If enacted, SB 516 would potentially modify existing state law to support a targeted approach in managing chronic diseases among Medi-Cal beneficiaries. The intent is to keep individuals in less restrictive environments while ensuring they receive necessary medical care. This waiver could result in improved patient outcomes by providing a broader range of services that are not covered under the standard Medi-Cal plan, thereby addressing specific needs of those diagnosed with critical health issues such as diabetes and heart disease.
Summary
Senate Bill 516 proposes amendments to the Welfare and Institutions Code relating to the Medi-Cal program, specifically introducing a Disease Management Waiver. This initiative aims to offer enhanced care services to eligible individuals who are part of the Medi-Cal system, particularly those dealing with chronic conditions. The department is tasked with applying for a federal waiver, which would allow California to test the effectiveness of implementing a disease management benefit under Medi-Cal, including evidence-based practices and patient education regarding health management.
Contention
Despite its benefits, the bill could face scrutiny regarding federal funding and the implementation process. Concerns about budget constraints and eligibility assessments may arise, particularly as the waiver is contingent upon the availability of federal financial support. Furthermore, the selected nature of the beneficiary pool—limited to individuals aged, blind, or disabled and those diagnosed with certain chronic diseases—may provoke debate over accessibility and equity in healthcare provisions for the broader Medi-Cal population.
Human services: medical services; specialty integrated plan; provide for in behavioral health services. Amends sec. 105d & 109f of 1939 PA 280 (MCL 400.105d & 400.109f).