BILL ANALYSIS Senate Appropriations Committee Fiscal Summary Senator Kevin Murray, Chairman 1469 (Cedillo) Hearing Date: 5/22/06 Amended: 5/9/06 Consultant: Nora Lynn Policy Vote: Health 9-0; Public Safety 5-0 _________________________________________________________________ ____ BILL SUMMARY: SB 1469 requires county juvenile detention facilities to provide Medi-Cal eligibility information to the parents or guardians of wards who are scheduled to be released from their facilities. SB 1469 also requires counties to initiate Medi-Cal applications and eligibility determinations on these wards' behalf and to provide the wards with sufficient documentation to enable the wards to receive medical care upon release. These requirements constitute a state-mandated local program. SB 1469 further requires the Department of Health Services to establish procedures by March 31, 2007, in consultation with state probation and welfare associations, and to seek federal waivers, if necessary, for its implementation. _________________________________________________________________ ____ Fiscal Impact (in thousands) Major Provisions 2006-07 2007-08 2008-09 Fund State mandated local program Unknown, significant costsGeneral (Medi-Cal eligibility determinations) Medi-Cal benefits Unknown, significant costs General Implementation protocol$80 General _________________________________________________________________ ____ STAFF COMMENTS: This bill meets the criteria to be placed on the Suspense file. State costs associated with the provision of Medi-Cal benefits to wards released from custody who otherwise might not have applied are unknown, but likely significant. For purposes of an estimate, if half of the minors released from local detention were found to be eligible for Medi-Cal and 15% of those minors would not otherwise have accessed Medi-Cal coverage without SB 1469's assessments and eligibility determinations, annual benefits costs for new enrollees would exceed $750,000 with a portion of these costs being carried over to future years to reflect ongoing eligibility and receipt of benefits. Costs for local juvenile detention facilities and agencies to initiate an application and determine Medi-Cal eligibility for wards released from custody are unknown, but potentially significant. In 2004, an estimated 56,600 youths were made wards of the court statewide. If each of the state's 58 counties were to spend $30,000 per year in conjunction with the Medi-Cal eligibility assessment and enrollment activities for released wards consistent with this measure, reimbursable costs would exceed $1.7 million annually. -- continued -- Page 2 SB 1469 (Cedillo) One-time costs for DHS to develop an implementation protocol for SB 1469's requirements and issue all-county letters to local agencies are estimated at $80,000. Any ongoing costs to the department should be minor and absorbable. STAFF NOTES approximately 10% of wards in county detention facilities are over age 18. The author may wish to consider amending the bill to limit provision of information to parents and guardians to cases when the ward in question is a minor. STAFF NOTES implementation protocols for local agencies are not required to be completed until March 31, 2007, although the measure's Medi-Cal application and eligibility determination requirements go into effect January 1, 2007. The author may wish to delay implementation of the Medi-Cal requirements of the measure to May 1, 2007, to permit DHS's protocols to reach local agencies.