BILL ANALYSIS                                                                                                                                                                                                    







                      SENATE COMMITTEE ON PUBLIC SAFETY
                           Senator Carole Migden, Chair              S
                             2005-2006 Regular Session               B

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          SB 896 (Runner)                                             
          As Amended June 21, 2006 
          Hearing date:  August 10, 2006
          Penal Code  (URGENCY)
          SM:br



                      LOCAL PERSONS "IN CUSTODY" AND JAIL INMATES

               REIMBURSEMENT TO PROVIDERS OF LOCAL EMERGENCY SERVICES
                                           

                                       HISTORY

          Source:  Author

          Prior Legislation: SB 159 (Runner) - Ch.481, Stats. 2005
                       SB 1102 (Committee on Budget and Fiscal Review) -  
                       Ch. 227,
                          Stats. 2004 (Urgency)
                       AB 2475 (Wolk) - 2004, held Senate Appropriations  
                       Committee

          Support: University of California; California Hospital  
          Association

          Opposition:None known

          Assembly Floor Vote:  Ayes  75 - Noes  0

           (  THIS BILL IS BEFORE THE COMMITTEE PURSUANT TO SENATE RULE  
          29.10.  THE COMMITTEE, BY A MAJORITY VOTE OF THE MEMBERSHIP, MAY  




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          EITHER: (1) HOLD THE BILL; OR (2) RETURN THE BILL TO THE SENATE  
          FLOOR FOR CONSIDERATION OF THE ASSEMBLY AMENDMENTS.)

                                        KEY ISSUES
           
          SHOULD LOCAL PUBLIC OFFICIALS OTHER THAN SHERIFFS AND POLICE CHIEFS  
          BE AUTHORIZED TO ENTER INTO CONTRACTS FOR EMERGENCY HEALTH SERVICES  
          FOR CARE TO "LOCAL LAW ENFORCEMENT PATIENTS?"

          SHOULD THE "INMATE HEALTH CARE AND MEDICAL PROVIDER FAIR PRICING  
          WORKING GROUP" ADDRESS THE ISSUE OF WHETHER A DISPROPORTIONATE SHARE  
          OF LOCAL LAW ENFORCEMENT PATIENTS IS BEING TREATED AT ANY ONE  
          HOSPITAL OR SYSTEM OF HOSPITALS?


                                       PURPOSE
          
          The purpose of this bill is to (1) amend current law which  
          permits sheriffs and police chiefs to contract for emergency  
          health services to extend this authority to "other public  
          officials" and (2) provide that existing Inmate Health Care and  
          Medical Provider Fair Pricing Working Groups address the issue  
          of whether a disproportionate share of local law enforcement  
          patients is being treated at any one hospital or system of  
          hospitals.
          
           Existing law  provides that it is the intent of the Legislature  
          to provide county sheriffs, chiefs of police, and directors or  
          administrators of local detention facilities with an incentive  
          to not engage in practices designed to avoid payment of  
          legitimate emergency health care costs for the treatment or  
          examination of persons lawfully in their custody, and to  
          promptly pay those costs as requested by the provider of  
          services.  Further, it is the intent of the Legislature to  
          encourage county sheriffs, chiefs of police, and directors or  
          administrators of local detention facilities to bargain in good  
          faith when negotiating a service contract with hospitals  
          providing emergency health care services.  The Legislature has  
          set a date of January 1, 2009, for this section to be repealed,  




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          and does not intend to delete or extend that date if county  
          sheriffs, chiefs of police, and directors or administrators have  
          not complied with the intent of the Legislature, as expressed in  
          this subdivision.  (Penal Code  4011.10 (a).)

           Existing law  provides that, notwithstanding any other provision  
          of law, a county sheriff or police chief may contract with  
          providers of emergency health care services.  Hospitals that do  
          not contract with the sheriff or police chief for emergency  
          health care services shall provide these services to their  
          departments at a rate equal to 110 percent of the hospital's  
          actual costs according to the most recent Hospital Annual  
          Financial Data report issued by the Office of Statewide Health  
          Planning and Development, as calculated using a cost-to-charge  
          ratio.  (Penal Code  4011.10 (b).)



           Existing law  provides that a county sheriff or police chief  
          shall not request the release of an inmate from custody for the  
          purpose of allowing the inmate to seek medical care at a  
          hospital, and then immediately rearrest the same individual  
          upon discharge from the hospital, unless the hospital  
          determines this action would enable it to bill and collect from  
          a third-party payment source.  (Penal Code  4011.10 (c).)

