BILL ANALYSIS                                                                                                                                                                                                    �




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          Date of Hearing:   July 2, 2013

                        ASSEMBLY COMMITTEE ON HUMAN SERVICES
                                  Mark Stone, Chair
                      SB 252 (Liu) - As Amended:  June 24, 2013

           SENATE VOTE  :  34-4
           
          SUBJECT  :  CalWORKs: welfare-to-work requirements

           SUMMARY  :  Clarifies that pregnant women who are CalWORKs  
          recipients and who do not have medical verification of a  
          pregnancy-related illness shall be considered for other  
          welfare-to-work exemptions that are applied under current law  
          for non-pregnant CalWORKs recipients and includes home visit  
          program participation within welfare-to-work activities, as  
          specified.

          Specifically,  this bill  : 

          1)Exempts a pregnant woman from CalWORKs welfare-to-work  
            requirements if she is unable to secure medical verification  
            of a pregnancy-related illness but is otherwise eligible for  
            another welfare-to-work exemption, including good cause for  
            temporary illness related to her pregnancy.

          2)Allows a pregnant woman to satisfy CalWORKs work requirements  
            through participation in a voluntary maternal, infant, and  
            early childhood home visiting program or another voluntary  
            home visiting program for low-income Californians, and allows  
            the hours spent in the home visiting program to be applied to  
            her required work participation hours for no more than a  
            10-month period.

          3)Provides that the authorization for voluntary home visiting  
            program hours to count toward work participation hours shall  
            only be granted if a waiver of compliance is received from the  
            US Department of Health and Human Services, as specified.

          4)States legislative findings and declarations related to the  
            advantages to breastfeeding for mothers and their children.

          5)Restates current law allowing a woman to breastfeed in a  
            public area where the mother and child are authorized to be  
            present and explicitly includes in that description of public  









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            area a county welfare department or other county office.

           EXISTING LAW  

          1)Establishes under federal law the Temporary Assistance for  
            Needy Families (TANF) program to provide aid and  
            welfare-to-work services to eligible families and, in  
            California, provides that TANF funds for welfare-to-work  
            services are administered through the California Work  
            Opportunity and Responsibility to Kids (CalWORKs) program.   
            (42 U.S.C. 601 et seq., WIC 11200 et seq.) 

          2)Establishes income, asset and real property limits used to  
            determine eligibility for the program, including net income  
            below the Maximum Aid Payment (MAP), based on family size and  
            county of residence, which is currently no higher than 40% of  
            the Federal Poverty Level.  (WIC 11450, 11150 et seq.)

          3)Establishes a 48-month lifetime limit of CalWORKs benefits for  
            eligible adults, including 24 months during which a recipient  
            must meet federal work requirements in order to retain  
            eligibility.  (WIC 11454, 11322.85)

          4)Requires all individuals over 16 years of age, unless they are  
            otherwise exempt, to participate in welfare-to-work activities  
            as a condition of eligibility for CalWORKs.  (WIC 11320.3,  
            11322.6)

          5)Requires payment of CalWORKs aid to an eligible pregnant woman  
            for the month in which the birth is anticipated and for the  
            three-month period immediately prior to the month in which the  
            birth is anticipated if the mother provides verification of  
            pregnancy and is in a family without a needy child qualified  
            for aid.  (WIC 11450 (b)) 

          6)Exempts specified categories of recipients from participation  
            in welfare-to-work activities, including a pregnant woman who  
            has medical verification that her pregnancy impairs her  
            ability to be regularly employed or participate in  
            welfare-to-work activities or a pregnant woman for whom the  
            county has otherwise determined that, at that time,  
            participation in welfare-to-work activities would not lead to  
            employment or a training activity is not appropriate.  (WIC  
            11320.3(b))










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          7)Exempts from welfare-to-work activities a parent or other  
            adult CalWORKs recipient with primary responsibility for  
            personally providing care to one child from birth to 23  
            months, inclusive, and requires this exemption to be available  
            only once in addition to any other young child exemption, as  
            specified.  (WIC 11320.3(b))

