BILL NUMBER: SB 1399	ENROLLED
	BILL TEXT

	PASSED THE SENATE  AUGUST 31, 2010
	PASSED THE ASSEMBLY  AUGUST 30, 2010
	AMENDED IN ASSEMBLY  AUGUST 20, 2010
	AMENDED IN ASSEMBLY  AUGUST 2, 2010
	AMENDED IN ASSEMBLY  JUNE 23, 2010
	AMENDED IN SENATE  MAY 20, 2010
	AMENDED IN SENATE  MAY 11, 2010
	AMENDED IN SENATE  APRIL 14, 2010
	AMENDED IN SENATE  APRIL 7, 2010
	AMENDED IN SENATE  APRIL 5, 2010

INTRODUCED BY   Senator Leno
   (Principal coauthors: Assembly Members Bonnie Lowenthal and
Ammiano)

                        FEBRUARY 19, 2010

   An act to add Section 2065 to, and to add Title 2.3 (commencing
with Section 3550) to Part 3 of, the Penal Code, relating to parole.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 1399, Leno. Parole: medical parole: permanently medically
incapacitated inmates.
   Existing law generally regulates the granting and conditioning of
parole, and places the duty to monitor parolees on the Division of
Adult Parole Operations. Existing law, the Victim's Bill of Rights
Act of 2008: Marsy's Law, as added by Proposition 9 at the November
4, 2008, statewide general election, provides that the Board of
Parole Hearings or its successor in interest shall be the state's
parole authority and shall be responsible for protecting victims'
rights in the parole process.
   This bill would provide that, except as specified, any prisoner
who the head physician for the institution where the prisoner is
located determines, as provided, is permanently medically
incapacitated with a medical condition that renders the prisoner
permanently unable to perform activities of basic daily living, and
results in the prisoner requiring 24-hour care, and that
incapacitation did not exist at the time of sentencing, shall be
granted medical parole, if the Board of Parole Hearings determines
that the conditions under which the prisoner would be released would
not reasonably pose a threat to public safety. Those provisions would
not apply to any prisoner sentenced to death or life in prison
without possibility of parole or to any inmate who is serving a
sentence for which parole pursuant to this bill is prohibited by any
initiative statute. The bill would provide that these provisions
shall not be construed to alter or diminish the rights conferred
under the Victim's Bill of Rights Act of 2008: Marsy's Law. The bill
would require a physician employed by the Department of Corrections
and Rehabilitation who is the primary care provider for a prisoner to
recommend that the prisoner be referred to the Board of Parole
Hearings for consideration for medical parole if the physician
believes the prisoner meets the medical criteria for medical parole.
The bill would provide that the Board of Parole Hearings or the
Division of Adult Parole Operations shall have the authority to
impose any reasonable conditions on prisoners subject to parole
pursuant to this bill, including, but not limited to, the requirement
that parolees submit to electronic monitoring.
   Existing law generally provides for the duties and functions of
the Department of Corrections and Rehabilitation. Existing law
provides that the State Department of Health Care Services is
designated as the state agency with full power to supervise every
phase of the administration of health care services and medical
assistance for which grants-in-aid are received from the federal
government or made by the state in order to secure full compliance
with the applicable provisions of state and federal laws.
   This bill would require the Department of Corrections and
Rehabilitation to, among other things, seek to enter into memoranda
of understanding with the Social Security Administration and the
State Department of Health Care Services, in addition to certain
other entities, to facilitate prerelease agreements to help inmates
initiate benefits claims, as specified. The bill would require the
department to reimburse county public hospitals on a quarterly basis
for the nonfederal share of Medi-Cal costs incurred by the county for
individuals who have been granted medical parole and the county
costs for providing health care services that are not allowable under
Medi-Cal but are required by the state to be furnished to eligible
persons who have been granted medical parole, including public
guardianship health care services. The bill would require the
department to provide, or provide reimbursement for, services
associated with public guardianship of medical parolees, as
specified. The bill would authorize the department to provide
supplemental reimbursements to providers, as specified. The bill
would require the department to establish contracts with appropriate
medical providers in cases where medical parolees are ineligible for
Medi-Cal, as specified.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 2065 is added to the Penal Code, to read:
   2065.  (a) The Department of Corrections and Rehabilitation shall
complete all of the tasks associated with inmates granted medical
parole pursuant to Section 3550 that are specified in this section.
Subdivisions (c) and (d) shall apply only to the period of time that
inmates are on medical parole.
   (b) The department shall seek to enter into memoranda of
understanding with the Social Security Administration and the State
Department of Health Care Services, in addition to other federal,
state, or county entities necessary to facilitate prerelease
agreements to help inmates initiate benefits claims.
   (c) This subdivision shall be implemented in a manner that is
consistent with federal Medicaid law and regulations. The Director of
Health Care Services shall seek any necessary federal approvals for
the implementation of this subdivision. Claiming of federal Medicaid
funds shall be implemented only to the extent that federal approval,
if necessary, is obtained. If an inmate is granted medical parole and
found to be eligible for Medi-Cal, all of the following shall apply:

