BILL ANALYSIS Ó ------------------------------------------------------------ |SENATE RULES COMMITTEE | SB 970| |Office of Senate Floor Analyses | | |1020 N Street, Suite 524 | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ------------------------------------------------------------ THIRD READING Bill No: SB 970 Author: De León (D), et al. Amended: 5/29/12 Vote: 21 SENATE HEALTH COMMITTEE : 8-0, 4/11/12 AYES: Hernandez, Harman, Alquist, Anderson, De León, DeSaulnier, Rubio, Wolk NO VOTE RECORDED: Blakeslee SENATE APPROPRIATIONS COMMITTEE : 5-2, 5/24/12 AYES: Kehoe, Alquist, Lieu, Price, Steinberg NOES: Walters, Dutton SUBJECT : Health Care Reform Eligibility, Enrollment, and Retention Planning Act: coordination with other programs SOURCE : Western Center on Law and Poverty DIGEST : This bill requires the states new single application for health subsidy programs (being developed pursuant to the Affordable Care Act) to interface with eligibility and enrollment systems used by county social service programs. ANALYSIS : Existing law: CONTINUED SB 970 Page 2 1. Requires the California Health Benefit Exchange (Exchange) to inform individuals of eligibility requirements for the Medi-Cal program, the Healthy Families Program, or any applicable state or local public program. Requires, through screening of the application for coverage by the Exchange, if the Exchange determines that an individual is eligible for any such program, the Exchange to enroll that individual in the program. 2. Requires, under the Health Care Reform Eligibility, Enrollment, and Retention Planning Act, the California Health and Human Services Agency (Agency), in consultation with the Department of Health Care Services (DHCS), the Managed Risk Medical Insurance Board (MRMIB), the Exchange, the California Office of Systems Integration, counties, health plans, consumer advocates, and other stakeholders to undertake a planning and development process regarding the federal Patient Protection and Affordable Care Act (ACA) related to eligibility for, and enrollment and retention in, state health subsidy programs. 3. Requires DHCS, in consultation with MRMIB and the Exchange, to develop a single, accessible, standardized paper, electronic, and telephone application for state health subsidy programs as part of the stakeholder process in #2 above. Requires the application to be used by all entities authorized to make an eligibility determination for any of the state health subsidy programs, and by their agents. This bill: 1. Requires, at the time of initial application for or renewal of health care coverage using the single state application required under existing law, that an individual be allowed to consent to have his or her application information used by the appropriate county human services department to initiate a simultaneous application for CalWORKs and CalFresh, and by other state or local departments for other human services or work support programs identified by the workgroup established by this bill. CONTINUED SB 970 Page 3 2. Requires a county human services department, with a beneficiary's consent, to take information used to renew a beneficiary's eligibility for a state health subsidy program and use that information to continue or recertify CalWORKs or CalFresh benefits for all eligible individuals, if the information is sufficient to meet the requirements for a CalWORKs or CalFresh semiannual report or annual recertification. 3. Requires Agency to convene a workgroup of human services and health care advocates, legislative staff, representatives of county human services departments and county eligibility workers, and staff from appropriate state and local departments, to consider and develop a plan for the integration of additional human services and work support programs into the process described in #1) above. 4. Requires the above requirements to be implemented by December 31, 2015. 5. Requires DHCS, in conjunction with counties, the Department of Social Services, and representatives of the Statewide Automated Welfare System (SAWS) consortia, county eligibility workers, consumers, and other affected stakeholder groups, to conduct a planning process and develop administrative enrollment and renewal policies and procedures, which DHCS is required to implement by means of all-county letters or similar instructions from the director. Background The ACA, enrollment application process, and this bill proposes changes. The ACA makes numerous changes to increase the number of individuals with health coverage. These changes include requiring a single streamlined form for state health subsidy programs, and by allowing individuals to be able to apply in person, by mail, through the internet, or by telephone. California, through the Exchange, has issued a request for proposal (RFP) to implement a new information technology CONTINUED SB 970 Page 4 system known as CalHEERS (California Healthcare Eligibility, Enrollment and Retention