This page is part of the CalCare AB2200 Reading Group project.
https://docs.google.com/document/d/1yYj2IC5SwW7Jd55WZpuw2JCR8H9oFmWLqjbAyhyyB_o/edit?usp=sharing
JK asked meeting participants to add notes to the text. Some are on there, but there’s a bit more to come. When they’re done, they’ll be copied over to this page and linked out.
Link to view or comment on Chapter 1
Link to view or comment on Chapter 2
Notes
| Bill Text | Notes |
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| SEC. 2. Title 23 (commencing with Section 100600) is added to the Government Code, to read:TITLE 23. The California Guaranteed Health Care for All Act CHAPTER 2. Governance | CHAPTER 2 GOVERNANCE Healthcare creates an executive board, the Cal Care board, comprised of nine members all residents of California: 5 appointed by the governor to by Senate rules committee and two by speaker of the house. There is a non-voting ex official member who is the California Health and human Services secretary. The board is appointed for 4 years. The board will hire an executive director. The board will abide by the open meeting Act. The board will convene a Cal Care public advisory committee made up of residents of California for 2-year terms. There are some DEI statements about having the board reflect California residents. The board will organize, administer and market single-payer and establish an enrollment system. They will produce an annual written progress report and contract with not-for-profit organizations to establish an advisory committee on long-term services and supports for guiding the board on policy. The board will approve funds from the Cal Care trust fund or other appropriated funds for dislocated employees as a result of the bill. The board will establish a committee on the public retirement system PERS health benefits. The board will analyze data to assess patient outcomes and utilization of care. The board will create a process for entering into participation agreements with healthcare providers and will establish a Cal Care contracting manual. The board is not to disclose PII, personal identifying information. And the board is to provide a fiscal analysis by July 1st. |
| 100610. (a) CalCare shall be governed by an executive board, known as the CalCare Board, consisting of nine voting members who are residents of California. The CalCare Board shall be an independent public entity not affiliated with an agency or department. Of the members of the board, five shall be appointed by the Governor, two shall be appointed by the Senate Committee on Rules, and two shall be appointed by the Speaker of the Assembly. The Secretary of California Health and Human Services or the secretary’s designee shall serve as a nonvoting, ex officio member of the board. | |
| (b) (1) A member of the board, other than an ex officio member, shall be appointed for a term of four years, except that the initial appointment by the Senate Committee on Rules shall be for a term of five years, and the initial appointment by the Speaker of the Assembly shall be for a term of two years. These members may be reappointed for succeeding four-year terms. | |
| (2) Appointments by the Governor shall be subject to confirmation by the Senate. A member of the board may continue to serve until the appointment and qualification of the member’s successor. Vacancies shall be filled by appointment for the unexpired term. The board shall elect a chairperson on an annual basis. | |
| (c) (1) Each person appointed to the board shall have demonstrated and acknowledged expertise in health care policy or delivery.(2) Appointing authorities shall also consider the expertise of the other members of the board and attempt to make appointments so that the board’s composition reflects a diversity of expertise in the various aspects of health care and the diversity of various regions within the state. | |
| (3) Appointments to the board shall be made as follows:(A) Two health care professionals who practice medicine. At least one shall be a practicing physician or medical doctor.(B) One registered nurse.(C) One public health professional.(D) One mental health professional.(E) One member with an institutional provider background.(F) One representative of a not-for-profit organization that advocates for individuals who use health care in California(G) One representative of a labor organization.(H) One member of the committee established pursuant to Section 100611, who shall serve on a rotating basis to be determined by the committee. | I’m wondering about gender diversity representation, women’s health, and also about LGBT health issues. – johnk |
| (d) Each member of the board shall have the responsibility and duty to meet the requirements of this title and all applicable state and federal laws and regulations, to serve the public interest of the individuals, employers, and taxpayers seeking health care coverage through CalCare, and to ensure the operational well-being and fiscal solvency of CalCare. | |
| (e) In making appointments to the board, the appointing authorities shall take into consideration the racial, ethnic, gender, and geographical diversity of the state so that the board’s composition reflects the communities of California. | 9 spaces isn’t that much space to create real representation – johnk |
