Bill Text: CA SB438 | 2009-2010 | Regular Session | Amended
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Charter schools: freedom of speech and of the press.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Passed) 2010-08-18 - Chaptered by Secretary of State. Chapter 142, Statutes of 2010. [SB438 Detail]
Download: California-2009-SB438-Amended.html
Bill Title: Charter schools: freedom of speech and of the press.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Passed) 2010-08-18 - Chaptered by Secretary of State. Chapter 142, Statutes of 2010. [SB438 Detail]
Download: California-2009-SB438-Amended.html
BILL NUMBER: SB 438 AMENDED
BILL TEXT
AMENDED IN SENATE APRIL 23, 2009
INTRODUCED BY Senator Yee
FEBRUARY 26, 2009
An act to add Section 12693.766 to , and to add Part 6.25
(commencing with Section 12694.10) to Division 2 of, the Insurance
Code, and to amend Sections 14005.30 and 14011.6 of the Welfare and
the Insurance Code and to add Section 14011.61 to the
Welfare and Institutions Code, relating to health care
coverage.
LEGISLATIVE COUNSEL'S DIGEST
SB 438, as amended, Yee. Health care coverage: Cal-Health
Act. coverage.
Existing law provides for creation of various programs to provide
health care services to persons with limited incomes and meeting
various eligibility requirements. These programs include the Healthy
Families Program administered by the Managed Risk Medical Insurance
Board and the Medi-Cal program administered by the State Department
of Health Care Services and county welfare departments.
This bill would require the board, in consultation with the
department, to begin , on or before July 1, 2010,
the transfer of initial and ongoing eligibility
determinations for the Healthy Families Program to the county welfare
department , and would require the counties to assume full
responsibility for eligibility determinations, annual
redeterminations, and ongoing case maintenance by January 1, 2011
. By imposing new duties on those county departments, the bill
would impose a state-mandated local program.
The bill would also create the Cal-Health Program, which would
provide coordination of the Healthy Families and Medi-Cal programs by
the Secretary of California Health and Human Services, with the
assistance of the board, the department, and county welfare
departments. The bill would authorize participating providers, to the
extent permitted under federal law, to screen and temporarily enroll
a child in the Medi-Cal program or the Healthy Families Program at
the time medical care is provided, and would require reimbursement of
the provider to the same extent as if the child were fully enrolled
in the program in which he or she is temporarily enrolled. The bill
would require preschools and elementary schools and licensed
hospitals, clinics, and other health facilities to inform parents or
primary caretakers of a child about Cal-Health, and in the case of
urgent or emergency services, the bill would require that parents or
primary caretakers of a child be informed about the program and given
an opportunity to apply after services have been rendered.
Under existing law, the State Department of Health Care Services
is required, to the extent federal financial participation is
available and subject to federal approval of any necessary state
plan amendments , to exercise an option under federal law
to expand Medi-Cal eligibility by establishing the amount of
countable resources individuals or families are allowed to retain at
a specified level and to adopt an income disregard for applicants
equal to the difference between a specified income standard and the
amount equal to 100% of the federal poverty level applicable to the
size of the family to implement a program for
accelerated enrollment of children in the Medi-Cal program .
This bill would , instead, require the department, to the
extent federal financial participation is available, to exercise
that option to simplify Medi-Cal eligibility by exempting all
resources from consideration in making eligibility determinations and
to adopt an income disregard for applicants equal to the difference
between that income standard and the amount equal to 133% of the
federal poverty level applicable to the size of the family. The bill
would also require the department , to the
extent federal financial participation is available and subject
to approval of any necessary state plan amendments, the
department to exercise an option under federal law to
implement a program for accelerated enrollment of children
and pregnant women in the Medi-Cal program and would make each
county welfare department a qualified entity for determining
eligibility for Medi-Cal benefits for those children and
pregnant women. Because the bill would increase duties on those
county departments, the bill would impose a state-mandated local
program.
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 these
statutory provisions.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. This act shall be known and may be
cited as the Cal-Health Act.
SEC. 2. SECTION 1. Section 12693.766
is added to the Insurance Code, to read:
12693.766. (a) Notwithstanding any other provision of this part,
on or before July 1, 2010, the board, in
consultation with the State Department of Health Care Services, shall
begin the transfer of initial and ongoing
eligibility determinations for the program to the county departments.
The counties shall assume full responsibility for the eligibility
determinations for the program by January 1, 2011.
(b) The board and the department shall consult with stakeholders,
including counties and advocates for program clients, in the
development of procedures for transferring the responsibility for
determinations , annual redeterminations, and ongoing case
maintenance to the county level.
(c) Upon transfer of program eligibility determinations to the
county level, the collection of family contributions and
participating health plan selection may continue to be contracted to
a private entity. In order to maximize efficiency, it is the intent
of the Legislature that plan selection and collection of
contributions be incorporated, to the extent possible, into the
Medi-Cal managed care enrollment broker contract administered by the
State Department of Health Care Services.
