BILL ANALYSIS                                                                                                                                                                                                    






                                 SENATE HEALTH
                               COMMITTEE ANALYSIS
                        Senator Elaine K. Alquist, Chair


          BILL NO:       AB 963                                       
          A
          AUTHOR:        Ammiano                                      
          B
          AMENDED:       May 25, 2010                                
          HEARING DATE:  June 9, 2010                                 
          9
          REFERRAL:      Human Services Committee                     
          6
          CONSULTANT:                                                 
          3
          Dunstan/jl                                                 
                                        

                                     SUBJECT

              Public social services: renewal and recertification of  
                                  eligibility


                                     SUMMARY  

          Requires the California Department of Health Care Services  
          (DHCS) to establish, in consultation with counties, the  
          Department of Social Services (DSS), consumers and  
          representatives of the Statewide Automated Welfare System  
          (SAWS) consortia, a stakeholder planning work group to  
          develop a joint renewal and recertification form to be used  
          by persons who are eligible for Medi-Cal, Food Stamp or  
          CalWORKS programs.

                            CHANGES TO EXISTING LAW  
          
          Existing federal law:
          Establishes the Medicaid program to provide comprehensive  
          health benefits to specified groups of low-income persons.   
          Establishes the Supplemental Nutrition Assistance Program  
          (SNAP), formerly known as the Food Stamp program,  
          administered by the U.S. Department of Agriculture (USDA),  
          which imposes specified rules on specified program  
          participants and limits benefits based on those rules.   
                                                         Continued---



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          Establishes the Personal Responsibility and Work  
          Opportunity Reconciliation Act of 1996 (Welfare Reform Act)  
          and the Temporary Aid to Needy Families program, which are  
          programs designed to help welfare recipients achieve  
          independence and self-sustenance through employment.

          Existing state law:
          Establishes the Medi-Cal program, the state's Medicaid  
          program, administered by DHCS, which provides comprehensive  
          health benefits to low-income children; their parents or  
          caretaker relatives; pregnant women; elderly, blind or  
          disabled persons; nursing home residents and refugees.   
          Defines the eligibility procedures to be used for  
          enrollment and redetermination of eligibility.  
          
          Establishes the Food Stamp program, administered by state  
          and local agencies, that enables recipients of aid and  
          other low-income households to receive federal food  
          assistance benefits 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.  CalWORKs is the state  
          version of the federal program Temporary Assistance for  
          Needy Families.   Both the Food Stamp program and the  
          CalWORKs program are administered at the state level by the  
          Department of Social Services.

          This bill:
          Requires DHCS, in consultation with DSS, counties,  
          representatives from the Statewide Automated Welfare System  
          (SAWS) consortia, consumer advocates, and other stakeholder  
          groups, to develop a joint renewal and recertification form  
          to be used by individuals and families who are recipients  
          of Medi-Cal, Food Stamp or CalWorks programs.

          Specifies criteria that the stakeholder group must consider  
          in developing the plan, including the following:
                 Eliminate any duplicative requests for information  
               or documentation.
                 Develop forms, policies and procedures to be used  
               for both paper and electronic renewal and  
               recertification.
                 Maximize use of shared technology and information  
               to minimize burdens on recipients and county  
               eligibility staff.




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                 Align renewal and recertification dates between the  
               programs without loss of any benefits.
                 Establish appropriate procedures and safeguards for  
               data and information sharing.
                 Consider any changes that may be needed under  
               federal health care reform and any other applicable  
               federal laws and regulations.

          Requires DHCS, in consultation with DSS, to obtain funding  
          from private or public sources to finance the stakeholder  
          planning work group.  Prohibits any General Fund money to  
          be used for that purpose.  

          Requires DHCS and DSS to submit the joint renewal and  
          recertification form and related policies and procedures  
          developed by the work group to the appropriate policy and  
          fiscal committees of the Legislature by January 31, 2012.
                                         

                                 FISCAL IMPACT  

          According to the Assembly Appropriations Committee  
          analysis, the bill would have the following fiscal impacts:

                 One-time, non-General Fund (e.g., federal or  
               private) costs of $50,000 to $100,000 to convene the  
               stakeholder group and conduct analysis to make  
               recommendations to reduce eligibility barriers.  This  
               bill specifies the stakeholder group will be funded  
               with non-General Fund support.  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.

