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HomeMy WebLinkAboutMINUTES - 06051990 - 1.71 A 1®0'71 TO: BOARD OF SUPERVISORS SE L•• Contra FROM: Phil Batchelor, County Administrator Costa May 30, 1990 T� Count 9: y DATE: SUBJECT: LEGISLATION - AB 3223 (Campbell) SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECONIlENDATION Indicate that the Board of Supervisors continues to be the SPONSOR of AB 3223 by Assemblyman Campbell which would establish not to exceed two pilot projects which would provide guaranteed eligibility and require continued enrollment ( lock-in) for a woman who is pregnant when she joins a prepaid health plan or who becomes pregnant while a member of the prepaid health plan for the balance of her pregnancy and until the end of the sixth month after the birth of the baby. BACKGROUND: On March 20, 1990 the Board of Supervisors indicated that it was the sponsor of AB 3223 . On May 22, 1990 the Board of Supervisors continued its sponsorship of AB 3223 as the bill was amended on April 16, 1990. On May 16 , 1990 the bill was again amended. One of the major problems facing health care institutions today is the fact that many low income women do not seek or have access to prenatal medical care when they become pregnant. In far too many cases the woman presents herself at a hospital emergency room while in labor. This failure to seek proper prenatal care tends to lead to more problem pregnancies, more low birth weight babies and more babies with diseases which could have been treated better if they had been discovered earlier. CONTINUED ON ATTACHME14PS YES SIGNATURE: L RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER SIGNATURE S: ACTION OF BOARD ON June , 1990 APPROVED AS RECOMMENDED OTHER VOTE OF SUPERVISORS 1 HEREBY CERTIFY THAT THIS IS A TRUE UNANIMOUS(ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. CC: ATTESTED zft PHIL BAMHELOR,CLERK OF THE BOARD OF Please see Page 3 . SUPERVISORS AND COUNTY ADMINISTRATOR M382 (10/88) BY- 'DEPUTY The public frequently ends up paying for these cases for years into the future as the children require more attention, assistance and special services when they get into school, require more medical care than other children - which the parents often cannot afford, and are denied the opportunity to live up to the potential he or she could have had. In addition, there are cases where a woman joins the Contra Costa Health Plan solely to cover the costs of delivery and then disenrolls, leaving the Health Plan with all of the delivery costs and perhaps one or two months premiums from Medi-Cal to cover all of the attendant costs. In an effort to improve the health of the mother and child and reduce the financial burden on the Contra Costa Health Plan, Assemblyman Campbell has agreed to introduce AB 3223 which would require the State Department of Health Services to contract with not to exceed two eligible prepaid health plans, including one publicly sponsored prepaid health plan to provide a woman who becomes pregnant while a member of the prepaid health plan or who is pregnant at the time she joins the prepaid health plan continued Medi-Cal. eligibility through the balance of the pregnancy and until the end of the sixth month following the birth of the . baby. This will provide time to establish a continuity of care, hopefully provide adequate prenatal care and insure that the baby and mother have the best start in life possible. It will also insure that the prepaid health plan has more revenue with which to cover the costs of delivery, thereby making the prepaid health plan more. viable financially. The May 16 , 1990 amendments provide that a pilot project could also be a primary care case management provider rather than just a prepaid health plan. As amended May 16, 1990 the bill provides that the beneficiary shall be notified in writing that if she enrolls or remains enrolled in the prepaid health plan she will be unable to disenroll until the end of the sixth month following the birth of the baby, except for defined good cause. The mother must also be advised in writing when the baby is born that she has the opportunity to enroll the baby in the prepaid health plan. AB 3223 also provides guaranteed eligibility for the mother and child during the period of "lock-in" , meaning that even though other circumstances might make the mother or child ineligible for Medi-Cal during the "lock-in" period, eligibility will continue until the end of the sixth month following the birth of the baby. The participating prepaid health plan can be required by the State Department of Health Services to maintain appropriate data . to show that the guaranteed eligibility and lock-in have improved the health of the mother and child. The bill also provides for criteria which are to be used to measure the success of the pilot project. The State Department of Health Services is to report to the Legislature on the success of the pilot projects within 24 months after the projects commence. The bill sunsets January 1, 1995. The concept of this legislation is included in the Board' s 1990 Legislative Program. In view of the fact that Assemblyman Campbell has agreed to introduce AB 3223 on behalf of the Board of Supervisors it is - appropriate for the Board to indicate that it continues to be the sponsor of AB 3223 . AB 3223 passed the Assembly Health Committee April 17 , 1990 by a vote of 20: 0 and is scheduled to be heard in the Assembly Ways & Means Committee 'on May 30 , 1990. cc: Assemblyman Robert Campbell County Administrator Health Services Director Executive Director, CCHP Les Spahnn, SRJ. Jackson, Barish & Associates