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Bill Text - SB-225 Health care coverage: timely access to care.
A health care service plan may indicate that exceptions to appointment wait times may apply if the department has found exceptions to be permissible.(d) The information required to be provided pursuant to this section shall be provided to an enrollee with individual coverage upon
	initial enrollment and annually thereafter upon renewal, and to enrollees and subscribers with group coverage upon initial enrollment and annually thereafter upon renewal. A health care service plan may include this information with other materials sent to the enrollee. The information shall also be provided in the following manner:(1) In a separate section of the evidence of coverage titled “Timely Access to Care.”(2) At least annually, in or with newsletters, outreach, or other materials that are routinely disseminated to the plan’s enrollees.(3) Commencing January 1, 2018, in a separate section of the provider directory published and maintained by the health care service plan pursuant to Section 1367.27. The separate
	section shall be titled “Timely Access to Care.”(4) On the internet website published and maintained by the health care service plan, in a manner that allows enrollees and prospective enrollees to easily locate the information.(e) (1) A health care service plan shall provide the information required by this section to contracting providers on no less than an annual basis.(2) A health care service plan shall also inform a contracting provider of all of the following:(A) Information about a health care service plan’s obligation under California law to provide or arrange for timely access to care.(B) How a contracting provider or enrollee can contact the health care service plan to obtain assistance if a patient is unable to obtain a timely referral to an appropriate provider.(C) The toll-free telephone number and internet website address for the Department of Managed Health Care where providers and enrollees can file a complaint if they are unable to obtain a timely referral to an appropriate provider.(3) A health care service plan may comply with this subdivision by including the information with an existing communication with a contracting provider.(f) This section shall apply to Medi-Cal managed care plan contracts entered into with the State
You searched for - California Grants Portal
Estimated Total Funding
$38,000,000

Estimated Low/High
$1 – $4,000,000

Funds Disbursement
Advances & Reimbursement(s)

 

	Current as of:	

	May 14, 2024, 2:19 pm	

Grantor

	CA Department of Veterans Affairs	

Grant Program ID

Portal ID
60495

Opportunity Type
 

	
	Grant
	

Purpose
The California Department of Veterans Affairs (CalVet) is announcing the availability of up to $38 million in competitive grants. Grantees will focus on prevention and early intervention efforts with the end goal of increasing access to mental health services for veterans and their families.  This initiative is to be known as the California Veterans Health Initiative (CVHI) Mental Health Support Grant Program (MHSGP). 

Eligible Applicants
 

	
	Nonprofit
	

Eligible Geographies
CalVet intends to ensure access to mental healthcare through the CVHI network by targeting 8 regions in California: North Valley, San Francisco Bay Area, Central Valley, Central Coast, Los Angeles, Inland Empire, Orange, and San Diego.  Multi-regional and statewide proposals will also be considered. A regional map can be found in the NOFA. 

	View Full Grant Details: California Veterans Health Initiative (CVHI) Mental Health Support Grant Program (MHSGP)>/span>	

Deadline

	Active	

	6/30/25 23:59	

Grant Title

Public Participation Grant Account

Open Date
Sep 8, 2023

State Agency / Department
Public Utilities Commission

Match Funding?
No

Estimated Total Funding
$100,000

Estimated Low/High
Dependent

Funds Disbursement
Reimbursement(s)

 

	Current as of:	

	February 22, 2024, 2:58 pm	

Grantor

	Public Utilities Commission	

Grant Program ID

Portal ID
59118

Opportunity Type
 

	
	Grant
	

Purpose
The Public Participation (PP) Grant Account helps remove barriers to participation and provides compensation for organizations involved in CPUC activities and influence policy decisions.
The 2024-25 Budget: Medi-Cal Analysis
Under the plan, most base payments for primary care, obstetrics, non‑specialty mental health care, specialty care, and emergency physician services would be tied to a percent of the Medicare level on an ongoing basis. The payments would range from 80 percent to 100 percent of Medicare, depending on the service. In addition, the department proposes to vary rates by geographic area to account for regional differences in costs, another feature of Medicare’s payment system.
Establishes New Prospective Payment Systems for Hospital Services. The administration’s proposal would change the way some hospital services are paid. Generally, these changes would adopt prospective payment systems, which pay for an episode of care instead of the volume of services. Specifically, DHCS proposes to establish a prospective payment system for outpatient services no sooner than 2027 and explore whether to adopt such a system for emergency room services. The department would model these payment systems largely based on the approach used in Medicare. In the interim, the department proposes to increase outpatient rates by an average of 10 percent and emergency room rates by an average of 40 percent. The administration also proposes to adopt a prospective payment system for inpatient services at UC and county hospitals, similar to the approach Medi‑Cal currently uses for private and district hospitals. This approach would replace the existing cost‑based reimbursement system and also replace a portion of local contributions with MCO tax funds.
Adopts New Equity Adjustment for Certain Services. For physician and hospital outpatient services, the administration also proposes establishing new equity adjustments. These adjustments would increase the level of payment to providers delivering services in certain geographic areas. The administration has not specified the exact parameters of the equity adjustment, but states that it could consider factors such as whether an area is a federally recognized health shortage area, whether an area is rural or is an urban health desert, the proportion of an area’s population that is enrolled in Medi‑Cal, and measures of the social determinants of health in an area. According to the administration, the goal of this proposal is to boost provider participation in Medi‑Cal in these geographic areas. The administration estimates the equity adjustment for physicians would cost $80 million MCO tax funds ($200 million total funds), or 7 percent of physician payments.
The 2024-25 Budget: Medi-Cal Analysis
Focus on changes that make Medi‑Cal payments more rational.

