Amended in Senate August 26, 2013

California Legislature—2013–14 Regular Session

Assembly Bill No. 104

Introduced by Committee on Budget ( begin delete Blumenfield end delete begin insert Skinner end insert (Chair), Bloom, begin delete Bonilla, end delete begin insert Campos, end insert Chesbro, Daly, Dickinson, Gordon, Jones-Sawyer, Mitchell, Mullin, Muratsuchi, Nazarian, begin delete Rendon, end delete Stone, and Ting)

January 10, 2013

begin delete An act relating to the Budget Act of 2013. end delete begin insert An act to amend Sections 11155, 11322.85, 11450.025, 14186.11, 14199.1, 17600.15, 17600.50, 17600.60, 17601.75, 17603, 17604, 17606.10, 17610, 17610.5, 17612.1, 17612.2, 17612.3, 17612.5, 17612.6, 17613.1, 17613.2, 17613.3, 17613.4, and 18901.2 of, and to repeal Section 17612.21 of, the Welfare and Institutions Code, relating to public health, and making an appropriation therefor, to take effect immediately, bill related to the budget. end insert

LEGISLATIVE COUNSEL’S DIGEST

AB 104, as amended, Committee on Budget. begin delete Budget Act of 2013. end delete begin insert Public health. end insert

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Existing law imposes limits on the amount of income and personal and real property an individual or family may possess in order to be eligible for public aid, including under the CalFresh program, including specifying the allowable value of a licensed vehicle retained by an applicant for, or recipient of, that aid.

end insert begin insert

This bill would change the term “licensed vehicle” to “motor vehicle” for these purposes.

end insert begin insert

Under existing law, with certain exceptions, every individual, as a condition of eligibility for aid under the CalWORKs program, is required to participate in certain welfare-to-work activities for a period of 24 months. Existing law provides that any month in which certain conditions exist shall not be counted as one of the 24 months of participation.

end insert begin insert

This bill would make a clarifying change to these provisions. This bill would also make a nonsubstantive technical change to these provisions.

end insert begin insert

Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid Program provisions. Existing law requires, to the extent that federal financial participation is available, and pursuant to a demonstration project or waiver of federal law, the department to establish specified pilot projects in up to 8 counties, known as Coordinated Care Initiative counties.

end insert begin insert

This bill would correct an erroneous cross-reference with respect to a provision of law relating to Coordinated Care Initiative counties.

end insert begin insert

Existing law establishes the Local Revenue Fund, a continuously appropriated fund that allocates Vehicle License Fund moneys and sales tax moneys. Existing law creates various accounts within the Local Revenue Fund, including the Sales Tax Account and the Sales Tax Growth Account, which each contain various subaccounts.

end insert begin insert

Existing law, for the 2013-14 fiscal year and subsequent fiscal years, allocates funds to the Social Services Subaccount, Health Subaccount, and Mental Health Subaccount of the Sales Tax Account using specified calculations.

end insert begin insert

This bill would modify the calculations used to allocate moneys to the above-described subaccounts, and would also require the Controller to transfer funds between the Social Services Subaccount and the Health Subaccount in an amount not to exceed $300 million for the 2013-14 fiscal year, or one billion dollars in any subsequent fiscal year, as specified, thereby making at appropriation.

end insert begin insert

Existing law requires counties, through a choice of methodologies, to provide specified health services to eligible county residents who are indigent. Existing law authorizes counties to receive funding for this program from the Health Subaccount by either proving actual costs or by electing to receive 60% of the funds that would otherwise have been allocated to them, and would establish a default contribution for counties that fail to make a choice or to inform the Director of Health Care Services by a specified date. Existing law places the difference between prior fiscal year contributions to counties from the Health Subaccount and the new contributions to counties in the Family Support Subaccount, which is established within the Sales Tax Account, to be used by counties for the CalWORKs program, as specified.

end insert begin insert

With respect to the redirection of funds to the Family Support Subaccount, existing law requires counties to determine the amount or percentage of funding to be redirected and to provide that calculation to the department by a specified date. Existing law provides a specified process to be used if the department disagrees with a county’s determination. Existing law authorizes the county to submit a petition to the County Health Care Funding Resolution Committee if no agreement between the parties is reached by a specified date. Existing law also establishes an expedited formal appeal process by which a county may contest the determinations, as specified.

end insert begin insert

This bill would make technical changes to these provisions and revise the deadlines by which counties must comply with the provisions described above.

end insert begin insert

Existing law requires the department, in consultation with the counties, to determine the historical low-income shortfall between Medi-Cal and uninsured revenues and the costs incurred by county public hospital health systems for health services to Medi-Cal beneficiaries and uninsured patients. In determining this shortfall, the department is required to apply against that shortfall county indigent realignment amounts, special local health funds specifically restricted for indigent care, amounts from other specified sources of funding, including unrestricted health care funds and one-time funds received or carried forward by a county public hospital health system, and then gains from all other payers.

end insert begin insert

This bill would require the department, once the department has accounted for amounts for county indigent realignment and special local health funds specifically restricted for indigent care, to determine and apply against the shortfall amounts for special local health funds that are not restricted for indigent care, amounts imputed for county low-income health, and one-time and carry-forward revenues, as defined. The bill would require the department to determine these amounts on a historical basis for the 2008-09 to 2011-12 fiscal years, inclusive.

end insert begin insert

This bill would also make technical, nonsubstantive changes to these provisions.

end insert begin insert

Existing law states the Legislature’s intent to create a program in California that provides a Low-Income Home Energy Assistance Program (LIHEAP) service benefit, through the LIHEAP block grant, to all recipient households of CalFresh, as specified.

end insert begin insert

Existing law requires that, if the demand for the nominal LIHEAP service benefit exceeds allocated funding, the Department of Community Services and Development and the State Department of Social Services report that information to the Legislature and develop a plan to maintain the program as intended.

end insert begin insert

This bill would delete those provisions. The bill would require that the nominal LIHEAP services benefit be funded through the LIHEAP grant allocated for outreach activities in accordance with state and federal requirements.

end insert begin insert

This bill would declare that it is to take effect immediately as a bill providing for appropriations related to the Budget Bill.

end insert begin delete

This bill would express the intent of the Legislature to enact statutory changes relating to the Budget Act of 2013.

end delete

Vote: majority. Appropriation:  begin delete no end delete begin insert yes end insert . Fiscal committee:  begin delete no end delete begin insert yes end insert . State-mandated local program: no.

The people of the State of California do enact as follows:

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begin insert SECTION 1. end insert   

end insert

begin insert Section 11155 of the end insert begin insert Welfare and Institutions
Code end insert begin insert , as added by Section 13 of Chapter 21 of the Statutes of 2013,
is amended to read: end insert

11155.  

(a) Notwithstanding Section 11257, in addition to the
personal property or resources permitted by other provisions of
this part, and to the extent permitted by federal law, an applicant
or recipient for aid under this chapter including an applicant or
recipient under Chapter 2 (commencing with Section 11200) may
retain countable resources in an amount equal to the amount
permitted under federal law for qualification for the federal
Supplemental Nutrition Assistance Program, administered in
California as CalFresh.

(b) The county shall determine the value of exempt personal
property other than motor vehicles in conformance with methods
established under CalFresh.

(c) (1) (A) The value of each begin delete licensed end delete begin insert motor end insert vehicle that is not
exempt under paragraph (4) shall be the equity value of the vehicle,
which shall be the fair market value less encumbrances.

(B) Any begin insert motor end insert vehicle with an equity value of nine thousand
five hundred dollars ($9,500) or less shall not be attributed to the
family’s resource level.

(C) For each begin delete licensed end delete begin insert motor end insert vehicle with an equity value of
more than nine thousand five hundred dollars ($9,500), the equity
value that exceeds nine thousand five hundred dollars ($9,500)
shall be attributed to the family’s resource level.

(2) The equity threshold described in paragraph (1) of nine
thousand five hundred dollars ($9,500) shall be adjusted upward
annually by the increase, if any, in the United States Transportation
Consumer Price Index for begin delete all urban consumers end delete begin insert All Urban
Consumers end insert published by the United States Department of Labor,
Bureau of Labor Statistics.

(3) The county shall determine the fair market value of the
vehicle in accordance with a methodology determined by the
department. The applicant or recipient shall self-certify the amount
of encumbrance, if any.

(4) The entire value of any begin delete licensed end delete begin insert motor end insert vehicle shall be
exempt if any of the following apply:

(A) It is used primarily for income-producing purposes.

(B) It annually produces income that is consistent with its fair
market value, even if used on a seasonal basis.

(C) It is necessary for long distance travel, other than daily
commuting, that is essential for the employment of a family
member.

(D) It is used as the family’s residence.

(E) It is necessary to transport a physically disabled family
member, including an excluded disabled family member, regardless
of the purpose of the transportation.

(F) It would be exempted under any of subparagraphs (A) to
(D), inclusive, but the vehicle is not in use because of temporary
unemployment.

(G) It is used to carry fuel for heating for home use, when the
transported fuel or water is the primary source of fuel or water for
the family.

(H) Ownership of the vehicle was transferred through a gift,
donation, or family transfer, as defined by the Department of Motor
Vehicles.

(d) This section shall become operative on January 1, 2014.

begin insert

begin insert SEC. 2. end insert   

end insert

begin insert Section 11322.85 of the end insert begin insert Welfare and Institutions Code end insert begin insert ,
as amended by Section 26 of Chapter 21 of the Statutes of 2013,
is amended to read: end insert

11322.85.  

(a) Unless otherwise exempt, an applicant or
recipient shall participate in welfare-to-work activities.

(1) For 24 cumulative months during a recipient’s lifetime, these
activities may include the activities listed in Section 11322.6 that
are consistent with the assessment performed in accordance with
Section 11325.4 and that are included in the individual’s
welfare-to-work plan, as described in Section 11325.21, to meet
the hours required in Section 11322.8. These 24 months need not
be consecutive.

(2) Any month in which the recipient meets the requirements
of Section 11322.8, through participation in an activity or activities
described in paragraph (3), shall not count as a month of activities
for purposes of the 24-month time limit described in paragraph
(1).

(3) After a total of 24 months of participation in welfare-to-work
activities pursuant to paragraph (1), an aided adult shall participate
in one or more of the following welfare-to-work activities, in
accordance with Section 607(c) and (d) of Title 42 of the United
States Code as of the operative date of this section, that are
consistent with the assessment performed in accordance with
Section 11325.4, and included in the individual’s welfare-to-work
plan, described in Section 11325.21:

(A) Unsubsidized employment.

(B) Subsidized private sector employment.

(C) Subsidized public sector employment.

(D) Work experience, including work associated with the
refurbishing of publicly assisted housing, if sufficient private sector
employment is not available.

(E) On-the-job training.

(F) Job search and job readiness assistance.

(G) Community service programs.

(H) Vocational educational training (not to exceed 12 months
with respect to any individual).

(I) Job skills training directly related to employment.

(J) Education directly related to employment, in the case of a
recipient who has not received a high school diploma or a
certificate of high school equivalency.

(K) Satisfactory attendance at a secondary school or in a course
of study leading to a certificate of general equivalence, in the case
of a recipient who has not completed secondary school or received
such a certificate.

(L) The provision of child care services to an individual who is
participating in a community service program.

(b) Any month in which begin insert any of end insert the following conditions begin delete exist end delete
begin insert exists end insert shall not be counted as one of the 24 months of participation
allowed under paragraph (1) of subdivision (a):

(1) The recipient is participating in job search or assessment
pursuant to subdivision (a) or (b) of Section 11320.1, is in the
process of appraisal as described in Section 11325.2, or is
participating in the development of a welfare-to-work plan, as
described in Section 11325.21.

(2) The recipient is no longer receiving aid, pursuant to Sections
11327.4 and 11327.5.

(3) The recipient has been excused from participation for good
cause, pursuant to Section 11320.3.

(4) The recipient is exempt from participation pursuant to
subdivision (b) of Section 11320.3.

(5) The recipient is only required to participate in accordance
with subdivision (d) of Section 11320.3.

(c) County welfare departments shall provide each recipient
who is subject to the requirements of paragraph (3) of subdivision
(a) written notice describing the 24-month time limitation described
in that paragraph and the process by which recipients may claim
exemptions from, and extensions to, those requirements.

(d) The notice described in subdivision (c) shall be provided at
the time the individual applies for aid, during the recipient’s annual
redetermination, and at least once after the individual has
participated for a total of 18 months, and prior to the end of the
21st month, that count toward the 24-month time limit.

(e) The notice described in this section shall include, but shall
not be limited to, all of the following:

(1) The number of remaining months the adult recipient may
be eligible to receive aid.

(2) The requirements that the recipient must meet in accordance
with paragraph (3) of subdivision (a) and the action that the county
will take if the adult recipient does not meet those requirements.

(3) The manner in which the recipient may dispute the number
of months counted toward the 24-month time limit.

(4) The opportunity for the recipient to modify his or her
welfare-to-work plan to meet the requirements of paragraph (3)
of subdivision (a).

(5) The opportunity for an exemption to, or extension of, the
24-month time limitation.

(f) For an individual subject to the requirements of paragraph
(3) of subdivision (a), who is not exempt or granted an extension,
and who does not meet those requirements, the provisions of
Sections 11327.4, 11327.5, 11327.9, and 11328.2 shall apply to
the extent consistent with the requirements of this section. For
purposes of this section, the procedures referenced in this
subdivision shall not be described as sanctions.

(g) (1) The department, in consultation with stakeholders, shall
convene a workgroup to determine further details of the noticing
and engagement requirements for the 24-month time limit, and
shall instruct counties via an all-county letter, followed by
regulations, no later than 18 months after the effective date of the
act that added this section.

(2) The workgroup described in paragraph (1) may also make
recommendations to refine or differentiate the procedures and due
process requirements applicable to individuals as described in
subdivision (f).

(h) (1) Notwithstanding paragraph (3) of subdivision (a) or any
other law, an assistance unit that contains an eligible adult who
has received assistance under this chapter, or from any state
pursuant to the Temporary Assistance for Needy Families program
(Part A (commencing with Section 401) of Title IV of the federal
Social Security Act (42 U.S.C. Sec. 601 et seq.)) prior to January
1, 2013, may continue in a welfare-to-work plan that meets the
requirements of Section 11322.6 for a cumulative period of 24
months commencing January 1, 2013, unless or until he or she
exceeds the 48-month time limitation described in Section 11454.

(2) All months of assistance described in paragraph (1) prior to
January 1, 2013, shall not be applied to the 24-month limitation
described in paragraph (1) of subdivision (a).

(i) This section shall remain in effect only until January 1, 2014,
and as of that date is repealed, unless a later enacted statute, that
is enacted before January 1, 2014, deletes or extends that date.

begin insert

begin insert SEC. 3. end insert   

end insert

begin insert Section 11322.85 of the end insert begin insert Welfare and Institutions Code end insert begin insert ,
as added by Section 27 of Chapter 21 of the Statutes of 2013, is
amended to read: end insert

11322.85.  

(a) Unless otherwise exempt, an applicant or
recipient shall participate in welfare-to-work activities.

(1) For 24 cumulative months during a recipient’s lifetime, these
activities may include the activities listed in Section 11322.6 that
are consistent with the assessment performed in accordance with
Section 11325.4 and that are included in the individual’s
welfare-to-work plan, as described in Section 11325.21, to meet
the hours required in Section 11322.8. These 24 months need not
be consecutive.

(2) Any month in which the recipient meets the requirements
of Section 11322.8, through participation in an activity or activities
described in paragraph (3), shall not count as a month of activities
for purposes of the 24-month time limit described in paragraph
(1).

(3) After a total of 24 months of participation in welfare-to-work
activities pursuant to paragraph (1), an aided adult shall participate
in one or more of the following welfare-to-work activities, in
accordance with Section 607(c) and (d) of Title 42 of the United
States Code as of the operative date of this section, that are
consistent with the assessment performed in accordance with
Section 11325.4, and included in the individual’s welfare-to-work
plan, described in Section 11325.21:

(A) Unsubsidized employment.

(B) Subsidized private sector employment.

(C) Subsidized public sector employment.

(D) Work experience, including work associated with the
refurbishing of publicly assisted housing, if sufficient private sector
employment is not available.

(E) On-the-job training.

(F) Job search and job readiness assistance.

(G) Community service programs.

(H) Vocational educational training (not to exceed 12 months
with respect to any individual).

(I) Job skills training directly related to employment.

(J) Education directly related to employment, in the case of a
recipient who has not received a high school diploma or a
certificate of high school equivalency.

(K) Satisfactory attendance at a secondary school or in a course
of study leading to a certificate of general equivalence, in the case
of a recipient who has not completed secondary school or received
such a certificate.

(L) The provision of child care services to an individual who is
participating in a community service program.

(b) Any month in which begin insert any of end insert the following conditions begin delete exist end delete
begin insert exists end insert shall not be counted as one of the 24 months of participation
allowed under paragraph (1) of subdivision (a):

(1) The recipient is participating in job search in accordance
with Section 11325.22, assessment pursuant to Section 11325.4,
is in the process of appraisal as described in Section 11325.2, or
is participating in the development of a welfare-to-work plan as
described in Section 11325.21.

(2) The recipient is no longer receiving aid, pursuant to Sections
11327.4 and 11327.5.

(3) The recipient has been excused from participation for good
cause, pursuant to Section 11320.3.

(4) The recipient is exempt from participation pursuant to
subdivision (b) of Section 11320.3.

(5) The recipient is only required to participate in accordance
with subdivision (d) of Section 11320.3.

(6) The recipient is participating in family stabilization pursuant
to Section 11325.24, and the recipient would meet the criteria for
good cause pursuant to Section 11320.3. This paragraph may apply
to a recipient for no more than six cumulative months.

(c) County welfare departments shall provide each recipient
who is subject to the requirements of paragraph (3) of subdivision
(a) written notice describing the 24-month time limitation described
in that paragraph and the process by which recipients may claim
exemptions from, and extensions to, those requirements.

(d) The notice described in subdivision (c) shall be provided at
the time the individual applies for aid, during the recipient’s annual
redetermination, and at least once after the individual has
participated for a total of 18 months, and prior to the end of the
21st month, that count toward the 24-month time limit.

(e) The notice described in this section shall include, but shall
not be limited to, all of the following:

(1) The number of remaining months the adult recipient may
be eligible to receive aid.

(2) The requirements that the recipient must meet in accordance
with paragraph (3) of subdivision (a) and the action that the county
will take if the adult recipient does not meet those requirements.

(3) The manner in which the recipient may dispute the number
of months counted toward the 24-month time limit.

(4) The opportunity for the recipient to modify his or her
welfare-to-work plan to meet the requirements of paragraph (3)
of subdivision (a).

(5) The opportunity for an exemption to, or extension of, the
24-month time limitation.

