Overview
Health Center Budget Priority: Health4All
Health Center Budget Priority: Medi-Cal Rx Transition – Supplemental Payment Pool Augmentation
Health Center Budget Priority: Medi-Cal Telehealth Flexibility and Payment
Health Center Budget Priority: Health Care Workforce
SB 939 (Pan): Prohibiting Discriminatory Contracting in the 340B Pharmacy Program
The 340B Drug Pricing Program is an essential source of support for CHCs and their patients. CHCs reinvest the savings from the 340B program into patient services, such as patient navigation, transportation, and other critical services. In recent years, community health centers have grown increasingly concerned about actions by pharmacy benefit managers (PBMs), manufacturers and others who are taking 340B savings from CHCs and their patients impacting patient services while also threatening patient access to critical medicines made affordable through the federal 340B Program. The legislature must prohibit discriminatory actions by PBMs and drug manufacturers when providing 340B drugs to CHCs and their patients. These important consumer protections are necessary to protect patient services and access to low-cost drugs.
Senate Bill 939 would prohibit discriminatory actions by PBMs and drug manufacturers when providing 340B drugs to CEs and their patients. These important consumer protections are necessary to protect the remaining 340B savings for CHCs and their patients. Status: Senate Health Committee SB 966 (Limón): Increasing Behavioral Health Access Our state is an extreme workforce shortage, leaving community health centers with decreased capacity to meet the increased demand of behavioral health services for California’s vulnerable safety net. Additionally, the ramifications of COVID-19 on mental health are extensive, and often disproportionately harmful to populations that have historically been marginalized. In May 2020, DHCS (and pursuant to SPA 20-0024) temporarily allowed Associate Clinical Social Workers (ASWs) and Associate Marriage and Family Therapists (AMFTs) as billable provider types for FQHCs and RHCs, contingent on the declared COVID-19 public health emergency. This flexibility has greatly increased access to behavioral health services and helped meet the increased patient demand during COVID-19. The looming concern for health centers is the inability to continue utilizing this workforce upon the expiration of the public health emergency greatly decreasing the ability to offer access to care and almost certainly interrupting continuity of care for patients finally receiving treatment. Behavioral health care should not be separate from the rest of the body. Training Associates in community health centers allows the future workforce to have field training in integrated care, where Associates will be working with a team to address both medical and behavioral health conditions. Health centers consider a patient’s physical, behavioral, and social determinants of health and are positioned to treat the whole person, not just a single ailment or diagnosis.
Senate Bill 966 would extend flexibilities allowed during the declared public health emergency to hire and bill for ASWs and AMFTs, therefore sustaining continuity of care for patients and increasing access to a diverse behavioral health workforce. This bill will also remove the current administrative barrier to utilizing LMFTs by aligning FQHC/RHC Medi-Cal Change in Scope-Of-Service Request (CSOSR) requirements for both medical and behavioral health services, ensuring that health centers are not disadvantaged when trying to bring in critical behavioral health workforce.
Status: Senate Health Committee SB 316 (Eggman): Same Day Visit Currently, CHCs may bill for a behavioral health visit or a physical health visit in a 24hour period, but will not be reimbursed for both. This means that patients with a medically necessary behavioral health condition must wait 24 hours before they can be seen for a visit if they already obtained a physical health visit on that same day. This restriction undermines a clinic’s ability to provide or expand behavioral health services that are in even greater demand as a result of this pandemic. SB 316 would ensure that FQHCs and RHCs are adequately compensated for the care they provide and can continue to strengthen care coordination and integration for the millions of patients our systems serve. Status: Assembly Floor
Status: Assembly Floor For more information on the State Budget or sponsored bills please contact Beth Malinowski, Director of Government Affairs, at Beth@healthplusadvocates.org.