BILL NUMBER: SB 32 AMENDED
BILL TEXT
AMENDED IN SENATE MAY 24, 2007
AMENDED IN SENATE MAY 2, 2007
AMENDED IN SENATE APRIL 19, 2007
AMENDED IN SENATE MARCH 28, 2007
INTRODUCED BY Senator Steinberg
(Principal coauthor: Assembly Member Laird)
( Coauthor: Senator Alquist
)
(Coauthor: Assembly Member Wolk)
DECEMBER 4, 2006
An act to amend Sections 12693.43 and 12693.70
, 12693.70, 12693.76, 12693.98, and 12693.98a of, to amend
and repeal Section 12693.981 of, to add Sections 12693.55, 12693.56,
12693.57, 12693.701, 12693.981a, and 12693.983 to, to add Chapter
16.2 (commencing with Section 12694.1) to Part 6.2 of Division 2 of,
and to repeal Section 12693.73 of, the Insurance Code, and to amend
Section 14005.23 of, and to add Sections 14005.26, 14011.01, and
14011.61 to, the Welfare and Institutions Code, relating to health
care coverage.
LEGISLATIVE COUNSEL'S DIGEST
SB 32, as amended, Steinberg. Health care coverage: children.
(1) Existing law establishes various public programs to provide
health care coverage to eligible children, including the Medi-Cal
program administered by the State Department of Health Care Services
and county welfare agencies, and the Healthy Families Program
administered by the Managed Risk Medical Insurance Board. Children
through 18 years of age are eligible for health care coverage under
these programs if they meet certain household income and other
criteria including specified citizenship and immigration status
requirements. Under existing law, the applicant's signed statement as
to the value or amount of income is accepted for eligibility
purposes under the Healthy Families Program if documentation cannot
otherwise be provided.
This bill would expand eligibility for the Medi-Cal program and
would expand eligibility for the Healthy Families Program by allowing
children with family incomes at or below 300% of the federal poverty
level to qualify for the program and would delete the specified
citizenship and immigration status requirements. The bill would
accept the applicant's signature on the application for the Healthy
Families Program as verification of the value or amount of income for
purposes of establishing eligibility for the program. The bill would
create the Healthy Families Buy-In Program that would be
administered by the Managed Risk Medical Insurance Board and would
make the coverage provided under the Healthy Families Program
available to children whose household income exceeds 300% of the
federal poverty level and who meet other specified criteria. The bill
would specify the family contribution required for children enrolled
in the buy-in program. The bill would also make various related
modifications to the Medi-Cal program and the Healthy Families
Program and would require the State Department of
Health Care Services and the Managed Risk Medical Insurance Board to
maximize federal matching funds for the Medi-Cal program and the
Healthy Families Program . Because the expansion of and
modifications to the Medi-Cal program would impose certain duties on
counties relative to administration of that program, the bill would
impose a state-mandated local program. The bill would require the
Managed Risk Medical Insurance Board and the State Department of
Health Care Services to take specified actions to improve and
coordinate the application and enrollment processes for the Medi-Cal
program and the Healthy Families Program and to develop a process to
transition the enrollment of children from local children's health
initiatives into those programs.
(2) Existing law establishes the Healthy Families-to-Medi-Cal
Bridge Benefits Program to provide any person enrolled for coverage
under the Healthy Families Program who meets certain criteria, as
specified, with 2 calendar months of health care benefits in order to
provide the person with the opportunity to apply for the Medi-Cal
program.
This bill would establish the Healthy Families to Medi-Cal
Presumptive Eligibility Program to provide a child who meets certain
criteria, as specified, with presumptive eligibility benefits
identical to the full scope of benefits provided under the Medi-Cal
program until a Medi-Cal eligibility determination is made, at which
point either the child would be enrolled in the Medi-Cal program with
no interruption in coverage or the presumptive eligibility benefits
would terminate in accordance with due process requirements. The bill
would require the Managed Risk Medical Insurance Board to execute a
declaration upon implementation of this program and would make the
Healthy Families-to-Medi-Cal Bridge Benefits Program inoperative as
of the date of that declaration.
(3) Existing law establishes the Healthy Families Presumptive
Eligibility Program, administered by the Managed Risk Medical
Insurance Board, to provide a child who satisfies specified criteria
health care benefits while the board determines the child's
eligibility for the Healthy Families Program.
This bill would rename the program the Medi-Cal to Healthy
Families Presumptive Eligibility Program and would require the
Managed Risk Medical Insurance Board and the State Department of
Health Care Services to monitor the program to ensure c
hildren are timely enrolled in the presumptive eligibility benefits
for which they are eligible.
(4) Existing law requires the state to
administer, to the extent allowed under federal law, and only if
federal financial participation is available, a program to provide a
child who meets specified eligibility requirements, including the
income requirements of the Healthy Families Program, with benefits
identical to full scope benefits under the Medi-Cal program with no
share of cost for the period during which the child has an
application pending for coverage under the Healthy Families Program.
This bill would establish, to the extent allowed by federal law
and to the extent federal financial participation is available, the
Medi-Cal Presumptive Eligibility Program that would provide a child
who meets specified eligibility requirements with presumptive
eligibility benefits identical to full scope benefits under the
Medi-Cal program with no share of cost until the child is found
eligible for the Medi-Cal program. The bill would require the county
to forward the child's application to the Healthy Families Program if
it finds the child eligible for the Medi-Cal program with a share of
cost.
(4)
(5) Existing law creates the Healthy Families Fund, and
provides that money in the fund is continuously appropriated for
purposes of the Healthy Families Program.
This bill would provide that the Managed Risk Medical Insurance
Board may implement the provisions of the bill expanding the Healthy
Families Program only to the extent that funds are appropriated for
those purposes in the annual Budget Act or in another statute.
(5)
(6) 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. It is the intent of the Legislature to accomplish the
following:
(a) Allow all children, from birth to 19 years of age, living in
California to have access to affordable, comprehensive health care
coverage.
(b) Build upon the successful aspects of California's publicly
funded state health care coverage programs, the Healthy Families
Program and the Medi-Cal program, and improve their operations,
including modernizing and simplifying the processes of enrolling all
eligible children in coverage and maintaining their enrollment in the
programs.
