BILL NUMBER: SB 4 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY SEPTEMBER 10, 2015
AMENDED IN ASSEMBLY SEPTEMBER 4, 2015
AMENDED IN ASSEMBLY SEPTEMBER 1, 2015
AMENDED IN ASSEMBLY JULY 16, 2015
AMENDED IN ASSEMBLY JULY 7, 2015
AMENDED IN SENATE JUNE 1, 2015
AMENDED IN SENATE APRIL 28, 2015
AMENDED IN SENATE APRIL 6, 2015
INTRODUCED BY Senator Lara
(Principal coauthor: Assembly Member Bonta)
(Coauthors: Senators Hall, Hancock, Hernandez, Hill, Hueso,
Mitchell, Monning, Pan, and Wolk)
(Coauthors: Assembly Members Alejo, Chiu, Gomez, Levine, Lopez,
and Thurmond)
DECEMBER 1, 2014
An act to amend Section 14007.8 of the Welfare and Institutions
Code, relating to health care coverage.
LEGISLATIVE COUNSEL'S DIGEST
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. 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.
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:
SECTION 1. The Legislature finds and declares all of the
following:
(a) No child in California should endure suffering and pain due to
a lack of access to health care services.
(b) Expanding access and increasing enrollment in comprehensive
health care coverage benefits the health and welfare of all
Californians.
(c) Through the enactment of Senate Bill 75, the California
Legislature has extended eligibility for full-scope Medi-Cal benefits
to all children in California, regardless of immigration status.
SEC. 2. Section 14007.8 of the Welfare and Institutions Code is
amended to read:
14007.8. (a) (1) After the director determines, and communicates
that determination in writing to the Department of Finance, that
systems have been programmed for implementation of this section, but
no sooner than May 1, 2016, an individual who is under 19 years of
age and who does not have satisfactory immigration status or is
unable to establish satisfactory immigration status as required by
Section 14011.2 shall be eligible for the full scope of Medi-Cal
benefits, if he or she is otherwise eligible for benefits under this
chapter.
(2) (A) Individuals under 19 years of age
enrolled in Medi-Cal pursuant to subdivision (d) of Section 14007.5
at the time the director makes the determination described in
paragraph (1) shall be enrolled in the full scope of Medi-Cal
benefits, if otherwise eligible, pursuant to an eligibility and
enrollment plan. This plan shall include outreach strategies
developed by the department in consultation with interested
stakeholders, including, but not limited to, counties, health care
service plans, consumer advocates, and the Legislature.
Individuals subject to this subparagraph shall not be required to
file a new application for Medi-Cal.
(B) The effective date of enrollment into Medi-Cal for individuals
described in subparagraph (A) shall be on the same day on which the
systems are operational to begin processing new applications pursuant
to the director's determination described in paragraph (1).
(C) Beginning January 31, 2016, and until the director makes the
determination described in paragraph (1), the department shall
provide monthly updates to the appropriate policy and fiscal
committees of the Legislature on the status of the implementation of
this section.
(b) To the extent permitted by state and federal law, an
individual eligible under this section shall be required to enroll in
a Medi-Cal managed care health plan. Enrollment in a Medi-Cal
managed care health plan shall 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.
(c) The department shall seek any necessary federal approvals to
obtain federal financial participation in implementing this section.
Benefits for services under this section shall be provided with
state-only funds only if federal financial participation is not
available for those services.
(d) The department shall maximize federal financial participation
in implementing this section to the extent allowable.
(e) This section shall be implemented only to the extent it is in
compliance with Section 1621(d) of Title 8 of the United States Code.
(f) (1) Notwithstanding Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code, the
department, without taking any further regulatory action, shall
implement, interpret, or make specific this section by means of
all-county letters, plan letters, plan or provider bulletins, or
similar instructions until the time any necessary regulations are
adopted. Thereafter, the department shall adopt regulations in
accordance with the requirements of Chapter 3.5 (commencing with
Section 11340) of Part 1 of Division 3 of Title 2 of the Government
Code.
(2) Commencing six months after the effective date of this
section, and notwithstanding Section 10231.5 of the Government Code,
the department shall provide a status report to the Legislature on a
semiannual basis, in compliance with Section 9795 of the Government
Code, until regulations have been adopted.
(g) In implementing this section, the department may contract, as
necessary, on a bid or nonbid basis. This subdivision establishes an
accelerated process for issuing contracts pursuant to this section.
Those contracts, and any other contracts entered into pursuant to
this subdivision, may be on a noncompetitive bid basis and shall be
exempt from the following:
(1) Part 2 (commencing with Section 10100) of Division 2 of the
Public Contract Code and any policies, procedures, or regulations
authorized by that part.
(2) Article 4 (commencing with Section 19130) of Chapter 5 of Part
2 of Division 5 of Title 2 of the Government Code.
(3) Review or approval of contracts by the Department of General
Services.