BILL ANALYSIS                                                                                                                                                                                                    �




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair


          AB 1223 (Cook) - Medi-Cal: Public Assistance Reporting 
          Information System
          
          Amended: August 24, 2011        Policy Vote: Health 9-0
          Urgency: No                     Mandate: No
          Hearing Date: July 2, 2012      Consultant: Brendan McCarthy
          
          This bill does not meet the criteria for referral to the 
          Suspense File.
          
          
          Bill Summary: AB 1223 would require the Department of Health 
          Care Services use the federal Public Assistance and Reporting 
          Information System to identify Medi-Cal enrollees who may be 
          eligible for federal veteran's benefits and assist them in 
          obtaining federal veteran's benefits.

          Fiscal Impact: Potential annual net savings to the Medi-Cal 
          program in the low millions, depending out outreach efforts by 
          the Department and local county veteran service officers (50 
          percent General Fund, 50 percent federal funds).

          Background: The Department of Health Care Services operates the 
          Medi-Cal program which provide health care services to low 
          income children and their parents, the blind, aged, and 
          disabled. One of the major expenditure areas under the Medi-Cal 
          program is support for long-term care.

          According to an analysis by the Legislative Analyst's Office, as 
          many as 144,000 veterans or their dependents are enrolled in 
          Medi-Cal. Many of those beneficiaries may be eligible for 
          veteran's health benefits, including long-term care benefits, 
          potentially with lower cost sharing required of the veteran. 
          Also, under state law, Medi-Cal can claim assets from a former 
          beneficiary's estate to recoup costs for long-term care, whereas 
          under federal law, the veteran's benefit system does not do so.

          Under current law (AB 1183, Committee on Budget, Chapter 758 of 
          2008), the Department has operated a pilot project to use 
          information in the federal Public Assistance and Reporting 
          Information System to identify Medi-Cal enrollees who may be 
          eligible for federal veteran's benefits. The Department, in 








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          coordination with the Department of Veteran's Affairs and local 
          county veteran service officers, has worked to contact those 
          enrollees to advise them of the federal benefits they are 
          entitled to and the potential financial benefits to the veteran 
          to access federal services instead of Medi-Cal. The Department 
          has implemented the pilot project in ten counties and has 
          realized two year net savings of about $1.4 million (50 percent 
          General Fund, 50 percent federal funds).

          Proposed Law: AB 1223 would require the Department of Health 
          Care Services use the federal Public Assistance and Reporting 
          Information System to identify Medi-Cal enrollees who may be 
          eligible for federal veteran's benefits and assist them in 
          obtaining federal veteran's benefits.

          The bill exempts the program from the requirements of the 
          Administrative Procedures Act (beginning at section 11340 of the 
          Government Code) and exempts any contracts entered into by the 
          Department from the Public Contract Code (beginning at section 
          11250 of the Government Code).

          Related Legislation: AB 1869 (J. Perez) would require the Office 
          of the Patient Advocate to provide information about veteran's 
          health benefits to the public. That bill will be heard in this 
          committee.

          Staff Comments: While the pilot project realized a net savings, 
          the Department expended only about $150,000 in staff costs to 
          identify Medi-Cal beneficiaries who are veterans and may benefit 
          from switching to federal benefits. The state Department of 
          Veteran's Affairs and local officials did not receive any 
          additional resources to assist in contacting eligible veterans. 
          According to the Department, the county veteran service officers 
          were only able to contact about 25 percent of the veterans 
          identified by the Department.

          If the Department extends this program statewide, as authorized 
          under the bill, additional resources would likely increase 
          future cost savings, particularly if the Department was able to 
          provide reimbursement to the Department of Veteran's Affairs and 
          local county veteran service officers to cover their costs.











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