Legislation

Legislation

We have completed the first year of the 2017-18 legislative session. This is a summary of the legislation I authored this year and some other major accomplishments. The Governor has 30 days to sign or veto a bill once it is received in his office. The last day he can sign or veto a bill is October 15.

Legislation

I authored the following legislation which was signed into law in 2016:

AB 72 – Health Care Coverage: Out-of-Network Coverage

This bill was authored by Asm. Jim Wood and five Democrats and Republicans. The bill will protect patients from the unfair practice of receiving surprise bills for healthcare when it was provided, unknowingly to the patient, by providers outside their health plan’s network.

For nearly 40 years patients covered by a health plan have carefully sought care from only those doctors and hospitals that are in their network; however, patients have continued to receive surprise bills, for instance, when they received care in an in-network hospital but received services from a lab or health care provider that was not in their network.

Under this law, patients will no longer be balance-billed and, as long as a patient is treated at an in-network facility, payment will be limited to the patient’s usual in-network share of cost – it will not matter that a particular provider was not in their network. Out-of-network doctors or other providers, such as labs, that operate at an in-network facility will be prohibited from billing patients any amount beyond the in-network rate. AB 72 sets up the reimbursement rates to these out-of-network providers at either the average contracted rate or 125 percent of the established Medicare amount, whichever is greater.

AB 21 – Medical Marijuana: Cultivation Licenses

The Medical Cannabis Regulation and Safety Act (MCRSA) required local jurisdictions to develop regulations for the cultivation of medical marijuana by March 1, 2016, or relinquish that authority to the state. Since MCRSA was signed by Governor Brown in October 2015, many cities and counties have not had enough time to meet that deadline and some, instead, have banned medical marijuana in order to “comply” with the March 1 requirement. In addition, MCRSA created the Bureau of Medical Marijuana Regulation within the Department of Consumer Affairs, but that bureau only exists on paper and it will be many months before it has the capacity to develop and enforce statewide regulations. AB 21 removes the March 1 deadline completely and allows local jurisdictions more time to develop thoughtful regulations around the cultivation of medical marijuana. As a result, it ensures that patients and primary caregivers continue to have access to the medical cannabis they require.

AB 1262 – Telecommunications: Universal Service

Access to broadband technology is limited, inconsistent and sometimes completely unavailable to many of the remote areas of the state. To address this, the Public Utilities Commission (PUC) administers the California Advance Services Fund (CASF) to encourage deployment of high-quality advanced communication services to all Californians. The Legislature initially approved a $10 million deposit into a fund so that communities could organize and apply for infrastructure projects that provide broadband access to households that are unserved or underserved.

This bill transfers $5 million from the Broadband Infrastructure Revolving Loan Account to the Rural and Urban Regional Broadband Consortia Grant Account, equivalent to approximately two additional years of funding to allow local experts and community leaders to continue working with telecommunication providers and key community stakeholders to promote access to broadband services.

AB 1549 – Department of Transportation: State Highway Rights-of-Way: Broadband: Fiber Optic Cables (Chapter 505, Statutes of 2016)

Currently, a central and statewide database of publicly owned network assets, such as fiber optic lines, broadband conduits or utility poles, does not exist in California; however, there are multiple public agencies that collect data on the broadband conduits that they own and/or manage, but the information is not centralized. For example, information regarding the location and management of a fiber optic cable within a conduit could be housed in multiple locations – a private broadband company, a municipal department or a state transportation agency. The lack of a central database creates unnecessary barriers to increasing the deployment of high-quality advanced communication services to all Californians. If a central database of broadband conduits existed or notification of the construction project was given, it would allow a broadband company to weigh the option of using existing resources, such as an existing conduit or joint trenching with Caltrans, before excavating the road unnecessarily.

This bill requires Caltrans to notify entities working on broadband deployment of upcoming Caltrans highway construction projects to encourage collaborative broadband conduit installation, and requires Caltrans to meet with stakeholders to discuss guidelines that would facilitate the installation of broadband conduit on state highway rights-of-way and report back to the Legislature by January 1, 2018.

