BILL ANALYSIS
SB 1147
Page 1
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).
SB 1147
Page 2
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
SB 1147
Page 3
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
SB 1147
Page 4
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
SB 1147
Page 5
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
FN: 0006608