| (f) (1) A member of the board or of the staff of the board shall not be employed by, a consultant to, a member of the board of directors of, affiliated with, or otherwise a representative of, a health care professional, institutional provider, or group practice while serving on the board or on the staff of the board, except board members who are practicing health care professionals may be employed by an institutional provider or group practice. A member of the board or of the staff of the board shall not be a board member or an employee of a trade association of health professionals, institutional providers, or group practices while serving on the board or on the staff of the board. A member of the board or of the staff of the board may be a health care professional if that member does not have an ownership interest in an institutional provider or a professional health care practice. | |
| (2) Notwithstanding Section 11009, a board member shall receive compensation for service on the board. A board member may receive a per diem and reimbursement for travel and other necessary expenses, as provided in Section 103 of the Business and Professions Code, while engaged in the performance of official duties of the board. | |
| (g) A member of the board shall not make, participate in making, or in any way attempt to use the member’s official position to influence the making of a decision that the member knows, or has reason to know, will have a reasonably foreseeable material financial effect, distinguishable from its effect on the public generally, on the member or a person in the member’s immediate family, or on either of the following: | |
| (1) Any source of income, other than gifts and other than loans by a commercial lending institution in the regular course of business on terms available to the public without regard to official status aggregating two hundred fifty dollars ($250) or more in value provided to, received by, or promised to the member within 12 months before the decision is made.(2) Any business entity in which the member is a director, officer, partner, trustee, employee, or holds any position of management. | |
| (h) There shall not be liability in a private capacity on the part of the board or a member of the board, or an officer or employee of the board, for or on account of an act performed or obligation entered into in an official capacity, when done in good faith, without intent to defraud, and in connection with the administration, management, or conduct of this title or affairs related to this title. | |
| (i) The board shall hire an executive director to organize, administer, and manage the operations of the board. The executive director shall be exempt from civil service and shall serve at the pleasure of the board.(j) The board shall be subject to the Bagley-Keene Open Meeting Act (Article 9 (commencing with Section 11120) of Chapter 1 of Part 1 of Division 3 of Title 2), except that the board may hold closed sessions when considering matters related to litigation, personnel, contracting, and provider rates. | |
| (k) The board may adopt rules and regulations as necessary to implement and administer this title in accordance with the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2). | |
| 100611. (a) The board shall convene a CalCare Public Advisory Committee to advise the board on all matters of policy for CalCare. The committee shall consist of members who are residents of California.(b) Members of the committee shall be appointed by the board for a term of two years. These members may be reappointed for succeeding two-year terms. | Board appointments are described in the note at the top. |
| (c) The members of the committee shall be as follows:(1) Four health care professionals.(2) One registered nurse.(3) One representative of a licensed health facility.(4) One representative of an essential community provider.(5) One representative of a physician organization or medical group.(6) One behavioral health provider.(7) One dentist or oral care specialist.(8) One representative of private hospitals.(9) One representative of public hospitals.(10) One individual who is enrolled in and uses health care items and services under CalCare.(11) Two representatives of organizations that advocate for individuals who use health care in California, including at least one representative of an organization that advocates for the disabled community.(12) Two representatives of organized labor, including at least one labor organization representing registered nurses. | What is an essential community provider? Patients have one seat on this Policy board. Two seats for healthcare advocacy orgs, one of which is for the disabled community. Roughly 3 seats for “the people”. What about PAs, NPs? As organizers how would you use 100611 to advocate for this bill? Objections will be that this is a bureaucracy. “Creating a new DMV.” (We need to share stories about good DMV experiences.) |
| (d) In convening the committee pursuant to this section, the board shall make good faith efforts to ensure that their appointments, as a whole, reflect, to the greatest extent feasible, the social and geographic diversity of the state. | |
