BILL ANALYSIS
------------------------------------------------------------
|SENATE RULES COMMITTEE | SB 1091|
|Office of Senate Floor Analyses | |
|1020 N Street, Suite 524 | |
|(916) 651-1520 Fax: (916) | |
|327-4478 | |
------------------------------------------------------------
UNFINISHED BUSINESS
Bill No: SB 1091
Author: Hancock (D), et al
Amended: 8/20/10
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
SENATE FLOOR : 35-0, 6/2/10 (Consent)
AYES: Aanestad, Alquist, Ashburn, Calderon, Cedillo,
Cogdill, Corbett, Correa, Cox, Denham, DeSaulnier,
Ducheny, Dutton, Florez, Hancock, Hollingsworth, Huff,
Kehoe, Leno, Liu, Lowenthal, Negrete McLeod, Padilla,
Pavley, Price, Romero, Runner, Simitian, Steinberg,
Strickland, Walters, Wolk, Wright, Wyland, Yee
NO VOTE RECORDED: Harman, Oropeza, Wiggins, Vacancy,
Vacancy
ASSEMBLY FLOOR : 77-0, 8/23/10 - See last page for vote
SUBJECT : Medi-Cal: individuals in county juvenile
detention facilities
SOURCE : Alameda County
CONTINUED
SB 1091
Page
2
DIGEST : This bill 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.
Assembly Amendments (1) condition implementation on written
confirmation of federal financial participation from the
Centers for Medicare and Medicaid Services and specified
declarations from the Secretary of Health and Human
Services, (2) delete the 30-day limit on the period of time
that federal financial participation may be obtained, (3)
delete the provisions that specify that this bill shall not
be construed to require a county to pay for the costs of
Medi-Cal benefits that the state is obligated to provide
under administrative action of final court order, and (4)
make other clarifying and technical changes.
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
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
CONTINUED
SB 1091
Page
3
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. Requires DHCS to seek federal approval or waiver as
necessary in order to obtain federal financial
participation 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.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
According to the Assembly Appropriations Committee:
1. Annual increased Medi-Cal costs of $10 million (50
percent federal/50 percent local) to $15 million (50
percent federal/50 percent 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.
SUPPORT : (Verified 8/24/10)
CONTINUED
SB 1091
Page
4
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
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.
ASSEMBLY FLOOR :
AYES: Adams, Ammiano, Anderson, Arambula, Bass, Beall,
Bill Berryhill, Tom Berryhill, Block, Blumenfield,
Bradford, Brownley, Buchanan, Caballero, Charles
CONTINUED
SB 1091
Page
5
Calderon, Carter, Chesbro, Conway, Cook, Coto, Davis, De
La Torre, De Leon, DeVore, Eng, Evans, Feuer, Fletcher,
Fong, Fuentes, Fuller, Gaines, Galgiani, Garrick, Gatto,
Gilmore, Hagman, Hall, Harkey, Hayashi, Hernandez, Hill,
Huber, Huffman, Jeffries, Jones, Knight, Lieu, Logue,
Bonnie Lowenthal, Ma, Mendoza, Miller, Monning, Nava,
Nestande, Niello, Nielsen, Norby, V. Manuel Perez,
Portantino, Ruskin, Salas, Saldana, Silva, Skinner,
Smyth, Solorio, Audra Strickland, Swanson, Torlakson,
Torres, Torrico, Tran, Villines, Yamada, John A. Perez
NO VOTE RECORDED: Furutani, Vacancy, Vacancy
CTW:mw 8/24/10 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
**** END ****
CONTINUED