Assembly Health Summary of the #CABudget

Here’s the health portions of the California Assembly’s Report of the 2014-15 Budget Plan, which is up for a vote later today, Sunday, June 15th. It’s a good summary of what the budget includes, complementary to our recent update which discusses what the bill *doesn’t* include:

Department of Health Care Services
* Approves of $437 million General Fund in Medi-Cal to support implementation of the Affordable Care Act.
* Increases Medi-Cal eligibility to 138 percent of the federal poverty level (FPL) for pregnant women, and establishes a “wrap program” for women between 139 and 213 percent FPL in which they can choose to have both Covered California coverage and Medi-Cal as a wrap to pay their premiums and co-pays and to cover services not covered by their Covered California plan, for $16.5 million General Fund savings.
* Includes $1.8 million for a rate increase for PACE programs, effective April 1, 2015.
* Includes trailer bill to allow DHCS to collect supplemental rebates on, and make supplemental payments for, specialty high-cost drugs through managed care, for $6 million General Fund savings. Denies the administration’s January proposal to create a statewide contract drug list, for $32.5 million General Fund savings.
* Approves trailer bill language that clarifies the role of Medicare Advantage plans related to the Coordinated Care Initiative.
* Approves trailer bill language that establishes a new payment structure for the Martin Luther King, Jr. Community Hospital to allow it to reopen in 2015. These provisions conform to federal Affordable Care Act and other federal funding structure changes and there are no additional state cost from this action.
* Approves of establishment of a 3-year mobile vision services pilot program for children in schools, for $1 million General Fund in 2014-15 and $2 million General Fund in 2015-16.
* Includes $3.2 million in one-time Major Risk Medical Insurance Fund for any health plan that is funded by contributions made by agricultural employers, and 85 percent or more of the plan’s eligible participants are agricultural employees for work performed and covered under a collective bargaining agreement.
* Requires the coverage of behavioral health treatment by Medi-Cal if required by the federal government, and requires DHCS to consult with stakeholders on the design of the benefit.
* Includes approximately $20 million and 86 positions for a variety of programs and purposes, including the following: healthcare reform, new county budgeting methodology, Coordinated Care Initiative, mental health wellness, MEDS modernization, ground emergency medical transportation, Breast & Cervical Cancer Program, and Drug Medi-Cal provider re-certifications.
* Includes $3.75 million one-time Major Risk Medical Insurance Fund as the state match in order to receive a total of $37 million to support electronic health records.

Department of Public Health
* Includes $4 million (General Fund) for the Black Infant Health Program and $3 million (General Fund) for new HIV demonstration projects.
* Approves $474,000 ($250,000 General Fund, $224,000 federal funds) and 1 position to establish a State Dental Director and a statewide dental health program.
* Approves $1.9 million and 18 limited-term positions to investigate complaints against long-term care professionals through the Licensing & Certification program.
* Includes $26 million for the Office of AIDS (OA) to add new Hepatitis C drugs to the ADAP formulary and $9.9 million savings to cover out-of-pocket costs for OA beneficiaries who have obtained comprehensive health coverage.
* Approves of trailer bill language to transfer the Drinking Water Program from the Department of Public Health to the State Water Resources Control Board.
* Adopts trailer bill language to require the Department to establish a stakeholder group and report to the Legislature on the Licensing & Certification Program which licenses nursing homes and other facilities. This proposal will enable the Department of Public Health to improve internal business practices and meet federal benchmarks, and support continuation of federal grants through complete and timely fulfillment of state licensing and federal certification workload.
* Adopts trailer bill language to require the Department to convene stakeholders to solicit input on nutrition education and obesity prevention programs, as well as on the transition from contracted to state civil service staff for the operation of the Supplemental Nutrition Assistance Program Education (SNAP-Ed) program.

Managed Risk Medical Insurance Board (MRMIB)
* Approves of the elimination of the MRMIB, the transfer of MRMIB programs to the Department of Health Care Services, and trailer bill for this purpose.
* Denies the proposed elimination of the Major Risk Medical Insurance Program, and instead adopts trailer bill language requiring DHCS to: 1) provide information to enrollees of state-only programs on opportunities for comprehensive coverage; and 2) establish a stakeholder workgroup to explore the use of Proposition 99 funds for on-going coverage for remaining uninsured populations.

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