| (e) Members of the committee shall serve without compensation, but shall be reimbursed for actual and necessary expenses incurred in the performance of their duties to the extent that reimbursement for those expenses is not otherwise provided or payable by another public agency or agencies, and shall receive one hundred fifty dollars ($150) for each full day of attending meetings of the committee. For purposes of this section, “full day of attending a meeting” means presence at, and participation in, not less than 75 percent of the total meeting time of the committee during any particular 24-hour period. | |
| (f) The committee shall meet at least once every quarter, and shall solicit input on agendas and topics set by the board. All meetings of the committee shall be open to the public, pursuant to the Bagley-Keene Open Meeting Act (Article 9 (commencing with Section 11120) of Chapter 1 of Part 1 of Division 3 of Title 2).(g) The committee shall elect a chairperson who shall serve for two years and who may be reelected for an additional two years. | |
| (h) Committee members, or their assistants, clerks, or deputies, shall not use for personal benefit any information that is filed with, or obtained by, the committee and that is not generally available to the public. | |
| 100612. (a) The board shall have all powers and duties necessary to establish and implement CalCare. The board shall provide, under CalCare, comprehensive universal single-payer health care coverage and a health care cost control system for the benefit of all residents of the state. | |
| (b) The board shall, to the maximum extent possible, organize, administer, and market CalCare and services as a single-payer program under the name “CalCare” or any other name as the board determines, regardless of which law or source the definition of a benefit is found, including, on a voluntary basis, retiree health benefits. In implementing this title, the board shall avoid jeopardizing federal financial participation in the programs that are incorporated into CalCare and shall take care to promote public understanding and awareness of available benefits and programs. | |
| (c) The board shall consider any matter to effectuate the provisions and purposes of this title. The board shall not have executive, administrative, or appointive duties except as otherwise provided by law.(d) The board shall designate the executive director to employ necessary staff and authorize reasonable, necessary expenditures from the CalCare Trust Fund to pay program expenses and to administer CalCare. The executive director shall hire or designate another to hire staff, who shall not be exempt from civil service, to implement fully the purposes and intent of CalCare. The executive director, or the executive director’s designee, shall give preference in hiring to all individuals displaced or unemployed as a direct result of the implementation of CalCare, including as set forth in Section 100615. | |
| (e) The board shall do or delegate to the executive director all of the following:(1) Determine goals, standards, guidelines, and priorities for CalCare.(2) Annually assess projected revenues and expenditures and ensure the financial solvency of CalCare.(3) Develop CalCare’s budget pursuant to Section 100676 to ensure adequate funding to meet the health care needs of the population, and review all budgets annually to ensure they address disparities in service availability and health care outcomes and for sufficiency of rates, fees, and prices to address disparities. | |
| (4) Establish standards and criteria for the development and submission of provider operating and capital expenditure requests pursuant to Article 2 (commencing with Section 100650) of Chapter 5.(5) Establish standards and criteria for the allocation of funds from the CalCare Trust Fund pursuant to Section 100676.(6) Determine when individuals may begin enrolling in CalCare. There shall be an implementation period that begins on the date that individuals may begin enrolling in CalCare and ends on a date determined by the board. | |
| (7) Establish an enrollment system that ensures all eligible California residents, including those who travel out of state, those who have disabilities that limit their mobility, hearing, vision, or mental or cognitive capacity, those who cannot read, and those who do not speak or write English, are aware of their right to health care and are formally enrolled in CalCare.(8) Negotiate payment rates, set payment methodologies, and set prices involving aspects of CalCare and establish procedures thereto, including procedures for negotiating fee-for-service payment to certain participating providers pursuant to Chapter 8 (commencing with Section 100685). | |
| (9) Oversee the establishment, as part of the administration of CalCare, of the committee pursuant to Section 100611.(10) Implement policies to ensure that all Californians receive culturally, linguistically, and structurally competent care, pursuant to Chapter 6 (commencing with Section 100660), ensure that all disabled Californians receive care in accordance with the federal Americans with Disabilities Act (42 U.S.C. Sec. 12101 et seq.) and Section 504 of the federal Rehabilitation Act of 1973 (29 U.S.C. Sec. 794), and develop mechanisms and incentives to achieve these purposes and a means to monitor the effectiveness of efforts to achieve these purposes. | |
| (11) Establish standards for mandatory reporting by participating providers and penalties for failure to report, including reporting of data pursuant to Section 100617 and to Section 100641.(12) Implement policies to ensure that all residents of this state have access to medically appropriate, coordinated mental health services. | |
