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HomeMy WebLinkAboutMINUTES - 01051999 - C43 TO: BOARD OF SUPERVISORS Contra {y FROM: PHIL BATCHELOR, COUNTY ADMINISTRATOR Costa c. County DATE: December 10, 1998 �S A . SUBJECT: LEGISLATION: AB 40 (WAYNE) - FUNDING FOR BREAST CANCER TREATMENT SPECIFIC REOUEST(S)OR RECOMMENDATIONS)&BACKGROUND AND JUSTIFICATION RECOMMENDATION: ADOPT a position in support of AB 40 by Assemblyman Wayne, which would establish and fund the Breast Cancer Treatment Program. BACKGROUND: The Board of Supervisors has included in Its 1999 Legislative Program support for efforts to increase funding for breast cancer awareness, public education, and treatment. Assemblyman Howard Wayne of San Diego has introduced AB 40 which, as introduced, would do all of the following: • Establish the Breast Cancer Treatment Program. • Provide that the Program would provide breast cancer treatment services to uninsured and underinsured women with incomes at or below 200% of the Federal poverty level. • Require the State Department of Health Services to administer the Program. • Require the Department to contract with a private non-profit organization that meets certain criteria specified in the bill. CONTINUED ON ATTACHMENT: Y€S SIGNATURE, X—RECOMMENDATION OF COUNTY ADMINISTRATOR —RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER SIGNATURE S ACTION IJP BOARD ON APPROVED AS RECOMMENDED dal VOTE OF SUPERVISORS �/ I HEREBY CERTIFY THAT THIS IS A TRUE ...Ll.._UNANIMOUS(ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT: ABSTAIN: OF SUPERVISO THE DATE SHOWN. ATTESTED ' Contact. HIL BATCHELOR, ESS OF THE BOARD OF cc' See Page 2 SUPERVISORS AND COUNTY ADMINISTRATOR BY /' DEPUTY i CALIFORNIA LEGISLATURE-1999-00 REGULAR.SESSION ASSEMBLY BILL No. 40 Introduced by Assembly Member Wayne December 7, 1998 An act to acid Article 1.5 (commencing with Section 144160) to Chapter 2 of Part 1 of Division 103 of the Health and Safety Code, relating to health, making an appropriation therefor, and declaring the urgency thereof, to take effect immediately. LEGISLATIVE COUNSELS DIGEST AB 40, as introduced,Wayne. Breast cancer: treatment. Existing law establishes the Breast Cancer Control Program, which provides early breast cancer detection services for uninsured and underinsured women. This bill would establish the Breast Cancer Treatment Program for purposes of providing breast cancer treatment services to uninsured and underinsured women with incomes at or below 200% of the federal poverty level, and would require the State Department of Health Services, only when the Legislature has appropriated funds for the program, to administer the program and any funds appropriated for the program. It would further require the department to award the contract for operation of the program to a bidder that meets specified eligibility criteria. in addition, the bill would require the organization awarded the contract to encourage recipients of benefits under this program to seek more comprehensive health coverage through the Major Risk Medical Insurance Program, 99 ;'jam AB 40 -2- and ""2-"and would authorize the contracting organization, in lieu of providing reimbursement for breast cancer treatment services, to provide incentives for recipients to enroll in the Magor Risk Medical Insurance Program by providing funds to reduce the individuals' costof participation. This bill would appropriate the sum of $3,000,000 from the General Fund to the State Department of Health Services for the provision of breast cancer treatment services in accordance with the bill's provisions. This bill would declare that it is to take effect immediately as an urgency statute. Vote: Y3. Appropriation: yes. Fiscal committee: yes. State-mandated local program.: no. The people of the State of California do enact as follows: 1 SECTION 1. Article 1.5 (commencing with Section 2 104150) is added to Chapter 2 of Part 1 of Division 103 of the Health and Safety Code, to read: 4 5 Article 1.5. Breast Cancer Treatment Program 6 7 104160. The Breast Cancer Treatment Program is 8 hereby established for the purposes of providing breast 9 cancer treatment services to uninsured and underinsured 10 women with incomes at or below 200 percent of the 11 federal poverty level. These services shall include, but 12 shall not be limited to, lumpectomy, mastectomy, 13 chemotherapy, hormone therapy, radiotherapy, 14 reconstructive surgery,and breast implant surgery. 15 104151. The program and its funding shall be 16 administered by the State Department of Health 17 Services. The department shall be obligated to administer 18 the program and funds for the program only during a 19 fiscal year in which the Legislature has appropriated 20 funds to the department for this purpose. 