BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  SB 1190
                                                                  Page  1

          Date of Hearing:  June 26, 2012

                            ASSEMBLY COMMITTEE ON HEALTH
                              William W. Monning, Chair
                    SB 1190 (Hancock) - As Amended:  May 29, 2012

           SENATE VOTE  :  38-0
           
          SUBJECT  :  Women, infants, and children's nutrition.

           SUMMARY  :  Directs the Department of Public Health (DPH) to 
          provide quarterly briefings on the development of an electronic 
          benefits transfer (EBT) system for the California Special 
          Supplemental Food Program for Women, Infants, and Children 
          (WIC), as specified, beginning on January 1, 2013, and until the 
          system is fully operational.  Specifically,  this bill  :

          1)Expresses legislative intent to implement an EBT system for 
            WIC as soon as feasible.

          2)Requires DPH to provide quarterly briefings to the appropriate 
            fiscal and policy committees of the Legislature, the 
            Legislative Analyst's Office, and the office of the State 
            Chief Information Officer on the development of the EBT system 
            for WIC, pursuant to authority granted under existing law.

          3)Specifies that the quarterly briefings in 2) above must be 
            provided within 30 days of the close of each quarter, with the 
            first quarter commencing January 1, 2013, and continue until 
            the EBT system is fully operational.

          4)Sunsets the provisions of this bill on January 1, 2023.

           EXISTING FEDERAL LAW  :  

          1)Establishes WIC under the United States Department of 
            Agriculture (USDA) to provide grants to states for 
            supplemental foods, health care referrals, and nutrition 
            education for low-income pregnant, breastfeeding, and 
            non-breastfeeding postpartum women, and for infants and 
            children up to age five who are found to be at nutritional 
            risk. 

          2)Requires states, under the Healthy, Hunger-Free Kids Act of 
            2010 (HHFKA), to implement EBT systems for WIC programs by 








                                                                  SB 1190
                                                                  Page  2

            October 1, 2020, with certain exemptions.

           EXISTING STATE LAW  :

          1)Establishes WIC in California, administered by DPH, and 
            provides for the redemption of nutrition coupons by WIC 
            participants at any approved WIC retail food vendor. 

          2)Authorizes the Department of Health Services (DHS now DPH) to 
            design, implement, and fund an EBT system for the WIC program.

          3)Requires DPH to develop a plan to determine the feasibility of 
            implementing an EBT system for WIC, and report the findings to 
            the Legislature by July 1, 2003.

          4)Conditions implementation of an EBT system on completion of 
            the feasibility study in 3) above and the allocation of 
            funding for the system in the annual Budget Act. 

          5)Requires DPH to obtain USDA's approval prior to the 
            establishment of any EBT system.
           
          FISCAL EFFECT :  According to the Senate Appropriations 
          Committee, minor costs to provide briefings (federal funds).

           COMMENTS  :

           1)PURPOSE OF THIS BILL  .  The author states that, due to limited 
            staff and funding, transition to an EBT system should be the 
            highest priority project for WIC.  The author maintains that 
            the current process of using WIC benefits in a paper check or 
            voucher form is outdated, cumbersome, and stigmatizing at the 
            grocery check stand.  According to the author, moving to EBT 
            will make WIC much easier for participants, benefit grocers, 
            and simplify program operations while lowering costs to local 
            agencies.  The author contends that the current WIC management 
            information system (MIS) is more than adequate as a platform 
            to generate WIC benefits for an EBT system and can easily be 
            interfaced to support EBT.  The sponsor, the California WIC 
            Association, notes that DPH is in the early stages of EBT 
            implementation and this bill would ensure that DPH is actively 
            engaged in providing quarterly status updates to the 
            Legislature and interested parties on the development of the 
            system.  









                                                                  SB 1190
                                                                  Page  3

           2)BACKGROUND  .  According to DPH, WIC is a 100% federally funded 
            nutrition and health program that provides education and food. 
             DPH states that the program is designed to provide temporary 
            assistance during brief periods in life that are more 
            challenging, such as before or after the birth of a newborn, 
            or raising a young child with nutrition and/or health 
            conditions.  Most families participating in WIC are employed 
            with incomes at or below 185% of the federal poverty level 
            (currently $42,642 for a family of four).  WIC provides, up to 
            a child's fifth birthday: nutritious food; parenting and 
            nutrition education; support for breastfeeding mothers and 
            babies; referrals for services needed by the family; and, 
            under certain conditions, medical care in order to continue 
            participation.  

