BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SB 817
                                                                  Page  1

          SENATE THIRD READING
          SB 817 (Hancock)
          As Amended  August 20, 2010
          Majority vote

           SENATE VOTE  :   Vote not relevant
            
           ELECTIONS                                                       
                    (vote not relevant)

           SUMMARY  :  Requires Medi-Cal benefits to be provided to juveniles  
          awaiting adjudication in the Alameda County jail, to the extent  
          federal financial participation (FFP) is available.   
          Specifically,  this bill  : 

          1)Requires Medi-Cal benefits to be provided to juveniles  
            awaiting adjudication in the Alameda County jail, to the  
            extent federal financial participation is available.  

          2)Conditions implementation on written confirmation of federal  
            financial participation from the Centers for Medicare and  
            Medicaid Services and specified declarations from the Director  
            of the Department of Health Care Services (DHCS) and  
            authorizes the Director to cease implementation as specified.

          3)Conditions the implementation on Alameda County voluntarily  
            agreeing to pay the state's share.

          4)Limits eligibility to an individual who is receiving Medi-Cal  
            benefits at the time of admission or is subsequently  
            determined to be eligible.

          5)Authorizes initial implementation by all-county letter and by  
            regulation thereafter.

          6)Makes findings and declarations relating to the necessity of a  
            special law for the County of Alameda.

           FISCAL EFFECT  :  This bill, as amended has not been analyzed by a  
          fiscal committee.

           COMMENTS  :  This bill, according to the sponsor, is intended to  
          take advantage of federal authority to use federal Medicaid  
          funds to reduce the costs of health and mental health services  
          that the county is already incurring for the first 30 days of a  








                                                                  SB 817
                                                                  Page  2

          youth's stay in juvenile hall.  According to the sponsor, the  
          average length of stay is 24 days.

          Medi-Cal regulations make individuals who are inmates of public  
          institutions ineligible for Medi-Cal.  A 2004 letter to State  
          Medicaid directors from the federal Centers for Medicare and  
          Medicaid Services encourages states to "suspend" and not  
          "terminate" benefits while a person is in a public institution  
          or Institute for Mental Disease, noting the payment exclusion  
          (known as the "inmate exception") under Medicaid does not affect  
          the eligibility of an individual for the Medicaid program.  This  
          policy was codified with regard to juveniles in SB 1147  
          (Calderon and Yee), Chapter 546, Statutes of 2008.  DHCS  
          indicated that the necessary protocols to implement a suspension  
          of benefits were issued in March 2010.

          Federal regulations also appear to allow states to claim FFP for  
          all Medicaid services provided to a person in a public  
          institution for a temporary period pending other arrangements as  
          an exception to unavailability of FFP for services provided to  
          inmates.  This bill is based on information from Pennsylvania  
          and New Mexico that have taken advantage of this opportunity.  


           Analysis Prepared by  :    Marjorie Swartz / HEALTH / (916)  
          319-2097 


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