           Existing law  provides that the California Hospital Association,  
          the University of California, the California State Sheriffs'  
          Association and the California Police Chiefs' Association shall,  
          immediately upon enactment of this section, convene the Inmate  
          Health Care and Medical Provider Fair Pricing Working Group.   
          The working group shall consist of at least six members from the  
          California Hospital Association and the University of  
          California, and six members from the California State Sheriffs'  
          Association and the California Police Chiefs' Association.  Each  
          organization should give great weight and consideration to  
          appointing members of the working group with diverse geographic  
          and demographic interests.  The working group shall meet at  
          least three times annually to identify and resolve industry  




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          issues that create fiscal barriers to timely and affordable  
          emergency inmate health care.  In addition, the working group  
          shall address issues including, but not limited to, inmates  
          being admitted for care and later rearrested and any other  
          fiscal barriers to hospitals being able to enter into fair  
          market contracts with public agencies.  No reimbursement is  
          required under this provision.  (Penal Code  4011.10 (d).)

           Existing law  provides that an entity that provides ambulance or  
          any other emergency or nonemergency response service to a  
          sheriff or police chief, and that does not contract with their  
          departments for that service, shall be reimbursed for the  
          service at the rate established by Medicare.  Neither the  
          sheriff nor the police chief shall reimburse a provider of any  
          of these services that their department has not contracted with  
          at a rate that exceeds the provider's reasonable and allowable  
          costs, as specified, regardless of whether the provider is  
          located within or outside of California.  (Penal Code  4011.10  
          (f).)

           Existing law  provides that, for purposes of this section, in  
          those counties in which the sheriff does not administer a jail  
          facility, a director or administrator of a local department of  
          corrections established pursuant to Section 23013 of the  
          Government Code is the person who may contract for services  
          provided to jail inmates in the facilities he or she administers  
          in those counties.  (Penal Code  4011.10 (h).)
           
          Existing law  provides that notwithstanding any other provision  
          of law, except in counties in which the sheriff, as of July 1,  
          1993, is not in charge of and the sole and exclusive authority  
          to keep the county jail and the prisoners in it, the sheriff  
          shall take charge of and be the sole and exclusive authority to  
          keep the county jail and the prisoners in it, except for work  
          furlough facilities where by county ordinance the work furlough  
          administrator is a person other than the sheriff.  (Government  
          Code  24000 and 26600 et seq.)






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           Existing law  provides that the board of supervisors of any  
          county may, by resolution, establish a department of  
          corrections, to be headed by an officer appointed by the board,  
          which shall have jurisdiction over all county functions,  
          personnel, and facilities, or so many as the board names in its  
          resolution, relating to institutional punishment, care,  
          treatment, and rehabilitation of prisoners including, but not  
          limited to, the county jail and industrial farms and road camps,  
          their functions and personnel.  (Government Code  23013.)

           Existing law  provides that the police department of a city which  
          creates one is under the control of the chief of police.   
          (Government Code  38630.)

           Existing law  states legislative intent that the California  
          Department of Corrections and Rehabilitation (CDCR) operate in  
          the most cost-effective and efficient manner possible when  
          purchasing health care services for inmates; to achieve this  
          goal, it is desirable that the CDCR have the benefit and  
          experience of the California Medical Assistance Commission  
          (CMAC) in planning and negotiating for the purchase of health  
          care services.  (Penal Code  5023(a).)

          Existing law  provides that the CDCR shall consult with the CMAC  
          to assist the CDCR in planning and negotiating contracts for the  
          purchase of health care services, the CMAC shall advise the  
          CDCR, and the CMAC may negotiate directly with providers on  
          behalf of the CDCR as mutually agreed upon by CMAC and the CDCR.  
           (Penal Code  5024(b).)

           Existing law  provides that in no event shall the provision of  
          emergency services and care be based upon, or affected by, the  
          person's race, ethnicity, religion, national origin,  
          citizenship, age, sex, preexisting medical condition, physical  
          or mental handicap, insurance status, economic status, or  
          ability to pay for medical services, except to the extent that a  
          circumstance such as age, sex, preexisting medical condition, or  
          physical or mental handicap is medically significant to the  




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          provision of appropriate medical care to the patient.  (Health  
          and Safety Code  1317(a) and (b).)

           Existing law  provides that notwithstanding any other provision  
          of law, the CDCR and the Division of Juvenile Justice (DJJ) may  
          contract with providers of emergency health care services.   
          Hospitals that do not contract with the CDCR or the DJJ for  
          emergency health care services shall provide these services to  
          these departments on the same basis as they are required to  
          provide these services pursuant to Section 489.24 of Title 42 of  
          the Code of Federal Regulations.  Neither the CDCR nor the DJJ  
          shall reimburse a hospital that provides these services, and  
          that the departments have not contracted with, at a rate that  
          exceeds the hospital's reasonable and allowable costs,  
          regardless of whether the hospital is located within or outside  
          of California.  (Penal Code  5023.5(a).)