(f) For an individual subject to the requirements of paragraph
(3) of subdivision (a), who is not exempt or granted an extension,
and who does not meet those requirements, the provisions of
Sections 11327.4, 11327.5, 11327.9, and 11328.2 shall apply to
the extent consistent with the requirements of this section. For
purposes of this section, the procedures referenced in this
subdivision shall not be described as sanctions.

(g) (1) The department, in consultation with stakeholders, shall
convene a workgroup to determine further details of the noticing
and engagement requirements for the 24-month time limit, and
shall instruct counties via an all-county letter, followed by
regulations, no later than 18 months after the effective date of the
act that added this section.

(2) The workgroup described in paragraph (1) may also make
recommendations to refine or differentiate the procedures and due
process requirements applicable to individuals as described in
subdivision (f).

(h) (1) Notwithstanding paragraph (3) of subdivision (a) or any
other law, an assistance unit that contains an eligible adult who
has received assistance under this chapter, or from any state
pursuant to the Temporary Assistance for Needy Families program
(Part A (commencing with Section 401) of Title IV of the federal
Social Security Act (42 U.S.C. Sec. 601 et seq.)) prior to January
1, 2013, may continue in a welfare-to-work plan that meets the
requirements of Section 11322.6 for a cumulative period of 24
months commencing January 1, 2013, unless or until he or she
exceeds the 48-month time limitation described in Section 11454.

(2) All months of assistance described in paragraph (1) prior to
January 1, 2013, shall not be applied to the 24-month limitation
described in paragraph (1) of subdivision (a).

(i) This section shall become operative on January 1, 2014.

begin insert

begin insert SEC. 4. end insert   

end insert

begin insert Section 11450.025 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

11450.025.  

(a) Notwithstanding any other law, effective on
March 1, 2014, the maximum aid payments in effect on July 1,
2012, as specified in subdivision (b) of Section 11450.02, shall be
increased by 5 percent.

(b) Commencing in 2014 and annually thereafter, on or before
January 10 and on or before May 14, the Director of Finance shall
do all of the following:

(1) Estimate the amount of growth revenues pursuant to
subdivision (f) of Section 17606.10 that will be deposited in the
Child Poverty and Family Supplemental Support Subaccount of
the Local Revenue Fund for the current fiscal year and the
following fiscal year and the amounts in the subaccount carried
over from prior fiscal years.

(2) For the current fiscal year and the following fiscal year,
determine the total cost of providing the increase described in
subdivision (a), as well as any other increase in the maximum aid
payments subsequently provided only under this section, after
adjusting for updated projections of CalWORKs costs associated
with caseload changes, as reflected in the local assistance
subvention estimates prepared by the State Department of Social
Services and released with the annual Governor’s Budget and
subsequent May Revision update.

(3) If the amount estimated in paragraph (1) plus the amount
projected to be deposited for the current fiscal year into the Child
Poverty and Family Supplemental Support Subaccount pursuant
to subparagraph (3) of subdivision (e) of Section 17600.15 is
greater than the amount determined in paragraph (2), the difference
shall be used to calculate the percentage increase to the CalWORKs
maximum aid payment standards that could be fully funded on an
ongoing basis beginning the following fiscal year.

(4) If the amount estimated in paragraph (1) plus the amount
projected to be deposited for the current fiscal year into the Child
Poverty and Family Supplemental Support Subaccount pursuant
to subparagraph (3) of subdivision (e) of Section 17600.15 is equal
to or less than the amount determined in paragraph (2), no
additional increase to the CalWORKs maximum aid payment
standards shall be provided in the following fiscal year in
accordance with this section.

(5) (A) Commencing with the 2014-15 fiscal year and for all
fiscal years thereafter, if changes to the estimated amounts
determined in paragraphs (1) or (2), or both, as of the May
Revision, are enacted as part of the final budget, the Director of
Finance shall repeat, using the same methodology used in the May
Revision, the calculations described in paragraphs (3) and (4) using
the revenue projections and grant costs assumed in the enacted
budget.

(B) If a calculation is required pursuant to subparagraph (A),
the Department of Finance shall report the result of this calculation
to the appropriate policy and fiscal committees of the Legislature
upon enactment of the Budget Act.

(c) An increase in maximum aid payments calculated pursuant
to paragraph (3) of subdivision (b), or pursuant to paragraph (5)
of subdivision (b) if applicable, shall become effective on October
1 of the following fiscal year.

(d) (1) An increase in maximum aid payments provided in
accordance with this section shall be funded with growth revenues
from the Child Poverty and Family Supplemental Support
Subaccount in accordance with paragraph (3) of subdivision (e)
of Section 17600.15 and subdivision (f) of Section 17606.10, to
the extent funds are available in that subaccount.

(2) If funds received by the Child Poverty and Family
Supplemental Support Subaccount in a particular fiscal year are
insufficient to fully fund any increases to maximum aid payments
made pursuant to this section, the remaining cost for that fiscal
year will be addressed through existing provisional authority
included in the annual Budget Act. Additional grant increases shall
not be provided until and unless the ongoing cumulative costs of
all prior grant increases provided pursuant begin insert to end insert this section are fully
funded by the Child Poverty and Family Supplemental Support
Subaccount.

(e) Notwithstanding Section 15200, counties shall not be
required to contribute a share of cost to cover the costs of increases
to maximum aid payments made pursuant to this section.

begin insert

begin insert SEC. 5. end insert   

end insert

begin insert Section 14186.11 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

14186.11.  

Section begin delete 14186.17 end delete begin insert 14182.17 end insert shall apply to the
provision of CBAS, MSSP, skilled nursing facility, and IHSS
services in Coordinated Care Initiative counties as set forth in this
article.

begin insert

begin insert SEC. 6. end insert   

end insert

begin insert Section 14199.1 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

14199.1.  

(a) The Legislature finds and declares the following:

(1) Beginning January 1, 2014, many low-income individuals
will be eligible for Medi-Cal coverage pursuant to federal law, as
part of health care reform.

(2) In implementing this expansion of Medi-Cal coverage, it is
critical to maintain the role of county public hospital health systems
that have traditionally served Medi-Cal and uninsured beneficiaries
to ensure adequate access to care is available for the new Medi-Cal
members, and to preserve the policy goal to support and strengthen
traditional safety net providers who treat a high volume of
uninsured and Medi-Cal patients.

(b) For purposes of this section, the following definitions shall
apply:

(1) “County public hospital health system” shall have the
meaning provided in subdivision (f) of Section 17612.2.

(2) “Default members” means newly eligible beneficiaries
enrolled in each Medi-Cal managed care plan who do not
affirmatively select a primary care provider as part of the
enrollment process.

(3) “Enrollment target” means the number of newly eligible
beneficiaries assigned to primary care providers within a county
public hospital health system, not to exceed the number of
unduplicated Low Income Health Program and uninsured patient
count in the county public hospital health system. The unduplicated
patient count shall be certified by the county public hospital health
system and provided to the department, along with its proposed
enrollment target, by November 30, 2013. The county public
hospital health system may notify the department of a proposed
reduction to its enrollment target based on its capacity to accept
new patients. A standardized protocol for determining the target
shall be developed by the department in consultation with the
public hospital health system counties.

(4) “Low Income Health Program” shall mean the LIHP as
defined in subdivision (c) of Section 15909.1.

(5) “Medi-Cal managed care plan” means an organization or
entity that enters into a contract with the department pursuant to
Article 2.7 (commencing with Section 14087.3), Article 2.8
(commencing with Section 14087.5), Article 2.81 (commencing
with Section 14087.96), Article 2.91 (commencing with Section
14089), or Chapter 8 (commencing with Section 14200).

(6) “Newly eligible beneficiaries” shall have the meaning
provided in subdivision (s) of Section 17612.2.

(7) “Primary care provider” means a primary care physician or
nonphysician medical practitioner, medical group, clinic, or a
medical home.

(8) “Public hospital health system county” shall have the
meaning provided in subdivision (u) of Section 17612.2.

(c) Subject to subdivision (d), default members who reside in
a public hospital health system county shall be assigned by each
Medi-Cal managed care plan in the county to a primary care
provider in accordance with the following:

(1) Throughout the three-year period ending on December 31,
2016, at least 75 percent of default members shall be assigned by
each Medi-Cal managed care plan to primary care providers within
the county public hospital health system until the county public
hospital health system meets its enrollment target.

(2) Following the expiration of the three-year period set forth
in paragraph (1), at least 50 percent of default members shall be
assigned by each Medi-Cal managed care plan to primary care
providers within the county public hospital health system until the
county public hospital health system meets its applicable
enrollment target.

(3) Paragraphs (1) and (2) shall not apply with respect to a
county public hospital health system during any time period in
which the county public hospital health system meets or exceeds
its applicable target. For time periods during which paragraphs (1)
and (2) do not apply, default members shall be assigned to primary
care providers in the same manner as other Medi-Cal members of
the Medi-Cal managed care plan who do not affirmatively select
primary care providers. Medi-Cal managed care plans shall not
modify the assignment procedures due to the default assignment
requirements of this section with respect to primary care providers
within the county public hospital health system.

(4) In implementing the assignment process set forth in
paragraphs (1) and (2), to the extent legally permissible and
consistent with federal and state privacy and patient confidentiality
laws, each Medi-Cal managed care plan shall first assign to a
primary care provider within the county public hospital health
system those default members who have accessed care within the
county public hospital health system two or more times within the
past 12 months. The department and the county public hospital
health systems shall work together to share patient information in
order to provide the Medi-Cal managed care plans with data
demonstrating which default members have accessed the county
public hospital health system providers prior to assignment to a
primary care provider.

(5) If at any time a county public hospital health system notifies
a contracted Medi-Cal managed care plan that it has reached its
maximum capacity for the assignment of default members, the
requirements set forth in paragraphs (1) and (2) shall not apply to
the Medi-Cal managed care plan so notified. Once the county
public hospital health system notifies a Medi-Cal managed care
plan that it has capacity to accept assignment of default members,
the requirements set forth in paragraphs (1) and (2) shall apply
effective on the first day of the month following that notice.

(6) A Medi-Cal managed care plan shall not assign default
members to a primary care provider within the county public
hospital health system if that primary care provider has notified
the Medi-Cal managed care plan that it does not have capacity to
accept new patients.

(d) The default process described in this section shall not apply
to Low Income Health Program enrollees subject to Section
begin delete 14005.60 end delete begin insert 14005.61 end insert .

(e) Nothing set forth in this section shall alter, reduce, or modify
in any manner the way in which Medi-Cal managed care plans
assign other Medi-Cal members to the county public hospital health
systems.

(f) (1) The department shall modify its contracts with the
Medi-Cal managed care plans in public hospital health system
counties to include the assignment requirements set forth in this
section.

(2) Each Medi-Cal managed care plan shall demonstrate and
certify that it has contracts or other arrangements in place with
county public hospital health systems that provide for implementing
the requirements of this section. To the extent a Medi-Cal managed
care plan is not compliant with any of the requirements of this
section, the department shall reduce by 25 percent the default
assignment into the Medi-Cal managed care plan with respect to
all Medi-Cal beneficiaries, as long as the other Medi-Cal managed
care plan or plans in that county have the capacity to receive the
additional default membership.

(g) Nothing in this section shall modify the ability of newly
eligible beneficiaries to select or change their primary care
providers.

(h) The department shall seek any necessary federal approvals
to implement the provisions of this section.

begin insert

begin insert SEC. 7. end insert   

end insert

begin insert Section 17600.15 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

17600.15.  

(a) Of the sales tax proceeds from revenues collected
in the 1991-92 fiscal year which are deposited to the credit of the
Local Revenue Fund, 51.91 percent shall be credited to the Mental
Health Subaccount, 36.17 percent shall be credited to the Social
Services Subaccount, and 11.92 percent shall be credited to the
Health Subaccount of the Sales Tax Account.

(b) For the 1992-93 fiscal year to the 2011-12 fiscal year,
inclusive, of the sales tax proceeds from revenues deposited to the
credit of the Local Revenue Fund, the Controller shall make
monthly deposits to the Mental Health Subaccount, the Social
Services Subaccount, and the Health Subaccount of the Sales Tax
Account until the deposits equal the amounts that were allocated
to counties, cities, and cities and counties mental health accounts,
social services accounts, and health accounts, respectively, of the
local health and welfare trust funds in the prior fiscal year pursuant
to this chapter from the Sales Tax Account and the Sales Tax
Growth Account. Any excess sales tax revenues received pursuant
to Sections 6051.2 and 6201.2 of the Revenue and Taxation Code
shall be deposited in the Sales Tax Growth Account of the Local
Revenue Fund.

(c) (1) For the 2012-13 fiscal year, of the sales tax proceeds
from revenues deposited to the credit of the Local Revenue Fund,
the Controller shall make monthly deposits to the Social Services
Subaccount and the Health Subaccount of the Sales Tax Account
until the deposits equal the amounts that were allocated to
counties’, cities’, and city and counties social services accounts
and health accounts, respectively, of the local health and welfare
trust funds in the prior fiscal year pursuant to this chapter from the
Sales Tax Account and the Sales Tax Growth Account.

(2) For the 2012-13 fiscal year, of the sales tax proceeds from
revenues deposited to the credit of the Local Revenue Fund, the
Controller shall make monthly deposits to the Mental Health
Subaccount of the Sales Tax Account until the deposits equal the
amounts that were allocated to counties’, cities’, and city and
counties CalWORKs Maintenance of Effort Subaccounts pursuant
to subdivision (a) of Section 17601.25, and any additional amounts
above the amount specified in subdivision (a) of Section 17601.25,
of the local health and welfare trust funds in the prior fiscal year
pursuant to this chapter from the Sales Tax Account and the Sales
Tax Growth Account. The Controller shall not include in this
calculation any funding deposited in the Mental Health Subaccount
from the Support Services Growth Subaccount pursuant to Section
30027.9 of the Government Code or funds described in subdivision
(c) of Section 17601.25.

(3) Any excess sales tax revenues received pursuant to Sections
6051.2 and 6201.2 of the Revenue and Taxation Code after the
allocations required by paragraphs (1) and (2) are made shall be
deposited in the Sales Tax Growth Account of the Local Revenue
Fund.

(d) (1) For the 2013-14 fiscal year, of the sales tax proceeds
from revenues deposited to the credit of the Local Revenue Fund,
the Controller shall make monthly deposits pursuant to a schedule
provided by the Department of Finance, which shall provide begin delete for
total allocations as follows: end delete begin insert end insert begin insert deposits to the Social Services
Subaccount and the Health Subaccount of the Sales Tax Account
until the deposits equal the amounts that were allocated to
counties end insert begin insert ’, cities end insert begin insert ’, and city and counties end insert begin insert ’ social services accounts
and health accounts, respectively, of the local health and welfare
trust funds in the prior fiscal year pursuant to this chapter from
the Sales Tax Account and the Sales Tax Growth Account. end insert

begin delete

(A) To the Social Services Subaccount of the Sales Tax Account
until the deposits are one billion dollars ($1,000,000,000) less than
the total amount that was allocated to the social services accounts
of the local health and welfare trust funds in the prior fiscal year
pursuant to this chapter from the Sales Tax Account and the Sales
Tax Growth Account.

(B) To the Health Subaccount of the Sales Tax Account until
the deposits are one billion dollars ($1,000,000,000) more than
the total amount that was allocated to the health accounts of the
local health and welfare trust funds in the prior fiscal year pursuant
to this chapter from the Sales Tax Account and the Sales Tax
Growth Account.

(C) To

end delete

begin insert (2) end insert begin insert   end insert begin insert For the 2013-14 fiscal year, of the sales tax proceeds from
revenues deposited to the credit of the Local Revenue Fund, the
Controller shall make monthly deposits to end insert the Mental Health
Subaccount of the Sales Tax Account until the deposits equal the
amounts that were allocated to counties’, cities’, and cities and
counties’ CalWORKs Maintenance of Effort Subaccounts pursuant
to subdivision (a) of Section 17601.25, and any additional amounts
above the amount specified in subdivision (a) of Section 17601.25,
of the local health and welfare trust funds in the prior fiscal year
pursuant to this chapter from the Sales Tax Account and the Sales
Tax Growth Account. The Controller shall not include in this
calculation any funding deposited in the Mental Health Subaccount
from the Support Services Growth Subaccount pursuant to Section
30027.9 of the Government Code or funds described in subdivision
(c) of Section 17601.25.

begin delete

(2)

end delete

begin insert (3) end insert  Any excess sales tax revenues received pursuant to Sections
6051.2 and 6201.2 of the Revenue and Taxation Code after the
allocations required by begin delete subparagraphs (A) to (C), inclusive, of
paragraph (1) end delete begin insert paragraphs (1) and (2) end insert are made shall be deposited
in the Sales Tax Growth Account of the Local Revenue Fund.

begin insert

(4) On a monthly basis, pursuant to a schedule provided by the
Department of Finance, the Controller shall transfer funds from
the Social Services Subaccount to the Health Subaccount in an
amount that shall not exceed three hundred million dollars
($300,000,000) for the 2013-14 fiscal year. The funds so
transferred shall not be used in calculating future year deposits
to the Social Services Subaccount or the Health Subaccount.

end insert

(e) For the 2014-15 fiscal year and fiscal years thereafter, of
the sales tax proceeds from revenues deposited to the credit of the
Local Revenue Fund, the Controller shall make the following
monthly deposits:

(1) To the Social Services begin delete Subaccount, end delete begin insert Subaccount end insert of the Sales
Tax Account begin insert , end insert until the deposits equal the total amount that was
begin delete allocated end delete begin insert deposited end insert to the begin delete social services accounts of the local
health and welfare trust funds end delete begin insert Social Services Subaccount end insert in the
prior fiscal year pursuant to this begin delete chapter, from the Sales Tax
Account and end delete begin insert section, in addition to the amounts that were allocated
to the social services accounts end insert begin insert of the local health and welfare trust
funds in the prior fiscal year pursuant to this chapter from end insert the
Sales Tax Growth Account.

(2) To the Health Subaccount of the Sales Tax Account, until
the deposits equal the total amount that was deposited begin insert to the Health
Subaccount end insert in the prior year from the Sales Tax Account in
addition to the amounts that were allocated to the health accounts
of the local health and welfare trust funds in the prior fiscal year
pursuant to this chapter from the Sales Tax Growth Account.

(3) To the Child Poverty and Family Supplemental Support
Subaccount until the deposits equal the amounts that were
deposited in the prior fiscal year from the Sales Tax Account and
the Sales Tax Growth Account.

(4) To the Mental Health Subaccount of the Sales Tax Account
until the deposits equal the amounts that were allocated to
counties’, cities’, and cities and counties’ CalWORKs Maintenance
of Effort Subaccounts pursuant to subdivision (a) of Section
17601.25, and any additional amounts above the amount specified
in subdivision (a) of Section 17601.25 of the local health and
welfare trust funds in the prior fiscal year pursuant to this chapter
from the Sales Tax Account and the Sales Tax Growth Account.
The Controller shall not include in this calculation any funding
deposited in the Mental Health Subaccount from the Support
Services Growth Subaccount pursuant to Section 30027.9 of the
Government Code or funds described in subdivision (c) of Section
17601.25.

