CAFP Positions on Legislation
CAFP continues to fight for a provision allocating $100 million to support primary care residency programs in the California State Budget, of which roughly $80 million will go to the Song-Brown Workforce Training Program. CAFP is also working to ensure that revenue generated by the Proposition 56 tobacco tax be used to increase access to care for Medi-Cal patients, particularly through increased Medi-Cal provider payment.
AB 315 (Wood) Pharmacy benefits management transparency.
Co-Sponsor with the California Medical Association (CMA)
SB 641 (Lara) Controlled Substance Utilization Review and Evaluation System: privacy.
Co-Sponsor with CMA
AB 40 (Santiago) CURES database: health information technology system.
This bill, which is sponsored by the California Chapter of the American College of Emergency Physicians (CalACEP), seeks to allow health information technology systems to connect to the CURES database to enable direct importation of CURES data into patient records.
AB 148 (Mathis) California Physician Corps Program: practice setting.
This bill changes the practice setting requirements for clinics and physician practices that participate in the Steven M. Thompson Physician Corp Loan Repayment program. In addition to being located in a medically underserved area, current statute requires that 50 percent of patients seen must be from medically underserved populations. This bill would reduce that requirement specifically for rural areas, requiring that only 30 percent of patients seen in rural areas and 50 percent of patients seen in urban areas be from medically underserved populations.
AB 265 (Wood) Prescription drugs: prohibition on price discount.
This bill would prohibit drug manufacturers from offering any discount, repayment, product voucher or other reduction in an individual’s out-of-pocket expenses for any prescription drug (including, but not limited to, a copayment or deductible) if a lower cost brand name or non-brand name prescription drug is available that is designated by the United States Food and Drug Administration as therapeutically equivalent to, or interchangeable with, that prescription drug.
AB 340 (Arambula) Early and Periodic Screening, Diagnosis, and Treatment Program: trauma.
This bill would require that screening services under the EPSDT program include screening for trauma. The goal of this bill is to identify those children who suffered trauma early in life and start providing them with preventative services. Evidence suggests that trauma early on in a child's life is directly coordinated to the development of a number of illnesses later in life including depression, anxiety, suicide/depression, heart disease, and high risk of alcohol and substance abuse.
AB 443 (Salas) Healing arts: optometry: required examination: notice.
Oppose Unless Amended
This bill is the vehicle through which Assemblymember Salas is attempting to reach a compromise between physicians and optometrists on scope issues. While the bill removes much of the primary care services optometrists were inappropriately seeking to expand their scope to provide, it still would enable optometrists to administer immunizations for herpes zoster virus, pneumococcus and influenza.
AB 447 (Gray) Medi-Cal: covered benefits: continuous glucose monitors.
This bill would add continuous glucose monitors as a benefit under the Medi-Cal program.
AB 461 (Muratsuchi) Personal income taxes: exclusion: forgiven student loan debt.
This bill authorizes the inclusion of additional loan repayment plans in determining the tax liability for federal loan amounts that have been repaid or cancelled. Current law applies only to income-based repayment plans and allows the repaid or cancelled amount to be excluded from determining an individual's gross income. This bill would allow loans that have been repaid or cancelled under additional repayment plans including standard repayment plans, graduated repayment plans, and extended repayment plans, to be eligible for the same exclusion.
AB 508 (Santiago) Health care practitioners: student loans.
Current law authorizes a licensing board to deny a license to an applicant to become a health care practitioner or deny renewal of a license if he or she is in default on a United States Department of Health and Human Services education loan, including a Health Education Assistance Loan until the default is cleared or until the applicant or licensee makes satisfactory repayment arrangements. This bill would repeal this potentially career-threatening disciplinary action against medical professionals.
AB 511 (Arambula) Tuberculosis risk assessment and examination.
This bill, which is sponsored by the Health Officers Association of California, aligns state law with guidelines adopted by multiple expert bodies including the Centers for Disease Control, the American Thoracic Society, the Infectious Diseases Society of America and the American Academy of Pediatrics. It eliminates mandatory tuberculosis screening and instead requires risk assessment first for health professionals. This move from screening to risk assessment aligns with changes recently made for school employees, volunteers, community college employees, instructors and students in public schools.
AB 893 (Eduardo Garcia) - Public Health: Graduate Medical Education
This bill would allow the Office of Statewide Health Planning and Development to gather data regarding the number of graduate medical education slots necessary to meet the current and future physician and surgeon needs of the County of Imperial and similar medically underserved counties.
AB 1002 (Cooley) Center for Cannabis Research.
This bill would expand the purview of the Center for Cannabis Research to include the power to study naturally occurring compounds similar to cannabis as well as develop testing methods for detecting harmful contaminants in marijuana products. This bill allows the program to cultivate marijuana for research purposes and allows the center to enter into private contracts with entities with experience in cultivating medical cannabis. This recommendation is consistent with CAFP policy which calls efforts to facilitate marijuana clinical research.
AB 1048 (Arambula) Health care: pain management and Schedule II drug prescriptions.
This bill would allow a pharmacist to dispense a Schedule II controlled substance as a partial fill if requested by the patient or the prescribing physician. It would also remove the requirement that pain be assessed at the same time as vital signs and prohibit a general acute care hospital or acute psychiatric hospital from in any way conditioning or basing executive compensation on patient satisfaction measurements for pain management.
AB 1316 (Quirk) Public health: childhood lead poisoning: prevention.
