BILL ANALYSIS Ó SB 346 Page 1 SENATE THIRD READING SB 346 (Beall) As Amended September 6, 2013 Majority vote SENATE VOTE :26-11 HUMAN SERVICES 5-2 ----------------------------------------------------------------- |Ayes:|Stone, Ammiano, Ian | | | | |Calderon, Garcia, Hall | | | | | | | | |-----+--------------------------+-----+--------------------------| |Nays:|Maienschein, Grove | | | | | | | | ----------------------------------------------------------------- SUMMARY : Provides that public social services, as defined in Welfare and Institutions Code (WIC) Section 10051, include publicly funded health care services, as specified, and establishes that this is a clarification of existing law. EXISTING LAW : 1)Requires all applications and records pertaining to public social services provided to individuals to be confidential and prohibits dissemination of such information unless it is for purposes of administering services to the individual or for purposes of investigation, prosecution, or criminal or civil proceeding related to the administration of the services the individual receives, as specified. (WIC Section 10850(a)) 2)Authorizes county welfare departments to release information regarding applicants for, or recipients of, public social services to other county welfare departments and the Department of Social Services solely for the purpose of administration of public social services programs, as specified. (WIC Section 10850(b)) 3)Authorizes counties to provide information pertaining to applicants for, and recipients of, public social services to other public entities for the purpose of determining program eligibility and to school officials, as specified, as necessary for the administration of federally assisted, SB 346 Page 2 needs-based programs. (WIC Section 10850(b)) 4)Defines public social services as those activities and functions of state and local government, administered or supervised by the State Department of Social Services or the State Department of Health Services, that provide aid, services, or both aid and services, including health care services and medical assistance, to those people of the state who are in need of such aid or services due to their economic circumstances or social condition. (WIC Section 10051) 5)Requires every city and county to provide relief and support to all indigent and dependent poor persons, when such persons do not receive adequate support or relief from their relatives or friends, by their own means, or by state hospitals or other state or private institutions. (WIC Section 17000) 6)Establishes the Low Income Health Program (LIHP) as a federal Medicaid demonstration project at the local level to provide specified health care services to eligible, low-income individuals 19 to 64 years of age who are not otherwise eligible for the Medi-Cal program or the Children's Health Insurance Program, as specified. (WIC Section 15909.1) 7)Permits a county board of supervisors of any county with a population of less than 300,000 to elect to participate in the County Medical Services Program (CMSP) to provide specified health care services to medically indigent persons. (WIC Section 16809) 8)Establishes local Medically Indigent Services Programs (MISP) to fulfill the obligations of larger counties under WIC Section 17000, and allows for county flexibility in the administration of those programs. FISCAL EFFECT : Unknown. This bill is keyed non-fiscal by the Legislative Counsel. COMMENTS : This bill seeks to clarify current law regarding the sharing of confidential client information related to public SB 346 Page 3 social services at the county level. Due to current statutory language that prevents the sharing of information pertaining to applicants and recipients of public social services, except under certain circumstances, there are perceived limitations on a county's ability to share information between its own regional departments or distinct agencies, including when the information needs to be shared for the benefit of the applicant for, or recipient of, public social services. Interoperability within the Affordable Care Act : The primary goals of the federal Patient Protection and Affordable Care Act of 2010 (ACA) are to expand health insurance coverage, reduce health care spending, and increase the regulation of private health insurers. With the January 2014 implementation date drawing near, many of California's statewide departments and county welfare departments are looking forward to a seamless transition to new health care coverage for many Californians, as well as more streamlined communication between health and social services systems. According to the Administration for Children and Families (ACF), within the federal Department of Health and Human Services, interoperability of health and social services systems is an essential component of proper implementation of the ACA. Automated eligibility systems : Three distinct Statewide Automated Welfare Systems (SAWS) are used in California to determine eligibility and benefit levels for public social services programs, including CalWORKs, CalFresh, Medi-Cal, foster care, the refugee program and CMSPs. Additionally, the SAWS maintain caseload and enrollment information for the purpose of case management for benefit recipients and the general administration of these programs. In 2011, the Legislature enacted AB 16 X1 (Blumenfield), Chapter 13, Statutes of 2011-12 First Extraordinary Session, to consolidate counties and decrease the number of SAWS to two. Although information sharing between the data portals for the public social services included in the SAWS should be seamless, proponents of this bill assert that health care eligibility information within counties with their own health care systems or public hospitals may be held in distinct data systems, thereby reducing opportunities for data matching. Need for the bill : Current law allows applications and applicant records to be shared with other public agencies for the purpose of establishing eligibility for, or administering, SB 346 Page 4 public social services (WIC Section 10850). Some counties have interpreted this as authority to share client information between their health and social services departments. However, the bill's sponsor, the Santa Clara County Board of Supervisors, sees the current confidentiality requirements, which explicitly allow information sharing to take place between county welfare departments, without any mention of other county departments or agencies, as barriers that prohibit the exchange of information even when the information would be shared for the client's benefit. According to the bill's sponsor, system interoperability within counties is essential in providing clients timely access to the services for which they are eligible. The author states, "SB 346 allows county human services departments to more easily share client eligibility information with county health departments in order to simplify enrollment in public health care coverage programs such as the Low-Income Health Program or the county Medically Indigent Services Program. As we look to implement the Affordable Care Act, which includes an emphasis on having no wrong door, we want to make sure that we are doing everything we can to make enrollment in health and human services programs as easy as possible for clients. SB 346 would further this goal." Analysis Prepared by : Myesha Jackson / HUM. S. / (916) 319-2089 FN: 0002546