          8)Requires a county to excuse a CalWORKs recipient from  
            welfare-to-work participation for good cause when the county  
            has determined the recipient has a condition or is faced with  
            a circumstance that temporarily prevents or significantly  
            impairs the recipient's ability to be regularly employed or to  
            participate in welfare-to-work activities, and requires county  
            welfare departments to review a good cause determination to  
            establish its continuing appropriateness, as specified, no  
            less than every three months.  (WIC 11320.3(f))

          9)Establishes the California Families and Children Home Visit  
            Program, through which grants are provided to counties for the  
            purpose of providing at-risk families, as defined, services to  
            improve parent and child outcomes, including reductions in the  
            mistreatment of children, increased rates of school  
            completion, reduced incidence of teenage pregnancy, reduced  
            interaction with the juvenile justice system, and improved  
            health.  (WIC 18994 et seq.) 

          10)Establishes in federal law The Maternal, Infant, and Early  
            Childhood Home Visiting program (MIECHV), which allows  
            collaboration at the federal, state, tribal, and community  
            levels and provides grant allocations to states for the  
            purpose of improving health and development outcomes for  
            at-risk children and families through evidence-based home  
            visiting programs.  (42 U.S.C. 711) 

          11)Permits the Secretary of US Department of Health and Human  
            Services to waive a state's compliance with TANF state plan  
            requirements, as specified, to conduct an experimental, pilot,  
            or demonstration project which, in the judgment of the  
            Secretary, will assist in promoting the objectives of federal  
            TANF law.  (42 U.S.C. 1315; Social Security Act Sec. 1115) 

          12)Requires DSS to obtain all necessary waivers from the US  
            Department of Health and Human Services to implement  
            welfare-to-work requirements that are inconsistent with  
            federal TANF law and requires any such waiver to only be  









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            operative during the period for which the waiver is granted,  
            as specified.  (WIC 11329.2) 

          13)Establishes, within the Unruh Civil Rights Act, the right of  
            all persons within the jurisdiction of the state to be free  
            and equal and entitled to full and equal accommodations, as  
            specified, regardless of their sex, race, color, religion,  
            ancestry, national origin, disability, medical condition,  
            genetic information, marital status, or sexual orientation.   
            (CIV 51)

          14)Allows a mother to breastfeed her child in any location,  
            public or private, except the private home or resident of  
            another, where the mother and the child are otherwise  
            authorized to be present.  (CIV 43.3)

           FISCAL EFFECT  :  According to the May 23, 2013 Senate  
          Appropriations Committee analysis, this bill may result in  
          potential one-time significant automation costs (General Fund)  
          to the extent enhancements are required for the allowance of  
          participation in a maternal home visiting program as countable  
          work participation hours.  Additionally, subject to waiver  
          approval, this bill may result in an increase in ongoing  
          CalWORKs grant costs potentially in excess of $150,000 (General  
          Fund) resulting from reduced sanctions to the extent the hours  
          spent participating in a maternal, infant, and early childhood  
          home visiting program are countable towards a recipient's  
          required monthly work participation hours.  Administrative costs  
          to collect and verify program participation hours could also be  
          incurred. 

           COMMENTS  :  The California Work Opportunity and Responsibility to  
          Kids (CalWORKs) program provides monthly income assistance and  
          employment-related services aimed at moving children out of  
          poverty and helping families meet basic needs.  Federal funding  
          for CalWORKs comes from the Temporary Assistance for Needy  
          Families (TANF) block grant.  The average monthly cash grant for  
          a family of three on CalWORKs (one parent and two children) is  
          $464.    According to data from the California Department of  
          Social Services, 562,570 families rely on CalWORKs, including  
          over one million children.  Nearly half of the children are  
          under age six.