AB 1808 – Minors: Mental Health Treatment or Counseling Services

Current law allows Licensed Marriage and Family Therapists (LMFTs), Licensed Professional Clinical Counselors (LPCCs) and, registered interns gaining hours toward LMFT or LPCC licensure, to provide mental health services to a minor, 12 years or older, in appropriate circumstances.

While registered LMFT and LPCC interns are listed as appropriate providers, LMFT and LPCC “trainees” are not included. This oversight negatively impacts the number of providers available to treat minors and contributes to the lack of mental health services available in schools. Additionally, this oversight limits the opportunities for trainees to gain the 3,000 hours of counseling experience needed to qualify to apply for licensure.

This bill permits trainees, working under the supervision of a LMFT or LPCC, to treat a minor under the same limited terms and conditions as interns. Trainees must be enrolled in a masters or doctoral program and must have completed at least 12 semester units in the postgraduate degree program.

AB 1863Medi-Cal: Federally Qualified Health Centers: Rural Health Centers

Currently, psychologists and license clinical social workers (LCSW) are employed by rural health clinics (RHCs) and federally qualified health centers (FQHCs) and these clinics can bill and receive reimbursement for their services from Medi-Cal. While clinics may employ a licensed marriage and family therapist (LMFT), there is not a Medi-Cal reimbursement mechanism for them and this creates a disincentive for hiring. LMFTs are billable and recognized providers by Medi-Cal in other settings but not in RHCs or FQHCs.

Within the primary care setting, up to 26 percent of patients have some mental health disorder and while chronic conditions such as heart disease and diabetes are common among the general adult population, adults with mental health needs have a 1.5 times higher incidence of chronic diseases such as high blood pressure, heart disease or asthma. This situation reinforces the value of integrating mental health services into the primary care settings of RHCs and FQHCs.

As part of California’s implementation of the Affordable Care Act, mental health and substance abuse disorder services were deemed an essential health benefit for Medi-Cal managed care plans. Along with the expansion of behavioral health benefits for Medi-Cal beneficiaries, there has been an increase in the number of patients qualified under Medi-Cal.

Adding LMFTs to the list of Medi-Cal billable providers will help to close existing gaps in workforce capacity by providing clinics with an adequate source of funding for their employment, which will also help meet the demand for mental health services, particularly in rural communities.

AB 1874 – Structural Pest Control

Current law requires that the structural pest control operator designated as the “qualifying manager” supervise the daily business of the company and be available to supervise and assist the company’s employees. Through enforcement activity, the Structural Pest Control Board became aware of the practice of operators “renting” their license where a registered company pays a recurring fee to an individual licensed as an operator and, in return, that individual will serve as the company’s qualifying manager without ever having any actual involvement with the company. This results in registered companies practicing structural pest control without the necessary supervision.

To strengthen consumer protection, this bill adds a requirement to existing law that structural pest control operators serving as qualifying managers be required to be physically present in the offices for a minimum of 9 days in every three consecutive calendar months. This requirement will help ensure that the companies performing structural pest control will have adequate supervision and improve consumer protection.

AB 1923Bioenergy Feed-in Tariff

Biomass power is a carbon neutral resource that is generated from recycling organic materials such as dead or decaying trees, wood byproducts and residuals and solid waste. These items are then efficiently combusted creating clean, renewable energy. The biomass process promotes healthy forests by managing diseased and overcrowded trees and reducing greenhouse gas emissions by replacing fossil-fuel-fired generators with renewable generators. It also provides quality employment opportunities in economically challenged rural areas of California and can provide a significant source of property tax and other local revenues that, in turn, can support local services.

Current law requires investor-owned utilities to purchase a cumulative 250 megawatts from qualifying bio-energy projects but the generating facility must have an “effective capacity of not more than three megawatts.” Many biomass producers prefer to operate at a 5-megawatt capacity because it is more cost-effective, and this bill allows utilities to purchase from those with a capacity of up to 5 megawatts as long as the facility delivers no more than 3 megawatts to the grid. The excess power generated can be used on site to lower energy costs of the facility. As a result of this new law, one new biomass facility is already planned to open in Fortuna, CA.

