CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION Assembly Bill No. 2303Introduced by Assembly Member Juan CarrilloFebruary 12, 2024 An act to add Section 14132.105 to the Welfare and Institutions Code, relating to health and care facilities. LEGISLATIVE COUNSEL'S DIGESTAB 2303, as introduced, Juan Carrillo. Health and care facilities: prospective payment system rate increase.Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law provides that federally qualified health center services and rural health clinic services, as defined, are covered benefits under the Medi-Cal program, to be reimbursed, to the extent that federal financial participation is obtained, to providers on a per-visit basis and at a per-visit prospective payment system rate, as defined.Existing law establishes 5 separate minimum wage schedules for covered health care employees, as defined, depending on the nature of the employer and includes increases beginning on June 1, 2024. Existing law generally requires the State Department of Public Health to license, regulate, and inspect health and care facilities.This bill would require the State Department of Health Care Services, on or before April 1, 2025, to submit a request for approval to the federal Centers for Medicare and Medicaid Services to authorize a waiver for specified health care facilities to request a change in its prospective payment system rate. Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO Bill TextThe people of the State of California do enact as follows:SECTION 1. The Legislature finds and declares all of the following:(a) Community health centers are a vital part of Californias safety net, providing high-quality comprehensive care to 7,700,000 people. More than one in five Californians receive care at a community health center and more than one in three of those are on Medi-Cal. Community Health Centers encompass Californias federally qualified health centers, community clinics, tribal health centers, free clinics, and rural health centers. Over 1,270 community health centers in California provide the full spectrum of care, from primary care to dental to behavioral health, to everyone who walks through their doors, regardless of their ability to pay, their immigration status, or their individual circumstances.(b) Community health centers are paid a predetermined rate for the health care services they provide through a restrictive and complex structure governed by state and federal law called the Prospective Payment System (PPS). A community health center is only allowed to request a reevaluation of its PPS rate, essentially a rate change request, under very strict circumstances. Those circumstances do not include state-mandated increases in the minimum wage. Community Health Centers are essentially on a fixed income and, unlike other entities or businesses, cannot raise the prices of their services to adjust to increases in the minimum wage.(c) In 2023, the Governor signed a historic increase in the minimum wage for Californias health care workers. Community health centers are eager to support their workers with higher wages but will struggle to pay state-mandated higher wages and maintain high-quality patient care, without rates that match their actual operational costs. Ensuring community health centers have a mechanism to address mandatory wage increases is crucial to community health centers long-term sustainability.(d) Based on these findings, the Legislature declares its intent to support community health centers in their mission to provide accessible, affordable, equitable, and high-quality health care for all Californians, by adjusting their rates to accurately cover the costs of the health care services they provide.SEC. 2. Section 14132.105 is added to the Welfare and Institutions Code, to read:14132.105. On or before April 1, 2025, the department shall submit a request for approval to the federal Centers for Medicare and Medicaid Services to authorize a waiver for a covered health care facility described in subdivision (l) of Section 1206 of the Health and Safety Code and clauses (xiv) and (xv) of subparagraph (A) of paragraph (3) of subdivision (b) of Section 1182.14 of the Labor Code to request a change in its prospective payment system rates, based on the minimum wage increases described in subdivisions (c) and (d) of Section 1182.14 of the Labor Code.
CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION Assembly Bill No. 2303Introduced by Assembly Member Juan CarrilloFebruary 12, 2024 An act to add Section 14132.105 to the Welfare and Institutions Code, relating to health and care facilities. LEGISLATIVE COUNSEL'S DIGESTAB 2303, as introduced, Juan Carrillo. Health and care facilities: prospective payment system rate increase.Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law provides that federally qualified health center services and rural health clinic services, as defined, are covered benefits under the Medi-Cal program, to be reimbursed, to the extent that federal financial participation is obtained, to providers on a per-visit basis and at a per-visit prospective payment system rate, as defined.Existing law establishes 5 separate minimum wage schedules for covered health care employees, as defined, depending on the nature of the employer and includes increases beginning on June 1, 2024. Existing law generally requires the State Department of Public Health to license, regulate, and inspect health and care facilities.This bill would require the State Department of Health Care Services, on or before April 1, 2025, to submit a request for approval to the federal Centers for Medicare and Medicaid Services to authorize a waiver for specified health care facilities to request a change in its prospective payment system rate. Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO
CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION
Assembly Bill
No. 2303
Introduced by Assembly Member Juan CarrilloFebruary 12, 2024
Introduced by Assembly Member Juan Carrillo
February 12, 2024
An act to add Section 14132.105 to the Welfare and Institutions Code, relating to health and care facilities.
