Amended IN Assembly March 18, 2021 CALIFORNIA LEGISLATURE 20212022 REGULAR SESSION Assembly Bill No. 369Introduced by Assembly Member Kamlager(Coauthors: Assembly Members Carrillo, Cristina Garcia, Gipson, Santiago, and Stone)(Coauthor: Senator Wiener)February 01, 2021 An act to add Sections 14011.67 and 14133.55 to, and to add and repeal Section 14133.02 of, the Welfare and Institutions Code, relating to Medi-Cal. LEGISLATIVE COUNSEL'S DIGESTAB 369, as amended, Kamlager. Medi-Cal: street medicine and utilization controls. Medi-Cal services: persons experiencing homelessness.Existing law provides for the Medi-Cal program, administered by the State Department of Health Care Services and 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. Under existing law, Medi-Cal covered benefits are generally subject to utilization controls, including prior authorization requirements.This bill, until January 1, 2026, would prohibit the Director of the State Department of Health Care Services from imposing prior authorization or other utilization controls on an item, service, or immunization that is intended to test for, prevent, treat, or mitigate COVID-19. Existing law requires the department to provide presumptive Medi-Cal eligibility to pregnant women and children. Existing law authorizes a qualified hospital to make presumptive eligibility determinations if it complies with specified requirements. Existing law authorizes the department, on a regional pilot project basis, to issue a benefits identification card to a person who is eligible for Medi-Cal program benefits, but does not possess a valid California drivers license or identification card issued by the Department of Motor Vehicles.This bill would require the department to implement a program of presumptive eligibility for individuals persons experiencing homelessness, under which an individual a person would receive full-scope Medi-Cal benefits without a share of cost. The bill would authorize a qualified hospital any enrolled Medi-Cal provider, including a health facility, such as a hospital or clinic, to make a presumptive eligibility determination for an individual a person experiencing homelessness if the individual that person gives their informed consent to receive Medi-Cal benefits. benefits, and would authorize the provider to issue a temporary Medi-Cal benefits identification card to that person. The bill would require a county to determine if an individual experiencing homelessness who has presumptive eligibility is eligible for Medi-Cal benefits. By creating new duties for counties, the bill would impose a state-mandated local program. If the county determines that the person experiencing homelessness is eligible for benefits, the bill would require the person to be enrolled in the Medi-Cal programs fee-for-service delivery system until they elect to enroll in a Medi-Cal managed care plan, as specified, including that they complete a Medi-Cal choice form with their chosen primary care provider.This bill would require the department to develop a payment mechanism for street medicine, which is a program to provide health care services directly to those living on the streets or who are otherwise unsheltered. The bill would prohibit the department from requiring an individual experiencing homelessness to receive primary care services from their primary care physician or to receive a referral to be able to receive specialist care. The bill would require the department to reimburse for those services and to allow providers to receive fee-for-service Medi-Cal reimbursement for services provided through street medicine. The bill would require the department to issue a benefits identification card to an individual experiencing homelessness who is not in possession of a valid drivers license or identification card. The bill would also make related findings and declarations.This bill would authorize Medi-Cal enrolled providers to bill the Medi-Cal program for Medi-Cal services that they render to people experiencing homelessness outside of traditional medical facilities, including street medicine teams, shelter-based care, or within transitional housing settings. The bill would authorize a provider to verify the Medi-Cal eligibility of a person experiencing homelessness through any system, including the Medi-Cal Eligibility Data System or the Homeless Management Information System. The bill would authorize a person experiencing homelessness to receive primary care services, and referrals for specialty care and diagnostics, from any Medi-Cal enrolled provider, would authorize any Medi-Cal enrolled provider to refer a patient for specialist care and diagnostics, and would require the department to reimburse for those services regardless of the care setting. The bill would also make related findings and declarations.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 the statutory provisions noted above.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YES Bill TextThe people of the State of California do enact as follows:SECTION 1. The Legislature finds and declares all of the following:(a) People experiencing homelessness have poorer health outcomes and increased mortality rates compared to the general population. This has been attributed to competing priorities, such as finding food and shelter and maintaining safety, which detract from prioritizing health care, independent of health care coverage status.(b) People experiencing homelessness have poor access to primary care, with only 8 percent of people experiencing homelessness having a primary care provider versus 82 percent of the general population.(c) People experiencing homelessness with Medi-Cal coverage rely on referrals from their primary care providers to access specialty care. Lack of access to primary care furthers lack of access to specialty care and necessitates at least two visits, each one difficult to accomplish, when only one might be necessary.(d) Poor health outcomes have been attributed to institutional trauma in the traditional health care system, such as distrust of the health care system, institutional discrimination, and feeling unwelcome, leading to an unwillingness to seek medical care.(e)Unsheltered homeless individuals are 3 times more likely to die than those who were homeless but sheltered, and 10 times more likely to die than the housed population.(f)(e) Deaths in the homeless population in the County of Los Angeles have doubled in the last five years, according to a report from the State Department of Public Health.(g)(f) Homelessness and homeless deaths disproportionately affect people of color, accounting for 68 percent of deaths and demonstrating a gross health inequity.(h)(g) The COVID-19 pandemic has increased reliance on telemedicine, but people experiencing homelessness often lack access to telephones, furthering health inequities and increasing isolation.(i)(h) Rates of COVID-19 have been increasing substantially for people experiencing homelessness. They are largely unable to follow the Governors safer at home orders, wash hands regularly, and keep face masks clean.(j)(i) Barriers to care prevent COVID-19 diagnosis and treatment, increasing morbidity and mortality, increasing rates of community transmission, and ultimately putting the general population at increased risk.(k)Street medicine, which is the provision of health care directly to those living on the streets, including health and social services, was developed specifically to address the unique needs and circumstances of unsheltered homeless individuals onsite where they reside.(l)Street medicine decreases barriers to care by providing medical care for acute and chronic health conditions, behavioral health care treatment, and treatment for substance use disorders, dispensing common medications, and drawing blood work.(j) There are effective, evidence-based models for delivering health care to persons experiencing homelessness, including street medicine, shelter-based care, and care provided in transitional housing. These models were developed specifically to address the unique needs and circumstances of persons experiencing homelessness onsite where they reside.(k) Through shelter-based care, street medicine, mobile clinics and related delivery models, providers remove access barriers for persons experiencing homelessness in order to deliver patient-centered care. Services provided include medical care for acute and chronic health conditions, behavioral health care treatment, and treatment for substance use disorders, dispensing common medications, and drawing blood work.(m)(l) Less than 30 percent of people experiencing homelessness who are insured have ever seen their primary care physician, versus 70 percent of those treated by street medicine, medicine teams, who are actively engaged in primary care within one week of referral.(n)Street medicine(m) Providing medical care to persons experiencing homelessness outside of traditional medical settings has demonstrated a decrease in hospital admissions by two-thirds with a hospital-based consult service.(o)Unsheltered homeless individuals (n) Persons experiencing homelessness have twice the length of stay while hospitalized compared to the housed population, and spend 740 percent more days in the hospital at a 170-percent greater cost per day than people who are housed.(p)Street medicine has demonstrated improved placement in housing after a hospital admission with a hospital-based consult service.(o) Providing health care and social services on the street or outside traditional medical facilities improves housing placement compared to only providing nonmedical outreach services. In the City of Los Angeles, street medicine teams have successfully transitioned 42 percent of their homeless patients into permanent housing, compared to 4 percent when the Los Angeles Homeless Services Authority is the responsible party.(q)(p) Direct care delivery to people experiencing homelessness has taken an important role during the COVID-19 response in shelters and encampments across the state, but has been limited due to small existing infrastructure before the pandemic.(r)(q) The COVID-19 pandemic has forced direct care providers to ration resources, either choosing to provide COVID-19 surveillance and testing, or needed ongoing primary care. Lack of infrastructure has made it impossible to do both well.SEC. 2. Section 14011.67 is added to the Welfare and Institutions Code, to read:14011.67. (a) To the extent federal financial participation is available, the department shall implement a program of presumptive eligibility for individuals persons experiencing homelessness.(b) The presumptive eligibility benefits provided under this section shall be identical to the benefits provided to individuals who receive full-scope Medi-Cal benefits without a share of cost, and shall only be made available through a Medi-Cal provider.(c) Upon implementation of the presumptive eligibility program for individuals persons experiencing homelessness, the department shall issue a declaration, which shall be retained by the director, stating that implementation of the program has commenced.(d) 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, interpret, or make specific this section by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions until the time any necessary regulations are adopted. Thereafter, the department shall adopt any necessary 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.(e) A hospital An enrolled Medi-Cal provider, including a health facility, such as a hospital or clinic, may make a presumptive eligibility determination for an individual a person experiencing homelessness in compliance with Section 14011.66 if the individual that person gives their informed consent to receive Medi-Cal benefits.(f) Upon the receipt of a timely and complete Medi-Cal application for an individual a person experiencing homelessness who has coverage pursuant to the presumptive eligibility program authorized by this section, a county shall determine whether the individual that person is eligible for Medi-Cal benefits. If (1) If the county determines that the individual person does not meet the eligibility requirements for participation in the Medi-Cal program, the county shall timely report this finding to the Medical Eligibility Data System so that presumptive eligibility benefits are discontinued.