BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 1223
                                                                  Page  1


          ASSEMBLY THIRD READING
          AB 1223 (Veterans Affairs Committee)
          As Introduced February 18, 2011
          Majority vote

           VETERANS AFFAIRS    9-0         HEALTH              18-0        
           
           ----------------------------------------------------------------- 
          |Ayes:|Cook, Pan, Atkins, Block, |Ayes:|Monning, Logue, Ammiano,  |
          |     |Knight, Nielsen, V.       |     |Atkins, Bonilla, Eng,     |
          |     |Manuel P�rez, Williams,   |     |Garrick, Gordon, Hayashi, |
          |     |Yamada                    |     |Bonnie Lowenthal,         |
          |     |                          |     |Mansoor, Mitchell,        |
          |     |                          |     |Nestande, Pan,            |
          |     |                          |     |V. Manuel P�rez, Silva,   |
          |     |                          |     |Smyth, Williams           |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           APPROPRIATIONS      17-0                                        
           
           -------------------------------- 
          |Ayes:|Fuentes, Harkey,          |
          |     |Blumenfield, Bradford,    |
          |     |Charles Calderon, Campos, |
          |     |Davis, Donnelly, Gatto,   |
          |     |Hall, Hill, Lara,         |
          |     |Mitchell, Nielsen, Norby, |
          |     |Solorio, Wagner           |
          |     |                          |
           -------------------------------- 
           SUMMARY  :  Requires the Department of Health Care Services (DHCS) 
          to utilize 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 statewide and repeals language making PARIS a two-year 
          pilot program where DHCS selects three consenting counties that 
          have in operation a United States Department of Veterans Affairs 
          (USDVA) medical center to participate in the pilot.

           FISCAL EFFECT  :  According to the Assembly Appropriations 
          Committee:

          1)Additional administrative costs to DHCS and the California 








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            Department of Veterans Affairs (CDVA), likely in the range of 
            $300,000 (50% General Fund (GF)) to expand the pilot project 
            statewide.  Activities would include identification, outreach, 
            and facilitation of enrollment of veterans into federal USDVA 
            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 (LAO), 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 
            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  :  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 LAO in 2007, which states 
          that implementing PARIS could save the state millions of dollars 
          annually in General Fund costs by shifting eligible veterans 
          enrolled in Medi-Cal who might be eligible for the USDVA health 
          care system.  According to the LAO analysis, 144,000 veterans 
          and dependents on Medi-Cal coverage could be eligible for 
          comprehensive medical care and health services through the USDVA 
          health care system.  The author argues that connecting only 10% 
          of these veterans will save the state $25 million annually.

          AB 1183 (Budget Committee), Chapter 758, Statutes of 2008, 
          required DHCS to utilize the federal PARIS by July 1, 2009 as a 
          two-year pilot program to identify veterans and their dependents 
          or survivors who are enrolled in the Medi-Cal Program and assist 
          them in obtaining federal veteran health care benefits.  Under 
          existing law, DHCS must select three consenting counties that 
          have in operation a USDVA medical center to participate in the 
          pilot program.  DHCS is required, under the pilot program, to 








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          exchange information with PARIS and identify veterans and their 
          dependents or survivors who are receiving Medi-Cal benefits in 
          the pilot program counties.  

          According to DHCS, the PARIS-Veterans pilot project 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.  DHCS is also 
          performing the PARIS matching process on a pilot basis to test 
          the cost effectiveness prior to implementing statewide.  For the 
          first two matches, DHCS selected beneficiary records from three 
          California counties.  In the third match, DHCS selected from six 
          California counties.   In the most recent PARIS-Veterans match, 
          DHCS selected from 10 California counties.  Since 
          implementation, DHCS has participated in eight instances of the 
          quarterly PARIS match process during the two year implementation 
          of the pilot program.  Based on these matches, DHCS has 
          successfully identified veterans and their dependents or 
          survivors who are enrolled in the Medi-Cal Program.  DHCS and 
          the CDVA have identified hundreds of Medi-Cal beneficiaries that 
          are simultaneously enrolled in the USDVA system of health care.  
          The pilot program outreach efforts have 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 USDVA 
          system of health care.  DHCS does not identify the total number 
          of veterans receiving Medi-Cal benefits.  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. 


           Analysis Prepared by  :    Marjorie Swartz / HEALTH / (916) 
          319-2097

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