LEGISLATIVE COUNSEL'S DIGEST
## LEGISLATIVE COUNSEL'S DIGEST
AB 2303, as introduced, Juan Carrillo. Health and care facilities: prospective payment system rate increase.
Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law provides that federally qualified health center services and rural health clinic services, as defined, are covered benefits under the Medi-Cal program, to be reimbursed, to the extent that federal financial participation is obtained, to providers on a per-visit basis and at a per-visit prospective payment system rate, as defined.Existing law establishes 5 separate minimum wage schedules for covered health care employees, as defined, depending on the nature of the employer and includes increases beginning on June 1, 2024. Existing law generally requires the State Department of Public Health to license, regulate, and inspect health and care facilities.This bill would require the State Department of Health Care Services, on or before April 1, 2025, to submit a request for approval to the federal Centers for Medicare and Medicaid Services to authorize a waiver for specified health care facilities to request a change in its prospective payment system rate.
Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.
Existing law provides that federally qualified health center services and rural health clinic services, as defined, are covered benefits under the Medi-Cal program, to be reimbursed, to the extent that federal financial participation is obtained, to providers on a per-visit basis and at a per-visit prospective payment system rate, as defined.
Existing law establishes 5 separate minimum wage schedules for covered health care employees, as defined, depending on the nature of the employer and includes increases beginning on June 1, 2024. Existing law generally requires the State Department of Public Health to license, regulate, and inspect health and care facilities.
This bill would require the State Department of Health Care Services, on or before April 1, 2025, to submit a request for approval to the federal Centers for Medicare and Medicaid Services to authorize a waiver for specified health care facilities to request a change in its prospective payment system rate.
## Digest Key
## Bill Text
The people of the State of California do enact as follows:SECTION 1. The Legislature finds and declares all of the following:(a) Community health centers are a vital part of Californias safety net, providing high-quality comprehensive care to 7,700,000 people. More than one in five Californians receive care at a community health center and more than one in three of those are on Medi-Cal. Community Health Centers encompass Californias federally qualified health centers, community clinics, tribal health centers, free clinics, and rural health centers. Over 1,270 community health centers in California provide the full spectrum of care, from primary care to dental to behavioral health, to everyone who walks through their doors, regardless of their ability to pay, their immigration status, or their individual circumstances.(b) Community health centers are paid a predetermined rate for the health care services they provide through a restrictive and complex structure governed by state and federal law called the Prospective Payment System (PPS). A community health center is only allowed to request a reevaluation of its PPS rate, essentially a rate change request, under very strict circumstances. Those circumstances do not include state-mandated increases in the minimum wage. Community Health Centers are essentially on a fixed income and, unlike other entities or businesses, cannot raise the prices of their services to adjust to increases in the minimum wage.(c) In 2023, the Governor signed a historic increase in the minimum wage for Californias health care workers. Community health centers are eager to support their workers with higher wages but will struggle to pay state-mandated higher wages and maintain high-quality patient care, without rates that match their actual operational costs. Ensuring community health centers have a mechanism to address mandatory wage increases is crucial to community health centers long-term sustainability.(d) Based on these findings, the Legislature declares its intent to support community health centers in their mission to provide accessible, affordable, equitable, and high-quality health care for all Californians, by adjusting their rates to accurately cover the costs of the health care services they provide.SEC. 2. Section 14132.105 is added to the Welfare and Institutions Code, to read:14132.105. On or before April 1, 2025, the department shall submit a request for approval to the federal Centers for Medicare and Medicaid Services to authorize a waiver for a covered health care facility described in subdivision (l) of Section 1206 of the Health and Safety Code and clauses (xiv) and (xv) of subparagraph (A) of paragraph (3) of subdivision (b) of Section 1182.14 of the Labor Code to request a change in its prospective payment system rates, based on the minimum wage increases described in subdivisions (c) and (d) of Section 1182.14 of the Labor Code.
