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.