(5) Any excess sales tax revenues received pursuant to Sections
6051.2 and 6201.2 of the Revenue and Taxation Code after the
allocations required by paragraphs (1) to (4), inclusive, are made
shall be deposited in the Sales Tax Growth Account of the Local
Revenue Fund.

begin insert

(6) On a monthly basis, pursuant to a schedule provided by the
Department of Finance, the Controller shall transfer funds from
the Social Services Subaccount to the Health Subaccount in an
amount that shall not exceed one billion dollars ($1,000,000,000)
in any fiscal year. The transfer schedule shall be based on the
amounts that each county is receiving in vehicle license fees
pursuant to this chapter. The funds so transferred shall not be used
in calculating future year deposits to the Social Services
Subaccount or the Health Subaccount.

end insert

begin insert

begin insert SEC. 8. end insert   

end insert

begin insert Section 17600.50 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

17600.50.  

(a) A county that participated in the County Medical
Services Program in the 2011-12 fiscal year, including the Counties
of Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, El
Dorado, Glenn, Humboldt, Imperial, Inyo, Kings, Lake, Lassen,
Madera, Marin, Mariposa, Mendocino, Modoc, Mono, Napa,
Nevada, Plumas, San Benito, Shasta, Sierra, Siskiyou, Solano,
Sonoma, Sutter, Tehama, Trinity, Tuolumne, and Yuba and the
Governing Board of the County Medical Services Program, shall
adopt resolutions by begin delete December 4, 2013, end delete begin insert January 22, 2014, end insert that
confirm acceptance for the following approach to determining
payments to the Family Support begin delete Services end delete Subaccount:

(1) The amount of payments to the Family Support begin delete Services end delete
Subaccount shall be equal to 60 percent of the sum of the
following:

(A) The 1991 health realignment funds that would have
otherwise been allocated to the counties listed above pursuant to
Sections 17603, 17604, begin delete 17606.10, end delete and 17606.20 and the
maintenance of effort in subdivision (a) of Section 17608.10 for
these counties, as those sections read on January 1, begin delete 2012 end delete begin insert 2012,
and Section 17606.10 as it read on July 1, 2013 end insert .

(B) The 1991 health realignment funds that would have
otherwise been allocated to the County Medical Services Program
pursuant to Sections 17603, 17604, 17605.07, and 17606.20, as
those sections read on January 1, 2012.

(2) The payment computed in paragraph (1) shall be achieved
through the following:

(A) Each county listed in subdivision (a) shall pay the amounts
otherwise payable to the County Medical Services Program
pursuant to subparagraph (B) of paragraph (2) of subdivision (j)
of Section 16809 to the Family Support begin delete Services end delete Subaccount.

(B) The County Medical Services Program shall pay the
difference between the total computed in paragraph (1) and the
amount calculated in subparagraph (A) from funds provided
pursuant to the Welfare and Institutions Code.

(b) The Counties of Fresno, Merced, Orange, Placer,
Sacramento, San Diego, San Luis Obispo, Santa Barbara, Santa
Cruz, Stanislaus, Tulare, and Yolo shall each tentatively inform
the state by begin delete October end delete begin insert November end insert 1, 2013, which of the following
options it selects for determining its payments to the Family
Support begin delete Services end delete Subaccount. On or before begin delete December 4, 2013, end delete
begin insert January 22, 2014, end insert the board of supervisors of each county and city
and county may adopt a resolution informing the state of the
county’s or city and county’s final selection of the option for
determining its payments to the Family Support begin delete Services end delete
Subaccount:

(1) The formula detailed in Article 13 (commencing with Section
17613.1).

(2) (A) A calculation of 60 percent of the total of 1991 health
realignment funds that would have otherwise been allocated to
that county or city and county pursuant to Sections 17603, 17604,
begin delete 17606.10, end delete and begin delete 17606.20 end delete begin insert 17606.20, as those sections read on
January 1, 2012, and Section 17606.10, as it end insert begin insert read on July 1, 2013, end insert
and 60 percent of the maintenance of effort in subdivision (a) of
Section 17608.10, as begin delete those sections end delete begin insert it end insert read on January 1, begin delete 2012 end delete
begin insert 2012 end insert .

(B) If a county’s maintenance of effort in subdivision (a) of
Section 17608.10 is greater than 14.6 percent of the total value of
the county’s 2010-11 allocation pursuant to Sections 17603, 17604,
17606.10, and 17606.20 and subdivision (a) of Section 17608.10,
the value of the maintenance of effort used in the calculation in
subparagraph (A) shall be limited to 14.6 percent.

(c) The Counties of Alameda, Contra Costa, Kern, Los Angeles,
Monterey, Riverside, San Bernardino, San Francisco, San Joaquin,
San Mateo, Santa Clara, and Ventura shall each tentatively inform
the state by begin delete October end delete begin insert November end insert 1, 2013, which of the following
options it selects for determining its payments to the Family
Support begin delete Services end delete Subaccount. On or before begin delete December 4, 2013, end delete
begin insert January 22, 2014, end insert the board of supervisors of each county and city
and county may adopt a resolution informing the state of the
county’s or city and county’s final selection of the option for
determining its payments to the Family Support begin delete Services end delete
Subaccount:

(1) The formula detailed in Article 12 (commencing with Section
17612.1).

(2) (A) A calculation of 60 percent of the total of 1991 health
realignment funds that would have otherwise been allocated to
that county or city and county pursuant to Sections 17603, 17604,
begin delete 17606.10, end delete and begin delete 17606.20 end delete begin insert 17606.20, as those sections read on
January 1, 2012, and Section 17606.10, as it read on July 1, 2013, end insert
and 60 percent of the maintenance of effort in subdivision (a) of
Section 17608.10, as begin delete those sections end delete begin insert it end insert read on January 1, begin delete 2012 end delete
begin insert 2012 end insert .

(B) If a county’s maintenance of effort in subdivision (a) of
Section 17608.10 is greater than 25.9 percent of the total value of
the county’s 2010-11 fiscal year allocation pursuant to Sections
17603, 17604, 17606.10, and 17606.20, and subdivision (a) of
Section 17608.10, the value of the maintenance of effort used in
the calculation in subparagraph (A) shall be limited to 25.9 percent.

(d) (1) If the board of supervisors of a county or city and county
fails to adopt a resolution pursuant to subdivision (b) or (c), as
applicable, or fails to inform the Director of Health Care Services
of the city and county or county’s final selection, by begin delete December 4,
2013, end delete begin insert January 22, 2014, end insert the calculation shall be 62.5 percent of
the total of 1991 health realignment funds that would have
otherwise been allocated to that county or city and county pursuant
to Sections 17603, 17604, begin delete 17606.10, end delete and begin delete 17606.20 end delete begin insert 17606.20, as
those sections read on January 1, 2012, and Section 17606.10, as
it read on July 1, 2013, end insert and 62.5 percent of the maintenance of
effort in subdivision (a) of Section begin delete 17608.10. end delete begin insert 17608.10, as it read
on January 1, 2012. end insert

(2) If the County Medical Services Program governing board
or the board of supervisors of a county that participates in the
County Medical Services Program fails to adopt a resolution
pursuant to subdivision (a), or fails to inform the Director of Health
Care Services of the county’s final selection, by begin delete December 4, 2013, end delete
begin insert January 22, 2014, end insert then paragraphs (1) and (2) of subdivision (a)
begin delete applies end delete begin insert apply end insert to the applicable counties and to the County Medical
Services Program.

begin insert

begin insert SEC. 9. end insert   

end insert

begin insert Section 17600.60 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

17600.60.  

(a) The County Health Care Funding Resolution
Committee is hereby created to do all of the following:

(1) Determine whether the calculation of the historical
percentage or amount to be applied in calculations in begin delete Section end delete
begin insert Sections end insert 17612.3 begin insert and 17613.3 end insert complies with begin delete that section end delete begin insert those
sections end insert , taking into account the data and calculations provided
by the county and any alternative data and calculations submitted
by the department.

(2) Hear and determine petitions from certain counties, as
defined, to make particularized changes in what provisions of
Section 17600.50 are controlling.

(3) Hear and determine petitions for an alternative cost
calculation to the cost per person calculation in subdivision (c) of
Section 17613.2.

(b) The committee shall consist of the following members:

(1) One person selected by the California State Association of
Counties.

(2) One person selected by the State Department of Health Care
Services.

(3) One person selected by the Director of Finance.

(c) (1) The committee is not subject to the Bagley-Keene Open
Meeting Act (Article 9 (commencing with Section 11120) of
Chapter 1 of Part 1 of Division 3 of Title 2 of the Government
Code) and shall be exempt from the Administrative Procedure Act
(Chapter 3.5 (commencing with Section 11340) of Part 1 of
Division 3 of Title 2 of the Government Code). The Department
of Finance shall provide staff for the committee.

(2) Pursuant to paragraph (2) of subdivision (b) of Section 3 of
Article I of the California Constitution, the Legislature finds and
declares that the public interest in affordable and accessible health
care outweighs the public interest in access to these proceedings.

(d) (1) A county or city and county, that chose to be subject to
paragraph (2) of subdivision (b) or paragraph (2) of subdivision
(c) of Section 17600.50 may submit a petition to the committee to
be subject to paragraph (1) of subdivision (b) or paragraph (1) of
subdivision (c) of Section 17600.50, as applicable, if the county
or city and county demonstrates and provides sufficient evidence
of both of the following criteria:

(A) There have been changes in expenditures related to state
and federal law, regulation and rulemaking, or court decisions that
have a material impact on the provision of health care services to
indigent adults.

(B) All of the data necessary to participate in Article 12
(commencing with Section 17612.1) or Article 13 (commencing
with Section 17613.1), as appropriate.

(2) The form of petition shall be determined by the committee
by begin delete December 31, 2013 end delete begin insert January 31, 2014 end insert .

(3) If the committee approves the petition the county or city and
county shall be subject to paragraph (1) of subdivision (b) or
paragraph (1) of subdivision (c) of Section 17600.50, as applicable,
at the start of the next fiscal year.

(e) (1) A county that chose to be subject to Article 13
(commencing with Section 17613.1) may submit a petition to the
committee for an alternative cost calculation to the cost per person
calculation in subdivision (c) of Section 17613.2 with the
documentation of extraordinary circumstances, including
circumstances related to the local health care marketplace, provider,
and provider contracts.

(2) The county shall submit all necessary data to support its
submission.

(f) The committee shall make decisions within 45 days of
hearing any petition.

begin insert

begin insert SEC. 10. end insert   

end insert

begin insert Section 17601.75 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

17601.75.  

(a) On or before the 27th day of the month, the
Controller shall allocate to the family support account in the local
health and welfare trust fund of each county and city and county
the amounts deposited and remaining unexpended and unreserved
on the 15th day of the month in the Family Support Subaccount
of the Local Revenue Fund, pursuant to schedules developed by
the Department of Finance in conjunction with the appropriate
state departments and in consultation with the California State
Association of Counties.

(b) All of the funds deposited in the family support account
shall be used by each county and city and county that receives an
allocation of those funds to pay an increased county contribution
toward the costs of begin delete CalWORKS end delete begin insert CalWORKs end insert grants. Each county’s
total annual contribution pursuant to this section shall equal the
total amount of funds deposited in each county’s and city and
county’s family support account during that fiscal year. The family
support account shall not be subject to the transferability provisions
of Section 17600.20. Each county’s contribution pursuant to this
section and Section 17601.25 shall be in addition to the shares of
cost required pursuant to Section 15200.

begin insert

begin insert SEC. 11. end insert   

end insert

begin insert Section 17603 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

17603.  

This paragraph shall only apply until the end of the
begin delete 2012-12 end delete begin insert 2012- end insert begin insert 13 end insert fiscal year. On or before the 27th day of each
month, the Controller shall allocate to the local health and welfare
trust fund health accounts the amounts deposited and remaining
unexpended and unreserved on the 15th day of the month in the
Health Subaccount of the Sales Tax Account of the Local Revenue
Fund, in accordance with subdivisions (a) and (b):

(a) For the 1991-92 fiscal year, allocations shall be made in
accordance with the following schedule:

 

Jurisdiction	Allocation Percentage
Alameda	4.5046
Alpine	0.0137
Amador	0.1512
Butte	0.8131
Calaveras	0.1367
Colusa	0.1195
Contra Costa	2.2386
Del Norte	0.1340
El Dorado	0.5228
Fresno	2.3531
Glenn	0.1391
Humboldt	0.8929
Imperial	0.8237
Inyo	0.1869
Kern	1.6362
Kings	0.4084
Lake	0.1752
Lassen	0.1525
Los Angeles	37.2606
Madera	0.3656
Marin	1.0785
Mariposa	0.0815
Mendocino	0.2586
Merced	0.4094
Modoc	0.0923
Mono	0.1342
Monterey	0.8975
Napa	0.4466
Nevada	0.2734
Orange	5.4304
Placer	0.2806
Plumas	0.1145
Riverside	2.7867
Sacramento	2.7497
San Benito	0.1701
San Bernardino	2.4709
San Diego	4.7771
San Francisco	7.1450
San Joaquin	1.0810
San Luis Obispo	0.4811
San Mateo	1.5937
Santa Barbara	0.9418
Santa Clara	3.6238
Santa Cruz	0.6714
Shasta	0.6732
Sierra	0.0340
Siskiyou	0.2246
Solano	0.9377
Sonoma	1.6687
Stanislaus	1.0509
Sutter	0.4460
Tehama	0.2986
Trinity	0.1388
Tulare	0.7485
Tuolumne	0.2357
Ventura	1.3658
Yolo	0.3522
Yuba	0.3076
Berkeley	0.0692
Long Beach	0.2918
Pasadena	0.1385

 

(b) For the 1992-93 fiscal year and fiscal years thereafter until
the commencement of the begin delete 2012-13 end delete begin insert 2013- end insert begin insert 14 end insert fiscal year, the
allocations to each county and city and county shall equal the
amounts received in the prior fiscal year by each county, city, and
city and county from the Sales Tax Account and the Sales Tax
Growth Account of the Local Revenue Fund into the health and
welfare trust fund.

(c) (1) For the 2013-14 fiscal year, on the 27th day of each
month, the Controller shall allocate, in the same proportion begin delete and end delete
begin insert as end insert funds in subdivision (b) were allocated, to each county’s and
city and county’s local health and welfare trust fund health
accounts, the amounts deposited and remaining unexpended and
unreserved on the 15th day of the month in the Health Subaccount
of the Sales Tax Account of the Local Revenue Fund.

(2) (A) Beginning January 2014 and for the remainder of the
2013-14 fiscal begin delete year ending June 30, 2014, end delete begin insert year, end insert on or before the
begin delete 25th end delete begin insert 27th end insert of each month, the Controller shall transfer to the Family
Support Subaccount from the Health Subaccount amounts
determined pursuant to a schedule prepared by the Department of
Finance in consultation with the California State Association of
Counties. Cumulatively, no more than three hundred million dollars
($300,000,000) shall be transferred.

(B) Every month, after the transfers in subparagraph (A) have
occurred, the remainder shall be allocated to the counties and cities
and counties in the same proportions as funds in subdivision (b)
were allocated.

(C) For counties participating in the County Medical Services
Program, transfers from each county shall not be greater than the
monthly amount the county would otherwise pay pursuant to
paragraph (2) of subdivision (j) of Section 16809 for participation
in the County Medical Services Program. Any difference between
the amount paid by these counties and the proportional share of
the three hundred million dollars ($300,000,000) calculated as
payable by these counties and the County Medical Services
Program shall be paid from the funds available for allocation to
the County Medical Services Program in accordance with the
Welfare and Institution Code.

(3) For the 2013-14 fiscal year, the Controller, using the same
timing and criteria used in paragraph (1), shall allocate to each
city, not to include a city and county, funds that shall equal the
amounts received in the prior fiscal year by each city from the
Sales Tax Account and the Sales Tax Growth Account of the Local
Revenue Fund into the health and welfare trust fund.

(d) (1) (A) For the 2014-15 fiscal year and for every fiscal
year thereafter, the Department of Finance, in consultation with
the California State Association of Counties, shall calculate the
amount each county or city and county shall contribute to the
Family Support Subaccount in accordance with Section 17600.50.

(B) On or before the begin delete 25th end delete begin insert 27th end insert of each month, the Controller
shall transfer, based on a schedule prepared the Department of
Finance in consultation with the California State Association of
Counties, from the funds deposited and remaining unexpended
and unreserved on the 15th day of the month in the Health
Subaccount of the Sales Tax Account of the Local Revenue Fund
to the Family Support Subaccount, funds that equal, over the course
of the year, the amount determined in subparagraph (A) pursuant
to a schedule provided by the Department of Finance.

(C) After the transfer in subparagraph (B) has occurred, the
State Controller shall allocate on or before the 27th of each month
to health account in the local health and welfare trust fund of every
county and city and county from a schedule prepared by the
Department of Finance, in consultation with the California State
Association of Counties, any funds remaining in the Health
Account from the funds deposited and remaining unexpended and
unreserved on the 15th day of the month in the Health Subaccount
of the Sales Tax Account of the Local Revenue Fund. The schedule
shall be prepared as the allocations would have been distributed
pursuant to subdivision (b).

(D) For the 2014-15 fiscal year and for every fiscal year
thereafter, the Controller, using the same timing and criteria as
had been used in subdivision (b), shall allocate to each city, not to
include a city and county, funds that equal the amounts received
in the prior fiscal year by each city from the Sales Tax Account
and the Sales Tax Growth Account of the Local Revenue Fund
into the health and welfare trust fund.

begin insert

begin insert SEC. 12. end insert   

end insert

begin insert Section 17604 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

17604.  

(a) All motor vehicle license fee revenues collected in
the 1991-92 fiscal year that are deposited to the credit of the Local
Revenue Fund shall be credited to the Vehicle License Fee Account
of that fund.

(b) (1) For the 1992-93 fiscal year and fiscal years thereafter,
from vehicle license fee proceeds from revenues deposited to the
credit of the Local Revenue Fund, the Controller shall make
monthly deposits to the Vehicle License Fee Account of the Local
Revenue Fund until the deposits equal the amounts that were
allocated to counties, cities, and cities and counties as general
purpose revenues in the prior fiscal year pursuant to this chapter
from the Vehicle License Fee Account in the Local Revenue Fund
and the Vehicle License Fee Account and the Vehicle License Fee
Growth Account in the Local Revenue Fund.

(2) Any excess vehicle fee revenues deposited into the Local
Revenue Fund pursuant to Section 11001.5 of the Revenue and
Taxation Code shall be deposited in the Vehicle License Fee
Growth Account of the Local Revenue Fund.