          Average grants of $464 per month for a family of three means  
          $15.46 per day, per family, or $5.15 per family member, per day  









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          to meet basic needs, including rent, clothing, utility bills,  
          food, and anything else a family needs to ensure children can be  
          cared for at home and safely remain with their families.  This  
          grant amount puts the annual household income at $5,568 per  
          year.  Federal Poverty Guidelines show that 100% of poverty for  
          2013 is three and a half times that at $19,530 per year.  In  
          addition to aiding eligible needy families with children,  
          CalWORKs provides assistance to eligible pregnant women, without  
          other children in the household qualified to receive aid, who  
          are in their third trimester of pregnancy and have provided  
          verification of pregnancy to the county office.  The maximum  
          monthly grant for a pregnant woman on CalWORKs who is the sole  
          recipient in the household is $317.

           Welfare-to-Work activities  :  Welfare-to-work activities within  
          the CalWORKs program include public or private sector subsidized  
          or unsubsidized employment; on-the-job training; community  
          service; secondary school, adult basic education and vocational  
          education and training when the education is needed for the  
          recipient to become employed; specific mental health, substance  
          abuse, domestic violence services if they are necessary to  
          obtain or retain employment; and a number of other activities  
          necessary to assist a recipient in obtaining unsubsidized  
          employment.  If a CalWORKs recipient who is not exempt from  
          participation does not meet his or her welfare-to-work  
          requirements, the recipient is sanctioned for noncompliance, and  
          that recipient's portion of the family's grant is removed.  This  
          means that in a typical family of three with one parent and two  
          children, the parent's sanction would reduce the family's  
          average monthly grant from $464 to $322. 

           Welfare-to-Work exemptions  :  Under current law, CalWORKs  
          recipients over 16 years of age are required to participate in  
          county-approved welfare-to-work activities as a condition of  
          receiving aid while on the program unless they are eligible for  
          a welfare-to-work exemption.  Included among the list of  
          exempted individuals are recipients with an enduring disability  
          that prevents them from being able to regularly participate in  
          welfare-to-work activities; recipients of advanced age;  
          recipient caretakers of disabled family members, or children at  
          risk of placement in foster care, whose care needs impair the  
          CalWORKs recipient's ability to be regularly employed or to  
          participate in welfare-to-work activities; and pregnant women  
          who can provide medical verification that their pregnancy  
          impairs their ability to participate in welfare-to-work  









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          activities or otherwise be regularly employed.  Exemptions from  
          welfare-to-work requirements can also be granted to parents or  
          other relative caretakers with personal responsibility to care  
          for children from zero to six months of age, the duration of  
          which can be reduced to 12 weeks or increased to 12 months at a  
          county's discretion.  As a result of SB 1041 (Committee on  
          Budget) Chapter 47, Statutes of 2012, which restricts the  
          applicability of certain welfare-to-work activities and support  
          services to a 24-month period within a recipient's lifetime  
          limit of 48 months of aid, state law includes a young child  
          exemption from welfare-to-work requirements that can be applied  
          to a parent or relative caretaker caring for a child under two  
          years of age.  This exemption can only be used once during the  
          parent or relative caretaker's time on aid.   

          Counties can also excuse recipients from participation in  
          welfare-to-work activities for good cause if a county has  
          determined that a recipient's condition or other circumstances  
          temporarily prevent him or her from being able to participate in  
          welfare-to-work activities or to be regularly employed.  Under  
          good cause, a victim of domestic violence must be excused if  
          participation in welfare-to-work would be detrimental to the  
          victim or his or her family.  Pregnant women who experience  
          temporary illness due to their pregnancy but are not able to  
          provide medical verification can also be excused under good  
          cause, provided that the county determines that the expectant  
          mother is not able to participate in welfare-to-work activities  
          or engage in regular employment.  However, unlike the specific  
          aforementioned exemptions from welfare-to-work requirements,  
          good cause is granted at the county's discretion based on a  
          county's determination that a condition or circumstance meets  
          specified criteria.  

