BILL ANALYSIS
------------------------------------------------------------
|SENATE RULES COMMITTEE | SB 1091|
|Office of Senate Floor Analyses | |
|1020 N Street, Suite 524 | |
|(916) 651-1520 Fax: (916) | |
|327-4478 | |
------------------------------------------------------------
THIRD READING
Bill No: SB 1091
Author: Hancock (D), et al
Amended: 5/4/10
Vote: 21
SENATE HEALTH COMMITTEE : 5-0, 4/21/10
AYES: Alquist, Leno, Negrete McLeod, Pavley, Romero
NO VOTE RECORDED: Strickland, Aanestad, Cedillo, Cox
SENATE APPROPRIATIONS COMMITTEE : 10-0, 5/27/10
AYES: Kehoe, Alquist, Corbett, Denham, Leno, Price,
Walters, Wolk, Wyland, Yee
NO VOTE RECORDED: Cox
SUBJECT : Medi-Cal: individuals in county juvenile
detention facilities
SOURCE : Alameda County
DIGEST : This bill permits counties to pay the
non-federal share of Medi-Cal for eligible youth
temporarily placed in a county juvenile detention facility
for up to 30 days or until their case is adjudicated,
whichever is shorter, in order to access available federal
Medi-Cal funding.
ANALYSIS : Existing federal law establishes the Medicaid
program to provide comprehensive health benefits to
specified groups of low-income persons. Existing federal
law prevents Medicaid benefits from being paid for
CONTINUED
SB 1091
Page
2
incarcerated individuals except when the inmate is a
patient in a medical institution. Although an incarcerated
individual's benefits are restricted, federal law does not
require that Medicaid eligibility be terminated. It
prohibits an inmate of a public institution from receiving
Medicaid benefits, but states that an individual is not
considered to be living in a public institution if the
individual is in a public institution for a temporary
period pending other arrangements appropriate to their
needs.
Existing state law establishes the Medi-Cal program, the
state's Medicaid program, administered by the Department of
Health Care Services (DHCS), which provides comprehensive
health benefits to low-income children; their parents or
caretaker relatives; pregnant women; elderly, blind or
disabled persons; nursing home residents and refugees.
Defines the health care benefits that are to be offered by
the Medi-Cal program. Excludes from the definition of
Medi-Cal health care benefits, care or services for any
individual who is an inmate of an institution (except as
permitted under federal law). Provides that a juvenile who
is an inmate of a public institution shall have their
Medi-Cal benefits suspended, as specified.
This bill:
1. Permits counties to pay the non-federal share of
Medi-Cal for eligible youth temporarily placed in a
county juvenile detention facility for up to 30 days or
until their case is adjudicated, whichever is shorter,
in order to access available federal Medi-Cal funding.
2. Requires the county to pay the state's share of Medi-Cal
expenditures and for any state administrative costs
through an intergovernmental transfer of funds.
3. Establishes that this bill will be implemented on
January 1, 2012, or whenever all necessary federal
approvals or waivers are obtained. Provides that this
bill takes effect only if federal financial
participation is available.
4. Provides that nothing in this section shall be construed
SB 1091
Page
3
to require a county to pay the state's share of Medi-Cal
expenditures or the state's administrative costs for
Medi-Cal benefits that the state is obligated to provide
pursuant to an administrative action or court order that
is final and no longer subject to appeal.
5. Grants DHCS an exemption from the Administrative
Procedures Act related to the development of regulations
and allows implementation by all-county letters or
similar instructions. Requires regulations be enacted
for subsequent actions.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
According to the Senate Appropriations Committee:
Fiscal Impact (in thousands)
Major Provisions 2010-11 2011-12
2012-13 Fund
Federal funds match to unknown, potentially in
the County/
counties for Medi-Cal benefits millions of
dollars annually Federal*
DHCS administration likely up to $100 annually
ongoingCounty/
Federal*
* Approximately 50 percent county funds and 50 percent
federal funds
SUPPORT : (Verified 5/27/10)
Alameda County (source)
Accessing Health Services for California's Children in
Foster Care Task Force
California Medical Association
California Probation, Parole and Correctional Association
California State Association of Counties
Central Valley Health Network
Chief Probation Officers of California
SB 1091
Page
4
Children's Advocacy Institute
Children's Hospital and Research Center Oakland
City and County of San Francisco
Counties of Contra Costa, Del Norte, Kern, Marin,
Sacramento, and Santa Clara
County Health Executives Association of California
Little Hoover Commission
Los Angeles County Probation Officers Union
Taxpayers for Improving Public Safety
Urban Counties Caucus
ARGUMENTS IN SUPPORT : According to supporters, every
county has an obligation to tend to the health care needs
of the persons detained in its institutions. They report
that their experience shows that children in the juvenile
justice system can have significant behavioral, mental
health and medical issues. These issues make meeting the
county's obligation very challenging especially with the
severe reductions in county funds. Supporters also note
that for many youths, the care they receive in juvenile
hall may be their first encounter with medical personnel in
many years; hence, providing medical, dental, and mental
health to individuals entering county juvenile detention
facilities comes at a significant cost to counties.
Alameda County reports that it costs them approximately $7
million annually to care for these juveniles. Supporters
argue that counties want to pursue federal funds to offset
the costs they already spend delivering these services.
CTW:mw 5/27/10 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
**** END ****