(3) The Controller shall calculate the difference between the
total amount of vehicle license fee proceeds deposited to the credit
of the Local Revenue Fund, pursuant to paragraph (1) of
subdivision (a) of Section 11001.5 of the Revenue and Taxation
Code, and deposited into the Vehicle License Fee Account for the
period of July 16, 2009, to July 15, 2010, inclusive, and the amount
deposited for the period of July 16, 2010, to July 15, 2011,
inclusive.

(4) Of vehicle license fee proceeds deposited to the Vehicle
License Fee Account after July 15, 2011, an amount equal to the
difference calculated in paragraph (3) shall be deemed to have
been deposited during the period of July 16, 2010, to July 15, 2011,
inclusive, and allocated to cities, counties, and a city and county
as if those proceeds had been received during the 2010-11 fiscal
year.

(c) (1) On or before the 27th day of each month, the Controller
shall allocate to each county, city, or city and county, as general
purpose revenues the amounts deposited and remaining unexpended
and unreserved on the 15th day of the month in the Vehicle License
Fee Account of the Local Revenue Fund, in accordance with
paragraphs (2) and (3).

(2) For the 1991-92 fiscal year, allocations shall be made in
accordance with the following schedule:

 

Jurisdiction	Allocation Percentage
Alameda	4.5046
Alpine	0.0137
Amador	0.1512
Butte	0.8131
Calaveras	0.1367
Colusa	0.1195
Contra Costa	2.2386
Del Norte	0.1340
El Dorado	0.5228
Fresno	2.3531
Glenn	0.1391
Humboldt	0.8929
Imperial	0.8237
Inyo	0.1869
Kern	1.6362
Kings	0.4084
Lake	0.1752
Lassen	0.1525
Los Angeles	37.2606
Madera	0.3656
Marin	1.0785
Mariposa	0.0815
Mendocino	0.2586
Merced	0.4094
Modoc	0.0923
Mono	0.1342
Monterey	0.8975
Napa	0.4466
Nevada	0.2734
Orange	5.4304
Placer	0.2806
Plumas	0.1145
Riverside	2.7867
Sacramento	2.7497
San Benito	0.1701
San Bernardino	2.4709
San Diego	4.7771
San Francisco	7.1450
San Joaquin	1.0810
San Luis Obispo	0.4811
San Mateo	1.5937
Santa Barbara	0.9418
Santa Clara	3.6238
Santa Cruz	0.6714
Shasta	0.6732
Sierra	0.0340
Siskiyou	0.2246
Solano	0.9377
Sonoma	1.6687
Stanislaus	1.0509
Sutter	0.4460
Tehama	0.2986
Trinity	0.1388
Tulare	0.7485
Tuolumne	0.2357
Ventura	1.3658
Yolo	0.3522
Yuba	0.3076
Berkeley	0.0692
Long Beach	0.2918
Pasadena	0.1385

 

(3) For the 1992-93, 1993-94, and 1994-95 fiscal year and
fiscal years thereafter, allocations shall be made in the same
amounts as were distributed from the Vehicle License Fee Account
and the Vehicle License Fee Growth Account in the prior fiscal
year.

(4) For the 1995-96 fiscal year, allocations shall be made in the
same amounts as distributed in the 1994-95 fiscal year from the
Vehicle License Fee Account and the Vehicle License Fee Growth
Account after adjusting the allocation amounts by the amounts
specified for the following counties:

 

Alpine	$(11,296)
Amador	25,417
Calaveras	49,892
Del Norte	39,537
Glenn	(12,238)
Lassen	17,886
Mariposa	(6,950)
Modoc	(29,182)
Mono	(6,950)
San Benito	20,710
Sierra	(39,537)
Trinity	(48,009)

 

(5) For the 1996-97 fiscal year and fiscal years thereafter,
allocations shall be made in the same amounts as were distributed
from the Vehicle License Fee Account and the Vehicle License
Fee Growth Account in the prior fiscal year.

Initial proceeds deposited in the Vehicle License Fee Account
in the 2003-04 fiscal year in the amount that would otherwise have
been transferred pursuant to Section 10754 of the Revenue and
Taxation Code for the period June 20, 2003, to July 15, 2003,
inclusive, shall be deemed to have been deposited during the period
June 16, 2003, to July 15, 2003, inclusive, and allocated to cities,
counties, and a city and county during the 2002-03 fiscal year.

(d) The Controller shall make monthly allocations from the
amount deposited in the Vehicle License Collection Account of
the Local Revenue Fund to each county in accordance with a
schedule to be developed by the State Department of Mental Health
in consultation with the California Mental Health Directors
Association, which is compatible with the intent of the Legislature
expressed in the act adding this subdivision.

(e) Prior to making the begin insert monthly end insert allocations in accordance with
paragraph (5) of subdivision (c) and subdivision (d), begin insert and pursuant
to a schedule provided by the Department of Finance, end insert the
Controller shall adjust the begin insert monthly end insert distributions from the Vehicle
License Fee Account to reflect an equal exchange of sales and use
tax funds from the Social Services Subaccount to the Health
Subaccount, as required by begin delete subdivision end delete begin insert subdivisions end insert (d) begin insert and (e) end insert
of Section 17600.15, and of Vehicle License Fee funds from the
Health Account to the Social Services Account. begin insert Adjustments made
to the Vehicle License Fee distributions pursuant to this subdivision
shall not be used in calculating future year allocations to the
Vehicle License Fee Account. end insert

begin insert

begin insert SEC. 13. end insert   

end insert

begin insert Section 17606.10 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

17606.10.  

(a) For the 1992-93 fiscal year and subsequent
fiscal years, the Controller shall allocate funds, on a monthly basis
from the General Growth Subaccount in the Sales Tax Growth
Account to the appropriate accounts in the local health and welfare
trust fund of each county, city, and city and county in accordance
with a schedule setting forth the percentage of total state resources
received in the 1990-91 fiscal year, including State Legalization
Impact Assistance Grants distributed by the state under Part 4.5
(commencing with Section 16700), funding provided for purposes
of implementation of Division 5 (commencing with Section 5000),
for the organization and financing of community mental health
services, including the Cigarette and Tobacco Products Surtax
proceeds which are allocated to county mental health programs
pursuant to Chapter 1331 of the Statutes of 1989, Chapter 51 of
the Statutes of 1990, and Chapter 1323 of the Statutes of 1990,
and state hospital funding and funding distributed for programs
administered under Sections 1794, 10101.1, and 11322.2, as
annually adjusted by the Department of Finance, in conjunction
with the appropriate state department to reflect changes in equity
status from the base percentages. However, for the 1992-93 fiscal
year, the allocation for community mental health services shall be
based on the following schedule:

 

	Percentage
	of Statewide
Jurisdiction	Resource Base
Alameda	4.3693
Alpine	0.0128
Amador	0.0941
Butte	0.7797
Calaveras	0.1157
Colusa	0.0847
Contra Costa	2.3115
Del Norte	0.1237
El Dorado	0.3966
Fresno	3.1419
Glenn	0.1304
Humboldt	0.6175
Imperial	0.5425
Inyo	0.1217
Kern	1.8574
Kings	0.4229
Lake	0.2362
Lassen	0.1183
Los Angeles	27.9666
Madera	0.3552
Marin	0.9180
Mariposa	0.0792
Mendocino	0.4099
Merced	0.8831
Modoc	0.0561
Mono	0.0511
Monterey	1.1663
Napa	0.3856
Nevada	0.2129
Orange	5.3423
Placer	0.5034
Plumas	0.1134
Riverside	3.6179
Sacramento	4.1872
San Benito	0.1010
San Bernardino	4.5494
San Diego	7.8773
San Francisco	3.5335
San Joaquin	2.4690
San Luis Obispo	0.6652
San Mateo	2.5169
Santa Barbara	1.0745
Santa Clara	5.0488
Santa Cruz	0.7960
Shasta	0.5493
Sierra	0.0345
Siskiyou	0.2051
Solano	0.6694
Sonoma	1.1486
Stanislaus	1.4701
Sutter/Yuba	0.6294
Tehama	0.2384
Trinity	0.0826
Tulare	1.4704
Tuolumne	0.1666
Ventura	1.9311
Yolo	0.5443
Berkeley	0.2688
Tri-City	0.2347

 

(b) The Department of Finance shall recalculate the resource
base used in determining the General Growth Subaccount
allocations to the Health Account, Mental Health Account, and
Social Services Account of the local health and welfare trust fund
of each city, county, and city and county for the 1994-95 fiscal
year general growth allocations according to subdivisions (c) and
(d). For the 1995-96 fiscal year and annually until the end of the
2012-13 fiscal year, the Department of Finance shall prepare the
schedule of allocations of growth based upon the recalculation of
the resource base as provided by subdivision (c).

(c) For the Mental Health Account, the Department of Finance
shall do all of the following:

(1) Use the following sources as reported by the State
Department of Mental Health:

(A) The final December 1992 distribution of resources
associated with Institutes for Mental Disease.

(B) The 1990-91 fiscal year state hospitals and community
mental health allocations.

(C) Allocations for services provided for under Chapter 1294
of the Statutes of 1989.

(2) Expand the resource base with the following nonrealigned
funding sources as allocated among the counties:

(A) Tobacco surtax allocations made under Chapter 1331 of the
Statutes of 1989 and Chapter 51 of the Statutes of 1990.

(B) For the 1994-95 allocation year only, Chapter 1323 of the
Statutes of 1990.

(C) 1993-94 fiscal year federal homeless block grant allocation.

(D) 1993-94 fiscal year Mental Health Special Education
allocations.

(E) 1993-94 fiscal year allocations for the system of care for
children, in accordance with Chapter 1229 of the Statutes of 1992.

(F) 1993-94 fiscal year federal Substance Abuse and Mental
Health Services Administration block grant allocations pursuant
to Subchapter 1 (commencing with Section 10801) of Chapter 114
of Title 42 of the United States Code.

(d) Until the end of the 2012-13 fiscal year, for the Health
Account, the Department of Finance shall use the historical
resource base of state funds as allocated among the counties, cities,
and city and county as reported by the State Department of Health
Services in a September 17, 1991, report of Indigent and
Community Health Resources.

(e) The Department of Finance shall use these adjusted resource
bases for the Health Account and Mental Health Account to
calculate what the 1994-95 fiscal year General Growth Subaccount
allocations would have been, and together with 1994-95 fiscal
year Base Restoration Subaccount allocations, CMSP subaccount
allocations, equity allocations to the Health Account and Mental
Health Account as adjusted by subparagraph (E) of paragraph (2)
of subdivision (c) of Section 17606.05, and special equity
allocations to the Health Account and Mental Health Account as
adjusted by subdivision (e) of Section 17606.15 reconstruct the
1994-95 fiscal year General Growth Subaccount resource base
for the 1995-96 allocation year for each county, city, and city and
county. Notwithstanding any other provision of law, the actual
1994-95 general growth allocations shall not become part of the
realignment base allocations to each county, city, and city and
county. The total amounts distributed by the Controller for general
growth for the 1994-95 allocation year shall be reallocated among
the counties, cities, and city and county in the 1995-96 allocation
year according to this paragraph, and shall be included in the
general growth resource base for the 1996-97 allocation year and
each fiscal year thereafter. For the 1996-97 allocation year and
fiscal years thereafter, the Department of Finance shall update the
base with actual growth allocations to the Health Account, Mental
Health Account, and Social Services Account of each county, city,
and city and county local health and welfare trust fund in the prior
year, and adjust for actual changes in nonrealigned funds specified
in subdivision (c) in the year prior to the allocation year.

(f) For the 2013-14 fiscal year and every fiscal year thereafter,
the Controller shall do all of the following:

(1) Allocate to the mental health account of each county begin insert , city, end insert
or city and county based on a schedule provided by the Department
of Finance. The Department of Finance shall recalculate the
resource base used in determining the General Growth Subaccount
allocations to mental health account in accordance with subdivision
(c) and allocate based on that recalculation.

(2) Allocate 18.4545 percent of the total General Growth
Subaccount to the Health Account.

(3) Allocate to the Child Poverty and Family Supplemental
Support Subaccount in the Sales Tax Account the remainder of
the funds in the General Growth Subaccount.

begin insert

begin insert SEC. 14. end insert   

end insert

begin insert Section 17610 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

17610.  

(a) In June 2016 and for every fiscal year thereafter,
for every begin delete county end delete begin insert county or city and county end insert that selected the option
pursuant to paragraph (1) of subdivision (b) or paragraph (1) of
subdivision (c) of Section 17600.50, the Director of Finance shall
make a final determination of the amount of the allocation
attributable to each county and city and county should have been
pursuant to subdivision (d) of Section 17603 for the penultimate
fiscal year.

(b) The amount of the final determination amount for each
county or city and county shall be subtracted from the amount
attributable to each county or city and county that was actually
transferred in the applicable fiscal year. This calculation shall be
made at the same time as the final determination in subdivision
(a).

(c) The Director of Finance shall promptly notify every affected
begin delete county end delete begin insert county or city and county end insert and the Joint Legislative Budget
Committee of the determinations made pursuant to subdivisions
(a) and (b).

(d) If the difference calculated in subdivision (b) is negative,
the state shall pay the applicable begin delete county end delete begin insert county or city and county, end insert
the difference and those funds shall be deposited in that begin delete county’s end delete
begin insert county’s or city and county’s end insert health account of the local health
and welfare trust fund. Notwithstanding Section 13340 of the
Government Code, there is hereby continuously appropriated to
the Director of Finance the funds necessary to pay any amounts
owed pursuant to this subdivision.

(e) If the difference determined in subdivision (b) is positive,
the applicable county or city and county shall pay the difference
to the family support account within the health and welfare trust
fund of that begin delete city end delete begin insert county end insert or city and county. If within three months
of receipt of the determination made in subdivision (b), the county
or city and county has failed to make the payment, then the Director
of Finance shall provide a supplemental schedule to the Controller
to have 1.5 times the amount of the determination transferred from
the next Health Subaccount allocations of the applicable county
or city and county to the Family Support Subaccount until 1.5
times the amount owed has been deposited in the family support
account.

begin insert

(f) Solely for the June 2016 final determination, the amount
redirected pursuant to this article shall not exceed the amount
determined for the county or city and county for the 2013-14 fiscal
year under subdivision (c) of Section 17603, as that amount may
have been reduced by the application of Section 17610.5.

end insert

begin insert

begin insert SEC. 15. end insert   

end insert

begin insert Section 17610.5 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

17610.5.  

(a) There is hereby created a 2013-14 Special
Holding Account in the Family Support Subaccount. Starting
January 1, begin delete 2014, and ending July 25, end delete 2014, begin insert until the end of the
2013- end insert begin insert 14 fiscal year, end insert funds transferred to the Family Support
Subaccount that are attributable to every county or city and county
that chose to be subject to paragraph (1) of subdivision (b), or
paragraph (1) of subdivision (c), of Section 17600.50 shall be
placed in the 2013-14 Special Holding Account.

(b) No later than April 20, 2014, the State Department of Health
Care Services shall provide an updated savings estimate for every
county and city and county that chose to be subject to paragraph
(1) of subdivision (b), or paragraph (1) of subdivision (c) of Section
17600.50 to the Department of Finance. On or before May 14,
2014, the Department of Finance shall, for each county or city and
county described in subdivision (a), determine whether the actual
savings for each county or city and county is greater or lesser than
the amount of funds deposited into the Special Holding Account.

(c) If the revised estimate of savings is greater than the funds
estimated by the Department of Finance to be deposited in the
Special Holding Account, the funds shall be transferred back to
the Family Support Subaccount by begin delete June 30, 2014, end delete begin insert the end of the
2013- end insert begin insert 14 fiscal year, end insert for allocation.

(d) If the revised estimate of savings is less than the funds
estimated by the Department of Finance to be deposited in the
Special Holding Account, the difference between the amount
estimated to be transferred and the revised estimated savings
amount shall be transferred to the health account of the local health
and welfare trust fund of every affected county or city and county
pursuant to a schedule prepared by the Director of Finance in
consultation with the California State Association of Counties and
provided to the Controller.

(e) This section shall remain in effect only until January 1, 2015,
and as of that date is repealed, unless a later enacted statute, that
is enacted before January 1, 2015, deletes or extends that date.

begin insert

begin insert SEC. 16. end insert   

end insert

begin insert Section 17612.1 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

17612.1.  

(a) For the 2013-14 fiscal year and each fiscal year
thereafter, for each public hospital health system county that
selected the option in paragraph (1) of subdivision (c) of Section
17600.50, the total amount that would be payable for the fiscal
year from 1991 Health Realignment funds under Sections 17603,
17604, begin delete 17606.10 end delete and 17606.20, as those sections read on January
1, 2012, begin insert and Section 17606.10, as it read on July 1, 2013, end insert and
deposited by the Controller into the local health and welfare trust
fund health account of the county in the absence of this section
shall be determined.

(b) The redirected amount determined for the public hospital
health system county pursuant to Section 17612.3 shall be divided
by the total determined in subdivision (a), except that, with respect
to the County of Los Angeles, the redirected amount shall be
determined by taking into account the adjustments required in
Section 17612.5.

(c) The resulting fraction determined in subdivision (b) shall
be the percentage of 1991 Health Realignment funds under Sections
17603, 17604, begin delete 17606.10, end delete and 17606.20, as those sections read on
January 1, 2012, begin insert and Section 17606.10, as it read on July 1, 2013, end insert
to be deposited each month into the Family Support Subaccount.

(d) The total amount deposited into the Family Support
Subaccount under subdivision (c) with respect to a public hospital
health system county for a fiscal year shall not exceed the
redirected amount determined pursuant to Section 17612.3, and
shall be subject to the appeal processes, and judicial review as
described in subdivision (d) of Section 17612.3.

(e) The Legislature finds and declares that this article is not
intended to change the local obligation pursuant to Section 17000.

begin insert

begin insert SEC. 17. end insert   

end insert

begin insert Section 17612.2 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

17612.2.  

For purposes of this article, the following definitions
shall apply:

(a) “Adjusted patient day” means a county public hospital health
system’s total number of patient census days, as defined by the
Office of Statewide Health Planning and Development, multiplied
by the following fraction: the numerator that is the sum of the
county public hospital health system’s total gross revenue for all
services provided to all patients, including nonhospital services,
and the denominator that is the sum of the county public hospital
health system’s gross inpatient revenue. The adjusted patient days
shall pertain to those services that are provided by the county public
hospital health system and shall exclude services that are provided
by contract or out-of-network clinics or hospitals.

(b) “Base year” means the fiscal year ending three years prior
to the fiscal year for which the redirected amount is calculated.