21 104162. The department shall award a contract to 22 operate the program to a bidder that is a nonprofit 23 organization established under Section 501(c)(3) of the -3— AB 40 1 Internal Revenue Code and that meets the following 2 additional eligibility criteria: 3 (a) The organization has at least two consecutive 4 years, or the equivalent, of successful administration of a 5 breast cancer treatment program operated on a 6 statewide level, or servicing a population of at least 500 7 patients. 8 (b) The organization has experience operating a 9 program dedicated to providing services to residents of 10 California diagnosed with primary breast cancer, who are 11 18 years of age or alder, at or below 2010 percent of the 12 federal poverty level, and who are uninsured or 13 underinsured. 14 (c) The organization has operated such a treatment 15 program with administrative costs no higher than 10 16 percent of appropriated program funds, or can 17 demonstrate the ability to do so. 18 (d) The organization has not operated a treatment 19 program designed to maximize the patient population 20 and make treatment choices largely based on pecuniary 21 factors, or that optimizes billing patients for service costs 22 above the established statewide Medi-Cal base rates of 23 reimbursement. 24 (e) The organization has demonstrated ability to 25 accomplish recruitment and commitment of breast 26 cancer treatment providers to work with the program to 27 provide cage at or below established statewide Medi-Cal 28 base rates of reimbursement. 29 1014163. The breast cancer treatment program shall be 30 modeled after other statewide treatment programs and 31 shall include,but shall not be limited to, the following: 32 (a) Coordination of patient services at or below 33 Medi-Cal rates of reimbursement, without collecting 34 premiums from patients, mandating copayments from 35 patients, or balance billing of patients. 36 (b) Statewide availability of services to both women 37 and men. 38 (c) Operation of the program with administrative 39 costs no higher than 10 percent of appropriated program 40 funds. 99 ................. AB 40 —4- 1 (d) Coordination with the Breast Cancer Control 2 Program established pursuant to Section 30461.6 of the 3 Revenue and Taxation Code. 4 (e) Provision of case management for each patient, or 5 assurance that case management services are 6 incorporated in provider services for a patient. 7 (f) The establishment of an advisory committee to 8 facilitate, guide, and provide oversight of the program. 9 104164. The contracting organization shall encourage 10 recipients of benefits under this article to seek more 11 comprehensive health coverage through the Major Risk 12 Medical Insurance Program established by Part 6.5 13 (commencing with Section 12700) of Division 2 of the 14 Insurance Code. The contracting organization may, in 15 lieu of providing reimbursement for breast cancer 16 treatment services, provide incentives for recipients to 17 enroll in the Major Risk Medical Insurance Program by 18 providing funds to reduce the individual's cost of 19 participation. 20 SEC. 2. The sum of three million dollars ($3,000,000) 21 is hereby appropriated from the General Fund to the 22 State Department of Health Services for the provision of 23 breast cancer treatment services in accordance with this 24 act. 25 SEC. 3. This act is an urgency statute necessary for the 26 immediate preservation of the public peace, health, or 27 safety within the meaning of Article IV of the 28 Constitution and shall go into immediate effect. The facts 29 constituting the necessity are: 30 In order to provide timely service to those in need of 31 breast cancer treatment services, and because current 32 funding will be exhausted by the end of the 1998-99 fiscal 33 year,it is necessary that this act take effect immediately. 0 44 L t J j.n • Require that the Program be modeled after other statewide treatment programs and include specified features. • Require the organization to encourage patients to seek more comprehensive health coverage through the Major Risk Medical InsuranceProgram. • Appropriate $3 million for purposes of funding the Program'. • Include an urgency clause and would, therefore, become effective immediately upon passage and signature by the Governor. In view of the fact that AB 40 appears to be consistent with the Board's adopted Legislative Program, it is recommended that the Board indicate its support of AB 40. cc: County Administrator Health Services Director Public Health Director Assemblyman Howard Wayne Room 21703 State Capitol Sacramento, CA 95814 Les Spahnn Heim, Noack, Kelly & Spahnn 1121 L Street, Suite 100 Sacramento, CA 95814 -2-