BILL ANALYSIS �
AB 720
Page 1
ASSEMBLY THIRD READING
AB 720 (Skinner)
As Amended May 24, 2013
Majority vote
PUBLIC SAFETY 7-0 APPROPRIATIONS 13-4
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|Ayes:|Ammiano, Melendez, |Ayes:|Gatto, Bocanegra, |
| |Jones-Sawyer, Mitchell, | |Bradford, |
| |Quirk, Skinner, Waldron | |Ian Calderon, Campos, |
| | | |Eggman, Gomez, Hall, |
| | | |Ammiano, Linder, Pan, |
| | | |Quirk, Weber |
| | | | |
|-----+--------------------------+-----+--------------------------|
| | |Nays:|Harkey, Bigelow, |
| | | |Donnelly, Wagner |
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SUMMARY : Requires counties to assist in enrolling county jail
inmates, as specified for a health insurance affordability
program, as defined, prior to release. Specifically, this bill :
1)Requires each county to designate an individual or agency to
complete and submit an application for a health insurance
affordability program application for specified inmates in a
county jail at any time before release.
2)States that the jail administrator, or his or her designee,
shall coordinate with the individual or agency designated by
the county.
3)Specifies that the designated individual or agency 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 the inmate has been in detention
for at least 72 hours and the inmate appears potentially
eligible to be enrolled in the health insurance affordability
program upon release.
4)Provides that, 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
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otherwise ineligible.
5)States, 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 bill.
6)States, notwithstanding any other provision of law, the
individual or agency designated by the county is authorized to
act on behalf of an individual detained in county jail, for
purposes of applying for, or a determination of, eligibility
for a health insurance affordability program.
7)Defines "health insurance affordability program" as a program
that is one of the following:
a) The state's Medi-Cal program under Title XIX of the
federal Social Security Act.
b) The state's children's health insurance program under
title XXI of the federal Social Security Act.
c) A program that makes coverage in a qualified health plan
through the California Health Benefit Exchange with advance
payment of the premium tax credit established under the
Section 36B of the Internal Revenue Code available to
qualified individuals.
d) A program that makes available coverage in a qualified
health plan through the California Health Benefit Exchange
with cost-sharing reductions established under the federal
Patient Protection and Affordable Care Act and any
subsequent amendments to that act.
8)Specifies notwithstanding existing provisions of law related
to administrative regulations and rulemaking, the Department
of Health Care Services (DHCS) department may implement
provisions in this bill by means of all-county letters or
similar instructions, without taking regulatory action.
EXISTING LAW :
1)Establishes the Medi-Cal program, administered by the DHCS, to
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provide comprehensive health benefits to low-income children,
their parents or caretaker relatives, pregnant women, elderly,
blind or disabled persons, nursing home residents, and
refugees who meet specified eligibility criteria.
2)Specifies that the county welfare department in each county
shall be the agency responsible for local administration of
the Medi-Cal program under the direction of DHCS.
3)Provides that, notwithstanding any other provision of law, the
California Department of Corrections and Rehabilitation and
DHCS may develop a process to maximize federal financial
participation for the provision of inpatient hospital services
rendered to individuals who, but for their institutional
status as inmates, are otherwise eligible for Medi-Cal or the
Low Income Health Program.
4)Exempts from eligibility of Medi-Cal benefits inmates of a
"public institution" unless they are out on bail or own
recognizance. This includes inmates in prison, county, city
or tribal jail, and inmates in custody awaiting arraignment,
conviction or sentencing. (Medi-Cal Eligibility Procedures
Manual, Article 6, Section 50273)
5)States that if an individual under 21 years of age is a
Medi-Cal beneficiary on the date he or she becomes an inmate
of a public institution, his or her benefits shall be
suspended effective the date he or she becomes an inmate of a
public institution. Provides that the suspension will 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.
FISCAL EFFECT : According to the Assembly Appropriations
Committee:
1)Significant state-reimbursable local administrative costs,
likely in excess of $4 million, assuming a 50/50 state/federal
share of costs. County jails statewide average about 86,000
per month (1,032,000 per year). This figure includes bookings
that do not result in more than 72 hours of detention, as well
as multiple releases for the same person. If half of these
releases require a Medi-Cal eligibility determination and an
application, assuming about 30 minutes per inmate, at a cost
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of about $30 per hour, the annual cost would be in the range
of $8 million.
To the extent counties are able to access private funding, such
as a recent announcement that the California Endowment will be
awarding close to $20 million to groups assisting in the
implementation of the Affordable Care Act, state costs could
be considerably reduced.
2)To the extent this bill results in providing Medi-Cal services
to individuals who might otherwise not avail themselves of the
program, the cost in most cases will be fully paid by the
federal government for several years, assuming California
adopts Medi-Cal expansion to include childless adults at 138%
of the poverty level, until the reimbursement ratio settles at
90:10, federal:state.
COMMENTS : According to the author, "AB 720 would require
counties to enroll eligible inmates into the Medi-Cal program
before being released. This would address one of the main
barriers to re-entry by helping formerly incarcerated inmates
access physical, mental health and substance abuse services.
"Research shows that formerly incarcerated individuals who have
access to medical services upon release have reduced recidivism
rates, increasing the likelihood they will become productive
citizens. A 2009 California Department of Corrections and
Rehabilitation report showed a 61% recidivism reduction for
female inmates who underwent substance abuse treatment and a 29%
reduction for male inmates who underwent such treatment."
(Footnote omitted.) (California Department of Corrections and
Rehabilitation Adult Programs Annual Report (June 2009) pages 7
and 8, .)
Please see the policy committee analysis for a full discussion
of this bill.
Analysis Prepared by : Stella Choe / PUB. S. / (916) 319-3744
FN: 0000893
AB 720
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