BILL ANALYSIS Ó
SENATE COMMITTEE ON APPROPRIATIONS
Senator Ricardo Lara, Chair
2015 - 2016 Regular Session
AB 376 (Lopez) - CalWORKs eligibility: immunizations
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|Version: June 19, 2015 |Policy Vote: HUMAN S. 5 - 0 |
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|Urgency: No |Mandate: Yes |
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|Hearing Date: June 29, 2015 |Consultant: Jolie Onodera |
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This bill meets the criteria for referral to the Suspense File.
Bill
Summary: AB 376 would, commencing July 1, 2016, require county
human services agencies to first review the California
Immunization Registry (CAIR) to verify that specified children
in the CalWORKs assistance unit have received all
age-appropriate immunizations prior to requiring CalWORKs
applicants and recipients to provide immunization records, as
specified.
Fiscal
Impact:
Potentially significant one-time and ongoing
state-reimbursable county administrative costs (General Fund)
for training and verification of immunizations of each
applicable child in the CAIR for applicants and recipients
prior to requesting immunization records. The new workload
would be offset in part by replacing the existing workload for
cases that provide and require verification of paper
documentation, as well as administrative cost savings for
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those cases found in the CAIR that would no longer require a
follow-up request for documentation. The net increase in
ongoing administrative costs is estimated at $360,000 to $1
million (General Fund).
Potentially significant decrease in CalWORKs sanctions for
failure to provide immunization records, resulting in
increased ongoing CalWORKs grant costs of about $1.5 million
(General Fund). DSS data indicates approximately 32 percent of
cases sanctioned for not providing the required documentation
were sanctioned for one month (and are assumed to otherwise
have the immunizations complete). This estimate assumes 38
percent of those cases sanctioned for one month would have
information available in the CAIR that would potentially
result in averted sanctions.
Potentially significant one-time costs (General Fund) for
reprogramming of the Statewide Automated Welfare System
(SAWS).
Background: Existing law provides that all applicants for or recipients of
CalWORKs are required to provide documentation within 30 or 45
days of determination of aid, as specified, that each child in
the assistance unit who is not required to be enrolled in school
has received all age-appropriate immunizations, unless it has
been medically determined that an immunization for the child is
not appropriate or the applicant or recipient has filed with the
county welfare department an affidavit that the immunizations
are contrary to the applicant's or recipient's beliefs. If the
county determines that good cause exists for not providing the
required documentation due to lack of reasonable access to
immunization services, the period is extended for an additional
30 days. (Welfare and Institutions Code § 11265.8.)
Under existing law, if the documentation is not provided within
the required time period, the needs of all parents or caretaker
relatives in the assistance unit are not to be considered in
determining the grant to the assistance unit until the required
documentation is provided.
Existing law provides that local health officers may operate
immunization information systems in conjunction with the
Immunization Branch of the State Department of Public Health
(DPH). (Health and Safety Code § 120440). For those counties
that do operate the CAIR, it is optional on the part of medical
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providers in that county to submit the immunization information
for all patients. According to the DPH, the annual cost to
operate the statewide system is $2.9 million utilizing funds
from the federal Centers for Disease Control (CDC) Immunization
grants.
Proposed
Law: This bill would, commencing July 1, 2016, require that in
lieu of initially requesting verification of age-appropriate
immunizations, the county shall first verify whether each child
has received all age-appropriate immunizations by reviewing the
California Immunization Registry. If the registry does not
contain records of these immunizations, the county shall require
the applicant or recipient to provide documentation that the
immunizations have been performed, unless the applicant or
recipient has filed an affidavit that the immunizations are
contrary to his or her beliefs or has supplied documentation
that it has been medically determined that an immunization is
not appropriate.
Staff
Comments: By placing new duties on county human services
agencies, this bill creates a state-mandated local program.
While it has been indicated that approximately one third to one
half of counties currently utilize the CAIR, by statutorily
requiring county agencies to use CAIR to verify immunization for
all children not required to be enrolled in school for all
applicants and recipients, this bill could result in a
reimbursable state mandate for costs associated with statewide
usage of the CAIR, which could include one-time costs for
training and ongoing costs for the administrative time required
to check the system for verification of each applicable child.
The new workload would replace in part the existing process of
verifying paper immunization records for those cases that
currently provide documentation and are not sanctioned.
The net increase in ongoing administrative costs are estimated
at $360,000 to $1 million (General Fund) assuming new county
administrative workload of three to five minutes per child to
query the CAIR for those cases that are sanctioned. No
additional net costs for counties to verify immunization in the
CAIR for the population that currently provides documented proof
of immunization is estimated, as the county administrative time
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would be replaced from verifying physical documentation to
verifying web-based documentation.
The DSS has indicated over 2,400 cases per month are sanctioned
for one month for not providing the required documentation. To
the extent utilization of the CAIR results in fewer CalWORKs
sanctions for failure to provide immunization records, the
provisions of this measure could result in increased ongoing
CalWORKs grant costs of about $1.5 million (General Fund). This
cost estimate assumes 38 percent of those cases would have
information available in the CAIR that would potentially result
in averted sanctions.
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