          Because recipients who are determined to be exempt or excused  
          from welfare-to-work activities have been deemed by the county  
          to be incapable of fully participating in available work  
          activities or other employment, these recipients cannot be  
          sanctioned for noncompliance and are eligible to continue to  
          receive their grants during the period of exemption.   
          Additionally, state law explicitly allows any recipient who is  
          exempt from welfare-to-work participation to voluntarily  
          participate, and that recipient can choose to end his or her  
          voluntary participation without losing eligibility for aid as  
          long as he or she continues to meet the exemption criteria.   
          This allows new mothers who are exempt, for example, to remain  









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          engaged in the workforce without penalizing them for choosing to  
          discontinue or lessen participation in their work activity to  
          spend time caring for their infants.

           Home visit programs  :  The Maternal, Infant, and Early Childhood  
          Home Visiting Program (MIECHV) was established within the  
          federal Patient Protection and Affordable Care Act (ACA) to  
          provide grants to states to enhance evidence-based home visiting  
          program models for at-risk pregnant women and young children.   
          According to the Administration for Children and Families (ACF)  
          within the US Department of Health and Human Services, home  
          visits under the MIECHV are offered, on a voluntary basis, to  
          pregnant women, expectant fathers, and primary caregivers of  
          children from birth to age 5.  MIECHV home visits are intended  
          to meet a number of targeted outcomes within the ACA, including  
          improved maternal, infant, and child health; improvement in  
          parenting skills; prevention of child injuries, child abuse or  
          maltreatment, and reduction of emergency room visits; reduction  
          in crime or domestic violence; improvement in school readiness  
          and child academic achievement; and improvements in family  
          economic self-sufficiency.<1>

          In California, the Maternal, Child, and Adolescent Health  
          Division was established within the California Department of  
          Public Health (DPH) to be the single state entity designated to  
          apply for and administer MIECHV funds for the state.  There are  
          two home visiting programs providing services to low-income  
          parents and their children in California; the Nurse Family  
          Partnership and Healthy Families America.  Both programs have  
          shown proven effectiveness in strengthening parent-child  
          relationships, increasing language and literacy skills, and  
          reducing child abuse and neglect. There are currently 22  
          MIECHV-funded home visiting sites throughout the state within 21  
          local health jurisdictions (LHJs), including communities in Los  
          Angeles, Kern, San Diego, Siskiyou, Sacramento, Merced, and  
          Fresno counties.

           Breastfeeding  :  According to an American Academy of Pediatrics  
          (AAP) policy statement titled "Breastfeeding and the Use of  
          Human Milk" (2012), scientific studies show that breastfeeding  
          ---------------------------
          <1> Affordable Care Act Maternal, Infant, and Early Childhood  
          Home Visiting Program (MIECHV) and Tribal MIECHV.  
           http://www.acf.hhs.gov/programs/ecd/programs/home-visiting  . 










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          is directly linked to positive infant health outcomes, including  
          a lowered risk of infections, leukemia, asthma, obesity, and  
          lowered hospitalization and overall mortality rates.  The AAP  
          also cites a correlation between breastfeeding and positive  
          neurodevelopmental outcomes for children, as well as short- and  
          long-term health benefits for mothers who breastfeed.<2>  

          While the US Court of Appeals recognized a woman's  
          constitutional right to breastfeed in  Dike v. Orange County  
          School Board  (1981), the right was not explicitly written into  
          California law until the late 1990's.  AB 157 (Villaraigosa),  
          Chapter 59, Statutes of 1997, established a woman's right to  
          breastfeed her child in any public or private location besides  
          the private home or residence of another person, provided that  
          she and her child are authorized to be there.  Recent amendments  
          to this bill restate current law and clarify that "public areas"  
          for purposes of a woman's right to breastfeed include county  
          welfare departments and other county offices.  Breastfeeding and  
          public benefits advocates have reported that they've received  
          several complaints from CalWORKs applicants and recipients who  
          have attempted to breastfeed in a county office and have been  
          told that they are not allowed to do so or that they need to  
          leave.  Given the positive physical and neurodevelopmental  
          health advantages that are linked to breastfeeding, mothers  
          receiving CalWORKs assistance could greatly benefit from  
          breastfeeding support in the county office rather than shame and  
          embarrassment in addition to the threat of losing access to the  
          temporary assistance they need to support their families.

