California Assembly Bill AB720 Amended / Bill

 BILL NUMBER: AB 720AMENDED BILL TEXT AMENDED IN SENATE SEPTEMBER 6, 2013 AMENDED IN SENATE SEPTEMBER 3, 2013 AMENDED IN SENATE JULY 9, 2013 AMENDED IN SENATE JUNE 24, 2013 AMENDED IN ASSEMBLY MAY 24, 2013 AMENDED IN ASSEMBLY APRIL 11, 2013 INTRODUCED BY Assembly Member Skinner (Coauthor: Senator Beall) FEBRUARY 21, 2013 An act to add Section 4011.11 to the Penal Code, and to amend Section 14011.10 of the Welfare and Institutions Code, relating to inmates. LEGISLATIVE COUNSEL'S DIGEST AB 720, as amended, Skinner. Inmates: health care enrollment. 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. The Medi-Cal program is, in part, governed and funded by federal Medicaid Program provisions. Existing federal law prohibits federal financial participation for medical care provided to inmates of a public institution, except when the inmate is a patient in a medical institution. Commencing January 1, 2014, the federal Patient Protection and Affordable Care Act expands eligibility under the Medicaid Program for certain groups and enacts various other health care coverage market reforms that take effect on that date. Existing federal law requires the Secretary of Health and Human Services to develop and provide to each state a single, streamlined form that may be used to apply for all state health subsidy programs, as defined, within the state. This bill would authorize the board of supervisors in each county, in consultation with the county sheriff, to designate an entity  or entities  to assist  certain   county  jail inmates to apply for a health insurance affordability program, as defined.  The bill would authorize the entity, to the extent authorized by federal law and federal financial participation is available, to act on behalf of a county jail inmate for the purpose of applying for, or determinations of, Medi-Cal eligibility for acute   inpatient hospital services, as specified.  The bill would provide that county jail inmates who are currently enrolled in the Medi-Cal program shall remain eligible for, and shall not be terminated from, the program due to their detention, unless required by federal law  or   ,  they become otherwise ineligible  , or the suspension of their benefits has ended  .  The bill would require the State Department of Health Care Services to establish, subject to federal law, a process to enable counties to obtain the maximum available federal financial participation for the services they provide pursuant to these provisions. The bill would also authorize an adult who has been involuntarily detained or incarcerated in a county facility to refuse assistance from the designated entity, as specified.  The bill would provide that the fact that an applicant is an inmate shall not, in and of itself, preclude a county human services agency from processing an application  for the Medi-Cal program  submitted to it by, or on behalf of, that inmate. Existing law also provides for the suspension of Medi-Cal benefits to an inmate of a public institution who is under 21 years of age. Existing law requires county welfare departments to notify the department within 10 days of receiving information that an individual under 21 years of age who is receiving Medi-Cal is or will be an inmate of a public institution. This bill would instead make these provisions applicable without regard to the age of the individual, provided that federal financial participation would not be jeopardized. By expanding the duties of county agencies, this bill would impose a state-mandated local program. The bill would also include a statement of legislative intent. 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: yes. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. It is the intent of the Legislature in enacting this act to, among other things, ensure that county human services agencies recognize that (a) federal law generally does not authorize federal financial participation for Medi-Cal when a person is an inmate of a public institution  ,  as defined in federal law, unless the inmate is admitted as an inpatient to a noncorrectional health care facility,  and  (b) federal financial participation is available after an inmate is released from a county jail  ,   and (c) the fact that an applicant is currently an inmate does not, in and of itself, preclude the county human services agency from processing the application submitted to it by, or on behalf of, that inmate  . SEC. 2. Section 4011.11 is added to the Penal Code, to read: 4011.11. (a) (1) The board of supervisors in each county, in consultation with the county sheriff, may designate an entity  or entities  to assist county jail inmates  described in subdivision (c)  with submitting an application for a health insurance affordability program consistent with federal requirements. (2) The board of supervisors shall not designate the county sheriff as  the   an  entity to assist with submitting an application for a health insurance affordability program for county jail inmates  described in subdivision (c)  unless the county sheriff agrees to perform this function. (3) If the board of supervisors designates a community-based organization as  the   an  entity to assist with submitting an application for a health insurance affordability program for county jail inmates  described in subdivision (c)  , the designation shall be subject to approval by the jail  administrator,   administrator  or his or her designee. (b) The jail administrator, or his or her designee, may coordinate with  the   an  entity designated pursuant to subdivision (a).  (c) The entity designated pursuant to subdivision (a) may assist a county jail inmate with submitting an application for a health insurance affordability program if all of the following conditions are met:   (1) The inmate has been in detention for at least 72 hours following remand into custody by a court or magistrate.   (2) The inmate appears potentially eligible to be enrolled in the health insurance affordability program upon release.   (3) The inmate does not currently have health care coverage.   (d)   (c)  Consistent with federal law,  a  county jail  inmates   inmate  who  are   is  currently enrolled in the Medi-Cal program shall remain eligible for, and shall not be terminated from, the program due to  their   his or her  detention unless required by federal law,  or they become   he or she becomes  otherwise ineligible  , or the inmate's suspension of   benefits has ended pursuant to Section 14011.10 of the Welfare and Institutions Code  .  (e) Notwithstanding any other provision of law, and only to the extent that federal law allows, the State Department of Health Care Services shall establish a process to enable counties to obtain the maximum available federal financial participation for services they provide related to this section.   (f)   (d)  Notwithstanding any other state law, and only to the extent federal law allows  and, for purposes of the Medi-Cal program,   and  federal financial participation is available,  the   an  entity designated pursuant to subdivision (a) is authorized to act on behalf of a county jail inmate  who meets all of the conditions described in paragraphs (1) to (3), inclusive of subdivision (c),  for the  limited  purpose of applying  for or a determination of   for, or determinations of, Medi-Cal  eligibility for  a health insurance affordability program, including, but not limited to, the Medi-Cal program   acute inpatient hospital services authorized by Section 14053.7 of the Welfare and Institutions Code  .  The   An  entity  designated pursuant to subdivision (a)  shall not determine Medi-Cal eligibility or redetermine Medi-Cal eligibility, unless the entity is the county human services agency.  The   (e)     The  fact that an applicant is an inmate shall not, in and of itself, preclude a county human services agency from processing an application  for the Medi-Cal program  submitted to it by, or on behalf of, that inmate.  (g) An adult who has been involuntarily detained or incarcerated in a county facility may refuse in writing to authorize the entity designated pursuant to subdivision (a) to act on his or her behalf for purposes of applying for or determining eligibility for a health insurance affordability program, in which case the entity shall not act on that person's behalf. That person shall be informed of, and given the opportunity to exercise, this right before the entity submits an application on his or her behalf.   (h)   (f) For purposes of this section, "health insurance affordability program" means a program that is one of the following: (1) The state's Medi-Cal program under Title XIX of the federal Social Security Act. (2) The state's children's health insurance program (CHIP) under  title   Title  XXI of the federal Social Security Act. (3) A program that makes coverage in a qualified health plan through the California Health Benefit Exchange established pursuant to Section 100500 of the Government Code with advance payment of the premium tax credit established under Section 36B of the Internal Revenue Code available to qualified individuals. (4) A program that makes available coverage in a qualified health plan through the California Health Benefit Exchange established pursuant to Section 100500 of the Government Code with cost-sharing reductions established under Section 1402 of the federal Patient Protection and Affordable Care Act (Public Law 111-148) and any subsequent amendments to that act.  (i)   (g)  Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement this section by means of all-county letters or similar instructions, without taking regulatory action. SEC. 3. Section 14011.10 of the Welfare and Institutions Code is amended to read: 14011.10. (a) Except as provided in  Section   Sections  14011.11,  14053.7, and 14053.8,  benefits provided under this chapter to an individual who is an inmate of a public institution shall be suspended in accordance with Section 1396d(a)(29)(A) of Title 42 of the United States Code as provided in subdivision (c). (b) County welfare departments shall notify the department within 10 days of receiving information that an individual on Medi-Cal in the county is or will be an inmate of a public institution. (c) If an individual 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 shall 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 inoperative. (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) The department shall determine whether federal financial participation will be jeopardized by implementing  the amendments to  this section  made by the act adding this subdivision  and shall implement  those provisions   this section  only if and to the extent that federal financial participation is not jeopardized. (j) 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. 4. 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.