BILL ANALYSIS
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|SENATE RULES COMMITTEE | SB 1469|
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THIRD READING
Bill No: SB 1469
Author: Cedillo (D)
Amended: 5/26/06
Vote: 21
SENATE HEALTH COMMITTEE : 9-0, 4/19/06
AYES: Ortiz, Runner, Aanestad, Alquist, Chesbro, Cox,
Figueroa, Kuehl, Maldonado
SENATE PUBLIC SAFETY COMMITTEE : 5-0, 5/2/06
AYES: Migden, Cedillo, Margett, Perata, Romero
NO VOTE RECORDED: Poochigian
SENATE APPROPRIATIONS COMMITTEE : 8-4, 5/25/06
AYES: Murray, Alarcon, Alquist, Escutia, Florez, Ortiz,
Romero, Torlakson
NOES: Aanestad, Ashburn, Battin, Dutton
NO VOTE RECORDED: Poochigian
SUBJECT : Medi-Cal: eligibility: juvenile offenders
SOURCE : Author
DIGEST : This bill requires, beginning May 1, 2007, the
Department of Corrections and Rehabilitation, Division of
Juvenile Facilities to notify county welfare departments
about the release of a ward so that eligibility for
Medi-Cal can be determined.
ANALYSIS :
CONTINUED
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Existing Federal law:
1.Establishes the Medicaid program to provide comprehensive
health benefits to low-income persons.
2.Provides that Medicaid benefits generally cannot be paid
for incarcerated individuals.
3.Allows incarcerated individuals to retain their Medicaid
eligibility.
Existing State law:
1.Establishes the Medi-Cal program, administered by the
Department of Health Services (DHS) to provide health
care benefits to qualified low-income individuals.
2.Defines health care benefits eligible under the Medi-cal
programs.
3.Excludes from the definition of health care benefits,
care or services for any individual who is an inmate of
an institution (except as a patient in a medical
institution).
This bill:
1.Commencing May 1, 2007, directs the Department of
Corrections and Rehabilitation, Division of Juvenile
Facilities (division) and county juvenile detention
facilities (county) to provide the appropriate county
welfare department with the ward's name, release date and
sufficient information for the county welfare department
to begin the process of determining the ward's
eligibility for Medi-Cal, including, if the ward is a
minor, contact information for the ward's parent or
guardian, if available.
2.Mandates the division and county to notify the ward's
parents or guardian so that they may have the option of
opting out of the Medi-Cal eligibility determination.
3.Requires the county welfare director to expedite the
review of the enrollment application.
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4.Directs the county welfare director to forward the
application to the appropriate entity for Healthy
Families eligibility or other appropriate health coverage
program, if the ward does not meet the requirements for
Medi-Cal.
5.Requires the county welfare department to issue
appropriate documentation to obtain necessary medical
care for a released ward who meets eligibility
requirements for Medi-Cal.
6.Requires the division and DHS in consultation with the
County Welfare Directors Association, Chief Probation
Officers of California and parole services of the
division, to establish protocols and procedures to
implement this bill.
7.Allows DHS to implement this bill though all-county
letters or similar methods without adopting regulations.
8.Requires DHS to seek any federal waivers necessary for
the implementation of this bill.
9.Establishes a method for paying any mandates that this
bill creates.
Background
Medi-Cal eligibility:
Under Medicaid law, states do not receive federal matching
funds for services provided to individuals in jail.
However, federal law does not require states to terminate
inmates' eligibility. Inmates may remain enrolled in
Medicaid even though services received while in jail are
not covered. Accordingly, someone who had a Medicaid card
when jailed may be able to use it to obtain needed services
and medication immediately after release.
Under federal rules, Medicaid eligibility should be
reinstated upon release unless the person is no longer
eligible. Before ending eligibility, states must determine
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the potential for qualifying under all the state's
eligibility categories. Regrettably, this re-determination
often does not occur.
Even inmates who keep their Medicaid eligibility may lose
Medicaid coverage unnecessarily because of procedures in
correctional facilities. Many individuals will be
incarcerated for so long that they will lose their Medicaid
benefits after the state's customary re-determination of
eligibility is conducted (annually for California).
Something as simple as the loss of a Medicaid card
following arrest can make it impossible to obtain mental
health services from Medicaid providers upon release.
Cards are often lost because jails take possession of all
personal property when booking a person. In many
jurisdictions, this property is destroyed if it is not
claimed within a certain time. Inmates cannot claim the
property themselves and if they have no one to do it for
them, their Medicaid card is destroyed.
Federal view:
As part of a federal effort to reduce homelessness, the
Centers for Medicare and Medicaid Services has sent a
letter encouraging states to suspend and not terminate
Medicaid benefits while a person is in a public
institution. The letter points out the difference between
the prohibitions on receiving benefits versus maintaining
eligibility while an eligible individual is in an
institution. The letter also encourages state Medicaid
agencies to work with corrections officials.
Related legislation
SB 1616 (Kuehl) - requires the division to work with the
Social Security Administration and DHS to ensure that
disabled wards are enrolled in Medi-Cal and that their
disability benefits are available to them when they are
released from a state institution.
AB 1945 (Coto) - requires that a juvenile detention
facility determine if an eligible minor being released is
enrolled in need-based health insurance programs.
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AB 2004 (Yee) - prohibits the use of inmate status to
terminate the eligibility of a minor under the Medi-Cal
program, require DHS to suspend rather than terminate
eligibility and ensure that eligibility was reinstated upon
release.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
According to the Senate Appropriations Committee:
Fiscal Impact (in thousands)
Major Provisions 2006-07 2007-08 2008-09
Fund
State mandated local
Program unknown,
significant costs General
Medi-Cal benefits unknown,
significant costs General
Implementation protocol $80 General
SUPPORT : (Verified 5/26/06)
Adolescent Health Working Group
Books Not Bars
California Coalition for Youth
California Commission on the Status of Women
California Medical Association
California Public Defenders Association
City of Los Angeles
City of Santa Monica
County Alcohol and Drug Program Administrators Association
of California
Girl Scout Councils of California
Juvenile Court Judges of California
Juvenile Justice Commission, County of Santa Clara
National Association of Social Workers, California Chapter
Stanford University Medical Center
Stanford University School of Medicine, Department of
Pediatrics
ARGUMENTS IN SUPPORT : The County Alcohol and Drug
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Program Administrators Association of California strongly
support the bill. They believe that this bill will provide
Medi-Cal and other health benefits for eligible adolescents
immediately upon their release from juvenile detention
facilities. They believe that this bill will be a valuable
effort to help trouble youth who are trying to put their
lives together after incarceration.
The National Association of Social Workers supports the
bill because it will help provide youth access to adequate
health care, member health treatment and substance abuse
treatment so that they have the opportunity to stay out of
the juvenile detention system.
CTW:nl 5/27/06 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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