BILL ANALYSIS
SB 1091
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Date of Hearing: August 4, 2010
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
SB 1091 (Hancock) - As Amended: May 4, 2010
Policy Committee: Health Vote:17-0
Urgency: No State Mandated Local Program:
No Reimbursable:
SUMMARY
This bill authorizes counties to access federal Medi-Cal
reimbursement for health services provided to specified youth
awaiting adjudication in county juvenile detention facilities
effective January 1, 2012, or when federal approval is received,
whichever is later. Specifically, this bill:
1)Requires both of the following conditions to be met in order
to receive federal funding:
a) The youth must be receiving Medi-Cal benefits when
admitted to the detention facility.
b) The county must agree to pay the non-federal share of
Medi-Cal costs and the state's administrative costs.
2)Requires the Medi-Cal benefits provided pursuant to this bill
to continue for up to 30 days or until adjudication, whichever
time period is less.
3)Requires the California Department of Health Care Services
(DHCS) to seek federal approval to allow for federal financial
participation.
FISCAL EFFECT
1)Annual increased Medi-Cal costs of $10 million (50%
federal/50% local) to $15 million (50% federal/50% local) to
the extent counties opt into the funding mechanism established
by this bill and provide a month of Medi-Cal health services
to youth awaiting adjudication.
2)Unknown administrative workload to DHCS to seek federal
approval and administer the funding mechanism established by
SB 1091
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this bill. Counties are required to pay the cost of state
administrative workload.
COMMENTS
1)Rationale . This bill is sponsored by Alameda County to
establish a funding mechanism to provide relief to counties
for providing health services to Medi-Cal beneficiaries at
100% county cost. This bill increases federal funding and
reduces county funding spent providing primary care and mental
health services to youth awaiting adjudication in juvenile
hall. According to the author and sponsor, this bill is based
on a program established in New Mexico in 2000 that allows
receipt of federal funding for health services for juveniles
in temporary custody.
2)Background . Under current Medi-Cal regulations individuals who
are inmates of public institutions are deemed ineligible for
Medi-Cal. However, direction from the federal government
encourages allowing Medicaid benefits to continue under
specified circumstances by suspending, rather than terminating
benefits. SB 1147 (Calderon), Chapter 546, Statutes of 2008
codified this directive from the federal government and
prohibits DHCS from terminating the Medi-Cal eligibility of a
ward due to the youth's status as an inmate. DHCS released
final guidance related to SB 1147 in March of 2010. This bill
addresses pre-adjudication juveniles, those who have neither
been committed as inmates nor returned home.
3)Related Case Law . A lawsuit brought by San Francisco and Santa
Clara in 2007 challenged California's practice of denying
Medi-Cal coverage of inpatient psychiatric hospital services
provided to youth who are in custody. In April 2010 the San
Francisco Superior Court ruled these denials violate federal
and state law and ordered the state to provide Medi-Cal
coverage of inpatient psychiatric hospital services for
individuals under age 21 regardless of their status as
detainees. This bill includes language to preserve that ruling
and not allow this bill's provisions interfere with the case
pending possible appeal.
Analysis Prepared by : Mary Ader / APPR. / (916) 319-2081