BILL ANALYSIS                                                                                                                                                                                                    �







                      SENATE COMMITTEE ON PUBLIC SAFETY
                            Senator Loni Hancock, Chair              A
                             2013-2014 Regular Session               B

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          AB 720 (Skinner)                                            
          As Amended June 24, 2013
          Hearing date:  July 2, 2013
          Penal Code
          JM:jr

                   HEALTHCARE COVERAGE FOR JAIL INMATES UPON RELEASE  

                                       HISTORY

          Source:  Californians for Safety and Justice

          Prior Legislation: SB 695 (Hancock) - Ch. 647, Stats. 2011
                       AB 1628 (Budget Committee) - Ch. 729, Stats. 2010
                       SB 1147 (Calderon) - Ch. 546, Stats. 2008

          Support:  American Civil Liberties Union; California Attorneys  
          for Criminal Justice;
                    California Pan-Ethnic Health Network; California  
                    Public Defenders Association; California State  
                    Association of Counties; California State Conference  
                    of the National Association for the Advancement of  
                    Colored People; Drug Policy Alliance; Ella Baker  
                    Center for Human Rights; Greenlining Institute; Legal  
                    Services for Prisoners with Children; Local Health  
                    Plans of California; 
                    Los Angeles Regional Reentry Partnership; National  
                    Association of Social Workers - California Chapter;  
                    San Francisco Sheriff; Taxpayers for Improving Public  
                    Safety; Women's Foundation of California; Berkeley  
                    Organizing Congregations for Action; California Nurses  
                    Association; County Alcohol and Drug Program  
                    Administrators of California; County of Lassen; County  












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                    of Sacramento; California State Associations of  
                    Counties; Chief Probation Officers of Contra Costa  
                    County; Friends Outside; Housing California; National  
                    Council of La Raza; Rural Counties Representatives of  
                    California; Urban Strategies Council; California  
                    Primary Care Association; Board of Supervisors County  
                    of Santa Clara; Californians for Safety and Justice;  
                    Chief Probation Officers of California

          Opposition:None known

          Assembly Floor Vote:  Ayes 56 - Noes 19



                                         KEY ISSUE
           
          SHOULD EACH COUNTY DESIGNATE AN ENTITY TO ASSIST JAIL INMATES APPLY  
          FOR SPECIFIED HEALTH INSURANCE COVERAGE UPON RELEASE?


                                       PURPOSE

          The purposes of this bill are to 1) require each county to  
          designate an entity or agency to assist jail inmates in applying  
          for a health insurance affordability program, where such inmates  
          appear to be eligible for Medi-Cal, the Healthy Families  
          Program, or federally subsidized coverage in the California  
          Health Benefit Exchange; 2) provide that the sheriff may not be  
          designated to perform this duty unless he or she consents; 3)  
          exclude inmates who are covered by insurance; and  4)  prohibit  
          detained individuals who are currently enrolled in the Medi-Cal  
          program from being terminated from Medi-Cal coverage due to  
          their detention unless required by federal law, or they become  
          ineligible.

           Existing law  establishes the Medi-Cal program, administered by  
          the Department of Health Care Services (DHCS), to provide  
          comprehensive health benefits to low-income children, their  
          parents or caretaker relatives, pregnant women, elderly, blind  




                                                                           







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          or disabled persons, nursing home residents, and refugees who  
          meet specified eligibility criteria.  (Welf. & Inst. Code �  
          14000 et seq.)

           Existing law  states that a person or family may be eligible for  
          Medi-Cal under one of the following programs (22 Cal. Code Regs.  
          Section 50201):

                 Aid to Families with Dependent Children
                 Supplemental Security Income/State Supplemental Program
                 Other Public Assistance
                 Medically Needy
                 Medically Indigent
                 Miscellaneous Special Programs
                 Medi-Cal Special Treatment Programs.

           Existing law  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.  (22 Cal. Code Regs. � 50004, subd. (c).)