| (13) Ensure the establishment of policies that support the public health.(14) Meet regularly with the committee.(15) Determine an appropriate level of, and provide support during the transition for, training and job placement for persons who are displaced from employment as a result of the initiation of CalCare pursuant to Section 100615. | |
| (16) In consultation with the Department of Managed Health Care, oversee the establishment of a system for resolution of disputes pursuant to Section 100637 and a system for independent medical review pursuant to Section 100637.(17) Establish and maintain an internet website that provides information to the public about CalCare that includes information that supports choice of providers and facilities and informs the public about meetings of the board and the committee.(18) Establish a process that is accessible to all Californians for CalCare to receive the concerns, opinions, ideas, and recommendations of the public regarding all aspects of CalCare. | Public input. |
| (19) (A) Annually prepare a written report on the implementation and performance of CalCare functions during the preceding fiscal year, that includes, at a minimum:(i) The manner in which funds were expended.(ii) The progress toward and achievement of the requirements of this title.(iii) CalCare’s fiscal condition.(iv) Recommendations for statutory changes.(v) Receipt of payments from the federal government and other sources.(vi) Whether current year goals and priorities have been met.(vii) Future goals and priorities. | |
| (B) The report shall be transmitted to the Legislature and the Governor, on or before October 1 of each year and at other times pursuant to this division, and shall be made available to the public on the internet website of CalCare.(C) A report made to the Legislature pursuant to this subdivision shall be submitted pursuant to Section 9795. | |
| (f) The board may do or delegate to the executive director all of the following:(1) Negotiate and enter into any necessary contracts, including contracts with health care providers and health care professionals.(2) Sue and be sued.(3) Receive and accept gifts, grants, or donations of moneys from any agency of the federal government, any agency of the state, and any municipality, county, or other political subdivision of the state.(4) Receive and accept gifts, grants, or donations from individuals, associations, private foundations, and corporations, in compliance with the conflict-of-interest provisions to be adopted by the board by regulation.(5) Share information with relevant state departments, consistent with the confidentiality provisions in this title, necessary for the administration of CalCare. | |
| (g) (1) A carrier shall not offer benefits or cover health care items or services for which coverage is offered to individuals under CalCare.(2) Notwithstanding paragraph (1), if otherwise authorized under state law, a carrier may offer benefits to cover health care items or services that are not offered to individuals under CalCare. | |
| (3) This title does not prohibit a carrier from offering either of the following:(A) Benefits to or for individuals, including their families, who are employed or self-employed in the state, but who are not residents of the state.(B) Benefits during the implementation period to individuals who enrolled or may enroll as members of CalCare. | |
| (4) Paragraph (1) applies to a carrier except as otherwise prohibited by federal law.(h) After the end of the implementation period, a person shall not be a board member unless the person is a member of CalCare, except the ex officio member. | |
| (i) No later than two years after the effective date of this section, the board shall develop proposals for the following:(1) In consultation with the Advisory Committee on Public Employees’ Retirement System Health Benefits established under Section 100616, accommodating employer retiree health benefits for people who have been members of the Public Employees’ Retirement System, but live as retirees out of the state.(2) Accommodating employer retiree health benefits for people who earned or accrued those benefits while residing in the state before the implementation of CalCare and live as retirees out of the state. | |
| (j) The board shall develop a proposal for CalCare coverage of health care items and services currently covered under the workers’ compensation system, including whether and how to continue funding for those item and services under that system and how to incorporate experience rating. | |
| 100613. The board may contract with not-for-profit organizations to provide both of the following:(a) Assistance to CalCare members with respect to selection of a participating provider, enrolling, obtaining health care items and services, disenrolling, and other matters relating to CalCare.(b) Assistance to a health care provider providing, seeking, or considering whether to provide health care items and services under CalCare. | |
| 100614. (a) There is hereby established in state government an Advisory Commission on Long-Term Services and Supports, to advise the board on matters of policy related to long-term services and supports for CalCare. | |
