BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                    AB 1849


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          CONCURRENCE IN SENATE AMENDMENTS


          AB  
          1849 (Gipson)


          As Amended  August 17, 2016


          Majority vote


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          Original Committee Reference:  HUM. S.


          SUMMARY:  Adopts changes to conform to existing law mandating  
          uninterrupted Medi-Cal coverage until age 26 for former foster  
          youth, as specified.  


          The Senate amendments:


          1)Clarify that the provisions of this bill apply to eligible  
            youth and nonminors.


          2)Make technical amendments.


          3)Make chaptering amendments.










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          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.  (Welfare and Institutions Code Section  
            (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  
            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  








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            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.  (Public Law  
            (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  
            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  








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            continuously enrolled during this period without any  
            interruption in coverage or new application required.  (WIC  
            14005.28)


          FISCAL EFFECT:  According to the Senate Appropriations Committee  
          analysis from August 1, 2016, this bill may result in potential  
          ongoing local-assistance costs of $36,158 ($28,959 General Fund)  
          per year to the extent that an additional 15 minutes of social  
          worker time is needed per case to provide the required  
          documentation for enrollment in Medi-Cal for youth who are  
          leaving foster care and for verification of the social worker's  
          steps in the youth's transition plan. 


          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  
          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.









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          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  
          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  








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          program's eligibility requirements when the state expanded  
          eligibility under the ACA, 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.


          Analysis Prepared by:                                             
                          Daphne Hunt / HUM. S. / (916) 319-2089  FN:  
          0004561