BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SB 1616
                                                                  Page  1

          Date of Hearing:   June 27, 2006
          Counsel:               Heather Hopkins


                         ASSEMBLY COMMITTEE ON PUBLIC SAFETY
                                  Mark Leno, Chair

                    SB 1616 (Kuehl) - As Amended:  April 17, 2006
                       As Proposed to be Amended in Committee


           SUMMARY  :   Requires the Division of Juvenile Facilities (DJJ) of  
          the Department of Corrections and Rehabilitation to work with  
          the Social Security Administration (SSA) and the Department of  
          Health Services (DHS) to ensure that disabled wards are enrolled  
          in Medi-Cal and that their disability benefits are available to  
          them when they are released from incarceration at a state  
          institution.  Specifically,  this bill  : 

          1)Requires DJJ to do all of the following with respect to a ward  
            with a disability:  

             a)   Identify any ward who is likely to be eligible for the  
               Medi-Cal program upon release and was not enrolled in  
               Medi-Cal prior to incarceration, and to ensure that ward  
               applies for Medi-Cal no less than 90 days before the date  
               of his or her scheduled release;   

             b)   Notify DHS regarding each ward who is determined by DJJ  
               to be likely to be eligible for Medi-Cal; 

             c)   Notify the parent or guardian of its intention to ensure  
               the submission of the information pursuant to Item 1(a)  
               above to the county welfare department (CWD), and to  
               provide a reasonable amount of time to opt out of the  
               Medi-Cal eligibility determination; and, 

             d)   Make sure that each ward who has been determined to be  
               eligible for Medi-Cal benefits by DHS possesses a Medi-Cal  
               card or temporary Medi-Cal documentation at the time of his  
               or her release from incarceration.  

          2)States that for purposes of this bill, a ward is "likely to be  
            eligible for Medi-Cal benefits" if any of the following  
            applies: 








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             a)   The ward's enrollment in the Medi-Cal program was  
               terminated during his or her incarceration; 

             b)   The ward was enrolled in the Medi-Cal program at any  
               time during the five years prior to his or her  
               incarceration; or, 

             c)   The ward was not previously enrolled, but is likely to  
               meet eligibility criteria, in the Medi-Cal program upon his  
               or her release from incarceration.

          3)Requires DJJ to do all of the following with respect to  
            supplemental security income (SSI) and social security  
            disability insurance (SSDI) benefits: 

             a)   Request the federal SSA to suspend, rather than  
               terminate, the benefits of a ward who is enrolled in SSI or  
               SSDI program while he or she is incarcerated, and notify  
               SSA of his or her scheduled release date; 

             b)   Ensure, when SSI or SSDI benefits are suspended or  
               terminated, that an application for reinstatement of  
               benefits is submitted no less than 90 days before the date  
               of the ward's release; 

             c)   Identify any ward with a disability who is likely to be  
               eligible for SSI or SSDI upon release but was not enrolled  
               prior to incarceration, and to ensure that each of the  
               following occurs:  

               i)     An application is filed on the ward's behalf no less  
                 than 90 days before his or her scheduled release from  
                 incarceration; and,  

               ii)          The ward possesses a copy of the application  
                 at the time of his or her release.

             d)   Provide a copy of each application to a family member  
               designated by the applicant and to any mental health case  
               worker who will work with the youth upon release.  States  
               that permission is not required to provide a copy to a  
               parent or guardian in the case of a minor under the age of  
               16 years; and, 









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             e)   Use its best efforts to negotiate pre-release agreements  
               with SSA to ensure that SSA considers applications  
               expeditiously.  

          4)States that "enrolled in the SSI or SSDI program" is defined  
            as currently eligible as determined by SSA pursuant to SSI or  
            SSDI program rules, and on eligibility rolls, even if cash  
            benefits are currently suspended.

