SB 1002,
as amended, De León. begin deleteMedi-Cal: redetermination.end deletebegin insert Low-income individuals: eligibility determinations.end insert
Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid Program provisions.
Existing law generally requires a county to redetermine a Medi-Cal beneficiary’s eligibility to receive Medi-Cal benefits every 12 months and whenever the county receives information about changes in a beneficiary’s circumstances that may affect his or her eligibility for Medi-Cal benefits. Under existing law, when a redetermination is performed due to a change in circumstances, if a county determines that the beneficiary remains eligible for Medi-Cal benefits, the county must begin a new 12-month eligibility period.
end deleteThis bill would require a county, when a redetermination is performed due to a change in circumstances, and the county received or gathered the information about the change in circumstance during a CalFresh application or recertification, and the beneficiary is determined eligible to receive CalFresh benefits, to begin the new 12-month Medi-Cal eligibility period on a date that would align the beneficiary’s Medi-Cal eligibility period with his or her household CalFresh certification period. The bill would also require a county, in certain circumstances, to begin a new 12-month Medi-Cal eligibility period that would align a beneficiary’s Medi-Cal eligibility period with his or her CalFresh household certification period. The bill would provide that these provisions only be implemented to the extent permitted by federal law and to the extent that they do not violate federal Medicaid maintenance of effort rules. By imposing additional duties on counties, this bill would impose a state-mandated local program.
end deleteThe California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
end deleteThis bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to these statutory provisions.
end deleteExisting federal law provides for the federal Supplemental Nutrition Assistance Program (SNAP), known in California as CalFresh, formerly the Food Stamp Program, under which supplemental nutrition assistance benefits allocated to the state by the federal government are distributed to eligible individuals by each county.
end insertbegin insertExisting law requires the State Department of Health Care Services to seek any federal waivers necessary to use eligibility information of certain individuals who have been determined eligible for the CalFresh program to determine their eligibility for Medi-Cal.
end insertbegin insertThis bill would also require the State Department of Health Care Services to seek any federal waivers necessary to use eligibility information of certain individuals who have been determined eligible for the CalFresh program to redetermine their eligibility for Medi-Cal. The bill would similarly require the State Department of Social Services to seek any federal waivers necessary to use eligibility information of individuals who have been determined eligible for the Medi-Cal program to determine or redetermine their eligibility for CalFresh eligibility. The bill would require the State Department of Social Services to consult with stakeholders in the implementation of this provision and would authorize the State Department of Social Services to implement this provision by means of all-county letters or similar instructions.
end insertVote: majority.
Appropriation: no.
Fiscal committee: yes.
State-mandated local program: begin deleteyes end deletebegin insertnoend insert.
The people of the State of California do enact as follows:
begin insert(a)end insertbegin insert end insertbegin insertThe Legislature finds and declares all of the
2following:end insert
3(1) Approximately 35 percent of Medi-Cal recipients are
4potentially eligible to receive CalFresh benefits, but are not
5currently receiving those benefits.
6(2) Only 77 percent of CalFresh recipients are currently
7enrolled in Medi-Cal despite the fact that the eligibility income
8threshold for Medi-Cal is higher than it is for CalFresh.
9(3) Recent collaboration between the State Department of Social
10Services, the State Department of Health Care Services, and county
11human services agencies has resulted in the Express Lane
12Enrollment Project, which is an effort to utilize information in a
13CalFresh case file to determine eligibility for Medi-Cal. The
14Express Lane Enrollment Project has been very successful,
15resulting in more than 222,000 CalFresh recipients being enrolled
16into Medi-Cal.
17(b) It is the intent of the Legislature in enacting this act to
18streamline enrollment and eligibility certification processes and
19procedures for CalFresh and Medi-Cal, both at initial enrollment
20and at renewal, to improve access to CalFresh and Medi-Cal, and
21to reduce administrative burdens on county agencies and applicant
22households.
begin insertSection 14005.66 of the end insertbegin insertWelfare and Institutions Codeend insert
24begin insert is amended to read:end insert
The department shall seek any federal waivers
26necessary to use the eligibility information of individuals who
27have been determined eligible for the CalFresh program under
28Chapter 10 (commencing with Section 18900) of Part 6, and who
29are under 65 years of age and are not disabled, to determinebegin insert or
30redetermineend insert their Medi-Cal eligibility.
begin insertSection 18901.05 is added to the end insertbegin insertWelfare and
32Institutions Codeend insertbegin insert, to read:end insert
(a) The department shall seek any federal waivers
34necessary to use the eligibility information of individuals who have
35been determined eligible for Medi-Cal under Chapter 7
P4 1(commencing with Section 14000) of Part 3 to determine or
2redetermine their CalFresh eligibility.
3(b) The department shall consult with stakeholders in the
4implementation of this section.
5(c) Notwithstanding the rulemaking provisions of the
6Administrative Procedure Act (Chapter 3.5 (commencing with
7Section 11340) of Part 1 of Division 3 of Title 2 of the Government
8Code), the department shall implement this section by all-county
9letters or similar instructions.
All matter omitted in this version of the bill appears in the bill as amended in the Senate, March 28, 2014. (JR11)
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