BILL NUMBER: AB 1299	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  APRIL 21, 2015

INTRODUCED BY   Assembly Member Ridley-Thomas

                        FEBRUARY 27, 2015

   An act to add Article 6 (commencing with Section 14695.1) to
Chapter 8.8 of Part 3 of Division 9 of the Welfare and Institutions
Code, relating to Medi-Cal.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 1299, as amended, Ridley-Thomas. Medi-Cal: specialty mental
health services: foster children.
   Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Care Services, under
which qualified low-income individuals receive health care services.
The Medi-Cal program is, in part, governed and funded by federal
Medicaid program provisions. Existing law provides that Early and
Periodic Screening, Diagnosis, and Treatment (EPSDT) for any
individual under 21 years of age is covered under Medi-Cal,
consistent with the requirements of federal law. Federal law defines
EPSDT mental health services to include screening services, vision
services, dental services, hearing services, and other necessary
services to correct or ameliorate defects and physical and mental
illnesses and conditions discovered by the screening services,
whether or not the services are covered under the state plan. EPSDT
is classified under the Medi-Cal program as a specialty mental health
service.
   Existing law requires each local mental health plan to establish a
procedure to ensure access to outpatient specialty mental health
services, as required by the EPSDT program standards, for children in
foster care who have been placed outside their county of
adjudication. Existing law includes standardized contracts,
procedures, documents, and forms, to facilitate the receipt of
medically necessary specialty mental health services by a foster
child who is placed outside his or her county of original
jurisdiction.
   This bill would declare the intent of the Legislature to ensure
that foster children who are placed outside of their county of
original jurisdiction, are able to access mental health services in a
timely manner consistent with their individualized strengths and
needs and the requirements of EPSDT program standards and
requirements. The bill would require the department to issue policy
guidance that establishes the presumptive transfer of responsibility
for providing or arranging for mental health services to foster youth
from the county of original jurisdiction to the foster child's
county of residence, as prescribed. The bill would define presumptive
transfer for these purposes.
   This bill would require the Department of Finance, by May 1,2016,
to set or adjust its allocation schedule of the Behavioral Health
Subaccount pursuant to realignment provisions enacted pursuant to a
specified measure, in order that counties that have paid, or will
pay, for the specialty mental health services provided pursuant to
the bill, are fully reimbursed during the fiscal year in which the
services were provided. This bill would require the department to
determine whether it is necessary to seek approval under the state's
Section 1915(b) Medicaid waiver from the federal Centers for Medicare
and Medicaid Services (CMS) prior to implementing the bill, and if
so, to do everything within its power necessary to secure an
expeditious approval.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Article 6 (commencing with Section 14695.1) is added to
Chapter 8.8 of Part 3 of Division 9 of the Welfare and Institutions
Code, to read:

      Article 6.  Specialty Mental Health Services for Foster
Children


   14695.1.  (a) (1) It is the intent of the Legislature to ensure
that foster children who are placed outside of their county of
original jurisdiction, are able to access mental health services in a
timely manner, consistent with their individualized strengths and
needs and the requirements of Early Periodic Screening Diagnosis and
Treatment (EPSDT) program standards and requirements.
   (2) It is the further intent of the Legislature to overcome the
barriers to care that exist under existing law, which place
responsibility for providing or arranging for mental health services
to foster children who are placed outside of their county of original
jurisdiction, on those same counties.
   (b) In order to facilitate the receipt of medically necessary
specialty mental health services by a foster child who is placed
outside of his or her county of original jurisdiction, the California
Health and Human Services Agency shall coordinate with the
department and the State Department of Social Services to take all of
the following actions:
   (1) On or before July 1, 2016, all of the following shall occur:
   (A) The department shall issue policy guidance, pursuant to
Section 14716, that establishes the presumptive transfer of
responsibility for providing or arranging for mental health services
to foster youth, consistent with the requirements of EPSDT program
standards and requirements, from the county of original jurisdiction
to the foster child's county of residence. 
   (B) "Presumptive transfer" for the purposes of this section means
that absent any conditions or exceptions as established pursuant to
this article, responsibility for providing or arranging for mental
health services shall immediately transfer from the county of
original jurisdiction to the county of residence, when the all of the
following conditions occur:  
   (i) A foster child is placed in a county other than the county of
original jurisdiction.  
   (ii) The transfer of responsibility is requested by the county
child welfare services agency, county probation department, foster
caregiver, or any other person authorized to make medical decisions
on behalf of the foster child.  
   (C) 
    (B)  The department shall establish the conditions and
exceptions to presumptive transfer in consultation with the State
Department of Social Services, and with the input of stakeholders
that include the County Welfare Directors Association of California,
the County Behavioral Health Directors Association of California,
provider representatives, and family and youth advocates. The
conditions and exceptions to presumptive transfer are intended to
ensure that the transfer of responsibility improves access to mental
health care services and does not impede the continuity of existing
care. 
   (D) 
    (C)  The department shall establish the procedures for
implementing presumptive transfer that are consistent with the
purposes and intent of this section and Early Periodic Screening
Diagnosis and Treatment program standards and requirements, and shall
include a procedure for expedited transfer within 48 hours. 
   (c) "Presumptive transfer" for the purposes of this section, means
that absent any conditions or exceptions as established pursuant to
this article, responsibility for providing or arranging for mental
health services shall immediately transfer from the county of
original jurisdiction to the county of residence, when all of the
following conditions occur:  
   (1) A foster child is placed in a county other than the county of
original jurisdiction.  
   (2) The transfer of responsibility is requested by the county
child welfare services agency, county probation department, foster
caregiver, or any other person authorized to make medical decisions
on behalf of the foster child. 
   14695.2.  By May 1, 2016, the Department of Finance shall set or
adjust its allocation schedule of the Behavioral Health Subaccount
pursuant to the requirements of Senate Bill 1020 (Chapter 40,
Statutes of 2012), in order that counties that have paid, or will
pay, for specialty mental health services for foster children placed
out of county pursuant to this article, are fully reimbursed during
the fiscal year in which the services are provided.
   14695.3.  (a) If the department determines it is necessary, it
shall seek approval under the state's Section 1915(b) Medicaid waiver
from the United States Department of Health and Human Services,
Centers for Medicare and Medicaid Services (CMS) prior to
implementing this article.
   (b) If the department makes the determination that it is necessary
to seek CMS approval pursuant to subdivision (a), the department
shall make an official request for approval from CMS no later than
 ____,   July 1, 2016,  and shall do
everything within its power necessary to secure an expeditious
approval from CMS.
   (c) The department shall not be required to implement any
provision of this article that CMS determines is not permitted under
the state's waiver.