SEC. 3. Part 6.25 (commencing with Section
12694.10) is added to Division 2 of the Insurance Code, to read:
PART 6.25. CAL-HEALTH PROGRAM
12694.10. It shall be the responsibility of the State of
California to make its best efforts to provide that all persons who
are eligible for the Healthy Families Program or the Medi-Cal
program, or other governmental health care coverage or assistance,
are enrolled in programs and services for which they are eligible.
12694.11. There is hereby created the California Health Care
Program (Cal-Health) to coordinate the Medi-Cal program (Chapter 7
(commencing with Section 14000) of Part 3 of Division 9 of the
Welfare and Institutions Code) and the Healthy Families Program (Part
6.2 (commencing with Section 12693)) for the purpose of marketing to
those who are potentially eligible for a single unified program in
an attempt to reduce possible confusion. The duties and functions of
establishing Cal-Health shall be carried out by the Secretary of
California Health and Human Services, with the assistance of the
State Department of Health Care Services, which is defined for the
purposes of this part as the "department," and the Managed Risk
Medical Insurance Board, which is defined for the purposes of this
part as the "board," and the county welfare departments, which are
defined for the purposes of this part as the "counties." The
coordinated Medi-Cal and Healthy Families programs established by
this part shall be known as Cal-Health.
12694.13. (a) The department and board, in consultation with the
counties and client advocates, shall make any changes necessary to
the existing Medi-Cal and Healthy Families joint application in order
to enable persons to apply for benefits under the Cal-Health
structure.
(b) The department and board, in consultation with the counties,
provider representatives, and client advocates, shall develop an
electronic process by which participating providers may screen and
temporarily enroll eligible children into the Medi-Cal program or the
Healthy Families Program, as provided in subdivisions (c) and (d).
During the period of temporary enrollment, providers shall be
reimbursed for services to the same extent as if the eligible child
were fully enrolled in the program in which he or she is temporarily
enrolled. A purpose of temporary enrollment under this section is to
facilitate and accelerate the final eligibility determination by the
counties.
(c) To the extent permitted by Section 1396r-1a of Title 42 of the
United States Code and Section 457.355 of Title 42 of the Code of
Federal Regulations, the state shall exercise its option to allow
participating providers to screen and temporarily enroll a child who
meets initial screening requirements into the Medi-Cal program or the
Healthy Families Program for 60 days pending a final eligibility
determination by the counties. No child shall be temporarily enrolled
into a program more than one time during a 12-month period. The
procedures governing the preenrollment process for the Medi-Cal
program and the Healthy Families Program pursuant to Section 14011.7
of the Welfare and Institutions Code, including, but not limited to,
the requirement that providers be certified by the state and that a
Medi-Cal application be submitted on the child's behalf within 60
days after the date the child is temporarily enrolled into the
programs shall be used to implement the temporary enrollment of
children under this section.
(d) The Cal-Health enrollment and application process shall secure
sufficient information to ensure that the counties are able to
perform screening and referral for children not eligible for programs
within Cal-Health, but potentially eligible for other state health
care programs.
12694.15. To the extent permitted by federal law and
notwithstanding any other provision of law, there shall not be an
assets test for Section 1931(b) of the Medi-Cal program for adults
and children.
12694.17. Preschools and public elementary and secondary schools,
with respect to each enrolled child, shall inform the parent or
primary caretaker living with the child at least once each year about
Cal-Health and its eligibility requirements, and shall allow an
application to be submitted at the preschool or school.
12694.18. (a) All licensed hospitals, clinics, and other health
facilities shall inform the parent or primary caretaker of a child
who is seen or admitted about Cal-Health and its eligibility
requirements at the time the person or child is seen or admitted, and
may participate in the temporary eligibility and accelerated
enrollment process described in Section 12694.13.
(b) In the case of urgent or emergency services, parents and
primary caretakers of a child shall be informed about Cal-Health and
given an opportunity to apply on behalf of eligible children after
services have been rendered and, in the case of inpatient admission,
during discharge planning.
SEC. 4. Section 14005.30 of the Welfare and
Institutions Code is amended to read:
14005.30. (a) (1) To the extent that federal financial
participation is available, Medi-Cal benefits under this chapter
shall be provided to individuals eligible for services under Section
1396u-1 of Title 42 of the United States Code, including any options
under Section 1396u-1(b)(2)(C) made available to and exercised by the
state.
(2) The department shall exercise its option under Section 1396u-1
(b)(2)(C) of Title 42 of the United States Code to adopt less
restrictive income and resource eligibility standards and
methodologies to the extent necessary to allow all recipients of
benefits under Chapter 2 (commencing with Section 11200) to be
eligible for Medi-Cal under paragraph (1).
(3) To the extent federal financial participation is available,
the department shall exercise its option under Section 1396u-1(b)(2)
(C) of Title 42 of the United States Code authorizing the state to
disregard all changes in income or assets of a beneficiary until the
next annual reaffirmation under Section 14012. The department shall
implement this paragraph only if, and to the extent that the federal
State Child Health Insurance Program waiver described in Section
12693.755 of the Insurance Code extending Healthy Families Program
eligibility to parents and certain other adults is approved and
implemented.
