BILL ANALYSIS                                                                                                                                                                                                    �



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          CONCURRENCE IN SENATE AMENDMENTS
          AB 2612 (Dababneh)
          As Amended August 19, 2014
          Majority Vote
           
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          |ASSEMBLY:  |69-1 |(May 28, 2104)  |SENATE: |32-1 |(August 25,    |
          |           |     |                |        |     |2014)          |
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           Original Committee Reference:    HEALTH

          SUMMARY  :  Requires the Department of Health Care Services (DHCS)  
          to request a federal waiver to authorize federal financial  
          participation (FFP) for health home services provided to  
          individuals who are otherwise eligible to receive health home  
          services and who are state or county inmates in their last 30  
          days in custody.

           The Senate amendments  remove provisions of the bill requiring  
          DHCS to request a federal waiver to receive FFP under the  
          Medi-Cal program for residential substance use disorder  
          treatment in institutions for mental diseases (IMD), and clarify  
          intent language.

           FISCAL EFFECT  :  According to the Senate Appropriations  
          Committee, minor additional staff costs to include a provision  
          relating to services for inmates in the state's forthcoming  
          waiver application to implement the Health Home Program.  No  
          significant increase in state costs is anticipated by adding  
          services for inmates to the Health Home Program. 

           COMMENTS  :  According to the author of this bill, drug or alcohol  
          abuse and dependency is a significant issue for people in the  
          criminal justice system.  Data collected in 2009 by the Office  
          of National Drug Control Policy's Arrestee Drug Abuse Monitoring  
          program showed that males 18 years and older in the justice  
          system tested positive for recent use of drugs and admitted to  
          that use in far higher rates than the general population, with  
          nearly 80% of arrestees in Sacramento testing positive for the  
          presence of at least one drug.  Over half of women in jail and  
          44% of men in jail have a drug or alcohol dependency.  Left  
          untreated, these issues can act as a driver of crime.  

          Until recently, most of the jail inmate population did not have  








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          access to health coverage - up to 90% were uninsured in one  
          survey of the San Francisco jail population.  Recent changes in  
          federal and California law under the federal Patient Protection  
          and Affordable Care Act have expanded coverage to this  
          population, creating new opportunities for coverage for drug  
          treatment programs.  However, because federal law prohibits  
          federal reimbursement for residential drug treatment in IMDs,  
          there is a dearth of available residential substance use  
          disorder treatment beds.  The author states that this bill would  
          help counties create innovative ways to access Drug Medi-Cal and  
          would seek a specific waiver of the IMD exclusion for  
          residential substance use disorder treatment less than 90 days.   


          Californians for Safety and Justice, the sponsor of this bill,  
          writes that the availability of substance use disorder treatment  
          is of particular import to people in the criminal justice  
          system.  Studies have shown up to 90% of the individuals that  
          cycle in and out of the justice system do not have health  
          insurance and suffer significantly higher prevalence of  
          substance use disorders.  When these underlying drivers of crime  
          remain undetected or untreated, the behaviors of people in the  
          justice system often remain the same or worsen, contributing to  
          recidivism and high costs in the justice system.  By seeking a  
          waiver to allow for FFP for residential substance use disorder  
          treatment, the sponsor argues, we can help stop the cycle of  
          crime.  The sponsor notes increased health care enrollment for  
          individuals in the justice system has demonstrated positive  
          results in other jurisdictions:  a 2009 California Department of  
          Corrections and Rehabilitation report showed a 61% recidivism  
          reduction for female inmates accessed substance abuse treatment  
          and a 29% reduction for male inmates who accessed such  
          treatment.   

          This bill has no known opposition.
           

          Analysis Prepared by  :    Paula Villescaz / HEALTH / (916)  
          319-2097 


          FN: 0005064  
          










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