Bill Text: CA AB1117 | 2015-2016 | Regular Session | Amended
Bill Title: Medi-Cal: vaccination rates.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Failed) 2016-11-30 - From Senate committee without further action. [AB1117 Detail]
Download: California-2015-AB1117-Amended.html
BILL NUMBER: AB 1117 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY JUNE 1, 2015
AMENDED IN ASSEMBLY MARCH 26, 2015
INTRODUCED BY Assembly Member Cristina Garcia
FEBRUARY 27, 2015
An act to add Article 6.3 (commencing with Section 14197) to
Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions
Code, relating to vaccinations.
LEGISLATIVE COUNSEL'S DIGEST
AB 1117, as amended, Cristina Garcia. Medi-Cal: vaccination rates.
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.
The Medi-Cal program is, in part, governed and funded by federal
Medicaid Program provisions. Existing law requires each county to
establish a community child health and disability prevention program
to include, among other things, health screening and evaluation
services for all children that include immunizations and an
assessment of immunization status.
This bill would require the State Department of Health Care
Services to establish and administer the California Childhood
Immunization Quality Improvement Fund (CCIQIF) program to improve
childhood immunization rates, and would require the department to
submit an application to the federal Centers for Medicare and
Medicaid Services for a waiver to implement a 5-year demonstration
project to implement the program. The bill would require the
department to develop a plan for the collection and expenditure of
CCIQIF moneys according to specified guidelines, including voluntary
contributions from Medi-Cal managed care plans to be used for
provider support payments and reward payments to Medi-Cal managed
care plans, as specified. The bill would require the department to
contract with specified researchers to develop and submit to the
Legislature an evaluation of the effectiveness of the demonstration
project. This bill would make these provisions inoperative on a
specified date.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Article 6.3 (commencing with Section 14197) is added to
Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions
Code, to read:
Article 6.3. California Childhood Immunization Quality
Improvement Fund (CCIQIF) Program
14197. (a) The Legislature finds and declares all of the
following:
(1) The 2014--15 2014-15 outbreaks
of vaccine-preventable diseases threaten the health and safety of the
California public.
(2) Only 71 percent of young children in California between the
ages of 19 to 35 months are immunized, which is below the national
average of 75 percent, according to 2010 data reported by the Kaiser
Family Foundation.
(3) In 2013, 39,000 two year olds
two-year-olds lacked one or more recommended immunizations,
according to the State Department of Health Care Services.
(4) The social and direct economic costs of ensuring each child
receives the Centers for Disease Control and Prevention Advisory
Committee for Immunization Practices recommended schedule for
vaccines far outweighs outweigh the
costs of not providing routine immunizations. It is estimated that
for every $1 one dollar ($1) spent on
vaccinations, as many as $29 twenty-nine
dollars ($29) can be saved in direct and indirect costs.
(5) California children are required to be fully vaccinated before
they enter kindergarten, with some exceptions. However, there are
no fewer official requirements for
younger children who are often more susceptible to dire consequences
from vaccine-preventable diseases.
(b) It is the intent of the Legislature, by enacting this chapter,
to ensure that all possible steps are taken to ensure that
two year old two-year-old children who are
enrolled in Medi-Cal managed care receive all recommended
immunizations.
14197.1. For purposes of this article, "Medi-Cal managed care
plan" means any prepaid health plan or Medi-Cal managed care plan
contracting with the department to provide services to enrolled
Medi-Cal beneficiaries under this chapter or Chapter 8 (commencing
with Section 14200).
14197.2. (a) The department shall establish and administer the
California Childhood Immunization Quality Improvement Fund (CCIQIF)
program to improve childhood immunization rates.
(b) (1) The department shall submit an application to the federal
Centers for Medicare and Medicaid Services for a waiver or
demonstration project to implement the CCIQIF program no later than
120 270 days after the operative date
of this article. The department shall determine the form of waiver
most appropriate to achieve the purposes of this article.
(2) The demonstration project shall operate for a period of five
years.
(c) In developing the waiver or demonstration project application,
the department shall consult with interested stakeholders, including
the Medi-Cal Children's Health Advisory Panel and the Managed Care
Advisory Workgroup. The department shall work with stakeholders to
incorporate public comment into the waiver or demonstration project
application.
14197.3. The department shall develop a plan for the collection
and expenditure of CCIQIF moneys according to all of the following
guidelines:
(a) The CCIQIF program may be financed through voluntary
contributions from Medi-Cal managed care plans that shall be used to
draw down federal financial participation consistent with federal
law.
(b) The department shall allocate 33.3 percent of CCIQIF
expenditures for provider support payments
for use by the department for administrative staff,
training, and other resources to support providers in employing
strategies to improve immunization rates in their practices, which
may include patient reminders, promotion of colocation vaccination
delivery with other services, and other strategies as specified by
the department after consideration of public comment. The funds
shall also be used to pay for the department's staffing and
administrative costs directly attributable to implementing this
article, including costs related to developing and seeking federal
approval for the CCIQIF and administering the fund.
(c) (1) The department shall allocate 66.7 percent of CCIQIF
expenditures for reward payments to Medi-Cal managed care plans. The
rate of the reward shall be $125 one hundred
twenty-five dollars ($125) for each enrollee who receives all
recommended vaccinations by the time he or she reaches two years of
age, as determined by the Childhood Immunization Status measure of
the Healthcare Effectiveness Data and Information Set (HEDIS).
(2) Any unearned reward payment expenditures shall roll over to
the subsequent demonstration project year. If all reward payment
expenditures are earned within a demonstration project year, no
additional reward payments shall be distributed until the next
demonstration project year begins.
(d) At least 20 percent of the CCIQIF expenditures used for reward
payments pursuant to subdivision (c) shall be passed through to
contracted providers based on the number of Medi-Cal enrollees who
are under two years of age in each provider's respective panel.
14197.4. (a) The department shall contract with the University of
California or any other researchers to develop and submit, in
compliance with Section 9795 of the Government Code, to the
Legislature an evaluation of the effectiveness of the demonstration
project using data collected from the first three years of the waiver
period or demonstration project. That evaluation shall be submitted
within the fourth year of the waiver period or demonstration project.
(b) The evaluation shall, at a minimum, include an assessment of
the most effective administrative support strategies.
(c) The evaluation shall be financed with no more than five
percent of the total annual CCIQIF program expenditure dollars.
During the waiver or demonstration project year that the evaluation
is commissioned, CCIQIF provider support expenditures shall be
reduced, commensurate with available funds, to offset the cost of the
evaluation contract.
14197.5. This chapter article shall
be implemented only if and to the extent that federal financial
participation is available and any necessary federal approvals have
been obtained.
14197.6. (a) This chapter article
shall become inoperative on the date that the Director of Health Care
Services executes a declaration, which shall be retained by the
director, stating that the demonstration project has concluded, and
shall, six months after the date the declaration is executed, be
repealed.
(b) In addition to the requirements specified in subdivision (a),
the director shall post the declaration on the department's Internet
Web site and the director shall send the declaration to the
appropriate policy committees of the Legislature and to the
Legislative Counsel.