(b) To the extent that federal financial participation is
available, the department shall exercise its option under Section
1396u-1(b)(2)(C) of Title 42 of the United States Code as necessary
to simplify eligibility for Medi-Cal under subdivision (a) by
exempting all resources.
(c) To the extent federal financial participation is available,
the department shall adopt an income disregard for applicants equal
to the difference between the income standard under the program
adopted pursuant to Section 1931(b) of the federal Social Security
Act (42 U.S.C. Sec. 1396u-1) and the amount equal to 133 percent of
the federal poverty level applicable to the size of the family. A
recipient shall be entitled to the same disregard, but only to the
extent it is more beneficial than, and is substituted for, the earned
income disregard available to recipients.
(d) For purposes of calculating income under this section during
any calendar year, increases in social security benefit payments
under Title II of the federal Social Security Act (42 U.S.C. Sec. 401
et seq.) arising from cost-of-living adjustments shall be
disregarded commencing in the month that these social security
benefit payments are increased by the cost-of-living adjustment
through the month before the month in which a change in the federal
poverty level requires the department to modify the income disregard
pursuant to subdivision (c) and in which new income limits for the
program established by this section are adopted by the department.
(e) 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, without taking regulatory action,
subdivisions (a) and (b) by means of an all county letter or similar
instruction. 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. Beginning six months after the effective date of this section,
the department shall provide a status report to the Legislature on a
semiannual basis until regulations have been adopted.
SEC. 5. Section 14011.6 of the Welfare and
Institutions Code is amended to read:
14011.6. (a) To the extent federal financial participation is
available, the department shall exercise the option provided in
Section 1920a of the federal Social Security Act (42 U.S.C. Sec.
1396r-1a) to implement a program for accelerated enrollment of
children and pregnant women.
(b) The department shall designate each county welfare department
as a qualified entity for determining eligibility under this section.
(c) The single point of entry, as defined in subdivision (d),
shall route any applications it receives directly to the appropriate
county for an accelerated eligibility determination pursuant to this
section.
(d) For purposes of this section, "single point of entry" means
the centralized processing entity that accepts and screens
applications for benefits under the Medi-Cal program for the purpose
of forwarding them to the appropriate counties.
(e) The department shall implement this section only if, and to
the extent that, federal financial participation is available.
(f) The department shall seek federal approval of any state plan
amendments necessary to implement this section. When federal approval
of the state plan amendment or amendments is received, the
department shall commence implementation of this section on the first
day of the second month following the month in which federal
approval of the state plan amendment or amendments is received, or on
July 1, 2010, whichever is later.
(g) Notwithstanding Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code, the
department shall, without taking any regulatory action, implement
this section by means of all-county letters. 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.
(h) Upon the receipt of an application for a child or a pregnant
woman from the single point of entry pursuant to subdivision (c)
directly from a parent, or from another source on behalf of the
child, or from a pregnant woman, a county shall determine whether the
child or pregnant woman appears eligible for Medi-Cal benefits and,
if so, grant accelerated enrollment to the child or pregnant woman.
Upon the granting of accelerated enrollment for a child or pregnant
woman, the county shall determine whether the child or pregnant woman
is eligible for Medi-Cal benefits. If the county determines that the
child or pregnant woman does not meet the eligibility requirements
for participation in the Medi-Cal program, the county shall report
this finding to the Medical Eligibility Data System so that
accelerated enrollment coverage benefits are discontinued and shall
determine whether the child or pregnant woman is eligible for the
Healthy Families Program.
SEC. 2. Section 14011.61 is added to the
Welfare and Institutions Code , to read:
14011.61. (a) To the extent federal financial participation is
available, the department shall exercise the option provided in
Section 1920a of the federal Social Security Act (42 U.S.C. Sec.
1396r-1a) to implement a program for accelerated enrollment of
children and pregnant women.
(b) The department shall designate each county welfare department
as a qualified entity for determining eligibility under this section.
(c) The department shall implement this section only if, and to
the extent that, federal financial participation is available.
(d) The department shall seek federal approval of any state plan
amendments necessary to implement this section. When federal approval
of the state plan amendment or amendments is received, the
department shall commence implementation of this section on the first
day of the second month following the month in which federal
approval of the state plan amendment or amendments is received, or on
July 1, 2010, whichever is later.
(e) Notwithstanding Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code, the
department shall, without taking any regulatory action, implement
this section by means of all-county letters. 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.
(f) Upon the receipt of an application for a child directly from
the pregnant woman or another source on behalf of the child, or an
application for a pregnant woman directly from the parent or another
source on behalf of the pregnant woman, the county shall determine
whether the child or pregnant woman appears eligible for Medi-Cal
benefits and, if so, grant accelerated enrollment to the child or
pregnant woman. Upon the granting of accelerated enrollment for a
child or pregnant woman, the county shall determine whether the child
or pregnant woman is eligible for Medi-Cal benefits. If the county
determines that the child or pregnant woman does not meet the
eligibility requirements for participation in the Medi-Cal program,
the county shall report this finding to the Medical Eligibility Data
System so that accelerated enrollment coverage benefits are
discontinued.
SEC. 6. SEC. 3. 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.
