BILL ANALYSIS                                                                                                                                                                                                    �






                             SENATE JUDICIARY COMMITTEE
                             Senator Noreen Evans, Chair
                              2013-2014 Regular Session


          SB 346 (Beall)
          As Amended April 2, 2013
          Hearing Date: April 23, 2013
          Fiscal: No
          Urgency: No
          NR
                    

                                        SUBJECT

                            Public social services: records

                                      DESCRIPTION  

          Existing law prohibits the disclosure of any records concerning  
          persons related to the administration of public social services,  
          except as exchanged by county welfare departments or other  
          public agencies, as specified, for purposes directly connected  
          with the administration of those services.  

          This bill would provide that if a county administers public  
          social services through more than one county department or  
          agency, each county department or agency that administers a  
          public social service shall be deemed a county welfare  
          department for the purposes of administering that public social  
          service.  Additionally, this bill would add "publicly funded  
          health care services," as defined, to the definition of public  
          social services. 

                                      BACKGROUND  

          The Patient Protection and Affordable Care Act (ACA), is a  
          United States federal statute signed into law by President Obama  
          in 2010.  By January 1, 2014, the ACA will fundamentally change  
          the way individuals access public health care coverage.  Instead  
          of applying for a particular health coverage program, the ACA  
          will require a seamless approach to coverage where regardless of  
          what coverage a person applies for, he or she will be evaluated  
          for all programs and enrolled into the most beneficial program  
          based on income and other criteria.  

                                                                (more)



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          Coordination between programs will result in individuals, at the  
          various public agencies which administer the programs, having  
          access to applicant data. California's Confidentiality of  
          Medical Information Act (CMIA), protects patient confidentiality  
          and provides that medical information may not generally be  
          disclosed by providers of health care, health care service  
          plans, or contractors without the patient's written  
          authorization.  However, medical information may be shared with  
          other health care professionals or facilities for the purposes  
          of diagnosis or treatment of the patient.  Existing law,  
          specific to public social services, echoes the CMIA and  
          prohibits disclosure of all applications and records made or  
          kept in connection with the administration of public social  
          services, except to other public agencies directly connected  
          with the administration of those services, as specified.  

          In an effort to facilitate the exchange of information between  
          various county agencies, this bill would provide that each  
          county department or agency administering a public social  
          service would be deemed a county welfare department, and would  
          clarify that the definition of "public social services" would  
          include publicly funded health care services.  This bill was  
          approved by the Senate Human Services Committee on April 9, 2013  
          by a vote of four to two. 


                                CHANGES TO EXISTING LAW
           
           Existing law  requires all applications and records concerning  
          any individual made or kept in connection with the  
          administration of any form of public social services to be  
          confidential, except as specified. (Welf. & Inst. Code Sec.  
          10850(a).)


           Existing law  authorizes any county welfare department to release  
          lists of applicants for, or recipients of, public social  
          services to any other county welfare department or the  
          Department of Social Services for purposes directly connected  
          with the administration of public social services. (Welf. &  
          Inst. Code Sec. 10850(b).)


           Existing law  provides that the provisions listed above shall not  
          prohibit the furnishing of this information to other public  
          agencies to the extent required for verifying eligibility or for  
                                                                      



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          other purposes directly connected with the administration of  
          public social services. (Welf. & Inst. Code Sec. 10850(b).)


           Existing law  defines "public social services" as activities and  
          functions of state and local government administered or  
          supervised by the State Department of Social Services or the  
          State Department of Health Services and involved in providing  
          aid or services or both, including health care services and  
          medical assistance, to those people of the state who, because of  
          their economic circumstances or social condition, are in need  
          thereof and may benefit thereby. (Welf. & Inst. Code Sec.  
          10051.)


           This bill  would provide that if a county administers public  
          social services through more than one county department or  
          agency, each department or agency administering a public social  
          service would be deemed a county welfare department for the  
          purposes of administering that public social service.  


          This bill  would clarify, except as to Medi-Cal, that the  
          definition of "public social services" would include publicly  
          funded health care services.
          
