Bill Text: CA AB608 | 2023-2024 | Regular Session | Enrolled

California Assembly Bill 608

Bill Title: Medi-Cal: comprehensive perinatal services.

Spectrum: Partisan Bill (Democrat 3-0)

Status: (Vetoed) 2024-01-29 - Consideration of Governor's veto stricken from file. [AB608 Detail]

Download: California-2023-AB608-Enrolled.html

Enrolled September 11, 2023

Passed IN Senate September 06, 2023

Passed IN Assembly September 07, 2023

Amended IN Senate July 12, 2023

Amended IN Assembly April 17, 2023

CALIFORNIA LEGISLATURE— 2023–2024 REGULAR SESSION

Assembly Bill

No. 608

Introduced by Assembly Member Schiavo
(Principal coauthors: Assembly Members Arambula and Cervantes)

February 09, 2023

An act to amend Section 14005.185 of, and to add Section 14134.51 to, the Welfare and Institutions Code, relating to Medi-Cal.

LEGISLATIVE COUNSEL'S DIGEST

AB 608, Schiavo. Medi-Cal: comprehensive perinatal services.

Existing law establishes 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 comprehensive perinatal services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Under existing law, a pregnant individual or targeted low-income child who is eligible for, and is receiving, health care coverage under any of specified Medi-Cal programs is eligible for full-scope Medi-Cal benefits for the duration of the pregnancy and for a period of one year following the last day of the individual’s pregnancy.

This bill, during the one-year postpregnancy eligibility period, and as part of comprehensive perinatal services under Medi-Cal, would require the department to cover additional comprehensive perinatal assessments and individualized care plans and to provide additional visits and units of services in an amount, duration, and scope that are at least proportional to those available on July 27, 2021, during pregnancy and the initial 60-day postpregnancy period in effect on that date. The bill would require the department, in coordination with the State Department of Public Health, to consider input from certain stakeholders, as specified, in determining the specific number of additional comprehensive perinatal assessments, individualized care plans, visits, and units of services to be covered.

The bill would require the department to cover comprehensive perinatal services that are rendered by a nonlicensed perinatal health worker in a beneficiary’s home or other community setting away from a medical site, as specified. The bill would also require the department to allow a nonlicensed perinatal health worker rendering those services to be supervised by a community-based organization (CBO) or a local health jurisdiction (LHJ). For these purposes, the bill would require a CBO or LHJ supervising a nonlicensed perinatal health worker to provide those services under contract with a Comprehensive Perinatal Services Program provider.

The bill would condition implementation of the provisions above on receipt of any necessary federal approvals and the availability of federal financial participation. The bill would authorize the department to implement these provisions by all-county letters or similar instructions until regulations are adopted.

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

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

SECTION 1.

Section 14005.185 of the Welfare and Institutions Code is amended to read:

14005.185.

(a) (1) Notwithstanding Section 15840, the income eligibility requirements specified in Section 15832, and the annual redetermination requirements described in Section 14005.37, a pregnant individual or targeted low-income child who is eligible for and is receiving health care coverage under a Medi-Cal program identified in subdivision (b) shall be eligible for full-scope Medi-Cal benefits for the duration of the pregnancy and for a period of one year following the last day of the individual’s pregnancy.

(2) (A) During the one-year postpregnancy eligibility period described in paragraph (1), as part of comprehensive perinatal services under the Medi-Cal program, as described in subdivision (u) of Section 14132 and in Section 14134.5, the department shall cover additional comprehensive perinatal assessments and individualized care plans and shall provide additional visits and units of services in an amount, duration, and scope that are at least proportional to those available on July 27, 2021, during pregnancy and the initial 60-day postpregnancy period in effect on that date.

(B) In determining the specific number of additional comprehensive perinatal assessments, individualized care plans, visits, and units of services to be covered pursuant to subparagraph (A), the department, in coordination with the Maternal, Child, and Adolescent Health Division of the State Department of Public Health, shall consider input from stakeholders, including, but not limited to, perinatal health workers and community-based organizations providing perinatal services.

(b) For purposes of this section, “Medi-Cal program” refers to any of the following programs:

(1) The Medi-Cal Access Program, as described in Chapter 2 (commencing with Section 15810) of Part 3.3.

(2) The Medi-Cal program, as described in this article.

(3) The Perinatal Services Program, as described in Article 4.7 (commencing with Section 14148).

(c) The department shall seek any federal approvals, including under Titles XIX and XXI of the federal Social Security Act (42 U.S.C. Sec. 1396 et seq.), that it determines are necessary to extend coverage for eligible pregnant and postpartum individuals or targeted low-income children as described in this section.

(d) (1) Except as provided in paragraph (2), coverage described in this section shall commence on April 1, 2022, or the effective date or dates reflected in any necessary federal approvals obtained by the department pursuant to subdivision (c), whichever is later.

(2) Notwithstanding paragraph (1), coverage described in this section for populations authorized under Title XXI of the federal Social Security Act (42 U.S.C. Sec. 1397aa) shall be effective on the date reflected in any necessary federal approvals obtained by the department pursuant to subdivision (c).

(e) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement, interpret, or make specific this section by means of all-county letters, provider bulletins, or similar instructions, without taking any further regulatory action.

(f) Implementation of this section is subject to an appropriation in the annual Budget Act, or any other act approved by the Legislature, for the purposes described in this section.

(g) (1) Except as provided in paragraph (2), this section shall be implemented only to the extent that any necessary federal approvals are obtained and federal financial participation is available and not otherwise jeopardized.

(2) With respect to coverage described in the section for populations authorized under Title XXI of the federal Social Security Act (42 U.S.C. Sec. 1397aa), the department may implement this section prior to receipt of all necessary federal approvals, so long as the department determines that federal financial participation under the Medi-Cal program is not otherwise jeopardized.

SEC. 2.

Section 14134.51 is added to the Welfare and Institutions Code, immediately following Section 14134.5, to read:

14134.51.

(a) As part of comprehensive perinatal services under the Medi-Cal program, as described in subdivision (u) of Section 14132 and in Section 14134.5, the department shall do both of the following:

(1) Cover comprehensive perinatal services that are rendered by a nonlicensed perinatal health worker in a beneficiary’s home or other community setting away from a medical site, subject to subparagraph (B) of paragraph (2).

(2) (A) Allow a nonlicensed perinatal health worker rendering comprehensive perinatal services in accordance with paragraph (1) to be supervised by a community-based organization or a local health jurisdiction, in addition to those entities otherwise authorized by law or regulation to supervise a nonlicensed perinatal health worker.

(B) For purposes of subparagraph (A), a community-based organization or local health jurisdiction supervising a nonlicensed perinatal health worker shall provide those comprehensive perinatal services under contract with a Comprehensive Perinatal Services Program provider.

(b) (1) This section shall be implemented only to the extent that any necessary federal approvals are obtained and federal financial participation is available and not otherwise jeopardized.

(2) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department, without taking any further regulatory action, may implement, interpret, or make specific this section by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions, until the time regulations are adopted.