California Legislature—2015–16 Regular Session

Assembly Bill No. 658

Introduced by Assembly Member Wilk

February 24, 2015

An act to amend Section 4011.10 of the Penal Code, relating to health care.

LEGISLATIVE COUNSEL’S DIGEST

AB 658, as introduced, Wilk. County jails: inmate health care services: rates.

Existing federal law provides for the federal Medicare Program, which is a public health insurance program for persons 65 years of age and older and specified persons with disabilities who are under 65 years of age.

Existing law authorizes a county sheriff, police chief, or other public agency that contracts for health care services, to contract with providers of health care services for care to local law enforcement patients. Existing law requires hospitals that do not contract with the county sheriff, police chief, or other public agency that contracts for health care services to provide health care services to local law enforcement patients at a rate equal to 110% of the hospital’s actual costs according to the most recent Hospital Annual Financial Data report issued by the Office of Statewide Health Planning and Development, as calculated using a cost-to-charge ratio.

This bill would authorize, in the alternative, those costs to be calculated according to the most recent approved cost-to-charge ratio from the Medicare Program. The bill would also make technical nonsubstantive changes.

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

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

SECTION 1.  

Section 4011.10 of the Penal Code is amended
to read:

4011.10.  

(a) It is the intent of the Legislature in enacting this
section to provide county sheriffs, chiefs of police, and directors
or administrators of local detention facilities with an incentive to
not engage in practices designed to avoid payment of legitimate
health care costs for the treatment or examination of persons
lawfully in their custody, and to promptly pay those costs as
requested by the provider of services. Further, it is the intent of
the Legislature to encourage county sheriffs, chiefs of police, and
directors or administrators of local detention facilities to bargain
in good faith when negotiating a service contract with hospitals
providing health care services.

(b) Notwithstanding any other provision of law, a county sheriff,
police chief or other public agency that contracts for health care
services, may contract with providers of health care services for
care to local law enforcement patients. Hospitals that do not
contract with the county sheriff, police chief, or other public agency
that contracts for health care services shall provide health care
services to local law enforcement patients at a rate equal to 110
percent of the hospital’s actual costs according to the most recent
Hospital Annual Financial Data report issued by the Office of
Statewide Health Planning and Development, as calculated using
a cost-to-charge begin delete ratio. end delete begin insert ratio, or according to the most recent
approved cost-to-charge ratio from the Medicare Program. end insert

(c) A county sheriff or police chief shall not request the release
of an inmate from custody for the purpose of allowing the inmate
to seek medical care at a hospital, and then immediately rearrest
the same individual upon discharge from the hospital, unless the
hospital determines this action would enable it to bill and collect
from a third-party payment source.

(d) The California Hospital Association, the University of
California, the California State Sheriffs’ Association begin insert , end insert and the
California Police begin delete Chiefs’ end delete begin insert Chiefs end insert Association shall, immediately
upon enactment of this section, convene the Inmate Health Care
and Medical Provider Fair Pricing Working Group. The working
group shall consist of at least six members from the California
Hospital Association and the University of California, and six
members from the California State Sheriffs’ Association and the
California Police begin delete Chiefs’ end delete begin insert Chiefs end insert Association. Each organization
should give great weight and consideration to appointing members
of the working group with diverse geographic and demographic
interests. The working group shall meet as needed to identify and
resolve industry issues that create fiscal barriers to timely and
affordable inmate health care. In addition, the working group shall
address issues including, but not limited to, inmates being admitted
for care and later rearrested and any other fiscal barriers to hospitals
being able to enter into fair market contracts with public agencies.
To the extent that the rate provisions of this statute result in a
disproportionate share of local law enforcement patients being
treated at any one hospital or system of hospitals, the working
group shall address this issue. No reimbursement is required under
this provision.

(e) Nothing in this section shall require or encourage a hospital
or public agency to replace any existing arrangements that any
city police chief, county sheriff, or other public agency that
contracts for health care services for local law enforcement patients
begin insert has with health care providers end insert .

(f) An entity that provides ambulance or any other emergency
or nonemergency response service to a sheriff or police chief, and
that does not contract with their departments for that service, shall
be reimbursed for the service at the rate established by Medicare.
Neither the sheriff nor the police chief shall reimburse a provider
of any of these services that begin delete their end delete begin insert his or her end insert department has not
contracted with at a rate that exceeds the provider’s reasonable
and allowable costs, regardless of whether the provider is located
within or outside of California.

(g) For the purposes of this section, “reasonable and allowable
costs” shall be defined in accordance with Part 413 of Title 42 of
the Code of Federal Regulations and federal Centers for Medicare
and Medicaid Services Publication Numbers begin delete 15.1 end delete begin insert 15-1 end insert and begin delete 15.2. end delete
begin insert 15-2. end insert

(h) For purposes of this section, in those counties in which the
sheriff does not administer a jail facility, a director or administrator
of a local department of corrections established pursuant to Section
23013 of the Government Code is the person who may contract
for services provided to jail inmates in the facilities he or she
administers in those counties.