(2) If the county determines that the person experiencing homelessness is eligible for benefits under the Medi-Cal program, the person shall be enrolled in the Medi-Cal programs fee-for-service delivery system until they elect, by providing informed consent, to enroll in a Medi-Cal managed care plan. If they elect to enroll in a Medi-Cal managed care plan, they shall complete a Medi-Cal choice form with their chosen primary care provider who is present for purposes of completing that form. The department shall not assign a person experiencing homelessness to a primary care provider without the persons informed consent under any circumstances, including any time beyond the 60-day choice period.SEC. 3. Section 14133.02 is added to the Welfare and Institutions Code, to read:14133.02. (a) The director shall not impose prior authorization or any other utilization controls on an item, service, or immunization that is intended to test for, prevent, treat, or mitigate COVID-19.(b) This section shall remain in effect only until January 1, 2026, and as of that date is repealed.SEC. 4. Section 14133.55 is added to the Welfare and Institutions Code, to read:14133.55.(a)The department shall, in consultation with street medicine providers and people with lived expertise in homelessness, develop a payment mechanism for street medicine.(b)The department shall allow health care providers to receive fee-for-service Medi-Cal reimbursement for services provided through street medicine.14133.55. (a) The department shall authorize Medi-Cal enrolled providers to bill the Medi-Cal program for the full range of benefits covered under the Medi-Cal program if those providers render services to people experiencing homelessness outside of traditional medical facilities. Services may be provided through street medicine teams, shelter-based care, or within transitional housing settings.(c)(b) (1) Notwithstanding Sections 14017 and 14017.5, the department shall issue a authorize an enrolled Medi-Cal provider, including a health facility, such as a hospital or clinic, to issue a temporary Medi-Cal benefits identification card to an individual a person experiencing homelessness who is a Medi-Cal beneficiary or receives full-scope Medi-Cal benefits pursuant to Section 14011.67, but is not in possession of 14011.67. The department shall not require a person experiencing homelessness to present a valid California drivers license or identification card issued by the Department of Motor Vehicles. Vehicles in order to receive services under the Medi-Cal program.(2) The department shall not require a provider to match the name and signature on the benefits identification card any Medi-Cal benefits identification card, including the initially issued temporary card, as described under paragraph (1), issued by the department to an individual department or provider to a person experiencing homelessness or that individuals valid California drivers license or California identification card against a signature executed at the time of service, or require a provider to visually verify the likeness of an individual a person experiencing homelessness to the photograph on the identification car or drivers license.(d) (1)If an individual experiencing homelessness is a Medi-Cal beneficiary or receives full-scope Medi-Cal benefits pursuant to Section 14011.67, the department shall not require primary care services to be provided by the individuals established primary care physician. The department shall reimburse a provider for covered primary care services provided to an individual experiencing homelessness regardless of the care setting.(2)If an individual experiencing homelessness is a Medi-Cal beneficiary or receives full-scope Medi-Cal benefits pursuant to Section 14011.67, the department shall not require that individual to receive a referral from their primary care physician to be able to receive specialist care. The department shall reimburse a specialist care provider for services provided to an individual experiencing homelessness without a referral from a primary care physician.(3) If a provider is unable to verify eligibility based on any Medi-Cal benefits identification card, including the initially issued temporary card, the provider may verify eligibility through any other system, including, but not limited to, the Medi-Cal Eligibility Data System or the Homeless Management Information System, as defined in subdivision (i) of Section 50216 of the Health and Safety Code.(c) A person experiencing homelessness may receive primary care services, and referrals for specialty care and diagnostics, from any Medi-Cal enrolled provider, and they shall not be limited to receive those services only from their designated primary care physician. Any Medi-Cal enrolled provider may refer a person experiencing homelessness for specialist care and diagnostics. The department shall reimburse a Medi-Cal enrolled provider for rendering covered primary care services or specialist care to a person experiencing homelessness regardless of the care setting, including services provided through street medicine teams, shelter-based care, and within transitional housing settings.(d) The department shall authorize persons experiencing homelessness to remain in the Medi-Cal programs fee-for-service program rather than enrolling them into a Medi-Cal managed care plan and assigning them a primary care provider within a plan. A person experiencing homelessness shall have the ability to elect to enroll in a Medi-Cal managed care plan once they have met and selected a primary care provider, as described under paragraph (2) of subdivision (f) of Section 14011.67.(e) The department shall seek all federal waivers necessary to allow federal financial participation in expenditures under this section.(f)For purposes of this section, street medicine means a program to provide health care services directly to those living on the streets or who are otherwise unsheltered.SEC. 5. 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.
Amended IN Assembly March 18, 2021 CALIFORNIA LEGISLATURE 20212022 REGULAR SESSION Assembly Bill No. 369Introduced by Assembly Member Kamlager(Coauthors: Assembly Members Carrillo, Cristina Garcia, Gipson, Santiago, and Stone)(Coauthor: Senator Wiener)February 01, 2021 An act to add Sections 14011.67 and 14133.55 to, and to add and repeal Section 14133.02 of, the Welfare and Institutions Code, relating to Medi-Cal. LEGISLATIVE COUNSEL'S DIGESTAB 369, as amended, Kamlager. Medi-Cal: street medicine and utilization controls. Medi-Cal services: persons experiencing homelessness.Existing law provides for the Medi-Cal program, administered by the State Department of Health Care Services and 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. Under existing law, Medi-Cal covered benefits are generally subject to utilization controls, including prior authorization requirements.This bill, until January 1, 2026, would prohibit the Director of the State Department of Health Care Services from imposing prior authorization or other utilization controls on an item, service, or immunization that is intended to test for, prevent, treat, or mitigate COVID-19. Existing law requires the department to provide presumptive Medi-Cal eligibility to pregnant women and children. Existing law authorizes a qualified hospital to make presumptive eligibility determinations if it complies with specified requirements. Existing law authorizes the department, on a regional pilot project basis, to issue a benefits identification card to a person who is eligible for Medi-Cal program benefits, but does not possess a valid California drivers license or identification card issued by the Department of Motor Vehicles.This bill would require the department to implement a program of presumptive eligibility for individuals persons experiencing homelessness, under which an individual a person would receive full-scope Medi-Cal benefits without a share of cost. The bill would authorize a qualified hospital any enrolled Medi-Cal provider, including a health facility, such as a hospital or clinic, to make a presumptive eligibility determination for an individual a person experiencing homelessness if the individual that person gives their informed consent to receive Medi-Cal benefits. benefits, and would authorize the provider to issue a temporary Medi-Cal benefits identification card to that person. The bill would require a county to determine if an individual experiencing homelessness who has presumptive eligibility is eligible for Medi-Cal benefits. By creating new duties for counties, the bill would impose a state-mandated local program. If the county determines that the person experiencing homelessness is eligible for benefits, the bill would require the person to be enrolled in the Medi-Cal programs fee-for-service delivery system until they elect to enroll in a Medi-Cal managed care plan, as specified, including that they complete a Medi-Cal choice form with their chosen primary care provider.This bill would require the department to develop a payment mechanism for street medicine, which is a program to provide health care services directly to those living on the streets or who are otherwise unsheltered. The bill would prohibit the department from requiring an individual experiencing homelessness to receive primary care services from their primary care physician or to receive a referral to be able to receive specialist care. The bill would require the department to reimburse for those services and to allow providers to receive fee-for-service Medi-Cal reimbursement for services provided through street medicine. The bill would require the department to issue a benefits identification card to an individual experiencing homelessness who is not in possession of a valid drivers license or identification card. The bill would also make related findings and declarations.This bill would authorize Medi-Cal enrolled providers to bill the Medi-Cal program for Medi-Cal services that they render to people experiencing homelessness outside of traditional medical facilities, including street medicine teams, shelter-based care, or within transitional housing settings. The bill would authorize a provider to verify the Medi-Cal eligibility of a person experiencing homelessness through any system, including the Medi-Cal Eligibility Data System or the Homeless Management Information System. The bill would authorize a person experiencing homelessness to receive primary care services, and referrals for specialty care and diagnostics, from any Medi-Cal enrolled provider, would authorize any Medi-Cal enrolled provider to refer a patient for specialist care and diagnostics, and would require the department to reimburse for those services regardless of the care setting. The bill would also make related findings and declarations.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 the statutory provisions noted above.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YES
Amended IN Assembly March 18, 2021
Amended IN Assembly March 18, 2021
CALIFORNIA LEGISLATURE 20212022 REGULAR SESSION
Assembly Bill
No. 369
Introduced by Assembly Member Kamlager(Coauthors: Assembly Members Carrillo, Cristina Garcia, Gipson, Santiago, and Stone)(Coauthor: Senator Wiener)February 01, 2021
Introduced by Assembly Member Kamlager(Coauthors: Assembly Members Carrillo, Cristina Garcia, Gipson, Santiago, and Stone)(Coauthor: Senator Wiener)
February 01, 2021
An act to add Sections 14011.67 and 14133.55 to, and to add and repeal Section 14133.02 of, the Welfare and Institutions Code, relating to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
## LEGISLATIVE COUNSEL'S DIGEST
AB 369, as amended, Kamlager. Medi-Cal: street medicine and utilization controls. Medi-Cal services: persons experiencing homelessness.
