BILL ANALYSIS                                                                                                                                                                                                    



                                                                     AB 376


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          Date of Hearing:  April 29, 2015


                        ASSEMBLY COMMITTEE ON APPROPRIATIONS


                                 Jimmy Gomez, Chair


          AB  
          376 (Lopez) - As Amended April 21, 2015


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          Urgency:  No  State Mandated Local Program:  YesReimbursable:   
          Yes


          SUMMARY:  


          This bill requires county welfare departments, beginning July 1,  
          2016, to first search the California Immunization Registry  
          (CAIR), and find no record of immunization, prior to requesting  








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          CalWORKs applicants or recipients to submit vaccination  
          documentation for children under age six who are not required to  
          be enrolled in school.


          FISCAL EFFECT:


          About one-third of counties already use CAIR for this purpose.  
          The costs to train additional staff to use CAIR are minor and  
          likely absorbable within existing county training budgets.


          COMMENTS:


          1)Purpose. By using CAIR to verify children's immunization  
            histories before requiring families to provide documentation,  
            this bill seeks to assist families in the navigation of the  
            CalWORKs eligibility and redetermination process and,  
            ultimately, reduce the number of families facing reduced grant  
            amounts resulting from tardy submission of verification.  



            According to the author, "this bill will help streamline and  
            simplify an administrative process, which will help families  
            access the support they need by using current technology to  
            verify immunization records.  Currently, CalWORKs requires an  
            applicant or recipient to immunize their minor children and  
            provide proof of immunization.  For our most vulnerable  
            populations, this extra step in the process to receive  
            benefits can add to an already stressful situation.  This bill  
            would require the county first review the California State  
            registry of immunizations, which is maintained by the  
            Department of Public Healt, before asking the family to  
            provide the records.  If the registry indicates that the  
            children have not met the immunization requirements, then the  
            county can request verification of immunization."








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          2)CalWORKs immunization requirements:  The Personal  
            Responsibility and Work Opportunity Reconciliation Act  
            (PRWORA) of 1996 was the federal law creating the federal TANF  
            program which offers block grants to states to design their  
            own welfare programs. One of the many provisions contained in  
            PRWORA permits states to create "individual responsibility  
            plans" for participants that may, among other things, require  
            individuals to immunize their children. 


            In 1997, the Legislature created the CalWORKs program as  
            California's implementation of federal welfare reform. Among  
            its many provisions is the requirement that all applicants for  
            and recipients of CalWORKs benefits provide documentation that  
            any children in the assistance unit under the age of 6 have  
            received all age-appropriate immunizations. If documentation  
            is not provided within the required 30 or 45 day time period,  
            a parent's or caretaker relative's needs are not considered in  
            determining the grant amount for the assistance unit. Since  
            2012, on average, 97,000 adults per year have been penalized  
            for not providing timely verification of immunization.


          3)California Immunization Registry (CAIR). Maintained by the  
            Department of Public Health, CAIR is a secure and confidential  
            statewide computerized information system consisting of nine  
            separate regional immunization registries.  CAIR covers 57 of  
            California's 58 counties; Imperial County operates its own  
            registry that is not part of the CAIR system.  CAIR enables  
            authorized users to access immunization data within their  
            defined region, however, look-up access to other regional  
            registries is available to state or county governmental  
            agencies upon request.  It is expected that CAIR will  
            eventually allow authorized users to access immunization data  








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            across the state by integrating its regional databases.  This  
            effort, the "CAIR 2.0 Project," is currently underway and  
            integration is expected to be completed by the summer of 2017.


            Nearly 2.9 million children under the age of 6 (96.7% of the  
            total age-group population in the state) have immunization  
            records contained in CAIR.  Authorized users of CAIR include  
            health care providers and plans, schools, county welfare  
            departments, foster care agencies, family child care homes and  
            child care facilities. Users must sign a confidentiality  
            agreement to access CAIR, and need a user ID and password to  
            log in to the registry.  








          Analysis Prepared by:Jennifer Swenson / APPR. / (916)  
          319-2081