BILL ANALYSIS �
AB 396
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Date of Hearing: May 18, 2011
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
AB 396 (Mitchell) - As Amended: May 12, 2011
Policy Committee: HealthVote:18-0
Public Safety Vote: 7-0
Urgency: No State Mandated Local Program:
No Reimbursable: No
SUMMARY
This bill requires the Department of Health Care Services (DHCS)
to develop a process to allow participating counties and the
state Department of Corrections and Rehabilitation (CDCR) to
receive any available federal financial participation for health
care services provided to juvenile detainees who are admitted as
inpatients in a medical institution.
FISCAL EFFECT
1)One-time administrative costs to DHCS, in the range of
$100,000 (50% GF), to develop and obtain federal approval for
a process to allow the state and counties to leverage federal
Medi-Cal funds for juvenile detainees. In addition, there
would be minor ongoing administrative costs to oversee the
program. The bill does not require counties to cover the
state's administrative costs of implementing the program.
2)If federal approval is granted:
a. Counties report they would see significant cost savings
by leveraging federal funds. Estimates from Los Angeles
County indicate that cost savings to counties could be in
the range of several million to over $10 million statewide.
b. Potential cost savings to the state by leveraging
federal funds in the range of $2.5 million (50% GF).
COMMENTS
1) Rationale . According to the author, currently, when
AB 396
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counties detain minors in a juvenile detention facility or
probation camp, their Medi-Cal benefits are suspended. The
author asserts that federal law permits Medi-Cal
reimbursement when otherwise eligible minors are admitted
to a hospital for treatment and are away from the facility
for more than 24 hours. The author states that due to
restrictive state regulations, counties are unable to use
this option, and are therefore paying the full cost of
minors detained in juvenile detention facilities or camps
when they are treated outside of the facility. According
to the author, this bill would require DHCS to make the
necessary administrative changes to allow counties to seek
reimbursement from the federal government.
2) Background . AB 1628 (Budget Committee), Chapter 729,
Statutes of 2010 (the 2010 corrections trailer bill)
authorized state departments to develop a process by which
the state could seek federal reimbursement through the
Medi-Cal program for the provision of inpatient hospital
services to inmates who would otherwise be eligible for
Medi-Cal or county-based low-income health programs (LIHP),
but for their institutional status as inmates. LIHPs are
county-funded health programs created last year through the
state's Section 1115 Medi-Cal waiver, and offer Medi-Cal
like benefits to low-income persons not currently eligible
for Medi-Cal.
AB 1628 also authorized a county to seek reimbursement from
the Medi-Cal program or the county LIHP program for the
provision of inpatient hospital services to adults in
county facilities, in which case the county would be
responsible for the nonfederal share of the reimbursement.
This bill would expand this ability to juvenile inmates.
Related Legislation . SB 695 (Hancock), 2011, pending in
Senate Appropriations committee, allows counties to seek
Medi-Cal reimbursement for care provided to juveniles
awaiting adjudication. SB 1091 (Hancock), 2010 was
substantially similar to SB 695, and was vetoed due to
concerns about inconsistency with federal law and GF risk.
SB 1147 (Calderon), Chapter 546, Statutes of 2008,
prohibits DHCS from terminating the Medi-Cal eligibility of
a juvenile due to their status as an inmate.
AB 396
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Analysis Prepared by : Lisa Murawski / APPR. / (916) 319-2081