BILL NUMBER: SB 213 AMENDED
BILL TEXT
AMENDED IN SENATE MARCH 24, 2011
INTRODUCED BY Senator Hancock
FEBRUARY 8, 2011
An act relating to community schools. An
act to amend Section 14115.8 of the Welfare and Institutions Code.
LEGISLATIVE COUNSEL'S DIGEST
SB 213, as amended, Hancock. Full service community
schools. Medi-Cal: local educational agencies:
billing.
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 the department to
amend the Medicaid state plan with respect to the billing option for
services by local educational agencies to ensure that schools are
reimbursed for all eligible services that they provide that are not
precluded by federal requirements. Existing law also requires the
department to perform various activities, including, among others, an
annual comparison of the school-based Medicaid systems in comparable
states and efforts to improve communications with the federal
government, the State Department of Education, and local educational
agencies.
This bill would additionally require the department to develop,
jointly with the State Department of Education, a plan for
identifying and providing assistance to districts that are
underutilizing the Medi-Cal administrative activities (MAA) billing
option, and would require the plan to address ways to collect
information about how districts are reinvesting dollars generated
through MAA billing and to promote promising strategies.
Existing law authorizes county boards of education to establish
and maintain one or more community schools. Existing law authorizes
county boards of education to enroll in community schools pupils who
have been expelled from a school district, pupils who have been
referred pursuant to a recommendation from a school attendance review
board, pupils who are on probation or parole, or homeless children.
This bill would express the intent of the Legislature to enact
legislation that would establish guidelines, as specified, for full
service community schools that would support pupils on or near
schoolsites in order for those pupils to be successful in school.
Vote: majority. Appropriation: no. Fiscal committee: no
yes . State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 14115.8 of the
Welfare and Institutions Code is amended to read:
14115.8. (a) (1) The department shall amend the Medicaid state
plan with respect to the billing option for services by local
educational agencies, to ensure that schools shall be reimbursed for
all eligible services that they provide that are not precluded by
federal requirements.
(2) The department shall examine methodologies for increasing
school participation in the Medi-Cal billing option for local
educational agencies so that schools can meet the health care needs
of their students.
(3) The department, to the extent possible , shall
simplify claiming processes for local educational agency billing.
(4) The department shall eliminate and modify state plan and
regulatory requirements that exceed federal requirements when they
are unnecessary.
(b) If a rate study for the LEA Medi-Cal billing option is
completed pursuant to Section 52 of Chapter 171 of the Statutes of
2001, the department, in consultation with the entities named in
subdivision (c), shall implement the recommendations from the study,
to the extent feasible and appropriate.
(c) In order to assist the department in formulating the state
plan amendments required by subdivisions (a) and (b), the department
shall regularly consult with the State Department of Education,
representatives of urban, rural, large and small school districts,
and county offices of education, the local education consortium, and
local educational agencies. It is the intent of the Legislature that
the department also consult with staff from Region IX of the federal
Centers for Medicare and Medicaid Services, experts from the fields
of both health and education, and state legislative staff.
(d) Notwithstanding any other provision of law, or any other
contrary state requirement, the department shall take whatever action
is necessary to ensure that, to the extent there is capacity in its
certified match, a local educational agency shall be reimbursed
retroactively for the maximum period allowed by the federal
government for any department change that results in an increase in
reimbursement to local educational agency providers.
(e) The department may undertake all necessary activities to
recoup matching funds from the federal government for reimbursable
services that have already been provided in the state's public
schools. The department shall prepare and take whatever action is
necessary to implement all regulations, policies, state plan
amendments, and other requirements necessary to achieve this purpose.
(f) The department shall file an annual report with the
Legislature that shall include at least all of the following:
(1) A copy of the annual comparison required by subdivision (i).
(2) A state-by-state comparison of school-based Medicaid total and
per eligible child claims and federal revenues. The comparison shall
include a review of the most recent two years for which completed
data is available.
(3) A summary of department activities and an explanation of how
each activity contributed toward narrowing the gap between California'
s per eligible student federal fund recovery and the per student
recovery of the top three states.
(4) A listing of all school-based services, activities, and
providers approved for reimbursement by the federal Centers for
Medicare and Medicaid Services in other state plans that are not yet
approved for reimbursement in California's state plan and the service
unit rates approved for reimbursement.
(5) The official recommendations made to the department by the
entities named in subdivision (c) and the action taken by the
department regarding each recommendation.
(6) A one-year timetable for state plan amendments and other
actions necessary to obtain reimbursement for those items listed in
paragraph (4).
(7) Identify any barriers to local educational agency
reimbursement, including those specified by the entities named in
subdivision (c), that are not imposed by federal requirements, and
describe the actions that have been, and will be, taken to eliminate
them.
(g) (1) These activities shall be funded and staffed by
proportionately reducing federal Medicaid payments allocable to local
educational agencies for the provision of benefits funded by the
federal Medicaid program under the billing option for services by
local educational agencies specified in this section. Moneys
collected as a result of the reduction in federal Medicaid payments
allocable to local educational agencies shall be deposited into the
Local Educational Agency Medi-Cal Recovery Fund, which is hereby
established in the Special Deposit Fund established pursuant to
Section 16370 of the Government Code. These funds shall be used, upon
appropriation by the Legislature, only to support the department to
meet all the requirements of this section. As of January 1, 2013,
unless the Legislature enacts a new statute or extends the repeal
date in subdivision (j), all funds in the Local Educational Agency
Medi-Cal Recovery Fund shall be returned proportionally to all local
educational agencies whose federal Medicaid funds were used to create
this fund. The annual amount funded shall not exceed one million
five hundred thousand dollars ($1,500,000).
(2) Funding received pursuant to paragraph (1) shall derive only
from federal Medicaid funds that exceed the baseline amount of local
educational agency Medicaid billing option revenues for the 2000-01
fiscal year.
(h) (1) The department may enter into a sole source contract to
comply with the requirements of this section.
(2) The level of additional staff to comply with the requirements
of this section, including, but not limited to, staff for which the
department has contracted for pursuant to paragraph (1), shall be
limited to that level that can be funded with revenues derived
pursuant to subdivision (g).
(i) The activities of the department shall include all of the
following:
(1) An annual comparison of the school-based Medicaid systems in
comparable states.
(2) Efforts to improve communications with the federal government,
the State Department of Education, and local educational agencies.
(3) The development and updating of written guidelines to local
educational agencies regarding best practices to avoid audit
exceptions, as needed.
(4) The establishment and maintenance of a local educational
agency user-friendly, interactive Internet Web site.
(5) The development, jointly with the State Department of
Education, of a plan for identifying and providing assistance to
districts that are underutilizing the Medi-Cal administrative
activities (MAA) billing option. The plan shall address ways to
collect information about how districts are reinvesting dollars
generated through MAA billing and to promote promising strategies.
(j) This section shall remain in effect only until January 1,
2013, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2013, deletes or extends
that date.
SECTION 1. It is the intent of the Legislature
to enact legislation that would establish guidelines for full service
community schools that would support pupils on or near schoolsites
in order for those pupils to be successful in school. It is the
intent of the Legislature that the guidelines established by this
legislation should include ways to achieve all of the following:
(a) Improvement of access to health care, including dental and
vision care and other support services.
(b) Expansion of community-parent outreach centers to help parents
and legal guardians get services for their children.
(c) Providing after school and summer activities in the community
for pupils to keep them safe and learning.
(d) Improvement of school readiness through supporting
high-quality child care and preschool programs.