| (b) The advisory commission shall consist of eleven members who are residents of California. Of the members of the advisory commission, five shall be appointed by the Governor, three shall be appointed by the Senate Committee on Rules, and three shall be appointed by the Speaker of the Assembly. The members of the advisory commission shall include all of the following:(1) At least two people with disabilities who use long-term services and supports.(2) At least two older adults who use long-term services and supports.(3) At least two providers of long-term services and supports, including one family attendant or family caregiver.(4) At least one representative of a disability rights organization.(5) At least one representative or member of a labor organization representing workers who provide long-term services and supports.(6) At least one representative of a group representing seniors.(7) At least one researcher or academic in long-term services and supports. | |
| (c) In making appointments pursuant to this section, the Governor, the Senate Committee on Rules, and the Speaker of the Assembly shall make good faith efforts to ensure that their appointments, as a whole, reflect, to the greatest extent feasible, the diversity of the population of people who use long-term services and supports, including their race, ethnicity, national origin, primary language use, age, disability, sex, including gender identity and sexual orientation, geographic location, and socioeconomic status. | |
| (d) (1) A member of the advisory commission may continue to serve until the appointment and qualification of that member’s successor. Vacancies shall be filled by appointment for the unexpired term.(2) Members of the advisory commission shall be appointed for a term of four years, except that the initial appointment by the Senate Committee on Rules shall be for a term of five years, and the initial appointment by the Speaker of the Assembly shall be for a term of two years. These members may be reappointed for succeeding four-year terms.(3) Vacancies that occur shall be filled within 30 days after the occurrence of the vacancy, and shall be filled in the same manner in which the vacating member was initially selected or appointed. The Secretary of California Health and Human Services shall notify the appropriate appointing authority of any expected vacancies on the long-term services and supports advisory commission. | |
| (e) Members of the advisory commission shall serve without compensation, but shall be reimbursed for actual and necessary expenses incurred in the performance of their duties to the extent that reimbursement for those expenses is not otherwise provided or payable by another public agency or agencies. Members shall also receive one hundred fifty dollars ($150) for each full day of attending meetings of the advisory commission. For purposes of this section, “full day of attending a meeting” means presence at, and participation in, not less than 75 percent of the total meeting time of the advisory commission during any particular 24-hour period. | |
| (f) The advisory commission shall meet at least six times per year in a place convenient to the public. All meetings of the advisory commission shall be open to the public, pursuant to the Bagley-Keene Open Meeting Act (Article 9 (commencing with Section 11120) of Chapter 1 of Part 1 of Division 3 of Title 2).(g) The advisory commission shall elect a chairperson who shall serve for two years and who may be reelected for an additional two years.(h) It is unlawful for the advisory commission members or any of their assistants, clerks, or deputies to use for personal benefit any information that is filed with, or obtained by, the advisory commission and that is not generally available to the public. | |
| 100615. (a) The board shall provide funds from the CalCare Trust Fund or funds otherwise appropriated for this purpose to the Secretary of Labor and Workforce Development for program assistance to individuals employed or previously employed in the fields of health insurance, health care service plans, or other third-party payments for health care, individuals providing services to health care providers to deal with third-party payers for health care, individuals who may be affected by and who may experience economic dislocation as a result of the implementation of this title, and individuals whose jobs may be or have been ended as a result of the implementation of CalCare, consistent with otherwise applicable law. | |
| (b) Assistance described in subdivision (a) shall include job training and retraining, job placement, preferential hiring, wage replacement, retirement benefits, and education benefits. | |
| 100616. (a) The board shall establish an Advisory Committee on Public Employees’ Retirement System Health Benefits to provide input, including recommendations, to the board on matters of policy related to public employee retiree health benefits and CalCare, including all of the following:(1) Processes to obtain approval of CalCare as a health benefits plan under public pension or retirement systems.(2) Recommendations to the Legislature and Governor to provide tax or other accommodations for people who have accrued retiree health benefit contributions under public employees’ retirement systems. | |