Support if Amended
Current law requires that the California Department of Public Health adopt regulations establishing a standard of care so all children are evaluated for risk of lead poisoning and that those determined to be "at risk" are screened. This bill seeks to specify that the regulations include a risk “assessment for determining whether a child is at risk that considers the most significant environmental risk factors, including, but not limited to, a child’s time spent in a home, school, or building built before 1978, a child’s proximity to a former lead or steel smelter, a child’s proximity to a freeway, a child’s consumption of imported foods and spices, and other known risk factors for lead exposure.”
AB 1368 (Calderon) Medi-Cal: authorization requests.
This bill is sponsored by the California Academy of Physician Assistants and would authorize a physician to designate a physician assistant to sign any authorization form required by the State Department of Health Care Services for benefits and services under the Medi-Cal program, provided that the physician and the designated physician assistant are each enrolled as Medi-Cal providers.
AB 1560 (Friedman) Nurse practitioners: supervision.
This bill would increase the cap to 18 (currently set at 4) for how many NPs, PAs and CNMWs a physician can supervise.
SB 17 (Hernandez) Health care: prescription drug costs.
This bill requires health plans to report rate information in the small and large group markets regarding all covered drugs. It would also require the reporting of the specialty tier formulary list and information on its use of a pharmacy benefit manager. The bill contains several other provisions seeking to increase transparency in pharmaceutical pricing and prior notice to consumers and other purchasers of any planned price increases for prescription drugs.
SB 54 (De León) Law enforcement: sharing data.
This bill was introduced to address concerns that information collected by California and California law enforcement entities could be used for federal immigration enforcement. The bill would remove the requirement that state and local law enforcement inform immigration authorities when an arrest for certain controlled substance related offenses is made. It would limit state and local law enforcement from detaining, investigating, or interrogating people for immigration enforcement purposes. It would prohibit sharing information in state databases for immigration enforcement purposes. It would require the Attorney General to publish model policies limiting immigration enforcement at various public facilities, including health facilities. Additionally, it will help provide resources to health facilities to establish policies that reduce fear that accessing health care will result in immigration enforcement.
SB 294 (Hernandez) Hospices: palliative care.
This bill seeks to clarify the law requiring the State Department of Health Care Services (DHCS) to establish standards for Medi-Cal managed care plans to ensure delivery of palliative care services. Confusion has arisen related to whether the hospice licensing statutes specifically allow for both the provision and coverage of palliative care in hospice facilities. This bill would ensure that hospices may provide these covered palliative care services for any person in need of those services, as determined by the physician in charge of the care of the patient.
SB 300 (Monning) Sugar-sweetened beverages: health warnings.
This bill would prohibit the sale of most non-alcoholic beverages with added sugar and over 75 calories per 12 fluid ounces without the following warning label, "STATE OF CALIFORNIA SAFETY WARNING: Drinking beverages with added sugar(s) contributes to obesity, type 2 diabetes, and tooth decay."
SB 374 (Newman) Health insurance: discriminatory practices: mental health.
This bill would require a large group, small group or individual health insurance policy to provide all covered mental health and substance use disorder benefits in the compliance with the Paul Wellstone and Pete Dominici Mental Health Parity and Equity Act of 2008 and all relevant rules, regulations, and guidance issued pursuant to the federal Public Health Service Act.
SB 396 (Lara) University of California: California Medical Residency Training Pilot Program
This bill requests the Regents of the University of California to develop and implement a California Medical Residency Training Pilot Program for undocumented individuals. There are currently some employment and other administrative challenges to these individuals’ ability to attend residency programs operated by the University of California.
SB 437 (Atkins) Health care coverage: joint senior level working group
The Department of Managed Health Care and the Department of Insurance maintain a joint senior level working group to ensure clarity for health care consumers about who enforces their patient rights and consistency in the regulations of the departments. The working group is tasked with reviewing and making recommendations on timely payment of claims and the grievance/consumer complaint processes, including coverage and medical necessity complaints, independent medical review, and information developed for consumer use. This bill adds timely access to care, network adequacy and state implementation of federal health care reform to the list of issues the joint working group reviews.
SB 456 (Pan) Medi-Cal managed care: federally qualified health centers and rural health clinics.
Previously a spot bill, recent amendments would allow payment and support at a federally qualified health center or rural health clinic to permit it to enter into an agreement with a payer to provide “services that follow the patient.” These services include, but are not limited to, services that promote continuity of care and contribute to overall patient wellness, including:
- Comprehensive care management.
- Care coordination.
- Health and wellness initiatives.
- Comprehensive transitional care.
- Individual and family support services.
- Referral to community and social supports.
SB 536 (Pan) Firearm Violence Research Center: gun violence restraining orders.
CAFP supported SB 1006 (Wolk) last year, which through the budget process, created and funded a Firearm Violence Research Center within the UC system. This bill requires the Department of Justice to share information relating to gun violence restraining orders with researchers at the newly established Center.
SB 562 (Atkins, Lara) Californians for a Healthy California Act.
This bill, the Healthy California Act, aims to create a universal single-payer health care coverage system. Funding for this system is not specified in the bill.
SB 790 (McGuire) Health care providers: gifts and benefits.
This bill would prohibit a manufacturer of a prescribed product from offering or giving a gift to a health care provider. The bill would define a gift as anything of value provided for free to a health care provider, or a payment, food, entertainment, travel, subscription, advance, service, or anything else of value provided to a health care provider, unless it is a specified allowable expenditure or the health care provider reimburses the cost at fair market value.
SR 37 (Hertzberg) Diabetes Awareness Month
This is a resolution that would declare November 2017 as Diabetes Awareness Month. It would also encourage individuals to seek screening to understand their diabetes risk and to pursue early treatment, if necessary, to reduce the incidence of diabetes and its complications. Finally it states that there is a significant need to focus additional prevention efforts in communities that are disproportionately affected by diabetes.