           Existing law  provides that an entity that provides ambulance or  
          any other emergency or nonemergency response service to the CDCR  
          and the DJJ, and that does not contract with the departments for  
          that service, shall be reimbursed for the service at the rate  
          established by Medicare.  Neither the CDCR nor the DJJ shall  
          reimburse a provider of any of these services that the  
          departments have not contracted with at a rate that exceeds the  
          provider's reasonable and allowable costs, regardless of whether  
          the provider is located within or outside of California.  (Penal  
          Code  5023.5(b).)

           Existing law  provides that CDCR and the DJJ shall work with the  
          Department of Health Services (DHS) in obtaining hospital cost  
          information in order to establish the costs specified in this  
          section.  DHS may provide the CDCR and the DJJ with the  
          hospital cost information that DHS obtains pursuant to Welfare  
          and Institutions Code Sections 14170 and 14171.  (Penal Code   
          5023.5(c).)

           Existing law  provides that "reasonable and allowable costs,"  
          for purposes of Penal Code Section 5023.5, shall be defined in  
          accordance with Part 413 of Title 42 of the Code of Federal  




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          Regulations and federal Centers for Medicare and Medicaid  
          Services Publication Numbers 15.1 and 15.2.  (Penal Code   
          5023.5(d).)








































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           This bill provides that "other public agencies," as well as  
          local sheriffs and police chiefs, are authorized to contract  
          with hospitals for emergency health care for "local law  
          enforcement patients."

          This bill  provides that, to the extent that the rate provisions  
          of Penal Code Section 4011.10 results in a disproportionate  
          share of local law enforcement patients being treated at any one  
          hospital or system of hospitals, the Inmate Health Care and  
          Medical Provider Fair Pricing Working Group shall address this  
          issue.

                                      COMMENTS
           
           1.  Need for This Bill  

          According to the author:

              This bill is a technical, clean-up measure to SB  
              159 (Runner), Chapter 481, Statues of 2005, that  
              dealt with emergency health care for local law  
              enforcement patients.  This bill will clarify that  
              public agencies, such as county public health  
              departments, can enter into contracts with  
              hospitals for emergency health care.

          2.  Background  

          Penal Code Section 4011.10 (enacted pursuant to SB 159 (Runner)  
          - Chap. 481, Stats. 2005) establishes that a county sheriff or  
          police chief may contract with providers of emergency health  
          care services.  Section 4011.10 also establishes a rate  
          structure for emergency health care provided to sheriffs or  
          police departments absent an existing contract between local law  
          enforcement and health care providers and created a working  
          group consisting of local law enforcement and health care  
          providers to consider a variety of issues related to inmate  
          health care.  A letter provided to Committee staff from the  
          University of California explains the problem that this bill is  




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          intended to address as follows:

              Existing contracts between UC medical centers and  
              local law enforcement are contained within larger  
              city or county contracts - these contracts find UC  
              partnering with local government to meet key public  
              health goals.  Central to these contracts is ensuring  
              health care access to medically indigent patients.   
              As amended on May 18th, SB 896 clarifies that the  
              contracts are for emergency health care services for  
              local law enforcement patients and can be entered  
              into with other public agencies that contract for  
              these types of services.  SB 896 also provides  
              similar clarification to the "grandfather" clause  
              contained in last year's legislation.  The June 21st  
              amendments added an urgency clause to the bill to  
              ensure that the above-referenced contracts for  
              emergency health services for care to local law  
              enforcement patients are maintained.

          3.  Vague Definition of the Relevant Patient Population  

          This bill amends Section 4011.10 to define the relevant patient  
          population as "local law enforcement patients."  This term is  
          vague and therefore subject to significantly different  
          interpretations.  Is it limited to county jail inmates?  Does it  
          include arrestees or detainees who are at a pre-booking stage  
          and thus might not be considered inmates?  Does it include an  
          indigent crime victim?  Does it include an injured law  
          enforcement officer?

          In defining the relevant patient population, Section 4011.10,  
          subdivision (a), refers to "persons lawfully in [law  
          enforcement] custody."  Section 4011.10, subdivisions (c), (d)  
          and (h) refer to "inmates."  The proposed term, "local law  
          enforcement patients," leaves the definition of exactly who the  
          intended patient population is in the eye of the beholder.

          This Committee's analysis of SB 159 states:











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              This bill is intended to address payment for  
              emergency services for persons in need of  
              emergency care who are in custody of local law  
              enforcement - but not necessarily arrested, in  
              jail, or are victims of crime who are at some  
              point the responsibility of local law enforcement.

          This indicates that Section 4011.10 was intended to address a  
          patient population broader than merely "inmates."  The  
          terminology currently existing in Section 4011.10, subdivision  
          (a), "persons lawfully in [law enforcement] custody" may most  
          accurately reflect the intent of both SB 159 and this bill in  
          identifying the relevant patient population.



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