Existing law, the federal Patient Protection and Affordable Care Act (PPACA) , enacts various health care coverage market reforms. Among other things, PPACA prohibits a group health plan and a health insurance issuer offering group health insurance coverage from applying a waiting period that exceeds 90 days. Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law also provides for the regulation of health insurers by the Department of Insurance. Existing law provides for the regulation of small employer, grandfathered small employer, and nongrandfathered small employer health care service plan contracts and health insurance policies, as defined. Existing law governs the health care coverage that may be provided to eligible employees of small employers and defines a "small employer" for these purposes. Existing law defines an "eligible employee" for purposes of these provisions to refer to an employee who is actively engaged on a full-time basis in the conduct of the business of the small employer with a normal workweek of at least 30 hours, at the small employer's regular places of business, who has met any statutorily authorized applicable waiting period requirements, and specifically includes sole proprietors and partners of a partnership if they are actively engaged on a full-time basis in the small employer's business and included as employees under a health care service plan contract or health benefit plan of a small employer. This bill would delete sole proprietors, partners of a partnership, and the spouses of sole proprietors and partners from the definition of "eligible employee" for purposes of those provisions. The bill would provide, with respect to a sole proprietorship that consists only of the sole proprietor and his or her spouse, or a partnership that consists solely of partners and their spouses, that the sole proprietor or the partner, as applicable, and the spouses of those persons, are not considered employees for purposes of determining eligibility for small employer coverage. The bill would prohibit employer group health care service plans and employer group health benefit plans from being issued, marketed, or sold to a sole proprietorship or partnership without employees directly or indirectly through any arrangement, and would require that only individual health care service plans and individual health benefit plans be sold to any entity without employees. The bill would also revise the definition of a small employer to include any small employer, as defined, who purchases coverage through any arrangement, except as specified. The bill would also make clarifying changes. Because a willful violation of the bill's requirements relative to health care service plans would be a crime, the bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
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Existing law, the Pharmacy Law, establishes the California State Board of Pharmacy, within the Department of Consumer Affairs, to license and regulate the practice of pharmacy. Existing law makes any violation of the Pharmacy Law punishable as a crime. Existing law generally requires a pharmacy that owns or provides dangerous drugs or dangerous devices dispensed through an automated drug delivery system (ADDS) to register the system, as provided, and authorizes the pharmacy to use the ADDS only if certain conditions are satisfied. Existing law authorizes the board to prohibit a pharmacy from using an ADDS if the board determines that those conditions are not satisfied. Existing law exempts from these requirements an ADDS operated by a licensed hospital pharmacy for doses administered in a facility operated under a consolidated license. Existing law specifies additional conditions for an ADDS located in a licensed clinic, a correctional clinic, or a health facility, as defined. Existing law authorizes a pharmacy or licensed wholesaler that is also an emergency medical services provider agency to restock dangerous drugs or dangerous devices into an emergency medical services automated drug delivery system that is licensed by the board, as provided. Existing law authorizes an inspector employed by the board to enter specified locations to inspect those locations for compliance with the Pharmacy Law. This bill, beginning on July 1, 2019, would repeal the general ADDS provisions and the additional conditions for an ADDS located in a health facility. The bill instead would require an ADDS, as defined, to meet specified requirements in order to be installed, leased, owned, or operated in the state, including a license for the ADDS issued by the board to the holder of a current, valid, and active pharmacy license of a pharmacy located and licensed in the state. The bill would limit the placement and operation of an ADDS to specified locations, including the licensed pharmacy holding that ADDS license, a licensed health facility, a licensed clinic, or a specified medical office if the ADDS is an automated patient dispensing system (APDS) , as defined. The bill would require the pharmacy holding the ADDS license to own or lease the ADDS and the drugs and devices located within it, as provided, and would require that pharmacy to supervise the operation of the ADDS. The bill would prescribe specified stocking and transfer requirements for those drugs and devices. The bill would require the pharmacy holding the ADDS license to provide training on the operation and use of that ADDS to specified individuals and would require the pharmacy to complete periodic self-assessments. The bill would also authorize a pharmacy inspector employed by the board to enter the location, or proposed location, of an ADDS to inspect the ADDS or the location pursuant to these provisions. This bill would require additional conditions for an APDS. The bill would exempt an automated unit dose system (AUDS) from licensure under these provisions if the AUDS is operated by a licensed hospital pharmacy and used to provide doses to specified patients, but would require the AUDS to comply with all other ADDS requirements described above. This bill would require, on or before January 1, 2024, the board to report to the appropriate policy committees of the Legislature on the regulation of ADDS units, as provided. Because a violation of the Pharmacy Law is punishable as a crime, the bill would expand the scope of an existing crime, thereby imposing a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
Existing law establishes the Medi-Cal program, administered by the State Department of Health Care Services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Under existing law, one of the methods by which Medi-Cal services, including medical, dental, and mental health services, are provided is pursuant to contracts with various types of managed care plans. Existing law requires the department to require all managed care plans and mental health plans contracting with the department to provide language assistance services, including translation services and oral interpretation services by an interpreter who meets specified minimum qualification criteria, to limited-English-proficient (LEP) Medi-Cal beneficiaries. This bill would modify the minimum qualifications that an interpreter is required to possess to provide oral interpretation services to an LEP beneficiary enrolled in either a managed care plan or a mental health plan.