   (1) The hospital shall first bill Medi-Cal to obtain any available
reimbursement.
   (2) Upon providing an acceptable invoice, the department shall
reimburse county public hospitals on a quarterly basis for all of the
following:
   (A) The nonfederal share of Medi-Cal costs incurred by the county
for individuals who have been granted medical parole.
   (B) An amount equal to the county costs for providing health care
services that are not allowable under Medi-Cal but are required by
the state to be furnished to eligible individuals who have been
granted medical parole, including public guardianship health care
services.
   (3) The department shall directly provide, or provide
reimbursement on a quarterly basis, after invoicing, for allowable
costs that cannot be claimed as Medi-Cal expenditures under targeted
case management and the nonfederal share of services associated with
public guardianship that can be claimed as Medi-Cal expenditures.
   (4) The department may provide supplemental reimbursements to
providers amounting to a total reimbursement that is allowable
pursuant to Section 5023.5. These supplemental reimbursements may
only be paid to the extent they comply with federal and state law and
regulations. The Director of Health Care Services may work with the
department to modify these supplemental reimbursements to the extent
necessary to comply with federal and state law and regulations.
   (5) The department and the State Department of Health Care
Services shall work together to do all of the following:
   (A) Maximize federal financial participation for service costs,
administrative costs, and targeted case management costs incurred
pursuant to this section.
   (B) Determine whether medical parolees shall be exempt from
mandatory enrollment in managed health care, including county
organized health plans, and determine the proper prior authorization
process for individuals who have been granted medical parole.
   (6) The department may submit retroactive Medi-Cal claims to the
State Department of Health Care Services for allowable certified
public expenditures that have been reimbursed by the department. The
department shall work with the Director of Health Care Services to
ensure that any process established regarding the submission of
retroactive claims shall be in compliance with state and federal law
and regulations.
   (d) If an inmate is granted medical parole and found to be
ineligible for Medi-Cal, all of the following shall apply:
   (1) The department shall consider the income and assets of a
medical parolee to determine whether the individual has the ability
to pay for the cost of his or her medical care.
   (2) If the individual is unable to pay the cost of their medical
care, the department shall establish contracts with appropriate
medical providers and pay costs that are allowable pursuant to
Section 5023.5.
   (3) The department shall retain the responsibility to perform
utilization review and cost management functions that it currently
performs under existing contracts with health care facilities.
   (4) The department shall directly provide, or provide
reimbursement for, services associated with public guardianship.
   (e) Notwithstanding the rulemaking provisions of Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 2 of the
Government Code, the department and the State Department of Health
Care Services may implement this section by means of all-facility
letters, all-county letters, or similar instructions, in addition to
adopting regulations, as necessary.
  SEC. 2.  Title 2.3 (commencing with Section 3550) is added to Part
3 of the Penal Code, to read:

