(a) A person shall be eligible to receive services pursuant to this chapter provided that the following conditions are met:
(1) The person is a resident of California.
(2) The person has a family income at or below 200 percent of the federal poverty level.
(3) The person has no other source of health care coverage unless the use of that health care coverage would create a barrier to access because of confidentiality.
(4) The person is not otherwise eligible for existing Medi-Cal services without a share of cost.
(b) Notwithstanding any other provision of law, the provision of family planning services shall not require the consent of anyone other than the person who is to receive the services.
(c) Eligibility shall be determined at point of service by the provider. The provider shall obtain information on the individual’s family size, income, and health care coverage and then, based on that information, determine if the individual meets the eligibility criteria specified in subdivision (a). All individuals who meet the eligibility requirements shall be certified by the provider as eligible for services under the program. A Medi-Cal share of cost shall not be used to deny access to family planning services under the program. The department may require the collection on a voluntary basis or the use of the individual’s social security number, or both. No services shall be denied to a client if a social security number is not provided.
(d) Eligibility shall be based on the individual’s self-declaration of gross annual or monthly income, family size, and other source of health care coverage, signed under penalty of perjury at each annual eligibility certification. No asset information shall be used to determine eligibility.
(e) The department may establish a copayment system for services provided pursuant to this chapter that is based upon the income level of the individual and the cost of the service provided. No individual whose documented family income is at or below 100 percent of the federal poverty level shall be subject to copayment. The copayment fee shall not be used to deny access to family planning services. State reimbursement to the provider shall be offset by that amount of the copayment collected from the eligible individual. The department shall notify providers on an annual basis of the copayment fee schedule.
(Added by Stats. 1996, Ch. 197, Sec. 52. Effective July 22, 1996.)
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