AB 1319: Medi-Cal benefits: share of cost requirements.

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. Under existing law, certain aged, blind, and disabled Medi-Cal recipients are required to pay a share of cost as a condition of eligibility, with the share of cost determined in accordance with specified requirements. For purposes of determining the share of cost, existing law establishes a formula to calculate the personal and incidental needs deduction for an individual residing in a licensed community care facility. Existing law prohibits that deduction from exceeding the amount by which the Supplemental Security Income recipient retention amount, as defined, exceeds $20.

This bill would revise the formula to determine the personal and incidental needs deduction. By increasing the responsibility of the counties in determining Medi-Cal eligibility, this bill would impose a state-mandated local program. The bill would also require that its provisions be implemented only to the extent that federal financial participation is available and that the department receives any necessary federal approvals.

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.