Amended in Assembly May 24, 2013

Amended in Assembly April 11, 2013

California Legislature—2013–14 Regular Session

Assembly Bill No. 720

Introduced by Assembly Member Skinner

February 21, 2013

An act to add Section 4011.11 to the Penal Code, relating to inmates.

LEGISLATIVE COUNSEL’S DIGEST

AB 720, as amended, Skinner. Inmates: health care enrollment.

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. Commencing January 1, 2014, the federal Patient Protection and Affordable Care Act expands eligibility under the Medicaid Program for certain groups. Existing federal law prohibits persons who are involuntarily incarcerated in jail from obtaining these services, but permits persons detained in jail, but not sentenced to jail, to be eligible for services, as specified.

This bill would require counties to designate an individual or agency, as specified, to begin delete enroll end delete begin insert assist end insert certain individuals held in county jail, as specified, begin delete consistent with federal requirements end delete begin insert to apply for health insurance affordability programs end insert . The bill would provide that individuals who are currently enrolled in the Medi-Cal program begin delete in the county where they reside end delete and who would become ineligible for benefits because of detention begin delete before or after conviction shall have their benefits suspended and shall end delete retain enrollment in that program begin insert , unless otherwise ineligible, as specified end insert . begin delete The bill would require the individual or agency designated by the county, as specified, to supply appropriate information regarding the California Health Benefit Exchange to those individuals detained in a county jail who are not eligible for Medi-Cal benefits and who do not have health care coverage, 30 days before their scheduled release. The bill would state findings and declarations of the Legislature regarding the above. end delete

By imposing additional duties on local governments, this bill would impose a state-mandated local program.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to these statutory provisions.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes.

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

begin delete

SECTION 1.  

Section 4011.11 is added to the Penal Code, to
read:

4011.11.  

(a) The Legislature finds and declares the following:

(1) The federal Patient Protection and Affordable Care Act, also
known as health care reform, is designed to ensure every American
has access to affordable quality health care. To help ensure access,
the federal low-income health insurance program, the Medi-Cal
program in California, will be expanded to previously uncovered
populations, including single men making less than 133 percent
of the federal poverty level.

(2) The cost of the Medi-Cal expansion will be fully paid by
the federal government until 2017, when the federal government
will cover 90 percent of the cost of the Medi-Cal expansion.

(3) According to research done by the National Health Law
Program, a large portion of individuals currently sentenced to
county jail, and those recently released, are currently uninsured
and may be eligible for Medi-Cal once released.

(4) According to a study published in the American Journal of
Public Health, many people coming out of county jail have
significant medical, mental health, and substance abuse needs that
are currently unmet.

(5) According to a study funded by the National Criminal Justice
Reference Service, individuals who are enrolled in Medicaid on
the day of release committed fewer repeat offenses, and the time
between offenses was longer.

(6) Therefore, it is the intent of the Legislature to enroll
individuals in county jail in the federally funded Medi-Cal program
to provide medical, mental health, and substance abuse services
to individuals when released from county jail, at no cost to the
state until 2017 and at minimal state cost beginning in 2017.

(b) Each county shall designate an individual or agency to enroll
the individuals described in subdivision (d) in the available
Medi-Cal program in that county, consistent with federal
requirements.

(c) The jail administrator, or his or her designee, shall coordinate
with the individual or agency designated pursuant to subdivision
(b).

(d) The individual or agency designated pursuant to subdivision
(b) shall enroll an inmate in the Medi-Cal program at any point
before release if all of the following conditions are met:

(1) The inmate has been in detention for at least 72 hours.

(2) The inmate will be eligible to be enrolled in the Medi-Cal
program upon release.

(e) Consistent with federal regulations, individuals who are
currently enrolled in the Medi-Cal program in the county where
they reside and who would become ineligible for benefits because
of detention before or after conviction shall have their benefits
suspended during detention and shall retain enrollment in the
program.

(f) The individual or agency designated pursuant to subdivision
(b) shall, 30 days before an inmate’s scheduled release, supply
appropriate information regarding the California Health Benefit
Exchange to those individuals detained in a county jail who are
not eligible for Medi-Cal benefits and who do not otherwise have
health care coverage.

end delete

begin insert

begin insert SECTION 1. end insert   

end insert

begin insert Section 4011.11 is added to the end insert begin insert Penal Code end insert begin insert , to
read: end insert

begin insert

begin insert 4011.11. end insert   

(a) Each county shall designate an individual or
agency to complete and submit an application for a health
insurance affordability program application for the individuals
described in subdivision (c) consistent with federal requirements.

(b) The jail administrator, or his or her designee, shall
coordinate with the individual or agency designated pursuant to
subdivision (a).

(c) The individual or agency designated pursuant to subdivision
(a) shall complete and submit an application for a health insurance
affordability program on behalf of an inmate in a county jail at
any time before release if both of the following conditions are met:

(1) The inmate has been in detention for at least 72 hours.

(2) The inmate appears potentially eligible to be enrolled in the
health insurance affordability program upon release.

(d) Consistent with federal regulations, individuals who are
currently enrolled in the Medi-Cal program shall not be terminated
from the program due to their detention unless required by federal
law, or they become otherwise ineligible.

(e) Notwithstanding any other provision of law, and only to the
extent that federal law allows, the state shall establish a process
to enable counties to obtain the maximum available federal
financial participation for administrative activities related to this
section.

(f) Notwithstanding any other provision of law, the individual
or agency designated pursuant to subdivision (a) is authorized to
act on behalf of an individual detained in county jail, for purposes
of applying for or a determination of eligibility for health insurance
affordability program.

(g) “Health insurance affordability program” means a program
that is one of the following:

(1) The state’s Medi-Cal program under Title XIX of the federal
Social Security Act.

(2) The state’s children’s health insurance program (CHIP)
under title XXI of the federal Social Security Act.

(3) A program that makes coverage in a qualified health plan
through the California Health Benefit Exchange established
pursuant to Section 100500 of the Government Code with advance
payment of the premium tax credit established under Section 36B
of the Internal Revenue Code available to qualified individuals.

(4) A program that makes available coverage in a qualified
health plan through the California Health Benefit Exchange
established pursuant to Section 100500 of the Government Code
with cost-sharing reductions established under Section 1402 of
the federal Patient Protection and Affordable Care Act (Public
Law 111-148) and any subsequent amendments to that act.

(h) Notwithstanding Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code,
the department may implement this section by means of all-county
letters or similar instructions, without taking regulatory action.

end insert

SEC. 2.  

If the Commission on State Mandates determines that
this act contains costs mandated by the state, reimbursement to
local agencies and school districts for those costs shall be made
pursuant to Part 7 (commencing with Section 17500) of Division
4 of Title 2 of the Government Code.