BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 963
                                                                  Page  1

          Date of Hearing:   January 21, 2010 

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Kevin De Leon, Chair

                   AB 963 (Ammiano) - As Amended:  January 13, 2010

          Policy Committee:                              Health Vote:18-0 

          Urgency:     No                   State Mandated Local Program:  
          Yes    Reimbursable:              Yes

           SUMMARY  

          This bill requires the California Department of Health Care  
          Services (DHCS) to establish a stakeholder planning group to  
          develop a joint renewal and recertification form to be used by  
          Medi-Cal, Food Stamps, and CalWORKs beneficiaries. Specifically,  
          this bill: 

          1)Requires DHCS to work with the Department of Social Services  
            (DSS), beneficiaries, and other stakeholders to generate  
            recommendations to reduce administrative eligibility barriers.  


          2)Requires the stakeholder group to develop forms, policies, and  
            procedures by July 1, 2011. 

          3)Requires specified features to be developed, determined, and  
            aligned such as reducing duplicative data, shortening forms,  
            increasing use of electronic forms, aligning benefit renewal  
            to reduce the loss of coverage, and increasing data  
            protections. 

          4)Requires resulting forms, policies, and procedures to be  
            implemented via All-County Letters (ACL) by January 1, 2012.

          5)Requires the stakeholder group to be funded only with private  
            funds. 

           FISCAL EFFECT  

          1)One-time GF cost pressures of $50,000 to $100,000 to convene  
            the stakeholder group and conduct analysis to make  
            recommendations to reduce eligibility barriers. Recent  
            stakeholder groups addressing similar issues have required  
            support of between $50,000 and $1 million. Costs depend on the  






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            depth and breadth of analytical issues considered. 

          2)This bill specifies the stakeholder group will be funded with  
            private funds. The author and sponsor indicate interest has  
            been expressed by philanthropic stakeholders and that federal  
            Food Stamps funding may also be available to support these  
            efforts. To enable receipt of federal funds and to reduce GF  
            costs and pressures, the author may consider clarifying  
            funding language and curtailing implementation requirements. 

          3)One-time costs to DHCS of $300,000 (50% GF) to promulgate  
            regulations and make technology, policy, and process changes  
            pursuant to this bill.

          4)To the extent stakeholder group recommendations are  
            implemented, unknown future cost pressures to provide  
            increased continuity of Medi-Cal, CalWORKs, and Food Stamps  
            benefits. Recent budget proposals by the governor include the  
            elimination of CalWORKs and the elimination of several core  
            health services in the Medi-Cal program. 

           COMMENTS  

           1)Rationale  . This bill is co-sponsored by the Western Center on  
            Law & Poverty (WCLP), the Children's Partnership, and the  
            United Way of the Bay Area to require DHCS and other  
            stakeholders to collaborate and make recommendations to reduce  
            administrative barriers to increase continuity of coverage for  
            Medi-Cal, Food Stamps, and CalWORKS beneficiaries. According  
            to the author and sponsors, many state and federal law and  
            policy changes have enabled a more streamlined approach than  
            currently implemented in California. This bill requires a  
            variety of stakeholders to review these law and policies  
            changes in order to identify administrative barriers to  
            continuity of coverage. 

           2)Background  . Current law requires counties to take steps to  
            prevent the loss of Medi-Cal eligibility.  For example, if a  
            county receives information about a change to Medi-Cal  
            eligibility, the county must continue Medi-Cal coverage during  
            the eligibility redetermination. In addition, the county is  
            prohibited from terminating Medi-Cal coverage unless a  
            specific eligibility requirement is not met.  Counties are  
            required to make every reasonable effort to gather available  
            information related to other public program data. Many  
            Medi-Cal beneficiaries who are dropped from coverage due to  
            non-compliance with reporting requirements later return to the  






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            program and are found eligible. Reducing the loss and gain of  
            coverage for beneficiaries, per the goals of AB 963, may  
            improve care and reduce county administrative costs. 

           3)Recent Budget Action on Centralized Eligibility  . ABX4 7  
            (Committee on Budget), Chapter 7, Statutes of 2008 authorized  
            DHCS and DSS to develop a comprehensive implementation plan  
            regarding a centralized statewide eligibility and enrollment  
            process for the Medi-Cal, CalWORKs, and Food Stamps programs.  
            Current eligibility processes are administered by county  
            welfare departments and rely on a face-to-face and mail-in  
            application process that is burdensome for both recipients and  
            administrators. 

          Several foundations have funded an AB X4 7 centralized  
            eligibility work group to assess the viability of current and  
            future efforts for a single statewide eligibility system for  
            enrollment across health and social service programs including  
            Medi-Cal, CalWORKs, and Food Stamps, and other programs,  
            including the Access for Infants and Mothers program (AIM),  
            Breast and Cervical Cancer Treatment program (BCCTP), Every  
            Women Counts (EWC) Cancer Detection program, Child Health and  
            Disability Prevention (CHDP), Family Planning, Access, Care  
            and Treatment program (FPACT), Healthy Families Program (HFP),  
            and the Women, Infants and Children Supplemental Nutrition  
            program (WIC).

          The stakeholder group established by AB 963 is much narrower in  
            scope than the ABX4 7 workgroup with an emphasis on  
            administrative barriers and reducing the intensity of  
            paper-based eligibility processes. 
           
          Analysis Prepared by  :    Mary Ader / APPR. / (916) 319-2081