BILL ANALYSIS �
AB 396
Page 1
Date of Hearing: April 5, 2011
Consultant: Stefani Salt
ASSEMBLY COMMITTEE ON PUBLIC SAFETY
Tom Ammiano, Chair
AB 396 (Mitchell) - As Amended: March 30, 2011
SUMMARY : Provides the opportunity for counties to receive
federal funding participation toward payments for the outpatient
medical costs of juvenile detainees. Specifically, this bill :
1)Requires the Department of Health Care Services (DHCS) to
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.
2)Declares that 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.
3)Mandates DHCS to consult with counties in the development of
this process.
4)Requires DHCS to seek any federal approvals necessary to
implement the process.
5)Provides 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.
6)Limits the application of this process to 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 be paid to the participating counties.
7)Provides that as part of this process DHCS may exempt juvenile
detainees from enrollment into new or existing managed care
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health plans.
8)Makes the following findings and declarations:
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 DHCS 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 Penal Code Section 5072 and Welfare and
Institutions Code (WIC) Section 14053.7, DHCS 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 DHCS 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.
EXISTING LAW :
1)States that Medi-Cal benefits provided to an individual under
21 years of age who is an inmate of a public institution shall
be suspended in accordance federal law. �WIC Section
14011.10(a).]
2)Declares that if an individual under 21 years of age is a
Medi-Cal beneficiary on the date he or she becomes an inmate
of a public institution, his or her benefits shall be
suspended effective the date he or she becomes an inmate of a
public institution. Provides that the suspension will end on
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the date he or she is no longer an inmate of a public
institution or one year from the date he or she becomes an
inmate of a public institution, whichever is sooner. �WIC
Section 14011.10(c).]
3)Provides that, notwithstanding any other provision of law, the
California Department of Corrections and Rehabilitation and
DHCS may develop a process to maximize federal financial
participation for the provision of inpatient hospital services
rendered to individuals who, but for their institutional
status as inmates, are otherwise eligible for Medi-Cal.
�Penal Code Section 5072(a).]
4)States that notwithstanding any other provision of law, and
only to the extent that federal financial participation is
available, DHCS may provide Medi-Cal eligibility and
reimbursement for inpatient hospital services, as specified.
�WIC Section 14053.7(a).]
FISCAL EFFECT : Unknown
COMMENTS :
1)Author's Statement : According to the author, "�This bill]
would require �DHCS] to develop a process to maximize federal
financial participation for the health care services provided
by counties to juveniles in custody who would otherwise be
eligible for Medi-Cal.
"Many minors who are detained in local detention facilities
require medical care that requires hospitalization. �This
bill] would allow counties to draw down federal matching funds
to reimburse them for medical treatment of minors who are
outside of the County detention facility for more than
24-hours and placed in inpatient facilities for treatment of
their medical condition."
2)Background : According to the author, "Currently, when
counties detain minors in a juvenile detention facility or
probation camp, their Medi-Cal benefits are suspended. Most
minors that are taken into custody are from low-income
families and would generally be eligible for Medi-Cal
benefits. Therefore, when a minor is in custody and is in
need of medical services the counties are burdened with the
total costs.
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"Medical care is provided for these wards in juvenile detention
facilities. However, many minors who are detained require
medical care that is outside of the medical services available
within the facility.
"Current law suspends Medi-Cal services for up to a year of any
individual under the age of 21 who is an inmate of a public
institution.
"Eligibility procedures of �DHCS] do not currently allow
counties to obtain available federal financing when inpatient
services are provided in a medical institution. However, the
Department is authorized to develop a process to maximize
federal financial participation for inpatient hospital
services to adult inmates.
"�This bill] would require �DHCS] to develop a process to
maximize federal financial participation for the health care
services provided by counties to juveniles in custody who
would otherwise be eligible for Medi-Cal.
"�This bill] would allow the counties to seek reimbursement for
medical treatment of minors who are outside of the County
detention facility for more than 24-hours.
"Counties have to pay the total medical costs for
post-adjudication minors when they are treated outside of the
juvenile detention facility. �This bill] will allow for
counties to request reimbursement when the medical treatment
requires a hospital stay of more than 24 hours away from the
facility."
3)Argument in Support : According to the Los Angeles County
Board of Supervisors , "Federal law generally suspends Medi-Cal
benefits for minors who are detainees in a State or local
juvenile detention facility. Medi-Cal benefits, however,
would be permitted if a minor is admitted to a hospital and is
away from the detention facility for more than 24-hours.
"�This bill] would allow counties to draw down federal matching
funds to reimburse them for the medical treatment of minors
who are hospitalized and outside of the County's detention
facility for more than 24-hours.
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"The Los Angeles County Probation Department operates three
juvenile detention facilities and 18 juvenile camps. Most of
the minors taken into custody are from low-income families
which makes them eligible for Medi-Cal.
"Many minors detained in local detention facilities often
require medical care which is outside the scope of medical
services available at the facility. Such medical conditions
requiring hospitalization include complications from asthma,
diabetes, epilepsy, or heart problems. In cases where minors
require hospitalization for a contagious or communicable
disease, care at a medical facility is vital not only for
their health and well being, but for the other detainees and
probation staff before the minor returns to the detention
facility."
4)Related Legislation : SB 695 (Hancock) allows counties to seek
reimbursement for Medi-Cal benefits for an individual awaiting
adjudication in a county juvenile detention facility or camp,
if that individual is eligible to receive benefits at the time
of their admittance. SB 695 is a reintroduction of SB 1091
(Hancock) of the 2009-10 Legislative Session.
5)Previous Legislation :
a) SB 1091 (Hancock), of the 2009-10 Legislative Session,
was vetoed.
b) SB 1147 (Calderon), Chapter 546, Statutes of 2008,
required suspension of Medi-Cal benefits for up to one year
for an individual under 21 years of age who is an inmate of
a public institution.
c) SB 648 (Calderon), of the 2008-07 Legislative Session,
would have required DHCS to suspend rather than terminate
Medi-Cal benefits of an incarcerated minor. SB 648 was
never heard by the Senate Health Committee.
d) SB 1469 (Cedillo), Chapter 657, Statutes of 2006,
required county juvenile detention facilities to notify
county welfare departments about the release of a ward so
that eligibility for Medi-Cal can be determined prior to
the release of the inmate.
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e) AB 1945 (Coto), of the 2005-06 Legislative Session,
would have required a juvenile detention facility, upon
release of a minor, to determine if the minor would have
health insurance after release, and if not, to evaluate the
eligibility of the minor for enrollment in appropriate
need-based programs. AB 1945 was never heard by the
Assembly Health Committee.
f) AB 2004 (Yee), of the 2005-06 Legislative Session, was
identical to SB 648 (Calderon) of the 2008-07 Legislative
Session. AB 2004 was vetoed
g) AB 470 (Yee), of the 2005-06 Legislative Session, was a
very similar to SB 648 (Calderon) of the 2008-07
Legislative Session. AB 470 failed passage on the Assembly
floor.
REGISTERED SUPPORT / OPPOSITION :
Support
American Federation of State, County and Municipal Employees,
AFL-CIO
California Psychiatric Association
California Public Defenders Association
Chief Probation Officers of California
Los Angeles County Board of Supervisors
Los Angeles Probation Officers' Union
Riverside Sheriffs' Association
Opposition
None
Analysis Prepared by : Stefani Salt / PUB. S. / (916) 319-3744