BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SB 1147
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          SENATE THIRD READING
          SB 1147 (Calderon)
          As Amended August 8, 2008
          Majority vote 

           SENATE VOTE  :27-13  
           
           HEALTH              12-5        APPROPRIATIONS      12-4        
           
           ----------------------------------------------------------------- 
          |Ayes:|Dymally, Berg, Carter, De |Ayes:|Leno, Caballero, Davis,   |
          |     |La Torre, Caballero,      |     |DeSaulnier, Furutani,     |
          |     |Hancock, Hayashi,         |     |Huffman, Karnette,        |
          |     |Hernandez, Jones, Lieber, |     |Krekorian, Lieu, Ma,      |
          |     |Ma, Salas                 |     |Nava, Solorio             |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Nakanishi, Emmerson,      |Nays:|Walters, Emmerson, La     |
          |     |Gaines, Huff, Silva       |     |Malfa, Nakanishi          |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Requires Medi-Cal benefits of an individual under age  
          21 to be suspended on the date he/she becomes an inmate of a  
          public institution, instead of making an individual under age 21  
          who is an inmate ineligible for Medi-Cal under existing law.   
          Specifically,  this bill  :


          1)Requires Medi-Cal benefits to an individual under 21 years of  
 
            age who is an inmate of a public institution (a state or  
 
            federal prison, correctional facility, county/city jail or  
 
            detention center) to be suspended in accordance with a  
 
            specified provision of federal law (current state Medi-Cal  
 
            regulations make individuals who are inmates of public  
 
            institutions ineligible for Medi-Cal).











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          2)Requires, if a Medi-Cal beneficiary is under age 21 on the  
 
            date he/she becomes an inmate of a public institution, his or  
 
            her Medi-Cal benefits to be suspended effective the date he or  
 
            she becomes an inmate of a public institution.  Requires the  
 
            suspension to end on the date he/she is no longer an inmate of  
 
            a public institution or one year from the date he/she becomes  
 
            an inmate of a public institution, whichever is sooner.  



          3)Requires county welfare departments to notify the Department  
 
            of Health Care Services (DHCS) 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. 



          4)Prohibits this bill from creating a state-funded benefit or  
 
            program, and prohibits health care services under the Medi-Cal  
 
            program from being provided to inmates of public institutions  
 
            whose Medi-Cal benefits have been suspended.



          5)Requires this bill to be implemented only if and to the extent  
 
            allowed by federal law, and only to the extent that any  
 
            necessary federal approvals are obtained.  Makes this bill  
 








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            inoperable if it is in conflict with or does not comply with  
 
            federal law.  Requires this bill be implemented on January 1,  
 
            2010, or when all necessary federal approvals are obtained,  
 
            whichever is later. 



          6)Requires DHCS, by January 1, 2010 or when all necessary  
 
            federal approvals are obtained, in consultation with the Chief  
 
            Probation Officers of California and the County Welfare  
 
            Directors Association, to establish the protocols and  
 
            procedures necessary to implement this bill, including any  
 
            needed changes to the protocols and procedures previously  
 
            established to implement a specified provision of existing  
 
            law.



          7)Requires DHCS to implement this bill by all-county letters or  
 
            similar instructions without taking regulatory action.   
 
            Thereafter, DHCS must implement this bill through regulation.



          8)Limits the existing law requirement that county welfare  
 
            departments initiate a Medi-Cal application to only those  
 
            wards not already enrolled in the Medi-Cal program, when a  
 
            county has received information on a ward from a county  
 








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            juvenile detention facility.



          9)Requires county welfare departments to deny a minor's Medi-Cal  
 
            application in accordance with due process requirements if the  
 
            cooperation of the minor's parent or guardian is necessary to  
 
            complete the application, but the minor's parent or guardian  
 
            fails to cooperate in completing the application.


           FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee:

          1)Annual increased Medi-Cal costs of $250,000 (50% General Fund  
            [GF]) to $500,000 (50% GF) to provide 150 to 300 formerly  
            incarcerated youth per month with two months of Medi-Cal  
            benefits immediately upon return to the community, rather than  
            youth having to reapply for benefits.

          2)This estimate reflects updated information on caseload,  
            Medi-Cal eligibility, administrative savings, county  
            variability with respect to Medi-Cal termination, youth  
            disposition in terms of length of stay in placement, and  
            current law provisions codified by SB 1469 (Cedillo), Chapter  
            657, Statutes of 2006. 

          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  :  This bill is sponsored by the Youth Law Center (YLC)  
          to ensure that eligible young people leaving detention do not  
          have to reapply for Medi-Cal, thereby supporting prompt and  
          continuous access to prescription medication, mental health  
          services and medical treatment.  YLC argues requiring formal  
          terminations of Medi-Cal eligibility and subsequent  
          reapplications is costly and makes little sense for children who  








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          may only be in custody for a period of days or weeks.   
          Supporters of this bill argue this measure will improve  
          continuity of care for youth, support rehabilitation,  
          particularly for youth who need mental health services, reduce  
          the cost to the state for delayed medical and mental health care  
          costs, reduce the time and money spent on the Medi-Cal  
          reapplication process, and bring California into compliance with  
          federal guidance.

          State Medi-Cal regulations make individuals who are inmates of  
          public institutions ineligible for Medi-Cal, and individuals  
          whose coverage is terminated must reapply upon release.   
          However, a 1997 letter from the federal Department of Health and  
          Human Services indicates federal financial participation is  
          available through Medicaid when an inmate becomes a patient in a  
          medical institution on an inpatient basis.  Additionally, a 2004  
          letter to State Medicaid directors from the federal Centers for  
          Medicare and Medicaid Services (CMS) encourages states to  
          "suspend" and not "terminate" benefits while a person is in a  
          public institution or Institute for Mental Disease, noting the  
          exclusion from payment by Medicaid does not affect the  
          eligibility of an individual for the Medicaid program.
           

          Analysis Prepared by  :    Scott Bain / HEALTH / (916) 319-2097 


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