BILL ANALYSIS Ó
AB 2589
Page 1
ASSEMBLY THIRD READING
AB
2589 (Gomez)
As Amended May 27, 2016
Majority vote
------------------------------------------------------------------
|Committee |Votes|Ayes |Noes |
| | | | |
| | | | |
| | | | |
|----------------+-----+----------------------+--------------------|
|Health |16-0 |Wood, Maienschein, | |
| | |Bonilla, Campos, | |
| | |Chiu, Dababneh, | |
| | |Gomez, Roger | |
| | |Hernández, Lackey, | |
| | |Nazarian, Olsen, | |
| | |Patterson, Rodriguez, | |
| | |Santiago, Steinorth, | |
| | |Waldron | |
| | | | |
|----------------+-----+----------------------+--------------------|
|Appropriations |20-0 |Gonzalez, Bigelow, | |
| | |Bloom, Bonilla, | |
| | |Bonta, Calderon, | |
| | |Chang, Daly, Eggman, | |
| | |Gallagher, Eduardo | |
| | |Garcia, Roger | |
| | |Hernández, Holden, | |
| | |Jones, Obernolte, | |
| | |Quirk, Santiago, | |
AB 2589
Page 2
| | |Wagner, Weber, Wood | |
| | | | |
| | | | |
------------------------------------------------------------------
SUMMARY: Requires the California Department of Public Health
(DPH) to coordinate with the Department of Health Care Services
(DHCS) and Covered California to streamline enrollment into the
California Special Supplemental Nutrition Program for Women,
Infants, and Children (WIC) through the Covered California; and,
requires DPH and DHCS to coordinate on a stakeholder process to
develop measures and outcomes for breastfeeding. Specifically,
this bill:
1)Requires DPH, DHCS, and Covered California to coordinate to
develop processes, procedures and an electronic interface for
eligibility-related information sharing to streamline
enrollment into the WIC program as part of the application
process for Medi-Cal and health plans offered through Covered
California.
2)Requires the California Healthcare Eligibility, Enrollment,
and Retention System (CalHEERS), on or before January 1, 2019,
to identify individuals who are potentially eligible for the
WIC Program and, if a potentially eligible individual wishes
to apply for the WIC Program, electronically link them to a
WIC Program application.
3)Requires CalHEERS, on or before January 1, 2022, to identify
individuals who are potentially eligible for the WIC Program
and, if a potentially eligible individual wishes to apply for
the WIC Program and provides consent to share confidential
data with the WIC Program, provide a simple interface for the
individual to electronically complete the WIC Program
application without resubmitting data already known to the
AB 2589
Page 3
CalHEERS system.
4)Requires DPH and DHCS to coordinate through a stakeholder
process that includes, but is not limited to representatives
from health care providers, primary care clinics, health
plans, state and local staff from the WIC program and the
Maternal, Child and Adolescent Health (MCAH) program, and
representatives from organizations representing women, infants
and children to, beginning prenatally and continuing through
the postpartum period and at least until the infant reaches
one year of age, develop measures and outcomes for
breastfeeding rates that do both of the following:
a) Include, at a minimum, women's intention to breastfeed,
breastfeeding initiation rates, and exclusivity and
duration; and,
b) Identify ethnic disparities and sociodemographic
differences
5)Specifies that the stakeholder process take no longer than six
months and the recommendations be posted on the departments'
Internet Web sites by January 1, 2018.
FISCAL EFFECT: According to the Assembly Committee on
Appropriations:
1)Costs to CDPH can be absorbed within their existing MCAH
program (federal Title V funds). Costs to DHCS for
consultation are also expected to be minor and absorbable
(General Fund (GF)/federal).
AB 2589
Page 4
2)Unknown, significant information technology costs potentially
in the millions of dollars (potentially GF/federal/special
funds) associated with the provision to develop an electronic
interface to share eligibility-related information in order to
streamline enrollment in WIC.
3)Unknown, significant administrative costs to ensure federal
approval and the availability of federal funding for this
work. WIC is fully funded by a federal grant, but it is
unknown whether existing federal funds could be used to
support this type of expense.
COMMENTS: According to the author, evidence indicates that
early infant feeding practices can affect later growth and
development in children, while significantly reducing their risk
for infections and chronic diseases such as diabetes, asthma and
obesity. The author notes that the United States Surgeon
General, and all the major health organizations, including the
American Academy of Pediatrics and the World Health Organization
recommend exclusive breastfeeding for most babies, unless
specifically contraindicated, for the first six months and
continued breastfeeding with the addition of appropriate foods
up to at least one year of age. The author contends that
California has supported breastfeeding policies that increase
rates among low-income women and must continue efforts, and
study and collect data relating to breastfeeding exclusivity,
initiation, and duration not only in a hospital setting, but at
home. The author also states that California has recognized
that low-income and minority women have lower rates when it
comes to breastfeeding duration, initiation, and exclusivity.
The author concludes, in order to help to achieve health equity
for new mothers and their children, we must expand data
collection outside our hospital settings.
Breastfeeding rates and recommendations. California in-hospital
infant feeding practices are monitored using data collected by
AB 2589
Page 5
the Newborn Screening (NBS) Program within DPH. All
non-military hospitals providing maternity services are required
to complete the Newborn Screening Test Form. In addition to
tracking genetic diseases and metabolic disorders, the NBS
Program gathers data on all infant feedings for about 24 to 48
hours since birth. The MCAH Program staff analyze this data and
publish breastfeeding rates by hospital, county and the State.
In addition to the Newborn Screening data, all hospitals with
300 or more births are required to report on the Perinatal Core
Measure Set, which includes a measure on exclusive breast milk
feeding.
According to the federal Centers for Disease Control and
Prevention, breastfeeding rates continue to rise in the United
States. In 2011, 79% of newborn infants started to breastfeed.
Yet breastfeeding does not continue for as long as recommended.
Of infants born in 2011, 49% were breastfeeding at 6 months and
27% at 12 months.
Current nutrition program linkages. When a family or individual
is applying for Medi-Cal or Covered California, the application
includes information that identifies the person as eligible for
CalFresh. The system is not completely automated, because the
CalFresh application is not auto-populated, but an on-line
application is made available and the applicant can fill that
out and the county is notified of the potential CalFresh
participant.
Currently there is no electronic linkage for WIC eligibility in
Medi-Cal or Covered California enrollment. The applications
provide a statewide toll-free number for mothers to call, where
they would receive another number or numbers for a local WIC
agency. The mother would then call that number to find out if
they are eligible.
AB 2589
Page 6
According to the proponents of this bill, CalFresh is working to
streamline related data sharing, integration and bridging
between programs, including Medi-Cal. WIC and CalFresh are
working on data sharing and analysis, particularly related to
the participation of children.
Analysis Prepared by:
Lara Flynn / HEALTH / (916) 319-2097 FN:
0003261