BILL ANALYSIS Ó
SB 970
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Date of Hearing: August 8, 2012
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
SB 970 (DeLeon) - As Amended: May 29, 2012
Policy Committee: HealthVote: 13-6
Urgency: No State Mandated Local Program:
Yes Reimbursable: Yes
SUMMARY
This bill establishes requirements for data-sharing in order to
facilitate enrollment in the specified human services programs
among applicants for state health subsidy programs.
Specifically, this bill:
1)Authorizes, at the time of initial application for, or renewal
of, health care coverage through state health subsidy
programs, an individual to consent to have his or her
application information used to initiate simultaneous
applications for California Work Opportunity and
Responsibility to Kids (CalWORKs),CalFresh, and other
programs.
2)Requires county human services departments to, with the
beneficiary's consent, use information received via a
data-sharing protocol described in (1), above, to continue or
recertify CalWORKs or CalFresh benefits for all eligible
individuals, if information used to renew a beneficiary's
eligibility for a state health subsidy program is sufficient
to meet the requirements for a CalWORKs or CalFresh semiannual
report or annual recertification.
3)Requires the California Health and Human Services Agency
(CHHSA) to convene a workgroup to consider and develop a plan
for the integration of additional human services and work
support programs into the application system.
4)Requires implementation of the bill's provisions by December
31, 2015. Renders (1) and (2), above, inoperative if the
Secretary of Health and Human Services determines the
operation of these subdivisions would delay the implementation
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of a single, standardized application for state health subsidy
programs.
FISCAL EFFECT
1)One-time costs to CHHSA in the range of $50,000 to $200,000,
depending on the level of technical detail addressed and staff
support provided, to convene a planning workgroup to address
further integration of human services programs.
2)Information Technology (IT) costs of up to $1.8 million (a
combination of TANF/MOE, for costs attributed to CalWORKS and
50% federal, 50% GF, for costs attributed to CalFresh) to
develop functionality that would satisfy the bill's
requirements. This bill requires an augmentation to a system
that has been commissioned by the California Health Benefit
Exchange (Exchange) and is now being designed and built.
Costs could be substantially higher than $1.8 million if
additional human services and work support programs are
considered for inclusion as authorized by this bill.
3)Increases in CalWORKS grant costs, if individuals who would
not otherwise enroll in CalWORKS enroll as a result of
data-sharing protocols established by this bill. For every 35
families who receive CalWORKs as a result of this bill, it
would increase costs by approximately $1 million (TANF/MOE)
per year.
4)If this legislation causes a 1% increase in non-assistance
CalFresh participation, it would bring in an additional $66
million annually in 100% federally funded CalFresh benefits.
Those cases would cost approximately $2.5 million (50% GF, 50%
federal) to administer. However, those administrative costs
are estimated to be offset by an additional $1.8 million in
state sales tax revenue.
5)Possible increased administrative costs related to the
requirement that county human services department use
information collected to continue or recertify eligibility in
CalWORKS or CalFresh, if this bill causes recertification to
occur before it is necessary.
6)Rapid implementation could cause a large administrative
backlog. The federal government has authority to impose
administrative sanctions if the state fails to meet federally
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required timetables.
COMMENTS
1)Rationale . The author believes ongoing development of the new
California Healthcare Eligibility, Enrollment and Retention
System (CalHEERS) poses a new opportunity to integrate
applications for human services programs with applications for
health care programs. CalHEERS is intended to be a one-stop
shop where an individual can apply for all subsidized health
care programs offered by the state, including Medi-Cal and
subsidies offered through the California Health Benefit
Exchange (Exchange). The author contends that individuals who
may qualify for CalWORKS or CalFresh should have the
opportunity to apply concurrently for these programs, as they
apply for health coverage.
2)Background . The federal Patient Protection and Affordable
Care Act (ACA) changes eligibility standards for Medicaid
(Medi-Cal in California) and requires states to use an
integrated, "no wrong door" system to determine eligibility of
applicants for health care coverage programs offered through
the state. This bill attempts to ensure that the IT system
being developed to support this effort also includes the
ability to transmit information adequate to allow individuals
to make a simultaneous application to human services programs,
including CalWORKS and CalFresh at a minimum.
Currently, individuals applying for Medi-Cal, CalWORKS, or
CalFresh in person or through online portals that connect to
county databases have the opportunity to apply for any of the
programs simultaneously. The sponsors of the measure, the
Western Center on Law and Poverty, believe that development of
a CalHEERS system for health care program enrollment that
lacks integration of human services programs would be a step
backward.
3)Solicitation and Award of CalHEERS Contract . In January 2012,
the Exchange released a solicitation that described the
business functions required for the CalHEERS system. Core
system functionality included eligibility determination for
state health programs, plan management, financial management,
consumer assistance, and assistance for navigators or agents.
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On June 26, 2012, the Exchange announced the award of a
contract to develop the CalHEERS system to Accenture LLC. The
contract includes about $183 million for the initial
development and implementation of the system; these costs will
primarily be paid by the federal government through funds
available to implement the ACA. Once the system is in place,
the contract also includes about $176 million for the
continued development and initial operating costs over about
three and a half years (approximately $50 million per year).
Horizontal integration of non-health services programs such as
CalWORKS and CalFresh was not included in the core system;
this integration was characterized as an enhancement that
would be available part of an expanded system at future state
option. The Exchange has officially stated that it
recognizes the importance of horizontal integration with human
services programs, and that this integration will be
considered subsequent to the deployment of the core system.
The current contract does not contain funding for horizontal
integration.
4)Federal Cost Rules . In order to promote flexibility for
states, the federal Department of Health and Human Services
has provided a time-limited, specific exception to normal cost
allocation requirements. The exception allows human services
programs such as CalWORKS and CalFresh to use systems designed
specifically for health coverage programs without sharing in
the common system development costs, so long as those costs
would have been incurred anyway. However, incremental costs
for additional requirements needed for the inclusion of those
programs must be charged entirely to the benefitting program.
This exception is in place until 2015.
5)Drafting Concern. As currently drafted, provision (1) of the
bill is vague with respect to the process whereby a
simultaneous application for human services programs will be
initiated. This bill provides applicants the ability to
consent to have information from their health care program
application transmitted for purposes to initiate simultaneous
applications for human services programs. However, it does
not require the information to be transmitted to county
welfare offices, nor specify that the information shall
constitute an application to be processed.
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Analysis Prepared by : Lisa Murawski / APPR. / (916) 319-2081