           Existing law  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.  (Pen. Code � 5072,  
          subd. (a).)

           Existing law  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 - Revised Apr. 18, 2001.) 

           Existing law  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  




                                                                           







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          suspended effective the date he or she becomes an inmate of a  
          public institution.  It 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.  (Welf. &  
          Inst. Code � 14011.10, subd. (c).)

           Existing federal law  - the Patient Protection and Affordable  
          Care Act (ACA) - was signed into law in 2010.  The goals of the  
          ACA include improving health care quality, reducing costs and  
          the increasing access to affordable health coverage by  
          prohibiting insurance companies from denying coverage based on  
          pre-existing conditions, allowing young adults to stay on their  
          parents' insurance longer, providing tax credits to help people  
          pay for coverage, and allowing states to cover more people on  
          Medicaid.  (Pub. L. No. 111-148 (MAR. 23, 2010) 124 Stat. 133.)

           Existing law  provides that Medi-Cal benefits shall be provided,  
          as specified, to an eligible or currently enrolled person held  
          in a county juvenile detention facility until the date of  
          adjudication (trial).  Benefits must be suspended if the  
          individual is placed in an institution.  (Welf. & Inst. Code �  
          14011.11.)

           This bill  requires each county to designate an individual or  
          agency to assist specified county jail inmates with submitting  
          application for coverage from a health insurance affordability  
          program if both of the following conditions are met:

                 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.
                 The inmate does not currently have health insurance.

           This bill  provides that the county may appoint the sheriff to  
          perform this duty only with the agreement of the sheriff.

          This bill provides that an entity designated to assist inmates  
          with health insurance applications shall be either a  




                                                                           







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          governmental agency or a community based organization.

           This bill  provides that any community-based organization  
          designated to assist inmates in enrolling in a health insurance  
          program shall be approved by the jail administrator. 

           This bill  , for purposes of enrolling jail inmates in health  
          insurance plans, defines a "health insurance affordability  
          program" as a program that is one of the following:

                 The state's Medi-Cal program;
                 The state's children's health insurance program (CHIP),  
               which is known as the Healthy Families Program in  
               California; or, 
                 A program that makes coverage in a qualified health plan  
               through the California Health Benefit Exchange (Covered  
               California) with federally established advance payment  
               premium tax credits or cost-sharing reductions.

           This bill  prohibits individuals who are currently enrolled in  
          the Medi-Cal program from being terminated from the Medi-Cal  
          program due to their detention, unless required by federal law  
          or they become otherwise ineligible.

           This bill  requires the state to establish a process to enable  
          counties to obtain the maximum available FFP for administrative  
          activities related to this bill.

           This bill  authorizes the individual or agency in 1) above to act  
          on behalf of an individual detained in county jail for purposes  
          of applying, or a determination of eligibility for, a health  
          insurance affordability program.

           This bill  permits DHCS to implement this bill by means of  
          all-county letters or similar instructions, without taking  
          regulatory action under the Administrative Procedure Act. 


                    RECEIVERSHIP/OVERCROWDING CRISIS AGGRAVATION





                                                                           







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          For the last several years, severe overcrowding in California's  
          prisons has been the focus of evolving and expensive litigation  
          relating to conditions of confinement.  On May 23, 2011, the  
          United States Supreme Court ordered California to reduce its  
          prison population to 137.5 percent of design capacity within two  
          years from the date of its ruling, subject to the right of the  
          state to seek modifications in appropriate circumstances.   

          Beginning in early 2007, Senate leadership initiated a policy to  
          hold legislative proposals which could further aggravate the  
          prison overcrowding crisis through new or expanded felony  
          prosecutions.  Under the resulting policy known as "ROCA" (which  
          stands for "Receivership/ Overcrowding Crisis Aggravation"), the  
          Committee held measures which created a new felony, expanded the  
          scope or penalty of an existing felony, or otherwise increased  
          the application of a felony in a manner which could exacerbate  
          the prison overcrowding crisis.  Under these




           principles, ROCA was applied as a content-neutral, provisional  
          measure necessary to ensure that the Legislature did not erode  
          progress towards reducing prison overcrowding by passing  
          legislation which would increase the prison population.  ROCA  
          necessitated many hard and difficult decisions for the  
          Committee.

