BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SB 1091
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          SENATE THIRD READING
          SB 1091 (Hancock)
          As Amended  August 20, 2010
          Majority vote

           SENATE VOTE  :35-0  
           
           HEALTH              17-0        APPROPRIATIONS      17-0        
           
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          |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
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          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
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