Implement realistic implementation schedule.

Develop plan for oversight.

Develop sustainable long‑term plan for the future.

Target Increases to Highest Need Areas of Medi‑Cal. We recommend the Legislature first consider which areas of Medi‑Cal to target for augmentations. Though last year’s enacted trailer bill legislation set forth specific areas for increases, the Legislature could consider how much funding to allocate and how to structure these allocations. For example, the Legislature could consider how much funding to allocate for base payment increases and how much funding to allocate for equity adjustments. 
Focus on Changes That Make Medi‑Cal Payment Methodologies More Rational. To the extent the Legislature would like to use these increases to also change the way Medi‑Cal pays providers, we recommend it focus on approaches that make the existing methodology more rational. For example, the Legislature could consider tying certain provider payments to a percent of the Medicare level, as proposed, which would help to mitigate existing inequities and allow for a consistent approach to adjust rates over time. The Legislature could consider many other approaches as well, such as tying payments to delivering high‑value services or meeting performance outcomes. 
Implement Realistic Implementation Schedule. During budget hearings, we recommend the Legislature solicit more information from the department, managed care plans, and providers on the implementation of the recently enacted payment increases and any anticipated challenges to implement proposed increases in 2025. To the extent this information suggests the proposed timing of augmentations may not be feasible, we recommend the Legislature consider approving increases over a longer time frame. For example, the Legislature could delay the timing of certain increases and payment methodology changes, allowing more time for DHCS and managed care plans to prepare. Alternatively, the Legislature could phase in payment increases and changes over multiple years, such as by enacting a multiyear schedule to ramp up rate increases to the desired level. Such an approach could have the added benefit of spreading the fiscal risks of the proposed package over a longer period of time, including by delaying the timing of when the provider payment reserve is depleted.
Develop Plan for Oversight.
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The 2024-25 Budget: Medi-Cal Analysis
Pursuant to the direction in the trailer bill legislation, the administration planned to release more information on the 2024‑25 augmentations as part of the Governor’s budget in January.
Proposal
Proposes Increases to Payments and Changes to Payment Methodologies. On January 19, 2024, DHCS released a policy brief describing a plan for most of the $2.7 billion package in annual augmentations. As Figure 13 shows, the administration’s brief includes information for augmentations totaling $1.9 billion MCO tax funds ($4.6 billion total funds). (In addition to support for ongoing augmentations totaling $366 million enacted last year, the $2.7 billion estimate includes $375 million in MCO tax funds for two proposals—behavioral health and health care workforce—where more information is forthcoming.) The proposed Medi‑Cal increases would be effective January 2025. As Figure 13 shows, the proposal would not solely increase payments to providers. In many cases, it also would change the way Medi‑Cal pays providers. Below, we describe some of the major features of this package.

Figure 13
Medi‑Cal Provider Payments and Payment MethodologiesWould Change in Several Ways
Major Components of Governor’s MCO Tax‑Funded Provider Payment Proposal (In Millions)

Servicea

Amount

Proposal

MCO Tax

Total Funds

Physician and professional services

$1,075

$2,688

Tie most payments for primary care, obstetric care, non‑specialty mental health care, specialty care, and emergency physician services to 80 percent to 100 percent of what Medicare pays, depending on the service. Adopt Medicare payment structure, including by adjusting rates for regional variations in cost. Adopt new equity adjustment to incentivize service delivery in underserved areas.

Hospital outpatient and emergency services

500

1,215

For outpatient services, transition toward Medicare prospective payment system and Medicare adjustments for regional variations in cost. Adopt new equity adjustment to incentivize service delivery in underserved areas. For emergency services, explore extent to which prospective payment system can be applied.
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The 2024-25 Budget: Medi-Cal Analysis
For example, the Legislature could delay the timing of certain increases and payment methodology changes, allowing more time for DHCS and managed care plans to prepare. Alternatively, the Legislature could phase in payment increases and changes over multiple years, such as by enacting a multiyear schedule to ramp up rate increases to the desired level. Such an approach could have the added benefit of spreading the fiscal risks of the proposed package over a longer period of time, including by delaying the timing of when the provider payment reserve is depleted.
Develop Plan for Oversight. As the administration releases proposed trailer bill legislation, we recommend the Legislature ensure it has an opportunity to review and approve key components of any provider payment changes before they go into effect. In cases where further study is warranted before implementing a change in payment methodology (such as adopting new hospital prospective payment systems), we recommend the Legislature authorize DHCS to study these effects and direct the department to report on its findings before enacting the new system. In addition, we recommend the Legislature be kept apprised of the package’s implementation by establishing reporting requirements in trailer bill legislation or supplemental reporting language. At a minimum, we recommend two reports: (1) an implementation update of approved rate increases, due March 2025, and (2) an initial analysis of how any enacted rate increases have affected access, quality, and equity in the Medi‑Cal program, due March 2026. 
Develop Sustainable Long‑Term Plan for the Future. In crafting its MCO tax package, we recommend the Legislature develop a sustainable long‑term plan that keeps in mind future uncertainties. For example, we recommend the Legislature plan for the possibility that the next MCO tax is smaller than this one and adopt an overall budget package with adequate capacity in the General Fund to sustain ongoing augmentations in the future. Such a plan also would consider the timing of when new augmentations and payment changes would begin and ensure these changes are not disrupted by the potential depletion of the provider payment reserve. Moreover, the Legislature may wish to consider the possibility that the voter initiative qualifies for the ballot and is enacted by voters and plan accordingly.
Other Budget Solutions