           Need for the bill  :  This bill seeks to enhance opportunities for  
          pregnant women on CalWORKs to engage in appropriate and  
          meaningful welfare-to-work activities while improving long term  
          outcomes for themselves and their children.  By screening  
          pregnant women in the CalWORKs program for the same  
          welfare-to-work exemptions as other applicants and recipients  
          who are not pregnant, this bill will ensure a greater degree of  
          fairness in the application of work requirements and sanction  
          policies.  Currently, a pregnant women who cannot obtain medical  
          verification of a condition that makes her unable to work can be  
          sanctioned, but the moment her child is born, she is eligible  
          ---------------------------
          <2>Section on Breastfeeding, American Academy of Pediatrics.   
          Breastfeeding and the Use of Human Milk.  Pediatrics (2012).  
           http://pediatrics.aappublications.org/content/129/3/e827.full.htm 
          l  . 
          








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          for the 24-month young child exemption from welfare-to-work.   
          This practice likely results in unnecessary administrative costs  
          and unfairly penalizes pregnant women who are focused on  
          maintaining their unborn babies' health.  Additionally, the  
          denial of basic needs aid during pregnancy only increases stress  
          levels for a pregnant woman, worsens her financial situation,  
          and threatens her physical and psychological well-being, thereby  
          increasing health risks for her baby. 

          This bill also allows the time-limited inclusion of  
          government-approved home visiting programs on the list of  
          welfare-to-work activities for pregnant women, provided the  
          state is granted the appropriate waiver.  For those women who  
          are pregnant and are able to work, or those who are exempt but  
          choose to volunteer, this new policy could increase promising  
          outcomes for them and their children through allowing them to be  
          aided while they interact with nurses and other professionals  
          who can help guide them through the initial stages of parenting.  
           Like many other welfare-to-work activities, evidence-based home  
          visiting programs increase soft skills for parents that help  
          them have healthy and successful transitions into the workforce,  
          as well as introduce parents to a broader spectrum of support  
          services that will help eliminate future dependency on programs  
          like CalWORKs.  Lastly, acknowledging the benefits of bonding  
          between mothers and their children and the health benefits of  
          breastfeeding, recent amendments to this bill reiterate a  
          woman's right to breastfeed in county offices.  These provisions  
          further ensure a mother will not be penalized for responding to  
          her child's needs while meeting her CalWORKs obligations.

           PROPOSED AMENDMENTS  :
          The June 24, 2013 amendments to this bill pertaining to a  
          woman's right to breastfeed in a public area include a statement  
          that this right is declaratory of existing law.  However, staff  
          believes there should be a direct reference to existing law that  
          establishes this right.  Therefore, staff recommends the  
          following amendments to add a cross reference to current law in  
          subdivision (a) and to delete subdivision (b), beginning on page  
          3, line 7:

          11218.  (a) Pursuant to Civil Code Section 43.3,  A  an applicant  
          or recipient of aid under this chapter is entitled to breastfeed  
          her child in any public area, or area where the mother and the  
          child are authorized to be present, in a county welfare  
          department or other county office.
         








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           (b) This section is declaratory of existing law.





















































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           REGISTERED SUPPORT / OPPOSITION  :

           Support 
           
          Asian Law Alliance
          BreastfeedLA
          California Alternative Payment Program Association (CAPPA)
          California Association of Food Banks
          California Catholic Conference
          Center for Work Life Law, UC Hastings College
          Children Now
          Coalition of California Welfare Rights Organizations
          Labor Project for Working Families
          National Association of Social Workers, CA Chapter (NASW-CA)
          Sacramento Housing Alliance
          UAW Local 2865
          Western Center on Law and Poverty
           
            Opposition 
           
          None on file

           Analysis Prepared by  :    Myesha Jackson / HUM. S. / (916)  
          319-2089