BILL NUMBER: AB 963 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY JANUARY 13, 2010
AMENDED IN ASSEMBLY APRIL 28, 2009
AMENDED IN ASSEMBLY APRIL 2, 2009
INTRODUCED BY Assembly Member Ammiano
FEBRUARY 26, 2009
An act to add Sections 14012.6, 14012.7, and 14012.8
Section 14012.6 to the Welfare and Institutions
Code, relating to Medi-Cal public social
services .
LEGISLATIVE COUNSEL'S DIGEST
AB 963, as amended, Ammiano. Medi-Cal eligibility.
Public Social services: renewal and recertification of
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.
Existing law requires recipients of Medi-Cal, Food
Stamp, and CalWORKs benefits to, on a specified basis, renew or
recertify their eligibility.
This bill would require the State Department of Health Care
Services, in consultation with counties, the State Department of
Social Services, representatives of the Statewide Automated Welfare
System (SAWS) consortia, consumers, and other affected stakeholder
groups to conduct a stakeholder planning workgroup to develop a joint
renewal and recertification form to be used by individuals and
families who are recipients of one or more of the Medi-Cal, Food
Stamp, or CalWORKs benefit programs. This bill would require the
stakeholder planning workgroup to develop the renewal and
recertification form, and any related policies and procedures, no
later than July 1, 2011. By modifying the Medi-Cal, Food Stamp, and
CalWORKs eligibility renewal and recertification processes, this bill
would increase the responsibilities of the counties in the
administration of the Medi-Cal, Food Stamp, and CalWORKs programs,
thereby imposing a state-mandated local program.
This bill would require the department to implement this measure
by all-county letters or similar instructions on or before January 1,
2012. After implementation by all-county letters or similar
instructions, the department would be required to adopt comprehensive
implementing regulations, as specified, on or before July 1, 2012.
This bill would require 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 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.
This bill would provide that 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 requirements to
return and sign a periodic report or annual form for the next
scheduled period in the Medi-Cal program. The bill would provide that
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.
This bill would provide that an individual or family that submits
and signs a Food Stamp Program application through any method
accepted by the Food Stamp Program shall be deemed to have met the
requirement to submit and sign a Medi-Cal application. The bill would
provide that if the information an applicant submits in the Food
Stamp Program application is sufficient to establish Medi-Cal
eligibility, the county shall enroll the applicant into the Medi-Cal
program. The bill would require the department to develop a procedure
to, among other things, give applicants the opportunity to opt out
of being enrolled in the Medi-Cal program based on information given
in his or her Food Stamp Program application. By modifying the
Medi-Cal eligibility determination process, this bill would increase
the responsibilities of the counties in the administration of the
Medi-Cal program, thereby imposing a state-mandated local program.
The bill would require the department to issue comprehensive
implementing instructions for policies and procedures, as specified,
for the aforementioned provisions, on or before March 1, 2011.
This bill would require the department to establish procedures and
guidelines for prepopulated renewal forms for all potential and
current Medi-Cal beneficiaries. The prepopulated renewal form and
procedures would be used for all beneficiaries whose Medi-Cal renewal
is not accomplished pursuant to the renewal procedures established
pursuant to this bill. The bill would require the procedures and
guidelines to include a timeline for phasing in the prepopulated
renewal forms statewide, beginning January 2011, and fully phasing in
the prepopulated renewal forms by January 2012.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that, if the Commission on State Mandates
determines that the bill contains costs mandated by the state,
reimbursement for those costs shall be made pursuant to these
statutory provisions.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.
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 counties, the State
Department of Social Services, counties,
representatives from of the Statewide
Automated Welfare System (SAWS) consortia, consumer
advocates consumers , and other affected
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. conduct a
stakeholder planning workgroup to develop a joint renewal and
recertification form to be used by individuals and families who are
recipients of one or more of the Medi-Cal, Food Stamp, or
CalWORKs benefits programs. The workgroup shall include consumer
advocates with expertise in each of the Medi-Cal, Food Stamp, and
CalWORKs programs.
(b) The stakeholder planning workgroup shall develop the joint
renewal and recertification form, and any related policies and
procedures, for adoption by the department, the counties, the State
Department of Social Services, and the SAWS consortia, no later than
July 1, 2011. In developing the form, policies, and procedures the
stakeholder planning workgroup shall do all of the following:
(1) Determine which questions and documentation requests on
existing renewal and recertification forms are necessary and
eliminate any requests for information or documentation that are
duplicative.
(2) Develop the joint renewal and recertification form to allow
recipients to skip sections on the form if they are not enrolled in,
or do not want to be evaluated for, one or more of the benefit
programs.
(3) Develop the forms, policies, and procedures to be used for
both paper and electronic renewal and recertification.