(c) “Blended CPI trend factor” means the blended percent
change applicable for the fiscal year that is derived from the
nonseasonally adjusted Consumer Price Index for All Urban
Consumers (CPI-U), United States City Average, for Hospital and
Related Services, weighted at 75 percent, and for Medical Care
Services, weighted at 25 percent, all as published by the United
States Bureau of Labor Statistics, computed as follows:

(1) For each prior fiscal year within the period to be trended
through the current fiscal year, the annual average of the monthly
index amounts shall be determined separately for the Hospital and
Related Services Index and the Medical Care Services Index.

(2) The year-to-year percentage changes in the annual averages
determined in paragraph (1) for each of the Hospital and Related
Services Index and the Medical Care Services Index shall be
calculated.

(3) A weighted average annual percentage change for each
year-to-year period shall be calculated from the determinations
made in paragraph (2), with the percentage changes in the Hospital
and Related Services Index weighted at 75 percent, and the
percentage changes in the Medical Care Services Index weighted
at 25 percent. The resulting average annual percentage changes
shall be expressed as a fraction, and increased by 1.00.

(4) The product of the successive year-to-year amounts
determined in paragraph (3) shall be the blended CPI trend factor.

(d) “Cost containment limit” means the public hospital health
system county’s Medi-Cal costs and uninsured costs determined
for the 2014-15 fiscal year and each subsequent fiscal year,
adjusted as follows:

(1) Notwithstanding paragraphs (2) to (4), inclusive, at the public
hospital health system county’s option it shall be deemed to comply
with the cost containment limit if the county demonstrates that its
total health care costs, including nursing facility, mental health,
and substance use disorder services, that are not limited to
Medi-Cal and uninsured patients, for the fiscal year did not exceed
its total health care costs in the base year, multiplied by the blended
CPI trend factor for the fiscal year. A county electing this option
shall elect by November 1 following the end of the fiscal year, and
submit its supporting reports for meeting this requirement,
including the annual report of financial transactions required to be
submitted to the Controller pursuant to Section 53891 of the
Government Code.

(2) (A) The public hospital health system county’s Medi-Cal
costs, uninsured costs, and other entity intergovernmental transfer
amounts for the fiscal year shall be added together. Medi-Cal costs,
uninsured costs, and other entity intergovernmental transfer
amounts for purposes of this paragraph are as defined in
subdivisions (q), (t), and (y) for the relevant fiscal period.

(B) The public hospital health system county’s Medi-Cal costs,
uninsured costs, and imputed other entity intergovernmental
transfer amounts for the base year shall be added together and
multiplied by the blended CPI trend factor. The base year costs
used shall not reflect any adjustments under this subdivision.

(C) The fiscal year amount determined in subparagraph (A)
shall be compared to the trended amount in subparagraph (B). If
the amount in subparagraph (B) exceeds the amount in
subparagraph (A), the public hospital health system county shall
be deemed to have satisfied the cost containment limit. If the
amount in subparagraph (A) exceeds the amount in subparagraph
(B), the calculation in paragraph (3) shall be performed.

(3) (A) If the number of adjusted patient days of service
provided by the county public hospital health system for the fiscal
year exceeds its number of adjusted patient days of service rendered
in the base year by at least 10 percent, the excess adjusted patient
days above the base year for the fiscal year shall be multiplied by
the cost per adjusted patient day of the county public hospital
health system for the base year. The result shall be added to the
trended base year amount determined in subparagraph (B) of
paragraph (2), yielding the applicable cost containment limit,
subject to paragraph (4).

(B) If the number of adjusted patient days of service provided
by a county’s public hospital health system for the fiscal year does
not exceed its number of adjusted patient days of service rendered
in the base year by 10 percent, the applicable cost containment
limit is the trended base year amount determined in subparagraph
(B) of paragraph (2), subject to paragraph (4).

(4) If a public hospital health system county’s costs, as
determined in subparagraph (A) of paragraph (2), exceeds the
amount determined in subparagraph (B) of paragraph (2) as
adjusted by paragraph (3), the portion of the following cost
increases incurred in providing services to Medi-Cal beneficiaries
and uninsured patients shall be added to and reflected in any cost
containment limit:

(A) Electronic Health Records and related implementation and
infrastructure costs.

(B) Costs related to state or federally mandated activities,
requirements, or benefit changes.

(C) Costs resulting from a court order or settlement.

(D) Costs incurred in response to seismic concerns, including
costs necessary to meet facility seismic standards.

(E) Costs incurred as a result of a natural disaster or act of
terrorism.

(5) If a public hospital health system county’s costs, as
determined in subparagraph (A) of paragraph (2), exceeds the
amount determined in subparagraph (B) of paragraph (2) as
adjusted by paragraphs (3) and (4), the county may request that
the department consider other costs as adjustments to the cost
containment limit, including, but not limited to, transfer amounts
in excess of the imputed other entity intergovernmental transfer
amount trended by the blended CPI trend factor, costs related to
case mix index increases, pension costs, expanded medical
education programs, increased costs in response to delivery system
changes in the local community, and system expansions, including
capital expenditures necessary to ensure access to and the quality
of health care. Costs approved by the department shall be added
to and reflected in any cost containment limit.

(e) “County indigent care health realignment amount” means
the product of the health realignment amount times the health
realignment indigent care percentage, as computed on a
county-specific basis.

(f) “County public hospital health system” means a designated
public hospital identified in paragraphs (6) to (20), inclusive, and
paragraph (22) of subdivision (d) of Section 14166.1, and its
affiliated governmental entity clinics, practices, and other health
care providers that do not provide predominantly public health
services. A county public hospital health system does not include
a health care service plan, as defined in subdivision (f) of Section
1345 of the Health and Safety Code. The Alameda County Medical
Center and County of Alameda shall be considered affiliated
governmental entities.

(g) “Department” means the State Department of Health Care
Services.

(h) “Health realignment amount” means the amount that, in the
absence of this article, would be payable to a public hospital health
system county under Sections 17603, 17604, begin delete 17606.10, end delete and
17606.20, as those sections read on January 1, 2012, begin insert and Section
17606.10, as it read on July 1, 2013, end insert for the fiscal year that is
deposited by the Controller into the local health and welfare trust
fund health account of the public hospital health system county.

(i) “Health realignment indigent care percentage” means the
county-specific percentage determined in accordance with the
following, and established in accordance with the procedures
described in subdivision (c) of Section 17612.3.

(1) Each public hospital health system county shall identify the
portion of that county’s health realignment amount that was used
to provide health services to the indigent, including Medi-Cal
beneficiaries and the uninsured, for each of the historical fiscal
years along with verifiable data in support thereof.

(2) The amounts identified in paragraph (1) shall be expressed
as a percentage of the health realignment amount of that county
for each historical fiscal year.

(3) The average of the percentages determined in paragraph (2)
shall be the county’s health realignment indigent care percentage.

(4) To the extent a county does not provide the information
required in paragraph (1) or the department determines that the
information provided is insufficient, the amount under this
subdivision shall be 85 percent.

(j) “Historical fiscal years” means the state 2008-09 to 2011-12,
inclusive, fiscal years.

(k) “Hospital fee direct grants” means the direct grants described
in Section 14169.7 that are funded by the Private Hospital Quality
Assurance Fee Act of 2011 (Article 5.229 (commencing with
Section 14169.31) of Chapter 7 of Part 3), or direct grants made
in support of health care expenditures funded by a successor
statewide hospital fee program.

(l) “Imputed county low-income health amount” means the
predetermined, county-specific amount of county general purpose
funds assumed, for purposes of the calculation in Section 17612.
3, to be available to the county public hospital health system for
services to Medi-Cal and uninsured patients. County general
purpose funds shall not include any other revenues, grants, or funds
otherwise defined in this section. The imputed county low-income
health amount shall be determined as follows and established in
accordance with subdivision (c) of Section 17612.3.

(1) For each of the historical fiscal years, an amount determined
to be the annual amount of county general fund contribution
provided for health services to Medi-Cal beneficiaries and the
uninsured, which does not include funds provided for nursing
facility, mental health, and substance use disorder services, shall
be determined through methodologies described in subdivision
(ab).

(2) If a year-to-year percentage increase in the amount
determined in paragraph (1) was present, an average annual
percentage trend factor shall be determined.

(3) The annual amounts determined in paragraph (1) shall be
averaged, and multiplied by the percentage trend factor, if
applicable, determined in paragraph (2), for each fiscal year after
the 2011-12 fiscal year through the applicable fiscal year.
However, if the percentage trend factor determined in paragraph
(2) is greater than the applicable percentage change for any year
of the same period in the blended CPI trend factor, the percentage
change in the blended CPI trend factor for that year shall be used.
The resulting determination is the imputed county low-income
health amount for purposes of Section 17612.3.

(m) “Imputed gains from other payers” means the
predetermined, county-specific amount of revenues in excess of
costs generated from all other payers for health services that is
assumed to be available to the county public hospital health system
for services to Medi-Cal and uninsured patients, which shall be
determined as follows and established in accordance with
subdivision (c) of Section 17612.3.

(1) For each of the historical fiscal years, the gains from other
payers shall be determined in accordance with methodologies
described in subdivision (ab).

(2) The amounts determined in paragraph (1) shall be averaged,
yielding the imputed gains from other payers.

(n) “Imputed other entity intergovernmental transfer amount”
means the predetermined average historical amount of the public
hospital health system county’s other entity intergovernmental
transfer amount, determined as follows and established in
accordance with subdivision (c) of Section 17612.3.

(1) For each of the historical fiscal years, the other entity
intergovernmental transfer amount shall be determined based on
the records of the public hospital health system county.

(2) The annual amounts in paragraph (1) shall be averaged.

(o) “Medicaid demonstration revenues” means payments paid
or payable to the county public hospital health system for the fiscal
year pursuant to the Special Terms and Conditions of the federal
Medicaid demonstration project authorized under Section 1115 of
the federal Social Security Act entitled the “Bridge to Health Care
Reform” (waiver number 11-W-00193/9), for uninsured care
services from the Safety Net Care Pool or as incentive payments
from the Delivery System Reform Improvement Pool, or pursuant
to mechanisms that provide funding for similar purposes under
the subsequent demonstration project. Medicaid demonstration
revenues do not include the nonfederal share provided by county
public hospital health systems as certified public expenditures,
and are reduced by any intergovernmental transfer by county public
hospital health systems or affiliated governmental entities that is
for the nonfederal share of Medicaid demonstration payments to
the county public hospital health system or payments to a Medi-Cal
managed care plan for services rendered by the county public
hospital health system, and any related fees imposed by the state
on those transfers; and by any reimbursement of costs, or payment
of administrative or other processing fees imposed by the state
relating to payments or other Medicaid demonstration program
functions. Medicaid demonstration revenues shall not include
Safety Net Care Pool revenues for nursing facility, mental health,
and substance use disorder services, as determined from the pro
rata share of eligible certified public expenditures for such services,
or revenues that are otherwise included as Medi-Cal revenues.

(p) “Medi-Cal beneficiaries” means individuals eligible to
receive benefits under Chapter 7 (commencing with Section 14000)
of Part 3, except for: individuals who are dual eligibles, as defined
in paragraph (4) of subdivision (c) of Section 14132.275, and
individuals for whom Medi-Cal benefits are limited to cost sharing
or premium assistance for Medicare or other insurance coverage
as described in Section 1396d(a) of Title 42 of the United States
Code.

(q) “Medi-Cal costs” means the costs incurred by the county
public hospital health system for providing Medi-Cal services to
Medi-Cal beneficiaries during the fiscal year, which shall be
determined in a manner consistent with the cost claiming protocols
developed for Medi-Cal cost-based reimbursement for public
providers and under Section 14166.8, and, in consultation with
each county, shall be based on other cost reporting and statistical
data necessary for an accurate determination of actual costs as
required in Section 17612.4. Medi-Cal costs shall include all
fee-for-service and managed care hospital and nonhospital
components, managed care out-of-network costs, and related
administrative costs. The Medi-Cal costs determined under this
paragraph shall exclude costs incurred for nursing facility, mental
health, and substance use disorder services.

(r) “Medi-Cal revenues” means total amounts paid or payable
to the county public hospital health system for medical services
provided under the Medi-Cal State Plan that are rendered to
Medi-Cal beneficiaries during the state fiscal year, and shall include
payments from Medi-Cal managed care plans for services rendered
to Medi-Cal managed care plan members, Medi-Cal copayments
received from Medi-Cal beneficiaries, but only to the extent
actually received, supplemental payments for Medi-Cal services,
and Medi-Cal disproportionate share hospital payments for the
state fiscal year, but shall exclude Medi-Cal revenues paid or
payable for nursing facility, mental health, and substance use
disorder services. Medi-Cal revenues do not include the nonfederal
share provided by county public hospital health systems as certified
public expenditures. Medi-Cal revenues shall be reduced by all of
the following:

(1) Intergovernmental transfers by the county public hospital
health system or its affiliated governmental entities that are for the
nonfederal share of Medi-Cal payments to the county public
hospital health system, or Medi-Cal payments to a Medi-Cal
managed care plan for services rendered by the county public
hospital health system for the fiscal year.

(2) Related fees imposed by the state on the transfers specified
in paragraph (1).

(3) Administrative or other fees, payments, or transfers imposed
by the state, or voluntarily provided by the county public hospital
health systems or affiliated governmental entities, relating to
payments or other Medi-Cal program functions for the fiscal year.

(s) “Newly eligible beneficiaries” means individuals who meet
the eligibility requirements in Section 1902(a)(10)(A)(i)(VIII) of
Title XIX of the federal Social Security Act (42 U.S.C. Sec.
1396a(a)(10)(A)(i)(VIII)), and who meet the conditions described
in Section 1905(y) of the federal Social Security Act (42 U.S.C.
Sec. 1396d(y)) such that expenditures for services provided to the
individual are eligible for the enhanced federal medical assistance
percentage described in that section.

(t) “Other entity intergovernmental transfer amount” means the
amount of intergovernmental transfers by a county public hospital
health system or affiliated governmental entities, and accepted by
the department, that are for the nonfederal share of Medi-Cal
payments or Medicaid demonstration payments for the fiscal year
to any Medi-Cal provider other than the county public hospital
health system, or to a Medi-Cal managed care plan for services
rendered by those other providers, and any related fees imposed
by the state on those transfers.

(u) “Public hospital health system county” means a county in
which a county public hospital health system is located.

(v) “Redirected amount” means the amount to be redirected in
accordance with Section 17612.1, as calculated pursuant to
subdivision (a) of Section 17612.3.

(w) “Special local health funds” means the amount of the
following county funds received by the county public hospital
health system for health services during the fiscal year:

(1) Assessments and fees restricted for health-related purposes.
The amount of the assessment or fee for this purpose shall be the
greater of subparagraph (A) or (B). If, because of restrictions and
limitations applicable to the assessment or fee, the county public
hospital health system cannot expend this amount, this amount
shall be reduced to the amount actually expended.

(A) The amount of the assessment or fee expended by the county
public hospital health system for the provision of health services
to Medi-Cal and uninsured beneficiaries during the fiscal year.

(B) The amount of the assessment or fee multiplied by the
average of the percentages of the amount of assessment or fees
that were allocated to and expended by the county public hospital
health system for health services to Medi-Cal and uninsured
beneficiaries during the historical fiscal years. The percentages
for the historical fiscal years shall be determined by dividing the
amount allocated in each fiscal year as described in subparagraphs
(B) and (C) of paragraph (2) of subdivision (ab) by the actual
amount of assessment or fee expended in the fiscal year.

(2) Funds available pursuant to the Master Settlement Agreement
and related documents entered into on November 23, 1998, by the
state and leading United States tobacco product manufacturers
during a fiscal year. The amount of the tobacco settlement funds
that may be used for this purpose shall be the greater of
subparagraph (A) or (B), less any bond payments and other costs
of securitization begin insert related to the funds described in this paragraph end insert .

(A) The amount of the funds expended by the county public
hospital health system for the provision of health services to
Medi-Cal and uninsured beneficiaries during the fiscal year.

(B) The amount of the tobacco settlement funds multiplied by
the average of the percentages of the amount of tobacco settlement
funds that were allocated to and expended by the county public
hospital health system for health services to Medi-Cal and
uninsured beneficiaries during the historical fiscal years. The
percentages for the historical fiscal years shall be determined by
dividing the amount allocated in each fiscal year as described in
begin delete subparagraph end delete begin insert subparagraphs (B) and end insert (C) of paragraph (2) of
subdivision (ab) by the actual amount of tobacco settlement funds
expended in the fiscal year.

(x) “Subsequent demonstration project” means the federally
approved Medicaid demonstration project implemented after the
termination of the federal Medicaid demonstration project
authorized under Section 1115 of the federal Social Security Act
entitled the “Bridge to Health Care Reform” (waiver number
11-W-00193/9), the extension of that demonstration project, or
the material amendment to that demonstration project.

(y) “Uninsured costs” means the costs incurred by the public
hospital health system county and its affiliated government entities
for purchasing, providing, or ensuring the availability of services
to uninsured patients during the fiscal year. Uninsured costs shall
be determined in a manner consistent with the cost-claiming
protocols developed for the federal Medicaid demonstration project
authorized under Section 1115 of the federal Social Security Act
entitled the “Bridge to Health Care Reform” (waiver number
11-W-00193/9), including protocols pending federal approval, and
under Section 14166.8, and, in consultation with each county, shall
be based on any other cost reporting and statistical data necessary
for an accurate determination of actual costs incurred. For this
purpose, no reduction factor applicable to otherwise allowable
costs under the demonstration project or the subsequent
demonstration project shall apply. Uninsured costs shall exclude
costs for nursing facility, mental health, and substance use disorder
services.

(z) “Uninsured patients” means individuals who have no source
of third-party coverage for the specific service furnished, as further
defined in the reporting requirements established pursuant to
Section 17612.4.

(aa) “Uninsured revenues” means self-pay payments made by
or on behalf of uninsured patients to the county public hospital
health system for the services rendered in the fiscal year, but shall
exclude revenues received for nursing facility, mental health, and
substance use disorder services. Uninsured revenues do not include
the health realignment amount or imputed county low-income
health amount and shall not include any other revenues, grants, or
funds otherwise defined in this section.

(ab) “Historical allocation” means the allocation for the amounts
in the historical years described in subdivisions (l), (m), and (w)
for health services to Medi-Cal beneficiaries and uninsured
patients. The allocation of those amounts in the historical years
shall be done in accordance with a process to be developed by the
department, in consultation with the counties, which includes the
following required parameters:

(1) For each of the historical fiscal years, the Medi-Cal costs,
uninsured costs, and costs of other entity intergovernmental transfer
amounts, as defined in subdivisions (q), (t), and (y), and the
Medicaid demonstration, Medi-Cal and uninsured begin delete revenues end delete
begin insert revenues, and end insert begin insert hospital fee direct grants end insert with respect to the services
as defined in subdivisions begin insert (k), end insert (o), (r), and (aa), shall be determined.
For these purposes, Medicaid demonstration revenues shall include
applicable payments as described in subdivision (o) paid or payable
to the county public hospital health system under the prior
demonstration project defined in subdivision (c) of Section
14166.1, under the Low Income Health Program (Part 3.6
(commencing with Section 15909)), and under the Health Care
Coverage Initiative (Part 3.5 (commencing with Section 15900)),
none of which shall include the nonfederal share of the Medicaid
demonstration payments. The revenues shall be subtracted from
the costs, yielding the initial low-income shortfall for each of the
historical fiscal years.

begin delete

(2) The following amounts shall be allocated, but shall not
exceed, the initial low-income shortfall determined in paragraph
(1) for each year:

end delete begin insert

(2) The following shall be applied in sequential order against,
but shall not exceed in the aggregate, the initial low-income
shortfall determined in paragraph (1) for each of the historical
fiscal years:

end insert

(A) First, the county indigent care health realignment amount
shall be applied 100 percent against the initial low-income shortfall.

