BILL ANALYSIS Ó
SB 695
Page 1
SENATE THIRD READING
SB 695 (Hancock)
As Amended May 23, 2011
Majority vote
SENATE VOTE :40-0
HEALTH 19-0 APPROPRIATIONS 17-0
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|Ayes:|Monning, Logue, Ammiano, |Ayes:|Fuentes, Harkey, |
| |Atkins, Bonilla, Eng, | |Blumenfield, Bradford, |
| |Garrick, Gordon, Hayashi, | |Charles Calderon, Campos, |
| |Roger Hernández, | |Davis, Donnelly, Gatto, |
| |Bonnie Lowenthal, | |Hall, Hill, Lara, |
| |Mansoor, Mitchell, | |Mitchell, Nielsen, Norby, |
| |Nestande, Pan, | |Solorio, Wagner |
| |V. Manuel Pérez, Silva, | | |
| |Smyth, Williams | | |
| | | | |
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SUMMARY : Authorizes Medi-Cal benefits to be provided to a
Medi-Cal eligible individual awaiting adjudication in a county
juvenile detention facility if the county agrees to pay the
state's share of Medi-Cal expenditures and administrative costs.
Specifically, this bill :
1)Provides that benefits shall be provided until the date of
adjudication and requires benefits to be suspended if the
individual is placed in an institution.
2)Limits eligibility to an individual who is receiving Medi-Cal
benefits at the time of admission or is subsequently determined
to be eligible.
3)Specifies that this bill shall not be construed to require a
county to pay for the costs of Medi-Cal benefits that the state
is obligated to provide under administrative action or final
court order.
4)Authorizes initial implementation by all-county letter and
requires the Department of Health Care Services (DHCS) to adopt
regulations by 2015.
5)Conditions implementation on receipt of written confirmation
SB 695
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from the federal Centers for Medicare and Medicaid Services that
federal financial participation (FFP) is available and the
execution of a declaration by the director of DHCS that
implementation will not jeopardize the state's ability to
receive FFP including any increase in the federal assistance
percentage available as specified.
6)Authorizes the Director of DHCS to cease operation if a
determination is made that the declaration specified in 5) above
is no longer accurate, authorizes implementation by
all-county-letter or similar instructions and requires notice to
the Joint Legislative Budget Committee, the Department of
Finance and posted on the DHCS Web site.
FISCAL EFFECT : According to the Assembly Appropriations
Committee:
1)Annual increased Medi-Cal costs, likely in the millions of
dollars (50% federal/50% local) to the extent counties opt into
the funding mechanism established by this bill and provide
Medi-Cal health services to youth awaiting adjudication.
2)Unknown one-time administrative workload to DHCS to seek federal
approval, not likely to exceed $100,000. Although this bill
requires counties to pay the state share of cost for state
administrative workload, it unclear whether the initial workload
necessary to receive federal approval will be reimbursed by
counties.
3)Unknown ongoing costs (50% federal/50% local) to DHCS to
administer the funding mechanism established by this bill, and
to county welfare departments to verify the Medi-Cal eligibility
status of youth awaiting adjudication and process new
applications. This bill requires counties to pay the state
share of cost for administrative workload. Actual costs would
depend on how many counties opt in to the program and how many
youth are found Medi-Cal eligible.
COMMENTS : This bill, according to the sponsor, Alameda County, is
intended to take advantage of federal authority to use federal
Medicaid funds to reduce the costs of health and mental health
services that the county is already incurring for the first 30
days of a youth's stay in juvenile hall. According to the
sponsor, the average length of stay is 24 days.
Medi-Cal regulations make individuals who are inmates of public
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institutions ineligible for Medi-Cal. A 2004 letter to State
Medicaid Directors from the federal Centers for Medicare and
Medicaid Services encourages states to "suspend" and not
"terminate" benefits while a person is in a public institution or
Institute for Mental Disease, noting the payment exclusion (known
as the "inmate exception") under Medicaid does not affect the
eligibility of an individual for the Medicaid Program. This
policy was codified with regard to juveniles in SB 1147 (Calderon
and Yee), Chapter 546, Statutes of 2008. DHCS indicated that the
necessary protocols to implement a suspension of benefits were
issued in March 2010.
Federal regulations also appear to allow states to claim FFP for
all Medicaid services provided to a person in a public institution
for a temporary period pending other arrangements as an exception
to unavailability of FFP for services provided to inmates. This
bill is based on information from Pennsylvania and New Mexico, two
states that have taken advantage of this opportunity.
SB 1091 (Hancock) of 2010 was substantially similar to this bill
and was vetoed. The veto message cited inconsistency with federal
law and potentially significant state costs. This bill, as
drafted, appears to be consistent with federal law and does not
appear to expose the state to significant costs.
Analysis Prepared by : Marjorie Swartz / HEALTH / (916) 319-2097
FN: 0002237