Existing law provides for the Medi-Cal program, administered by the State Department of Health Care Services and 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. Under existing law, Medi-Cal covered benefits are generally subject to utilization controls, including prior authorization requirements.This bill, until January 1, 2026, would prohibit the Director of the State Department of Health Care Services from imposing prior authorization or other utilization controls on an item, service, or immunization that is intended to test for, prevent, treat, or mitigate COVID-19. Existing law requires the department to provide presumptive Medi-Cal eligibility to pregnant women and children. Existing law authorizes a qualified hospital to make presumptive eligibility determinations if it complies with specified requirements. Existing law authorizes the department, on a regional pilot project basis, to issue a benefits identification card to a person who is eligible for Medi-Cal program benefits, but does not possess a valid California drivers license or identification card issued by the Department of Motor Vehicles.This bill would require the department to implement a program of presumptive eligibility for individuals persons experiencing homelessness, under which an individual a person would receive full-scope Medi-Cal benefits without a share of cost. The bill would authorize a qualified hospital any enrolled Medi-Cal provider, including a health facility, such as a hospital or clinic, to make a presumptive eligibility determination for an individual a person experiencing homelessness if the individual that person gives their informed consent to receive Medi-Cal benefits. benefits, and would authorize the provider to issue a temporary Medi-Cal benefits identification card to that person. The bill would require a county to determine if an individual experiencing homelessness who has presumptive eligibility is eligible for Medi-Cal benefits. By creating new duties for counties, the bill would impose a state-mandated local program. If the county determines that the person experiencing homelessness is eligible for benefits, the bill would require the person to be enrolled in the Medi-Cal programs fee-for-service delivery system until they elect to enroll in a Medi-Cal managed care plan, as specified, including that they complete a Medi-Cal choice form with their chosen primary care provider.This bill would require the department to develop a payment mechanism for street medicine, which is a program to provide health care services directly to those living on the streets or who are otherwise unsheltered. The bill would prohibit the department from requiring an individual experiencing homelessness to receive primary care services from their primary care physician or to receive a referral to be able to receive specialist care. The bill would require the department to reimburse for those services and to allow providers to receive fee-for-service Medi-Cal reimbursement for services provided through street medicine. The bill would require the department to issue a benefits identification card to an individual experiencing homelessness who is not in possession of a valid drivers license or identification card. The bill would also make related findings and declarations.This bill would authorize Medi-Cal enrolled providers to bill the Medi-Cal program for Medi-Cal services that they render to people experiencing homelessness outside of traditional medical facilities, including street medicine teams, shelter-based care, or within transitional housing settings. The bill would authorize a provider to verify the Medi-Cal eligibility of a person experiencing homelessness through any system, including the Medi-Cal Eligibility Data System or the Homeless Management Information System. The bill would authorize a person experiencing homelessness to receive primary care services, and referrals for specialty care and diagnostics, from any Medi-Cal enrolled provider, would authorize any Medi-Cal enrolled provider to refer a patient for specialist care and diagnostics, and would require the department to reimburse for those services regardless of the care setting. The bill would also make related findings and declarations.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 the statutory provisions noted above.
Existing law provides for the Medi-Cal program, administered by the State Department of Health Care Services and 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. Under existing law, Medi-Cal covered benefits are generally subject to utilization controls, including prior authorization requirements.
This bill, until January 1, 2026, would prohibit the Director of the State Department of Health Care Services from imposing prior authorization or other utilization controls on an item, service, or immunization that is intended to test for, prevent, treat, or mitigate COVID-19.
Existing law requires the department to provide presumptive Medi-Cal eligibility to pregnant women and children. Existing law authorizes a qualified hospital to make presumptive eligibility determinations if it complies with specified requirements. Existing law authorizes the department, on a regional pilot project basis, to issue a benefits identification card to a person who is eligible for Medi-Cal program benefits, but does not possess a valid California drivers license or identification card issued by the Department of Motor Vehicles.
This bill would require the department to implement a program of presumptive eligibility for individuals persons experiencing homelessness, under which an individual a person would receive full-scope Medi-Cal benefits without a share of cost. The bill would authorize a qualified hospital any enrolled Medi-Cal provider, including a health facility, such as a hospital or clinic, to make a presumptive eligibility determination for an individual a person experiencing homelessness if the individual that person gives their informed consent to receive Medi-Cal benefits. benefits, and would authorize the provider to issue a temporary Medi-Cal benefits identification card to that person. The bill would require a county to determine if an individual experiencing homelessness who has presumptive eligibility is eligible for Medi-Cal benefits. By creating new duties for counties, the bill would impose a state-mandated local program. If the county determines that the person experiencing homelessness is eligible for benefits, the bill would require the person to be enrolled in the Medi-Cal programs fee-for-service delivery system until they elect to enroll in a Medi-Cal managed care plan, as specified, including that they complete a Medi-Cal choice form with their chosen primary care provider.
This bill would require the department to develop a payment mechanism for street medicine, which is a program to provide health care services directly to those living on the streets or who are otherwise unsheltered. The bill would prohibit the department from requiring an individual experiencing homelessness to receive primary care services from their primary care physician or to receive a referral to be able to receive specialist care. The bill would require the department to reimburse for those services and to allow providers to receive fee-for-service Medi-Cal reimbursement for services provided through street medicine. The bill would require the department to issue a benefits identification card to an individual experiencing homelessness who is not in possession of a valid drivers license or identification card. The bill would also make related findings and declarations.
This bill would authorize Medi-Cal enrolled providers to bill the Medi-Cal program for Medi-Cal services that they render to people experiencing homelessness outside of traditional medical facilities, including street medicine teams, shelter-based care, or within transitional housing settings. The bill would authorize a provider to verify the Medi-Cal eligibility of a person experiencing homelessness through any system, including the Medi-Cal Eligibility Data System or the Homeless Management Information System. The bill would authorize a person experiencing homelessness to receive primary care services, and referrals for specialty care and diagnostics, from any Medi-Cal enrolled provider, would authorize any Medi-Cal enrolled provider to refer a patient for specialist care and diagnostics, and would require the department to reimburse for those services regardless of the care setting. The bill would also make related findings and declarations.
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 the statutory provisions noted above.
## Digest Key
## Bill Text
The people of the State of California do enact as follows:SECTION 1. The Legislature finds and declares all of the following:(a) People experiencing homelessness have poorer health outcomes and increased mortality rates compared to the general population. This has been attributed to competing priorities, such as finding food and shelter and maintaining safety, which detract from prioritizing health care, independent of health care coverage status.(b) People experiencing homelessness have poor access to primary care, with only 8 percent of people experiencing homelessness having a primary care provider versus 82 percent of the general population.(c) People experiencing homelessness with Medi-Cal coverage rely on referrals from their primary care providers to access specialty care. Lack of access to primary care furthers lack of access to specialty care and necessitates at least two visits, each one difficult to accomplish, when only one might be necessary.(d) Poor health outcomes have been attributed to institutional trauma in the traditional health care system, such as distrust of the health care system, institutional discrimination, and feeling unwelcome, leading to an unwillingness to seek medical care.(e)Unsheltered homeless individuals are 3 times more likely to die than those who were homeless but sheltered, and 10 times more likely to die than the housed population.(f)(e) Deaths in the homeless population in the County of Los Angeles have doubled in the last five years, according to a report from the State Department of Public Health.(g)(f) Homelessness and homeless deaths disproportionately affect people of color, accounting for 68 percent of deaths and demonstrating a gross health inequity.(h)(g) The COVID-19 pandemic has increased reliance on telemedicine, but people experiencing homelessness often lack access to telephones, furthering health inequities and increasing isolation.(i)(h) Rates of COVID-19 have been increasing substantially for people experiencing homelessness. They are largely unable to follow the Governors safer at home orders, wash hands regularly, and keep face masks clean.(j)(i) Barriers to care prevent COVID-19 diagnosis and treatment, increasing morbidity and mortality, increasing rates of community transmission, and ultimately putting the general population at increased risk.(k)Street medicine, which is the provision of health care directly to those living on the streets, including health and social services, was developed specifically to address the unique needs and circumstances of unsheltered homeless individuals onsite where they reside.(l)Street medicine decreases barriers to care by providing medical care for acute and chronic health conditions, behavioral health care treatment, and treatment for substance use disorders, dispensing common medications, and drawing blood work.(j) There are effective, evidence-based models for delivering health care to persons experiencing homelessness, including street medicine, shelter-based care, and care provided in transitional housing. These models were developed specifically to address the unique needs and circumstances of persons experiencing homelessness onsite where they reside.(k) Through shelter-based care, street medicine, mobile clinics and related delivery models, providers remove access barriers for persons experiencing homelessness in order to deliver patient-centered care. Services provided include medical care for acute and chronic health conditions, behavioral health care treatment, and treatment for substance use disorders, dispensing common medications, and drawing blood work.(m)(l) Less than 30 percent of people experiencing homelessness who are insured have ever seen their primary care physician, versus 70 percent of those treated by street medicine, medicine teams, who are actively engaged in primary care within one week of referral.(n)Street medicine(m) Providing medical care to persons experiencing homelessness outside of traditional medical settings has demonstrated a decrease in hospital admissions by two-thirds with a hospital-based consult service.(o)Unsheltered homeless individuals (n) Persons experiencing homelessness have twice the length of stay while hospitalized compared to the housed population, and spend 740 percent more days in the hospital at a 170-percent greater cost per day than people who are housed.(p)Street medicine has demonstrated improved placement in housing after a hospital admission with a hospital-based consult service.(o) Providing health care and social services on the street or outside traditional medical facilities improves housing placement compared to only providing nonmedical outreach services. In the City of Los Angeles, street medicine teams have successfully transitioned 42 percent of their homeless patients into permanent housing, compared to 4 percent when the Los Angeles Homeless Services Authority is the responsible party.(q)(p) Direct care delivery to people experiencing homelessness has taken an important role during the COVID-19 response in shelters and encampments across the state, but has been limited due to small existing infrastructure before the pandemic.