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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