          In January of 2013, just over a year after the enactment of the  
          historic Public Safety Realignment Act of 2011, the State of  
          California filed court documents seeking to vacate or modify the  
          federal court order issued by the Three-Judge Court three years  
          earlier to reduce the state's prison population to 137.5 percent  
          of design capacity.  The State submitted in part that the, ". .  
          .  population in the State's 33 prisons has been reduced by over  
          24,000 inmates since October 2011 when public safety realignment  
          went into effect, by more than 36,000 inmates compared to the  
          2008 population . . . , and by nearly 42,000 inmates since 2006  
          . . . ."  Plaintiffs, who opposed the state's motion, argue in  
          part that, "California prisons, which currently average 150% of  




                                                                           







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          capacity, and reach as high as 185% of capacity at one prison,  
          continue to deliver health care that is constitutionally  
          deficient."  In an order dated January 29, 2013, the federal  
          court granted the state a six-month extension to achieve the  
          137.5 % prisoner population cap by December 31st of this year.  

          In an order dated April 11, 2013, the Three-Judge Court denied  
          the state's motions, and ordered the state of California to  
          "immediately take all steps necessary to comply with this  
          Court's . . . Order . . . requiring defendants to reduce overall  
          prison population to 137.5% design capacity by December 31,  
          2013."         

          The ongoing litigation indicates that prison capacity and  
          related issues concerning conditions of confinement remain  
          unresolved.  However, in light of the real gains in reducing the  
          prison population that have been made, although even greater  
          reductions are required by the court, the Committee will review  
          each ROCA bill with more flexible consideration.  The following  
          questions will inform this consideration:

                 whether a measure erodes realignment;
                 whether a measure addresses a crime which is directly  
               dangerous to the physical safety of others for which there  
               is no other reasonably appropriate sanction; 
                 whether a bill corrects a constitutional infirmity or  
               legislative drafting error; 
                 whether a measure proposes penalties which are  
               proportionate, and cannot be achieved through any other  
               reasonably appropriate remedy; and
                 whether a bill addresses a major area of public safety  
               or criminal activity for which there is no other  
               reasonable, appropriate remedy.






                                      COMMENTS




                                                                           







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          1.  Need for this Bill  

          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.

          2.  Medi-Cal Expansion under the Affordable Care Act  

          On March 23, 2010, President Obama signed the ACA into law  
          (Public Law 111-148), as amended by the Health Care and  
          Education Reconciliation Act of 2010 (Public Law 111-152).  The  
          ACA greatly expands health insurance coverage in California.  
          Beginning in 2014, millions of low- and middle-income  
          Californians will gain access to coverage under the expansion of  
          Medi-Cal through easier enrollment requirements established for  
          Medi-Cal, and through premium tax credits and cost-sharing  
          subsidies offered through Covered California.  As a result of  
          the coverage expansions under the ACA, between 89 and 91 percent  
          of non-elderly Californians are predicted to have health  
          coverage under the ACA, and the number of uninsured is projected  
          to decrease by between 1.8 and 2.7 million by 2019. 

          Prior to the enactment of the ACA, adults were generally not  
          eligible for Medi-Cal coverage unless they were low income and  
          met categorical eligibility requirements, such as having minor  
          children living at home, having a disability, being over the age  




                                                                           







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          of 65, or being pregnant. The Medicaid expansion's largest  
          enrollment impact will be from the expansion to non-disabled  
          childless adults with incomes at or below 138 percent of the FPL  
          (for a single adult, 138 percent of the FPL is $1,321 per month  
          or $15,856 per year in 2013).  Among other provisions, AB X1 1  
          (John A. P�rez) would implement the Medicaid expansion in  
          California, and SB X1 1 (Hernandez and Steinberg) would  
          establish the benefit package for the expansion population and  
          augment the benefit package for the current population.