          5)States that, for purposes of this bill, a ward is "likely to  
            be eligible for SSI or SSDI benefits" if any of the following  
            applies: 

             a)   The ward's enrollment in the SSI or SSDI program was  
               terminated during his or her incarceration; 

             b)   The ward was enrolled in the SSI or SSDI program at any  
               time during the five years prior to his or her  
               incarceration; or, 

             c)   The ward was not previously enrolled, but is likely to  
               meet eligibility criteria, in the SSI or SSDI program upon  
               his or her release from incarceration.

          6)Requires DHS, with respect to an incarcerated youth with a  
            disability who was enrolled in the Medi-Cal program prior to  
            incarceration, to do both of the following: 

             a)   Suspend, rather than terminate, eligibility for Medi-Cal  
               if permitted under federal law; and, 

             b)   Restore Medi-Cal eligibility when such a youth is  
               released from incarceration.  

          7)Requires DHS, with respect to an incarcerated youth with a  
            disability who applies for Medi-Cal while incarcerated, to  
            review the application within 14 days of its receipt.   
            Requires DHS, if DHS has not completed an application review  
            prior to a ward's release and if DJJ has determined that the  
            ward is likely to be eligible for Medi-Cal, to issue a  
            temporary Medi-Cal document that establishes eligibility to  
            the youth prior to his or her release.

          8)Requires a CWD, when a youth with a disability is found to be  
            ineligible for Medi-Cal, to forward information to the  








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            appropriate entity to determine if the ward is eligible for  
            the Healthy Families Program or another appropriate health  
            coverage program.

          9)Requires DHS to convene a group of interested parties to help  
            implement this bill.  Requires DJJ and DHS to collaborate in  
            the development of regulations, policies and procedures to  
            implement this bill.  

          10)   Requires DHS to use its best efforts to obtain any  
            Medi-Cal state plan amendment necessary to implement this  
            bill.  States that the Medi-Cal provisions of this bill will  
            apply only to the extent that federal financial participation  
            (FFP) is available.

          11)   Permits DHS to implement this bill using provider  
            bulletins and all county letters rather than regulations.  

          12)   Defines "ward" and "incarcerated youth" for purposes of  
            this bill to as a person in the custody of DJJ.

           EXISTING LAW  :

          1)Establishes the Medi-Cal program, administered by DHS, which  
            provides comprehensive health benefits to low-income children,  
            their parents or caretaker relatives, pregnant women, elderly,  
            blind or disabled persons, nursing home residents and  
            refugees, who meet specified eligibility criteria.

          2)States that Medi-Cal benefits do not include care or services  
            for any individual who is an inmate of an institution (except  
            as a patient in a medical institution), except to the extent  
            permitted by federal law.

          3)Prohibits, notwithstanding any other provision of law, the  
            denial of Medi-Cal benefits to any person for whom FFP is  
            available solely because such person is incarcerated in a  
            county or city jail or juvenile detention facility. 

          4)States, under California regulations, that individuals who are  
            inmates of public institutions are not eligible for Medi-Cal.

           FISCAL EFFECT  :   Unknown

           COMMENTS  :   








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           1)Author's Statement  :  According to the author, "Ensuring that  
            incarcerated youth who are eligible for federal benefits have  
            access to those benefits will reduce recidivism and enhances  
            public safety - and provides these youth with a fair chance to  
            succeed after their release."

           2)Scope of the Problem  :  According to background provided by the  
            author's office, "Each year, more than 2,000 youth are  
            released from DJJ, formerly the 'California Youth Authority'  
            (CYA).  Many of these youth suffer from severe mental health  
            problems and disabilities, which hamper their successful  
            reentry into their communities.  In fact, CYA estimated in  
            2001 that 71% of male wards have three to five diagnosable  
            mental health disorders and 82% of female wards have three to  
            nine diagnosable disorders.  Further, 85% have substance abuse  
            problems.  In order to successfully reintegrate into their  
            communities, these youth must have immediate access, upon  
            their release, to vital benefits and services for which they  
            are eligible, such as Medi-Cal and Supplemental Security  
            Income.  However, at the present time, little effort is made  
            to ensure that youth who are receiving these benefits at the  
            time they are locked up retain their eligibility for them  
            during incarceration so they may start receiving them  
            immediately upon release, or to ensure that applications are  
            processed prior to release for youth who are likely to be but  
            not yet deemed eligible for benefits.  Not surprisingly,  
            because inadequate efforts are made to obtain benefits for  
            youth that are necessary for them to succeed in the community,  
            76% of these youth are re-arrested within 42 months of  
            release.

