BILL NUMBER: AB 720 AMENDED
BILL TEXT
AMENDED IN SENATE SEPTEMBER 6, 2013
AMENDED IN SENATE SEPTEMBER 3, 2013
AMENDED IN SENATE JULY 9, 2013
AMENDED IN SENATE JUNE 24, 2013
AMENDED IN ASSEMBLY MAY 24, 2013
AMENDED IN ASSEMBLY APRIL 11, 2013
INTRODUCED BY Assembly Member Skinner
(Coauthor: Senator Beall)
FEBRUARY 21, 2013
An act to add Section 4011.11 to the Penal Code, and to amend
Section 14011.10 of the Welfare and Institutions 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. Existing federal law prohibits federal
financial participation for medical care provided to inmates of a
public institution, except when the inmate is a patient in a medical
institution.
Commencing January 1, 2014, the federal Patient Protection and
Affordable Care Act expands eligibility under the Medicaid Program
for certain groups and enacts various other health care coverage
market reforms that take effect on that date. Existing federal law
requires the Secretary of Health and Human Services to develop and
provide to each state a single, streamlined form that may be used to
apply for all state health subsidy programs, as defined, within the
state.
This bill would authorize the board of supervisors in each county,
in consultation with the county sheriff, to designate an entity
or entities to assist certain county
jail inmates to apply for a health insurance affordability
program, as defined. The bill would authorize the entity, to the
extent authorized by federal law and federal financial participation
is available, to act on behalf of a county jail inmate for the
purpose of applying for, or determinations of, Medi-Cal eligibility
for acute inpatient hospital services, as specified.
The bill would provide that county jail inmates who are currently
enrolled in the Medi-Cal program shall remain eligible for, and shall
not be terminated from, the program due to their detention, unless
required by federal law or , they
become otherwise ineligible , or the suspension of their
benefits has ended . The bill would require the State
Department of Health Care Services to establish, subject to federal
law, a process to enable counties to obtain the maximum available
federal financial participation for the services they provide
pursuant to these provisions. The bill would also authorize an adult
who has been involuntarily detained or incarcerated in a county
facility to refuse assistance from the designated entity, as
specified. The bill would provide that the fact that an
applicant is an inmate shall not, in and of itself, preclude a county
human services agency from processing an application for the
Medi-Cal program submitted to it by, or on behalf of, that
inmate.
Existing law also provides for the suspension of Medi-Cal benefits
to an inmate of a public institution who is under 21 years of age.
Existing law requires county welfare departments to notify the
department within 10 days of receiving information that an individual
under 21 years of age who is receiving Medi-Cal is or will be an
inmate of a public institution.
This bill would instead make these provisions applicable without
regard to the age of the individual, provided that federal financial
participation would not be jeopardized. By expanding the duties of
county agencies, this bill would impose a state-mandated local
program.
The bill would also include a statement of legislative intent.
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:
SECTION 1. It is the intent of the Legislature in enacting this
act to, among other things, ensure that county human services
agencies recognize that (a) federal law generally does not authorize
federal financial participation for Medi-Cal when a person is an
inmate of a public institution , as defined in federal
law, unless the inmate is admitted as an inpatient to a
noncorrectional health care facility, and (b)
federal financial participation is available after an inmate is
released from a county jail , and (c) the fact that
an applicant is currently an inmate does not, in and of itself,
preclude the county human services agency from processing the
application submitted to it by, or on behalf of, that inmate .
SEC. 2. Section 4011.11 is added to the Penal Code, to read:
4011.11. (a) (1) The board of supervisors in each county, in
consultation with the county sheriff, may designate an entity or
entities to assist county jail inmates described in
subdivision (c) with submitting an application for a health
insurance affordability program consistent with federal
requirements.
(2) The board of supervisors shall not designate the county
sheriff as the an entity to assist with
submitting an application for a health insurance affordability
program for county jail inmates described in subdivision (c)
unless the county sheriff agrees to perform this function.
(3) If the board of supervisors designates a community-based
organization as the an entity to assist
with submitting an application for a health insurance affordability
program for county jail inmates described in subdivision (c)
, the designation shall be subject to approval by the jail
administrator, administrator or his or
her designee.
(b) The jail administrator, or his or her designee, may coordinate
with the an entity designated pursuant
to subdivision (a).
(c) The entity designated pursuant to subdivision (a) may assist a
county jail inmate with submitting an application for a health
insurance affordability program if all of the following conditions
are met:
(1) The inmate has been in detention for at least 72 hours
following remand into custody by a court or magistrate.