(B) Second, special local health funds specifically restricted for
indigent care shall be applied 100 percent against the initial
low-income shortfall.

begin delete

(C) Third, all other sources of funding, excluding funds for
nursing facility, mental health, and substance use disorder services
and gains from other payers, shall be allocated in a fair and
reasonable manner to determine the proportion applied to, and not
to exceed, the initial low-income shortfall. Other sources of funding
shall include any of the following:

(i) Unrestricted special local health funds.

(ii) One-time funds received by the county public hospital health
system for health services for that year or prior period
carry-forward amounts, or carry-forward amounts.

(iii) County general purpose funds described in subdivision (l).

end delete begin insert

(C) Third, the sum of clauses (iv), (v), and (vi). Clause (iv) is
the special local health funds, as defined in subdivision (w) and
not otherwise identified as restricted special local health funds
under subparagraph (B), clause (v) is the imputed county
low-income health amount defined in subdivision (l), and clause
(vi) is the one-time and carry-forward revenues as defined in
subdivision (aj), all allocated to the historical low-income shortfall.
These amounts shall be calculated as follows:

end insert begin insert

(i) Determine the sum of the special local health funds, as
defined in subdivision (w) and not otherwise identified as restricted
special local health funds under subparagraph (B), the imputed
county low-income health amount defined in subdivision (l), and
one-time and carry-forward revenues as defined in subdivision
(aj).

end insert begin insert

(ii) Divide the historical total shortfall defined in subdivision
(ah) by the sum in clause (i) to get the historical usage of funds
percentage defined in subdivision (ai). If this calculation produces
a percentage above 100 percent in a given historical fiscal year,
then the historical usage of funds percentage in that historical
fiscal year shall be deemed to be 100 percent.

end insert begin insert

(iii) Multiply the historical usage of funds percentage defined
in subdivision (ai) and calculated in clause (ii) by each of the
following funds:

end insert begin insert

(I) Special local health funds, as defined in subdivision (w) and
not otherwise identified as restricted special local health funds
under subparagraph (B).

end insert begin insert

(II) The imputed county low-income health amount defined in
subdivision (l).

end insert begin insert

(III) One-time and carry-forward revenues as defined in
subdivision (aj).

end insert begin insert

(iv) Multiply the product of subclause (I) of clause (iii) by the
historical low-income shortfall percentage defined in subdivision
(af) to determine the amount of special local health funds, as
defined in subdivision (w) and not otherwise identified as restricted
special local health funds under subparagraph (B), allocated to
the historical low-income shortfall.

end insert begin insert

(v) Multiply the product of subclause (II) of clause (iii) by the
historical low-income shortfall percentage defined in subdivision
(af) to determine the amount of the imputed county low-income
health amount defined in subdivision (l) allocated to the historical
low-income shortfall.

end insert begin insert

(vi) Multiply the product of subclause (III) of clause (iii) by the
historical low-income shortfall percentage defined in subdivision
(af) to determine the amount of one-time and carry-forward
revenues as defined in subdivision (aj) allocated to the historical
low-income shortfall.

end insert

(D) Finally, to the extent that the process above does not result
in completely allocating revenues up to the amount necessary to
address the initial low-income shortfall in the historical years,
gains from other payers shall be allocated to fund those costs only
to the extent that such other payer gains exist.

(ac) “Gains from other payers” means the county-specific
amount of revenues in excess of costs generated from all other
payers for health services. For purposes of this subdivision, patients
with other payer coverage are patients who are identified in all
other financial classes, including, but not limited to, commercial
coverage and dual eligible, other than begin insert allowable costs and
associated revenues for end insert Medi-Cal and begin insert the end insert uninsured.

(ad) “New mandatory other entity intergovernmental transfer
amounts” means other entity intergovernmental transfer amounts
required by the state after July 1, 2013.

begin insert

(ae) “Historical low-income shortfall” means, for each of the
historical fiscal years described in subdivision (j), the initial
low-income shortfall for Medi-Cal and uninsured costs determined
in paragraph (1) of subdivision (ab), less amounts identified in
subparagraphs (A) and (B) of paragraph (2) of subdivision (ab).

end insert begin insert

(af) “Historical low-income shortfall percentage” means, for
each of the historical fiscal years described in subdivision (j), the
historical low-income shortfall described in subdivision (ae)
divided by the historical total shortfall described in subdivision
(ah).

end insert begin insert

(ag) “Historical other shortfall” means, for each of the
historical fiscal years described in subdivision (j), the shortfall
for all other types of costs incurred by the public hospital health
system that are not Medi-Cal or uninsured costs, and is determined
as total costs less total revenues, excluding any costs and revenue
amounts used in the calculation of the historical low-income
shortfall, and also excluding those costs and revenues related to
mental health and substance use disorder services. If the amount
of historical other shortfall in a given historical fiscal year is less
than zero, then the historical other shortfall for that historical
fiscal year shall be deemed to be zero.

end insert begin insert

(ah) “Historical total shortfall” means, for each of the historical
fiscal years described in subdivision (j), the sum of the historical
low-income shortfall described in subdivision (ae) and the
historical other shortfall described in subdivision (ag).

end insert begin insert

(ai) “Historical usage of funds percentage” means, for each of
the historical fiscal years described in subdivision (j), the historical
total shortfall described in subdivision (ah) divided by the sum of
special local health funds as defined in subdivision (w) and not
otherwise identified as restricted special local health funds under
subparagraph (B) of paragraph (2) of subdivision (ab), the imputed
county low-income health amount defined in subdivision (l), and
one-time and carry-forward revenues as defined in subdivision
(aj). If this calculation produces a percentage above 100 percent
in a given historical fiscal year, then the historical usage of funds
percentage in that historical fiscal year shall be deemed to be 100
percent.

end insert begin insert

(aj) “One-time and carry-forward revenues” mean, for each of
the historical fiscal years described in subdivision (j), revenues
and funds that are not attributable to services provided or
obligations in the applicable historical fiscal year, but were
available and utilized during the applicable historical fiscal year
by the public hospital health system.

end insert

begin insert

begin insert SEC. 18. end insert   

end insert

begin insert Section 17612.21 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is repealed. end insert

begin delete

17612.21.  

For the purposes of determining the fair and
reasonable manner of allocation described in subparagraph (C) of
paragraph (2) of subdivision (ab) of Section 17612.2, it is the intent
of the Legislature to codify an allocation methodology by
September 13, 2013. Prior to that codification, the following steps
shall occur:

(a) The department shall meet with representatives of the county
public hospital health systems to formulate the fair and reasonable
allocation methodology.

(b) No later than August 1, 2013, the department shall submit
to the Legislature a proposed allocation methodology. If the county
public hospital health systems and the department fail to agree on
a proposed allocation methodology, the department shall also be
required to submit an alternative approach from the county public
hospital health systems, which the county public hospital health
systems shall submit to the department prior to July 30, 2013, and
the department’s analysis of why it chose its recommended
approach.

(c) If the Legislature enacts legislation implementing the
allocation methodology described in subparagraph (C) of paragraph
(2) of subdivision (ab) of Section 17612.2 by July 1, 2014, then
notwithstanding Chapter 3.5 (commencing with Section 11340)
of Part 1 of Division 3 of Title 2 of the Government Code, the
department, without taking any further regulatory action, may
implement, interpret, or make specific this section by means of
all-county letters, plan letters, plan or provider bulletins, or similar
instructions.

(d) If the Legislature does not enact legislation implementing
the allocation methodology described in subparagraph (C) of
paragraph (2) of subdivision (ab) of Section 17612.2 by July 1,
2014, the department may implement the allocation methodology
described in subparagraph (C) of paragraph (2) of subdivision (ab)
of Section 17612.2 only by means that are in conformity with
Chapter 3.5 (commencing with Section 11340) of Part 1 of Division
3 of Title 2 of the Government Code.

end delete

begin insert

begin insert SEC. 19. end insert   

end insert

begin insert Section 17612.3 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

17612.3.  

(a) For each fiscal year, commencing with the
2013-14 fiscal year, the amount to be redirected in accordance
with Section 17612.1 shall be determined for each public hospital
health system county as follows:

(1) The public hospital health system county’s revenues and
other funds paid or payable for the state fiscal year shall be
comprised of the total of the following:

(A) Medi-Cal revenues.

(B) Uninsured revenues.

(C) Medicaid demonstration revenues.

(D) Hospital fee direct grants.

(E) Special local health funds.

(F) The county indigent care health realignment amount.

(G) The imputed county low-income health amount.

(H) Imputed gains from other payers.

(I) The amount by which the public hospital health system
county’s costs exceeded the cost containment limit for the fiscal
year, expressed as a negative number, multiplied by 0.50.

(2) The following, incurred by the public hospital health system
county for the fiscal year, not to exceed in total the cost
containment limit, shall be subtracted from the sum in paragraph
(1):

(A) Medi-Cal costs.

(B) Uninsured costs.

(C) The lesser of the other entity intergovernmental transfer
amount or the imputed other entity intergovernmental transfer
amounts.

(D) New mandatory other entity intergovernmental transfer
amounts.

(3) The resulting amount determined in paragraph (2) shall be
multiplied by 0.80, except that for the 2013-14 fiscal year the
resulting amount determined in paragraph (2) shall be multiplied
by 0.70.

(4) If the amount in paragraph (3) is a positive number, that
amount, subject to paragraph (5), shall be redirected in accordance
with Section begin delete 17612.1 end delete begin insert 17612.1, except that for the 2013 end insert begin insert -14 fiscal
year the amount to be redirected shall not exceed the amount
determined for the county for the 2013-14 fiscal year under
subdivision (c) of Section 17603, as that amount may have been
reduced by the application of Section 17610.5 end insert . If the amount
determined in paragraph (3) is a negative number, the redirected
amount shall be zero.

(5) Notwithstanding any other law, the amount to be redirected
as determined in paragraph (4) for any fiscal year shall not exceed
the county indigent care health realignment amount for that fiscal
year.

(6) (A) The redirected amount shall be applied until the later
of the following:

(i) June 30, 2023.

(ii) The beginning of the fiscal year following a period of two
consecutive fiscal years in which both of the following occur:

(aa) The total interim amount determined under subdivision (b)
of Section 17612.3 in May of the previous fiscal year is within 10
percent of the final, reconciled amount in subdivision (d) of that
section.

(bb) The final, reconciled amounts under subdivision (d) of
Section 17612.3 are within 5 percent of each other.

(B) After the redirected amount ceases as provided in
subparagraph (A), a permanent redirected amount shall be
established to be an amount determined by calculating the
percentage that the redirected amount was in the last fiscal year
of the operation of this article of the county’s health realignment
amount of that same fiscal year, multiplied by the county’s health
realignment amount of all subsequent years.

(b) Commencing with the 2014-15 fiscal year, the department
shall calculate an interim redirected amount for each public hospital
health system county under subdivision (a) by the January
immediately prior to the starting fiscal year, using the most recent
and accurate data available. For purposes of the interim
determinations, the cost containment limit shall not be applied.
The interim redirected amount shall be updated in the May before
the start of the fiscal year in consultation with each public hospital
health system county and based on any more recent and accurate
data available at that time. During the fiscal year, the interim
redirected amount will be applied pursuant to Section 17612.1.

(c) The predetermined amounts or historical percentages
described in subdivisions (i), (l), (m), (n), and (w) of Section
17612.2 shall each be established in accordance with the following
procedure:

(1) By begin delete September 30, end delete begin insert October 31, end insert 2013, each public hospital
health system county shall determine the amount or percentage
described in the applicable subdivision, and shall provide this
calculation to the department, supported by verifiable data and a
description of how the determination was made.

(2) If the department disagrees with the public hospital health
system county’s determination, the department shall confer with
the public hospital health system county by begin delete November end delete begin insert December end insert
15, 2013 begin insert , and shall issue its determination by January 31, 2014 end insert .

(3) If no agreement between the parties has been reached by
begin delete December end delete begin insert January end insert 31, begin delete 2013, end delete begin insert 2014, end insert the department shall apply the
county’s determination when making the interim calculations
pursuant to subdivision (b), until a decision is issued pursuant to
paragraph (6).

(4)  begin delete A end delete begin insert If no agreement between the parties has been reached by
January 31, 2014, the end insert public hospital health system county begin delete may end delete
begin insert shall end insert submit a petition begin insert by February 28, 2014, end insert to the County Health
Care Funding Resolution Committee, established pursuant to
Section 17600.60, to seek a decision regarding the historical
percentage or amount to be applied in calculations under this
section.

(5) The County Health Care Funding Resolution Committee
shall hear and make a determination as to whether the county’s
proposed percentage or amount complies with the requirements
of this section taking into account the data and calculations of the
county and any alternative data and calculations submitted by the
department.

(6) The committee shall issue begin delete a decision end delete begin insert its final determination end insert
within 45 days of the petition. If the county chooses to contest the
begin insert final end insert determination, the begin delete decision end delete begin insert final determination end insert of the
committee will be applied for purposes of any interim calculation
under subdivision (b) until a final decision is issued pursuant to
de novo administrative review pursuant to paragraph (2) of
subdivision (d).

(d) (1) The data for the final calculations under subdivision (a)
for the fiscal year shall be submitted by public hospital health
system counties within 12 months after the conclusion of each
fiscal year as required in begin delete section end delete begin insert Section end insert 17612.4. The data shall
be the most recent and accurate data from the public hospital health
system county’s books and records pertaining to the revenues paid
or payable, and the costs incurred, for services provided in the
subject fiscal year. begin delete The end delete begin insert After consulting with the county, the end insert
department shall make final calculations using the data submitted
pursuant to this paragraph by December begin delete 31 end delete begin insert 15 end insert of the following
fiscal year, and shall provide begin delete the calculation end delete begin insert its final determination end insert
to the county. The final begin delete calculations end delete begin insert determination end insert will also reflect
the application of the cost containment limit, if any. begin delete A end delete begin insert If the county
and the department agree, a revised end insert recalculation and
reconciliation begin delete shall end delete begin insert may end insert be completed by the department within
six months thereafter.

(2) The director shall establish an expedited formal appeal
process for a public hospital health system county to contest begin delete the end delete
begin insert final end insert determinations made begin delete in this article, and only as follows: end delete begin insert under
this article. No appeal shall be available for interim determinations
made under subdivision (b). The appeals process shall include all
of the following: end insert

(A) The public hospital health system county shall have 30
calendar days, following the issuance of a begin insert final end insert determination made
under begin delete this article, end delete begin insert paragraph (6) of subdivision (c) or paragraph
(1) of this subdivision, end insert to file an appeal with the Director of Health
Care Services. All appeals shall be governed by Section 100171
of the Health and Safety Code, except for those provisions of
paragraph (1) of subdivision (d) of Section 100171 of the Health
and Safety Code relating to accusations, statements of issues,
statement to respondent, and notice of defense, and except as
otherwise set forth in this section. All appeals shall be in writing
and shall be filed with the State Department of Health Care
Service’s Office of Administrative Hearings and Appeals. An
appeal shall be deemed filed on the date it is received by the Office
of Administrative Hearings and Appeals.

(i) An appeal shall specifically set forth each issue in dispute,
which may include any component of the determination, and
include the public hospital health system county’s contentions as
to those issues. A formal hearing before an Office of
Administrative Hearings and Appeals Administrative Law Judge
shall commence within begin delete 45 end delete begin insert 60 end insert days of the filing of the appeal
requesting a formal hearing. A final decision begin insert under this paragraph end insert
shall be adopted begin delete within 60 days of the close of the record, but end delete no
later than begin delete five end delete begin insert six end insert months following the begin delete issuance end delete begin insert filing end insert of the
appeal.

(ii) If the public hospital health system county fails to file an
appeal within 30 days of the issuance of a determination made
under this begin delete article end delete begin insert section end insert , the determination of the department shall
be deemed final and not appealable either administratively or to a
court of general begin delete jurisdiction end delete begin insert jurisdiction, except that a county may
elect to appeal a determination under subdivision (c) within 30
days of the issuance of the County Health Care Funding Resolution
Committee’s final determination under paragraph (6) of
subdivision (c) or as a component of an appeal of the department’s
final determination under paragraph (1) of this subdivision for
the 2013 end insert begin insert -14 fiscal year end insert .

(B) If a final decision begin insert under this paragraph end insert is not issued by the
department within two years of the begin delete issuance of a determination
made under this article, end delete begin insert last day of the subject fiscal year, end insert the
public hospital health system county shall be deemed to have
exhausted its administrative remedies and shall not be precluded
from pursuing any available judicial review. However, the time
period in this subdivision shall be extended by either of the
following:

(i) Undue delay caused by the public hospital health system
county.

(ii) An extension of time granted to a public hospital health
system county at its sole request, or following the joint request of
the public hospital health system county and the department.

begin delete

(D)

end delete

begin insert (C) end insert  If the final decision issued by the department pursuant to
this begin delete section end delete begin insert paragraph end insert results in a different determination than
that originally determined by the department, then the Department
of Finance shall adjust the original determination by that amount,
pursuant to a process developed by the Department of Finance and
in consultation with the public hospital health system counties.

(e) For purposes of this article, all references to “health services”
or “health care services,” unless specified otherwise, shall exclude
nursing facility, mental health, and substance use disorder services.

begin insert

begin insert SEC. 20. end insert   

end insert

begin insert Section 17612.5 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

17612.5.  

(a) For the 2013-14 fiscal year and each year
thereafter, the amount to be redirected in accordance with Section
17612.1 for the County of Los Angeles shall be determined in
accordance with Section 17612.3, except that the formula in
subdivision (a) of Section 17612.3 shall be replaced with the
following formula:

(1) The total revenues as defined in paragraph (7) of subdivision
(b) paid or payable to the County of Los Angeles, Department of
Health Services, for the fiscal year, which shall include special
local health funds and as adjusted in accordance with Section
17612.6, shall be added together.

(2) The sum of three hundred twenty-three million dollars
($323,000,000), which represents the imputed county low-income
health amount trended annually by 1 percent from the 2012-13
fiscal year through the applicable fiscal year, and the county
indigent care health realignment amount, as determined in
accordance with subdivision (e) of begin delete section end delete begin insert Section end insert 17612.2 for the
fiscal year.

