(a) No earlier than January 1, 2018, the State Department of Health Care Services shall establish a Medically Tailored Meals Pilot Program to operate for a period of three years, or until funding is no longer available for the program, whichever date is earlier.
(1) The department shall determine the number of eligible participants and providers in the program and shall use Medi-Cal data to identify eligible members for participation in the program.
(2) The program shall provide medically tailored meal intervention services to Medi-Cal participants with one or more of the following health conditions: congestive heart failure, cancer, diabetes, chronic obstructive pulmonary disease, or renal disease.
(3) The department may establish additional eligibility requirements based on acuity and other selection criteria. Each participant in the program shall receive a standard intervention as determined by the department, of up to 21 meals per week for 12 to 24 weeks. All meals provided shall be medically tailored and designed to meet the specific nutritional needs of the participant’s specific illness.
(4) The program shall be conducted in the following counties: Alameda, Los Angeles, Marin, San Diego, San Francisco, San Mateo, Santa Clara, and Sonoma.
(5) (A) At the conclusion of the program, the department shall use Medi-Cal data on the program participants to evaluate what impact, to the extent it can be determined, the program had on hospital readmissions, decreased admissions to long term care facilities, and emergency room utilization.
(B) The department shall send a report containing its evaluation to the Legislature on or before January 1, 2021, or within 12 months after the end of the three-year program.
(C) The legislative report submitted pursuant to subparagraph (B) shall be submitted in compliance with Section 9795 of the Government Code.
(b) For the purposes of this section, “medically tailored meals” means a specifically tailored diet to address the participant’s specific medical condition and associated symptoms.
(c) The department shall develop a methodology for reimbursing contractors, or other entities as applicable, for services or activities provided pursuant to this section based on, and not to exceed, the aggregate amount of funds allocated per year for purposes of the program. The department may use up to 20 percent of the funds allocated per year for the program to support its administration and evaluation.
(d) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement, interpret, or make specific this section, in whole or in part, by means of policy letters, all-county letters, plan letters, or other similar instructions, without taking regulatory action.
(e) For purposes of implementing this section, the department may enter into exclusive or nonexclusive contracts, or amend existing contracts, on a bid or negotiated basis. Contracts entered into or amended pursuant to this section shall be exempt from Chapter 6 (commencing with Section 14825) of Part 5.5 of Division 3 of Title 2 of the Government Code, Section 19130 of the Government Code, and Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code, and shall be exempt from the review or approval of any division of the Department of General Services.
(f) The department shall seek any federal approvals necessary to implement this section, including any waivers it deems necessary to obtain federal financial participation for the program, and shall claim federal financial participation to the full extent permitted by law. In the event federal financial participation is not available, the department shall implement the program using available state-only funds, subject to annual appropriation by the Legislature.
(g) This section shall remain in effect until the earlier of January 1, 2021, or six months following the end of the program, and as of that date is repealed.
(Added by Stats. 2017, Ch. 52, Sec. 22. (SB 97) Effective July 10, 2017. Repealed on or before January 2, 2021, by its own provisions.)
Last modified: October 25, 2018