          3.  Suspension - not Termination - of Medi-Cal Eligibility while a  
            Person is Jailed 

          This bill prohibits individuals who are currently enrolled in  
          the Medi-Cal program from being terminated from coverage unless  
          required by federal law, or they otherwise become ineligible .  
          States cannot claim Medicaid funding for services furnished to  
          any person who is incarcerated or receiving mental health  
          treatment in a specified public facility.  However, federal law  
          and regulations do not require that Medicaid eligibility be  
          terminated while individuals are in jail or a mental health  
          facility.  Instead, a state may place the person in suspended  
          status and return the individual to active Medicaid eligibility  
          upon release from jail (including release to parole or  
          probation) or discharge from the mental health facility.

          In 2004, the Center for Medicare and Medicaid Services (CMS)  
          issued a State Medicaid Director Letter to clarify that  
          incarceration or institutionalization: "? does not affect the  
          eligibility of an individual for the Medicaid program.   
          Individuals who meet the requirements for eligibility for  
          Medicaid may be enrolled in the program before, during, and  
          after the time in which they are held involuntarily in secure  
          custody of a public institution or as a resident of an IMD  
          [institute for mental disorders]." 

          Instead of terminating Medicaid eligibility, CMS urged states to  
          "? establish a process under which an eligible inmate or [IMD]  
          resident is placed in a suspended status so that the state does  
          not claim FFP for services the individual receives, but the  




                                                                           







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          person remains on the state's rolls as being eligible for  
          Medicaid (assuming the person continues to meet all applicable  
          eligibility requirements).  Once discharge from the facility is  
          anticipated, the state should take whatever steps are necessary  
          to ensure that an eligible individual is placed in payment  
          status so that he or she can begin receiving Medicaid-covered  
          services immediately upon leaving the facility."

          4.  Expansion of Drug and Mental Health Treatment in the County  
            Criminal Justice System  

          Extensive research has concluded that many, if not most, persons  
          in the criminal justice system have unmet needs for treatment  
          for abuse of drugs or alcohol, or both.  Many of these persons  
          suffer from co-existing mental illnesses.  The National  
          Institutes of Health reported that criminal offenders have drug  
          abuse and dependence rates that are four times that of the  
          general population.<1>  Despite the nearly universal agreement  
          that drug treatment should be expanded for inmates and persons  
          on community supervision, relatively little money is spent on  
          drug treatment.  SACPA - the Substance Abuse and Crime  
          Prevention Act (Prop. 36, Nov. 2000 Gen. Elec.) - requires that  
          nonviolent drug offenders be given treatment on probation,  
          without incarceration.  SACPA received state funding for six  
          years, but now receives no state money.  Counties must find  
          funding for the required treatment.  The lack of funding has  
          resulted in long waiting lists for treatment, limited capacity  
          and limited programs.  UCLA studies of SACPA found that every  
          dollar spent on the program saved $2.50 dollars and that savings  
          rose to $4 for defendants who completed SACPA treatment.<2>  The  
          NIH found that every dollar spent on drug treatment saved  
          between $2 and $6.

          Similarly, drug courts are widely heralded as effective  
          programs, but are chronically underfunded.  Drug courts use the  
          ---------------------------
          <1>  
          http://report.nih.gov/NIHfactsheets/ViewFactSheet.aspx?csid=22
          <2>  
          http://www.adp.state.ca.us/SACPA/PDF/SACPAEvaluationReport_Final2 
          007Apr13.pdf, p. 6.



