BILL ANALYSIS                                                                                                                                                                                                    �






                             SENATE COMMITTEE ON HEALTH
                          Senator Ed Hernandez, O.D., Chair

          BILL NO:       SB 1190
          AUTHOR:        Hancock
          AMENDED:       March 29, 2012
          HEARING DATE:  April 11, 2012
          CONSULTANT:    Orr

           SUBJECT  :  Women, infants, and children's nutrition.
           
          SUMMARY :  Requires the California Department of Public Health 
          (CDPH) to implement an electronic benefits transfer (EBT) system 
          for the California Special Supplemental Food Program for Women, 
          Infants and Children (WIC) by January 1, 2015.

          Existing law:
          1.Establishes WIC under the United States Department of 
            Agriculture (USDA), which provides grants to states for 
            supplemental foods, health care referrals, and nutrition 
            education for low-income pregnant, breastfeeding, and 
            non-breastfeeding postpartum women, and to infants and 
            children up to age five who are found to be at nutritional 
            risk. Establishes WIC in California, administered by CDPH, for 
            these purposes.

          2.Establishes, in federal law, the Healthy, Hunger-Free Kids Act 
            of 2010 (HHFKA), which requires, among other provisions, that 
            states implement EBT systems for WIC programs by October 1, 
            2020, with specified exemptions.

          3.Authorizes the Department of Health Services (DHS, now CDPH) 
            to design, implement and fund an EBT system for the WIC 
            program. Requires CDPH to study the feasibility of 
            implementing an EBT system for the WIC program and report the 
            findings to the Legislature by July 1, 2003. Prohibits CDPH 
            from implementing an EBT system until the feasibility study 
            was completed and funding was allocated in the annual Budget 
            Act. Requires CDPH to obtain USDA's approval prior to the 
            establishment of any EBT system.

          4.Authorizes the issuance of nutrition coupons by local agencies 
            to program recipients in order to exchange with vendors for 
            the purchase of approved nutritious foods. Requires CDPH to 
            print specified information on each coupon. Requires CDPH to 
            provide this information on the coupons using optical scanning 
                                                         Continued---



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            technology, to the extent feasible, and requires CDPH to 
            report to the Legislature on the feasibility and costs of 
            using this technology by July 1, 2003. 
          
          This bill: 
          1.Requires CDPH to design, implement and maintain an EBT system 
            for WIC by January 1, 2015. Prohibits CDPH from implementing 
            the EBT system until funding is provided in the annual Budget 
            Act.

          2.Deletes the requirement that CDPH complete a feasibility study 
            on implementing EBT and report findings to the Legislature by 
            January 1, 2003.  

          3.Extends the date by which CDPH must report to the Legislature 
            on the feasibility and costs of using optical scanning 
            technology for the nutrition coupons to July 1, 2013. 
            Additionally requires CDPH to report on which electronic card 
            option the state will use to implement the required EBT 
            system. 

           FISCAL EFFECT  :  This bill has not been analyzed by a fiscal 
          committee.

           COMMENTS  :  
           1.Author's statement.  According to the author, an EBT system 
            for WIC would replace the current paper checks, which are 
            cumbersome and outdated for grocers, stigmatizing for 
            participants at the check stand, and costly to operate. With 
            WIC EBT, WIC participants would use the electronic system to 
            purchase healthy, WIC-approved foods with an EBT card instead 
            of multiple paper checks.

          2.WIC. WIC is a 100 percent federally-funded nutrition and 
            health program that provides nutrition education and food for 
            low-income pregnant women, new mothers, infants or children 
            under age five. The WIC food package is specifically designed 
            to meet the special nutritional needs of its target 
            population, and includes items like infant formula, milk, 
            breakfast cereal, cheese, eggs, fruits, vegetables and 
            legumes. Allocated quantities depend on the age of the infant 
            or child, and whether a mother is pregnant, postpartum, and 
            partially or fully breastfeeding. WIC provides checks or 
            coupons for buying healthy supplemental foods from 
            WIC-authorized vendors. The coupons are required to be printed 
            with specified information, including the specific food item 




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            for which the coupon may be used, the specific quantities of 
            that food item, the valid dates during which the coupon may be 
            used, and the maximum value for the coupon. In addition to 
            nutritious foods, WIC also provides nutrition education, 
            assistance with finding health care and other community 
            services, and support and information about breastfeeding. 

          3.EBT. EBT is the automated delivery, redemption and 
            reconciliation of benefits, most commonly used by the federal 
            Supplemental Nutrition Assistance Program, known in California 
            as CalFresh, the California Food Assistance Program, and cash 
            assistance benefits. EBT provides recipients receiving public 
            assistance with electronic access to food and cash benefits 
            through the use of magnetic striped cards at point-of-sale 
            (POS) devices at stores and ATMs. EBT is used in all 50 states 
            and in the District of Columbia, Puerto Rico, the Virgin 
            Islands, and Guam. The California EBT system currently 
            processes and reconciles food and cash assistance benefit 
            transactions for over two million EBT cardholders per month. 
            The state does not own or operate its own EBT system. Instead, 
            the state contracts with ACS State & Local Solutions, Inc., a 
            Xerox Company.  
               
