BILL NUMBER: AB 963	INTRODUCED
	BILL TEXT


INTRODUCED BY   Assembly Member Ammiano

                        FEBRUARY 26, 2009

   An act to add Sections 14012.6 and 14012.7 to the Welfare and
Institutions Code, relating to Medi-Cal.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 963, as introduced, Ammiano. Medi-Cal eligibility.
   Existing law creates various programs to provide health care
services to persons who have limited incomes and meet various
eligibility requirements, including, but not limited to, the Medi-Cal
program, which is administered by the State Department of Health
Care Services, and under which qualified low-income individuals
receive health care benefits. Existing law also provides for the Food
Stamp Program, under which food stamps are allocated by each county
in accordance with federal requirements, and the CalWORKS program,
under which each county provides cash assistance and other benefits
to qualified low-income families and individuals who meet specified
eligibility criteria. Under existing law, the Food Stamp Program and
the CalWORKs program are administered at the state level by the State
Department of Social Services.
   This bill would require the department, in consultation with the
State Department of Social Services, to make necessary technological
and policy changes to update the data sharing, computer programming,
and administrative procedures, as provided, to ensure the
continuation of Medi-Cal benefits when a beneficiary reports a change
in circumstances to the Food Stamp Program or the CalWORKs program
that would continue Medi-Cal eligibility. The bill would declare
these provisions to be declaratory of existing law. The bill would
require the department to issue comprehensive implementing
instructions for policies and procedures, as specified, for this
administrative transition, on or before March 1, 2011.
   This bill would require the department to establish procedures and
guidelines for an electronic enrollment or renewal application with
all relevant eligibility information that provides for the electronic
enrollment or renewal of all potential and current Medi-Cal
beneficiaries. The electronic enrollment or renewal application shall
be used for all beneficiaries whose Medi-Cal enrollment or renewal
is not accomplished pursuant to the administrative procedures. The
bill would require the procedures and guidelines to be phased in
statewide by January 2012.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 14012.6 is added to the Welfare and
Institutions Code, to read:
   14012.6.  (a) (1) The department, in consultation with the State
Department of Social Services, counties, representatives from the
Statewide Automated Welfare System (SAWS) consortia, consumer
advocates, and other stakeholder groups, shall make all necessary
technological and policy changes to update data sharing, computer
programming, and administrative procedures, to ensure that Medi-Cal
is continued when a Medi-Cal beneficiary reports a change in
circumstances to the Food Stamp Program or the CalWORKs program that
would continue Medi-Cal eligibility.
   (2) Nothing in this section shall increase the frequency of the
reporting requirements in the Medi-Cal program or amend the counties'
obligation to redetermine Medi-Cal eligibility and follow all due
process requirements prior to terminating Medi-Cal benefits.
   (3) A beneficiary's failure to complete a periodic report or
annual renewal requirement in the CalWORKs program or Food Stamp
Program shall not result in termination or redetermination of
Medi-Cal eligibility.
   (4) This subdivision is declaratory of existing law.
Implementation of this subdivision shall not be delayed in order to
implement the other provisions of this section.
   (b) A beneficiary who completes a periodic report or annual
renewal form in the CalWORKs program or Food Stamp Program shall be
deemed to have met the requirement to return a periodic report or
annual renewal form for the next scheduled period in the Medi-Cal
program.
   (c) If information a beneficiary submits in the CalWORKs program
or Food Stamp Program periodic reporting or annual renewal process is
sufficient to continue Medi-Cal eligibility, the county shall deem
the beneficiary to have met the Medi-Cal annual redetermination
requirement in Section 14012. These Medi-Cal beneficiaries shall have
their eligibility continued for the greatest period of time allowed
under this chapter and all scheduled renewal dates or reporting
dates, if any, shall be reset accordingly from the date of
redetermination. Nothing in this section affects a beneficiary's
responsibility to report changes to the county that affect Medi-Cal
eligibility within 10 days of their occurrence.
   (d) The procedures described in this section shall be conducted by
electronic means to the greatest extent possible and shall be
developed according to subdivision (g).
   (e) Use of the information shared pursuant to this section shall
not be used for any other purposes except as set out in this section.

   (f) This section shall supplement, not supplant, the requirements
already in effect pursuant to subdivision (e) of Section 14005.37.
   (g) The department, in conjunction with counties, the State
Department of Social Services, and representatives of the SAWS
consortia, consumers, and other affected stakeholder groups, shall
conduct a planning process and develop administrative enrollment and
renewal policies and procedures, to be implemented by all county
letters or similar instructions. After implementation by all county
letters or similar instructions, the department shall adopt
regulations in accordance with the requirements of Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 3 of Title 2 of
the Government Code. Comprehensive implementing instructions shall
be issued no later than March 1, 2011. The policies and procedures
shall do all of the following:
   (1) Establish appropriate data sharing procedures and safeguards
that do not require any additional consent from beneficiaries for the
information sharing pursuant to this section and that meet
confidentiality and privacy requirements in the Medi-Cal program.
   (2) Give priority to the programming changes necessary to enable
the SAWS consortia to automate this enrollment and renewal procedure
in order to minimize manual workload.
   (3) Develop procedural protections to ensure that beneficiaries
experience no disruption in coverage and no diminution of their
rights under this chapter.
  SEC. 2.  Section 14012.7 is added to the Welfare and Institutions
Code, to read:
   14012.7.  (a) The department, in conjunction with counties and
representatives of the Statewide Automated Welfare System (SAWS)
consortia, consumers, and other affected stakeholder groups, shall
establish procedures and guidelines for an electronic enrollment or
renewal application with all relevant eligibility information that
provides for the electronic enrollment or renewal of all potential
and current Medi-Cal beneficiaries.
   (b) The electronic enrollment or renewal application shall be used
for all beneficiaries whose Medi-Cal enrollment or renewal is not
accomplished through the enrollment and renewal procedures set forth
in Section 14012.6. Periodic reporting forms, if any, shall also be
electronically created in accordance with this subdivision.
   (c) The department shall use the electronic enrollment or renewal
application as the annual reaffirmation form required under Section
14012.
   (d) The procedures and guidelines established pursuant to this
section shall include a timeline for phasing in this procedure
statewide, beginning in January 2011, and fully phasing in the
procedure by January 2012.