BILL NUMBER: AB 396	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  MAY 12, 2011
	AMENDED IN ASSEMBLY  APRIL 25, 2011
	AMENDED IN ASSEMBLY  MARCH 30, 2011

INTRODUCED BY   Assembly Member Mitchell
   (Coauthors: Assembly Members Blumenfield, Dickinson,  and
Jeffries   Jeffries,   and V. Manuel Pérez
 )

                        FEBRUARY 14, 2011

   An act to add  Section 14053.8   Sections
14053.8 and 14053.9  to the Welfare and Institutions Code,
relating to Medi-Cal.



	LEGISLATIVE COUNSEL'S DIGEST


   AB 396, as amended, Mitchell. Medi-Cal: juvenile detention
facilities.
   Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Care Services, under
which qualified low-income individuals receive health care services.
The Medi-Cal program is, in part, governed and funded by federal
Medicaid provisions. Existing federal law, with certain exceptions,
excludes federal financial participation for medical care provided to
any individual who is an inmate in a public institution, and
existing state law suspends Medi-Cal benefits, for a specified period
of time, to an individual under 21 years of age who is an inmate of
a public institution. Existing state law also provides that no person
shall be denied benefits, for whom and for which federal financial
participation is available, based solely on the individual's
incarcerated status  in a county or city jail or juvenile
detention facility .
   Existing law authorizes the Department of Corrections and
Rehabilitation and the State Department of Health Care Services, to
the extent that federal participation is not jeopardized and federal
approval is obtained, to develop a process for the provision of
inpatient hospital services to inmates who would otherwise be
eligible for Medi-Cal, but for their institutional status as inmates.
Existing law also authorizes, to the extent federal financial
participation is available, the State Department of Health Care
Services to provide Medi-Cal eligibility and reimbursement for
inpatient hospital services to inmates, as defined.
   This bill would additionally require the State Department of
Health Care Services to develop  a process  
processes  to allow counties  and the Division of Juvenile
Facilities within the Department of Corrections and Rehabilitation
 to receive any available federal financial participation for
health care services provided to juvenile detainees  or detained
youth, as applicable,  who are admitted as inpatients in a
medical institution. The bill would require the department to consult
with counties  and the Division of Juvenile Facilities  in
the development of  this process   these
processes  , and would require the department to seek any
federal approvals necessary to implement  the process
  these provisions  . The bill would  also
limit application of this process to   provide that
these provisions shall be implemented only to the extent that the
Division of Juvenile Facilities and  counties  that
 elect to voluntarily provide the nonfederal share of
expenditures for health care services, and would require that the
federal financial participation associated with services provided
pursuant to  the process   these processes 
be paid to the participating counties  or the Department of
Corrections and Rehabilitation, as applicable  . The bill would
provide that these provisions shall be implemented only to the extent
that any necessary federal approval is obtained and existing levels
of federal financial participation are not jeopardized. The bill
would make related findings and declarations.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  The Legislature finds and declares all of the
following:
   (a) Federal financial participation may be available for counties
that provide health care services to juvenile detainees while the
juveniles are admitted as patients in a medical institution.
   (b) Current law provides that an individual under 21 years of age
who is an inmate of a public institution shall have his or her
Medi-Cal services suspended for up to one year.
   (c) The eligibility procedures of the State Department of Health
Care Services currently do not allow counties to obtain available
federal financial participation for health care services provided to
juvenile detainees when they have been transferred to a medical
institution for inpatient services.
   (d) Pursuant to Section 5072 of the Penal Code and Section 14053.7
of the Welfare and Institutions Code, the department is authorized
to develop a process to maximize federal financial participation for
inpatient hospital services to adult inmates residing in a state
prison facility.
   (e) To reduce the fiscal strain on counties, it is imperative that
the department work with counties to develop and implement a similar
process to allow counties to obtain federal financial participation
based on county expenditures for inpatient hospital services provided
to juveniles in their custody. 
   (f) It is not the intent of the Legislature to alter or abrogate
any obligation of the state under federal or state law to cover,
fund, or reimburse under Medi-Cal any medical services provided to a
