BILL NUMBER: AB 963 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY APRIL 28, 2009
AMENDED IN ASSEMBLY APRIL 2, 2009
INTRODUCED BY Assembly Member Ammiano
FEBRUARY 26, 2009
An act to add Sections 14012.6, 14012.7, and 14012.8 to the
Welfare and Institutions Code, relating to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
AB 963, as amended, Ammiano. Medi-Cal eligibility.
Existing law creates various programs to provide health care
services to persons who have limited incomes and meet various
eligibility requirements, including, but not limited to, the Medi-Cal
program, which is administered by the State Department of Health
Care Services, and under which qualified low-income individuals
receive health care benefits. Existing law also provides for the Food
Stamp Program, under which food stamps are allocated by each county
in accordance with federal requirements, and the CalWORKS
CalWORKs program, under which each county
provides cash assistance and other benefits to qualified low-income
families and individuals who meet specified eligibility criteria.
Under existing law, the Food Stamp Program and the CalWORKs program
are administered at the state level by the State Department of Social
Services.
This bill would require the department, in consultation with the
State Department of Social Services, counties, representatives
from the Statewide Automated Welfare System (SAWS) consortia,
consumer advocates, and other stakeholder groups to make
necessary technological and policy changes to update the data
sharing, computer programming, and administrative procedures, as
provided, to ensure the continuation of Medi-Cal benefits when a
beneficiary reports a change in circumstances to the Food Stamp
Program or the CalWORKs program that would continue Medi-Cal
eligibility. The bill would declare these provisions to be
declaratory of existing law.
This bill would provide that a beneficiary who completes a
periodic report or annual renewal form in the CalWORKs program or
Food Stamp Program shall be deemed to have met the requirements to
return and sign a periodic report or annual form for the next
scheduled period in the Medi-Cal program. The bill would provide that
if information a beneficiary submits in the CalWORKs program or Food
Stamp Program periodic reporting or annual renewal process is
sufficient to continue Medi-Cal eligibility, the county shall deem
the beneficiary to have met the Medi-Cal annual redetermination
requirement.
This bill would provide that an individual or family that submits
and signs a Food Stamp Program application through any method
accepted by the Food Stamp Program shall be deemed to have met the
requirement to submit and sign a Medi-Cal application. The bill would
provide that if the information an applicant submits in the Food
Stamp Program application is sufficient to establish Medi-Cal
eligibility, the county shall enroll the applicant into the Medi-Cal
program. The bill would require the department to develop a procedure
to, among other things, give applicants the opportunity to opt out
of being enrolled in the Medi-Cal program based on information given
in his or her Food Stamp Program application. By modifying the
Medi-Cal eligibility determination process, this bill would increase
the responsibilities of the counties in the administration of the
Medi-Cal program, thereby imposing a state-mandated local program.
The bill would require the department to issue comprehensive
implementing instructions for policies and procedures, as specified,
for the aforementioned provisions, on or before March 1, 2011.
This bill would require the department to establish procedures and
guidelines for pre-populated prepopulated
renewal forms for all potential and current Medi-Cal
beneficiaries. The pre-populated prepopulated
renewal form and procedures shall
would be used for all beneficiaries whose Medi-Cal renewal is
not accomplished pursuant to the aforementioned enrollment
renewal procedures established pursuant to
this bill . The bill would require the procedures and
guidelines to be phased in statewide include
a timeline for phasing in the prepopulated renewal forms statewide,
beginning January 2011, and fully phasing in the prepopulated renewal
forms by January 2012.
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. Section 14012.6 is added to the Welfare and
Institutions Code, to read:
14012.6. (a) (1) The department, in consultation with the State
Department of Social Services, counties, representatives from the
Statewide Automated Welfare System (SAWS) consortia, consumer
advocates, and other stakeholder groups, shall make all necessary
technological and policy changes to update data sharing, computer
programming, and administrative procedures, to ensure that Medi-Cal
is continued when a Medi-Cal beneficiary reports a change in
circumstances to the Food Stamp Program or the CalWORKs program that
would continue Medi-Cal eligibility.
(2) Nothing in this section shall increase the frequency of the
reporting requirements in the Medi-Cal program or amend the counties'
obligation to redetermine Medi-Cal eligibility and follow all due
process requirements prior to terminating Medi-Cal benefits.
(3) A beneficiary's failure to complete a periodic report or
annual renewal requirement in the CalWORKs program or Food Stamp
Program shall not result in termination or redetermination of
Medi-Cal eligibility.
(4) This subdivision is declaratory of existing law.
Implementation of this subdivision shall not be delayed in order to
implement the other provisions of this section.
(b) A beneficiary who completes a periodic report or annual
renewal form in the CalWORKs program or Food Stamp Program shall be
deemed to have met the requirement to return and sign a periodic
report or annual renewal form for the next scheduled period in the
Medi-Cal program.
(c) If information a beneficiary submits in the CalWORKs program
or Food Stamp Program periodic reporting or annual renewal process is
sufficient to continue Medi-Cal eligibility, the county shall deem
the beneficiary to have met the Medi-Cal annual redetermination
requirement in Section 14012. These Medi-Cal beneficiaries shall have
their eligibility continued for the greatest period of time allowed
under this chapter and all scheduled renewal dates or reporting
dates, if any, shall be reset accordingly from the date of
redetermination. Nothing in this section affects a beneficiary's
responsibility to report changes to the county that affect Medi-Cal
eligibility within 10 days of their occurrence.
