BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 1223
                                                                  Page  1

          Date of Hearing:   May 18, 2011

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Felipe Fuentes, Chair

              AB 1223 (Committee on Veterans Affairs) - As Introduced:  
                                 February 18, 2011 

          Policy Committee:                             HealthVote:18-0
                       Veteran's Affairs                Vote: 9-0

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

           SUMMARY  

          This bill requires the Department of Health Care Services (DHCS) 
          to use the federal Public Assistance and Reporting Information 
          System (PARIS) to identify veterans and their dependents or 
          survivors who are enrolled in the Medi-Cal Program, and assist 
          them in obtaining federal veterans' health care benefits. It 
          also deletes the previous authorization for a similar two-year 
          pilot project.

           FISCAL EFFECT  

          1)Additional administrative costs to DHCS and CDVA, likely in 
            the range of $300,000 (50% GF) to expand the pilot project 
            statewide. Activities would include identification, outreach, 
            and facilitation of enrollment of veterans into the federal VA 
            benefits. Costs would subside in future years as fewer 
            veterans are identified in the Medi-Cal system.  

          2)Potentially significant cost savings to the Medi-Cal program. 
            According to the Legislative Analyst's Office, full 
            implementation of the PARIS match system and subsequent 
            enrollment of identified veterans in federal veterans' health 
            care benefits could save the state as much as $500 million 
            ($250 million GF) annually.  The amount and timing of actual 
            cost savings will depend on how quickly the project is 
            implemented throughout the state. 

          3)DHCS has already implemented a pilot program that is expected 
            to have resulted in cost savings.  Additional savings 
            specifically related to this bill will depend on the level 








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            cost savings the state is currently experiencing due to the 
            pilot program. DHCS has not finalized an analysis of the pilot 
            at this time.

           COMMENTS  

           1)Rationale  .  According to the author, the purpose of this bill 
            is to remove the pilot project nature of the provisions in 
            existing law and require DHCS to implement the program 
            statewide.  The author relies on an analysis by the 
            Legislative Analyst's Office (LAO) in 2007 that stated 
            implementing PARIS could save the state millions of dollars 
            annually in General Fund cost by shifting eligible veterans 
            enrolled in Medi-Cal to the federal Department of Veteran's 
            Affairs (USDVA) health care system.  According to the LAO 
            Report, 144,000 veterans and dependents on Medi-Cal coverage 
            could be eligible for services through the USDVA health care 
            system.  DHCS currently has the authority to expand the pilot 
            statewide, but is waiting until the results of the pilot 
            project are complete in order to make a determination to 
            proceed with statewide adoption.

           2)Pilot program  . According to DHCS, the PARIS-Veterans pilot 
            program was implemented on July 1, 2009.   DHCS entered into a 
            memorandum of understanding with the CDVA to operate the 
            PARIS-Veterans pilot program.  Under the pilot, the CDVA is 
            focusing outreach efforts on veterans and their dependents or 
            survivors who are receiving Medi-Cal benefits and who are 
            receiving high-cost services in pilot counties.  CDVA is 
            tracking the contact of these individuals and reporting 
            outcomes to DHCS.

            The pilot program outreach efforts have reportedly resulted in 
            some of the individuals choosing to no longer be enrolled in 
            Medi-Cal and have allowed DHCS to better coordinate care with 
            the US DVA system of health care. The pilot ends on July 1, 
            2011.  Actual data resulting from the PARIS-Veterans pilot 
            program will be presented in a Legislative Report that is due 
            on November 1, 2011. DHCS has authority under existing law to 
            implement the pilot program statewide if the department 
            determines it is cost-effective.

          3)Related Legislation  .  AB 1568 (Committee on Veterans Affairs) 
            in 2009, would have made PARIS pilot project a permanent, 
            statewide program.  AB 1658 was amended into a different 








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            subject matter.

            AB 3082 (Committee on Veterans Affairs) of 2008, would have 
            required any state or public assistance agency using PARIS to 
            identify veterans enrolled in the Medi-Cal Program for the 
            purpose of assisting them in obtaining federal health care 
            benefits. It also required CDVA to develop a plan for handling 
            data-match information given to a CVSO.  AB 3082 died on the 
            Senate Appropriations Suspense File.

            AB 1183 (Committee on Budget), Chapter 758, Statutes of 2008, 
            requires DHCS to establish a two-year pilot program for the 
            use of PARIS by July 1, 2009, and to report to the Legislature 
            the effectiveness of the program, and included authority for 
            DHCS to make PARIS a permanent program if the program was 
            deemed cost-effective. 


           Analysis Prepared by  :    Lisa Murawski / APPR. / (916) 319-2081