BILL ANALYSIS �
Senate Appropriations Committee Fiscal Summary
Senator Kevin de Le�n, Chair
AB 419 (Lowenthal) - CalWORKs eligibility: hospitalization.
Amended: As Introduced Policy Vote: Human Services 6-0
Urgency: No Mandate: Yes
Hearing Date: July 1, 2013 Consultant: Jolie Onodera
This bill does not meet the criteria for referral to the
Suspense File.
Bill Summary: AB 419 would repeal the two-month cap on CalWORKs
aid payments to a child in a public hospital and instead would
provide that a child who is a patient in a public or private
hospital for medical or surgical care shall be considered
temporarily absent from the home, and therefore eligible for a
CalWORKs grant, for the duration of the hospital stay.
Fiscal Impact:
Minor one-time costs to the Department of Social Services
(DSS) to revise regulations consistent with the provisions
of this measure.
Potential increase in CalWORKs program costs potentially in
the range of $16,000 to $40,000 (General Fund) per year.
Background: Current law provides for the California Work
Opportunity and Responsibility to Kids (CalWORKs) program under
which each county provides cash assistance and other benefits to
qualified low-income families. Existing state law prohibits
CalWORKs aid payments to a child while he or she is a patient in
a public hospital, except with respect to temporary medical or
surgical care not exceeding two calendar months. This two-month
provision only applies to children who are absent from the home
and receiving care in a public hospital. In contrast,
CalWORKs-aided children in private hospitals are considered
temporarily absent from the home, and therefore eligible for a
CalWORKs grant, for the duration of the hospital stay.
Federal law generally prohibits a state to which a TANF grant is
made from using any part of the grant to provide assistance for
a minor child who has been, or is expected by a parent of the
child to be, absent from the home for a period of 45 consecutive
days or, at the option of the state, such period of not less
AB 419 (Lowenthal)
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than 30 days and not more than 180 consecutive days, as
specified in the state plan. Federal law, however, grants states
the authority to establish good cause exceptions to providing
benefits for minor children who are absent from the home for a
significant period, if such exceptions are provided for in the
state plan (42 USC � 608(10)).
This bill seeks to create parity among patients in public and
private hospitals who are also recipients of CalWORKs aid.
Proposed Law: This bill would repeal the existing limit on
CalWORKs aid to only two months when a child is absent from the
home and a patient in a public hospital. This bill removes the
two month cap and extends the payment of CalWORKs benefits to a
child while he or she is a patient in a public or private
hospital for the duration of the hospital stay.
Staff Comments: To the extent the provisions of this bill result
in fewer families being removed from CalWORKs aid or having
their CalWORKs grant reduced due to a child requiring an
extended public hospital stay could result in increased CalWORKs
grants and services costs.
Based on information from the Office of Statewide Health
Planning and Development (OSHPD), 3,365 children in California
were hospitalized for longer than 60 days in 2011, and 1,644
children in California were hospitalized for longer than 60 days
from January through June 2012 (six months). This results in an
average of 3,325 children in California who are hospitalized for
longer than 60 days per year. Applying this number to 2010
Census data on the number of children in California (9.3
million) equates to a ratio of approximately 0.03 percent of
children in California who are hospitalized for longer than 60
days per year.
It is unknown how many of the children hospitalized are also
CalWORKs recipients, and of those hospitalized, how many receive
treatment in public hospitals. However, based on information
from the California Public Hospitals and Health Systems, 30
percent of persons treated are Medi-Cal patients. Applying the
ratio noted above against the projected number of children in
CalWORKs results in an estimate of approximately 96 children per
year who would not be removed from the CalWORKs assistance unit
(AU) during their hospital stay. Additional information from
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OSHPD regarding the average length of stay for children
hospitalized for longer than 60 days indicate an average length
of stay of approximately 100 days, or 40 days more than the 60
days allowable to retain eligibility for CalWORKs under existing
law.
Estimated CalWORKs grant costs for 96 children assuming a grant
cost of $122 per month for an additional 40 days would equate to
approximately $16,000 per year. It is unknown how many of the
hospitalized children would be members of families of one child,
resulting in loss of CalWORKs eligibility for the entire family
upon a public hospital stay in excess of 60 days. To the extent
10 to 25 percent of the 96 children would have been a member of
a family with one child, resulting in lost eligibility for the
entire family, potential costs would increase to $25,000 to
$40,000 assuming extended CalWORKs grant and services costs for
the entire family.
The DSS would incur minor and absorbable one-time costs to
revise regulations to reflect the provisions of this measure.