AB 1299, as amended, Ridley-Thomas. Medi-Cal: specialty mental health services: foster children.
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) for any individual under 21 years of age is covered under Medi-Cal, consistent with the requirements of federal law. Federal law defines EPSDT mental health services to 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. EPSDT is classified under the Medi-Cal program as a specialty mental health service.
Existing law requires each local mental health plan to establish a procedure to ensure access to outpatient specialty mental health services, as required by the EPSDT program standards, for children in foster care who have been placed outside their county of adjudication. Existing law includes standardized contracts, procedures, documents, and forms, to facilitate the receipt of medically necessary specialty mental health services by a foster child who is placed outside his or her county of original jurisdiction.
This bill would declare the intent of the Legislature to ensure that foster children who are placed outside of their county of original jurisdiction, are able to access mental health services in a timely manner consistent with their individualized strengths and needs and the requirements of EPSDT program standards and requirements. The bill would require the department to issue policy guidance that establishes the presumptive transfer of responsibility for providing or arranging for mental health services to foster youth from the county of original jurisdiction to the foster child’s county of residence, as prescribed. The bill would define presumptive transfer for these purposes.
This bill would require the Department of Finance, by May 1,2016, to set or adjust its allocation schedule of the Behavioral Health Subaccount pursuant to realignment provisions enacted pursuant to a specified measure, in order that counties that have paid, or will pay, for the specialty mental health services provided pursuant to the bill, are fully reimbursed during the fiscal year in which the services were provided. This bill would require the department to determine whether it is necessary to seek approval under the state’s Section 1915(b) Medicaid waiver from the federal Centers for Medicare and Medicaid Services (CMS) prior to implementing the bill, and if so, to do everything within its power necessary to secure an expeditious approval.
Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.
The people of the State of California do enact as follows:
Article 6 (commencing with Section 14695.1) is
2added to Chapter 8.8 of Part 3 of Division 9 of the Welfare and
3Institutions Code, to read:
4
(a) (1) It is the intent of the Legislature to ensure
8that foster children who are placed outside of their county of
9original jurisdiction, are able to access mental health services in
P3 1a timely manner, consistent with their individualized strengths and
2needs and the requirements of Early Periodic Screening Diagnosis
3and Treatment (EPSDT) program standards and requirements.
4(2) It is the further intent of the Legislature to overcome the
5barriers to care that exist under existing law, which place
6responsibility for providing or arranging for mental health services
7to foster children who are placed outside of their county of original
8jurisdiction, on
those same counties.
9(b) In order to facilitate the receipt of medically necessary
10specialty mental health services by a foster child who is placed
11outside of his or her county of original jurisdiction, the California
12Health and Human Services Agency shall coordinate with the
13department and the State Department of Social Services to take
14all of the following actions:
15(1) On or before July 1, 2016, all of the following shall occur:
16(A) The department shall issue policy guidance, pursuant to
17Section 14716, that establishes the presumptive transfer of
18responsibility for providing or arranging for mental health services
19to foster youth, consistent with the requirements of EPSDT
20program standards and requirements, from the county
of original
21jurisdiction to the foster child’s county of residence.
22(B) “Presumptive transfer” for
the purposes of this section means
23that absent any conditions or exceptions as established pursuant
24to this article, responsibility for providing or arranging for mental
25health services shall immediately transfer from the county of
26original jurisdiction to the county of residence, when the all of the
27following conditions occur:
28(i) A foster child is placed in a county other than the county of
29original jurisdiction.
30(ii) The transfer of responsibility is requested by the county
31child welfare services agency, county probation department, foster
32caregiver, or any other person authorized to make medical decisions
33on behalf of the foster child.
34(C)
end delete
35begin insert(B)end insert The department shall establish the conditions and exceptions
36to presumptive transfer in consultation with the State Department
37of Social Services, and with the input of stakeholders that include
38the County Welfare Directors Association of California, the County
39Behavioral Health Directors Association of California, provider
40representatives, and family and youth advocates. The conditions
P4 1and exceptions to presumptive transfer are intended to ensure that
2the transfer of responsibility improves access to mental health care
3services and does not impede the continuity of existing care.
4(D)
end delete
5begin insert(C)end insert The department shall establish the procedures for
6implementing presumptive transfer that are consistent with the
7purposes and intent of this section and Early Periodic Screening
8Diagnosis and Treatment program standards and requirements,
9and shall include a procedure for expedited transfer within 48
10hours.
11(c) “Presumptive transfer” for the purposes of this section,
12means that absent any conditions or exceptions as established
13pursuant to this article, responsibility for providing or arranging
14for mental health services shall immediately transfer from the
15county of original jurisdiction to the county of residence, when all
16of the following conditions occur:
17(1) A foster child is placed in a county other than the county of
18original jurisdiction.
19(2) The transfer of responsibility is requested by the county
20child welfare services agency, county probation department, foster
21caregiver, or any other person authorized to make medical
22decisions on behalf of the foster child.
By May 1, 2016, the Department of Finance shall set
24or adjust its allocation schedule of the Behavioral Health
25Subaccount pursuant to the requirements of Senate Bill 1020
26(Chapter 40, Statutes of 2012), in order that counties that have
27paid, or will pay, for specialty mental health services for foster
28children placed out of county pursuant to this article, are fully
29reimbursed during the fiscal year in which the services are
30provided.
(a) If the department determines it is necessary, it
32shall seek approval under the state’s Section 1915(b) Medicaid
33waiver from the United States Department of Health and Human
34Services, Centers for Medicare and Medicaid Services (CMS) prior
35to implementing this article.
36(b) If the department makes the determination that it is necessary
37to seek CMS approval pursuant to subdivision (a), the department
38shall make an official request for approval from CMS no later than
39begin delete____,end deletebegin insert July 1, 2016,end insert and shall
do everything within its power
40necessary to secure an expeditious approval from CMS.
P5 1(c) The department shall not be required to implement any
2provision of this article that CMS determines is not permitted under
3the state’s waiver.
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