(c) Build upon the lessons and successes of local children's
health initiatives.
(d) Support coverage for children currently enrolled in local
children's health initiatives until the expansion of the statewide
program is fully implemented and provide for a smooth transition for
these children into the Healthy Families Program and the Medi-Cal
program.
(e) Ensure sustainable financing that supports the statewide
programs over the long term, including maximizing federal funding for
those programs.
SEC. 2. Section 12693.43 of the Insurance Code is amended to read:
12693.43. (a) Applicants applying to the purchasing pool shall
agree to pay family contributions, unless the applicant has a family
contribution sponsor. Family contribution amounts consist of the
following two components:
(1) The flat fees described in subdivision (b) or (d).
(2) Any amounts that are charged to the program by participating
health, dental, and vision plans selected by the applicant that
exceed the cost to the program of the highest cost family value
package in a given geographic area.
(b) In each geographic area, the board shall designate one or more
family value packages for which the required total family
contribution is:
(1) Seven dollars ($7) per child with a maximum required
contribution of fourteen dollars ($14) per month per family for
applicants with annual household incomes up to and including 150
percent of the federal poverty level.
(2) Nine dollars ($9) per child with a maximum required
contribution of twenty-seven dollars ($27) per month per family for
applicants with annual household incomes greater than 150 percent and
up to and including 200 percent of the federal poverty level and for
applicants on behalf of children described in clause (ii) of
subparagraph (A) of paragraph (6) of subdivision (a) of Section
12693.70.
(3) On and after July 1, 2005, fifteen dollars ($15) per child
with a maximum required contribution of forty-five dollars ($45) per
month per family for applicants with annual household income greater
than 200 percent and up to and including 250 percent of the federal
poverty level.
(4) Twenty-two dollars and fifty cents ($22.50) per child with a
maximum required contribution of sixty-seven dollars and fifty cents
($67.50) per month per family for applicants with an annual household
income greater than 250 percent and up to and including 300 percent
of the federal poverty level.
(c) Combinations of health, dental, and vision plans that are more
expensive to the program than the highest cost family value package
may be offered to and selected by applicants. However, the cost to
the program of those combinations that exceeds the price to the
program of the highest cost family value package shall be paid by the
applicant as part of the family contribution.
(d) The board shall provide a family contribution discount to
those applicants who select the health plan in a geographic area that
has been designated as the Community Provider Plan. The discount
shall reduce the portion of the family contribution described in
subdivision (b) to the following:
(1) A family contribution of four dollars ($4) per child with a
maximum required contribution of eight dollars ($8) per month per
family for applicants with annual household incomes up to and
including 150 percent of the federal poverty level.
(2) Six dollars ($6) per child with a maximum required
contribution of eighteen dollars ($18) per month per family for
applicants with annual household incomes greater than 150 percent and
up to and including 200 percent of the federal poverty level and for
applicants on behalf of children described in clause (ii) of
subparagraph (A) of paragraph (6) of subdivision (a) of Section
12693.70.
(3) On and after July 1, 2005, twelve dollars ($12) per child with
a maximum required contribution of thirty-six dollars ($36) per
month per family for applicants with annual household income greater
than 200 percent and up to and including 250 percent of the federal
poverty level.
(4) Sixteen dollars ($16) per child with a maximum required
contribution of forty-eight dollars ($48) per month per family for
applicants with an annual household income greater than 250 percent
and up to and including 300 percent of the federal poverty level.
(e) Applicants, but not family contribution sponsors, who pay
three months of required family contributions in advance shall
receive the fourth consecutive month of coverage with no family
contribution required.
(f) Applicants, but not family contribution sponsors, who pay the
required family contributions by an approved means of electronic fund
transfer shall receive a 25-percent discount from the required
family contributions.
(g) It is the intent of the Legislature that the family
contribution amounts described in this section comply with the
premium cost sharing limits contained in Section 2103 of Title XXI of
the Social Security Act. If the amounts described in subdivision (a)
are not approved by the federal government, the board may adjust
these amounts to the extent required to achieve approval of the state
plan.
(h) The adoption and one readoption of regulations to implement
paragraph (3) of subdivision (b) and paragraph (3) of subdivision (d)
shall be deemed to be an emergency and necessary for the immediate
preservation of public peace, health, and safety, or general welfare
for purposes of Sections 11346.1 and 11349.6 of the Government Code,
and the board is hereby exempted from the requirement that it
describe specific facts showing the need for immediate action and
from review by the Office of Administrative Law. For purposes of
subdivision (e) of Section 11346.1 of the Government Code, the
120-day period, as applicable to the effective period of an emergency
regulatory action and submission of specified materials to the
Office of Administrative Law, is hereby extended to 180 days.
SEC. 3. Section 12693.55 is added to the Insurance Code, to read:
12693.55. The board and the State Department of Health Care
Services shall maximize federal matching funds available under
the program and the Medi-Cal program and shall implement
strategies that coordinate and integrate other programs that provide
health care coverage for children to maximize federal matching funds
and efficiently use state funds. , such as
matching funds available for emergency or pregnancy-related benefits
under the Medi-Cal program for all eligible children.
SEC. 4. Section 12693.56 is added to the Insurance Code, to read:
12693.56. The confidentiality and privacy protections of Sections
10500 and 14100.2 of the Welfare and Institutions Code shall apply
to all children seeking, applying for, or enrolled in, the program.
SEC. 5. Section 12693.57 is added to the Insurance Code, to read:
12693.57. Upon implementation of Section 14005.26 of the Welfare
and Institutions Code and Section 12693.701, the board, in
consultation with the State Department of Health Care Services, shall
develop a process for the transition of eligible children from local
children's health initiatives to the Medi-Cal program and to the
Healthy Families Program. The process shall include, but not be
limited to, the following provisions:
(a) A child enrolled in comprehensive health care coverage
provided by a children's health initiative shall, upon his or her
annual renewal date, be automatically enrolled in the Medi-Cal
program or the Healthy Families Program, if an application is made
and the child is eligible for either program. The child shall be
enrolled in the same health plan that provided coverage to the child
under the local children's health initiative, if the health plan is a
participating plan in the Medi-Cal program or the Healthy Families
Program.
