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                                         
           
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          |Ayes:|Stone, Ammiano, Ian       |     |                          |
          |     |Calderon, Garcia, Hall    |     |                          |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Maienschein, Grove        |     |                          |
          |     |                          |     |                          |
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           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,  








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            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  








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          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,  








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          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 


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