| (3) Recommendations to, and coordination with, public employee retirement system boards to fully integrate beneficiaries into CalCare.(4) Processes to change or phase out health benefits under public employees’ retirement systems to fully integrate beneficiaries into CalCare.(5) Federal approvals that may support transition of Medicare plans under public employees’ retirement systems to CalCare. | |
| (b) (1) The board shall appoint the members of the advisory committee during the implementation period. Appointments shall be made by a majority vote of the voting members of the board. When appointing members to the advisory committee, the board shall aim for broad representation, including, at a minimum, the following representatives of public sector labor organizations, the Public Employees’ Retirement System, the State Teachers’ Retirement System, the University of California Retirement System, and locally administered public pension or retirement systems. At a minimum, one-half of the advisory committee members shall be representatives of public sector labor organizations. | |
| (2) Each appointed member shall serve at the discretion of the board and may be removed at any time by a majority vote of the voting members of the board.(3) Advisory committee members shall not have access to confidential, nonpublic information that is accessible to the board and office. Instead, the advisory committee shall only have access to information that is publicly available. Neither the board nor the office shall disclose any confidential, nonpublic information to the advisory committee members.(4) Advisory committee members shall receive reimbursement for travel and other actual costs. | |
| (c) The advisory committee shall meet at least four times per year in a place convenient to the public. All meetings of the advisory committee shall be open to the public, pursuant to the Bagley-Keene Open Meeting Act (Article 9 (commencing with Section 11120) of Chapter 1 of Part 1 of Division 3 of Title 2).(d) The board shall consider input, including recommendations, from the advisory committee, along with public comments, in the board’s deliberation and decisionmaking. | |
| 100617. (a) The board shall utilize the data collected pursuant to Chapter 1 (commencing with Section 128675) of Part 5 of Division 107 of the Health and Safety Code to assess patient outcomes and to review utilization of health care items and services paid for by CalCare. | |
| (b) As applicable to the type of provider, the board shall require and enforce the collection and availability of all of the following data to promote transparency, assess quality of care, compare patient outcomes, and review utilization of health care items and services paid for by CalCare, which shall be reported to the board and, as applicable, the Department of Health Care Access and Information or the Medical Board of California:(1) Inpatient discharge data, including severity of illness and risk of mortality, with respect to each discharge.(2) Emergency department, ambulatory surgical center, and other outpatient department data, including cost data, charge data, length of stay, and patients’ unit of observation with respect to each individual receiving health care items and services. | |
| (3) For hospitals and other providers receiving global budgets, annual financial data, including all of the following:(A) Community benefit activities, including charity care, to which Section 501(r) of Title 26 of the United States Code applies, provided by the provider in dollar value at cost.(B) Number of employees by employee classification or job title and by patient care unit or department.(C) Number of hours worked by the employees in each patient care unit or department.(D) Employee wage information by job title and patient care unit or department.(E) Number of registered nurses per staffed bed by patient care unit or department.(F) A description of all information technology, including health information technology and artificial intelligence, used by the provider and the dollar value of that information technology.(G) Annual spending on information technology, including health information technology, artificial intelligence, purchases, upgrades, and maintenance. | |
| (4) Risk-adjusted and raw outcome data, including:(A) Risk-adjusted outcome reports for medical, surgical, and obstetric procedures selected by the Department of Health Care Access and Information pursuant to Sections 128745 to 128750, inclusive, of the Health and Safety Code.(B) Any other risk-adjusted outcome reports that the board may require for medical, surgical, and obstetric procedures and conditions as it deems appropriate. | |
| (5) A disclosure made by a provider as set forth in Article 6 (commencing with Section 650) of Chapter 1 of Division 2 of the Business and Professions Code. | |
| (c) (1) The Medical Board of California shall collect data for the outpatient surgery settings that the Medical Board of California regulates that meets the Ambulatory Surgery Data Record requirements of Section 128737 of the Health and Safety Code, and shall submit that data to the CalCare board.(2) The CalCare board shall make that data available as required pursuant to subdivision (d). | |
| (d) The board shall make all disclosed data collected under this section publicly available and searchable through an internet website and through the Department of Health Care Access and Information public data sets.(e) Consistent with state and federal privacy laws, the board shall make available data collected through CalCare to the Department of Health Care Access and Information and the California Health and Human Services Agency, consistent with this title and otherwise applicable law, to promote and protect public, environmental, and occupational health. | |