            There are two main models of electronic card options for EBT 
            that the WIC program could consider. An off-line model is the 
            most common approach, and uses "smart" cards with an embedded 
            chip that stores the contents of the WIC food package on the 
            card. Smart cards require that at least one terminal at the 
            grocery store be equipped to read the chip, and infrastructure 
            costs for this approach have so far prohibited its widespread 
            expansion. An on-line model uses conventional magnetic stripe 
            cards swiped in a common card reader in any grocery store 
            checkout lane. The recipient enters an encrypted personal 
            identification number to securely validate their identity. The 
            transaction flows from the POS device to the central database, 
            where the contents of the recipient's individualized food 
            package are stored.  This bill requires that CDPH report to 
            the Legislature on which model is chosen by July 1, 2013 in 
            order to give the vendors and retailers time to prepare 
            accordingly.
          
          4.Federal WIC requirements for EBT. The HHFKA requires that 
            states implement EBT systems for WIC programs by October 1, 
            2020, unless the United States Secretary of Health and Human 
            Services grants an exemption. To be eligible for an exemption 
            from this deadline, a state must demonstrate either unusual 




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            technological barriers to implementation, operational costs 
            are not affordable within their nutritional services and 
            administration grant, or if it is otherwise within the best 
            interest of the program. States requesting an exemption must 
            specify a date by which the state agency anticipates statewide 
            implementation of the program, as required. HHFKA also 
            requires state agencies to submit annual status reports 
            demonstrating their progress toward statewide EBT 
            implementation. 
               
          5.Related legislation. AB 2280 (Lara) would require CDPH, within 
            30 days, to provide written notice, as prescribed, to a WIC 
            vendor if CDPH determines that the vendor has committed an 
            initial violation for which a pattern of the violation must be 
            established to impose a sanction. AB 2280 would require the 
            notice to be delivered to the vendor before CDPH conducts a 
            second investigation for purposes of establishing a pattern of 
            the violation.  This bill is pending hearing in the Assembly 
            Health Committee.

          6.Prior legislation. AB 313 (Goldberg) Chapter 842, Statutes of 
            2003, required DHS to study the feasibility of implementing an 
            EBT system for the WIC Program, and report the findings to the 
            Legislature by July 1, 2003. 

          7.Support.  Supporters such as the Kings County Department of 
            Public Health, Planned Parenthood of Orange and San Bernardino 
            Counties, Bay Region WIC Association, and Antelope Valley 
            Hospital WIC Program claim that each day over 240,000 WIC 
            checks are issued in 650 sites in California, and redeemed at 
            over 5,500 WIC-authorized grocery stores.  The State 
            Treasurer's Office processes over 4.8 million WIC checks 
            monthly. They argue that this paper check system used by the 
            WIC program is cumbersome and outdated for grocers, 
            stigmatizing for participants at the check stand, and costly 
            to operate. Community Resource Project, Inc. WIC Program says 
            that the current check system requires participants to 
            purchase all of their food on a single check at once, which 
            causes a hardship for families who travel by bus. They believe 
            EBT for WIC would have an especially positive impact on their 
            local WIC community because an EBT card would allow those 
            recipients that take multiple buses to get around to buy their 
            food in quantities that are more manageable on public 
            transportation.  

            Additionally, the American Red Cross WIC program claims they 




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            hear firsthand about frustrations from using paper checks at 
            grocery stores, and how this draws negative attention to WIC 
            participants. Mono County WIC program claims they have only 
            one grocery store in their area, and the cumbersome WIC check 
            process can become a nightmare, contributing to long lines and 
            extended wait times at their sole grocery store.
          
          8.Challenges with EBT implementation for other California public 
            programs. According to the July 2011 California EBT Project 
            Report to the Legislature, the state transitioned to the ACS 
            California EBT system on September 20, 2009 for other public 
            assistance programs, including CalFresh. During the first year 
            of the new system, some EBT cardholders experienced issues 
            with their EBT transactions. For instance, there were 
            occurrences where database slowdowns led to some cardholders' 
            accounts being incorrectly debited for certain transactions. 
            These problems have been identified and appear to have been 
            rectified through corrective actions. There was also an 
            instance of an EBT system breach in January of 2011, where 
            some cardholders' benefits were stolen. The State Office of 
            Systems Integration and the Department of Social Services 
            worked with ACS to disable the source of the breach on the EBT 
            website, replace the stolen benefits, and have since 
            implemented additional safety precautions to identify unusual 
            system or website activity to prevent further system breaches. 
            They continue to work with ACS to improve the system and 
            provide oversight of the EBT system performance. 

          9.Deadline differences. According to federal law, states will 
            have to transition to an EBT system by October 2020. This bill 
            implements an earlier deadline of 2015. While CDPH completed 
            the EBT feasibility study required by state statutes passed 
            back in 2003, they appear to be only in the early stages of 
            USDA's process for gaining approval for EBT. CDPH must still 
            complete a comprehensive cost-benefit analysis, define system 
            requirements, determine which functions and services will be 
            outsourced or completed by existing staff, then use the 
            information to submit an Implementation Advance Planning 
            document to USDA for approval. USDA estimates that EBT 
            planning can take from 2.5 to 4 years and EBT implementation 
            can take from 3 to 8 years.

           SUPPORT AND OPPOSITION  :
          Support:  California WIC Association (sponsor)
                    American Red Cross WIC Program
                    Antelope Valley Hospital WIC Program




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                    Bay Region WIC Association
                    California Catholic Conference
                    California Food Policy Advocates
                    Community Resource Project, Inc. WIC Program of 
                              Sacramento
                    Fresno County Economic Opportunities Commission
                    Insight Center for Community Economic Development
                    Kings County WIC
                    Mono County WIC
                    Scripps Mercy WIC Program
                    Watts Healthcare Corporation
                    Western Center on Law and Poverty
                    WIC of Planned Parenthood of Orange and San Bernardino 
                              Counties

          Oppose:   None received.

                                      -- END --