                 Recent amendments narrow the scope of this bill to  
               delete implementation requirements and to clarify that  
               no General Fund costs or pressures will be created.


                            BACKGROUND AND DISCUSSION  

          According to the author, AB 963 creates a stakeholder work  
          group tasked with providing strategic direction for  
          updating program forms and renewal processes to allow  
          eligible people to stay enrolled in Medi-Cal, Food Stamps  




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          and CalWORKs more efficiently.  According to the author,  
          each county administers multiple programs to provide basic  
          necessities to low-income individuals and families,  
          including Medi-Cal, Food Stamps and CaIWORKS and that many  
          of the same people are eligible for two or more programs.   
          The author argues that efforts to modernize and streamline  
          enrollment in these programs will address the issue of  
          eligible children and adults who are dropped from coverage  
          because of complex renewal requirements.  The author also  
          notes that the stakeholder work group recommendations will  
          identify administrative barriers to the continuity of  
          coverage, reduce county administrative costs and improve  
          efficiency in the renewal process for eligible  
          beneficiaries and counties.

          SNAP/Food Stamp program
          In California, more than three million people receive  
          federal food assistance benefits under the SNAP program.   
          To qualify for SNAP benefits, households must meet certain  
          income tests, and some households must meet certain  
          resource tests and work requirements.  According to the  
          USDA, in 2009, California received $4.3 billion in federal  
          food assistance benefits; yet, only about half of eligible  
          persons actually receive food stamps.  Some advocates argue  
          that the state could be receiving billions more in food  
          assistance benefits and the state should take actions to  
          improve food stamp participation for the benefit of  
          low-income individuals and the state's economy.

          The Food Stamp program is California's most significant  
          means of reducing hunger and improving nutrition among the  
          state's poor.  It serves a total of nearly two million  
          people.  The benefits, paid monthly through an electronic  
          benefit transfer system, are entirely funded by the federal  
          government.  The federal, state, and county governments  
          share the cost of administration.  It is administered  
          locally by county welfare departments.  

          CalWORKS
          CalWORKs is a program based on a partnership concept  
          between government and the participant, under which the  
          government promises to provide a monthly cash grant and  
          offer supportive services to the participant.  Together,  
          the cash and services are intended to defray living  
          expenses and help the participant overcome barriers, such  




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          as substance abuse or domestic violence, or to give them  
          the basic tools, such as a bus pass or proper work  
          clothing, that make obtaining and maintaining a job  
          possible.  While counties administer the cash aid and  
          arrange for or provide supportive services for a  
          participant, the state and federal governments provide most  
          of the funding for this program.

          Statewide Automated Welfare System (SAWS) 
          Each of California's fifty-eight counties uses one of four  
          automated systems to administer California's human services  
          programs, including Medi-Cal, CalWORKs, and Food Stamps.   
          Taken together, these four automated systems comprise the  
          Statewide Automated Welfare System (SAWS).  These systems  
          facilitate initial and ongoing eligibility determinations,  
          case management, sending of notices, processing of mid-year  
          and quarterly reports, and annual eligibility  
          redeterminations. 

          The systems also interface directly with the state's  
          Medi-Cal Eligibility Data System (MEDS), the statewide  
          Medi-Cal database.  SAWS allows counties to determine  
          initial eligibility for Food Stamps, CalWORKS, and Medi-Cal  
          all at the same time.  However, currently, the annual  
          redeterminations for these three programs are done via two  
          separate processes, one for Medi-Cal and another for Food  
          Stamps and CalWORKs, which creates additional work for both  
          county workers and recipients and acts as a barrier to  
          reenrollment.  A specific barrier to continued enrollment  
          in Medi-Cal is that annual redetermination forms sent to  
          recipients do not contain prior information reported by the  
          recipient to the county, such as household composition and  
          income. 

          ABX4 7 (Budget Committee), Chapter 7, Statutes of 2009,  
          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 Stamp 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 ABX4 7 centralized  
          eligibility work group to assess the viability of a broader  
          effort to develop a single statewide eligibility system for  




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          enrollment in health and social service programs.
          