      TITLE 2.3.  MEDICAL PAROLE


   3550.  (a) Notwithstanding any other provision of law, except as
provided in subdivision (b), any prisoner who the head physician of
the institution where the prisoner is located determines, as provided
in this section, is permanently medically incapacitated with a
medical condition that renders him or her permanently unable to
perform activities of basic daily living, and results in the prisoner
requiring 24-hour care, and that incapacitation did not exist at the
time of sentencing, shall be granted medical parole if the Board of
Parole Hearings determines that the conditions under which the
prisoner would be released would not reasonably pose a threat to
public safety.
   (b) Subdivision (a) shall not apply to any prisoner sentenced to
death or life in prison without possibility of parole or to any
inmate who is serving a sentence for which parole, pursuant to
subdivision (a), is prohibited by any initiative statute. The
provisions of this section shall not be construed to alter or
diminish the rights conferred under the Victim's Bill of Rights Act
of 2008: Marsy's Law.
   (c) When a physician employed by the Department of Corrections and
Rehabilitation who is the primary care provider for an inmate
identifies an inmate that he or she believes meets the medical
criteria for medical parole specified in subdivision (a) the primary
care physician shall recommend to the head physician of the
institution where the prisoner is located that the prisoner be
referred to the Board of Parole Hearings for consideration for
medical parole. Within 30 days of receiving that recommendation, if
the head physician of the institution concurs in the recommendation
of the primary care physician, he or she shall refer the matter to
the Board of Parole Hearings using a standardized form and format
developed by the department, and if the head physician of the
institution does not concur in the recommendation, he or she shall
provide the primary care physician with a written explanation of the
reasons for denying the referral.
   (d) Notwithstanding any other provisions of this section, the
prisoner or his or her family member or designee may independently
request consideration for medical parole by contacting the head
physician at the prison or the department. Within 30 days of
receiving the request, the head physician of the institution shall,
in consultation with the prisoner's primary care physician, make a
determination regarding whether the prisoner meets the criteria for
medical parole as specified in subdivision (a) and, if the head
physician of the institution determines that the prisoner satisfies
the criteria set forth in subdivision (a), he or she shall refer the
matter to the Board of Parole Hearings using a standardized form and
format developed by the department. If the head physician of the
institution does not concur in the recommendation, he or she shall
provide the prisoner or his or her family member or designee with a
written explanation of the reasons for denying the application.
   (e) The Department of Corrections and Rehabilitation shall
complete parole plans for inmates referred to the Board of Parole
Hearings for medical parole consideration. The parole plans shall
include, but not be limited to, the inmate's plan for residency and
medical care.
   (f) Notwithstanding any other law, medical parole hearings shall
be conducted by two-person panels consisting of at least one
commissioner. In the event of a tie vote, the matter shall be
referred to the full board for a decision. Medical parole hearings
may be heard in absentia.
   (g) Upon receiving a recommendation from the head physician of the
institution where a prisoner is located for the prisoner to be
granted medical parole pursuant to subdivision (c) or (d), the board,
as specified in subdivision (f), shall make an independent judgment
regarding whether the conditions under which the inmate would be
released pose a reasonable threat to public safety, and make written
findings related thereto.
   (h) Notwithstanding any other provision of law, the board or the
Division of Adult Parole Operations shall have the authority to
impose any reasonable conditions on prisoners subject to medical
parole supervision pursuant to subdivision (a), including, but not
limited to, the requirement that the parolee submit to electronic
monitoring. As a further condition of medical parole, pursuant to
subdivision (a), the parolee may be required to submit to an
examination by a physician selected by the board for the purpose of
diagnosing the parolee's current medical condition. In the event such
an examination takes place, a report of the examination and
diagnosis shall be submitted to the board by the examining physician.
If the board determines, based on that medical examination, that the
person's medical condition has improved to the extent that the
person no longer qualifies for medical parole, the board shall return
the person to the custody of the department.
   (1) Notwithstanding any other provision of law establishing
maximum periods for parole, a prisoner sentenced to a determinate
term who is placed on medical parole supervision prior to the
earliest possible release date and who remains eligible for medical
parole, shall remain on medical parole, pursuant to subdivision (a),
until that earliest possible release date, at which time the parolee
shall commence serving that period of parole provided by, and under
the provisions of, Chapter 8 (commencing with Section 3000) of Title
1.
   (2) Notwithstanding any other provisions of law establishing
maximum periods for parole, a prisoner sentenced to an indeterminate
term who is placed on medical parole supervision prior to the
prisoner's minimum eligible parole date, and who remains eligible for
medical parole, shall remain on medical parole pursuant to
subdivision (a) until that minimum eligible parole date, at which
time the parolee shall be eligible for parole consideration under all
other provisions of Chapter 8 (commencing with Section 3000) of
Title 1.
   (i) The Department of Corrections and Rehabilitation shall, at the
time a prisoner is placed on medical parole supervision pursuant to
subdivision (a), ensure that the prisoner has applied for any federal
entitlement programs for which the prisoner is eligible, and has in
his or her possession a discharge medical summary, full medical
records, parole medications, and all property belonging to the
prisoner that was under the control of the department. Any additional
records shall be sent to the prisoner's forwarding address after
release to health care-related parole supervision.
   (j) The provisions for medical parole set forth in this title
shall not affect an inmate's eligibility for any other form of parole
or release provided by law.