          "Ensuring that incarcerated youth have immediate access to  
            health care and cash assistance upon release will help ensure  
            successful reentry into their communities and reduce  
            recidivism in California.  In fact, recent studies have shown  
            that youth who receive structured and meaningful mental health  
            treatment have recidivism rates 25% lower than those that go  
            untreated.  The most successful mental health programs have  
            been shown to reduce recidivism rates up to 80%.  Further,  
            these federal benefits will save California money in caring  
            for these vulnerable youth, while increasing the quality and  
            level of services they receive. 

          "The Fair Chance Act will assist youth with disabilities in  








                                                                  SB 1616
                                                                  Page  6

            maintaining their eligibility for Medi-Cal and SSI benefits  
            while they are incarcerated and in applying for benefits so  
            that, upon release, all eligible youth with disabilities  
            immediately begin to receive the benefits for which they are  
            eligible by directing DJJ and DHS to adopt policies and  
            procedures that enable youth with disabilities, upon release  
            from incarceration, to participate in federal/state benefit  
            programs for which they qualify and directing DJJ and DHS to  
            expeditiously reinstate and/or enroll youth with disabilities  
            in federal/state benefit programs for which they are eligible  
            immediately upon their release.

          "By instituting these changes, the Fair Chance Act will greatly  
            improve outcomes for youth, ensure that more youth  
            successfully reintegrate into their communities, and reduce  
            recidivism in California."  

           3)Related Legislation  :

             a)   AB 2004 (Yee) requires DHS, in the case of a minor who  
               has been incarcerated, to suspend the minor's Medi-Cal  
               benefits but not terminate the minor's Medi-Cal  
               eligibility; to ensure that such minors receive all health  
               care benefits for which they are eligible immediately on  
               release from incarceration; and to take all necessary  
               action to ensure that the Medi-Cal application of a minor  
               not previously been determined to be eligible for Medi-Cal  
               and enable the minor, if eligible, to receive Medi-Cal  
               covered services immediately upon release from  
               incarceration.   AB 2004 applies to juvenile incarceration  
               in state or county facilities.  AB 2004 pending hearing by  
               the Senate Health Committee.  

             b)   SB 1469 (Cedillo) requires notifying the CWD when a  
               juvenile is released from state custody so that the CWD can  
               determine if the individual is eligible for Medi-Cal or  
               Healthy Families.  SB 1469, pending hearing by the Assembly  
               Appropriations Committee, is limited to juveniles in county  
               facilities and imposes requirements primarily on CWDs.  

             c)   AB 1945 (Coto) requires a juvenile detention facility,  
               when a minor is released from custody, to determine if the  
               minor will have health insurance after release, and if the  
               minor will not, to evaluate the eligibility of the minor  
               for enrollment in appropriate need-based programs.  AB 1945  








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               was held by the author in the Assembly Health Committee.

           REGISTERED SUPPORT / OPPOSITION  :

           Support 
           
          National Center for Youth Law (Sponsor)
          Association of Regional Center Agencies
          California Medical Association
          California National Organization of Women
          California Psychiatric Association
          California Public Defenders Association
          Chief Probation Officers
          Children's Advocacy Institute
          Commission on the Status of Women
          Fight Crime Invest in Kids California
          National Association for the Mentally Ill
          National Association of Social Workers
          Solano County Board of Supervisors
          Youth Law Center 
           
            Opposition 
           
          None on file


           Analysis Prepared by  :    Heather Hopkins / PUB. S. / (916)  
          319-3744