California Senate Bill SB485 Amended / Bill

 BILL NUMBER: SB 485AMENDED BILL TEXT AMENDED IN SENATE APRIL 14, 2011 AMENDED IN SENATE MARCH 24, 2011 INTRODUCED BY Senator Hernandez FEBRUARY 17, 2011 An act to add Section 14134.7 to the Welfare and Institutions Code, relating to  Medi-Cal   health facilities  . LEGISLATIVE COUNSEL'S DIGEST SB 485, as amended, Hernandez.  Medi-Cal.   Health facilities: emergency units.  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 services.  Existing law provides for the licensure of health facilities, including general acute care hospitals.  This bill would require the department to establish a pilot program to facilitate collaboration between  a federally qualified health clinic   an available and accessible provider of nonemergency medical care  and a general acute care hospital to provide a Medi-Cal beneficiary  or patient who lacks health insurance  with an alternative to the use of the emergency unit of a general acute care hospital for care and services if the Medi-Cal beneficiary  or patient  , after a medical screening, is determined by a physician and surgeon  or other health care provider, as specified,  to not have an emergency medical condition and the Medi-Cal beneficiary  or patient  is provided the specified information, in writing, before  nonemergency medical care is provided in   discharge from  the emergency unit. Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. Section 14134.7 is added to the Welfare and Institutions Code, to read: 14134.7. (a) The department shall establish a pilot program to facilitate collaboration between  a federally qualified health clinic   an available and accessible provider of nonemergency medical care  and a general acute care hospital,  as a benefit of the Medi-Cal program, to provide a Medi-Cal beneficiary with an   within two geographic locations, to provide a Medi-Cal beneficiary, a patient who lacks health insurance, or   both, with an  alternative to the use of the emergency unit of a general acute care hospital for care and services if the Medi-Cal beneficiary  or patient who lacks health insurance  , after a medical screening, is determined by a physician and surgeon  or other health care provider who acts within his or her scope of practice  to not have an emergency medical condition and the Medi-Cal beneficiary  or patient who lacks health insurance  is provided the following information, in writing, before  nonemergency medical care is provided in the emergency unit:   the patient is discharged from the emergency unit:  (1) The name and address of an available and accessible provider of nonemergency medical care  who does not charge a copay or may charge a lower copay than the general acute care hospital.   .  (2) A referral from the general acute care hospital if necessary to coordinate the scheduling of treatment. (b) The department shall submit any necessary application to the federal Centers for Medicare and Medicaid Services for a waiver to implement the pilot project described in this section. The department shall determine the form of waiver most appropriate to achieve the purposes of this section. The waiver request shall be included in any waiver application submitted within 12 months after the effective date of this section, or shall be submitted as an independent application within that time period. After federal approval is secured, the department shall implement the waiver within 12 months of the date of approval. (c) The department shall develop  a request for proposal process for available and accessible providers of nonemergency medical care and general acute care hospitals that want to participate in the pilot project. The department also shall develop  a timeline and process for monitoring and evaluating the pilot project and provide this timeline and process to the appropriate fiscal and policy committees of the Legislature. (d) For purposes of this section,  an   "an  available and accessible provider of nonemergency medical  care   care"  includes the office of a physician and surgeon, health clinic, community health center, and hospital outpatient department, provided that the provider of nonemergency medical care is able to diagnose or treat contemporaneously within the same amount of time that a physician within the emergency unit of a general acute care hospital would have taken to provide the same nonemergency services.