BILL ANALYSIS �
SB 346
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Date of Hearing: June 18, 2013
ASSEMBLY COMMITTEE ON HUMAN SERVICES
Mark Stone, Chair
SB 346 (Beall) - As Amended: May 30, 2013
SENATE VOTE : 26-11
SUBJECT : Public social services: records
SUMMARY : Clarifies that county departments and agencies, under
specified circumstances, may share confidential information
pertaining to applicants for, and recipients of, public social
services for the purpose of administering public social
services.
Specifically, this bill :
1)Provides that, in a county in which public social services are
administered through more than one department or agency, each
county department or agency that administers a specific public
social service shall be deemed a county welfare department for
the purpose of providing that public social service.
2)Provides that public social services, as defined in Section
10051, include publicly funded health care services, as
specified.
EXISTING LAW :
1)Requires all applications and records pertaining to public
social services provided to individuals to be confidential and
prohibits dissemination of such information unless it is for
purposes of administering services to the individual or for
purposes of investigation, prosecution, or criminal or civil
proceeding related to the administration of the services the
individual receives, as specified. (WIC 10850(a))
2)Authorizes county welfare departments to release information
regarding applicants for, or recipients of, public social
services to other county welfare departments and the
Department of Social Services solely for the purpose of
administration of public social services programs, as
specified. (WIC 10850(b))
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3)Authorizes counties to provide information pertaining to
applicants for, and recipients of, public social services to
other public entities for the purpose of determining program
eligibility and to school officials, as specified, as
necessary for the administration of federally assisted,
needs-based programs. (WIC 10850(b))
4)Defines public social services as those 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, that provide aid,
services, or both aid and services, including health care
services and medical assistance, to those people of the state
who are in need of such aid or services due to their economic
circumstances or social condition. (WIC 10051)
5)Requires every city and county to provide relief and support
to all indigent and dependent poor persons, when such persons
do not receive adequate support or relief from their relatives
or friends, by their own means, or by state hospitals or other
state or private institutions. (WIC 17000)
6)Provides for the establishment of county General Assistance
programs to fulfill county obligations under WIC 17000 and
allows for county flexibility in the establishment of that
aid.
7)Establishes the Low Income Health Program (LIHP) as a federal
Medicaid demonstration project at the local level to provide
specified health care services to eligible, low-income
individuals 19 to 64 years of age who are not otherwise
eligible for the Medi-Cal program or the Children's Health
Insurance Program, as specified. (WIC 15909.1)
8)Permits a county board of supervisors of any county with a
population of less than 300,000 to elect to participate in the
County Medical Services Program (CMSP) to provide specified
health care services to medically indigent persons. (WIC
16809)
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9)Establishes local Medically Indigent Services Programs (MISP)
to fulfill the obligations of larger counties under WIC 17000,
and allows for county flexibility in the administration of
those programs.
FISCAL EFFECT : Unknown.
COMMENTS : This bill seeks to clarify statute regarding the
sharing of confidential client information related to public
social services at the county level. Due to current statutory
language that prevents the sharing of information pertaining to
applicants and recipients of public social services, except
under certain circumstances, there are perceived limitations on
a county's ability to share information between its own regional
departments or distinct agencies, including when the information
needs to be shared for the benefit of the applicant for, or
recipient of, public social services.
According to the author, "SB 346 allows county human services
departments to more easily share client eligibility information
with county health departments in order to simplify enrollment
in public health care coverage programs such as the Low-Income
Health Program or the county Medically Indigent Services
Program. As we look to implement the Affordable Care Act, which
includes an emphasis on having no wrong door, we want to make
sure that we are doing everything we can to make enrollment in
health and human services programs as easy as possible for
clients. SB 346 would further this goal."
Interoperability within the Affordable Care Act : The primary
goals of the federal Patient Protection and Affordable Care Act
of 2010 (ACA) are to expand health insurance coverage, reduce
health care spending, and increase the regulation of private
health insurers. With the January 2014 implementation date
drawing near, many of California's statewide departments and
county welfare departments are looking forward to a seamless
transition to new health care coverage for many Californians, as
well as more streamlined communication between health and social
services systems.
