BILL ANALYSIS Ó
AB 1849
Page 1
Date of Hearing: March 29, 2016
ASSEMBLY COMMITTEE ON HUMAN SERVICES
Susan Bonilla, Chair
AB 1849
(Gipson) - As Amended March 28, 2016
SUBJECT: Foster youth: transition to independent living:
health insurance coverage
SUMMARY: Adopts changes to conform to existing law mandating
uninterrupted Medi-Cal coverage until age 26 for former foster
youth, as specified.
Specifically, this bill:
1)Expands the information, documents, and services that a county
welfare department must verify have been provided, or that
attempts have been made to provide, to a nonminor prior to the
court terminating dependency jurisdiction to include:
a) Written verification that the nonminor is enrolled in
Medi-Cal;
b) The nonminor's Medi-Cal Benefits Identification Card;
and
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c) Continued and uninterrupted enrollment in Medi-Cal, as
specified.
2)Requires mandatory health insurance information included in a
youth's or nonminor's 90-day transition plan to include
verification that the youth or nonminor is enrolled in
Medi-Cal, alongside a description of the steps that have been
or will be taken to ensure that the youth or nonminor is
transitioned into the Medi-Cal program for former foster youth
upon case closure with no interruption in coverage and without
a new application being required, as specified.
EXISTING LAW:
1)Permits the juvenile court to adjudge a child a dependent of
the court for specified reasons, including, but not limited
to, if a child has suffered or is at substantial risk of
suffering serious physical harm, emotional damage, or sexual
abuse, as specified. (WIC 300)
2)States that the purpose of foster care law is to provide
maximum safety and protection for children who are currently
being physically, sexually, or emotionally abused, neglected,
or exploited, and to ensure the safety, protection, and
physical and emotional well-being of children who are at risk
of harm. (WIC 300.2)
3)Declares the intent of the Legislature to, whenever possible,
preserve and strengthen a child's family ties and, when a
child must be removed from the physical custody of his or her
parents, to give preferential consideration to placement with
relatives. States the intent of the Legislature to reaffirm
its commitment to children who are in out-of-home placement to
live in the least restrictive family setting and as close to
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the child's family as possible, as specified. Further states
the intent of the Legislature that all children live with a
committed, permanent, nurturing family and states that
services and supports should be tailored to meet the specific
needs of the individual child and family being served, as
specified. (WIC 16000)
4)Requires out-of-home placement of a child in foster care to be
based upon selection of a safe setting that is the least
restrictive family setting that promotes normal childhood
experiences and the most appropriate setting that meets the
child's individual needs, as specified. Further requires the
selection of placement to consider, in order of priority,
placement with: relatives, nonrelated extended family
members, and tribal members; foster family homes, resource
families, and nontreatment certified homes of foster family
agencies; followed by treatment and intensive treatment
certified homes of foster family agencies or multidimensional
treatment foster care homes or therapeutic foster care homes;
group care placements in the order of short-term residential
treatment centers, group homes, community treatment
facilities, and out-of-state residential treatment, as
specified. (WIC 16501.1(d)(1))
5)Revises and expands federal funding and programs for certain
foster and adopted children via the Fostering Connections to
Success and Increasing Adoptions Act of 2008. (P.L. 110-351)
6)Provides for extended foster care funding for youth until age
21, as well as adopts other changes to conform to the federal
Fostering Connections to Success Act. (WIC 241.1, 303, 366.3,
388, 391, 450, 11400, 11402, 11403)
7)Defines "nonminor dependent" as a current or former foster
youth who is between 18 and 21 years old, in foster care under
the responsibility of the county welfare department, county
probation department, or Indian Tribe, and participating in a
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transitional independent living plan, as specified. (WIC
11400 (v))
8)Prohibits the dependency court from terminating jurisdiction
over a nonminor until a hearing is conducted and the county
welfare department has submitted a report verifying that
specified information, documents, and services have been
provided, or that attempts have been made to provide them, to
the nonminor. (WIC 391 (e)(1))
9)Establishes requirements for the development and maintenance
of a case plan for youth in the child welfare services system.