AB 1958 – Forestry: Timberlands: Restoration and Conservation Forest Management Activities

Oak woodlands play an important role in sustaining healthy ecosystems across California. They retain soils, purify air, conserve water, and serve as excellent environments for grazing and hunting and provide food and cover for a wide range of wildlife, including many game species.

Conifers are encroaching on these oak woodlands and are growing over oak trees, shading them and jeopardizing the oaks ability to survive and regenerate. In recent years there have been considerable efforts to preserve and restore oak woodlands across the state; however, efforts to reverse conifer encroachment can be very expensive and are being hindered by certain prohibitive forestry policies.

This bill clarifies that removing conifers in order to restore oak woodlands is not a conversion from timberland and therefore does not require the very costly conversion permit as defined in the forest practice act. AB 1958 also provides a narrow timber harvest exemption for qualifying land owners to sell the conifers they remove during the restoration of oak woodlands, helping to offset the cost of this very expensive work.

AB 1977 – Tribal Gaming: Compact Amendment Ratification

Existing law allows for a state and Indian tribes to enter into negotiations of tribal-state gaming compacts. This bill ratified the tribal-state gaming compact entered into between the State of California and the Yurok Tribe executed on August 4, 2016. Specifically, this revised compact aligns the Yurok Tribe’s workers’ compensation provisions to other tribes in California. Before the revision was made, the Yurok Tribe was considering closing down the Redwood Hotel Casino which would have resulted in hundreds of lost jobs. The Yurok tribe is well represented on the North Coast and provides quality employment and economic opportunity to the surrounding area. Read the press release here.

AB 2024 – Critical Access Hospitals: Employment

Current law prohibits hospitals from employing physicians with the exception of county, charitable and teaching hospitals. These restrictions are a significant barrier to adequately staffing small rural hospitals. AB 2024 authorizes, until January 1, 2024, a federally certified Critical Access Hospital (CAH) to employ physicians and bill for their services.

CAHs are defined by the federal government as small (25 beds or less) and must be located in rural areas. These hospitals suffer significant challenges in meeting their staffing needs for physicians because there are not enough physicians practicing in the community to recruit from. Being a physician in private practice in these communities is often not financially feasible; however, recent studies show that many physicians are attracted to the economic and financial stability of being employed by a hospital. This bill creates an opportunity for these small hospitals to recruit physicians as employees which can improve access for the patients in the community.

AB 2207Medi-Cal: Dental Program

The Denti-Cal system is so broken that many dentists provide pro-bono care rather than participate in the program. Findings by the Little Hoover Commission, published in April 2016, provided scathing criticism of the system, including limited coverage for procedures, low utilization rates, some of the lowest provider reimbursement rates in the nation and an oppressive and bureaucratic administration system.

To address these shortcomings, this bill requires the Department of Health Care Services (DHCS) to implement an expedited provider enrollment process, report utilization data more often and look for opportunities to increase patient utilization. For example, increasing utilization of preventive services, currently only 14 percent of all services provided, can provide long-term benefits to patients by preventing more serious dental disease and has the potential to save money in the state’s Denti-Cal budget by eventually shifting care away from more costly care.

Much still needs to be done to improve the Denti-Cal program. This bill is a start by requiring DHCS to fix some of the barriers that prevent dentists from being able to treat the program’s beneficiaries.

AB 2516 – Medical Cannabis: State Cultivator License Types: Specialty Cottage Type

The Medical Cannabis Regulation and Safety Act (MCRSA) provides for the licensure of commercial medical cannabis activities. MCRSA establishes various types of state cultivator licenses and tasks the California Department of Food and Agriculture with issuing licenses to qualified applicants.

Ensuring that regulations are fair and reasonable for all is essential to bringing farmers into compliance. This law specifically addresses the small medical cannabis growers to ensure that they can comply with regulations and requires the California Department of Food and Agriculture (CDFA) to develop regulations for 2018 that address the unique characteristics of small farm practices.

