Medi-Cal.

(1) Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income persons receive health care benefits. The Medi-Cal program is, in part, governed and funded by federal Medicaid provisions. Existing law establishes the Medi-Cal Hospital/Uninsured Care Demonstration Project Act that revises hospital reimbursement methodologies in order to maximize the use of federal funds consistent with federal Medicaid law and stabilize the distribution of funding for hospitals. Under existing law, to the extent required to maximize available federal funds under the demonstration project and to the extent authorized by the Special Terms and Conditions for the demonstration project, the department may claim federal reimbursement for expenditures in a certain priority order, as specified. This bill would provide, notwithstanding the above-described provisions, in order to maximize federal claiming under the demonstration project, that the department shall have broad discretion to claim federal reimbursement consistent with all applicable federal claiming rules for certain expenditures in an order of priority determined by the department. This bill would authorize the department to claim for any and all additional demonstration project funding made available pursuant to any amendments to the demonstration project made on or after October 1, 2008, or pursuant to any federal laws that increase the amount of available funding, including, but not limited to, the federal American Recovery and Reinvestment Act of 2009. This bill would provide that any amounts received in the 2008–09, 2009–10, and 2010–11 fiscal years from the federal government pursuant to additional demonstration project funding, as specified in the above provisions, shall be deposited in the Federal Trust Fund and would authorize the Department of Finance to authorize expenditure of these funds, as specified. This bill would require the department to submit an application to the federal Centers for Medicare and Medicaid Services (CMS) for a waiver or demonstration project that would implement specified objectives. The bill would require the waiver or demonstration project to include designated restructuring proposals for the organization and delivery of services under the Medi-Cal program. The bill would require the department to submit the waiver or demonstration project application to the CMS by a date that allows sufficient time for the waiver or demonstration project to be approved by no later than September 1, 2010, or the conclusion of any extension period granted in the demonstration project set forth in the Medi-Cal Hospital/Uninsured Care Demonstration Project Act, whichever happens last. (2) This bill would require the California Health and Human Services Agency or successor entity or designated department to submit an implementation plan to the appropriate policy and fiscal committees of the Legislature for implementation of the federally approved waiver or demonstration project for purposes of improving health care for low-income Californians, as specified. This bill would provide that the department shall only implement the waiver or demonstration project upon submittal of an implementation plan to the appropriate policy and fiscal committees of the Legislature at least 60 days prior to any appropriation. This bill would require the agency or successor entity or designated department, prior to preparing the implementation plan, to convene a stakeholder committee to advise on preparation of the implementation plan, as specified. The California Constitution authorizes the Governor to declare a fiscal emergency and to call the Legislature into special session for that purpose. The Governor issued a proclamation declaring a fiscal emergency, and calling a special session for this purpose, on July 1, 2009. This bill would state that it addresses the fiscal emergency declared by the Governor by proclamation issued on July 1, 2009, pursuant to the California Constitution. This bill would declare that it is to take effect immediately as an urgency statute.