(b) Upon a child's enrollment in the Medi-Cal program or in the
Healthy Families Program, the department or the board shall
immediately notify the child's family that it may change coverage to
another health plan. The family may make this change at any time
within 90 days from the date of its receipt of this notice.
SEC. 6. Section 12693.70 of the Insurance Code is amended to read:
12693.70. To be eligible to participate in the program, an
applicant shall meet all of the following requirements:
(a) Be an applicant applying on behalf of an eligible child, which
means a child who is all of the following:
(1) Less than 19 years of age. An application may be made on
behalf of a child not yet born up to three months prior to the
expected date of delivery. Coverage shall begin as soon as
administratively feasible, as determined by the board, after the
board receives notification of the birth. However, no child less than
12 months of age shall be eligible for coverage until 90 days after
the enactment of the Budget Act of 1999.
(2) Not eligible for no-cost full-scope Medi-Cal or Medicare
coverage at the time of application.
(3) In compliance with Sections 12693.71 and 12693.72.
(4) A resident of the State of California pursuant to Section 244
of the Government Code; or, if not a resident pursuant to Section 244
of the Government Code, is physically present in California and
entered the state with a job commitment or to seek employment,
whether or not employed at the time of application to or after
acceptance in, the program.
(5) (A) In either of the following:
(i) In a family with an annual or monthly household income equal
to or less than 200 percent of the federal poverty level.
(ii) When implemented by the board, subject to subdivision (b) of
Section 12693.765 and pursuant to this section, a child under the age
of two years who was delivered by a mother enrolled in the Access
for Infants and Mothers Program as described in Part 6.3 (commencing
with Section 12695). Commencing July 1, 2007, eligibility under this
subparagraph shall not include infants during any time they are
enrolled in employer-sponsored health insurance or are subject to an
exclusion pursuant to Section 12693.71 or 12693.72, or are enrolled
in the full scope of benefits under the Medi-Cal program at no share
of cost. For purposes of this clause, any infant born to a woman
whose enrollment in the Access for Infants and Mothers Program begins
after June 30, 2004, shall be automatically enrolled in the Healthy
Families Program, except during any time on or after July 1, 2007,
that the infant is enrolled in employer-sponsored health insurance or
is subject to an exclusion pursuant to Section 12693.71 or 12693.72,
or is enrolled in the full scope of benefits under the Medi-Cal
program at no share of cost. Except as otherwise specified in this
section, this enrollment shall cover the first 12 months of the
infant's life. At the end of the 12 months, as a condition of
continued eligibility, the applicant shall provide income
information. The infant shall be disenrolled if the gross annual
household income exceeds the income eligibility standard that was in
effect in the Access for Infants and Mothers Program at the time the
infant's mother became eligible, or following the two-month period
established in Section 12693.981 or the period established in Section
12693.981a if the infant is eligible for Medi-Cal with no share of
cost. At the end of the second year, infants shall again be screened
for program eligibility pursuant to this section, with income
eligibility evaluated pursuant to clause (i), subparagraphs (B) and
(C), and paragraph (2) of subdivision (a).
(B) All income over 200 percent of the federal poverty level but
less than or equal to 300 percent of the federal poverty level shall
be disregarded in calculating annual or monthly household income.
(C) In a family with an annual or monthly household income greater
than 300 percent of the federal poverty level, any income deduction
that is applicable to a child under Medi-Cal shall be applied in
determining the annual or monthly household income. If the income
deductions reduce the annual or monthly household income to 300
percent or less of the federal poverty level, subparagraph (B) shall
be applied.
(b) The applicant shall agree to remain in the program for six
months, unless other coverage is obtained and proof of the coverage
is provided to the program.
(c) An applicant shall enroll all of the applicant's eligible
children in the program.
(d) In providing information to meet program eligibility
requirements, the applicant's signature on the application shall be
deemed to constitute verification of the applicant's value or amount
of income.
(e) An applicant shall pay in full any family contributions owed
in arrears for any health, dental, or vision coverage provided by the
program within the prior 12 months.
(f) By January 2008, the board, in consultation with stakeholders,
shall implement processes by which applicants for subscribers may
certify income at the time of annual eligibility review, including
rules concerning which applicants shall be permitted to certify
income and the circumstances in which supplemental information or
documentation may be required. The board may terminate using these
processes not sooner than 90 days after providing notification to the
Chair of the Joint Legislative Budget Committee. This notification
shall articulate the specific reasons for the termination and shall
include all relevant data elements that are applicable to document
the reasons for the termination. Upon the request of the Chair of the
Joint Legislative Budget Committee, the board shall promptly provide
any additional clarifying information regarding implementation of
the processes required by this subdivision.
SEC. 7. Section 12693.701 is added to the Insurance Code, to read:
12693.701. (a) (1) Notwithstanding any
other provision of law, a child all chil
dren under 19 years of age who meets
meet the state residency requirements of the
Medi-Cal program or the Healthy Families Program shall be eligible
for either the Medi-Cal program (Chapter 7 (commencing with
Section 14000) of Part 3 of Division 9 of the Welfare and
Institutions Code) if he or she meets the income and resource
requirements of Section 14005.7 or 14005.30 of the Welfare and
Institutions Code or the Healthy Families Program if he or she lives
in a family with a household income at or below 300 percent of the
federal poverty level, including for both health
coverage in accordance with subdivision (b) if they satisfy either of
the following criteria:
(A) Live in families with countable household income at or below
300 percent of the federal poverty level.
(B) Meet the income requirements of Section 14005.7 of the Welfare
and Institutions Code or the income and resource requirements of
Section 14005.30 of the Welfare and Institutions Code.
(2) The eligibility under paragraph (1)
includes for both programs those children for whom federal
financial participation is not available under Title XIX of the
federal Social Security Act (42 U.S.C. Sec. 1396 et seq.), or under
Title XXI of the federal Social Security Act (42 U.S.C. Sec. 1397aa
et seq.).
(b) A child described in subdivision (a) who is ineligible for the
full scope of benefits under the Medi-Cal program at no share of
cost because of his or her family's household income shall be
eligible for the Healthy Families Program if he or she is ineligible
for Medicare coverage and complies with Sections 12693.71 and
12693.72. A child's eligibility for the Healthy Families Program
pursuant to this section shall not affect that child's eligibility
for the Medi-Cal program with a share of cost in accordance with
Section 14005.7 of the Welfare and Institutions Code.