(4) Maximize use of shared technology and information to minimize
burdens on recipients and county eligibility staff, and assist
families in a consumer friendly renewal and recertification process.
(5) Align renewal and recertification dates for recipients without
requiring the recipients to lose any benefits earlier than they
otherwise would have in the initial alignment year.
(6) Establish appropriate procedures and safeguards for data and
information sharing pursuant to this section that meet the
confidentiality and privacy requirements of the Medi-Cal, Food Stamp,
and CalWORKs programs but do not require additional consent from the
recipients.
(7) Give priority to the program changes necessary to enable the
SAWS consortia to automate the renewal and recertification procedure,
maximize the use of available information, and minimize manual
workload.
(8) Ensure that recipients experience no disruption in coverage or
diminution of their rights under this chapter.
(9) Consider any additional modifications that could be made to
the renewal and recertification procedures to minimize burdens on the
recipients and encourage retention of Medi-Cal, Food Stamp, and
CalWORKs benefits. Additional modifications to be considered shall
include, but not be limited to, those permitted under federal law,
including those permitted through a waiver, such as electronic and
telephonic renewal methods, prepopulated forms, elimination of
interview requirements, and electronic verifications.
(10) Consider any changes that may be needed under federal health
reform, any guidance provided by the United States Department of
Agriculture, and any other changes that may be needed in federal law
or policy that would ensure a smooth transition to the use of the
joint renewal and recertification form.
(c) The department, in consultation with the State Department of
Social Services, shall obtain funding only from private sources to
finance the stakeholder workgroup.
(d) This section shall be implemented by all-county letters or
similar instructions no later than January 1, 2012. After
implementation by all-county letters or similar instructions, the
department shall adopt comprehensive implementing 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. Regulations shall be issued no later than July 1, 2012.
(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 and sign 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) 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) An individual or family that submits and signs a
Food Stamp Program application through any method accepted by the
Food Stamp Program shall be deemed to have met the requirement to
submit and sign a Medi-Cal application.
(b) If information an applicant submits in the Food Stamp Program
application is sufficient to establish Medi-Cal eligibility, the
county shall enroll the applicant into the Medi-Cal program.
(c) For an applicant who is not enrolled into the Medi-Cal program
based upon information provided in his or her Food Stamp Program
application, the county shall make every reasonable effort to gather
information available to the county that is relevant to the applicant'
s Medi-Cal eligibility prior to contacting the applicant. The county
shall follow the same process used for redeterminations of
eligibility described in subdivisions (e) to (g), inclusive, of
Section 14005.37 to attempt to establish Medi-Cal eligibility.
(d) All Medi-Cal applicants whose Medi-Cal eligibility is
established pursuant to this section shall have their eligibility
established for the greatest period of time allowed under this
chapter and all scheduled renewal dates or reporting dates, if any,
shall be set accordingly from the date the Medi-Cal applicant submits
his or her Food Stamp Program application. 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.
(e) The procedures described in this section shall be conducted by
electronic means to the greatest extent possible and shall be
developed according to subdivision (h).
(f) The information shared pursuant to this section shall not be
used for any other purposes except as set out in this section.
(g) This section shall supplement, not supplant, the requirements
already in effect pursuant to subdivision (e) of Section 14005.37.
(h) 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 applicants 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 application and enrollment
procedure in order to minimize manual workload.
(3) Develop procedural protections to ensure that applicants
experience no delay in coverage and no diminution of their rights
under this chapter.
(4) Develop a procedure whereby applicants for benefits under the
Food Stamp Program are informed about the benefits of the Medi-Cal
program and are given an opportunity to opt out of Medi-Cal
enrollment, as described in subdivision (b). The opt out procedure
shall be minimally burdensome to the applicant. The county shall
presume the applicant wants to be enrolled in the Medi-Cal program
unless the applicant expressly opts out verbally, in writing, or
electronically, and the county documents the opt out in the case
file.
SEC. 3. Section 14012.8 is added to the Welfare
and Institutions Code, to read:
14012.8. (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 prepopulated renewal forms
for all potential and current Medi-Cal beneficiaries.
(b) The prepopulated renewal form and procedures shall be used for
all beneficiaries whose Medi-Cal renewal is not accomplished through
the renewal procedures set forth in Sections 14012.6 and 14012.7.
Periodic reporting forms, if any, shall also be created in accordance
with this subdivision.
(c) The department shall use the prepopulated renewal form 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 the prepopulated
renewal forms statewide, beginning in January 2011, and fully phasing
in the prepopulated renewal forms by January 2012.
SEC. 4. SEC. 2. If the Commission on
State Mandates determines that this act contains costs mandated by
the state, reimbursement to local agencies and school districts for
those costs shall be made pursuant to Part 7 (commencing with Section
17500) of Division 4 of Title 2 of the Government Code.