          
                                           
                                       COMMENT
           
           1.Stated need for the bill
          
          According to the author: 

            SB 346 would allow county departments to talk with one  
            another, sharing limited eligibility information ? to  
            facilitate enrollment in public health care programs.   
            Additionally, the changes would allow counties to take actions  
            benefiting clients, such as using eligibility information from  
            the General Assistance database to proactively enroll  
            individuals in low income health program (LIHP), eliminating  
            the need for them to enroll later-and more easily access  
            health care services. 

           2.Clarify existing law which permits county welfare departments  
            and other public agencies to share limited information for  
                                                                      



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            purposes directly connected with the administration of public  
            social services 
           
          Existing law provides that all applications and records  
          concerning applicants for any public social service shall be  
          confidential, except that such information may be shared by or  
          with other county welfare departments or with public agencies  
          for the purpose of verifying eligibility or for other purposes  
          directly connected with the administration of public social  
          services.  (Welf. & Inst. Code Sec. 10850.) Additionally,  
          existing law defines "public social services" to include "health  
          care services and medical assistance" administered by state and  
          local government. (Welf. & Inst. Code Sec. 10051.)

          This bill would provide that each county department or agency  
          administering a public social service shall be deemed a county  
          welfare department for purposes of administering that public  
          social service, and would clarify that "public social services"  
          include publicly funded health care services.

          The author argues that this bill would allow county human  
          services departments to more easily share client eligibility  
          information with county health departments.  Yet, because  
          existing law explicitly allows county welfare departments and/or  
          public agencies to exchange information related to eligibility  
          or enrollment in public social services, it is not clear whether  
          this bill would substantially change existing law or simply  
          clarify existing provisions. Furthermore, other California  
          county welfare departments and agencies are reportedly sharing  
          information in the manner resolved by this bill.  Additionally,  
          a recent report from Alameda County notes that it automatically  
          enrolls all CalWORKS recipients into Medi-Cal. The report  
          details how the exchange of information between Alameda County  
          Health Care Services Agency and Alameda County Social Services  
          Administration has resulted in an automated enrollment process  
          for General Assistance recipients. (Alameda County Health Care  
          Services Agency, Alameda County Eligibility and Enrollment  
          Systems for Low-Income Health Coverage Programs. (February 27,  
          2013)   
          )

          However, the author and sponsor perceive confidentiality  
          requirements as a barrier to the exchange of this information.   
          According to the Santa Clara Board of Supervisors,  
          confidentiality requirements for public social services records  
                                                                      



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          prevent the Social Services Agency, which determines eligibility  
          for Medi-Cal, from sharing eligibility information with the  
          Santa Clara Valley Health and Hospital System.  As a result,  
          Santa Clara County states that clients are forced to travel  
          significant distances between offices across the county to  
          enroll in various public programs. 

          Staff notes that it possible that perceived barriers to the  
          exchange of information result from various counties'  
          interpretation of particular agencies or entities as falling  
          outside the scope of "county welfare department." While "county  
          welfare department" is not clearly defined under existing law,  
          existing law does anticipate that there may be more than one  
          welfare department per county.  Additionally, because existing  
          law authorizes the sharing of information with "public agencies"  
          connected to the administration of public social services,  
          existing law seems to provide a catch-all for entities that  
          might not technically qualify as a county welfare department,  
          such as a public hospital.  

          Regarding the difficulties experienced by some counties, the  
          author indicates that "there are different interpretations of  
          this issue.  SB 346 would provide clarity that this type of data  
          sharing is acceptable, and it would expedite the process of  
          moving clients into health care programs." To that end, this  
          bill would clarify existing law which permits the sharing of  
          information related to enrollment in public social services  
          between county welfare departments and other public agencies. 

           Support  :  California Food Policy Advocates; California State  
          Association of Counties; County Welfare Directors Association of  
          California; Lassen County; Urban Counties Caucus

           Opposition  :  None Known

                                        HISTORY
           
           Source  :  Board of Supervisors, County of Santa Clara

           Related Pending Legislation  : None Known

           Prior Legislation  :  AB 402 (Skinner, Ch. 504, Stats. 2011)  
          authorized school districts and county offices of education to  
          share information provided on the School Lunch Program  
          application with the local agency that determines CalFresh  
          program eligibility, as provided.  
                                                                      



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           Prior Vote  :  Senate Human Services (Ayes 4, Noes 2)

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