BILL ANALYSIS                                                                                                                                                                                                    






                                  SENATE HUMAN
                               SERVICES COMMITTEE
                            Senator Carol Liu, Chair


          BILL NO:       AB 963                                       
          A
          AUTHOR:        Ammiano                                      
          B
          VERSION:       May 25, 2010
          HEARING DATE:  June 22, 2010                                
          9
          FISCAL:        Appropriations                               
          6
                                                                      
          3
          CONSULTANT:                                                
          Park
                                        

                                     SUBJECT
                                         
             Public social services: renewal and recertification of  
                                  eligibility

                                     SUMMARY  

          Requires the 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 workgroup to develop a joint renewal  
          and recertification form to be used by persons who are  
          eligible for the Medi-Cal, Food Stamp or CalWORKs programs.

                                     ABSTRACT  

          Existing federal law:

          1.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, which provides food assistance benefits to  
            qualifying individuals based on specified rules.   
            Establishes the Temporary Aid to Needy Families program,  
                                                         Continued---



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            which provides time-limited cash assistance to qualifying  
            individuals based on specified rules.  Each of these  
            federal programs is administered through state and local  
            entities.

          Existing state law:

          1.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.

          2.Establishes the Food Stamp program, overseen by DSS and  
            administered by counties, that enables recipients of aid  
            and other low-income households to receive federal food  
            assistance benefits (under SNAP).

          3.Establishes the California Work Opportunity and  
            Responsibility to Kids program, or CalWORKs, overseen by  
            DSS, under which each county provides time-limited cash  
            assistance and welfare-to-work services to qualified  
            low-income families and individuals who meet specified  
            eligibility criteria.  CalWORKs is the state version of  
            the federal Temporary Assistance for Needy Families  
            program.

          4.Requires DHCS and DSS to develop a statewide eligibility  
            and enrollment determination process for CalWORKs,  
            Medi-Cal, and food stamps, as specified. Requires the  
            departments to convene a stakeholder steering committee  
            for consultation in the development of the statewide  
            eligibility and enrollment determination process and  
            comprehensive plan. Makes implementation of these  
            provisions contingent upon the availability of federal  
            financial participation. 

          This bill:

          1.Requires DHCS, in consultation with DSS, counties,  
            representatives from the Statewide Automated Welfare  
            System (SAWS) consortia, consumer advocates, and other  




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            stakeholder groups, 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 programs, as well as  
            related policies and procedures.

          2.Specifies tasks for the stakeholder group to undertake in  
            developing the form, policies, and procedures to be  
            considered for adoption by DHCS, DSS, the counties, and  
            the SAWS consortia, including the following:

             a.   Eliminate any duplicative requests for information  
               or documentation.
             b.   Develop forms, policies and procedures to be used  
               for both paper and electronic renewal and  
               recertification.
             c.   Maximize use of shared technology and information  
               to minimize burdens on recipients and county  
               eligibility staff.
             d.   Align renewal and recertification dates between the  
               programs without loss of any benefits.
             e.   Establish appropriate procedures and safeguards for  
               data and information sharing.
             f.   Consider any changes that may be needed under  
               federal health care reform and other federal laws and  
               regulations, as specified.

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

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

                                 FISCAL IMPACT  

          According to the Assembly Appropriations Committee analysis  
          of a prior version of the bill, the bill would have  
          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  




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          eligibility barriers.  Recent amendments narrow the scope  
          of this bill and clarify that no General Fund costs or  
          pressures will be created.


                            BACKGROUND AND DISCUSSION  

          Author's statement
          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  
          and CalWORKs more efficiently.  The author states that 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 workgroup  
          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.

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

          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  




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          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.

          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.  Food stamp benefits  
          are paid monthly through an electronic benefit transfer  
          system and administered locally by county welfare  
          departments.  The benefits are entirely funded by the  
          federal government, although federal, state, and county  
          governments share in the cost of administration.

          SNAP requires all recipients, unless exempted by law, to  
          register for work at the appropriate employment office,  
          participate in an employment and training program if  
          assigned by a state or local administering agency, and  
          accept an offer of suitable employment.  Food stamp  
          recipients are exempted from registering for work and  
          engaging in employment and training activities if they are  
          under age 16 or over age 59; physically or mentally unfit  
          for employment; caring for a child under the age of 6 (or  
          12, in some cases); employed 30 hours a week; or subject to  
          and complying with work requirements for other programs,  
          such as those required by CalWORKs.  Additionally, others  
          are exempted because they are receiving unemployment  
          insurance compensation, participating in a drug and alcohol  
          treatment and rehabilitation program, or are students  
          enrolled at least half time (these students must meet other  
          work participation requirements).