(r)(q) The COVID-19 pandemic has forced direct care providers to ration resources, either choosing to provide COVID-19 surveillance and testing, or needed ongoing primary care. Lack of infrastructure has made it impossible to do both well.SEC. 2. Section 14011.67 is added to the Welfare and Institutions Code, to read:14011.67. (a) To the extent federal financial participation is available, the department shall implement a program of presumptive eligibility for individuals persons experiencing homelessness.(b) The presumptive eligibility benefits provided under this section shall be identical to the benefits provided to individuals who receive full-scope Medi-Cal benefits without a share of cost, and shall only be made available through a Medi-Cal provider.(c) Upon implementation of the presumptive eligibility program for individuals persons experiencing homelessness, the department shall issue a declaration, which shall be retained by the director, stating that implementation of the program has commenced.(d) 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, interpret, or make specific this section by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions until the time any necessary regulations are adopted. Thereafter, the department shall adopt any necessary 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.(e) A hospital An enrolled Medi-Cal provider, including a health facility, such as a hospital or clinic, may make a presumptive eligibility determination for an individual a person experiencing homelessness in compliance with Section 14011.66 if the individual that person gives their informed consent to receive Medi-Cal benefits.(f) Upon the receipt of a timely and complete Medi-Cal application for an individual a person experiencing homelessness who has coverage pursuant to the presumptive eligibility program authorized by this section, a county shall determine whether the individual that person is eligible for Medi-Cal benefits. If (1) If the county determines that the individual person does not meet the eligibility requirements for participation in the Medi-Cal program, the county shall timely report this finding to the Medical Eligibility Data System so that presumptive eligibility benefits are discontinued.(2) If the county determines that the person experiencing homelessness is eligible for benefits under the Medi-Cal program, the person shall be enrolled in the Medi-Cal programs fee-for-service delivery system until they elect, by providing informed consent, to enroll in a Medi-Cal managed care plan. If they elect to enroll in a Medi-Cal managed care plan, they shall complete a Medi-Cal choice form with their chosen primary care provider who is present for purposes of completing that form. The department shall not assign a person experiencing homelessness to a primary care provider without the persons informed consent under any circumstances, including any time beyond the 60-day choice period.SEC. 3. Section 14133.02 is added to the Welfare and Institutions Code, to read:14133.02. (a) The director shall not impose prior authorization or any other utilization controls on an item, service, or immunization that is intended to test for, prevent, treat, or mitigate COVID-19.(b) This section shall remain in effect only until January 1, 2026, and as of that date is repealed.SEC. 4. Section 14133.55 is added to the Welfare and Institutions Code, to read:14133.55.(a)The department shall, in consultation with street medicine providers and people with lived expertise in homelessness, develop a payment mechanism for street medicine.(b)The department shall allow health care providers to receive fee-for-service Medi-Cal reimbursement for services provided through street medicine.14133.55. (a) The department shall authorize Medi-Cal enrolled providers to bill the Medi-Cal program for the full range of benefits covered under the Medi-Cal program if those providers render services to people experiencing homelessness outside of traditional medical facilities. Services may be provided through street medicine teams, shelter-based care, or within transitional housing settings.(c)(b) (1) Notwithstanding Sections 14017 and 14017.5, the department shall issue a authorize an enrolled Medi-Cal provider, including a health facility, such as a hospital or clinic, to issue a temporary Medi-Cal benefits identification card to an individual a person experiencing homelessness who is a Medi-Cal beneficiary or receives full-scope Medi-Cal benefits pursuant to Section 14011.67, but is not in possession of 14011.67. The department shall not require a person experiencing homelessness to present a valid California drivers license or identification card issued by the Department of Motor Vehicles. Vehicles in order to receive services under the Medi-Cal program.(2) The department shall not require a provider to match the name and signature on the benefits identification card any Medi-Cal benefits identification card, including the initially issued temporary card, as described under paragraph (1), issued by the department to an individual department or provider to a person experiencing homelessness or that individuals valid California drivers license or California identification card against a signature executed at the time of service, or require a provider to visually verify the likeness of an individual a person experiencing homelessness to the photograph on the identification car or drivers license.(d) (1)If an individual experiencing homelessness is a Medi-Cal beneficiary or receives full-scope Medi-Cal benefits pursuant to Section 14011.67, the department shall not require primary care services to be provided by the individuals established primary care physician. The department shall reimburse a provider for covered primary care services provided to an individual experiencing homelessness regardless of the care setting.(2)If an individual experiencing homelessness is a Medi-Cal beneficiary or receives full-scope Medi-Cal benefits pursuant to Section 14011.67, the department shall not require that individual to receive a referral from their primary care physician to be able to receive specialist care. The department shall reimburse a specialist care provider for services provided to an individual experiencing homelessness without a referral from a primary care physician.(3) If a provider is unable to verify eligibility based on any Medi-Cal benefits identification card, including the initially issued temporary card, the provider may verify eligibility through any other system, including, but not limited to, the Medi-Cal Eligibility Data System or the Homeless Management Information System, as defined in subdivision (i) of Section 50216 of the Health and Safety Code.(c) A person experiencing homelessness may receive primary care services, and referrals for specialty care and diagnostics, from any Medi-Cal enrolled provider, and they shall not be limited to receive those services only from their designated primary care physician. Any Medi-Cal enrolled provider may refer a person experiencing homelessness for specialist care and diagnostics. The department shall reimburse a Medi-Cal enrolled provider for rendering covered primary care services or specialist care to a person experiencing homelessness regardless of the care setting, including services provided through street medicine teams, shelter-based care, and within transitional housing settings.(d) The department shall authorize persons experiencing homelessness to remain in the Medi-Cal programs fee-for-service program rather than enrolling them into a Medi-Cal managed care plan and assigning them a primary care provider within a plan. A person experiencing homelessness shall have the ability to elect to enroll in a Medi-Cal managed care plan once they have met and selected a primary care provider, as described under paragraph (2) of subdivision (f) of Section 14011.67.(e) The department shall seek all federal waivers necessary to allow federal financial participation in expenditures under this section.(f)For purposes of this section, street medicine means a program to provide health care services directly to those living on the streets or who are otherwise unsheltered.SEC. 5. 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.
The people of the State of California do enact as follows:
## The people of the State of California do enact as follows:
SECTION 1. The Legislature finds and declares all of the following:(a) People experiencing homelessness have poorer health outcomes and increased mortality rates compared to the general population. This has been attributed to competing priorities, such as finding food and shelter and maintaining safety, which detract from prioritizing health care, independent of health care coverage status.(b) People experiencing homelessness have poor access to primary care, with only 8 percent of people experiencing homelessness having a primary care provider versus 82 percent of the general population.(c) People experiencing homelessness with Medi-Cal coverage rely on referrals from their primary care providers to access specialty care. Lack of access to primary care furthers lack of access to specialty care and necessitates at least two visits, each one difficult to accomplish, when only one might be necessary.(d) Poor health outcomes have been attributed to institutional trauma in the traditional health care system, such as distrust of the health care system, institutional discrimination, and feeling unwelcome, leading to an unwillingness to seek medical care.(e)Unsheltered homeless individuals are 3 times more likely to die than those who were homeless but sheltered, and 10 times more likely to die than the housed population.(f)(e) Deaths in the homeless population in the County of Los Angeles have doubled in the last five years, according to a report from the State Department of Public Health.(g)(f) Homelessness and homeless deaths disproportionately affect people of color, accounting for 68 percent of deaths and demonstrating a gross health inequity.(h)(g) The COVID-19 pandemic has increased reliance on telemedicine, but people experiencing homelessness often lack access to telephones, furthering health inequities and increasing isolation.(i)(h) Rates of COVID-19 have been increasing substantially for people experiencing homelessness. They are largely unable to follow the Governors safer at home orders, wash hands regularly, and keep face masks clean.(j)(i) Barriers to care prevent COVID-19 diagnosis and treatment, increasing morbidity and mortality, increasing rates of community transmission, and ultimately putting the general population at increased risk.(k)Street medicine, which is the provision of health care directly to those living on the streets, including health and social services, was developed specifically to address the unique needs and circumstances of unsheltered homeless individuals onsite where they reside.(l)Street medicine decreases barriers to care by providing medical care for acute and chronic health conditions, behavioral health care treatment, and treatment for substance use disorders, dispensing common medications, and drawing blood work.(j) There are effective, evidence-based models for delivering health care to persons experiencing homelessness, including street medicine, shelter-based care, and care provided in transitional housing. These models were developed specifically to address the unique needs and circumstances of persons experiencing homelessness onsite where they reside.(k) Through shelter-based care, street medicine, mobile clinics and related delivery models, providers remove access barriers for persons experiencing homelessness in order to deliver patient-centered care. Services provided include medical care for acute and chronic health conditions, behavioral health care treatment, and treatment for substance use disorders, dispensing common medications, and drawing blood work.(m)(l) Less than 30 percent of people experiencing homelessness who are insured have ever seen their primary care physician, versus 70 percent of those treated by street medicine, medicine teams, who are actively engaged in primary care within one week of referral.(n)Street medicine(m) Providing medical care to persons experiencing homelessness outside of traditional medical settings has demonstrated a decrease in hospital admissions by two-thirds with a hospital-based consult service.(o)Unsheltered homeless individuals (n) Persons experiencing homelessness have twice the length of stay while hospitalized compared to the housed population, and spend 740 percent more days in the hospital at a 170-percent greater cost per day than people who are housed.(p)Street medicine has demonstrated improved placement in housing after a hospital admission with a hospital-based consult service.(o) Providing health care and social services on the street or outside traditional medical facilities improves housing placement compared to only providing nonmedical outreach services. In the City of Los Angeles, street medicine teams have successfully transitioned 42 percent of their homeless patients into permanent housing, compared to 4 percent when the Los Angeles Homeless Services Authority is the responsible party.(q)(p) Direct care delivery to people experiencing homelessness has taken an important role during the COVID-19 response in shelters and encampments across the state, but has been limited due to small existing infrastructure before the pandemic.(r)(q) The COVID-19 pandemic has forced direct care providers to ration resources, either choosing to provide COVID-19 surveillance and testing, or needed ongoing primary care. Lack of infrastructure has made it impossible to do both well.
