BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SB 1147 
                                                                  Page  1

          Date of Hearing:   July 2, 2008

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                  Mark Leno, Chair

                   SB 1147 (Calderon) - As Amended:  June 19, 2008 

          Policy Committee:                              Health Vote:12-5

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              

           SUMMARY  

          This bill addresses the Medi-Cal eligibility status of  
          incarcerated persons under 21 years of age to conform to federal  
          law. Specifically, this bill: 

          1)Prohibits the California Department of Health Care Services  
            (DHCS) from terminating the Medi-Cal eligibility of a ward due  
            to the youth's status as an inmate. 

          2)Requires DHCS, in consultation with the Chief Probation  
            Officers of California (CPOC) and the County Welfare Directors  
            Association (CWDA), to establish the protocols and procedures  
            necessary to ensure Medi-Cal eligibility is not terminated and  
            claims for Medi-Cal services provided to a ward are made only  
            when federal financial participation is available.

          3)Specifies the processes and contents for development of  
            related notifications for use by juvenile detention facilities  
            to communicate with families with regard to Medi-Cal status. 

          4)Requires DHCS to review implementation of requirements of this  
            bill by January 2010. 

           FISCAL EFFECT  

          1)Annual increased Medi-Cal benefit costs of $3 million (50% GF)  
            to $5 million to provide formerly incarcerated youth with  
            Medi-Cal immediately upon return to the community, rather than  
            providing Medi-Cal after initiating eligibility, which can  
            take several months.  One-time costs of approximately $100,000  
            (75% GF) to DHCS to convene stakeholder groups and modify  
            processes accordingly. 








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          2)The average daily population in California's juvenile halls  
            and camps is a combined 14,000 youth. The average length of  
            stay for this population is generally very short, with  
            releases occurring after, on average, 30 days for juvenile  
            hall and 100 days for juvenile camps. The proportion of  
            Medi-Cal eligible in this population is unknown, though higher  
            than the general population. This estimate assumes  
            approximately one-third of minors released from institutions  
            receive Medi-Cal benefits two months earlier as a result of  
            this bill. 


          3)Potentially significant loss of federal funds to the extent  
            continued non-compliance results in punitive action from the  
            federal government. Medi-Cal GF spending is matched dollar for  
            dollar with federal financial support. Therefore a reduction  
            in this area would have serious GF implications. 


           COMMENTS  

           1)Rationale . This bill is sponsored by the Youth Law Center to  
            conform state Medi-Cal eligibility for wards to federal law.  
            Under federal law, inmates in locked facilities are not  
            eligible for federal financial participation (FFP) under  
            Medi-Cal. Due to this ineligibility for payment, DHCS has  
            historically terminated, rather than suspended a ward's  
            Medi-Cal eligibility status. California is one of the only  
            states in the country to terminate benefits under these  
            circumstances. Because eligibility has been terminated, a  
            juvenile must re-apply for Medi-Cal upon release, which can  
            result in a several month delay in care. 

          According to many stakeholders, including the plaintiffs in the  
            San Francisco case, current California law contravenes federal  
            law with respect to these issues. Therefore, California may  
            risk loss of federal funding for continued non-compliance in  
            this area. 

           2)Current Law Results in Termination of Eligibility  . Under  
            current law, Medi-Cal applications take 45 days for  
            processing, and may take much longer, leading to significant  
            and unnecessary lapses in care for a population with  
            significant health and mental health needs.  In addition,  








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            because their eligibility has been terminated while they are  
            inmates, they are not eligible for FFP in other settings, such  
            as state psychiatric care, which may be authorized for payment  
            under federal law. This bill codifies ongoing efforts,  
            including an MOU between DHCS and the California Department of  
            Corrections and Rehabilitation (CDCR) and litigation in which  
            San Francisco has filed against DHCS to address these issues  
            and increase access to care for wards leaving locked  
            facilities. 

           3)Related Legislation  . SB 1469 (Cedillo), Chapter 657, Statutes  
            of 2007, requires county juvenile detention facilities  
            committing a county ward to a juvenile hall, camp, or ranch  
            for 30 days or longer, to provide the county welfare  
            department with any known information regarding the ward's  
            Medi-Cal status prior to disposition, and sufficient  
            information for the county welfare department to begin the  
            process of determining the ward's Medi-Cal eligibility.

          AB 2004 (Yee) in 2006 prohibited the use of inmate status to  
            terminate the Medi-Cal eligibility of a youth ward, and  
            required DHCS to suspend, but not terminate, the Medi-Cal  
            eligibility of a ward.  AB 2004 was vetoed because, according  
            to the governor, the bill did not address the need for better  
            coordination between county welfare, county probation, and  
            juvenile detention facilities.


          Analysis Prepared by  :    Mary Ader / APPR. / (916) 319-2081