According to the Administration for Children and Families (ACF),
within the federal Department of Health and Human Services,
interoperability of health and social services systems is an
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essential component of proper implementation of the ACA for the
following reasons:
1)Linking health and human services can improve client outcomes
by treating the whole person with improved care coordination,
increase timely access to critical information for decision
making, prevent illness, reduce exacerbating conditions,
decrease hospital reentries and help build individuals'
self-sufficiency.
2)Health programs can benefit from closer linkages with human
services by having access to more timely and accurate
verification information for eligibility determination and
enrollment purposes. States will have access to a larger pool
of eligible clients that are not yet enrolled in Medicaid but
are likely to be involved already with some human services
programs. A larger enrolled population will also spread the
financial risk of the health insurance exchange.
3)Stronger system linkages will increase the use of shared
services, streamline business and information systems, and
minimize duplicative costs for building, maintaining and
updating redundant systems.
4)Transparency across programs will also improve the ability of
systems to reduce fraud, waste and abuse. <1>
Automated eligibility systems : Three distinct Statewide
Automated Welfare Systems (SAWS) are used in California to
determine eligibility and benefit levels for public social
services programs, including CalWORKs, CalFresh, Medi-Cal,
foster care, the refugee program and CMSPs. Additionally, the
SAWS maintain caseload and enrollment information for the
purpose of case management for benefit recipients and the
general administration of these programs. In 2011, the
Legislature enacted ABX1 16, (Blumenfield), Chapter 13, Statutes
of 2011 to consolidate counties and decrease the number of SAWS
to two. Although information sharing between the data portals
for the public social services included in the SAWS should be
seamless, proponents of this bill assert that health care
---------------------------
<1>Administration for Children and Families. "Your Essential
Interoperability Toolkit, an ACF/HHS Resource Guide" (2012).
http://www.acf.hhs.gov/sites/default/files/assets/acf_toolkit_jul
y_2012_final.pdf
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eligibility information within counties with their own health
care systems or public hospitals may be held in distinct data
systems, thereby reducing opportunities for data matching.
Need for the bill : Current law allows applications and
applicant records to be shared with other public agencies for
the purpose of establishing eligibility for, or administering,
public social services (WIC 10850). Some counties have
interpreted this as authority to share client information
between their health and social services departments. However,
the bill's sponsor, the Santa Clara County Board of Supervisors,
sees the current confidentiality requirements, which explicitly
allow information sharing to take place between county welfare
departments, without any mention of other county departments or
agencies, as barriers that prohibit the exchange of information
even when the information would be shared for the client's
benefit. According to the bill's sponsor, system
interoperability within counties is essential in providing
clients timely access to the services for which they are
eligible.
In support of this bill, the County Welfare Directors
Association (CWDA) writes, "This bill will break down the
eligibility and enrollment processes for public social services
and health programs at the county level. This bill will
encourage a "client centered" model of integrated services by
allowing county social services and health departments to share
limited eligibility information."
PRIOR LEGISLATION
AB 402 (Skinner) Chapter 504, Statutes of 2011, authorized
education agencies to enter into MOUs with specified local
agencies to share School Meal Program application information
for the purpose of enrolling families in CalFresh. The bill
prohibited the information shared from being disclosed to any
other governmental agency.
REGISTERED SUPPORT / OPPOSITION :
Support
California Association of Public Hospitals and Health Systems
(CAPH)
California Food Policy Advocates (CFPA)
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California State Association of Counties (CSAC)
County of Santa Clara Board of Supervisors
County Welfare Directors Association of California (CWDA)
Lassen County Administrative Services
LIUNA Locals 777 & 792
Urban Counties Caucus (UCC)
Opposition
None on file
Analysis Prepared by : Myesha Jackson / HUM. S. / (916)
319-2089