SECTION 1. The Legislature finds and declares all of the following:(a) People experiencing homelessness have poorer health outcomes and increased mortality rates compared to the general population. This has been attributed to competing priorities, such as finding food and shelter and maintaining safety, which detract from prioritizing health care, independent of health care coverage status.(b) People experiencing homelessness have poor access to primary care, with only 8 percent of people experiencing homelessness having a primary care provider versus 82 percent of the general population.(c) People experiencing homelessness with Medi-Cal coverage rely on referrals from their primary care providers to access specialty care. Lack of access to primary care furthers lack of access to specialty care and necessitates at least two visits, each one difficult to accomplish, when only one might be necessary.(d) Poor health outcomes have been attributed to institutional trauma in the traditional health care system, such as distrust of the health care system, institutional discrimination, and feeling unwelcome, leading to an unwillingness to seek medical care.(e)Unsheltered homeless individuals are 3 times more likely to die than those who were homeless but sheltered, and 10 times more likely to die than the housed population.(f)(e) Deaths in the homeless population in the County of Los Angeles have doubled in the last five years, according to a report from the State Department of Public Health.(g)(f) Homelessness and homeless deaths disproportionately affect people of color, accounting for 68 percent of deaths and demonstrating a gross health inequity.(h)(g) The COVID-19 pandemic has increased reliance on telemedicine, but people experiencing homelessness often lack access to telephones, furthering health inequities and increasing isolation.(i)(h) Rates of COVID-19 have been increasing substantially for people experiencing homelessness. They are largely unable to follow the Governors safer at home orders, wash hands regularly, and keep face masks clean.(j)(i) Barriers to care prevent COVID-19 diagnosis and treatment, increasing morbidity and mortality, increasing rates of community transmission, and ultimately putting the general population at increased risk.(k)Street medicine, which is the provision of health care directly to those living on the streets, including health and social services, was developed specifically to address the unique needs and circumstances of unsheltered homeless individuals onsite where they reside.(l)Street medicine decreases barriers to care by providing medical care for acute and chronic health conditions, behavioral health care treatment, and treatment for substance use disorders, dispensing common medications, and drawing blood work.(j) There are effective, evidence-based models for delivering health care to persons experiencing homelessness, including street medicine, shelter-based care, and care provided in transitional housing. These models were developed specifically to address the unique needs and circumstances of persons experiencing homelessness onsite where they reside.(k) Through shelter-based care, street medicine, mobile clinics and related delivery models, providers remove access barriers for persons experiencing homelessness in order to deliver patient-centered care. Services provided include medical care for acute and chronic health conditions, behavioral health care treatment, and treatment for substance use disorders, dispensing common medications, and drawing blood work.(m)(l) Less than 30 percent of people experiencing homelessness who are insured have ever seen their primary care physician, versus 70 percent of those treated by street medicine, medicine teams, who are actively engaged in primary care within one week of referral.(n)Street medicine(m) Providing medical care to persons experiencing homelessness outside of traditional medical settings has demonstrated a decrease in hospital admissions by two-thirds with a hospital-based consult service.(o)Unsheltered homeless individuals (n) Persons experiencing homelessness have twice the length of stay while hospitalized compared to the housed population, and spend 740 percent more days in the hospital at a 170-percent greater cost per day than people who are housed.(p)Street medicine has demonstrated improved placement in housing after a hospital admission with a hospital-based consult service.(o) Providing health care and social services on the street or outside traditional medical facilities improves housing placement compared to only providing nonmedical outreach services. In the City of Los Angeles, street medicine teams have successfully transitioned 42 percent of their homeless patients into permanent housing, compared to 4 percent when the Los Angeles Homeless Services Authority is the responsible party.(q)(p) Direct care delivery to people experiencing homelessness has taken an important role during the COVID-19 response in shelters and encampments across the state, but has been limited due to small existing infrastructure before the pandemic.(r)(q) The COVID-19 pandemic has forced direct care providers to ration resources, either choosing to provide COVID-19 surveillance and testing, or needed ongoing primary care. Lack of infrastructure has made it impossible to do both well.
SECTION 1. The Legislature finds and declares all of the following:
### SECTION 1.
(a) People experiencing homelessness have poorer health outcomes and increased mortality rates compared to the general population. This has been attributed to competing priorities, such as finding food and shelter and maintaining safety, which detract from prioritizing health care, independent of health care coverage status.
(b) People experiencing homelessness have poor access to primary care, with only 8 percent of people experiencing homelessness having a primary care provider versus 82 percent of the general population.
(c) People experiencing homelessness with Medi-Cal coverage rely on referrals from their primary care providers to access specialty care. Lack of access to primary care furthers lack of access to specialty care and necessitates at least two visits, each one difficult to accomplish, when only one might be necessary.
(d) Poor health outcomes have been attributed to institutional trauma in the traditional health care system, such as distrust of the health care system, institutional discrimination, and feeling unwelcome, leading to an unwillingness to seek medical care.
(e)Unsheltered homeless individuals are 3 times more likely to die than those who were homeless but sheltered, and 10 times more likely to die than the housed population.
(f)
(e) Deaths in the homeless population in the County of Los Angeles have doubled in the last five years, according to a report from the State Department of Public Health.
(g)
(f) Homelessness and homeless deaths disproportionately affect people of color, accounting for 68 percent of deaths and demonstrating a gross health inequity.
(h)
(g) The COVID-19 pandemic has increased reliance on telemedicine, but people experiencing homelessness often lack access to telephones, furthering health inequities and increasing isolation.
(i)
(h) Rates of COVID-19 have been increasing substantially for people experiencing homelessness. They are largely unable to follow the Governors safer at home orders, wash hands regularly, and keep face masks clean.
(j)
(i) Barriers to care prevent COVID-19 diagnosis and treatment, increasing morbidity and mortality, increasing rates of community transmission, and ultimately putting the general population at increased risk.
(k)Street medicine, which is the provision of health care directly to those living on the streets, including health and social services, was developed specifically to address the unique needs and circumstances of unsheltered homeless individuals onsite where they reside.
(l)Street medicine decreases barriers to care by providing medical care for acute and chronic health conditions, behavioral health care treatment, and treatment for substance use disorders, dispensing common medications, and drawing blood work.
(j) There are effective, evidence-based models for delivering health care to persons experiencing homelessness, including street medicine, shelter-based care, and care provided in transitional housing. These models were developed specifically to address the unique needs and circumstances of persons experiencing homelessness onsite where they reside.
(k) Through shelter-based care, street medicine, mobile clinics and related delivery models, providers remove access barriers for persons experiencing homelessness in order to deliver patient-centered care. Services provided include medical care for acute and chronic health conditions, behavioral health care treatment, and treatment for substance use disorders, dispensing common medications, and drawing blood work.
(m)
(l) Less than 30 percent of people experiencing homelessness who are insured have ever seen their primary care physician, versus 70 percent of those treated by street medicine, medicine teams, who are actively engaged in primary care within one week of referral.
(n)Street medicine
(m) Providing medical care to persons experiencing homelessness outside of traditional medical settings has demonstrated a decrease in hospital admissions by two-thirds with a hospital-based consult service.
(o)Unsheltered homeless individuals
(n) Persons experiencing homelessness have twice the length of stay while hospitalized compared to the housed population, and spend 740 percent more days in the hospital at a 170-percent greater cost per day than people who are housed.
(p)Street medicine has demonstrated improved placement in housing after a hospital admission with a hospital-based consult service.
(o) Providing health care and social services on the street or outside traditional medical facilities improves housing placement compared to only providing nonmedical outreach services. In the City of Los Angeles, street medicine teams have successfully transitioned 42 percent of their homeless patients into permanent housing, compared to 4 percent when the Los Angeles Homeless Services Authority is the responsible party.
(q)
(p) Direct care delivery to people experiencing homelessness has taken an important role during the COVID-19 response in shelters and encampments across the state, but has been limited due to small existing infrastructure before the pandemic.
(r)
(q) The COVID-19 pandemic has forced direct care providers to ration resources, either choosing to provide COVID-19 surveillance and testing, or needed ongoing primary care. Lack of infrastructure has made it impossible to do both well.
