BILL ANALYSIS Ó
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: SB 1002
AUTHOR: De León
INTRODUCED: February 13, 2014
HEARING DATE: March 26, 2014
CONSULTANT: Bain
SUBJECT : Medi-Cal: redetermination.
SUMMARY : Requires a county to begin a new 12-month Medi-Cal
eligibility period on a date that aligns that Medi-Cal
eligibility period with the beneficiary's household CalFresh
certification period, when a county determines or recertifies
CalFresh eligibility. Implements these provisions to the extent
permitted by federal law and to the extent that they do not
violate federal Medicaid maintenance of effort rules.
Existing law:
1.Establishes the Medi-Cal program, administered by the
Department of Health Care Services (DHCS), under which
qualified low-income individuals receive health care services.
2.Establishes the federal Supplemental Nutrition Assistance
Program (SNAP), under which each county distributes nutrition
assistance benefits provided by the federal government to
eligible households. In California, federal nutrition
assistance benefits are administered through CalFresh.
3.Requires counties to perform Medi-Cal eligibility
redeterminations every 12 months, and to promptly redetermine
Medi-Cal eligibility whenever the county receives information
about changes in a beneficiary's circumstances (such as the
birth of a child, change in family size, or change in income)
that may affect eligibility for benefits.
4.Requires a county to begin a new 12-month Medi-Cal eligibility
period in a redetermination due to a change in circumstances,
if a county determines that the beneficiary remains eligible
for Medi-Cal benefits.
This bill:
1.Requires a county, when a Medi-Cal redetermination due to a
change of circumstance is required, to begin a new 12-month
Medi-Cal eligibility period on a date that aligns that
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eligibility period with the beneficiary's household CalFresh
certification period if the county receives information about
the change in circumstances in a CalFresh application or
during a CalFresh recertification, and the Medi-Cal
beneficiary is determined eligible to receive CalFresh
benefits.
2.Requires a county, when a Medi-Cal redetermination is not
required, to begin a new 12-month Medi-Cal eligibility period
that aligns the beneficiary's Medi-Cal eligibility period with
his or her CalFresh household certification period, if a
county receives an application or recertification for CalFresh
benefits from a Medi-Cal beneficiary who is not receiving
CalWORKs benefits, and who is determined eligible to receive
CalFresh benefits.
3.Prohibits 2) from applying if doing so would either increase
the Medi-Cal beneficiary's share of cost or reduce the
benefits for any member of the beneficiary's CalFresh family
budget unit. Requires the Medi-Cal beneficiary's eligibility
period and CalFresh certification period to remain unaligned
in such a situation.
4.Prohibits 2) from being construed to permit a CalFresh
recipient who is otherwise ineligible for Medi-Cal benefits to
receive Medi-Cal benefits.
5.Implements the provisions of this bill and a specified
provision of existing law to the extent permitted by federal
law and to the extent that this action does not violate
federal maintenance of effort rules.
6.Names this bill "The Aligning Opportunities for Health Act of
2014."
FISCAL EFFECT : This bill has not been analyzed by a fiscal
committee.
COMMENTS :
1.Author's statement. According to the author, in an effort to
further the connection between nutrition and health and ensure
that Californians receive the federal benefits to which they are
entitled, the link between CalFresh and Medi-Cal should be
strengthened. With the implementation of the federal Affordable
Care Act, there will be an estimated 10 million Californians on
Medi-Cal this year. Many households covered through Medi-Cal also
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receive CalFresh. Based on this significant overlap in
eligibility, California has taken great strides to improve dual
enrollment and strengthen alignment between CalFresh and Medi-Cal.
SB 1002 builds on these efforts by improving program efficiency
for both administrators and the low-income families they serve. SB
1002 clarifies that a county may, under certain circumstances,
align a household's Medi-Cal redetermination date with the
household's CalFresh certification date. Consequently, SB 1002
would reduce the number of households that lose eligibility due to
an inadvertent paperwork error, and not an actual change in
eligibility for benefits. The need to reapply for benefits in such
a situation is redundant and inefficient for both low-income
families and administering agencies.
2.Background. Counties perform Medi-Cal, CalWORKS and CalFresh
eligibility determinations for the state. Individuals can apply
for all three programs at one time using a joint application, but
individuals may apply for each program at different times using
separate applications. While an individual who is enrolled in
CalWORKS is automatically categorically eligible for Medi-Cal,
when individuals apply for CalFresh and Medi-Cal at different
times, they can have different deadlines to renew eligibility for
each program. According to state data from the last quarter of
2012, 66 percent of Medi-Cal households received CalFresh and 77
percent of CalFresh households received Medi-Cal.
3.Double referral. This bill is double referred. Should it pass
out of this committee, it will be referred to the Senate
Committee on Human Services.
