BILL ANALYSIS Ó
SB 1089
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Date of Hearing: June 10, 2014
ASSEMBLY COMMITTEE ON HEALTH
Richard Pan, Chair
SB 1089 (Mitchell) - As Introduced: February 19, 2014
SENATE VOTE : 34-0
SUBJECT : Medi-Cal: juvenile inmates.
SUMMARY : Makes clarifying changes to existing law requiring the
Department of Health Care Services (DHCS) to allow counties to
receive federal Medicaid funds (Medi-Cal in California) for
inpatient services provided in a medical institution off the
grounds of a correctional facility to juvenile inmates who would
be eligible for Medi-Cal if not in a correctional facility.
Specifically, this bill :
1)Clarifies that counties drawing down federal Medicaid funds for
specified juveniles are only required to provide their
proportional share of the non-federal share of the state's
administrative costs.
2)States legislative intent that this program will result in no
increased cost to the state General Fund (GF).
3)Makes other clarifying and correcting amendments.
EXISTING LAW :
1)Establishes the Medi-Cal program, administered by DHCS, under
which qualified low-income individuals, including children up
to 19 years of age, receive health care services.
2)Requires DHCS to allow counties to receive any available federal
financial participation (FFP) for acute inpatient hospital
services and inpatient psychiatric services provided to
juvenile inmates who are admitted as inpatients in a medical
institution off the grounds of the correctional facility, and
who would be eligible for Medi-Cal benefits if they were not
in a correctional facility.
3)Provides that if a county has elected to pursue obtaining FFP for
juvenile inmates, it does not alter or abrogate any obligation
of the state pursuant to an administrative action or a court
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order that is final and no longer subject to appeal to fund
and reimburse counties for any medical services provided to a
juvenile inmate.
4)Provides that a county can elect to pursue obtaining FFP only if
it provides the non-federal share of the state's
administrative costs associated with implementation of this
requirement, and the non-federal share of expenditures for
acute inpatient hospital services and inpatient psychiatric
services provided to eligible juvenile inmates.
FISCAL EFFECT : According to the Senate Appropriations Committee
pursuant to Senate Rule 28.8, negligible state costs.
COMMENTS :
1)PURPOSE OF THIS BILL . According to the author, AB 396
(Mitchell), Chapter 394, Statutes of 2011 establishes a
voluntary program to allow the state, on behalf of counties
and the California Department of Corrections and
Rehabilitation, to draw down FFP under Medi-Cal for hospital
inpatient services and inpatient psychiatric services for
Medi-Cal-eligible detained juveniles at no cost to the state.
Counties electing to voluntarily participate would provide the
non-federal share of expenditures, and be paid the resulting
federal funds. In the case of a federal audit disallowance,
the state will recoup from the participating county the amount
of the disallowance plus any applicable interest. The author
states this bill will address the concern of DHCS that AB 396
may subject the State's General Fund to cost pressures, which
was never the intent of the author or the sponsors of AB 396.
2)BACKGROUND . Under federal Medicaid law, payments for care and
services provided to inmates of a public institution are not
eligible for FFP through Medicaid unless the inmate is a
patient in a medical institution. Existing state law provides
an opportunity to draw down federal funds by establishing
juvenile and adult inmate eligibility for Medi-Cal when an
individual is receiving services at a medical facility off the
grounds of the correctional facility. This approach enables
state and county savings to be achieved by funding health care
services with federal Medicaid matching funds, rather than
state and county funds. In January 2014, DHCS issued a letter
to counties informing them of the new Medicaid claiming
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options. Claims under AB 396 are eligible for reimbursement
retroactive to January 1, 2012.
3)SUPPORT . This bill is sponsored by the Los Angeles County
(L.A. County) Board of Supervisors, which writes this bill is
a technical clean-up measure to AB 396 that contains
clarifying language required by DHCS to reaffirm that if
counties choose to participate in the program established by
AB 396, they will pay their pro rate share of the state's
administrative costs. L.A. County indicates DHCS requested
the additional intent language to further protect the state's
GF.
DHCS writes that this bill provides clean-up language to make
technical and clarifying changes that the scope of services
under the AB 396 process is limited to acute inpatient
hospital and inpatient psychiatric services, emphasizing the
Legislature's intent that the implementation of the AB 396
process will result in no increased cost to the state GF and
that DHCS agrees with the sponsor's intent that each county
will only pay its pro-rate share of the state's administrative
expenses.
4)PREVIOUS LEGISLATION .
a) SB 695 (Hancock), Chapter 647, Statutes of 2011,
authorizes, until January 1, 2014, Medi-Cal benefits to be
provided to a Medi-Cal-eligible individual awaiting
adjudication in a county juvenile detention facility if the
county agrees to pay the state's share of Medi-Cal
expenditures and administrative costs.
b) AB 1628 (Committee on Budget), Chapter 729, Statutes of
2010, requires counties participating in the Medi-Cal
Coordinated Care Initiative to enroll Medi-Cal eligible
state inmates and parolees.
REGISTERED SUPPORT / OPPOSITION :
Support
Los Angeles County Board of Supervisors
California Department of Health Care Services
California State Association of Counties
Urban Counties Caucus
SB 1089
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Opposition
None on file.
Analysis Prepared by : Roger Dunstan / HEALTH / (916) 319-2097