SEC. 2. Section 14011.67 is added to the Welfare and Institutions Code, to read:14011.67. (a) To the extent federal financial participation is available, the department shall implement a program of presumptive eligibility for individuals persons experiencing homelessness.(b) The presumptive eligibility benefits provided under this section shall be identical to the benefits provided to individuals who receive full-scope Medi-Cal benefits without a share of cost, and shall only be made available through a Medi-Cal provider.(c) Upon implementation of the presumptive eligibility program for individuals persons experiencing homelessness, the department shall issue a declaration, which shall be retained by the director, stating that implementation of the program has commenced.(d) 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, interpret, or make specific this section by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions until the time any necessary regulations are adopted. Thereafter, the department shall adopt any necessary 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.(e) A hospital An enrolled Medi-Cal provider, including a health facility, such as a hospital or clinic, may make a presumptive eligibility determination for an individual a person experiencing homelessness in compliance with Section 14011.66 if the individual that person gives their informed consent to receive Medi-Cal benefits.(f) Upon the receipt of a timely and complete Medi-Cal application for an individual a person experiencing homelessness who has coverage pursuant to the presumptive eligibility program authorized by this section, a county shall determine whether the individual that person is eligible for Medi-Cal benefits. If (1) If the county determines that the individual person does not meet the eligibility requirements for participation in the Medi-Cal program, the county shall timely report this finding to the Medical Eligibility Data System so that presumptive eligibility benefits are discontinued.(2) If the county determines that the person experiencing homelessness is eligible for benefits under the Medi-Cal program, the person shall be enrolled in the Medi-Cal programs fee-for-service delivery system until they elect, by providing informed consent, to enroll in a Medi-Cal managed care plan. If they elect to enroll in a Medi-Cal managed care plan, they shall complete a Medi-Cal choice form with their chosen primary care provider who is present for purposes of completing that form. The department shall not assign a person experiencing homelessness to a primary care provider without the persons informed consent under any circumstances, including any time beyond the 60-day choice period.
SEC. 2. Section 14011.67 is added to the Welfare and Institutions Code, to read:
### SEC. 2.
14011.67. (a) To the extent federal financial participation is available, the department shall implement a program of presumptive eligibility for individuals persons experiencing homelessness.(b) The presumptive eligibility benefits provided under this section shall be identical to the benefits provided to individuals who receive full-scope Medi-Cal benefits without a share of cost, and shall only be made available through a Medi-Cal provider.(c) Upon implementation of the presumptive eligibility program for individuals persons experiencing homelessness, the department shall issue a declaration, which shall be retained by the director, stating that implementation of the program has commenced.(d) 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, interpret, or make specific this section by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions until the time any necessary regulations are adopted. Thereafter, the department shall adopt any necessary 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.(e) A hospital An enrolled Medi-Cal provider, including a health facility, such as a hospital or clinic, may make a presumptive eligibility determination for an individual a person experiencing homelessness in compliance with Section 14011.66 if the individual that person gives their informed consent to receive Medi-Cal benefits.(f) Upon the receipt of a timely and complete Medi-Cal application for an individual a person experiencing homelessness who has coverage pursuant to the presumptive eligibility program authorized by this section, a county shall determine whether the individual that person is eligible for Medi-Cal benefits. If (1) If the county determines that the individual person does not meet the eligibility requirements for participation in the Medi-Cal program, the county shall timely report this finding to the Medical Eligibility Data System so that presumptive eligibility benefits are discontinued.(2) If the county determines that the person experiencing homelessness is eligible for benefits under the Medi-Cal program, the person shall be enrolled in the Medi-Cal programs fee-for-service delivery system until they elect, by providing informed consent, to enroll in a Medi-Cal managed care plan. If they elect to enroll in a Medi-Cal managed care plan, they shall complete a Medi-Cal choice form with their chosen primary care provider who is present for purposes of completing that form. The department shall not assign a person experiencing homelessness to a primary care provider without the persons informed consent under any circumstances, including any time beyond the 60-day choice period.
14011.67. (a) To the extent federal financial participation is available, the department shall implement a program of presumptive eligibility for individuals persons experiencing homelessness.(b) The presumptive eligibility benefits provided under this section shall be identical to the benefits provided to individuals who receive full-scope Medi-Cal benefits without a share of cost, and shall only be made available through a Medi-Cal provider.(c) Upon implementation of the presumptive eligibility program for individuals persons experiencing homelessness, the department shall issue a declaration, which shall be retained by the director, stating that implementation of the program has commenced.(d) 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, interpret, or make specific this section by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions until the time any necessary regulations are adopted. Thereafter, the department shall adopt any necessary 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.(e) A hospital An enrolled Medi-Cal provider, including a health facility, such as a hospital or clinic, may make a presumptive eligibility determination for an individual a person experiencing homelessness in compliance with Section 14011.66 if the individual that person gives their informed consent to receive Medi-Cal benefits.(f) Upon the receipt of a timely and complete Medi-Cal application for an individual a person experiencing homelessness who has coverage pursuant to the presumptive eligibility program authorized by this section, a county shall determine whether the individual that person is eligible for Medi-Cal benefits. If (1) If the county determines that the individual person does not meet the eligibility requirements for participation in the Medi-Cal program, the county shall timely report this finding to the Medical Eligibility Data System so that presumptive eligibility benefits are discontinued.(2) If the county determines that the person experiencing homelessness is eligible for benefits under the Medi-Cal program, the person shall be enrolled in the Medi-Cal programs fee-for-service delivery system until they elect, by providing informed consent, to enroll in a Medi-Cal managed care plan. If they elect to enroll in a Medi-Cal managed care plan, they shall complete a Medi-Cal choice form with their chosen primary care provider who is present for purposes of completing that form. The department shall not assign a person experiencing homelessness to a primary care provider without the persons informed consent under any circumstances, including any time beyond the 60-day choice period.
14011.67. (a) To the extent federal financial participation is available, the department shall implement a program of presumptive eligibility for individuals persons experiencing homelessness.(b) The presumptive eligibility benefits provided under this section shall be identical to the benefits provided to individuals who receive full-scope Medi-Cal benefits without a share of cost, and shall only be made available through a Medi-Cal provider.(c) Upon implementation of the presumptive eligibility program for individuals persons experiencing homelessness, the department shall issue a declaration, which shall be retained by the director, stating that implementation of the program has commenced.(d) 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, interpret, or make specific this section by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions until the time any necessary regulations are adopted. Thereafter, the department shall adopt any necessary 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.(e) A hospital An enrolled Medi-Cal provider, including a health facility, such as a hospital or clinic, may make a presumptive eligibility determination for an individual a person experiencing homelessness in compliance with Section 14011.66 if the individual that person gives their informed consent to receive Medi-Cal benefits.(f) Upon the receipt of a timely and complete Medi-Cal application for an individual a person experiencing homelessness who has coverage pursuant to the presumptive eligibility program authorized by this section, a county shall determine whether the individual that person is eligible for Medi-Cal benefits. If (1) If the county determines that the individual person does not meet the eligibility requirements for participation in the Medi-Cal program, the county shall timely report this finding to the Medical Eligibility Data System so that presumptive eligibility benefits are discontinued.(2) If the county determines that the person experiencing homelessness is eligible for benefits under the Medi-Cal program, the person shall be enrolled in the Medi-Cal programs fee-for-service delivery system until they elect, by providing informed consent, to enroll in a Medi-Cal managed care plan. If they elect to enroll in a Medi-Cal managed care plan, they shall complete a Medi-Cal choice form with their chosen primary care provider who is present for purposes of completing that form. The department shall not assign a person experiencing homelessness to a primary care provider without the persons informed consent under any circumstances, including any time beyond the 60-day choice period.
14011.67. (a) To the extent federal financial participation is available, the department shall implement a program of presumptive eligibility for individuals persons experiencing homelessness.
(b) The presumptive eligibility benefits provided under this section shall be identical to the benefits provided to individuals who receive full-scope Medi-Cal benefits without a share of cost, and shall only be made available through a Medi-Cal provider.
(c) Upon implementation of the presumptive eligibility program for individuals persons experiencing homelessness, the department shall issue a declaration, which shall be retained by the director, stating that implementation of the program has commenced.
(d) 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, interpret, or make specific this section by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions until the time any necessary regulations are adopted. Thereafter, the department shall adopt any necessary 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.
(e) A hospital An enrolled Medi-Cal provider, including a health facility, such as a hospital or clinic, may make a presumptive eligibility determination for an individual a person experiencing homelessness in compliance with Section 14011.66 if the individual that person gives their informed consent to receive Medi-Cal benefits.
(f) Upon the receipt of a timely and complete Medi-Cal application for an individual a person experiencing homelessness who has coverage pursuant to the presumptive eligibility program authorized by this section, a county shall determine whether the individual that person is eligible for Medi-Cal benefits. If
(1) If the county determines that the individual person does not meet the eligibility requirements for participation in the Medi-Cal program, the county shall timely report this finding to the Medical Eligibility Data System so that presumptive eligibility benefits are discontinued.
(2) If the county determines that the person experiencing homelessness is eligible for benefits under the Medi-Cal program, the person shall be enrolled in the Medi-Cal programs fee-for-service delivery system until they elect, by providing informed consent, to enroll in a Medi-Cal managed care plan. If they elect to enroll in a Medi-Cal managed care plan, they shall complete a Medi-Cal choice form with their chosen primary care provider who is present for purposes of completing that form. The department shall not assign a person experiencing homelessness to a primary care provider without the persons informed consent under any circumstances, including any time beyond the 60-day choice period.
SEC. 3. Section 14133.02 is added to the Welfare and Institutions Code, to read:14133.02. (a) The director shall not impose prior authorization or any other utilization controls on an item, service, or immunization that is intended to test for, prevent, treat, or mitigate COVID-19.(b) This section shall remain in effect only until January 1, 2026, and as of that date is repealed.
