BILL NUMBER: AB 1018 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY MAY 28, 2015
AMENDED IN ASSEMBLY APRIL 13, 2015
INTRODUCED BY Assembly Member Cooper
(Coauthor: Assembly Member Dodd)
FEBRUARY 26, 2015
An act to add and repeal Section 14727 to the Welfare
and Institutions Code, relating to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
AB 1018, as amended, Cooper. Medi-Cal: Early and Periodic
Screening, Diagnosis, and Treatment (EPSDT).
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 law provides that Early and
Periodic Screening, Diagnosis, and Treatment (EPSDT) services
for any individual under 21 years of age is covered under
Medi-Cal consistent with the requirements of federal law. Under
federal law, EPSDT services include screening services, vision
services, dental services, hearing services, and other necessary
services to correct or ameliorate defects and physical and mental
illnesses and conditions discovered by the screening services,
whether or not the services are covered under the state plan.
Existing federal law, the Individuals with Disabilities Education
Act, requires that a free appropriate public education be made
available to individuals with exceptional needs, and be tailored to
their individual needs.
This bill would require the department to permit county mental
health plans to contract with local educational agencies (LEAs), as
defined, to provide services for Medi-Cal eligible pupils under
EPSDT. The bill would also require the department to permit an LEA to
make claims for federal financial participation directly to the
department for EPSDT services provided by the LEA or that the LEA has
contracted for. The bill would also require the department to
examine methodologies for increasing LEA participation in the
Medi-Cal program so that schools can meet the educationally related
health care needs of their pupils.
This bill would require the State Department of Health Care
Services and the Department of Education to convene a joint task
force to examine the delivery of mental health services to children
eligible for EPSDT services and for services pursuant to the federal
Individuals with Disabilities Education Act, and to consider
specified subjects. The bill would require the task force to hold at
least 2 public meetings by October 1, 2016, and to submit a report to
the Legislature covering key findings and recommendations for
further action, if any.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 14727 is added to the
Welfare and Institutions Code , to read:
14727. (a) The Legislature finds that it is in the state's
interest to ensure delivery of mental health services to children in
California is coordinated, accessible, and cost-effective.
(b) The State Department of Health Care Services and the State
Department of Education shall convene a joint task force to examine
the delivery of mental health services to children eligible for Early
and Periodic Screening, Diagnosis, and Treatment services and for
services pursuant to the federal Individuals with Disabilities
Education Act (20 U.S.C. Sec. 1400 et seq.). The goal of the task
force shall be to ensure children are provided accessible and
coordinated care that is compliant with state and federal law, in a
way that is maximally cost-effective for the state. The task force
shall consider all of the following:
(1) Whether current technical assistance and guidance to county
mental health plans and schools is sufficient to optimize service
delivery and overall cost-effectiveness of service delivery.
(2) Whether current funding arrangements for services available
through the Early and Periodic Screening, Diagnosis, and Treatment
Program and pursuant to the federal Individuals with Disabilities
Education Act maximize federal funding to the state for provision of
these services.
(3) Issuing best practice guidelines for how special education
local plan areas and county mental health plans can work together to
optimize access to federal financial participation for eligible
services in both systems.
(4) How disputes over responsibility for service delivery is, and
should be, resolved in cases where children are dually eligible for
Early Periodic Screening, Diagnosis, and Treatment services and
services pursuant to the federal Individuals with Disabilities
Education Act.
(c) The task force shall solicit information from relevant
stakeholders. By October 1, 2016, the task force shall hold at least
two public meetings. By January 1, 2017, the task force shall report
to the Legislature a summary of key findings and recommendations for
further action, if any.
(d) (1) A report to be submitted pursuant to subdivision (c) shall
be submitted in compliance with Section 9795 of the Government Code.
(2) Pursuant to Section 9795 of the Government Code, this section
is repealed on January 1, 2021.
SECTION 1. Section 14727 is added to the
Welfare and Institutions Code, to read:
14727. (a) (1) The department shall permit county mental health
plans to contract with local educational agencies (LEAs) to provide
services for Medi-Cal eligible pupils under Early and Periodic
Screening, Diagnosis, and Treatment (EPSDT).
(2) (A) Subject to subparagraph (B), if an LEA does not have a
contract with the county mental health plan, the department shall
permit an LEA to make claims for federal financial participation
directly to the department for EPSDT services provided by the LEA or
that the LEA has contracted for. Unless otherwise precluded by
federal law, an LEA shall be reimbursed for all eligible EPSDT
services provided under this section.
(B) To receive federal financial participation under this
paragraph, the LEA shall pay the nonfederal share of EPSDT
expenditures and shall certify its public expenditures for EPSDT
services to the department.
(b) (1) Services that a county mental health plan may contract
with an LEA for, or that an LEA may receive federal financial
participation for, under this section include, but are not limited
to, any of the following:
(A) Mental health assessments.
(B) Targeted case management services.
(C) Behavioral services.
(D) Mental health, social work, and counseling services.
(E) Individual and group services.
(F) Crisis intervention.
(G) Day treatment.
(H) Residential treatment.
(I) Medication support services.
(2) The Legislature does not intend for this section to authorize
an LEA or a county mental health plan to knowingly provide, or submit
a claim for, duplicated EPSDT services.
(c) The department shall examine methodologies for increasing LEA
participation in the Medi-Cal program so that schools can meet the
educationally related health care needs of their pupils, which shall
include simplifying the claiming processes for Medi-Cal billing to
the extent possible.
(d) For purposes of this section, "local educational agency" has
the same meaning as that term is defined in Section 56026.3 of the
Education Code.
(e) This section shall be implemented to the extent permitted by
federal law. The department shall seek any necessary state plan
amendments or waiver amendments to implement this section and shall
undertake all necessary activities to obtain federal financial
participation for reimbursable services provided by LEAs or
contracted for by LEAs under this section.