System). CalHEERS will provide a "one-stop-shop" to determine eligibility for non-subsidized health coverage for individuals in the Exchange, and subsidized coverage for individuals eligible for state health subsidy programs. The Exchange RFP for CalHEERS calls for vendors to provide the ability to notify the applicant that he or she may be eligible for other state programs (for example, CalWORKs and CalFresh), that would direct the individual to the appropriate links, and collect and send the basic application data (along with any documents provided by the applicant) to the system of record for that program to complete the application process. The Exchange asked vendors to have the ability to provide this expanded system by December 31, 2015, but the Exchange has a not made a decision on whether it wishes to purchase these additional services (known as a "state option to buy"). Vendor submissions to the Exchange were submitted earlier this year, and the bids are not public information. Vendor selection is anticipated for late April or early May 2012. Once the contract has been awarded, the contract and the dollar amounts will be made public. The current application process for Medi-Cal is primarily through county human services departments, where individuals can apply either in person, through the mail, or online. In addition, individuals can also apply (through the county) for enrollment in human services programs such as CalWORKs or CalFresh (previously known as Food Stamps) using the same application, but those programs have additional requirements that Medi-Cal does not. FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes Local: Yes According to the Senate Appropriations Committee, unknown costs to convene a workgroup and develop a plan to integrate social service program eligibility and enrollment systems into the single application (mostly federal funds). SUPPORT : (Verified 5/29/12) Western Center on Law and Poverty (source) CONTINUED SB 970 Page 5 ACCESS Women's Health Justice Alameda County Community Food Bank American Federation of State, County and Municipal Employees, AFL-CIO California Association of Food Banks California Black Health Network California Catholic Conference, Inc. California Children's Health Coverage Coalition California Commission on Aging California Communities United Institute California Coverage & Health Initiatives California Family Resource Association California Food Policy Advocates California Hunger Action Coalition California Pan Ethnic Health Network California Partnership to End Domestic Violence California Rural Legal Assistance Foundation California School Nutrition Association California WIC Association Catholic Charities of California United Children Now Children's Defense Fund Coalition of California Welfare Rights Organizations, Inc. Community Clinic Association of Los Angeles County Consumer Federation of California County Welfare Directors Association of California George M. Shirakawa, President, Santa Clara County Board of Supervisors Greenlining Institute Having Our Say Health Access California Hunger Action Los Angeles Jericho: A Voice for Justice La Cooperativa Campesina de California Latino Coalition for a Healthy California LifeLong Medical Care Los Angeles Regional Food Bank Madera Coalition for Community Justice National Association of Social Workers National Health Law Program River City Food Bank San Francisco Food Security Task Force Service Employees International Union The Children's Partnership CONTINUED SB 970 Page 6 United Way CA ARGUMENTS IN SUPPORT : According to the author's office, this bill has two goals: (1) to allow consumers applying for health coverage through the new streamlined California Healthcare Eligibility, Enrollment and Retention System (CalHEERS is an information technology system) to also apply for human services programs, so they can receive needed public benefits; and (2) to maximize enrollment in health coverage by 2014 by identifying CalFresh recipients who are uninsured and, with their consent, using their CalFresh information to apply for health coverage. Integrating human services programs into CalHEERS increases administrative efficiency and streamlines the application and renewal processes for consumers. The benefits of maximizing health coverage enrollment are several. Californians will be required by law to have health coverage in 2014 and coverage for the newly eligible will be paid for with 100 percent federal funds from 2014-2016, going to a still-high 90 percent federal match by 2020. Multiple strategies are needed to maximize health coverage enrollment including "pre-enrollment" of eligible populations such as CalFresh recipients. Additional strategies to reach those eligible for CalFresh benefits (a 100 percent federally financed benefit) are also needed given California's low participation level. CTW:do 5/29/12 Senate Floor Analyses SUPPORT/OPPOSITION: SEE ABOVE **** END **** CONTINUED