(b) Children described in subdivision (a) in families whose
household income would make them ineligible for the Medi-Cal program
with no share of cost or for Medicare, and who are in compliance with
Sections 12693.71 and 12693.72, shall be eligible for the Healthy
Families Program and shall also be eligible for the Medi-Cal program
with a share of cost in accordance with Section 14005.7 of the
Welfare and Institutions Code. The remaining children described in
subdivision (a) shall be eligible for the Medi-Cal program with no
share of cost.
(c) Nothing in this section shall be construed to authorize the
denial or reduction of medical assistance under the
Medi-Cal program (Chapter 7 (commencing with Section 14000) of Part 3
of Division 9 of the Welfare and Institutions Code) to a
child person who, without the application of
this section, would qualify for that assistance or to excuse
relieve the Medi-Cal program or the Healthy
Families Program of the obligation to determine eligibility on all
other available grounds.
(d) The board shall implement this section, and children made
eligible for the program by this section shall be able to enroll in
the program, no later than January 1, 2008.
SEC. 8. Section 12693.73 of the Insurance Code is repealed.
SEC. 9. Section 12693.76 of the
Insurance Code is amended to read:
12693.76. (a) Notwithstanding any other provision of law, a child
who is a qualified alien as defined in Section 1641 of
Title 8 of the United States Code Annotated shall not be
determined ineligible solely on the basis of his or her date of entry
into the United States.
(b) Notwithstanding any other provision of law, subdivision (a)
may only be implemented to the extent provided in the annual Budget
Act.
(c) Notwithstanding any other provision of law, any
an uninsured parent or responsible adult who is
a qualified alien, as defined in Section 1641 of Title 8 of the
United States Code, shall not be determined to be ineligible solely
on the basis of his or her date of entry into the United States.
(d) Notwithstanding any other provision of law, subdivision (c)
may only be implemented to the extent of funding provided in the
annual Budget Act.
SEC. 10. Section 12693.98 of the
Insurance Code is amended to read:
12693.98. (a) (1) The Medi-Cal-to-Healthy Families Bridge
Benefits Program is hereby established to provide any
a child who meets the criteria set forth in
subdivision (b) with a one calendar-month period of health care
benefits in order to provide the child with an opportunity to apply
for the Healthy Families Program established under Chapter
16 (commencing with Section 12693) .
(2) The Medi-Cal-to-Healthy Families Bridge Benefits Program shall
be administered by the board and the State Department of Health
Care Services.
(b) (1) Any A child who meets all of
the following requirements shall be eligible for one calendar month
of Healthy Families benefits funded by Title XXI of the Social
Security Act, known as the State Children's Health Insurance Program:
(A) He or she has been receiving, but is no longer eligible for,
full-scope Medi-Cal benefits without a share of cost.
(B) He or she is eligible for full-scope Medi-Cal benefits with a
share of cost.
(C) He or she is under 19 years of age at the time he or she is no
longer eligible for full-scope Medi-Cal benefits without a share of
cost.
(D) He or she has family income at or below 200 percent of the
federal poverty level.
(E) He or she is not otherwise excluded under the definition of
"targeted low-income child" under subsections (b)(1)(B)(ii), (b)(1)
(C), and (b)(2) of Section 2110 of the Social Security Act (42 U.S.C.
Secs. 1397jj(b)(1)(B)(ii), 1397jj(b)(1)(C), and 1397jj(b)(2)).
(2) The one calendar month of benefits under this chapter shall
begin on the first day of the month following the last day of the
receipt of benefits without a share of cost.
(c) The income methodology for determining a child's family
income, as required by paragraph (1) of subdivision (b) shall be the
same methodology used in determining a child's eligibility for the
full scope of Medi-Cal benefits.
(d) The one calendar-month period of Healthy Families benefits
provided under this chapter shall be identical to the scope of
benefits that the child was receiving under the Medi-Cal program
without a share of cost.
(e) The one calendar-month period of Healthy Families benefits
provided under this chapter shall only be made available through a
Medi-Cal provider or under a Medi-Cal managed care arrangement or
contract.
(f) Except as provided in subdivision (j), nothing in this section
shall be construed to provide Healthy Families benefits for more
than a one calendar-month period under any circumstances, including
the failure to apply for benefits under the Healthy Families Program
or the failure to be made aware of the availability of the Healthy
Families Program, unless the circumstances described in subdivision
(b) reoccur.
(g) (1) This section shall become operative on the first day of
the second month following the effective date of this section,
subject to paragraph (2).
(2) Under no circumstances shall this section become operative
until, and shall be implemented only to the extent that, all
necessary federal approvals, including approval of any amendments to
the State Child Health Plan have been sought and obtained and federal
financial participation under the federal State Children's Health
Insurance Program, as set forth in Title XXI of the Social Security
Act, has been approved.
(h) This section shall become inoperative if an unappealable court
decision or judgment determines that any of the following apply:
(1) The provisions of this section are unconstitutional under the
United States Constitution or the California Constitution.
(2) The provisions of this section do not comply with the State
Children's Health Insurance Program, as set forth in Title XXI of the
Social Security Act.
(3) The provisions of this section require that the health care
benefits provided pursuant to this section are required to be
furnished for more than two calendar months.
(i) If the State Child Health Insurance Program waiver described
in Section 12693.755 is approved, and at the time the waiver is
implemented, the benefits described in this section shall also be
available to persons who meet the eligibility requirements of the
program and are parents of, or, as defined by the board, adults
responsible for, children enrolled to receive coverage under this
part or enrolled to receive full-scope Medi-Cal services with no
share of cost.
(j) The one month of benefits provided in this section shall be
increased to two months commencing on implementation of the waiver
referred to in Section 12693.755.
(k) This section shall cease to be implemented on the date that
the Director of Health Care Services executes a
declaration stating that implementation of the Medi-Cal to
Healthy Families Presumptive Eligibility Program established
pursuant to Section 12693.98a has commenced, and as of that date is
repealed.