(WIC 16501.1)
10)Requires, pursuant to federal law as specified, an individual
who was in foster care on his or her 18th birthday to receive
Medi-Cal benefits until his or her 26th birthday, and to be
continuously enrolled during this period without any
interruption in coverage or new application required. (WIC
14005.28)
FISCAL EFFECT: Unknown.
COMMENTS:
Child Welfare Services: The purpose of California's Child
Welfare Services (CWS) system is to protect children from abuse
and neglect and provide for their health and safety. When
children are identified as being at risk of abuse, neglect or
abandonment, county juvenile courts hold legal jurisdiction and
children are served by the CWS system through the appointment of
a social worker. Through this system, there are multiple
opportunities for the custody of the child, or his or her
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placement outside of the home, to be evaluated, reviewed and
determined by the judicial system, in consultation with the
child's social worker, to help provide the best possible
services to the child. The CWS system seeks to help children
who have been removed from their homes reunify with their
parents or guardians, whenever appropriate, or unite them with
other individuals they consider to be family.
Extended foster care is available to youth up to the age of 21,
provided certain conditions are met. As of October 1, 2015,
there were 62,605 children in California's child welfare system,
7,580 of whom were between the ages of 18 and 20. In 2014,
2,500 youth ages 18 and over exited foster care, with 1,623 (65
%) of them exiting to emancipation.
Medi-Cal coverage for former foster youth: The federal Patient
Protection and Affordable Care Act (ACA) allows young adults to
be covered under their parents' health insurance until age 26.
If a youth was in foster care on his or her 18th birthday and
receiving Medicaid, and later emancipates, he or she is required
to receive continued, uninterrupted health insurance coverage
through Medicaid (called Medi-Cal in California), regardless of
income, and with no need to complete a new application.
Need for this bill: SB 508 (Hernandez), Chapter 831, Statutes
of 2014, clarified, per the ACA, that former foster youth are
eligible for Medi-Cal coverage up to age 26 if the youth was in
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foster care on his or her 18th birthday. This bill adopts
conforming changes to CWS processes to ensure that nonminors are
provided continued, uninterrupted, Medi-Cal coverage.
According to the author, this bill "will clarify that child
welfare and probation workers must ensure the youth have their
Medi-Cal benefit cards and other information regarding their
eligibility for Medi-Cal until age 26. Child welfare workers
must also verify that the young person has been transitioned
into the Medi-Cal program for former foster youth with no
interruption in coverage and no new application. Youth aging
out of foster care have disproportionately high rates of
physical and behavioral health issues. It is essential that
these youth have ongoing health coverage and are given
information about their automatic Medi-Cal eligibility until age
26. Without access to health insurance these young people are
at serious risk of ongoing health problems. The lack of
conformity in existing law is a barrier to a smooth transition
to continuing coverage."
PRIOR LEGISLATION:
SB 508 (Hernandez), Chapter 831, Statutes of 2014, adopted a
number of changes to Medi-Cal eligibility rules to codify
existing eligibility levels or clarify changes made to the
program's eligibility requirements when the state expanded
eligibility under the federal Patient Protection and Affordable
Care Act, including clarifying that former foster youth are
eligible for Medi-Cal coverage up to age 26 if he or she was in
foster care on his or her 18th birthday, as specified.
REGISTERED SUPPORT / OPPOSITION:
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Support
Alliance for Children's Rights
Aspiranet
California Alliance of Child and Family Services
California Black Health Network (CBHN)
California CASA Association
California Pan-Ethic Health Network (CPEHN)
California Primary Care Association (CPCA)
California Youth Connection
Children Now
Children's Advocacy Institute
Children's Law Center of California (CLC)
Community Clinic Association of Los Angeles
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Community College Foundation
East Bay Children's Law Offices (EBCLO)
Families NOW
FosterClub Inc.,
Health Access California
John Burton Foundation
Journey House, Inc.
National Center for Youth Lawn (NYCL)
National Health Law Program
Orangewood Foundation
Public Counsel's Children's Rights Project
Sanctuary of Hope
St. Anne's
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UCLA Bruin Guardian Scholars Program
Western Center on Law and Poverty
Young Minds Advocacy
Youth Law Center
Opposition
None on file.
Analysis Prepared by:Daphne Hunt / HUM. S. / (916) 319-2089