The people of the State of California do enact as follows:
## The people of the State of California do enact as follows:
SECTION 1. The Legislature finds and declares all of the following:(a) Community health centers are a vital part of Californias safety net, providing high-quality comprehensive care to 7,700,000 people. More than one in five Californians receive care at a community health center and more than one in three of those are on Medi-Cal. Community Health Centers encompass Californias federally qualified health centers, community clinics, tribal health centers, free clinics, and rural health centers. Over 1,270 community health centers in California provide the full spectrum of care, from primary care to dental to behavioral health, to everyone who walks through their doors, regardless of their ability to pay, their immigration status, or their individual circumstances.(b) Community health centers are paid a predetermined rate for the health care services they provide through a restrictive and complex structure governed by state and federal law called the Prospective Payment System (PPS). A community health center is only allowed to request a reevaluation of its PPS rate, essentially a rate change request, under very strict circumstances. Those circumstances do not include state-mandated increases in the minimum wage. Community Health Centers are essentially on a fixed income and, unlike other entities or businesses, cannot raise the prices of their services to adjust to increases in the minimum wage.(c) In 2023, the Governor signed a historic increase in the minimum wage for Californias health care workers. Community health centers are eager to support their workers with higher wages but will struggle to pay state-mandated higher wages and maintain high-quality patient care, without rates that match their actual operational costs. Ensuring community health centers have a mechanism to address mandatory wage increases is crucial to community health centers long-term sustainability.(d) Based on these findings, the Legislature declares its intent to support community health centers in their mission to provide accessible, affordable, equitable, and high-quality health care for all Californians, by adjusting their rates to accurately cover the costs of the health care services they provide.
SECTION 1. The Legislature finds and declares all of the following:(a) Community health centers are a vital part of Californias safety net, providing high-quality comprehensive care to 7,700,000 people. More than one in five Californians receive care at a community health center and more than one in three of those are on Medi-Cal. Community Health Centers encompass Californias federally qualified health centers, community clinics, tribal health centers, free clinics, and rural health centers. Over 1,270 community health centers in California provide the full spectrum of care, from primary care to dental to behavioral health, to everyone who walks through their doors, regardless of their ability to pay, their immigration status, or their individual circumstances.(b) Community health centers are paid a predetermined rate for the health care services they provide through a restrictive and complex structure governed by state and federal law called the Prospective Payment System (PPS). A community health center is only allowed to request a reevaluation of its PPS rate, essentially a rate change request, under very strict circumstances. Those circumstances do not include state-mandated increases in the minimum wage. Community Health Centers are essentially on a fixed income and, unlike other entities or businesses, cannot raise the prices of their services to adjust to increases in the minimum wage.(c) In 2023, the Governor signed a historic increase in the minimum wage for Californias health care workers. Community health centers are eager to support their workers with higher wages but will struggle to pay state-mandated higher wages and maintain high-quality patient care, without rates that match their actual operational costs. Ensuring community health centers have a mechanism to address mandatory wage increases is crucial to community health centers long-term sustainability.(d) Based on these findings, the Legislature declares its intent to support community health centers in their mission to provide accessible, affordable, equitable, and high-quality health care for all Californians, by adjusting their rates to accurately cover the costs of the health care services they provide.
SECTION 1. The Legislature finds and declares all of the following:
### SECTION 1.
(a) Community health centers are a vital part of Californias safety net, providing high-quality comprehensive care to 7,700,000 people. More than one in five Californians receive care at a community health center and more than one in three of those are on Medi-Cal. Community Health Centers encompass Californias federally qualified health centers, community clinics, tribal health centers, free clinics, and rural health centers. Over 1,270 community health centers in California provide the full spectrum of care, from primary care to dental to behavioral health, to everyone who walks through their doors, regardless of their ability to pay, their immigration status, or their individual circumstances.
