BILL NUMBER: AB 1018AMENDED BILL TEXT AMENDED IN ASSEMBLY APRIL 13, 2015 INTRODUCED BY Assembly Member Cooper ( Coauthor: Assembly Member Dodd ) FEBRUARY 26, 2015 An act to add Section 14727 to the Welfare and Institutions Code, relating to Medi-Cal. LEGISLATIVE COUNSEL'S DIGEST AB 1018, as amended, Cooper. Medi-Cal: Early and Periodic Screening, Diagnosis, and Treatment (EPSDT). 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 law provides that Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) for any individual under 21 years of age is covered under Medi-Cal consistent with the requirements of federal law. Under federal law, EPSDT services include screening services, vision services, dental services, hearing services, and other necessary services to correct or ameliorate defects and physical and mental illnesses and conditions discovered by the screening services, whether or not the services are covered under the state plan. This bill would require the department to permit county mental health plans to contract with local educational agencies (LEAs), as defined, to provide services for Medi-Cal eligible pupils under EPSDT. The bill would also require the department to permit an LEA to make claims for federal financial participation directly to the department for EPSDT services provided by the LEA or that the LEA has contracted for. The bill would also require the department to examine methodologies for increasing LEA participation in the Medi-Cal program so that schools can meet the educationally related health care needs of their pupils. Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. Section 14727 is added to the Welfare and Institutions Code, to read: 14727. (a) (1) The department shall permit county mental health plans to contract with local educational agencies (LEAs) to provide services for Medi-Cal eligible pupils under Early and Periodic Screening, Diagnosis, and Treatment (EPSDT). (2) (A) Subject to subparagraph (B), if an LEA does not have a contract with the county mental health plan, the department shall permit an LEA to make claims for federal financial participation directly to the department for EPSDT services provided by the LEA or that the LEA has contracted for. Unless otherwise precluded by federal law,LEAsan LEA shall be reimbursed for all eligible EPSDT services provided under this section. (B) To receive federal financial participation under this paragraph, the LEA shall pay the nonfederal share of EPSDT expenditures and shall certify its public expenditures for EPSDT services to the department. (b) (1) Services that a county mental health plan may contract with an LEA for, or that an LEA may receive federal financial participation for, under this section include, but are not limited to, any of the following: (A) Mental health assessments. (B) Targeted case management services. (C) Behavioral services. (D) Mental health, social work, and counseling services. (E) Individual and group services. (F) Crisis intervention. (G) Day treatment. (H) Residential treatment. (I) Medication support services. (2) The Legislature does not intend for this section to authorize an LEA or a county mental health plan to knowingly provide, or submit a claim for, duplicated EPSDT services. (c) The department shall examine methodologies for increasing LEA participation in the Medi-Cal program so that schools can meet the educationally related health care needs of their pupils, which shall include simplifying the claiming processes for Medi-Cal billing to the extent possible. (d) For purposes of this section, "local educational agency" has the same meaning as that term is defined in Section 56026.3 of the Education Code. (e) This section shall be implemented to the extent permitted by federal law. The department shall seek any necessary state plan amendments or waiver amendments to implement this section and shall undertake all necessary activities to obtain federal financial participation for reimbursable services provided by LEAs or contracted for by LEAs under this section.