(d) The procedures described in this section shall be conducted by
electronic means to the greatest extent possible and shall be
developed according to subdivision (g).
(e) The information shared pursuant to this section shall not be
used for any other purposes except as set out in this section.
(f) This section shall supplement, not supplant, the requirements
already in effect pursuant to subdivision (e) of Section 14005.37.
(g) The department, in conjunction with counties, the State
Department of Social Services, and representatives of the SAWS
consortia, consumers, and other affected stakeholder groups, shall
conduct a planning process and develop administrative enrollment and
renewal policies and procedures, to be implemented by all
county all-county letters or similar
instructions. After implementation by all county
all-county letters or similar instructions, the department
shall adopt regulations 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. Comprehensive implementing
instructions shall be issued no later than March 1, 2011. The
policies and procedures shall do all of the following:
(1) Establish appropriate data sharing procedures and safeguards
that do not require any additional consent from beneficiaries for the
information sharing pursuant to this section and that meet
confidentiality and privacy requirements in the Medi-Cal program.
(2) Give priority to the programming changes necessary to enable
the SAWS consortia to automate this enrollment and renewal procedure
in order to minimize manual workload.
(3) Develop procedural protections to ensure that beneficiaries
experience no disruption in coverage and no diminution of their
rights under this chapter.
SEC. 2. Section 14012.7 is added to the Welfare and Institutions
Code, to read:
14012.7. (a) An individual or family that submits and signs a
Food Stamp Program application through any method accepted by the
Food Stamp Program shall be deemed to have met the requirement to
submit and sign a Medi-Cal application.
(b) If information an applicant submits in the Food Stamp Program
application is sufficient to establish Medi-Cal eligibility, the
county shall enroll the applicant into the Medi-Cal program.
(c) For an applicant who is not enrolled into the Medi-Cal program
based upon information provided in his or her Food Stamp Program
application, the county shall make every reasonable effort to gather
information available to the county that is relevant to the applicant'
s Medi-Cal eligibility prior to contacting the applicant. The county
shall follow the same process used for redeterminations of
eligibility described in subdivisions (e) to (g), inclusive, of
Section 14005.37 to attempt to establish Medi-Cal eligibility.
(d) All Medi-Cal applicants whose Medi-Cal eligibility is
established pursuant to this section shall have their eligibility
established for the greatest period of time allowed under this
chapter and all scheduled renewal dates or reporting dates, if any,
shall be set accordingly from the date the Medi-Cal applicant submits
his or her Food Stamp Program application. Nothing in this section
affects a beneficiary's responsibility to report changes to the
county that affect Medi-Cal eligibility within 10 days of their
occurrence.
(e) The procedures described in this section shall be conducted by
electronic means to the greatest extent possible and shall be
developed according to subdivision (h).
(f) The information shared pursuant to this section shall not be
used for any other purposes except as set out in this section.
(g) This section shall supplement, not supplant, the requirements
already in effect pursuant to subdivision (e) of Section 14005.37.
(h) The department, in conjunction with counties, the State
Department of Social Services, and representatives of the SAWS
consortia, consumers, and other affected stakeholder groups, shall
conduct a planning process and develop administrative enrollment and
renewal policies and procedures, to be implemented by all
county all-county letters or similar
instructions. After implementation by all county
all-county letters or similar instructions, the department
shall adopt regulations 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. Comprehensive implementing
instructions shall be issued no later than March 1, 2011. The
policies and procedures shall do all of the following:
(1) Establish appropriate data sharing procedures and safeguards
that do not require any additional consent from applicants for the
information sharing pursuant to this section and that meet
confidentiality and privacy requirements in the Medi-Cal program.
(2) Give priority to the programming changes necessary to enable
the SAWS consortia to automate this application and enrollment
procedure in order to minimize manual workload.
(3) Develop procedural protections to ensure that applicants
experience no delay in coverage and no diminution of their rights
under this chapter.
(4) Develop a procedure whereby applicants for benefits under the
Food Stamp Program are informed about the benefits of the Medi-Cal
program and are given an opportunity to opt out of Medi-Cal
enrollment, as described in subdivision (b). The opt out procedure
shall be minimally burdensome to the applicant. The county shall
presume the applicant wants to be enrolled in the Medi-Cal program
unless the applicant expressly opts out verbally, in writing, or
electronically, and the county documents the opt out in the case
file.
SEC. 3. Section 14012.8 is added to the Welfare and Institutions
Code, to read:
14012.8. (a) The department, in conjunction with counties and
representatives of the Statewide Automated Welfare System (SAWS)
consortia, consumers, and other affected stakeholder groups, shall
establish procedures and guidelines for pre-populated
prepopulated renewal forms for all potential and
current Medi-Cal beneficiaries.
(b) The pre-populated prepopulated
renewal form and procedures shall be used for all beneficiaries whose
Medi-Cal renewal is not accomplished through the renewal procedures
set forth in Sections 14012.6 and 14012.7. Periodic reporting forms,
if any, shall also be created in accordance with this subdivision.
(c) The department shall use the pre-populated
prepopulated renewal form as the annual reaffirmation form
required under Section 14012.
(d) The procedures and guidelines established pursuant to this
section shall include a timeline for phasing in this
procedure the prepopulated renewal forms
statewide, beginning in January 2011, and fully phasing in the
procedure prepopulated renewal forms by
January 2012.
SEC. 4. 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.