SB 4, as amended, Lara. Health care coverage: immigration status.
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 extends eligibility for full-scope Medi-Cal benefits to individuals under 19 years of age who do not have, or are unable to establish, satisfactory immigration status, commencing after the Director of Health Care Services determines that systems have been programmed for implementation of this extension, but in no case sooner than May 1, 2016. Existing law requires these individuals to enroll in a Medi-Cal managed care health plan in those counties in which a Medi-Cal managed care health plan is available.
This bill would require individuals under 19 years of age enrolled in restricted-scope Medi-Cal at the time the director makes the above-described determination to be enrolled in the full scope of Medi-Cal benefits, if otherwise eligible, pursuant to an eligibility and enrollment plan, as specified.begin insert The bill would require the department, beginning January 31, 2016, and until the director makes the above-described determination, to provide monthly updates to the policy and fiscal committees of the Legislature, as specified.end insert The bill would also require that an individual who is eligible pursuant to these provisions enroll in a Medi-Cal managed care health plan. The bill would not preclude a beneficiary from being enrolled in any other children’s Medi-Cal specialty program that he or she would otherwise be eligible for.
Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.
The people of the State of California do enact as follows:
The Legislature finds and declares all of the
2following:
3(a) No child in California should endure suffering and pain due
4to a lack of access to health care services.
5(b) Expanding access and increasing enrollment in
6comprehensive health care coverage benefits the health and welfare
7of all Californians.
8(c) Through the enactment of Senate Bill 75, the California
9Legislature has extended eligibility for full-scope Medi-Cal benefits
10to all children in California, regardless of immigration status.
Section 14007.8 of the Welfare and Institutions Code
12 is amended to read:
(a) (1) After the director determines, and
14communicates that determination in writing to the Department of
P3 1Finance, that systems have been programmed for implementation
2of this section, but no sooner than May 1, 2016, an individual who
3is under 19 years of age and who does not have satisfactory
4immigration status or is unable to establish satisfactory immigration
5status as required by Section 14011.2 shall be eligible for the full
6scope of Medi-Cal benefits, if he or she is otherwise eligible for
7benefits under this chapter.
8(2) begin insert(A)end insertbegin insert end insert Individuals under 19 years of age enrolled in Medi-Cal
9pursuant to subdivision (d) of Section 14007.5 at the time the
10director makes the determination described in paragraph (1) shall
11be enrolled in the full scope of Medi-Cal benefits, if otherwise
12eligible, pursuant to an eligibility and enrollment plan. This plan
13shall include outreach strategies developed by the department in
14consultation with interested stakeholders, including, but not limited
15to, counties, health care service plans, consumer advocates, and
16the Legislature.begin insert Individuals subject to this subparagraph shall not
17be required to file a new application for Medi-Cal.end insert
18(B) The effective date of enrollment into Medi-Cal for
19individuals described in subparagraph (A) shall be on the same
20day on which the systems are operational to begin processing new
21applications pursuant to the director’s determination described
22in paragraph (1).
23(C) Beginning January 31, 2016, and until the director makes
24the determination described in paragraph (1), the department shall
25provide monthly updates to the appropriate policy and fiscal
26committees of the Legislature on the status of the implementation
27of this section.
28(b) To the extent permitted by state and federal law, an
29individual eligible under this section shall be required to enroll in
30a Medi-Cal managed care health plan. Enrollment in
a Medi-Cal
31managed care health plan shall not preclude a beneficiary from
32being enrolled in any other children’s Medi-Cal specialty program
33that he or she would otherwise be eligible for.
34(c) The department shall seek any necessary federal approvals
35to obtain federal financial participation in implementing this
36section. Benefits for services under this section shall be provided
37with state-only funds only if federal financial participation is not
38available for those services.
39(d) The department shall maximize federal financial participation
40in implementing this section to the extent allowable.
P4 1(e) This section shall be implemented only to the extent it is in
2compliance with Section 1621(d) of Title 8 of the
United States
3Code.
4(f) (1) Notwithstanding Chapter 3.5 (commencing with Section
511340) of Part 1 of Division 3 of Title 2 of the Government Code,
6the department, without taking any further regulatory action, shall
7implement, interpret, or make specific this section by means of
8all-county letters, plan letters, plan or provider bulletins, or similar
9instructions until the time any necessary regulations are adopted.
10Thereafter, the department shall adopt regulations in accordance
11with the requirements of Chapter 3.5 (commencing with Section
1211340) of Part 1 of Division 3 of Title 2 of the Government Code.
13(2) Commencing six months after the effective date of this
14section, and notwithstanding Section 10231.5 of the Government
15Code, the department shall
provide a status report to the Legislature
16on a semiannual basis, in compliance with Section 9795 of the
17Government Code, until regulations have been adopted.
18(g) In implementing this section, the department may contract,
19as necessary, on a bid or nonbid basis. This subdivision establishes
20an accelerated process for issuing contracts pursuant to this section.
21Those contracts, and any other contracts entered into pursuant to
22this subdivision, may be on a noncompetitive bid basis and shall
23be exempt from the following:
24(1) Part 2 (commencing with Section 10100) of Division 2 of
25the Public Contract Code and any policies, procedures, or
26regulations authorized by that part.
27(2) Article 4 (commencing with Section 19130) of
Chapter 5
28of Part 2 of Division 5 of Title 2 of the Government Code.
29(3) Review or approval of contracts by the Department of
30General Services.
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