SEC. 11. Section 12693.98a of the
Insurance Code is amended to read:
12693.98a. (a) (1) The Medi- Cal to Healthy
Families Presumptive Eligibility Program is hereby established to
provide any a child who meets the
criteria set forth in subdivision (b) with presumptive eligibility
benefits until the board has determined the child's eligibility for
the Healthy Families Program.
(2) The Medi-Cal to Healthy Families Presumptive
Eligibility Program shall be administered by the board.
(b) (1) Any A child who meets both
of the following requirements shall be eligible for presumptive
eligibility benefits under the Medi-Cal to Healthy
Families Presumptive Eligibility Program:
(A) He or she has been receiving, but is no longer eligible for,
full-scope Medi-Cal benefits without a share of cost, or he or she is
eligible for full-scope Medi-Cal benefits with a share of cost.
(B) He or she otherwise appears to meet the income eligibility
criteria for the Healthy Families Program.
(2) The presumptive eligibility benefits under this section shall
begin on the first day of the month following the last day of the
receipt of Medi-Cal benefits without a share of cost. Presumptive
eligibility benefits under this section shall terminate at the end of
the month in which a child's effective date in the Healthy Families
Program begins or the end of the month in which the board determines
that the child is not eligible for the Healthy Families Program. If
the board determines that the child is eligible for the Healthy
Families Program, the board shall enroll the child in the Healthy
Families Program without an interruption in coverage. If the board
determines that the child is ineligible for the Healthy Families
Program, the board shall terminate the child's benefits under the
Medi-Cal to Healthy Families Presumptive Eligibility
Program.
(c) The income methodology for determining a child's family income
for the purposes of the Medi-Cal to Healthy Families
Presumptive Eligibility Program, as required by paragraph (1) of
subdivision (b), shall be the same methodology used in determining a
child's eligibility for the full scope of Medi-Cal benefits.
(d) The scope of presumptive eligibility benefits provided under
the Medi-Cal to Healthy Families Presumptive Eligibility
Program shall be identical to the scope of benefits that the child
was receiving under the Medi-Cal program without a share of cost.
(e) The presumptive eligibility benefits provided under this
section shall only be made available through a Medi-Cal provider or
under a Medi-Cal managed care arrangement or contract.
(f) When an application is forwarded by the county to the Healthy
Families Program, the county shall send the application to the
Healthy Families Program via an electronic application format defined
by the department,
provided that the department has implemented the automated interfaces
necessary to accomplish electronic submission of applications from
the county to the Healthy Families Program without requiring
duplicative data entry by the county. The transmission of the
electronic application to the Healthy Families Program shall occur
within the timeframes designated by the department.
(g) To the extent necessary, the department and the board may
exchange a child's case file solely for the purpose of determining
the child's eligibility for the Medi-Cal program or the Healthy
Families Program, without requiring the family's consent, to the
extent allowed by federal law. Any information, including the child's
case file, shall be kept confidential by the department and the
board pursuant to state and federal law, and it shall be used only
for the determination or continuation of eligibility.
(h) 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 any further
regulatory action. Thereafter, the department may adopt regulations,
as necessary, to implement this section 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.
(i) This section shall be implemented when the state has sought
and obtained approval of any amendments to its state plan necessary
to implement the changes to this section, pursuant to this act, and
has obtained funding under Title XXI of the Social Security Act (42
U.S.C. Sec. 1397aa et seq.) for the provision of benefits under this
section. Until the changes to this section, made by this act, are
implemented, the Medi-Cal to Healthy Families Bridge Program
established pursuant to Section 12693.98 shall remain in effect.
Notwithstanding any other provision of law, and only when all
necessary federal approvals have been obtained by the state, this
section shall be implemented only to the extent federal financial
participation under Title XXI of the Social Security Act (42 U.S.C.
Sec. 1397aa et seq.) is available to fund benefits provided under
this section.
(j) Upon implementation of the Medi-Cal to Healthy
Families Presumptive Eligibility Program pursuant to this section,
the Director of Health Care Services shall execute a
declaration, which shall be retained by the director, stating that
implementation of the section has commenced.
SEC. 9. SEC. 12. Section 12693.981
of the Insurance Code is amended to read:
12693.981. (a) (1) The Healthy Families-to-Medi-Cal Bridge
Benefits Program is hereby established to provide any person enrolled
for coverage under this part who meets the criteria set forth in
subdivision (b) with a two calendar-month period of health care
benefits in order to provide the person with an opportunity to apply
for Medi-Cal.
(2) The Healthy Families-to-Medi-Cal Bridge Benefits Program shall
be administered by the board.
(b) (1) Any person who meets all of the following requirements
shall be eligible for two additional calendar months of Healthy
Families benefits:
(A) He or she has been receiving, but is no longer eligible for,
benefits under the program.
(B) He or she appears to be income eligible for full-scope
Medi-Cal benefits without a share of cost.
(2) The two additional calendar months of benefits under this
chapter shall begin on the first day of the month following the last
day of the person's eligibility for benefits under the program.
(c) The two-calendar-month period of Healthy Families benefits
provided under this chapter shall be identical to the scope of
benefits that the person was receiving under the program.
(d) Nothing in this section shall be construed to provide Healthy
Families benefits for more than a two-calendar-month period under any
circumstances, including the failure to apply for benefits under the
Medi-Cal program or the failure to be made aware of the availability
of the Medi-Cal program unless the circumstances described in
subdivision (b) reoccur.
(e) This section shall become inoperative if an unappealable court
decision or judgment determines that any of the following apply:
(1) The provisions of this section are unconstitutional under the
United States Constitution or the California Constitution.
(2) The provisions of this section do not comply with the State
Children's Health Insurance Program, as set forth in Title XXI of the
federal Social Security Act.
(3) The provisions of this section require that the health care
benefits provided pursuant to this section are required to be
furnished for more than two calendar months.
(f) This section shall become inoperative on the date that the
board executes a declaration stating that the implementation of the
Healthy Families to Medi-Cal Presumptive Eligibility Program
established pursuant to Section 12693.981a has commenced. As of the
next occurring January 1, this section is repealed, unless a later
enacted statute, enacted before that January 1 date, deletes or
extends the dates on which this section becomes inoperative and is
repealed.
