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HomeMy WebLinkAboutMINUTES - 04132010 - C.50RECOMMENDATION(S): SUPPORT SB 1091 (Hancock), a bill that makes individuals awaiting adjudication in county juvenile detention facilities eligible for Medi-Cal benefits if the individual is receiving Medi-Cal benefits at the time he or she is admitted to the detention facility and the county agrees to pay the state's share of Medi-Cal expenditures and the state's administrative costs through an intergovernmental transfer of funds, as recommended by the Chief Probation Officer. FISCAL IMPACT: To be determined.... BACKGROUND: Alameda County is sponsoring SB 1091 (Hancock) to enable counties to draw down federal funds to help pay for health and mental health services for the care they are providing to the youth in their juvenile halls. As you may know, if a person is enrolled in Medi-Cal, those benefits end when they walk across the threshold into a detention facility. Nonetheless, the county is responsible for APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 04/13/2010 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, District I Supervisor Gayle B. Uilkema, District II Supervisor Mary N. Piepho, District III Supervisor Susan A. Bonilla, District IV Supervisor Federal D. Glover, District V Supervisor Contact: Lara DeLaney (925) 335-1097 I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown. ATTESTED: April 13, 2010 David J. Twa, County Administrator and Clerk of the Board of Supervisors By: EMY L. SHARP, Deputy cc: C. 50 To:Board of Supervisors From:David Twa, County Administrator Date:April 13, 2010 Contra Costa County Subject:Support Position for SB 1091 (Hancock): Medi-Cal: Individuals in Juvenile Detention providing BACKGROUND: (CONT'D) care for all the inmates and paying for it. New Mexico has been able for the past five years to use Medicaid for the youths in its detention facilities. Federal regulations do allow for this in certain situations. Alameda County would like to benefit in the same way as counties in New Mexico. However, since our State’s coffers are empty, the County is offering to put up the dollars it is already spending on health care for these youths (and cover the State’s costs of administration) as a match for the federal funds in lieu of state funds. Senator Hancock has introduced SB 1091 to accomplish this. The March 23 version of the bill reflects Alameda County's intent, but there will be further amendments soon to indicate that not only the youths who are already on Medi-Cal when they are admitted to the facility can receive Medi-Cal services under the bill, but also those who are “eligible” to receive them. (Families who have not yet signed up but could have.) Alameda County estimates that about ¾ of the youths in juvenile hall are either on Medi-Cal or are eligible for the program. Having a Medicaid match for these youths would make a huge dent in the County’s bill for health and mental health services for this population. ATTACHMENTS SB 1091 Bill Text AMENDED IN SENATE MARCH 23, 2010 SENATE BILL No. 1091 Introduced by Senator Hancock February 17, 2010 An act relating to Medi-Cal. An act to amend Sections 14011.10 and 14053 of, and to add Section 14011.11 to, the Welfare and Institutions Code, relating to Medi-Cal. legislative counsel’s digest SB 1091, as amended, Hancock.Medi-Cal: reimbursement: individuals in county juvenile detention facilities. Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. Under existing law, children in juvenile facilities are ineligible to receive Medi-Cal benefits. This bill would state the intent of the Legislature to enact legislation that would ensure that adequate health care services are provided to children in county juvenile detention facilities by allowing the facilities to receive Medi-Cal reimbursement for health care services provided to children while they are being detained and awaiting adjudication by the courts. This bill would, subject to the receipt of federal financial participation, make individuals awaiting adjudication in county juvenile detention facilities eligible for Medi-Cal benefits if the individual is receiving Medi-Cal benefits at the time he or she is admitted to the detention facility and the county agrees to pay the state’s share of Medi-Cal expenditures and the state’s administrative costs through an intergovernmental transfer of funds. This bill would provide that these 98 individuals would have their Medi-Cal benefits continued for the first 30 days of the individual’s stay in the county juvenile detention facility, or until the date of adjudication, whichever period of time is less. This bill would require the department to seek all federal approvals or waivers necessary to implement these provisions and to allow for federal financial participation. Vote: majority. Appropriation: no. Fiscal committee: no yes. State-mandated local program: no. The people of the State of California do enact as follows: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 SECTION 1.Section 14011.10 of the Welfare and Institutions Code is amended to read: 14011.10.(a)  Benefits Except as provided in Section 14011.11, 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. 98 — 2 —SB 1091 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 (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. SEC. 2.Section 14011.11 is added to the Welfare and Institutions Code, to read: 14011.11.(a)  To the extent that federal financial participation is available, benefits provided under this chapter may be provided to an individual awaiting adjudication in a county juvenile detention facility if all of the following requirements are met: (1)  The individual is receiving Medi-Cal benefits at the time the individual is admitted to the juvenile detention facility. (2)  The county agrees to pay the state’s share of Medi-Cal expenditures and the state’s administrative costs through an intergovernmental transfer of funds. (b)  Benefits provided pursuant to this section shall continue for the first 30 days of the individual’s stay in the juvenile detention facility, or until the date of adjudication, whichever period of time is less. (c)  The department shall seek all federal approvals or waivers necessary to implement this section and to allow for federal financial participation. (d)  This section shall be implemented on January 1, 2012, or on the date that all necessary federal approvals or waivers are 98 SB 1091— 3 — 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 obtained and federal financial participation is available, whichever is later. (e)  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. SEC. 3.Section 14053 of the Welfare and Institutions Code is amended to read: 14053.(a)  The term “health care services” means the benefits set forth in Article 4 (commencing with Section 14131) of this chapter and in Section 14021. The term includes inpatient hospital services for any individual under 21 years of age in an institution for mental diseases. Any individual under 21 years of age receiving inpatient psychiatric hospital services immediately preceding the date on which he or she attains age 21 may continue to receive these services until he or she attains age 22. The term also includes early and periodic screening, diagnosis, and treatment for any individual under 21 years of age. (b)  The term “health care services” does not include, except to the extent permitted by federal law, any of the following: (1)  Care or services for any individual who is an inmate of an institution (except, except as a patient in a medical institution) institution, or pursuant to Section 14011.11. (2)  Care or services for any individual who has not attained 65 years of age and who is a patient in an institution for tuberculosis. (3)  Care or services for any individual who is 21 years of age or over, except as provided in the first paragraph of this section, and has not attained 65 years of age and who is a patient in an institution for mental disease. (4)  Inpatient services provided to individuals 21 to 64 years of age, inclusive, in an institution for mental diseases operating under a consolidated license with a general acute care hospital pursuant to Section 1250.8 of the Health and Safety Code, unless federal financial participation is available for such inpatient services. SECTION 1.It is the intent of the Legislature to enact legislation that would ensure that adequate health care services are provided to children in county juvenile detention facilities by 98 — 4 —SB 1091 1 2 3 allowing the facilities to receive Medi-Cal reimbursement for health care services provided to children while they are being detained and awaiting adjudication by the courts. O 98 SB 1091— 5 —