          Families receiving CalWORKs must comply with CalWORKs work  
          requirements in order to be exempt from meeting the food  
          stamp work requirements.  Non-CalWORKs families (known as  
          non-assistance food stamps population) must register for  




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          work, unless exempt, and participate in food stamp  
          employment and training program activities, if assigned to  
          such a program.  Federal law also requires that able-bodied  
          adults without dependents (ABAWDs) are generally limited to  
          three months of food assistance benefits in a 36-month  
          period unless they fulfill federal work requirements or  
          receive an exemption.  The American Recovery and  
          Reinvestment Act of 2009 eliminated this time-limit  
          restriction until September 30, 2010.

          CalWORKs
          CalWORKs is supervised by DSS and administered by the  
          counties. CalWORKs has requirements relating to  
          eligibility, cash grant levels, work participation,  
          exemptions, time limits, and sanctions. CalWORKs families  
          receive cash assistance and most receive employment and  
          supportive services aimed at promoting self-sufficiency.   
          To be eligible, families must meet income and asset  
          requirements and must include a child who is "deprived" of  
          parental support or care, as defined.  The cash grant is  
          based, in part, on the number of people in the family, the  
          number eligible to receive aid, the region the family lives  
          in, and whether anyone in the household is exempt from work  
          participation.

          All CalWORKs recipients are required to participate in  
          welfare-to-work activities as a condition of aid, unless  
          the recipient is exempt.  State law requires counties to  
          sanction individuals for noncompliance with specific  
          welfare-to-work program requirements. When a family,  
          without good cause, does not comply with program  
          requirements, the family's grant is reduced to remove  
          support for the noncompliant adult (or adults), leaving a  
          "child-only" grant.

          In general, CalWORKs has a 60-month limit.  However, some  
          months may not be counted towards the 60-month time limit,  
          and some eligible adults may have their aid or services  
          extended beyond the 60-month limit.  (Under new state time  
          limits enacted in one of last year's budget trailer bills,  
          adult CalWORKs recipients may receive aid for up to 48  
          cumulative months.  At that point, the adult portion of the  
          grant is eliminated and a child-only grant is given for 12  
          months.  If at that point, after the 12 months, the adult  
          continues to be eligible, the adult is added back into the  




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          family grant for the remaining 12 months of his or her  
          60-month limit.)

          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  
          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. Additionally, counties redetermine recipient  
          eligibility and grant amounts for food stamps and CalWORKs  
          on a quarterly basis. 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.

          Centralized statewide eligibility and enrollment
          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 generally 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 workgroup to assess the  
          viability of a broader effort to develop a single statewide  
          eligibility system for enrollment in health and social  
          service programs.  Though the Health and Human Services  




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          Agency has convened a few meetings to date, several issues  
          concerning the direction of the stakeholder process and  
          work product remain. It is also unclear how federal health  
          reform and pending guidance impact the direction of the  
          stakeholder process and work product.
          
          Arguments in support
          The sponsors of AB 963, Western Center on Law & Poverty  
          (WCLP), the Children's Partnership, and United Way of the  
          Bay Area believe 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 likewise state that eligible  
          recipients of these benefits are often have lapses in  
          coverage or drop coverage due to the complex renewal  
          requirements.

          Related/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 (Lieber) 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 programs.




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          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.


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

                                     COMMENTS
           
          1.Author's amendments. The author proposes the following  
            clarifying amendments in response to questions raised by  
            committee staff. 

            14012.6. (a) The department, 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, shall conduct a stakeholder planning  
            workgroup to develop a  joint  single 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  single renewal and recertification form, and any  
            related policies and procedures, to be considered for  
            adoption by the department, the counties, the State  
            Department of Social Services, and the SAWS consortia. 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  




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               are necessary and eliminate any requests for  
               information or documentation that are duplicative.

               (2) Develop the  joint  single 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.
               ?

               (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 positive verification  s  of  
               information required for determination of eligibility.  
                 

               (10) Consider implications of  any changes that may be  
               needed under  federal health reform implementation,  any  
               guidance provided by the United States Department of  
               Agriculture,  and identify any waivers to  other changes  
               that may be needed in  federal  law or policy   
               regulations or policies needed to  that would  ensure a  
                smooth transition  successful implementation  to the use  
                of the  joint  single renewal and recertification form,  
               policies, and procedures.
                 ?

            (d) The department and the State Department of Social  
            Services shall submit the  joint  single renewal and  
            recertification form and related policies and procedures  
            developed by the workgroup to the appropriate policy and  
            fiscal committees of the Legislature by  January  October  
            31,  2012  2011. 

                                    POSITIONS  

          Support:   Children's Partnership (co-sponsor)
                 United Way of the Bay Area (co-sponsor)




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                 Western Center on Law & Poverty (co-sponsor)
                 AIDS Project Los Angeles 
                 Alameda County Food Bank
                 Aspiranet
                 California Association of Food Banks
                 California Children's Hospital Association
                 California Medical Association
                 California School Employees Association
                 County Welfare Directors Association of California
                 LifeLong Medical Care 
                 Los Angeles County Board of Supervisors
                 National Association of Social Workers - California  
          Chapter
                 San Diego Hunger Coalition
                 Ventura County Board of Supervisors

          Oppose:    None received
                                   -- END --