SEC. 10. SEC. 13. Section 12693.981a
is added to the Insurance Code, to read:
12693.981a. (a) The Healthy Families to Medi-Cal Presumptive
Eligibility Program is hereby established to provide a child who
meets the criteria set forth in subdivision (c) with presumptive
eligibility benefits until the child's eligibility for full scope
Medi-Cal benefits with no share of cost has been determined.
(b) The Healthy Families to Medi-Cal Presumptive Eligibility
Program shall be administered by the board.
(c) A child who meets both of the following requirements shall be
eligible for presumptive eligibility benefits under the Healthy
Families to Medi-Cal Presumptive Eligibility Program:
(1) He or she has been receiving, but is no longer eligible for,
benefits under the Healthy Families Program.
(2) He or she otherwise appears to be income-eligible for
full-scope Medi-Cal benefits with no share of cost.
(d) The presumptive eligibility benefits under this section shall
begin on the first day of the month following the board's
determination that the child is no longer eligible for the Healthy
Families Program. To prevent an interruption in coverage, benefits
under the Healthy Families Program shall continue until the end of
the month in which that determination is made.
(1) If the county determines that the child is eligible for the
Medi-Cal program, the county shall enroll the child in the Medi-Cal
program without an interruption in coverage. The presumptive
eligibility benefits under this section shall terminate on the last
day of the month that precedes the month in which the child begins
receiving benefits under the Medi-Cal program.
(2) If the county determines that the child is ineligible for the
Medi-Cal program, with or without a share of cost, the county shall
terminate the child's benefits under the Healthy Families to Medi-Cal
Presumptive Eligibility Program in accordance with due process
requirements.
(e) The income methodology for determining a child's family income
for the purposes of the Healthy Families to Medi-Cal Presumptive
Eligibility Program, as required by subdivision (c), shall be the
same methodology used in determining a child's eligibility for the
full scope of Medi-Cal benefits.
(f) The scope of presumptive eligibility benefits provided under
the Healthy Families to Medi-Cal Presumptive Eligibility Program
shall be identical to the full scope of benefits under the Medi-Cal
program.
(g) No family contribution is required for a child receiving
presumptive eligibility benefits under the Healthy Families to
Medi-Cal Presumptive Eligibility Program.
(h) To the extent necessary and to the extent allowed by federal
law, the State Department of Health Care Services, counties, and the
board may exchange a child's case file solely for the purpose of
determining the child's eligibility for the Medi-Cal program or the
Healthy Families Program, without requiring the family's consent. Any
information, including the child's case file, shall be kept
confidential by the department and the board in accordance with the
confidentiality and privacy protections set forth in Sections 10500
and 14100.2 of the Welfare and Institutions Code.
(i) The board shall develop, in consultation with consumer
advocates and other stakeholders, a system for tracking cases where
children receive benefits under the Healthy Families to Medi-Cal
Presumptive Eligibility Program for more than two months and for
followup of those cases. The followup system shall include the
following activities to ensure that children in the Healthy Families
to Medi-Cal Presumptive Eligibility Program are enrolled in a timely
manner into the ongoing health care benefits program for which they
are eligible:
(1) The board shall identify those cases where children are
enrolled in the Healthy Families to Medi-Cal Presumptive Eligibility
Program for more than two months and report those cases to the
department. The department shall consult with the counties to
determine the status of each case and provide support and technical
assistance to assist the counties to take the necessary actions to
complete the eligibility determination process for each child to
obtain the ongoing health care benefits for which the child is
eligible.
(2) If children in the Healthy Families to Medi-Cal Presumptive
Eligibility Program are not enrolled in the Medi-Cal program or
denied enrollment in the Medi-Cal program in accordance with due
process requirements within two months of their enrollment date in
the Healthy Families to Medi-Cal Presumptive Eligibility Program, the
board shall contact the State Department of Health Care Services or
the county where the child resides in order to determine the status
of the child's application for, and enrollment in, the Medi-Cal
program. The department shall assist the county in enrolling the
child in the program for which he or she is eligible.
(j) Notwithstanding Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code, the board
shall implement this section by means of all-county letters or
similar instructions without taking any further regulatory action.
Thereafter, the board may adopt regulations, as necessary, to
implement this section 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.
(k)
(j) Upon implementation of the Healthy Families to
Medi-Cal Presumptive Eligibility Program pursuant to this section,
the board shall execute a declaration, which it shall retain, stating
that implementation of the section has commenced.
SEC. 11. SEC. 14. Section 12693.983
is added to the Insurance Code, to read:
12693.983. (a) The board and the State Department of Health Care
Services shall monitor the Medi-Cal to Healthy Families
Presumptive Eligibility Program in Section 12693.98a and the Healthy
Families to Medi-Cal Presumptive Eligibility Program in Section
12693.981a in order to ensure that all children are enrolled in a
timely manner in the presumptive eligibility benefits for which they
are eligible.
(b) The monitoring responsibilities required by this section shall
consist of the following activities:
(1) The board and the department shall collect and make publicly
available on their respective Internet Web sites, the
following data on a monthly and annual
quarterly basis:
(A) The number of children enrolled in the Medi-Cal to
Healthy Families Presumptive Eligibility Program and the number of
children enrolled in the Healthy Families to Medi-Cal Presumptive
Eligibility Program.
(B) The length of time these children were enrolled in each
program.
(C) The status of the children enrolled in each program, including
a status report for each child enrolled more than one month in the
Medi-Cal to Healthy Families Presumptive Eligibility
Program and more than two months in the Healthy Families to Medi-Cal
Presumptive Eligibility Program.
(2) The board and the department shall record all attempts to
assist the child to enroll in ongoing health benefits programs and
shall record the final disposition of the child's application for
continuing health coverage.
(c) The board and the department shall report to the Legislature
the data collected pursuant to subdivision (b) on a monthly and
annual basis.
SEC. 12. SEC. 15. Chapter 16.2
(commencing with Section 12694.1) is added to Part 6.2 of Division 2
of the Insurance Code, to read:
CHAPTER 16.2. HEALTHY FAMILIES BUY-IN PROGRAM
12694.1. On or after ____, the board shall implement the Healthy
Families Buy-In Program that shall be referred to as the buy-in
program for purposes of this chapter.
12694.2. A child under 19 years of age is eligible for the buy-in
program if he or she meets all of the following criteria:
(a) Lives in a family whose monthly or annual income exceeds 300
percent of the federal poverty level.