SEC. 3. Section 14133.02 is added to the Welfare and Institutions Code, to read:
### SEC. 3.
14133.02. (a) The director shall not impose prior authorization or any other utilization controls on an item, service, or immunization that is intended to test for, prevent, treat, or mitigate COVID-19.(b) This section shall remain in effect only until January 1, 2026, and as of that date is repealed.
14133.02. (a) The director shall not impose prior authorization or any other utilization controls on an item, service, or immunization that is intended to test for, prevent, treat, or mitigate COVID-19.(b) This section shall remain in effect only until January 1, 2026, and as of that date is repealed.
14133.02. (a) The director shall not impose prior authorization or any other utilization controls on an item, service, or immunization that is intended to test for, prevent, treat, or mitigate COVID-19.(b) This section shall remain in effect only until January 1, 2026, and as of that date is repealed.
14133.02. (a) The director shall not impose prior authorization or any other utilization controls on an item, service, or immunization that is intended to test for, prevent, treat, or mitigate COVID-19.
(b) This section shall remain in effect only until January 1, 2026, and as of that date is repealed.
SEC. 4. Section 14133.55 is added to the Welfare and Institutions Code, to read:14133.55.(a)The department shall, in consultation with street medicine providers and people with lived expertise in homelessness, develop a payment mechanism for street medicine.(b)The department shall allow health care providers to receive fee-for-service Medi-Cal reimbursement for services provided through street medicine.14133.55. (a) The department shall authorize Medi-Cal enrolled providers to bill the Medi-Cal program for the full range of benefits covered under the Medi-Cal program if those providers render services to people experiencing homelessness outside of traditional medical facilities. Services may be provided through street medicine teams, shelter-based care, or within transitional housing settings.(c)(b) (1) Notwithstanding Sections 14017 and 14017.5, the department shall issue a authorize an enrolled Medi-Cal provider, including a health facility, such as a hospital or clinic, to issue a temporary Medi-Cal benefits identification card to an individual a person experiencing homelessness who is a Medi-Cal beneficiary or receives full-scope Medi-Cal benefits pursuant to Section 14011.67, but is not in possession of 14011.67. The department shall not require a person experiencing homelessness to present a valid California drivers license or identification card issued by the Department of Motor Vehicles. Vehicles in order to receive services under the Medi-Cal program.(2) The department shall not require a provider to match the name and signature on the benefits identification card any Medi-Cal benefits identification card, including the initially issued temporary card, as described under paragraph (1), issued by the department to an individual department or provider to a person experiencing homelessness or that individuals valid California drivers license or California identification card against a signature executed at the time of service, or require a provider to visually verify the likeness of an individual a person experiencing homelessness to the photograph on the identification car or drivers license.(d) (1)If an individual experiencing homelessness is a Medi-Cal beneficiary or receives full-scope Medi-Cal benefits pursuant to Section 14011.67, the department shall not require primary care services to be provided by the individuals established primary care physician. The department shall reimburse a provider for covered primary care services provided to an individual experiencing homelessness regardless of the care setting.(2)If an individual experiencing homelessness is a Medi-Cal beneficiary or receives full-scope Medi-Cal benefits pursuant to Section 14011.67, the department shall not require that individual to receive a referral from their primary care physician to be able to receive specialist care. The department shall reimburse a specialist care provider for services provided to an individual experiencing homelessness without a referral from a primary care physician.(3) If a provider is unable to verify eligibility based on any Medi-Cal benefits identification card, including the initially issued temporary card, the provider may verify eligibility through any other system, including, but not limited to, the Medi-Cal Eligibility Data System or the Homeless Management Information System, as defined in subdivision (i) of Section 50216 of the Health and Safety Code.(c) A person experiencing homelessness may receive primary care services, and referrals for specialty care and diagnostics, from any Medi-Cal enrolled provider, and they shall not be limited to receive those services only from their designated primary care physician. Any Medi-Cal enrolled provider may refer a person experiencing homelessness for specialist care and diagnostics. The department shall reimburse a Medi-Cal enrolled provider for rendering covered primary care services or specialist care to a person experiencing homelessness regardless of the care setting, including services provided through street medicine teams, shelter-based care, and within transitional housing settings.(d) The department shall authorize persons experiencing homelessness to remain in the Medi-Cal programs fee-for-service program rather than enrolling them into a Medi-Cal managed care plan and assigning them a primary care provider within a plan. A person experiencing homelessness shall have the ability to elect to enroll in a Medi-Cal managed care plan once they have met and selected a primary care provider, as described under paragraph (2) of subdivision (f) of Section 14011.67.(e) The department shall seek all federal waivers necessary to allow federal financial participation in expenditures under this section.(f)For purposes of this section, street medicine means a program to provide health care services directly to those living on the streets or who are otherwise unsheltered.
SEC. 4. Section 14133.55 is added to the Welfare and Institutions Code, to read:
### SEC. 4.
14133.55.(a)The department shall, in consultation with street medicine providers and people with lived expertise in homelessness, develop a payment mechanism for street medicine.(b)The department shall allow health care providers to receive fee-for-service Medi-Cal reimbursement for services provided through street medicine.14133.55. (a) The department shall authorize Medi-Cal enrolled providers to bill the Medi-Cal program for the full range of benefits covered under the Medi-Cal program if those providers render services to people experiencing homelessness outside of traditional medical facilities. Services may be provided through street medicine teams, shelter-based care, or within transitional housing settings.(c)(b) (1) Notwithstanding Sections 14017 and 14017.5, the department shall issue a authorize an enrolled Medi-Cal provider, including a health facility, such as a hospital or clinic, to issue a temporary Medi-Cal benefits identification card to an individual a person experiencing homelessness who is a Medi-Cal beneficiary or receives full-scope Medi-Cal benefits pursuant to Section 14011.67, but is not in possession of 14011.67. The department shall not require a person experiencing homelessness to present a valid California drivers license or identification card issued by the Department of Motor Vehicles. Vehicles in order to receive services under the Medi-Cal program.(2) The department shall not require a provider to match the name and signature on the benefits identification card any Medi-Cal benefits identification card, including the initially issued temporary card, as described under paragraph (1), issued by the department to an individual department or provider to a person experiencing homelessness or that individuals valid California drivers license or California identification card against a signature executed at the time of service, or require a provider to visually verify the likeness of an individual a person experiencing homelessness to the photograph on the identification car or drivers license.(d) (1)If an individual experiencing homelessness is a Medi-Cal beneficiary or receives full-scope Medi-Cal benefits pursuant to Section 14011.67, the department shall not require primary care services to be provided by the individuals established primary care physician. The department shall reimburse a provider for covered primary care services provided to an individual experiencing homelessness regardless of the care setting.(2)If an individual experiencing homelessness is a Medi-Cal beneficiary or receives full-scope Medi-Cal benefits pursuant to Section 14011.67, the department shall not require that individual to receive a referral from their primary care physician to be able to receive specialist care. The department shall reimburse a specialist care provider for services provided to an individual experiencing homelessness without a referral from a primary care physician.(3) If a provider is unable to verify eligibility based on any Medi-Cal benefits identification card, including the initially issued temporary card, the provider may verify eligibility through any other system, including, but not limited to, the Medi-Cal Eligibility Data System or the Homeless Management Information System, as defined in subdivision (i) of Section 50216 of the Health and Safety Code.(c) A person experiencing homelessness may receive primary care services, and referrals for specialty care and diagnostics, from any Medi-Cal enrolled provider, and they shall not be limited to receive those services only from their designated primary care physician. Any Medi-Cal enrolled provider may refer a person experiencing homelessness for specialist care and diagnostics. The department shall reimburse a Medi-Cal enrolled provider for rendering covered primary care services or specialist care to a person experiencing homelessness regardless of the care setting, including services provided through street medicine teams, shelter-based care, and within transitional housing settings.(d) The department shall authorize persons experiencing homelessness to remain in the Medi-Cal programs fee-for-service program rather than enrolling them into a Medi-Cal managed care plan and assigning them a primary care provider within a plan. A person experiencing homelessness shall have the ability to elect to enroll in a Medi-Cal managed care plan once they have met and selected a primary care provider, as described under paragraph (2) of subdivision (f) of Section 14011.67.(e) The department shall seek all federal waivers necessary to allow federal financial participation in expenditures under this section.(f)For purposes of this section, street medicine means a program to provide health care services directly to those living on the streets or who are otherwise unsheltered.
(a)The department shall, in consultation with street medicine providers and people with lived expertise in homelessness, develop a payment mechanism for street medicine.
(b)The department shall allow health care providers to receive fee-for-service Medi-Cal reimbursement for services provided through street medicine.