juvenile detainee. 
  SEC. 2.  Section 14053.8 is added to the Welfare and Institutions
Code, to read:
   14053.8.  (a) Notwithstanding any other provision of law, the
department shall develop a process to allow counties to receive any
available federal financial participation for health care services
provided to juvenile detainees who are admitted as inpatients in a
medical institution. This process shall be coordinated, to the extent
possible, with the processes and procedures established pursuant to
Section 14053.7 of this code and Section 5072 of the Penal Code. This
subdivision shall not be construed to alter or abrogate any
obligation of the state pursuant to an administrative action or a
court order that is final and no longer subject to appeal to fund and
reimburse counties for any medical services provided to a juvenile
detainee.
   (b) A juvenile detainee who is an inpatient in a medical
institution shall not be denied Medi-Cal eligibility because of his
or her institutional status as a detainee of a public institution.
   (c) The department shall consult with counties in the development
of the process pursuant to this section.
   (d) The department shall seek any federal approvals necessary to
implement the process developed pursuant to this section. This
section shall be implemented only if and to the extent that any
necessary federal approval is obtained, and only to the extent that
existing levels of federal financial participation are not otherwise
jeopardized.
   (e) Notwithstanding any other provision of law, as part of the
process developed pursuant to this section, the department may exempt
the juvenile detainees from enrollment into new or existing managed
care health plans.
   (f) The process developed pursuant to this section shall be
implemented in only those counties that elect to voluntarily provide
the nonfederal share of expenditures for health care services to
juvenile detainees who, but for their inpatient status, would be
ineligible for Medi-Cal as detainees of a public institution.
   (g) The federal financial participation received pursuant to the
process implemented under this section shall be paid to the
participating counties for services rendered to the juvenile
detainees.  If a federal audit disallowance and interest results
from claims made under the process created pursuant to this section,
the department shall recoup from the county that received the
disallowed   funds the amount of the disallowance and any
applicable interest. 
   (h) Notwithstanding Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 2 of Title 2 of the Government Code, the
department may, without taking any further regulatory action,
implement this section by means of all-county letters or similar
instructions.
   SEC. 3.    Section 14053.9 is added to the  
Welfare and Institutions Code   , to read:  
   14053.9.  (a) Notwithstanding any other provision of law, the
department shall develop a process to allow the Department of
Corrections and Rehabilitation, Division of Juvenile Facilities, or
any successor, to receive any available federal financial
participation for health care services provided to any youth detained
in the Division of Juvenile Facilities who are admitted as
inpatients in a medical institution. This process shall be
coordinated, to the extent possible, with the processes and
procedures established pursuant to Section 14053.7 of this code and
Section 5072 of the Penal Code.
   (b) Any youth detained in the Division of Juvenile Facilities who
is an inpatient in a medical institution shall not be denied Medi-Cal
eligibility because of his or her institutional status as a ward
committed to, or a youth housed in, the Division of Juvenile
Facilities.
   (c) The department shall consult with the Division of Juvenile
Facilities in the development of the process pursuant to this
section.
   (d) The department shall seek any federal approvals necessary to
implement the process developed pursuant to this section. This
section shall be implemented only if and to the extent that any
necessary federal approval is obtained, and only to the extent that
existing levels of federal financial participation are not otherwise
jeopardized.
   (e) Notwithstanding any other provision of law, as part of the
process developed pursuant to this section, the department may exempt
any youth detained in a facility operated by the Division of
Juvenile Facilities from enrollment into new or existing managed care
health plans.
   (f) The process developed pursuant to this section shall be
implemented only to the extent that the Division of Juvenile
Facilities agrees voluntarily to provide the nonfederal share of
expenditures for health care services to any youth detained in the
Division of Juvenile Facilities who, but for their inpatient status,
would be ineligible for Medi-Cal as an inmate of a public
institution.
   (g) The federal financial participation received pursuant to the
process implemented under this section shall be paid to the
Department of Corrections and Rehabilitation for services rendered to
any youth detained in the Division of Juvenile Facilities.