(b) Community health centers are paid a predetermined rate for the health care services they provide through a restrictive and complex structure governed by state and federal law called the Prospective Payment System (PPS). A community health center is only allowed to request a reevaluation of its PPS rate, essentially a rate change request, under very strict circumstances. Those circumstances do not include state-mandated increases in the minimum wage. Community Health Centers are essentially on a fixed income and, unlike other entities or businesses, cannot raise the prices of their services to adjust to increases in the minimum wage.
(c) In 2023, the Governor signed a historic increase in the minimum wage for Californias health care workers. Community health centers are eager to support their workers with higher wages but will struggle to pay state-mandated higher wages and maintain high-quality patient care, without rates that match their actual operational costs. Ensuring community health centers have a mechanism to address mandatory wage increases is crucial to community health centers long-term sustainability.
(d) Based on these findings, the Legislature declares its intent to support community health centers in their mission to provide accessible, affordable, equitable, and high-quality health care for all Californians, by adjusting their rates to accurately cover the costs of the health care services they provide.
SEC. 2. Section 14132.105 is added to the Welfare and Institutions Code, to read:14132.105. On or before April 1, 2025, the department shall submit a request for approval to the federal Centers for Medicare and Medicaid Services to authorize a waiver for a covered health care facility described in subdivision (l) of Section 1206 of the Health and Safety Code and clauses (xiv) and (xv) of subparagraph (A) of paragraph (3) of subdivision (b) of Section 1182.14 of the Labor Code to request a change in its prospective payment system rates, based on the minimum wage increases described in subdivisions (c) and (d) of Section 1182.14 of the Labor Code.
SEC. 2. Section 14132.105 is added to the Welfare and Institutions Code, to read:
### SEC. 2.
14132.105. On or before April 1, 2025, the department shall submit a request for approval to the federal Centers for Medicare and Medicaid Services to authorize a waiver for a covered health care facility described in subdivision (l) of Section 1206 of the Health and Safety Code and clauses (xiv) and (xv) of subparagraph (A) of paragraph (3) of subdivision (b) of Section 1182.14 of the Labor Code to request a change in its prospective payment system rates, based on the minimum wage increases described in subdivisions (c) and (d) of Section 1182.14 of the Labor Code.
14132.105. On or before April 1, 2025, the department shall submit a request for approval to the federal Centers for Medicare and Medicaid Services to authorize a waiver for a covered health care facility described in subdivision (l) of Section 1206 of the Health and Safety Code and clauses (xiv) and (xv) of subparagraph (A) of paragraph (3) of subdivision (b) of Section 1182.14 of the Labor Code to request a change in its prospective payment system rates, based on the minimum wage increases described in subdivisions (c) and (d) of Section 1182.14 of the Labor Code.
14132.105. On or before April 1, 2025, the department shall submit a request for approval to the federal Centers for Medicare and Medicaid Services to authorize a waiver for a covered health care facility described in subdivision (l) of Section 1206 of the Health and Safety Code and clauses (xiv) and (xv) of subparagraph (A) of paragraph (3) of subdivision (b) of Section 1182.14 of the Labor Code to request a change in its prospective payment system rates, based on the minimum wage increases described in subdivisions (c) and (d) of Section 1182.14 of the Labor Code.
14132.105. On or before April 1, 2025, the department shall submit a request for approval to the federal Centers for Medicare and Medicaid Services to authorize a waiver for a covered health care facility described in subdivision (l) of Section 1206 of the Health and Safety Code and clauses (xiv) and (xv) of subparagraph (A) of paragraph (3) of subdivision (b) of Section 1182.14 of the Labor Code to request a change in its prospective payment system rates, based on the minimum wage increases described in subdivisions (c) and (d) of Section 1182.14 of the Labor Code.