                                                                           







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          collaborative courts model, in which the judge closely monitors  
          participants in collaboration with probation, prosecutors,  
          defense attorneys, treatment providers and community  
          organizations.  Drug court participants need not have been  
          convicted of a drug offense, but drug abuse is often at the root  
          of their criminal behavior.  The third major program for drug  
          treatment in the criminal justice system and the county level  
          are the deferred entry of judgment (DEJ) and related pre-plea  
          diversion programs.<3>  In DEJ, a defendant pleads guilty to a  
          drug offense and judgment is deferred pending his or her  
          participation in a drug treatment program.  If the person  
          successfully completes the program, the conviction and  
          underlying charges are dismissed.  (Pen. Code � 1000, et seq.)   
          Funding for DEJ treatment programs is also scarce, as it must be  
          provided by the county, although the county may seek funding  
          from various sources, including the federal government and the  
          state.

          This bill will likely make drug treatment much more available to  
          former jail inmates, including those who are being supervised in  
          the community.  The ACA has confirmed that mental health and  
          drug treatment should have parity with other forms of medical  
          treatment.  The Mental Health Parity and Addiction Equity Act of  
          2008 (MHPAEA) requires that private and public sector employers  
          with 50 or more employees who offer coverage for mental illness  
          and substance use disorders "provide those benefits in a no more  
          restrictive way than all other medical and surgical  
             procedures."<4> The parity rule should apply under the ACA to  
          individuals who purchase insurance on the exchange or who are  
          otherwise eligible for Medi-Cal.

          This bill could be especially helpful for judges and defendants  
          ---------------------------
          <3> In a true diversion program, the defendant is placed in a  
          treatment program without having to plead guilty.  If the  
          defendant completes the program, the charges are dismissed.  If  
          the defendant fails, the case moves forward.  A diversion  
          program can be instituted if the court, district attorney and  
          public defender agree.  (Pen. Code � 1000.5.)
          <4> Substance Abuse and Mental Health Services Administration,  
          January 15, 2013, http://www.samhsa.gov/healthreform/parity/



                                                                           







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          in split-sentencing cases under Penal Code Section 1170,  
          subdivision (h)(5).  Under a split sentence, the court sentences  
          a defendant to a felony term in the county jail, but suspends a  
          portion of the sentence and places the defendant on supervision  
          in the community.  During the suspended portion of the sentence,  
          the defendant is supervised in the community by the probation  
          department in a program equivalent to probation.  The court  
          could order a defendant into drug treatment upon commencement of  
          the period of supervision.

          5. Amendments Requested by the Sheriffs:  1) Broad Discretion for  
            Designation of the Entity that will Enroll Inmates in  
            Healthcare Coverage, and 2) Inmates are Eligible for  
            Enrollment only after Court Remand to the Custody of the  
            Sheriff  

          The author and sponsor have been in ongoing discussions with the  
          California State Sheriffs' Association and representatives of  
          the Los Angeles Sheriff concerning requested amendments.  The  
          author has agreed to these amendments, described below:

                 1)  The bill provides that the county board of  
               supervisors will designate an agency or entity to enroll  
               inmates in medical care programs.  The amendments eliminate  
               a definition of the term "entity."  Leaving the term  
               undefined provides more discretion and flexibility to  
               counties in implementing the bill.


                 2)  The bill will be amended to provide that an inmate  
               will not be eligible for evaluation or enrollment in a  
               health care program until he or she has been remanded to  
               the Sheriff or correctional administrator for at least 72  
               hours.  An arrestee could be held in police or sheriff's  
               sub-station for much of the 72 period before being  
               transferred to a main jail facility.  Also, an arrestee may  
               be released on bail at any time, making it infeasible to  
               complete the process of evaluation or enrollment in a  
               healthcare program.  Requiring that inmates shall not be  
               subject to evaluation and enrollment until the inmate has  




                                                                           







                                                           AB 720 (Skinner)
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               been remanded to the custody of the sheriff or jail  
               administrator by a court will provide some clarity and  
               consistency to the process. 


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