BILL ANALYSIS
SB 1091
Page 1
SENATE THIRD READING
SB 1091 (Hancock)
As Amended August 20, 2010
Majority vote
SENATE VOTE :35-0
HEALTH 17-0 APPROPRIATIONS 17-0
-----------------------------------------------------------------
|Ayes:|Monning, Fletcher, |Ayes:|Fuentes, Conway, |
| |Ammiano, Carter, De La | |Bradford, |
| |Torre, De Leon, Eng, | |Huffman, Coto, Davis, De |
| |Gaines, Hayashi, | |Leon, Gatto, Hall, |
| |Hernandez, Jones, | |Harkey, Miller, Nielsen, |
| |Bonnie Lowenthal, Nava, | |Norby, Skinner, Solorio, |
| |Salas, Smyth, Audra | |Torlakson, Torrico |
| |Strickland, Silva | | |
| | | | |
-----------------------------------------------------------------
SUMMARY: Authorizes counties to receive Medi-Cal reimbursement
for medical and mental health services they provide to eligible
individuals less than 21 years of age entering county juvenile
detention facilities until adjudication. Specifically, this
bill :
1)Requires the Department of Health Care Services (DHCS) to seek
federal approval or waiver as necessary in order to obtain
federal financial participation (FFP) for Medi-Cal benefits
provided to an individual under 21 until adjudication.
2)Conditions the implementation on a county voluntarily agreeing
to pay the state's share.
3)Limits eligibility to an individual who is receiving Medi-Cal
benefits at the time of admission or is subsequently
determined to be eligible.
4)Requires the provisions to be implemented on the later of
January 1, 2010 or when all federal approvals or waivers have
been obtained, whichever is later.
5)Authorizes initial implementation by all-county letter or
similar instruction without taking regulatory action.
SB 1091
Page 2
FISCAL EFFECT : According to the Assembly Appropriations
Committee:
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 this
bill. Counties are required to pay the cost of state
administrative workload.
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
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
SB 1091
Page 3
FN: 0006415