(a) The State Department of Developmental Services, after consultation with stakeholder groups, shall develop a system of enrollment fees, copayments, or both, to be assessed against the parents of each child between the ages of three and 17 years who lives in the parent’s home and receives services purchased through a regional center. This system shall be submitted to the Legislature on or before April 1, 2004, immediately prior to the fiscal year in which the system is to be implemented, and as a part of the Governor’s proposed 2004–05 budget or subsequent legislation.
(b) The department, after consultation with stakeholder groups, shall submit a detailed plan for implementing a parental copayment system for children receiving services purchased through a regional center. This plan shall be submitted to the Legislature by April 1, 2004.
(c) The plan submitted on or before April 1, 2004, pursuant to subdivision (b), and any resources requested in the 2004–05 Governor’s Budget and related authority may be subsequently modified during the legislative review process.
(d) The parental copayment system shall only be applicable to families that have adjusted gross family incomes of over 200 percent of the federal poverty level and that have a child who meets all of the following criteria:
(1) The child is receiving services purchased through a regional center.
(2) The child is living at home.
(3) The child is not otherwise eligible to receive services provided under the Medi-Cal program.
(4) The child is at least three years of age and not more than 17 years of age.
(e) The department’s plan shall address, at a minimum all of the following components for the development of a parental copayment system:
(1) Description of the families and children affected, including those families with more than one child as described under subdivision (d).
(2) Privacy issues and potential safeguards regarding the families’ income, the children’s regional center clinical records, and related matters.
(3) Schedule of parental copayments and any other related assessments, and criteria or service thresholds for which these copayments and assessments are based.
(4) The options for a sliding scale for the schedule of parental copayments based on family income and family size.
(5) Proposed limits on parental cost sharing.
(6) An exemption process for families who are experiencing financial hardships and may need deferral or waiver of any copayments or assessments.
(7) An appeal process for families who may dispute the level of copayment or assessments for which they are billed.
(8) The specific methods and processes to be used by the department, regional centers, or other responsible party, for the collection of all parental copayments and assessments.
(9) Any potentials for the disruption of services to applicable regional center consumers due to the implementation of a parental copayment system.
(10) The estimated amount of revenues to be collected and any applicable assumptions made for making this determination.
(11) Any estimate related to a slowing of the trend in the growth for regional center services due to the implementation of a parental copayment system.
(12) A comparison to how the State Department of Health Services and other state agencies utilize personal information to manage the delivery of benefits and assessment of copayments.
(13) A recommendation on whether the parental copayment system should be centralized at the department or decentralized in the regional centers and the basis for this recommendation.
(14) The estimated cost for implementing a parental copayment system, including any costs associated with consultant contracts, state personnel, revenue collection, computer system processing, regional center operations, or any other cost factor that would need to be included in order to capture all estimated costs for implementation.
(15) The timeframe for which the parental copayment system is to be implemented.
(f) (1) In order for the department to develop a detailed plan for the implementation of a parental copayment system, the department shall collect information from selected families. In order to be cost efficient and prudent regarding the collection of information, the department may conduct a survey of only those families known to have children not eligible for the Medi-Cal program. The survey instrument may only be used for the sole purpose of obtaining information that is deemed necessary for the development of a parental copayment system, including the following:
(A) A family’s annual adjusted gross family income.
(B) The number of family members dependent on that income.
(C) The number of children who meet the criteria specified in subdivision (d).
(2) Results of the survey in the aggregate shall be provided to the Legislature as part of the department’s plan as required by subdivision (a).
(Added by Stats. 2003, Ch. 230, Sec. 47. Effective August 11, 2003.)
Last modified: October 25, 2018