          Uninsured children
          There are approximately 700,000 children in California who  
          are not covered by health insurance, according to  
          researchers.  Many of these uninsured children come from  
          low-income working families.  As a result of the lack of  
          insurance, they are less likely to visit a doctor, less  
          likely to receive preventive services, and may delay  
          seeking necessary care. Often when they seek care, they  
          have more serious conditions and require more extensive and  
          costly treatment.

          According to the UCLA Center for Health Policy Research,  
          among the nearly 700,000 children who are uninsured, over  
          half are eligible for two of California's public health  
          insurance programs; approximately 200,000 for Medi-Cal and  
          180,000 for Healthy Families.  

          Studies have reported that when parents of uninsured  
          children, who are potentially eligible for Medi-Cal, were  
          asked why their children were not enrolled, close to eight  
          percent reported being unsure about their children's  
          eligibility as the reason for not applying, and less than  
          one percent did not know the program existed.  Parents of  
          about one in eight uninsured eligible children objected to  
          some characteristics of the program, particularly the  
          onerous paperwork.  Of the uninsured children who are  
          eligible for Healthy Families, parents of nearly 25 percent  
          did not know of the program's existence and 20 percent knew  
          of the program but thought that their children were not  
          eligible. 

















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          Prior legislation
          ABX4 7 (Committee on Budget), Ch. 7, Statutes of 2008)  
          requires a task force to convene to assess current and  
          future efforts for enrollment across health and social  
          services programs including Medi-Cal, CalWORKs and Food  
          Stamps.
          
          AB 2875 (Liebert) of 2008 would have required that a  
          Medi-Cal beneficiary who completes a periodic report or  
          annual renewal form, under the CalWORKS program or Food  
          Stamps program, be deemed to have met the requirement for  
          periodic redetermination for the Medi-Cal program and would  
          have made other changes in Medi-Cal enrollment.  This bill  
          was held on the Senate Appropriations Committee suspense  
          file.

          SB 493 (Sher), Chapter 897, Statutes of 2001, implements a  
          simplified eligibility process as part of the Food Stamp  
          program, to expedite the enrollment of individuals and  
          families in the Medi-Cal and Healthy Families. 

          SB 87 (Escutia), Chapter 1088, Statutes of 2000, requires  
          counties to follow specified steps and procedures  
          determining Medi-Cal eligibility for those beneficiaries  
          who have lost their CalWORKS eligibility.  
          
          Arguments in support
          The sponsors of AB 963, Western Center on Law & Poverty  
          (WCLP) and the Children's Partnership argue that this bill  
          will help to streamline the Medi-Cal eligibility process  
          and eliminate duplicate, burdensome paperwork.  The  
          sponsors state that this bill proposes a simple solution to  
          ensuring that eligible children and families stay enrolled  
          in Medi-Cal, Food Stamps and CalWORKS.  Supporters note  
          that, while these programs have very similar eligibility  
          and renewal requirements and are administered by the same  
          county departments, many low-income families lose their  
          benefits because they are required to complete separate  
          renewal paperwork for each program, which is both  
          frustrating and time consuming. Supporters also argue that  
          under current law, eligible recipients of these benefits  
          are often subject to drops or lapses in coverage due to the  
          complex renewal requirements.






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                                  PRIOR ACTIONS

           Assembly Health Committee               18- 0
          Assembly Appropriations Committee     12- 5
          Assembly Floor                45-26

                                     COMMENTS


           1.  Double referral.  This bill has been double referred to  
          the Human Services Committee.
                                    POSITIONS  
                                        
          Support:   Children's Partnership (co-sponsor)
                 Western Center on Law & Poverty (co-sponsor)
                 AIDS Project Los Angeles (APLA)
                 Alameda County Food Bank
                     Aspiranet
                 California Association of Food Banks
                 California Primary Care Association (CPCA)
                 California School Employees Association
                 County Welfare Directors Association of California  
          (CWDA)
                 Los Angeles County Board of Supervisors
                 National Association of Social Workers - California  
          Chapter (NASW-CA)
                 Ventura County Board of Supervisors


          Oppose:    None received




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