BILL NUMBER: SB 1147 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY AUGUST 8, 2008
AMENDED IN ASSEMBLY JUNE 19, 2008
AMENDED IN SENATE APRIL 9, 2008
INTRODUCED BY Senators Calderon and Yee
FEBRUARY 4, 2008
An act to amend Section 14029.5 of, and to add Section
14011.95 14011.10 to, the Welfare and
Institutions Code, relating to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
SB 1147, as amended, Calderon. Medi-Cal: eligibility: juvenile
offenders.
Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Care Services, and
under which qualified low-income persons receive health care
benefits. The Medi-Cal program is governed, in part, by federal
Medicaid provisions.
This bill would specify that inmate status shall not be used to
terminate the eligibility of a child under the Medi-Cal program, and
would require the department to establish the protocols and
procedures necessary to ensure that Medi-Cal eligibility is not
terminated in violation of that requirement.
This bill would, commencing the later of January 1, 2010, or the
date that all necessary federal approvals are obtained, require, to
the extent permitted under federal law, Medi-Cal benefits provided to
an individual under 21 years of age who is an inmate of a public
institution to be suspended, rather than terminated. This bill would
require county welfare departments to notify the department within 10
days of receiving information that an individual under 21 years of
age on Medi-Cal in the county is or will be an inmate of a public
institution. This bill would also require, by a specified time
period, the department, in consultation with the Chief Probation
Officers of California and the County Welfare Directors Association,
to establish the protocols and procedures necessary to implement
these provisions.
By expanding the duties of county welfare departments, this bill
would impose a state-mandated local program.
Existing law requires a county juvenile detention facility to
provide specified information relating to a ward of the county who is
scheduled to be released to the appropriate county welfare
department, and requires the county to initiate an application and
determine the individual's eligibility for the Medi-Cal program.
Existing law also requires a county juvenile detention facility,
prior to providing the information to the county welfare department,
to notify the parent or guardian of a ward who is a minor of its
intention to submit the information. Existing law requires the parent
or guardian be given a reasonable time to opt out of the Medi-Cal
determination.
This bill would require, no later than July 1, 2009, the
department, in consultation with specified stakeholders, to develop a
model notification letter for use by the juvenile detention
facilities to notify a parent or guardian of a ward who is a minor of
its intent to submit the information described above, and would
limit the requirement that a county welfare department initiate an
application for any ward to, instead, apply to any ward not already
enrolled in the Medi-Cal program. This bill would also
provide that if the cooperation of the minor's parent or
guardian is necessary to complete the application, but the
parent or guardian fails to cooperate in completing the
application, the county shall deny the application in accordance with
due process requirements.
The bill would further require the department, no later than
January 1, 2010, and after the development and dissemination of the
model notification letter described above, to convene a workgroup
comprised of specified members to review the implementation of these
provisions and, if appropriate, to make specified recommendations, as
provided.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that, if the Commission on State Mandates
determines that the bill contains costs mandated by the state,
reimbursement for those costs shall be made pursuant to these
statutory provisions.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no yes .
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 14011.10 is added to the
Welfare and Institutions Code , to read:
14011.10. (a) Benefits provided under this chapter to an
individual under 21 years of age who is an inmate of a public
institution shall be suspended in accordance with Section 1396d(a)
(28)(A) of Title 42 of the United States Code as provided in
subdivision (c).
(b) County welfare departments shall be required to notify the
department within 10 days of receiving information that an individual
under 21 years of age on Medi-Cal in the county is or will be an
inmate of a public institution.
(c) 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 under this chapter and under Chapter
8 (commencing with Section 14200) shall be suspended effective the
date he or she becomes an inmate of a public institution. The
suspension will end on 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.
(d) Nothing in this section shall create a state-funded benefit or
program. Health care services under this chapter and Chapter 8
(commencing with Section 14200) shall not be available to inmates of
public institutions whose Medi-Cal benefits have been suspended under
this section.
(e) This section shall be implemented only if and to the extent
allowed by federal law. This section shall be implemented only to the
extent that any necessary federal approval of state plan amendments
or other federal approvals are obtained.
(f) If any part of this section is in conflict with or does not
comply with federal law, this entire section shall be inoperable.
(g) This section shall be implemented on January 1, 2010, or the
date when all necessary federal approvals are obtained, whichever is
later.
(h) By January 1, 2010, or the date when all necessary federal
approvals are obtained, whichever is later, the department, in
consultation with the Chief Probation Officers of California and the
County Welfare Directors Association, shall establish the protocols
and procedures necessary to implement this section, including any
needed changes to the protocols and procedures previously established
to implement Section 14029.5.
(i) Notwithstanding Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code, the
department shall implement this section by means of all-county
letters or similar instructions without taking regulatory action.
Thereafter, the department shall adopt regulations in accordance with
the requirements of Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code.
SECTION 1. Section 14011.95 is added to the
Welfare and Institutions Code, to read:
14011.95. (a) For purposes of this section, "child" means any
individual under 21 years of age.