          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 beans.  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 over 5,500 
            WIC-authorized vendors.  The coupons are required to be 
            printed with specified information, including the specific 
            food item 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.   

          84 local agencies, consisting of local governments as well as 
            private, non-profit community organizations, operate WIC 
            centers in 650 locations statewide.  Approximately 3,000 local 
            WIC personnel at these centers assess WIC eligibility based on 
            residency requirements, income, and health or nutritional 
            risk, and issue six million food checks every month.  DPH 
            maintains that WIC is a direct infusion into the California 
            economy of about $1.1 billion per year, with the retail value 
            of WIC checks averaging $63 per month per participant.

          DPH indicates that WIC is not an entitlement program for which 
            Congress sets aside funds to serve every eligible individual, 
            but rather a discretionary program that operates under a 
            capped grant administered by the USDA for which Congress 
            appropriates a specified amount of funds annually.  California 
            WIC supplements this allocation with formula manufacturer 








                                                                  SB 1190
                                                                  Page  4

            rebates.  According to the USDA, nationwide, WIC operates in 
            all 50 states plus tribal organizations and territories.  In 
            fiscal year 2011, the program served 8.9 million participants, 
            including almost half of all infants born in the U.S.  
            California is the nation's largest WIC program serving 16.4% 
            (1.46 million) of all WIC participants.  

           3)EBT  .  EBT is an electronic system that automates the delivery, 
            redemption, and reconciliation of public assistance benefits 
            from the California Work Opportunity and Responsibility to 
            Kids program (CalWORKs) and the CalFresh program.  EBT is 
            currently used in all 50 states.  In California, CalWORKs and 
            CalFresh recipients access their benefits via a state-issued 
            EBT card.

          Similar to a bank-issued Automated Teller Machine (ATM) card, 
            the EBT card slides through a Point-of-Sale (POS) device, or 
            is used at an ATM.  It is designed to be convenient and 
            secure, and to reduce the stigma that is sometimes associated 
            with public assistance.  According to the state Office of 
            Systems Integration Internet Website, EBT food and cash aid 
            benefits are redeemable at more than 80,000 locations in 
            California.  The state's 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 and, instead, contracts 
            with ACS State & Local Solutions, Inc., a Xerox Company.  

           4)FEDERAL EBT REQUIREMENTS FOR WIC  .  The HHFKA mandates that 
            states implement WIC EBT systems by October 1, 2020, unless 
            the federal Secretary of Health and Human Services grants an 
            exemption.  To qualify for an exemption, a state must 
            demonstrate that there are unusual technological barriers to 
            implementation, that operational costs are unaffordable within 
            the state's nutritional services and administration grant, or 
            that it is within the best interest of the state's EBT program 
            to be exempt.  States that request an exemption must specify a 
            date by which the state agency anticipates statewide 
            implementation of the EBT program.  State WIC programs are 
            also required to submit annual status reports demonstrating 
            their progress toward statewide EBT implementation.

           5)EBT & CALIFORNIA WIC  .  Pursuant to the HHFKA, the USDA is 
            encouraging states to start migrating from a paper-based 
            benefits delivery system to an EBT system by providing funding 








                                                                  SB 1190
                                                                  Page  5

            for WIC EBT planning projects.  DPH reports that California 
            was awarded grant funds on September 17, 2010, to hire a 
            contractor to conduct a comprehensive EBT planning and 
            feasibility study by September 30, 2012.  The feasibility 
            study will assess the following specified components, among 
            others, to determine whether EBT is feasible within the 
            State's operating environment: 

             a)   Evaluate the capability of the WIC MIS to electronically 
               issue and track benefits; 
             b)   Review WIC business capacity; 
             c)   Survey a sample of WIC-approved retailers for their 
               readiness for EBT; 
             d)   Assess EBT effects on financial payments to vendors; 
             e)   Address infrastructure issues; 
             f)   Examine the choices of cards for the development, 
               testing, and evaluation of integrated EBT solutions; 
             g)   Analyze the available EBT technologies and vendors; and,
             h)   Recommend a two to five year plan for the State to 
               pursue WIC EBT.    