| (f) Before full implementation of CalCare, and, for providers seeking to receive global budgets or salaried payments under Article 2 (commencing with Section 100650) of Chapter 5, as applicable, before the negotiation of initial payments, the board shall provide for the collection and availability of the following data:(1) The number of patients served. | |
| (2) The dollar value of the care provided, at cost, for all of the following categories of Department of Health Care Access and Information data items:(A) Patients receiving charity care.(B) Contractual adjustments of county and indigent programs, including traditional and managed care.(C) Bad debts or any other unpaid charges for patient care that the provider sought, but was unable to collect. | |
(g) The board shall regularly analyze information reported under this section and shall establish rules and regulations to allow researchers, scholars, participating providers, and others to access and analyze data for purposes consistent with this title, without compromising patient privacy. | |
| (h) (1) The board shall establish regulations for the collection and reporting of data to promote transparency, assess patient outcomes, and review utilization of services provided by physicians and other health care professionals, as applicable, and paid for by CalCare.(2) In implementing this section, the board shall utilize data that is already being collected pursuant to other state or federal laws and regulations whenever possible.(3) Data reporting required by participating providers under this section shall supplement the data collected by the Department of Health Care Access and Information and shall not modify or alter other reporting requirements to governmental agencies. | |
| (i) The board shall not utilize quality or other review measures established under this section for the purposes of establishing payment methods to providers.(j) The board may coordinate and cooperate with the Department of Health Care Access and Information or other health planning agencies of the state to implement the requirements of this section. | Prevent “pay for performance”? P4P discourages providers from providing service for difficult cases. BPD. Obesity. |
| 100618. (a) The board shall establish and use a process to enter into participation agreements with health care providers and other contracts with contractors. A contract entered into pursuant to this title shall be exempt from Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code, and shall be exempt from the review or approval of the Department of General Services. The board shall adopt a CalCare Contracting Manual incorporating procurement and contracting policies and procedures that shall be followed by CalCare. The policies and procedures in the manual shall be substantially similar to the provisions contained in the State Contracting Manual. | |
| (b) The adoption, amendment, or repeal of a regulation by the board to implement this section, including the adoption of a manual pursuant to subdivision (a) and any procurement process conducted by CalCare in accordance with the manual, is exempt from the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2). | |
| 100619. (a) Notwithstanding any other law, CalCare, a state or local agency, or a public employee acting under color of law shall not provide or disclose to anyone, including the federal government, any personally identifiable information obtained, including a person’s religious beliefs, practices, or affiliation, national origin, ethnicity, or immigration status, for law enforcement or immigration purposes. | |
| (b) Notwithstanding any other law, law enforcement agencies shall not use CalCare moneys, facilities, property, equipment, or personnel to investigate, enforce, or assist in the investigation or enforcement of a criminal, civil, or administrative violation or warrant for a violation of a requirement that individuals register with the federal government or a federal agency based on religion, national origin, ethnicity, immigration status, or other protected category as recognized in the Unruh Civil Rights Act (Section 51 of the Civil Code). | |
| 100620. (a) On or before July 1, ____, the board shall conduct and deliver a fiscal analysis to determine both of the following:(1) Whether or not CalCare may be implemented.(2) If revenue is more likely than not to be sufficient to pay for program costs within eight years of CalCare’s implementation. | |
| (b) The board may contract with one or more independent entities with the appropriate expertise or coordinate with other state agencies to conduct the fiscal analysis.(c) The board shall deliver, and upon request present, the fiscal analysis to the Chair of the Senate Committee on Health, the Chair of the Assembly Committee on Health, the Chair of the Senate Committee on Appropriations, and the Chair of the Assembly Committee on Appropriations. |
Take Action
Alert to all: We need letters to the CA Assembly Committee on Health by April 17. Orgs are a priority, but they do also tabulate letters from individuals. Here is a Sample Letter.
This page is part of the CalCare AB2200 Reading Group project.