The technical requirements for the new license type 1C, or specialty cottage cultivator license, are for farms with 2,500 square feet or less of total canopy size for mixed-light cultivation, up to 25 mature plants for outdoor cultivation, or 500 square feet or less of total canopy size for indoor cultivation, on one premises. CDFA will issue the licenses to qualified candidates as well as develop the requirements for each license type.

AB 2615 – After-School Programs (Chapter 470, Statutes of 2016)

Under current law, the California Department of Education is responsible in overseeing and administering funds to school districts for the After School Education and Safety Program. The program provides school districts with after-school funding to ensure that students have an after-school alternative, especially critical for students in need of academic assistance or to provide for a safe and social after-school environment.

The current distribution of funds unjustly favors areas with higher population densities and places rural schools at a significant disadvantage. Larger school districts often have staff dedicated to coordinating and writing applications for these funds, putting small rural schools at a competitive disadvantage. This law will provide a more equitable grant application process and distribution of after-school program funding in each geographic region ensuring rural schools can access their fair share of funding.

2015 Legislation

I authored the following legislation which was signed into law in 2015:

AB 81 – Frank Howard Hospital

This bill extends the seismic safety deadline for the Frank Howard Memorial Hospital (HMH) in Willits, California to September 1, 2015. This extension allowed Frank Howard Hospital continue serving patients while construction was completed on the new hospital building that is now serving patients in the Norther Mendocino County Area.

AB 143 – Food in Small Wineries

This bill eliminates the need to obtain a local food permit for wineries that serve pretzels or other specified items such as vacuumed-sealed snacks or foods instead, in addition to crackers. The bill also eliminates the need for wineries to obtain a local food permit if they maintain no more than a 25-square-foot retail display of packaged foods.

AB 243 – Marijuana Watershed Protection Act

This bill is part of the Medical Marijuana Regulation and Safety Act (MMRSA) which together has created the most robust medical cannabis framework in the country. Specifically AB 243 requires all nine Regional Water Quality Control Boards to develop environmental protections to address wastewater discharges from medical marijuana farms and created the permanent Watershed Enforcement Team (WET) designed to protect these valuable resources It also eliminates the legal grey area for cannabis famers by creating a licensing structure that ensures that medical marijuana farms use best practices while cultivating and will protect the environment.

AB 325 -- Access to the Community Development Block Grant

The Community Development Block Grant (CDBG) program provides millions of federal dollars to rural communities in California. This bill streamlines the program and cuts red tape at the state level. AB 325 requires the California Department of Housing and Community Development (HCD) to respond to completed grant applications within 60 days. If the applicant is denied by the state agency, this bill requires HCD to list the reasons for denial and what steps need to be taken for approval.

AB 644 – Subdivision Findings Waiver

This bill makes it more affordable for land owners to keep their property as open space and resist the increasing pressure to increase development on their land. This bill creates an exemption for subdivided properties that will remain open space or resource management land. These properties are now exempt from the expensive finding process of the Subdivision Map Act as long as no residential structures are built on the newly subdivided property.

AB 707 – Williamson Act – Cancellation Fees

This bill repeals the ability for a landowner and the Department of Conservation to cut out local municipalities from negotiating a cancellation of the Williamson Act.

AB 941 – Tribal Health Clinics

This bill exempts clinics operated by a tribe or tribal organization, regardless if the clinic is located on tribal land, from obtaining a license from Department of Public Health. These health clinics would operate under a contract with the United States pursuant to the Indian Self Determination and Education Assistance Act. This bill will help increase access to health clinics throughout the state, especially in rural areas of California.

AB 1149 – Emergency Medical Preparedness

The Hospital Preparedness Program trains medical staff how to respond when a natural disaster or public health emergency hits. This bill removed a legal barrier that prevented trade associations from helping to administer the training.

AB 1262 – Rural Broadband

This bill transfers $5 million from the Broadband Infrastructure Revolving Loan Account to the Rural and Urban Regional Broadband Consortia Grant Account and provides approximately two additional years of funding to continue working with telecommunication providers and key community stakeholders to promote California Advanced Services Fund for years to come.