14133.55. (a) The department shall authorize Medi-Cal enrolled providers to bill the Medi-Cal program for the full range of benefits covered under the Medi-Cal program if those providers render services to people experiencing homelessness outside of traditional medical facilities. Services may be provided through street medicine teams, shelter-based care, or within transitional housing settings.(c)(b) (1) Notwithstanding Sections 14017 and 14017.5, the department shall issue a authorize an enrolled Medi-Cal provider, including a health facility, such as a hospital or clinic, to issue a temporary Medi-Cal benefits identification card to an individual a person experiencing homelessness who is a Medi-Cal beneficiary or receives full-scope Medi-Cal benefits pursuant to Section 14011.67, but is not in possession of 14011.67. The department shall not require a person experiencing homelessness to present a valid California drivers license or identification card issued by the Department of Motor Vehicles. Vehicles in order to receive services under the Medi-Cal program.(2) The department shall not require a provider to match the name and signature on the benefits identification card any Medi-Cal benefits identification card, including the initially issued temporary card, as described under paragraph (1), issued by the department to an individual department or provider to a person experiencing homelessness or that individuals valid California drivers license or California identification card against a signature executed at the time of service, or require a provider to visually verify the likeness of an individual a person experiencing homelessness to the photograph on the identification car or drivers license.(d) (1)If an individual experiencing homelessness is a Medi-Cal beneficiary or receives full-scope Medi-Cal benefits pursuant to Section 14011.67, the department shall not require primary care services to be provided by the individuals established primary care physician. The department shall reimburse a provider for covered primary care services provided to an individual experiencing homelessness regardless of the care setting.(2)If an individual experiencing homelessness is a Medi-Cal beneficiary or receives full-scope Medi-Cal benefits pursuant to Section 14011.67, the department shall not require that individual to receive a referral from their primary care physician to be able to receive specialist care. The department shall reimburse a specialist care provider for services provided to an individual experiencing homelessness without a referral from a primary care physician.(3) If a provider is unable to verify eligibility based on any Medi-Cal benefits identification card, including the initially issued temporary card, the provider may verify eligibility through any other system, including, but not limited to, the Medi-Cal Eligibility Data System or the Homeless Management Information System, as defined in subdivision (i) of Section 50216 of the Health and Safety Code.(c) A person experiencing homelessness may receive primary care services, and referrals for specialty care and diagnostics, from any Medi-Cal enrolled provider, and they shall not be limited to receive those services only from their designated primary care physician. Any Medi-Cal enrolled provider may refer a person experiencing homelessness for specialist care and diagnostics. The department shall reimburse a Medi-Cal enrolled provider for rendering covered primary care services or specialist care to a person experiencing homelessness regardless of the care setting, including services provided through street medicine teams, shelter-based care, and within transitional housing settings.(d) The department shall authorize persons experiencing homelessness to remain in the Medi-Cal programs fee-for-service program rather than enrolling them into a Medi-Cal managed care plan and assigning them a primary care provider within a plan. A person experiencing homelessness shall have the ability to elect to enroll in a Medi-Cal managed care plan once they have met and selected a primary care provider, as described under paragraph (2) of subdivision (f) of Section 14011.67.(e) The department shall seek all federal waivers necessary to allow federal financial participation in expenditures under this section.(f)For purposes of this section, street medicine means a program to provide health care services directly to those living on the streets or who are otherwise unsheltered.
14133.55. (a) The department shall authorize Medi-Cal enrolled providers to bill the Medi-Cal program for the full range of benefits covered under the Medi-Cal program if those providers render services to people experiencing homelessness outside of traditional medical facilities. Services may be provided through street medicine teams, shelter-based care, or within transitional housing settings.(c)(b) (1) Notwithstanding Sections 14017 and 14017.5, the department shall issue a authorize an enrolled Medi-Cal provider, including a health facility, such as a hospital or clinic, to issue a temporary Medi-Cal benefits identification card to an individual a person experiencing homelessness who is a Medi-Cal beneficiary or receives full-scope Medi-Cal benefits pursuant to Section 14011.67, but is not in possession of 14011.67. The department shall not require a person experiencing homelessness to present a valid California drivers license or identification card issued by the Department of Motor Vehicles. Vehicles in order to receive services under the Medi-Cal program.(2) The department shall not require a provider to match the name and signature on the benefits identification card any Medi-Cal benefits identification card, including the initially issued temporary card, as described under paragraph (1), issued by the department to an individual department or provider to a person experiencing homelessness or that individuals valid California drivers license or California identification card against a signature executed at the time of service, or require a provider to visually verify the likeness of an individual a person experiencing homelessness to the photograph on the identification car or drivers license.(d) (1)If an individual experiencing homelessness is a Medi-Cal beneficiary or receives full-scope Medi-Cal benefits pursuant to Section 14011.67, the department shall not require primary care services to be provided by the individuals established primary care physician. The department shall reimburse a provider for covered primary care services provided to an individual experiencing homelessness regardless of the care setting.(2)If an individual experiencing homelessness is a Medi-Cal beneficiary or receives full-scope Medi-Cal benefits pursuant to Section 14011.67, the department shall not require that individual to receive a referral from their primary care physician to be able to receive specialist care. The department shall reimburse a specialist care provider for services provided to an individual experiencing homelessness without a referral from a primary care physician.(3) If a provider is unable to verify eligibility based on any Medi-Cal benefits identification card, including the initially issued temporary card, the provider may verify eligibility through any other system, including, but not limited to, the Medi-Cal Eligibility Data System or the Homeless Management Information System, as defined in subdivision (i) of Section 50216 of the Health and Safety Code.(c) A person experiencing homelessness may receive primary care services, and referrals for specialty care and diagnostics, from any Medi-Cal enrolled provider, and they shall not be limited to receive those services only from their designated primary care physician. Any Medi-Cal enrolled provider may refer a person experiencing homelessness for specialist care and diagnostics. The department shall reimburse a Medi-Cal enrolled provider for rendering covered primary care services or specialist care to a person experiencing homelessness regardless of the care setting, including services provided through street medicine teams, shelter-based care, and within transitional housing settings.(d) The department shall authorize persons experiencing homelessness to remain in the Medi-Cal programs fee-for-service program rather than enrolling them into a Medi-Cal managed care plan and assigning them a primary care provider within a plan. A person experiencing homelessness shall have the ability to elect to enroll in a Medi-Cal managed care plan once they have met and selected a primary care provider, as described under paragraph (2) of subdivision (f) of Section 14011.67.(e) The department shall seek all federal waivers necessary to allow federal financial participation in expenditures under this section.(f)For purposes of this section, street medicine means a program to provide health care services directly to those living on the streets or who are otherwise unsheltered.
14133.55. (a) The department shall authorize Medi-Cal enrolled providers to bill the Medi-Cal program for the full range of benefits covered under the Medi-Cal program if those providers render services to people experiencing homelessness outside of traditional medical facilities. Services may be provided through street medicine teams, shelter-based care, or within transitional housing settings.(c)
14133.55. (a) The department shall authorize Medi-Cal enrolled providers to bill the Medi-Cal program for the full range of benefits covered under the Medi-Cal program if those providers render services to people experiencing homelessness outside of traditional medical facilities. Services may be provided through street medicine teams, shelter-based care, or within transitional housing settings.
(c)
(b) (1) Notwithstanding Sections 14017 and 14017.5, the department shall issue a authorize an enrolled Medi-Cal provider, including a health facility, such as a hospital or clinic, to issue a temporary Medi-Cal benefits identification card to an individual a person experiencing homelessness who is a Medi-Cal beneficiary or receives full-scope Medi-Cal benefits pursuant to Section 14011.67, but is not in possession of 14011.67. The department shall not require a person experiencing homelessness to present a valid California drivers license or identification card issued by the Department of Motor Vehicles. Vehicles in order to receive services under the Medi-Cal program.
(2) The department shall not require a provider to match the name and signature on the benefits identification card any Medi-Cal benefits identification card, including the initially issued temporary card, as described under paragraph (1), issued by the department to an individual department or provider to a person experiencing homelessness or that individuals valid California drivers license or California identification card against a signature executed at the time of service, or require a provider to visually verify the likeness of an individual a person experiencing homelessness to the photograph on the identification car or drivers license.
(d) (1)If an individual experiencing homelessness is a Medi-Cal beneficiary or receives full-scope Medi-Cal benefits pursuant to Section 14011.67, the department shall not require primary care services to be provided by the individuals established primary care physician. The department shall reimburse a provider for covered primary care services provided to an individual experiencing homelessness regardless of the care setting.
(2)If an individual experiencing homelessness is a Medi-Cal beneficiary or receives full-scope Medi-Cal benefits pursuant to Section 14011.67, the department shall not require that individual to receive a referral from their primary care physician to be able to receive specialist care. The department shall reimburse a specialist care provider for services provided to an individual experiencing homelessness without a referral from a primary care physician.
(3) If a provider is unable to verify eligibility based on any Medi-Cal benefits identification card, including the initially issued temporary card, the provider may verify eligibility through any other system, including, but not limited to, the Medi-Cal Eligibility Data System or the Homeless Management Information System, as defined in subdivision (i) of Section 50216 of the Health and Safety Code.
(c) A person experiencing homelessness may receive primary care services, and referrals for specialty care and diagnostics, from any Medi-Cal enrolled provider, and they shall not be limited to receive those services only from their designated primary care physician. Any Medi-Cal enrolled provider may refer a person experiencing homelessness for specialist care and diagnostics. The department shall reimburse a Medi-Cal enrolled provider for rendering covered primary care services or specialist care to a person experiencing homelessness regardless of the care setting, including services provided through street medicine teams, shelter-based care, and within transitional housing settings.
(d) The department shall authorize persons experiencing homelessness to remain in the Medi-Cal programs fee-for-service program rather than enrolling them into a Medi-Cal managed care plan and assigning them a primary care provider within a plan. A person experiencing homelessness shall have the ability to elect to enroll in a Medi-Cal managed care plan once they have met and selected a primary care provider, as described under paragraph (2) of subdivision (f) of Section 14011.67.
(e) The department shall seek all federal waivers necessary to allow federal financial participation in expenditures under this section.
(f)For purposes of this section, street medicine means a program to provide health care services directly to those living on the streets or who are otherwise unsheltered.
SEC. 5. 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.
SEC. 5. 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.
SEC. 5. 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.
### SEC. 5.