4.Prior legislation. SB 970 (De León) of 2012 would have allowed an
individual, at initial application or renewal of health care
coverage using the single state application, to have his or her
health care application information used to initiate a
simultaneous application for CalWORKs or CalFresh programs to be
transmitted to the applicable county human services department to
initiate the application, if the individual granted consent. SB
970 was vetoed by Governor Brown.
SB X1 1 (Hernandez and Steinberg), Chapter 4, Statutes of 2013,
among other provisions, requires DHCS to seek any federal waivers
necessary to use the eligibility information of individuals who
have been determined eligible for the CalFresh who are under 65
years of age and are not disabled, to determine their Medi-Cal
eligibility.
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5.Support. This bill is jointly sponsored by California Food
Policy Advocates (CFPA) and the Western Center on Law &
Poverty (WCLP) to improve alignment between Medi-Cal and
CalFresh reporting periods. In order to maintain benefits,
individuals and families must meet ongoing reporting
requirements for both programs, including the submission of
paperwork with necessary information for the annual renewal of
benefits. If a household's reporting periods are aligned, a
beneficiary will have a common due date for renewal paperwork,
thus reducing the administrative burden for program
administrators and facilitating joint reporting and renewal
for beneficiaries. Additionally, individuals and families are
less likely to confuse reporting requirements if the paperwork
for both programs is due concurrently. Doing so would
encourage benefit retention and promote Medi-Cal and CalFresh
dual enrollment.
6.Amendments. To clarify the language and intent of this bill,
staff and sponsors have negotiated the following language:
(n) (1) In the case of a redetermination due to a change in
circumstances, if a county determines that the beneficiary
remains eligible for Medi-Cal benefits, the county shall begin
a new 12-month eligibility period. If the county received or
gathered the information about the change in circumstances in
during a CalFresh application or gathered the information
about the change in circumstances during a CalFresh
recertification, and the beneficiary is determined eligible to
receive CalFresh benefits, then the county shall begin the new
12-month Medi-Cal eligibility period on a date that aligns the
beneficiary's eligibility period with his or her household 's
CalFresh certification period.
(2) (A) If a county receives an application for CalFresh
benefits from a Medi-Cal beneficiary who is not receiving
CalWORKs benefits, or redetermines or recertifies eligibility
for CalFresh benefits for a Medi-Cal beneficiary who is not
receiving CalWORKs benefits, and no information contained in
the CalFresh application, or no information gathered during
the CalFresh redetermination or recertification process,
requires the county to redetermine the beneficiary's
eligibility for Medi-Cal pursuant to this section, and the
beneficiary is determined eligible to receive CalFresh
benefits, the county shall begin a new 12-month Medi-Cal
eligibility period that aligns the beneficiary's eligibility
period with his or her CalFresh household certification
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period, unless doing so would increase the beneficiary's share
of cost or reduce Medi-Cal benefits for any member of the
beneficiary's CalFresh family budget unit, in which case the
beneficiary's Medi-Cal eligibility period and CalFresh
certification period shall remain unaligned.
(A)Except as provided in paragraph (B), if a county
recertifies eligibility or approves an application for
CalFresh benefits from a Medi-Cal beneficiary who is not
receiving CalWORKs benefits and is not subject to a
redetermination pursuant to paragraph (1) of this subdivision,
the county shall begin a new 12-month Medi-Cal eligibility
period that aligns the beneficiary's eligibility period with
his or her CalFresh household certification period.
(B) The county shall not take the action in paragraph (A) if
doing so would increase the beneficiary's share of cost or
reduce Medi-Cal benefits for any member of the beneficiary's
CalFresh family budget unit, in which case the beneficiary's
Medi-Cal eligibility period and CalFresh certification period
shall remain unaligned.
(B) (C) This paragraph shall not be construed to permit a
CalFresh recipient who is otherwise ineligible for Medi-Cal
benefits to receive Medi-Cal benefits.
(3) This The changes made by this subdivision shall be
implemented to the extent permitted by federal law and to the
extent that this action does not violate federal Medicaid
maintenance of effort rules.
SUPPORT AND OPPOSITION :
Support: California Food Policy Advocates (co-sponsor)
Western Center on Law and Poverty
(co-sponsor)
Alameda County Community Food Bank
Asian Law Alliance
California Association of Food Banks
California Coverage and Health Initiatives
California Center for Public Health Advocacy
California Hunger Advocacy Coalition
Children Now
Children's Defense Fund-California
Coalition of California Welfare Rights Organization
Community Food and Justice Coalition
Congress of California Seniors
Greenlining Institute
Los Angeles Regional Food Bank
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National Health Law Program
PICO California
Redwood Empire Food Bank
San Francisco Living Wage Coalition
SF-Marin Food Bank
St. Anthony Foundation
The Children's Partnership
United Way Monterey County
United Way of the Bay Area
United Ways of California
1 individual
Oppose: None received
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