(3) The amount by which the county’s total costs exceeded the
cost containment limit for the fiscal year, expressed as a negative
number, multiplied by 0.50.

(4) (A) The total costs as defined in paragraph (6) of subdivision
(b) incurred by or on behalf of the County of Los Angeles,
Department of Health Services, begin delete during end delete begin insert for end insert the fiscal year shall be
added together, but shall not exceed the cost containment limit
determined in accordance with paragraph (3) of subdivision (b).

(B) The costs in paragraph (A) shall be subtracted from the sum
of paragraphs (1) to (3), inclusive.

(5) The resulting amount determined in subparagraph (B) of
paragraph (4) shall be multiplied by 0.80, except that for the
2013-14 fiscal year, the resulting amount determined in
subparagraph (B) of paragraph (4) shall be multiplied by 0.70.

(6) If the amount in paragraph (5) is a positive number, that
amount, subject to paragraph (7), shall be redirected in accordance
with Section 17612.1 of this article begin insert , except that for the 2013-14
fiscal year the amount to be redirected shall not exceed the amount
determined for the County of Los Angeles for the 2013-14 fiscal
year under subdivision (c) of Section 17603, as that amount may
have been reduced by the application of Section 17610.5 end insert . If the
amount determined in paragraph (5) is a negative number, the
redirected amount shall be zero.

(7) Notwithstanding any other provision of law, the amount to
be redirected as determined in paragraph (6) for any fiscal year
shall not exceed the county indigent care health realignment
amount for that fiscal year.

(8) (A) The redirected amount shall be applied until the later
of:

(i) June 30, 2023.

(ii) The beginning of fiscal year following a period of two
consecutive fiscal years that both of the following occur:

(aa) The total interim amount determined under subdivision (b)
of Section 17612.3 in May of the previous fiscal year is within 10
percent of the final, reconciled amount in subdivision (d) of that
section.

(bb) The final, reconciled amounts under subdivision (d) of
Section 17612.3 are within 5 percent of each other.

(B) After the redirected amount ceases as provided in
subparagraph (A), a permanent redirected amount shall be
established to be an amount determined by calculating the
percentage that the redirected amount was in the last fiscal year
of the operation of this article of the county’s health realignment
amount of that same fiscal year, multiplied by the county’s health
realignment amount of all subsequent years.

(b) Except as otherwise provided in this section, the definitions
in Section 17612.2 shall apply. For purposes of this section, and
for purposes the calculations in Section 17612.3 that apply to the
County of Los Angeles, the following definitions shall apply:

(1) “Adjusted patient day” means LA County DHS’s total
number of patient days multiplied by the following fraction: the
numerator that is the sum of the county public hospital health
system’s total gross revenue for all services provided to all patients,
including nonhospital services, and the denominator that is the
sum of the county public hospital health system’s gross inpatient
revenue. The adjusted patient days shall pertain to those services
that are provided by the LA County DHS, and shall exclude
services that are provided by contract or out-of-network clinics or
hospitals. For purposes of this paragraph, gross revenue shall be
adjusted as necessary to reflect the relationship between inpatient
costs and begin delete revenues end delete begin insert charges end insert and outpatient costs and charges.

(2) “Blended CPI trend factor” means the blended percent
change applicable for the state fiscal year that is derived from the
nonseasonally adjusted Consumer Price Index for All Urban
Consumers (CPI-U), United States City Average, for Hospital and
Related Services, weighted at 90 percent, and for Medical Care
Services, weighted at 10 percent, all as published by the United
States Bureau of Labor Statistics, computed as follows:

(A) For each prior fiscal year, within the period to be trended
through the fiscal year, the annual average of the monthly index
amounts shall be determined separately for the Hospital and
Related Services Index and the Medical Care Services Index.

(B) The year-to-year percentage changes in the annual averages
determined in subparagraph (A) for each of the Hospital and
Related Services Index and the Medical Care Services Index shall
be determined.

(C) A weighted average annual percentage change for each
year-to-year period shall be calculated from the determinations
made in subparagraph (B), with the percentage changes in the
Hospital and Related Services Index weighted at 90 percent, and
the percentage changes in the Medical Care Services Index
weighted at 10 percent. The resulting average annual percentage
changes shall be expressed as a fraction, and increased by 1.00.

(D) The product of the successive year to year amounts
determined in subparagraph (C) shall be the blended CPI trend
factor.

(3) “Cost containment limit” means the LA County DHS’s total
costs determined for the 2014-15 fiscal year and each subsequent
fiscal year adjusted as follows:

(A) The County of Los Angeles will be deemed to comply with
the cost containment limit if the county demonstrates that its total
costs for the fiscal year did not exceed its total costs in the base
year, multiplied by the blended CPI trend factor for the fiscal year
as reflected in the annual report of financial transactions required
to be submitted to the Controller pursuant to Section 53891 of the
Government Code. If the total costs for the fiscal year exceeded
the total cost in the base year, multiplied by the blended CPI trend
factor for the fiscal year, the calculation in subparagraph (B) shall
be performed.

(B) (i) If the number of adjusted patient days of service provided
by LA County DHS for the fiscal year exceeds its number of
adjusted patient days of service rendered in the base year by at
least 10 percent, the excess adjusted patient days above the base
year for the fiscal year shall be multiplied by the cost per adjusted
patient day of the public hospital health system for the base year.
The result shall be added to the trended base year amount
determined in subparagraph (A), yielding the applicable cost
containment limit, subject to subparagraph (C). Costs per adjusted
patient day shall be based upon only those LA County DHS costs
incurred for patient care services.

(ii) If the number of adjusted patient days of service provided
by LA County DHS for the fiscal year does not exceed its number
of adjusted patient days of service rendered in the base begin delete year, end delete begin insert year
by at least 10 percent, end insert the applicable limit is the trended base year
amount determined in subparagraph (A) subject to subparagraph
(C).

(C) If LA County DHS’s total costs for the fiscal year in as
determined in subparagraph (A) exceeds the trended cost as
determined in subparagraph (A) as adjusted by subparagraph (B),
the following cost increases shall be added to and reflected in any
cost containment limit:

(i) Electronic health records and related implementation and
infrastructure costs.

(ii) Costs related to state or federally mandated activities,
requirements, or benefit changes.

(iii) Costs resulting from a court order or settlement.

(iv) Costs incurred in response to seismic concerns, including
costs necessary to meet facility seismic standards.

(v) Costs incurred as a result of a natural disaster or act of
terrorism.

(vi) The total amount of any intergovernmental transfer for the
nonfederal share of Medi-Cal payments to the hospital facility
described in subdivision (f) of Section 14165.50.

(D) If LA County DHS’s total begin delete costs, end delete begin insert costs for the fiscal year
exceed the trended costs end insert as adjusted by subparagraphs (B) and
(C), begin delete exceed total costs for the fiscal year, end delete the county may request
that the department consider other costs as adjustments to the cost
containment limit, including, but not limited to, transfer amounts
in excess of the imputed other entity intergovernmental transfer
amount trended by the blended CPI trend factor, costs related to
case mix index increases, pension costs, expanded medical
education programs, increased costs in response to delivery system
changes in the local community, and system expansions, including
capital expenditures necessary to ensure access to and the quality
of health care. Costs approved by the department shall be added
to and reflected in the cost containment limit.

(4) “Health realignment indigent care percentage” means 83
percent.

(5) “Special local health funds” means begin delete the total amount of the
following funds received by LA County DHS and expended for
health services during the fiscal year: end delete begin insert both of the following: end insert

(A)  begin delete Assessments end delete begin insert The total amount of assessments end insert begin insert end insert and fees
restricted for health-related purposes begin insert that are received by LA
County DHS and expended for health services during the fiscal
year end insert .

(B) Ninety-one percent of the funds begin delete available end delete begin insert actually received
by the County o end insert f begin insert Los Angeles during the fiscal year end insert pursuant to
the Master Settlement Agreement and related documents entered
into on November 23, 1998, by the state and leading United States
tobacco product begin delete manufacturers and allocated to LA County DHS
during a fiscal year end delete begin insert manufacturers, less any bond payments and
other costs of securitization related to the funds described in this
paragraph end insert .

(6) “Total costs” means the actual net expenditures, excluding
encumbrances, for all operating budget units of the LA County
DHS. Operating budget units consist of four Hospital Enterprise
Funds plus the LA County DHS’s budget units within the county
general fund. Net expenditures, excluding encumbrances, are those
recognized within LA County DHS, net of intrafund transfers,
expenditure distributions, and all other billable services recorded
from and to the LA County DHS enterprise funds and the LA
County DHS general fund budget units, determined based on its
central accounting system known as eCAPS, as of November 30
of the year following the fiscal year, and shall include the new
mandatory other entity intergovernmental transfer amounts, as
defined in subdivision (ad) of Section 17612.2, and the lesser of
other entity intergovernmental transfer amounts or the imputed
other entity intergovernmental transfer amounts.

(7) “Total revenues” means the sum of the revenue paid or
payable for all operating budget units of the LA County DHS
determined based on its central accounting system known as
eCAPS, as of November 30 of the year following the fiscal year.

(8) “LA County DHS” means operating budget units consisting
of four hospital enterprise funds plus the DHS budget units within
the county’s general fund.

begin insert

begin insert SEC. 21. end insert   

end insert

begin insert Section 17612.6 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

17612.6.  

(a) For purposes of this section, the following
definitions shall apply:

(1) “Type A payers” means the following sources of revenue
for amounts paid to the County of Los Angeles, Department of
Health Services:

(A) Title XVIII of the federal Social Security Act, known as
the Medicare program.

(B) Commercial health insurance.

(C)  begin delete In-home end delete begin insert Health care coverage for providers of in-home end insert
supportive services, consistent with Article 7 (commencing with
Section 12300) of Chapter 3 and Chapter 7 (commencing with
Section 14000) of Part 3 begin insert of Division 9 end insert .

(2) “Type B payers” means the following sources of revenue
for amounts paid to the County of Los Angeles, Department of
Health Services:

(A) Patient care revenues received for services provided to other
county departments.

(B) State payments for patient financial services workers.

(C) Other federal payers, not including begin delete Medicare and Medicaid end delete
begin insert federal grants, Medicare, Medicaid, and payments pursuant to
Section 1011 of the federal Medicare Prescription Drug,
Improvement, and Modernization Act of 2003 (Public Law
108-173) end insert .

(3) “Historical Base Type A revenues” means revenues from
Type A payers in the historical fiscal years, calculated as follows:

(A) For each historical fiscal year, the actual revenue received
from Type A payers.

(B) Calculate the average of the historical year’s amounts in
subparagraph (A). This average shall be considered the historical
Base Type A revenues.

(4) “Historical Base Type B revenues” means revenues from
Type B payers in the historical fiscal years, calculated as follows:

(A) For each historical fiscal year, the actual revenue received
from Type B payers.

(B) Calculate the average of the historical years amounts in
subparagraph (A). This average shall be considered the historical
Base Type B revenues.

(5) “Type A payer revenue” means the amount of revenue that
is the greater of the following:

(A) The amount of the revenue received from Type A payers
for services rendered during the fiscal year.

(B) The historical Base Type A revenues, as adjusted by the
Type A adjustment, defined in paragraph (8).

(6) “Type B payer revenue” means the amount of revenue that
is the greater of the following:

(A) The amount of the revenue received from Type B payers
for services rendered during the fiscal year.

(B) The historical Base Type B revenues.

(7) “Baseline Type A payer costs” means the average of the
costs of services provided to Type A payer patients rendered in
each of the four historical fiscal years to be determined as follows:

(A) For each historical year, the actual costs incurred in
providing services to Type A payer patients.

(B) Calculate the average of the historical fiscal year amounts
in subparagraph (A), this average shall be considered the baseline
Type A payer costs.

(8) “Type A adjustment” means the value of the revenue
adjustment to historical base Type A revenues as defined in
paragraph (3).

(A) This adjustment will occur only if the Type A payer revenue
for the fiscal year is less than historical base, otherwise the
adjustment is considered to be zero.

(B) If the requirement in subparagraph (A) is met, then there
will only be an adjustment if one or more of the specified Type A
payers’ data meets all of the following conditions:

(i) The Type A payer revenue for the fiscal year is less than the
historical base.

(ii) The Type A payer costs for the fiscal year are less than the
historical base trended by the blended CPI trend factor.

(iii) The Type A payer volume for the fiscal year is less than
the historical base.

(C) For each Type A payer that meets all the conditions in
subparagraph (B) the adjustment to the Type A payer revenue for
that Type A payer will be as follows:

(i) Calculate the percentage decrease in cost from the baseline
Type A payer cost as trended by the blended CPI trend factor as
defined in begin insert paragraph (2) of end insert subdivision (b) begin insert of Section 17612.5 end insert and
applied from the 2010-11 fiscal year to the subject fiscal year.

(ii) Calculate the percentage decrease in volume, based on the
adjusted patient days, from the baseline Type A payer volume to
the subject fiscal year.

(iii) Calculate the average of the percentages in clauses (i) and
(ii).

(iv) The percentage begin insert reduction end insert in clause begin delete (ii) end delete begin insert (iii) end insert shall be applied
to the historical Base Type A payer revenue for the individual
Type A payer.

(b) The Type A payer revenues included in the total revenues
in subdivision (a) of Section 17612.5 shall be the greater of the
adjusted historical Type A baseline or the actual revenues received
from Type A payers for services rendered in the subject fiscal year.

(c) The Type B payer revenues included in the total revenues
in subdivision (a) of Section 17612.5 shall be the greater of the
historical Base Type B revenues or the actual revenues received
from Type B payers for services rendered in the subject fiscal year.

begin insert

begin insert SEC. 22. end insert   

end insert

begin insert Section 17613.1 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

17613.1.  

(a) For the 2013-14 fiscal year and each fiscal year
thereafter, for each county, the total amount that would be payable
for the fiscal year from 1991 Health Realignment funds under
Sections 17603, 17604, begin delete 17606.10, end delete and 17606.20, as those sections
read on January 1, 2012, begin insert and Section 17606.10, as it read on July
1, 2013, end insert and deposited by the Controller into the local health and
welfare trust fund health account of the county in the absence of
this section, shall be determined begin delete pursuant to paragraph (2) of
subdivision (b) of Section 17600.50 end delete .

(b) The redirected amount determined for the county pursuant
to Section 17613.3 begin delete , or in accordance with subdivision (b) of Section
17600.50 option-to-forgo formula, end delete shall be divided by the total
determined in subdivision (a).

(c) The resulting fraction determined in subdivision (b) shall
be the percentage of 1991 Health Realignment funds under Sections
17603, 17604, begin delete 17606.10, end delete and 17606.20, as those sections read on
January 1, 2012, begin insert and Section 17606.10, as it read on July 1, 2013, end insert
to be deposited each month into the Family Support Subaccount.

(d) The total amount deposited pursuant to subdivision (c) with
respect to a county for a fiscal year shall not exceed the redirected
amount determined pursuant to Section 17613.3, and shall be
subject to the appeal processes, and judicial review as described
in subdivision (d) of Section 17613.3.

(e) The Legislature finds and declares that this article is not
intended to change the local obligation pursuant to section 17000.

begin insert

begin insert SEC. 23. end insert   

end insert

begin insert Section 17613.2 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

17613.2.  

For purposes of this article, the following definitions
shall apply:

(a) “Base year” means the fiscal year ending three years prior
to the fiscal year for which the redirected amount is calculated.

(b) “Blended CPI trend factor” means the blended percent
change applicable for the fiscal year that is derived from the
nonseasonally adjusted Consumer Price Index for All Urban
Consumers (CPI-U), United States City Average, for Hospital and
Related Services, weighted at 75 percent, and for Medical Care
Services, weighted at 25 percent, all as published by the United
States Bureau of Labor Statistics, computed as follows:

(1) For each prior fiscal year within the period to be trended
through the state fiscal year, the annual average of the monthly
index amounts shall be determined separately for the Hospital and
Related Services Index and the Medical Care Services Index.

(2) The year-to-year percentage changes in the annual averages
determined in paragraph (1) for each of the Hospital and Related
Services Index and the Medical Care Services Index shall be
determined.

(3) A weighted average annual percentage change for each
year-to-year period shall be calculated from the determinations
made in paragraph (2), with the percentage changes in the Hospital
and Related Services Index weighted at 75 percent, and the
percentage changes in the Medical Care Services Index weighted
at 25 percent. The resulting average annual percentage changes
shall be expressed as a fraction, and increased by 1.00.

(4) The product of the successive year to year amounts
determined in paragraph (3) shall be the blended CPI trend factor.

(c) “Calculated cost per person” is determined by dividing
county indigent program costs by the number of indigent program
individuals for the applicable fiscal year. If a county expands
eligibility, the enrollment count is limited to those indigent program
individuals who would have been eligible for services under the
eligibility requirements in existence on July 1, 2013, except if
approved as an exception allowed pursuant to subparagraph (3) of
paragraph (C) of subdivision (d).

(d) “Cost containment limit” means the county’s indigent
program costs determined for the 2014-15 fiscal year and each
subsequent fiscal year, to be adjusted as follows:

(1) (A) The county’s indigent program costs for the state fiscal
year shall be determined as indigent program costs for purposes
of this paragraph for the relevant fiscal period.

(B) The county’s calculated costs per person for the base year
will be multiplied by the blended CPI trend factor and then
multiplied by the county’s fiscal year indigent program individuals.
The base year costs used shall not reflect any adjustments under
this subdivision.

(C) The fiscal year amount determined in subparagraph (A)
shall be compared to the trended amount in subparagraph (B). If
the amount in subparagraph (B) exceeds the amount in
subparagraph (A), the county will be deemed to have satisfied the
cost containment limit. If the amount in subparagraph (A) exceeds
the amount in subparagraph (B), the calculation in paragraph (2)
shall be performed.

(2) If a county’s costs as determined in subparagraph (A) of
paragraph (1) exceeds the amount determined in subparagraph (B)
of paragraph (1), the following costs, as allocated to the county’s
indigent care program, shall be added to the cost and reflected in
any containment limit:

(A) Costs related to state or federally mandated activities,
requirements, or benefit changes.

(B) Costs resulting from a court order or settlement.

(C) Costs incurred as a result of a natural disaster or act of
terrorism.

(3) If a county’s costs as determined in subparagraph (A) of
paragraph (1) exceed the amount determined in subparagraph (B)
of paragraph (1), as adjusted by paragraph (2), the county may
request that the department consider other costs as adjustments to
the cost containment limit. These costs would require departmental
approval.

(e) “County” for purposes of this article means the following
counties: Fresno, Merced, Orange, Placer, Sacramento, San Diego,
San Luis Obispo, Santa Barbara, Santa Cruz, Stanislaus, Tulare,
and Yolo.