(b) Inmate status shall not be used to terminate the eligibility
of a child under the Medi-Cal program.
(c) Commencing January 1, 2009, the department, in consultation
with the Chief Probation Officers of California and the County
Welfare Directors Association, shall establish the protocols and
procedures necessary to ensure both of the following:
(1) Medi-Cal eligibility is not terminated in violation of this
section.
(2) Claims for Medicaid-covered health care services pursuant to
paragraph (1) of subdivision (b) of Section 14053 are made only when
federal financial participation is available.
(d) Notwithstanding Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code, the
department shall implement this section by means of all-county
letters or similar instructions, without taking any further
regulatory action. Thereafter, but no later than January 1, 2011, the
department shall adopt regulations, as necessary, to implement this
section in accordance with the requirements of Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 3 of Title 2 of
the Government Code.
SEC. 2. Section 14029.5 of the Welfare and Institutions Code is
amended to read:
14029.5. (a) (1) Commencing January 1, 2008, immediately
following the issuance of an order of the juvenile court, pertaining
to the disposition of a ward of the county, committing that ward to a
juvenile hall, camp, or ranch for 30 days or longer, the county
juvenile detention facility shall provide the appropriate county
welfare department with the ward's name, his or her scheduled or
actual release date, any known information regarding the ward's
Medi-Cal status prior to disposition, and sufficient information,
when available, for the county welfare department to begin the
process of determining the ward's eligibility for benefits under this
chapter, including, if the ward is a minor, contact information for
the ward's parent or guardian, if available.
(2) (A) If the ward is a
minor, prior to providing information to the county welfare
department pursuant to paragraph (1), the county juvenile detention
facility shall notify the parent or guardian, in writing, of its
intention to submit the information required by that paragraph to the
county welfare department. The parent or guardian shall be given a
reasonable time to opt out of the Medi-Cal eligibility determination
provided for under this section, in which case the county juvenile
detention facility shall not comply with paragraph (1).
(B) No later than July 1, 2009, the department shall, in
consultation with stakeholders, including, but not limited to, county
probation departments, county human services agencies, and consumer
advocates, develop a model notification letter for use by juvenile
detention facilities to meet the requirements of subparagraph (A).
(3) For purposes of this section, "ward" means a person in the
custody of a county juvenile detention facility.
(b) (1) Upon receipt of the information described in paragraph (1)
of subdivision (a), and pursuant to the protocols and procedures
developed pursuant to subdivision (c) , the county welfare
department shall initiate an application for any ward not already
enrolled in the Medi-Cal program, and determine the individual's
eligibility for benefits under the Medi-Cal program. If the ward is a
minor, the county welfare department shall promptly contact the
parent or guardian to arrange for completion of the application. If
the minor's parent or guardian cooperation of
the minor's parent or guardian is necessary to complete the
application, but the parent or guardian fails to cooperate in
completing the application, the county welfare department shall deny
the application in accordance with due process requirements. The
county shall expedite the application of a ward who, according to the
information provided pursuant to paragraph (1) of subdivision (a),
is scheduled to be released in fewer than 45 days.
(2) If the county welfare department determines that the ward does
not meet the eligibility requirements for the Medi-Cal program, the
county welfare department, with the consent of the ward's parent or
guardian, if the ward is a minor, shall forward the ward's
information to the appropriate entity to determine eligibility for
the Healthy Families Program, or other appropriate health coverage
program, as determined by the department.
(3) If the county welfare department determines that a ward meets
eligibility requirements for the Medi-Cal program, the county shall
provide sufficient documentation to enable the ward to obtain
necessary medical care upon his or her release from custody.
(c) (1) No later than January 1, 2010, and after the development
and dissemination of the model notification letter, as required by
subparagraph (B) of paragraph (2) of subdivision (a), the department
shall convene a workgroup for the purpose of reviewing the
implementation of this section, and making recommendations, if
appropriate, to increase the rate of successful eligibility
determinations and minimize county administrative burden. The
workgroup shall consider, at a minimum, whether to recommend an
opt-in, rather than an opt-out, process for parents of wards who are
minors.
(2) The workgroup shall include representatives of the Chief
Probation Officers of California and the County Welfare Directors
Association, legislative staff, and consumer advocates.
(d)
(c) Notwithstanding Chapter 3.5 (commencing with
Section 11340) of Part 1 of Division 3 of Title 2 of the Government
Code, the department shall implement this section by means of
all-county letters or similar instructions, without taking any
further regulatory action. Thereafter, the department shall adopt
regulations, as necessary, to implement this section in accordance
with the requirements of Chapter 3.5 (commencing with Section 11340)
of Part 1 of Division 3 of Title 2 of the Government Code.
(e)
(d) The department shall seek any federal waivers
necessary for the implementation of this section.
SEC. 3. If the Commission on State Mandates
determines that this act contains costs mandated by the state,
reimbursement to local agencies and school districts for those costs
shall be made pursuant to Part 7 (commencing with Section 17500) of
Division 4 of Title 2 of the Government Code.