shall prioritize public, nonprofit, and community-based organizations or entities that provide California-grown produce and products. Any contract entered into or amended pursuant to this section shall be exempt from Chapter 6 (commencing with Section 14825) of Part 5.5 of Division 3 of Title 2 of the Government Code, Section 19130 of the Government Code, and Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code, and shall be exempt from the review or approval of any division of the Department of General Services.
(f) (1) Upon the completion of the pilot program, and to the extent it can be determined, the department shall evaluate the impact of the pilot program, including, but not limited to, relevant data collected under the Medi-Cal program, and the pilot program’s impact on hospital readmissions, admissions into long-term care facilities, and emergency room utilization rates. The department shall prepare these findings, including its recommendation on expanding the pilot program on a statewide-basis or for an extended period of time, into a finalized report, and shall submit this report to the Legislature by January 1, 2024, or within 12 months after the end of the pilot program, whichever is sooner.
(2) A report submitted pursuant to this subdivision shall be submitted in compliance with Section 9795 of the Government Code.

(f)

(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 implement this section by means of a provider bulletin or similar instruction, without taking regulatory action.

(g)

(h) This section shall only be implemented to the extent permitted by federal law.

(h)

(i) This section shall be implemented only to the extent that federal financial participation is available and any necessary federal approvals have been obtained.
(j) This section shall remain in effect only until January 1, 2026, and as of that date is repealed.

SEC. 2.

 The Legislature finds and declares that a special statute is necessary and that a general statute cannot be made applicable within the meaning of Section 16 of Article IV of the California Constitution because of the unique position of the County of Alameda to continue to build upon its efforts to provide medically supportive food to medically needy residents for purposes of developing a model pilot program to be expanded on a statewide basis.