(2) The inmate appears potentially eligible to be enrolled in the
health insurance affordability program upon release.
(3) The inmate does not currently have health care coverage.
(d)
(c) Consistent with federal law, a county
jail inmates inmate who are
is currently enrolled in the Medi-Cal program
shall remain eligible for, and shall not be terminated from, the
program due to their his or her
detention unless required by federal law, or they become
he or she becomes otherwise ineligible , or
the inmate's suspension of benefits has ended pursuant to
Section 14011.10 of the Welfare and Institutions Code .
(e) Notwithstanding any other provision of law, and only to the
extent that federal law allows, the State Department of Health Care
Services shall establish a process to enable counties to obtain the
maximum available federal financial participation for services they
provide related to this section.
(f)
(d) Notwithstanding any other state law, and only to
the extent federal law allows and, for purposes of the
Medi-Cal program, and federal financial
participation is available, the an
entity designated pursuant to subdivision (a) is authorized to act on
behalf of a county jail inmate who meets all of the
conditions described in paragraphs (1) to (3), inclusive of
subdivision (c), for the limited purpose
of applying for or a determination of for,
or determinations of, Medi-Cal eligibility for a
health insurance affordability program, including, but not limited
to, the Medi-Cal program acute inpatient hospital
services authorized by Section 14053.7 of the Welfare and
Institutions Code . The An entity
designated pursuant to subdivision (a) shall not
determine Medi-Cal eligibility or redetermine Medi-Cal eligibility,
unless the entity is the county human services agency. The
(e) The fact that an applicant is
an inmate shall not, in and of itself, preclude a county human
services agency from processing an application for the Medi-Cal
program submitted to it by, or on behalf of, that inmate.
(g) An adult who has been involuntarily detained or incarcerated
in a county facility may refuse in writing to authorize the entity
designated pursuant to subdivision (a) to act on his or her behalf
for purposes of applying for or determining eligibility for a health
insurance affordability program, in which case the entity shall not
act on that person's behalf. That person shall be informed of, and
given the opportunity to exercise, this right before the entity
submits an application on his or her behalf.
(h)
(f) For purposes of this section, "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 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.
(i)
(g) 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.
SEC. 3. Section 14011.10 of the Welfare and Institutions Code is
amended to read:
14011.10. (a) Except as provided in Section
Sections 14011.11, 14053.7, and 14053.8,
benefits provided under this chapter to an individual who is an
inmate of a public institution shall be suspended in accordance with
Section 1396d(a)(29)(A) of Title 42 of the United States Code as
provided in subdivision (c).
(b) County welfare departments shall notify the department within
10 days of receiving information that an individual on Medi-Cal in
the county is or will be an inmate of a public institution.
(c) If an individual is a Medi-Cal beneficiary on the date he or
she becomes an inmate of a public institution, his or her benefits
under this chapter and under Chapter 8 (commencing with Section
14200) shall be suspended effective the date he or she becomes an
inmate of a public institution. The suspension shall end on the date
he or she is no longer an inmate of a public institution or one year
from the date he or she becomes an inmate of a public institution,
whichever is sooner.
(d) Nothing in this section shall create a state-funded benefit or
program. Health care services under this chapter and Chapter 8
(commencing with Section 14200) shall not be available to inmates of
public institutions whose Medi-Cal benefits have been suspended under
this section.
(e) This section shall be implemented only if and to the extent
allowed by federal law. This section shall be implemented only to the
extent that any necessary federal approval of state plan amendments
or other federal approvals are obtained.
(f) If any part of this section is in conflict with or does not
comply with federal law, this entire section shall be inoperative.
(g) This section shall be implemented on January 1, 2010, or the
date when all necessary federal approvals are obtained, whichever is
later.
(h) By January 1, 2010, or the date when all necessary federal
approvals are obtained, whichever is later, the department, in
consultation with the Chief Probation Officers of California and the
County Welfare Directors Association, shall establish the protocols
and procedures necessary to implement this section, including any
needed changes to the protocols and procedures previously established
to implement Section 14029.5.
(i) The department shall determine whether federal financial
participation will be jeopardized by implementing the
amendments to this section made by the act adding
this subdivision and shall implement those
provisions this section only if and to the
extent that federal financial participation is not jeopardized.
(j) Notwithstanding Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code, the
department shall implement this section by means of all-county
letters or similar instructions without taking regulatory action.
Thereafter, the department shall adopt regulations in accordance with
the requirements of Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code.
SEC. 4. 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.