BILL NUMBER: AB 2612 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY MAY 23, 2014
AMENDED IN ASSEMBLY MAY 5, 2014
AMENDED IN ASSEMBLY MARCH 28, 2014
INTRODUCED BY Assembly Member Dababneh
FEBRUARY 21, 2014
An act to add Sections 14124.27, 14124.28,
14124.28 and 14129 to the Welfare and Institutions Code,
relating to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
AB 2612, as amended, Dababneh. Medi-Cal: substance use disorder
treatment.
Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Care Services, under
which qualified low-income individuals receive health care services.
The Medi-Cal program is, in part, governed and funded by federal
Medicaid Program provisions. Existing federal law prohibits federal
financial participation for care or services provided to inmates of a
public institution and care or services provided to patients in an
institution for mental diseases. Existing law establishes the Drug
Medi-Cal Treatment Program (Drug Medi-Cal) under which the department
is authorized to enter into contracts with counties for various drug
treatment services to Medi-Cal recipients, or is required to
directly arrange for these services if a county elects not to do so.
This bill would also authorize the department to
establish a 5-year pilot project with 6 counties to develop models
for housing individuals with substance use disorders to provide
substance use disorder treatment to those individuals who do not fall
within the institution for mental diseases exclusion. The bill would
provide that these provisions shall only be implemented if and to
the extent that federal financial participation is not jeopardized.
The bill would also require the department to submit an
application for a specified waiver or waiver amendment necessary to
create a process by which federal financial participation may be
claimed for stays of 120 days or less in an institution for mental
diseases for beneficiaries with a substance use disorder diagnosis.
Existing law authorizes the department, subject to federal
approval, to create a health home program for enrollees with chronic
conditions, as prescribed.
This bill would require the department, in implementing that
program, to request a waiver of federal law to authorize the state to
claim federal financial participation for health home services
provided to individuals, who are otherwise eligible under the health
home program and who are state or county inmates in their last 30
days in custody, by a provider or team of providers, as specified, to
ensure coordination of care and reduce gaps in care.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. (a) The Legislature finds and declares all of the
following:
(1) The federal Patient Protection and Affordable Care Act, also
known as health care reform, is designed to ensure every American has
access to health care. Eligibility for the federal low-income health
insurance program, which is Medi-Cal in California, was expanded to
include childless adults earning less than 138 percent of the federal
poverty level.
(2) The cost of the Medi-Cal expansion will be fully paid by the
federal government until 2017, when the federal government
contribution will decline gradually to 90 percent, where it will
remain in 2020 and each year thereafter.
(3) According to research done by the National Health Law Program,
a large percentage of individuals in county jails, and those being
released, are uninsured and may be eligible for Medi-Cal.
(4) According to a study published in the American Journal of
Public Health, many individuals in county jails, and those being
released, have untreated substance use disorders.
(5) In implementing health care reform, California expanded
insurance benefits for substance use disorder treatment for new and
existing Medi-Cal beneficiaries.
(6) Placement in residential programs can treat issues associated
with substance use disorders and thereby reduce costs and recidivism
associated with individuals in county jails.
(b) Therefore, it is the intent of the Legislature to encourage
the use of appropriate residential substance use disorder treatment
programs for individuals in the criminal justice system.
(c) It is further the intent of the Legislature, in order to
increase access to primary care, mental health treatment, and
substance use disorder treatment for individuals in the criminal
justice system, that individuals who are otherwise eligible for
Medi-Cal and who are not inmates of a public institution shall be
eligible for Medi-Cal benefits. This includes, but is not limited to,
individuals in formal or informal diversion or deferred entry of
judgment programs; individuals on probation, as defined in Section
1203 of the Penal Code; individuals on parole, as described in
Section 3000 of the Penal Code; individuals on postrelease community
supervision, as described in Section 3451 of the Penal Code; and
individuals on mandatory supervision as defined in clause (ii) of
subparagraph (B) of paragraph (5) of subdivision (h) of Section 1170
of the Penal Code.
SEC. 2. Section 14124.27 is added to the
Welfare and Institutions Code, immediately following Section
14124.26, to read:
14124.27. (a) The department may establish a five-year pilot
program with six counties, which shall include three urban counties
and three rural counties, to develop models for housing individuals
with substance use disorders to provide substance use disorder
treatment to those individuals who do not fall within the institution
for mental diseases exclusion in federal law, thereby maximizing
federal financial participation.
(b) This section shall not create a state-only funded benefit or
program. The department shall implement this section only if and to
the extent that federal financial participation is not jeopardized.
SEC. 3. SEC. 2. Section 14124.28 is
added to the Welfare and Institutions Code, to read:
14124.28. The department shall submit an application for any
Section 1115 waiver or waiver amendment necessary to create a process
by which federal financial participation may be claimed for stays of
120 days or less in an institution for mental diseases, as defined
in Section 1396d(i) of Title 42 of the United States Code, for
beneficiaries with a substance use disorder diagnosis for purposes of
treating the individual's diagnosed substance use disorder.
SEC. 4. SEC. 3. Section 14129 is
added to the Welfare and Institutions Code, immediately following
Section 14128, to read:
14129. The department shall, in implementing this article,
request a waiver of federal law to authorize the state to claim
federal financial participation for health home services provided to
individuals, who are otherwise eligible to receive health home
services under this article and who are state or county inmates in
their last 30 days in custody, by a provider or team of providers, as
described in subdivision (c) of Section 14127, to ensure
coordination of care and reduce gaps in care. Prerelease health home
services shall be limited to services described in Section 14127.2
and shall not include health care services.