            DPH currently maintains on its Internet Website an ongoing WIC 
            EBT update.  According to the Website, WIC EBT will result in 
            a better shopping experience.  Specifically, DPH points to the 
            following benefits of a WIC EBT system:

             a)   With WIC EBT, transactions will be approved at the POS 
               and all checks will be eliminated;      
             b)   Cashiers will no longer be responsible for ensuring the 
               correct foods are purchased by participants because only 
               the prescribed foods on the Approved Product List will be 
               able to be purchased with WIC benefits;
             c)   Requirements imposed on WIC EBT cashiers to verify the 
               shopper's identity and check the "valid through" date on 
               multiple paper food checks will be eliminated;
             d)   With WIC EBT, the time in lane, redemption errors, and a 
               need for extensive clerk training will be reduced;
             e)   WIC EBT presents the possibility for a "mixed basket" 
               approach to benefit redemption, meaning that participants, 
               depending on the cash register system or vendor, will no 
               longer be required to physically separate WIC food items 
               from other items; the system will sort WIC-allowable foods 
               from non-WIC foods being purchased automatically; and,
             f)   WIC EBT will reduce paper processes and may reduce 
               errors in-lane that result in rejected WIC checks.








                                                                  SB 1190
                                                                  Page  6


           6)RELATED LEGISLATION  .  

             a)   AB 2280 (Lara) requires DPH to provide written notice 
               with specified information to a WIC vendor within 30 days, 
               if DPH 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 is pending in 
               the Senate Human Services Committee.

             b)   AB 2322 (Gatto) directs DPH to adopt regulations to 
               specify the criteria to be used and actions to be taken 
               when initiating a moratorium on applications for new WIC 
               retail food vendor locations.  AB 2322 is pending in the 
               Senate Appropriations Committee.

           7)PRIOR LEGISLATION  .  AB 313 (Goldberg), Chapter 842, Statutes 
            of 2003, requires DHS to conduct a feasibility study regarding 
            implementation of a WIC EBT system, and report the findings to 
            the Legislature by July 1, 2003.

           8)SUPPORT  .  Supporters point out that other states, such as 
            Texas, Michigan, Nevada, and New Mexico, have fully 
            implemented a WIC EBT system and California already has an EBT 
            system for the California Food Assistance Program, or 
            CalFresh, (formerly known as food stamps) that was implemented 
            in 2003.  The sponsor writes that this bill is needed to 
            expedite the WIC program's transition to EBT because EBT will 
            bring much needed modernization to the program and create ease 
            and efficiency for WIC participants and grocers.  The 
            California National Organization for Women states that moving 
            the WIC program into the electronic age would greatly benefit 
            mothers in the program who would no longer be required to 
            purchase all their items at once and could retain some 
            anonymity in the grocery line by simply swiping a card for 
            their purchase instead of using the current paper checks that 
            require verification for each item being purchased.  The 
            Western Center on Law and Poverty adds that requiring 
            quarterly updates from DPH on the progress of shifting WIC to 
            EBT delivery of benefits will ensure that the department 
            pursues implementation in a swift but thoughtful manner and 
            provides a forum for continued stakeholder engagement.

           9)POLICY COMMENT  .  Given that DPH currently maintains updates on 
            the WIC EBT transition process on its Website, the author may 








                                                                  SB 1190
                                                                  Page  7

            wish to address to what extent the requirement for quarterly 
            briefings in this bill can be accomplished administratively.

           10)AUTHOR'S AMENDMENT  .  To address a concern raised by committee 
            staff that the requirement in this bill for DPH to provide 
            briefings every three months may be too frequent and inhibit 
            DPH's ability to perform this function in a way that yields 
            useful information, the author has agreed to accept an 
            amendment to increase the frequency of the mandated briefings 
            to every six months.

           REGISTERED SUPPORT / OPPOSITION  :

           Support 
           
          California WIC Association (sponsor)
          Alameda County Board of Supervisors (prior version)
          American Red Cross WIC Program (prior version)
          Antelope Valley Hospital WIC Program (prior version) 
          Bay Region WIC Association (prior version)
          California Catholic Conference (prior version)
          California Food Policy Advocates (prior version)
          California National Organization for Women
          Community Resource Project, Inc. WIC Program (prior version)
          Insight Center for Community Economic Development (prior 
          version)
          Planned Parenthood of Orange & San Bernardino Counties (prior 
          version)
          Kings County WIC (prior version)
          Mono County WIC (prior version)
          San Francisco Food Security Task Force (prior version)
          Watts Healthcare Corporation (prior version)
          Western Center on Law and Poverty
           
            Opposition 
           
          None on file.

           Analysis Prepared by  :    Cassie Royce / HEALTH / (916) 319-2097