(b) Is not eligible for full scope Medi-Cal benefits or the
Healthy Families Program.
(c) Has been without health care coverage for, at minimum, a
period of six consecutive months immediately preceding the date of
application for the buy-in program. Compliance with this
criteria shall be determined by the board using the same verification
procedures that it uses to verify compliance with
Sections 12693.71 and 12693.72.
12694.4. The coverage for children in the buy-in program shall be
identical to the coverage for children enrolled in the Healthy
Families Program and shall be provided solely by a participating
health plan.
12694.5. (a) The family of a child enrolled in the buy-in program
shall pay the board a monthly contribution amount that equals the
full cost of coverage for the child under the Healthy Families
Program.
(b) The family of a child enrolled in the buy-in program shall
receive the same discounts from their contributions under this
section as provided to applicants pursuant to paragraph (4) of
subdivision (d) of, and subdivisions (e) and (f) of, Section 12693.43
and shall be subject to the payment procedures set forth in Section
2699.6813 of Title 10 of the California Code of Regulations.
12694.6. (a) A county that determines a child ineligible for the
Medi-Cal program or for the Healthy Families Program shall inform the
applicant of the option of enrolling the child in the buy-in program
and, with the applicant's approval, shall transmit the application
to the board.
(b) If the board determines a child is ineligible for the Healthy
Families Program or the Medi-Cal program, it shall inform the
applicant of the option of enrolling the child in the buy-in program
and, with the applicant's approval, shall consider the application
for the child's eligibility for the buy-in program.
SEC. 13. SEC. 16. Section 14005.23
of the Welfare and Institutions Code is amended to read:
14005.23. (a) To the extent federal financial participation is
available, the department shall, when determining eligibility for
children under Section 1396a()(1)(D) of Title 42 of the United States
Code, designate a birth date by which all children who have not
attained the age of 19 years will meet the age requirement of Section
1396a()(1)(D) of Title 42 of the United States Code.
(b) On and after January 1, 2008, the department shall apply the
less restrictive income deduction described in Section 1396a(r) of
Title 42 of the United States Code when determining eligibility for
the children identified in Section 14005.26. The amount of this
deduction shall be the difference between 133 percent and 100 percent
of the federal poverty level applicable to the size of the family.
SEC. 14. SEC. 17. Section 14005.26
is added to the Welfare and Institutions Code, to read:
14005.26. (a) Notwithstanding any other provision of law, a child
under 19 years of age who meets the state residency requirements of
the Medi-Cal program or the Healthy Families Program (Part 6.2
(commencing with Section 12693) of Division 2 of the Insurance Code)
shall be eligible for either the Medi-Cal program if he or she meets
the income and resource requirements of Section 14005.7 or 14005.30,
or the Healthy Families Program if he or she lives in a family with
household income at or below 300 percent of the federal poverty
level, including for both programs those children for whom federal
financial participation is not available under Title XIX of the
federal Social Security Act (42 U.S.C. Sec. 1396 et seq.), or under
Title XXI of the federal Social Security Act (42 U.S.C. Sec. 1397aa
et seq.).
(b) A child described in subdivision (a) who is ineligible for the
full scope of benefits under the Medi-Cal program at no share of
cost because of his or her family's household income, shall be
eligible for the Healthy Families Program pursuant to Section
12693.701 of the Insurance Code if he or she is ineligible for
Medicare coverage and complies with Sections 12693.71 and 12693.72 of
the Insurance Code. A child's eligibility for the Healthy Families
Program pursuant to this section shall not affect the child's
eligibility for the Medi-Cal program with a share of cost in
accordance with Section 14005.7.
(c) Nothing in this section shall be construed to authorize the
denial of medical assistance under the Medi-Cal program to a child
who, without the application of this section, would qualify for that
assistance or to excuse the Medi-Cal program or the Healthy Families
Program of the obligation to determine eligibility on all other
available grounds.
(d) The department shall maximize federal matching funds available
for eligible children's health insurance under the Medi-Cal program,
and the department shall implement strategies to coordinate and
integrate existing children's health insurance programs to
efficiently use state funds and maximize available federal matching
funds, such as matching funds available for emergency or
pregnancy-related Medi-Cal benefits, for all eligible children.
(e) The department shall implement this section, and children made
eligible for the Medi-Cal program by this section shall be able to
enroll in the Medi-Cal program, no later than January 1, 2008.
14005.26. (a) Children, including children for whom federal
financial participation is not available under Title XIX of the
federal Social Security Act (42 U.S.C. Sec. 1396 et seq.) for
full-scope coverage, who meet the household income and age
requirements in Section 14005.23 shall be eligible to enroll in the
Medi-Cal program.
(b) When determining the eligibility of children described in
subdivision (a), the department shall apply the less restrictive
income disregard described in Section 1396a(r) of Title 42 of the
United States Code. The income disregard shall be equal to the
difference between the income standard and the amount equal to 133
percent of the federal poverty level applicable to the family size.
(c) Nothing in this section shall be construed to authorize the
denial, discontinuance, or reduction of medical assistance under the
Med-Cal program or the Healthy Families Program (Part 6.2 (commencing
with Section 12693) of Division 2 of the Insurance Code) to a person
who qualifies for the Medi-Cal program or for the Healthy Families
Program, or who, without the application of this section, would
qualify for either program, or to relieve the Medi-Cal program or the
Healthy Families Program of the obligation to determine eligibility
on all other available grounds.
SEC. 15. SEC. 18. Section 14011.01
is added to the Welfare and Institutions Code, to read:
14011.01. (a) The department, in coordination with the Managed
Risk Medical Insurance Board, counties, consumer advocates, and other
stakeholders, shall make technological improvements to the existing
eligibility determination and enrollment systems for the Medi-Cal
program, such as the Medi-Cal Eligibility Data System (MEDS), and the
Healthy Families Program based on the guidelines set forth in
subdivisions (b), (c), and (d) in order to better integrate the
enrollment processes for those programs.
(b) The improvements shall allow families to be screened for, and
with their consent to apply to, multiple programs from more than one
location.
