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AB-914 Medi-Cal: inmates: eligibility.(2019-2020)

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Date Published: 09/11/2019 09:00 PM
AB914:v95#DOCUMENT

Enrolled  September 11, 2019
Passed  IN  Senate  September 05, 2019
Passed  IN  Assembly  September 09, 2019
Amended  IN  Senate  August 30, 2019
Amended  IN  Assembly  May 16, 2019
Amended  IN  Assembly  March 18, 2019

CALIFORNIA LEGISLATURE— 2019–2020 REGULAR SESSION

Assembly Bill
No. 914


Introduced by Assembly Member Holden

February 20, 2019


An act to amend Section 14011.10 of the Welfare and Institutions Code, relating to Medi-Cal.


LEGISLATIVE COUNSEL'S DIGEST


AB 914, Holden. Medi-Cal: inmates: eligibility.
Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law requires Medi-Cal benefits of an individual who is an inmate of a public institution to be suspended effective the date the individual becomes an inmate of a public institution. Existing law requires the suspension to end on the date that the individual is no longer an inmate of a public institution or one year from the date they become an inmate of a public institution, whichever is sooner. Existing law generally requires a county to redetermine a Medi-Cal beneficiary’s eligibility to receive Medi-Cal benefits every 12 months and whenever the county receives information about changes in a beneficiary’s circumstances that may affect their eligibility for Medi-Cal benefits.
This bill would, commencing October 1, 2020, and subject to federal approval, for individuals under 26 years of age, instead require the suspension of Medi-Cal eligibility to end either on the date that the individual is no longer an inmate of the public institution or is no longer otherwise eligible for benefits under the Medi-Cal program, whichever is sooner, and would require the department, in consultation with specified stakeholders, to develop and implement a simplified annual redetermination of eligibility for individuals under 26 years of age whose eligibility is suspended pursuant to these provisions. Because counties are required to make Medi-Cal eligibility determinations, and the bill would expand Medi-Cal annual redetermination of eligibility for certain inmates of public institutions, the bill would impose a state-mandated local program.
Existing law makes these provisions inoperative if any part of these provisions is in conflict, or does not comply, with federal law.
This bill, instead, would make inoperative only the provision that is noncompliant or in conflict with federal law.
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.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: YES  

The people of the State of California do enact as follows:


SECTION 1.

 Section 14011.10 of the Welfare and Institutions Code is amended to read:

14011.10.
 (a) Except as provided in Sections 14053.7 and 14053.8, benefits provided under this chapter to an individual who is an inmate of a public institution shall be suspended in accordance with Section 1396d(a)(30)(A) of Title 42 of the United States Code as provided in subdivision (c).
(b) County welfare departments shall notify the department within 10 days of receiving information that an individual on Medi-Cal in the county is or will be an inmate of a public institution.
(c) If an individual is a Medi-Cal beneficiary on the date they become an inmate of a public institution, their benefits under this chapter and under Chapter 8 (commencing with Section 14200) shall be suspended effective the date they become an inmate of a public institution. Subject to subdivision (f), suspension shall end according to the following:
(1) For an individual 26 years of age or older, suspension shall end on the date the individual is no longer an inmate of a public institution or one year from the date the individual becomes an inmate of a public institution, whichever is sooner.
(2) Until October 1, 2020, for an individual under 26 years of age, suspension shall end on the date the individual is no longer an inmate of a public institution or one year from the date the individual becomes an inmate of a public institution, whichever is sooner, unless otherwise set forth under federal law, including, but not limited to, the federal SUPPORT for Patients and Communities Act (House Resolution 6 (2018) (Public Law 115-271)).
(3) Commencing October 1, 2020, for an individual under 26 years of age, suspension shall end on the date the individual is no longer an inmate of a public institution or is no longer otherwise eligible for benefits under the Medi-Cal program, whichever is sooner.
(d) (1) The department, in consultation with stakeholders, including the County Welfare Directors Association of California and advocates, shall develop and implement a simplified annual redetermination of eligibility, as described in Section 14005.37, for individuals under 26 years of age whose eligibility is suspended pursuant to this section.
(2) It is the intent of the Legislature that paragraph (1) supplement, not supplant, any existing programs established or implemented by the department to assist individuals in enrolling in the Medi-Cal program.
(e) This section does not create a state-funded benefit or program. Health care services under this chapter and Chapter 8 (commencing with Section 14200) shall not be available to inmates of public institutions whose Medi-Cal benefits have been suspended under this section.
(f) This section shall be implemented only if and to the extent allowed by federal law. This section shall be implemented to the extent that any necessary federal approval of state plan amendments or other federal approvals, including waivers, are obtained.
(g) If any provision of this section is in conflict, or does not comply, with federal law, only that provision shall be inoperative.
(h) This section shall be implemented on January 1, 2010, or the date when all necessary federal approvals are obtained, whichever is later.
(i) By January 1, 2010, or the date when all necessary federal approvals are obtained, whichever is later, the department, in consultation with the Chief Probation Officers of California and the County Welfare Directors Association of California, shall establish the protocols and procedures necessary to implement this section, including any needed changes to the protocols and procedures previously established to implement Section 14029.5.
(j) The department shall determine whether federal financial participation will be jeopardized by implementing this section and shall implement this section only if and to the extent that federal financial participation is not jeopardized.
(k) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department shall implement this section by means of all-county letters or similar instructions without taking regulatory action. Thereafter, the department shall adopt regulations in accordance with the requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.

SEC. 2.

 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.