This measure would call upon the President and the United States Congress to acknowledge that the separation of immigrant children from their families at the border is detrimental to the short- and long-term physical and mental well-being of the children and incompatible with our fundamental values as a nation. The measure would also call upon the United States Congress to issue a formal apology to all child detainees who were forcibly separated from their parents and legal guardians and seized by the United States Department of Homeland Security or United States Customs and Border Protection and to the parents of those children.
The Optometry Practice Act provides for the licensure and regulation of the practice of optometry by the State Board of Optometry in the Department of Consumer Affairs. The act requires an optometrist who has been certified to use therapeutic pharmaceutical agents to be certified for the administration of immunizations by complying with specified requirements, including completing an immunization training program endorsed by the federal Centers for Disease Control and Prevention. This bill would instead require the training program to be endorsed by the federal Centers for Disease Control and Prevention or the Accreditation Council for Pharmacy Education. The bill would also make nonsubstantive changes, including correcting erroneous cross-references. This bill would declare that it is to take effect immediately as an urgency statute.
This measure would urge President Trump, United States Attorney General Sessions, the United States Department of Justice, the United States Department of Homeland Security, and all other relevant federal departments to immediately cease the implementation of the "zero tolerance" federal immigration policy and to not propose any additional inhumane immigration policies in the future. The measure would further call for compassion and decency for all individuals, families, and children who arrive at our borders seeking a better life.
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 program provisions. Existing law requires family planning services to be offered to all former, current, or potential Medi-Cal recipients of childbearing age and provided to all eligible individuals who voluntarily request the services. Existing law also establishes the Family Planning, Access, Care, and Treatment (Family PACT) Program, administered by the Office of Family Planning within the department, Planning, under which comprehensive clinical family planning services are provided to a person who has a family income at or below 200% of the federal poverty level, as revised annually, and who is eligible to receive these services. This bill would clarify that the requirement to provide family planning benefits under the Medi-Cal program does not prohibit family planning services from being delivered through telehealth, including mobile telehealth delivered according to clinical guidelines. The bill would, beginning January 1, 2020, require the Family PACT Program to cover services provided by a Family PACT provider through direct video and telephonic communications with a provider and direct or asynchronous care provided through a smartphone application that is appropriate to be delivered remotely based on current clinical guidelines. Beginning January 1, 2020, the bill would allow Family PACT providers to determine program eligibility remotely and to enroll clients remotely, as specified, and would authorize the State Department of Health Care Services to develop program policies to support implementation of offsite eligibility determination and enrollment. The bill would, if a patient is ineligible for the Family PACT Program, but may be eligible for more comprehensive health care coverage through Medi-Cal or Covered California, require the Family PACT provider to share information with the patient about his or her coverage options, beginning January 1, 2020.
Existing federal law, the federal Patient Protection and Affordable Care Act (PPACA) , enacts various health care coverage market reforms that took effect January 1, 2014. Among other things, PPACA requires each state, by January 1, 2014, to establish an American Health Benefit Exchange that facilitates the purchase of qualified health plans by qualified individuals and qualified small employers. Existing state law establishes the California Health Benefit Exchange (the Exchange) within state government for the purpose of facilitating the enrollment of qualified individuals and qualified small employers in qualified health plans, and specifies the powers and duties of the board governing the Exchange. Existing law requires the board to establish the Small Business Health Options Program, otherwise referred to as the SHOP Program, separate from the activities of the board related to the individual market, to assist qualified small employers in facilitating the enrollment of their employees in qualified health plans offered through the Exchange in the small employer market in a manner consistent with a specified provision of the federal act. This bill would change the name of the SHOP Program to the Covered California for Small Business Exchange and make related conforming changes.
Existing law, the Knox-Keene Health Care Service Plan Act of 1975 (Knox-Keene) , provides for the licensure and regulation of health care service plans by the Department of Managed Health Care. Existing law regulates Medicare supplement contracts, including, among other things, prohibiting an issuer of a Medicare supplement contract from advertising, soliciting, or issuing for delivery a Medicare supplement contract before it has been filed with and approved by the director, and requiring an issuer to secure the director's review of a Medicare supplement contract by submitting specified information not less than 30 days before any proposed advertising or other use of the contract. Existing law requires an outline of coverage for a Medicare supplement contract sold on or after June 1, 2010, to include specified items set forth in the National Association of Insurance Commissioners (NAIC) Minimum Standards Model Act, as adopted by NAIC in 2008. This bill would require the director to require an issuer of a Medicare supplement contract to annually complete and submit the National Association of Insurance Commissioners Medicare supplement experience exhibit. The bill would express the intent of the Legislature that the department participate in proceedings of NAIC's Senior Issues Task Force that relate to Medicare supplement insurance.
Existing federal law, the Patient Protection and Affordable Care Act (PPACA) , requires each state to establish an American Health Benefit Exchange that facilitates the purchase of qualified health plans by qualified individuals and qualified small employers and that meets certain other requirements. Existing law creates the California Health Benefit Exchange, also known as Covered California, for the purpose of facilitating the enrollment of qualified individuals and qualified small employers in qualified health plans as required under the PPACA. Existing law specifies the powers of the Covered California executive board, including the power to assist in the administration of subsidies for individuals with coverage made available through Covered California. This bill would require Covered California to administer financial assistance to help low- and middle-income Californians access affordable coverage, as specified, if the Legislature appropriates funds for that purpose. The bill would provide that priority for financial assistance shall be given to an individual whose premium payment is equal to or greater than 8% of his or her annual household income, as specified, or an individual whose annual household income is equal to or greater than 200% of the federal poverty level, as specified.