(c) The improvements shall include, but not be limited to,
accomplishment of all of the following objectives:
(1) Promote accessible enrollment opportunities through public
service programs that are widely used by families, including schools,
and other public access points, while incorporating mechanisms to
minimize duplicate applications and to identify whether a child is
currently enrolled in the Medi-Cal program, the Healthy Families
Program, or other coverage before processing a new application.
(2) Eliminate all duplicative requests and requirements for
applications and other information and require the Managed Risk
Medical Insurance Board, the department, and the counties to use the
procedures in subdivisions (e) to (g), inclusive, of Section 14005.37
for all applications to minimize the burdens on families.
(3) Support electronic and digital signature approaches to reduce
the burden of the applicant appearing in person and to allow the
applicant to submit any application without appearing in person,
wherever possible.
(4) Eliminate all documentation requirements, other than those
required by federal law, and verify necessary information through
other available databases and through the use of the procedures
established in subdivisions (e) to (g), inclusive, of Section
14005.37.
(5) Promote data integrity by expanding access to and improving
MEDS search and file clearance functionality.
(6) Include the ability to obtain birth and other state maintained
verification documents electronically.
(7) Support electronic exchange of information with the Statewide
Automated Welfare System.
(8) Guarantee privacy protections and secure information exchange.
(d) To improve the integration and efficiency of technological
systems used by the state to operate the Medi-Cal program and the
Healthy Families Program, the department shall take the following
actions:
(1) Establish reusable service-based interfaces to allow multiple
existing enrollment systems to exchange data electronically.
(2) Support the electronic submission of verification documents
that are also available for exchange and reuse by multiple existing
enrollment systems.
(3) Develop a plan and timeline for the implementation of
technology that provides an infrastructure to allow legacy systems,
new enrollment systems, and other systems to access common system
functions, features, and rules through a central repository of shared
services.
SEC. 16. SEC. 19. Section 14011.61
is added to the Welfare and Institutions Code, to read:
14011.61. (a) To the extent allowed under Title XIX of the
federal Social Security Act (42 U.S.C. Sec. 1396 et seq.) and Title
XXI of the federal Social Security Act (42 U.S.C. Sec. 1397aa et
seq.), and only if to the extent
federal financial participation is available under Title XXI of the
federal Social Security Act, the department shall administer the
Medi-Cal Presumptive Eligibility Program to provide a child who meets
the criteria set forth in subdivision (c)
(d) with presumptive eligibility benefits for the period
described in subdivision (f) (g) .
(b) The department shall designate all 58 counties as qualified
entities for determining eligibility under this section.
(b)
(c) A county shall perform an initial screen of every
application for the Medi-Cal program or the Healthy Families Program
that is filed in with that county. The
initial screen shall be completed within 48 hours from the time of
submission of the application for the Medi-Cal program or the Healthy
Families Program.
(c)
(d) On the basis of the initial screen performed by the
county, a child who meets all of the following requirements shall be
eligible for presumptive eligibility benefits under this section:
(1) The child, or his or her parent or guardian, submits an
application for the Medi-Cal program or the Healthy Families Program
directly to with the county.
(2) The child's income, as screened by the county on the basis of
the application described in paragraph (1), appears to be within the
income levels necessary to establish eligibility for the Medi-Cal
program with no share of cost.
(3) The child is under 19 years of age at the time of the
application.
(4) The child is not receiving no-cost Medi-Cal benefits or
benefits under the Healthy Families Program at the time that the
application is submitted.
(d)
(e) When the county performs the initial screen and
determines that the child meets the criteria described in subdivision
(c) (d) , the county shall immediately
establish presumptive eligibility for the Medi-Cal program for that
child. The presumptive eligibility benefits provided under this
section shall be identical to the benefits provided to children who
receive full-scope Medi-Cal benefits with no share of cost and shall
only be made available through a Medi-Cal program provider.
(e)
(f) Once presumptive eligibility has been established,
the county shall continue to determine a child's eligibility for the
Medi-Cal program on the basis of the application submitted to it.
(f)
(g) The period of presumptive eligibility provided for
under this section begins on the first day of the month that the
application is filed.
(g)
(h) If the county determines that the child is eligible
for the Medi-Cal program without a share of cost, the county shall
enroll the child in the Medi-Cal program without an interruption in
coverage. If the county determines that the child is eligible for the
Medi-Cal program with a share of cost, the county shall enroll the
child in the Medi-Cal program and forward the application to the
Managed Risk Medical Insurance Board for an evaluation of the child's
eligibility for the Healthy Families Program. To ensure continuity
of coverage, the presumptive eligibility benefits under this section
shall terminate on the last day of the month that precedes the month
in which the child begins receiving benefits under the Medi-Cal
program.
(h)
(i) If the county determines that the child is
ineligible for the Medi-Cal program with or without a share of cost,
the county shall terminate the child's presumptive eligibility
benefits under this section in accordance with due process
requirements.
(i)
(j) The Managed Risk Medical Insurance Board and the
department, in consultation with counties, consumer advocates, and
other stakeholders, shall develop a notice to inform families of the
transfer of a case between the Medi-Cal program and the Healthy
Families Program and from presumptive eligibility benefits to
benefits under one of those programs, to minimize the confusion for
the family, to clarify that coverage is continued during the
transfer, and to provide the family with contact information advising
the family where to ask questions about continuity of coverage and
access to care.
(j)
(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 any
further regulatory action. Thereafter, the department may adopt
regulations, as necessary, to implement this section 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.
(k)
(l) The department, in consultation with
representatives of the local agencies that administer the Medi-Cal
program, consumer advocates, and other stakeholders, shall develop
and distribute the policies and procedures, including any all-county
letters, necessary to implement this section.
(l)
(m) Nothing in this section shall be construed to
authorize the denial of medical assistance under the Medi-Cal program
to a child who, without the application of this section, would
qualify for that assistance or to excuse the Medi-Cal program or the
Healthy Families Program of the obligation to determine eligibility
on all other available grounds.
(m)
(n) The department shall begin to implement this
section on January 1, 2008.
SEC. 17. SEC. 20. Notwithstanding
any other provision of law, the Managed Risk Medical Insurance Board
may implement the provisions of this act expanding the Healthy
Families Program only to the extent that funds are appropriated for
those purposes in the annual Budget Act or in another statute.
SEC. 18. SEC. 21. 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.