BILL ANALYSIS �
Senate Appropriations Committee Fiscal Summary
Senator Christine Kehoe, Chair
SB 1081 (Fuller) - Medi-Cal: demonstration projects
Amended: April 10, 2012 Policy Vote: Health 8-0
Urgency: Yes Mandate: No
Hearing Date: April 30, 2012
Consultant: Brendan McCarthy
This bill does not meet the criteria for referral to the
Suspense File.
Bill Summary: SB 1031 would authorize a nondesignated public
hospital to operate a Low Income Health Program if it is located
in a county that does not have a county hospital and the county
does not intend to operate a such a program.
Fiscal Impact:
Unknown, but likely minor, state costs. All state costs to
be fully reimbursed by participating nondesignated public
hospitals.
Additional local government reimbursements up to $2.7
million (federal funds).
Background: Under current law and the existing federal Medi-Cal
hospital waiver, locally operated Low Income Health Programs are
authorized to extend health care coverage to individuals between
19 and 64 years of age, with incomes up to 200 percent of the
federal poverty level, who are not otherwise eligible for
Medi-Cal. (The operator of the program can set more restrictive
enrollment criteria.) The costs of Low Income Health Programs
are split between local funds and federal funds at a 50 percent
federal participation rate. Under current law, cities, counties,
cities and counties, a consortium of counties, or a health
authority may establish a Low Income Health Program.
Nondesignated public hospitals (public hospitals that are not
one of 22 specified University of California or county public
hospitals) are not permitted to operate Low Income Health
Programs.
By January 1, 2014, participants in Low Income Health Programs
will be transitioned either to an expanded Medi-Cal program or
will be required to purchased health insurance through the
SB 1081 (Fuller)
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California Health Benefit Exchange.
Low Income Health Programs are operated and financed by local
government entities and the federal government. Current law
prohibits the use of General Fund monies for their operation.
The Department of Health Care Services may play a role in the
drawdown of federal funds and the distribution of those funds to
local government agencies. Current law requires any
administrative costs incurred by the Department to be reimbursed
by program operators.
As of February 2012, about 340,000 participants were enrolled in
Low Income Health Programs. Three counties (San Luis Obispo,
Tulare, and Santa Barbara) have put their development of a Low
Income Health Program on hold and Fresno County has decided not
to proceed with one. There is no nondesignated public hospital
in Fresno County, so this bill would not apply there.
Proposed Law: SB 1081 would authorize a nondesignated public
hospital to operate a Low Income Health Program provided that it
is located in a county that does not have a county hospital and
does not intend to operate a Low Income Health Program.
Staff Comments: At this point, staff is only aware of plans in
Tulare County for a nondesignated public hospital to set up a
Low Income Health Program under this bill. The sponsors of this
bill estimate that between 7,000 and 8,000 residents of Tulare
County could be enrolled in a Low Income Health Program. The
sponsors estimate that up to $2.7 million in federal funds could
be drawn down, based on current expenditures in Tulare County
for care of the medically indigent.
This bill is an urgency measure.
Because federal funds for Low Income Health Programs are
continuously appropriated in statute and this bill expands the
entities that may participate in that program, this bill makes
an appropriation.