BILL NUMBER: SB 1081 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY JUNE 20, 2012
AMENDED IN SENATE MAY 7, 2012
AMENDED IN SENATE APRIL 10, 2012
INTRODUCED BY Senator Fuller
FEBRUARY 14, 2012
An act to amend Section 15909.1 of, and to add Section 15910.5 to,
the Welfare and Institutions Code, relating to Medi-Cal, making an
appropriation therefor, and declaring the urgency thereof, to take
effect immediately.
LEGISLATIVE COUNSEL'S DIGEST
SB 1081, as amended, Fuller. Public health care: Medi-Cal:
demonstration projects.
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 Program provisions. Existing law provides for the Health
Care Coverage Initiative, which is a federal waiver demonstration
project established to expand health care coverage to low-income
uninsured individuals who are not currently eligible for the Medi-Cal
program and other specified public health coverage programs.
Existing law requires the department, pursuant to federal approval of
a successor demonstration project, to authorize a local Low Income
Health Program (LIHP) to provide health care services to eligible
low-income individuals under certain circumstances. Under existing
law, a county, city and county, consortium of counties serving a
region of more than one county, or a health authority may be eligible
to operate an approved LIHP. Existing law establishes the
continuously appropriated LIHP Fund, which consists of moneys
transferred to the fund from a participating entity to meet the
nonfederal share of estimated payments to the LIHP.
This bill would provide that a nondesignated public hospital, as
defined, may be eligible to operate an approved LIHP if it is located
in a county that does not have a designated public hospital, as
defined, and does not intend to operate an LIHP. By increasing the
number of entities that may transfer funds into the LIHP Fund, this
bill would make an appropriation.
This bill would declare that it is to take effect immediately as
an urgency statute.
Vote: 2/3. Appropriation: yes. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 15909.1 of the Welfare and Institutions Code is
amended to read:
15909.1. For purposes of this part, the following definitions
shall apply:
(a) "Demonstration project" means a federal waiver or
demonstration project described in Section 14180 approved by the
federal Centers for Medicare and Medicaid Services that authorizes
the implementation of a successor to the Health Care Coverage
Initiative under Part 3.5 (commencing with Section 15900).
(b) (1) "Eligible entity" means any of the following:
(A) A county.
(B) A city and county.
(C) A consortium of counties serving a region consisting of more
than one county.
(D) A health authority.
(E) A nondesignated public hospital, if the hospital is located in
a county that does not have a designated public hospital and the
county does not intend to operate a local Low Income Health Program
pursuant to Section 15910.5.
(2) For purposes of this section and to the extent allowed under
the Special Terms and Conditions of the demonstration project, a
County Medical Services Program shall be considered a consortium of
counties serving a region consisting of more than one county.
(c) "LIHP" means a local Low Income Health Program authorized
pursuant to this part that is comprised of the following populations:
(1) The Medicaid Coverage Expansion (MCE) population, which means
low-income individuals 19 to 64 years of age, inclusive, who are not
pregnant, have family incomes at or below 133 percent of the federal
poverty level, are not eligible for the Medi-Cal program or the
Children's Health Insurance Program, are United States citizens,
nationals, or have satisfactory immigration status, and meet the
county of residence requirements.
(2) The Health Care Coverage Initiative (HCCI) population, which
means low-income individuals 19 to 64 years of age, inclusive, who
are not pregnant, have family incomes above 133 percent through 200
percent of the federal poverty level, are not eligible for the
Medicare Program, the Medi-Cal program, the Children's Health
Insurance Program, or other third-party coverage, are United States
citizens, nationals, or have satisfactory immigration status, and
meet the county of residence requirements.
(d) "Participating entity" means an eligible entity that operates
an approved LIHP.
(e) "Designated public hospital" has the same meaning as defined
in subdivision (d) of Section 14166.1.
(f) "Nondesignated public hospital" has the same meaning as
defined in subdivision (f) of Section 14166.1.
SEC. 2. Section 15910.5 is added to the Welfare and Institutions
Code, to read:
15910.5. (a) An application by a
nondesignated public hospital, pursuant to subparagraph (E) of
paragraph (1) of subdivision (b) of Section 15909.1, to the
department to operate an LIHP also shall be provided at the same time
to the county in which the hospital is located. If the county does
not indicate in writing to the department that it will proceed with
its application within 30 days from the date of the application by
the nondesignated public hospital to the department, the department
shall consider the application of the nondesignated public hospital
to operate the LIHP.
(b) The department shall seek any necessary federal approvals for
the implementation of this section. This section shall be implemented
only if and to the extent that any necessary federal approvals are
obtained.
SEC. 3. It is the intent of the Legislature that if a
nondesignated public hospital submits an application pursuant to this
act, the hospital initially shall establish a local stakeholder
advisory committee comprised of health plans, community health
centers, consumers, and other interested stakeholders to provide
input regarding the development, implementation, and operation of the
LIHP.
SEC. 4. This act is an urgency statute necessary for the immediate
preservation of the public peace, health, or safety within the
meaning of Article IV of the Constitution and shall go into immediate
effect. The facts constituting the necessity are:
In order to improve access to health care services for patients in
underserved areas at the earliest possible time, it is necessary
that this act take effect immediately.