(f) “County indigent care health realignment amount” means
the product of the health realignment amount times the health
realignment indigent care percentage, as computed on a
county-specific basis.

(g) “County savings determination process” means the process
for determining the amount to be redirected in accordance with
Section 17613.1, as calculated pursuant to subdivision (a) of
Section 17613.3.

(h) “Department” means the State Department of Health Care
Services.

(i) “Health realignment amount” means the amount that, in the
absence of this article, would be payable to a county under Sections
17603, 17604, begin delete 17606.10, end delete and 17606.20, as those sections read on
January 1, 2012, begin insert and Section 17606.10, as it read on July 1, 2013, end insert
for the fiscal year that is deposited by the Controller into the local
health and welfare trust fund health account of the county.

(j) “Health realignment indigent care percentage” means the
county-specific percentage determined in accordance with the
following, and established in accordance with the procedures
described in subdivision (c) of Section 17613.3:

(1) Each county shall identify the portion of that county’s health
realignment amount that was used to provide health services to
the indigent, including the indigent program individuals, for each
of the historical fiscal years, along with verifiable data in support
thereof.

(2) The amounts identified in paragraph (1) shall be expressed
as a percentage of the health realignment amount of that county
for each fiscal year of the historical fiscal years.

(3) The average of the percentages determined in paragraph (2)
shall be the county’s health realignment indigent care percentage.

(4) To the extent a county does not provide the information
required in paragraph (1) or the department determines that the
information required is insufficient, the amount under this
subdivision shall be considered to be 85 percent.

(k) All references to “health services” or “health care services,”
unless specified otherwise, shall exclude mental health and
substance use disorder services.

(l) “Historical fiscal years” means the fiscal years 2008-09 to
2011-12, inclusive.

(m) “Imputed county low-income health amount” means the
predetermined, county-specific amount of county general purpose
funds assumed, for purposes of the calculation in Section 17613.3,
to be available to the county for services to indigent program
individuals. The imputed county low-income health amount shall
be determined as set forth below and established in accordance
with subdivision (c) of Section 17613.3.

(1) For each of the historical fiscal years, an amount shall be
determined as the annual amount of county general fund
contribution provided for health services to the indigent, which
does not include funds provided for mental health and substance
use disorder services, through a methodology to be developed by
the department, in consultation with the California State
Association of Counties.

(2) If a year-to-year percentage increase in the amount
determined in paragraph (1) was present, an average annual
percentage trend factor shall be determined.

(3) The annual amounts determined in paragraph (1) shall be
averaged and multiplied by the percentage trend factor, if
applicable, determined in paragraph (2), for each fiscal year after
the 2011-12 fiscal year through the applicable fiscal year.
Notwithstanding the foregoing, if the percentage trend factor
determined in paragraph (2) is greater than the applicable
percentage change for any year of the same period in the blended
CPI trend factor, the percentage change in the blended CPI trend
factor for that year shall be used. The resulting determination is
the imputed county low-income health amount for purposes of
Section 17613.3.

(n) “Indigent program costs” means the costs incurred by the
county for purchasing, providing, or ensuring the availability of
services to indigent program individuals during the fiscal year.
The costs for mental health and substance use disorder services
shall not be included in these costs.

(o) “Indigent program individuals” means all individuals
enrolled in a county indigent health care program at any point
throughout the fiscal year. If a county does not enroll individuals
into an indigent health care program, indigent program individuals
shall mean all individuals who used services offered through the
county indigent health care program in the fiscal year.

(p) “Indigent program revenues” means self-pay payments made
by or on behalf of indigent program individuals to the county for
the services rendered in the fiscal year, but shall exclude revenues
received for mental health and substance use disorder services.

(q) “Redirected amount” means the amount to be redirected in
accordance with Section 17613.1, as calculated pursuant to
subdivision (a) of Section 17613.3.

(r) “Special local health funds” means the amount of the
following county funds received by the county for health services
to indigent program individuals during the fiscal year and shall
include funds available pursuant to the Master Settlement
Agreement and related documents entered into on November 23,
1998, by the state and leading United States tobacco product
manufacturers during a fiscal year. The amount of the tobacco
settlement funds to be used for this purpose shall be the greater of
begin delete subparagraph (A) or (B), end delete begin insert paragraph (1) or (2), end insert less any bond
payments and other costs of securitization begin insert related to the funds
described in this subdivision end insert .

begin delete

(A)

end delete

begin insert (1) end insert  The amount of the funds expended by the county for the
provision of health services to indigent program individuals during
the fiscal year.

begin delete

(B)

end delete

begin insert (2) end insert  The amount of the tobacco settlement funds multiplied by
the average of the percentages of the amount of tobacco settlement
funds that were allocated to and expended by the begin delete noncounty end delete begin insert county end insert
for health services to indigent program individuals during the
historical fiscal years.

begin insert

begin insert SEC. 24. end insert   

end insert

begin insert Section 17613.3 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

17613.3.  

(a) For each fiscal year commencing with the
2013-14 fiscal year, the amount to be redirected in accordance
with Section 17613.1 shall be determined for each county as set
forth in this section.

(1) The county’s revenues and other funds paid or payable for
the fiscal year shall be comprised of the total of the following:

(A) Indigent program revenues.

(B) Special local health funds.

(C) The county indigent care health realignment amount.

(D) The imputed county low-income health amount.

(2) Indigent program costs incurred by the county for the fiscal
year, not to exceed in total the cost containment limit, shall be
subtracted from the sum in paragraph (1).

(3) The resulting amount shall be multiplied by 0.80, except
that for the 2013-14 fiscal year where the resulting amount shall
be multiplied by 0.70.

(4) If the amount in paragraph (3) is a positive number, that
amount, subject to paragraph (5), shall be redirected in accordance
with Section begin delete 17613.1 end delete begin insert 17613.1, except that for the 2013-14 fiscal
year, the amount to be redirected shall not exceed the amount
determined for the county for the 2013 end insert begin insert -14 fiscal year under
subdivision (c) of Section 17603, as that amount may have been
reduced by the application of Section 17610.5 end insert . If the amount
determined in paragraph (3) is a negative number, the redirected
amount shall be zero.

(5) Notwithstanding any other law, the amount to be redirected
as determined in paragraph (4) for a fiscal year shall not exceed
the county indigent care health realignment amount for that fiscal
year.

(6) (A) The redirected amount shall be applied until the later
of the following:

(i) June 30, 2023.

(ii) The beginning of the fiscal year following a period of two
consecutive fiscal years in which both of the following occur:

(aa) The total interim amount determined under subdivision (b)
in May of the previous fiscal year is within 10 percent of the final,
reconciled amount in subdivision (d).

(bb) The final, reconciled amounts under subdivision (d) are
within 5 percent of each other.

(B) After the redirected amount ceases as provided in
subparagraph (A), a permanent redirected amount shall be
established to be the amount determined by calculating the
percentage that the redirected amount was in the last fiscal year
of the operation of this article of the county’s health realignment
amount of that same fiscal year, multiplied by the county’s health
realignment amount of all subsequent years.

(b) Starting with the 2014-15 fiscal year, the department shall
calculate an interim redirected amount for each county under
subdivision (a) by the January immediately prior to the starting
fiscal year, using the most recent and accurate data available. For
purposes of the interim determinations, the cost containment limit
shall not be applied. The interim redirected amount shall be updated
in the May before the start of the fiscal year in consultation with
each county and based on any more recent and accurate data
available at that time. During the fiscal year, the interim redirected
amount will be applied pursuant to Section 17613.1.

(c) The predetermined amounts or historical percentages
described in subdivisions begin delete (i), end delete begin insert (j), end insert (m), and begin delete (n) end delete begin insert (r) end insert of Section 17613.2
shall each be established in accordance with the following
procedure:

(1) By begin delete September 30, end delete begin insert October 31, end insert 2013, each county shall
determine the amount or percentage described in the applicable
subdivision, and shall provide this calculation to the department,
supported by verifiable data and a description of how the
determination was made.

(2) If the department disagrees with the county’s determination,
the department shall confer with the county by begin delete November end delete
begin insert December end insert 15, begin delete 2013 end delete begin insert 2013, and shall issue its determination by
January 31, 2014 end insert .

(3) If no agreement between the parties has been reached by
begin delete December end delete begin insert January end insert 31, begin delete 2013, end delete begin insert 2014, end insert the department shall apply the
county’s determination when making the interim calculations
pursuant to subdivision (b), until a decision is issued pursuant to
paragraph (6).

(4)  begin delete A end delete begin insert If no agreement between the parties has been reached by
January 31, 2014, the end insert begin insert end insert county begin delete may end delete begin insert shall end insert submit a petition begin insert by
February 28, 2014, end insert to the County Health Care Funding Resolution
Committee, established pursuant to Section 17600.60, to seek a
decision regarding the historical percentage or amount to be applied
in calculations under this section.

(5) The County Health Care Funding Resolution Committee
shall hear and make a determination as to whether the county’s
proposed percentage or amount complies with the requirements
of this section based on the data and calculations of the county and
any alternative data and calculations submitted by the department.

(6) The County Health Care Funding Resolution Committee
shall issue begin delete a decision end delete begin insert its final determination end insert within 45 days of the
petition. If the county chooses to contest the begin insert final end insert determination,
the begin delete decision end delete begin insert final determination end insert of the committee will be applied
for purposes of any interim calculation under subdivision (b) until
a final decision is issued pursuant to de novo administrative review
under paragraph (2) of subdivision (d).

(d) (1) The data for the final calculations under subdivision (a)
for the fiscal year shall be submitted by counties within 12 months
after the conclusion of each fiscal year as required in Section
17613.4. The data shall be the most recent and accurate data from
the county’s books and records pertaining to the revenues paid or
payable, and the costs incurred, for services provided in the subject
fiscal year. begin delete The end delete begin insert After consulting with the county, the end insert department
shall make final calculations using the data submitted pursuant to
this paragraph by December begin delete 31 end delete begin insert 15 end insert of the following fiscal year,
and shall provide begin delete the calculation end delete begin insert its final determination end insert to the
county. The final begin delete calculations end delete begin insert determination end insert will also reflect the
application of the cost containment limit, if any. begin delete A end delete begin insert If the county
and the department agree, a revised end insert recalculation and
reconciliation begin delete shall end delete begin insert may end insert be completed by the department within
six months thereafter.

(2) The Director of Health Care Services shall establish an
expedited formal appeal process for a county to contest begin delete the end delete begin insert final end insert
determinations made begin delete in end delete begin insert under end insert this begin delete article, and only as follows: end delete
begin insert article. No appeal shall be available for interim determinations
made under subdivision (b). The appeals process shall include all
of the following: end insert

(A) The county shall have 30 calendar days, following the
issuance of a begin insert final end insert determination made under begin delete this article, end delete begin insert paragraph
(6) of subdivision (c) or paragraph (1) of this subdivision, end insert to file
an appeal with the director. All appeals shall be governed by
Section 100171 of the Health and Safety Code, except for those
provisions of paragraph (1) of subdivision (d) of Section 100171
of the Health and Safety Code relating to accusations, statements
of issues, statement to respondent, and notice of defense, and
except as otherwise set forth in this section. All appeals shall be
in writing and shall be filed with the State Department of Health
Care Service’s Office of Administrative Hearings and Appeals.
An appeal shall be deemed filed on the date it is received by the
Office of Administrative Hearings and Appeals.

(i) An appeal shall specifically set forth each issue in dispute,
including, but not limited to, any component of the determination,
and include the county’s contentions as to those issues. A formal
hearing before an Office of Administrative Hearings and Appeals
Administrative Law Judge shall commence within begin delete 45 end delete begin insert 60 end insert days of
the filing of the appeal requesting a formal hearing. A final decision
begin insert under this paragraph end insert shall be adopted begin delete within 60 days of the close
of the record, but end delete no later than begin delete five end delete begin insert six end insert months following the
begin delete issuance end delete begin insert filing end insert of the appeal.

(ii) If the county fails to file an appeal within 30 days of the
issuance of a determination made under this begin delete article, end delete begin insert section, end insert the
determination of the department shall be deemed final and not
appealable either administratively or to a court of general
begin delete jurisdiction end delete begin insert jurisdiction, except that a county may elect to appeal
a determination under subdivision (c) within 30 days of the
issuance of the County Health Care Funding Resolution
Committee’s final determination under paragraph (6) of
subdivision (c) or as a component of an appeal of the department’s
final determination under paragraph (1) for the 2013-14 fiscal
year end insert .

(B) If a final decision begin insert under this paragraph end insert is not issued by the
department within two years of the begin delete issuance of a determination
made under this article, end delete begin insert last day of the subject fiscal year, end insert the
county shall be deemed to have exhausted its administrative
remedies, and shall not be precluded from pursuing any available
judicial review. However, the time period in this subdivision shall
be extended by either of the following:

(i) Undue delay caused by the county.

(ii) An extension of time granted to a county at its sole request,
or following the joint request of the county and the department.

(C) If the final decision issued by the department pursuant to
this begin delete section end delete begin insert paragraph end insert results in a different determination than
that originally made by the department, then the Department of
Finance shall adjust the original determination by that amount,
pursuant to a process developed by the Department of Finance and
in consultation with the California State Association of Counties.

begin insert

begin insert SEC. 25. end insert   

end insert

begin insert Section 17613.4 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

17613.4.  

(a) Beginning with the 2013-14 fiscal year, each
county that has elected to participate in the County Savings
Determination Process shall, within five months after the end of
each fiscal year, be required to submit initial reports on both of
the following:

(1) All revenue data required for the operation of Section
17613.3, including both of the following:

(A) Indigent program revenues.

(B) Special local health funds.

(2) All cost data required for the operation of Section 17613.3,
including indigent program costs.

(b) Counties shall submit final reports of cost and revenue data
identified in subdivision (a) to the department for the each fiscal
year no later than June 30 of the fiscal year ending one year after
the subject fiscal year.

(c) The department shall develop, in consultation with California
State Association of Counties, the methodologies used to determine
the costs and revenues required to be reported and the format of
the submissions.

(d) Reports submitted under this section shall be accompanied
by a certification by an appropriate public official attesting to the
accuracy of the reports.

(e) Notwithstanding Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code,
the department, without taking any further regulatory action, shall
implement, interpret, or make specific this begin delete section end delete begin insert article end insert by means
of all-county letters, plan letters, plan or provider bulletins, or
similar instructions.

begin insert

begin insert SEC. 26. end insert   

end insert

begin insert Section 18901.2 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

18901.2.  

(a) It is the intent of the Legislature to create a
program in California that provides a nominal Low-Income Home
Energy Assistance Program (LIHEAP) service benefit, through
the LIHEAP block grant, to all recipient households of CalFresh
so that they are made aware of services available under LIHEAP
and so that some households may experience an increase in federal
Supplemental Nutrition Assistance Program benefits, as well as
benefit from paperwork reduction.

(b) To the extent permitted by federal law, the State Department
of Social Services (DSS) shall, in conjunction with the Department
of Community Services and Development (CSD), design,
implement, and maintain a utility assistance initiative: the “Heat
and Eat” program.

(1) The nominal LIHEAP service benefit shall be funded through
the LIHEAP block grant begin insert allocated for outreach activities in
accordance with state and federal requirements, and shall be end insert
provided by the CSD to the DSS begin delete upon end delete begin insert after end insert receipt by the CSD of
the LIHEAP block grant funds from the federal funding authorities.

(2) The total amount transferred shall be the product of the
nominal LIHEAP service benefit established by the CSD in the
LIHEAP state plan multiplied by the number of CalFresh recipient
households as agreed upon annually by the CSD and the DSS.

(3) The total amount transferred shall be reduced by any
unexpended or reinvested amounts remaining from prior transfers
for the nominal LIHEAP service benefits as provided in
subparagraph (C) of paragraph (1) of subdivision (c).

begin delete

(4) Should the demand for the nominal LIHEAP service benefit
exceed allocated funding, established by the CSD in the LIHEAP
state plan, the CSD and DSS shall report that information to the
Legislature and develop a plan to maintain the program as intended.

end delete

(c) In implementing and maintaining the utility assistance
initiative, the State Department of Social Services shall do all of
the following:

(1) (A) Grant recipient households of CalFresh benefits pursuant
to this chapter a nominal LIHEAP service benefit out of the federal
LIHEAP block grant (42 U.S.C. Sec. 8621 et seq.).

(B) In establishing the nominal LIHEAP service benefit amount,
the department shall take into consideration that the benefit level
need not provide significant utility assistance.

(C) Any funds allocated for this purpose not expended by
CalFresh recipient households shall be recouped through the “Heat
and Eat” program and reinvested into the program on an annual
basis as determined by both departments.

(2) Provide the nominal LIHEAP service benefit without
requiring the applicant or recipient to provide additional paperwork
or verification.

(3) To the extent permitted by federal law and to the extent
federal funds are available, provide the nominal LIHEAP service
benefit annually to each recipient of CalFresh benefits.

(4) (A) Deliver the nominal LIHEAP service benefit using the
Electronic Benefit Transfer (EBT) system or other nonpaper
delivery system.

(B) Notification of a recipient’s impending EBT dormant
account status shall not be required when the remaining balance
in a recipient’s account at the time the account becomes inactive
is ninety-nine cents ($0.99) or less of LIHEAP service benefits.

(5) Ensure that receipt of the nominal LIHEAP service benefit
pursuant to this section shall not adversely affect a CalFresh
recipient household’s eligibility, reduce a household’s CalFresh
benefits, or disqualify the applicant or recipient of CalFresh
benefits from receiving other nominal LIHEAP service benefits
or other utility benefits for which they may qualify.

(d) Recipients of the nominal LIHEAP service benefit pursuant
to this section shall remain subject to the additional eligibility
requirements for LIHEAP assistance as outlined in the California
LIHEAP state plan, developed by the CSD.

(e) (1) To the extent permitted by federal law, a CalFresh
household receiving or anticipating receipt of nominal LIHEAP
service benefits pursuant to the utility assistance initiative or any
other law shall be entitled to use the full standard utility allowance
(SUA) for the purposes of calculating CalFresh benefits. A
CalFresh household shall be entitled to use the full SUA regardless
of whether the nominal LIHEAP service benefit is actually
redeemed.

(2) If use of the full SUA, instead of the homeless shelter
deduction, results in a lower amount of CalFresh benefits for a
homeless household, the homeless household shall be entitled to
use the homeless shelter deduction instead of the full SUA.

(f) The department shall implement the initiative by January 1,
2013.

begin insert

begin insert SEC. 27. end insert   

end insert begin insert

This act is a bill providing for appropriations related
to the Budget Bill within the meaning of subdivision (e) of Section
12 of Article IV of the California Constitution, has been identified
as related to the budget in the Budget Bill, and shall take effect
immediately.

end insert

begin delete

SECTION 1.  

It is the intent of the Legislature to enact statutory
changes relating to the Budget Act of 2013.

end delete