BILL ANALYSIS
SENATE HEALTH AND HUMAN SERVICES
COMMITTEE ANALYSIS
Senator Deborah V. Ortiz, Chair
BILL NO: SB 765
S
AUTHOR: Chesbro
B
AMENDED: As Introduced
HEARING DATE: April 4, 2001
7
FISCAL: Appropriations
6
5
CONSULTANT:
Flores / ak
SUBJECT
Child Health and Disability Prevention Program
SUMMARY
Requires the Department of Health Services to develop the
minimum standards for the Child Health and Disability
Prevention Program based on the most current
"Recommendations for Preventative Pediatric Health Care" of
the American Academy of Pediatrics.
ABSTRACT
Existing law:
1.Establishes the Child Health and Disability Prevention
Program (CHDP) that provides and promotes preventive
health services for the early detection and prevention of
disease and disabilities in children and youth.
2.Establishes the eligibility of the CHDP for children who
are enrolled in Medi-Cal and are 20 years of age or
younger; are without health insurance, are 18 years of
age or younger and live in families with incomes up to
200 percent of the federal poverty level; are enrolled in
Head Start or State Preschool.
Continued---
STAFF ANALYSIS OF SENATE BILL 765 (CHESBRO) Page
2
3.Requires the Department of Health Services (DHS) to
administer the program and adopt minimum standards for
the approval of community child health and disability
prevention programs and regulations as necessary.
4.Requires the standards, rules, and regulations may be
adopted only with the advice and written recommendations
of the State Maternal, Child, and Adolescent Health
Board.
This bill:
1.Requires DHS to develop the standards based on the most
current "Recommendations for Preventative Pediatric
Health Care" of the American Academy of Pediatrics (AAP).
2.Requires the standards be updated as necessary to be
consistent with any changes made by the AAP.
FISCAL IMPACT
The bill would result in significant annual costs estimated
to be $8.6 million ($6.7 million General Fund) in 2001-2002
to expand the number of health assessments provided in the
CHDP and fee-for-service Medi-Cal programs.
BACKGROUND AND DISCUSSION
Intent of the bill:
The author states that the intent of the bill is to ensure
that children in the CHDP, including those eligible for
Medi-Cal, receive well child health assessments consistent
with current standards of practice as recommended by the
American Academy of Pediatrics (AAP). When the CHDP
program began in 1974, the schedule for preventive health
assessments did conform to the recommendations of the AAP,
but the standards have not been updated in over ten years.
Adopting the AAP periodicity schedule for CHDP and
fee-for-service Medi-Cal would provide up to five
additional screens for children ages 0 to 12, and up to six
Continued---
STAFF ANALYSIS OF SENATE BILL 765 (CHESBRO) Page
3
additional screens for ages 13 to 20 years. The author
adds that this change would make the program consist with
existing practice in other publicly funded health programs.
Background:
The updated AAP standards have been adopted by the Medi-Cal
Managed Care plans and the Healthy Family Program health
plans, as well as commercial insurance plans. However,
children enrolled in the CHDP or fee-for-service Medi-Cal
Program are not covered by these updated standards. The
federal Health Care Financing Administration (HCFA) has
notified California that it is concerned about this
discrepancy because children enrolled in Medi-Cal are
treated differently under CHDP than in Medi-Cal Managed
Care.
Senate Budget and Fiscal Review Subcommittee #3:
On March 12, 2001, the Subcommittee #3 of the Senate Budget
and Fiscal Review Committee added $8.6 million ($6.7
million General Fund) to update the periodicity schedule
for the CHDP.
Continued---
Letters of support and opposition:
The California Medical Association (CMA) is the sponsor of
SB 765 and writes that the AAP has revised its
recommendations several times since 1975. For example,
newborns are now frequently discharged from the hospital
within 24-48 hours after delivery. As a
result, critical physiological assessments done between 48
and 72 hours of age are not commonly conducted in the
hospital anymore. As such, the AAP added a health
assessment visit at two-four days of age to assess and
examine newborn infants. The CMA adds that the bill also
would increase the opportunity to access the uninsured
population by creating new opportunities to enroll eligible
children into the Health Families and Medi-Cal programs.
The California Children's Lobby writes that the AAP is the
recognized authority on health care for children and it is
only fitting that the CHDP reflect these standards of
excellence.
The Capitol Resource Institute writes in opposition
believing SB 765 sets a dangerous precedent because it
grants an unelected body to set state standards according
to its own criteria and guidelines. Child and Family
Protection Association is opposed for similar reasons.
POSITIONS
Support: California Medical Association (sponsor)
California Children's Lobby
California Primary Care Association
Children's Specialty Care Coalition
Oppose: Capitol Resource Institute
Child and Family Protection Association
-- END --
Continued---