BILL ANALYSIS Ó
SB 1002
Page 1
Date of Hearing: June 10, 2014
ASSEMBLY COMMITTEE ON HEALTH
Richard Pan, Chair
SB 1002 (De León) - As Amended: March 28, 2014
SENATE VOTE : 34-0
SUBJECT : Medi-Cal: redetermination.
SUMMARY : Requires a county to begin a new 12-month Medi-Cal
eligibility period on a date that aligns the Medi-Cal
eligibility period with the beneficiary's household CalFresh
(formerly known as the Supplemental Nutrition Assistance Program
(SNAP)) certification period, when a county determines or
recertifies CalFresh eligibility. Specifically, 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
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
California Work Opportunity and responsibility to Kids
(CalWORKs) benefits, and who is determined eligible to receive
CalFresh benefits.
3)Prohibits a county from beginning a new Medi-Cal eligibility
period if it 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.
4)Prohibits the provisions of this bill from being construed to
permit a CalFresh recipient who is otherwise ineligible for
Medi-Cal benefits to receive Medi-Cal benefits.
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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.
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 federal 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.
FISCAL EFFECT : According to the Senate Appropriations
Committee, pursuant to Senate Rule 28.8, negligible state costs.
COMMENTS :
1)PURPOSE OF THIS BILL . 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. The author states, with the
implementation of the Patient Protection and Affordable Care
Act, there will be an estimated 10 million Californians on
Medi-Cal this year and many households covered through
Medi-Cal also 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. The author argues that this bill
builds on these efforts by improving program efficiency for
both administrators and the low-income families they serve and
clarifies that a county may, under certain circumstances,
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align a household's Medi-Cal redetermination date with the
household's CalFresh certification date. The author states
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 also 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% of
Medi-Cal households received CalFresh and 77% of CalFresh
households received Medi-Cal.
While recent efforts to promote horizontal integration between
public benefits, such as Medi-Cal and CalFresh, have encouraged
dual enrollment at the initial point of application, this does not
always happen. For a variety of reasons, families apply for
Medi-Cal and CalFresh at different times. If dual enrollment is
not achieved at application, paperwork deadlines, such as those
for annual renewal, are more likely to be unaligned which means
that families have to submit duplicative reports and paperwork.
Consequently, individuals and families may become confused and
inadvertently miss a deadline for one program or another. For
example, many CalFresh households who fail to submit their annual
recertification forms and lose eligibility return to the County
Human Service Agency within subsequent months to submit a new
application. This inadvertent lapse in eligibility is due to a
paperwork error, not an actual change in the household's
eligibility for benefits. Low-income families lose essential
nutrition benefits for which they are eligible and administering
agencies face the expenditure of critical resources processing new
applications on behalf of households who never lost eligibility.
3)SUPPORT . This bill is jointly sponsored by California Food
Policy Advocates and the Western Center on Law and Poverty to
improve alignment between Medi-Cal and CalFresh reporting
periods. Supporters argue in order to maintain benefits,
individuals and families must meet ongoing reporting
requirements for both programs, including the submission of
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paperwork with necessary information for the annual renewal of
benefits. The sponsors state 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, the sponsors
argue, individuals and families are less likely to confuse
reporting requirements if the paperwork for both programs is
due concurrently and doing so would encourage benefit
retention and promote Medi-Cal and CalFresh dual enrollment.
4)PREVIOUS LEGISLATION .
a) AB 191 (Bocanegra), Chapter 669, Statutes of 2013,
focuses on strengthening the connection between Medi-Cal
and CalFresh by improving alignment between income limits.
b) 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, among its
other provisions. SB 970 was vetoed by Governor Brown who
objected to the bill's creation of a work group and a
required report.
c) SB 1 X1 (Ed Hernandez and Steinberg), Chapter 4,
Statutes of 2013-14 First Extraordinary Session, 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.
REGISTERED SUPPORT / OPPOSITION :
Support
California Food Policy Advocates (co-sponsor )
Western Center on Law & Poverty (sponsor)
Alameda County Community Food Bank
American Federation of State, County and Municipal Employees
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(AFSCME)
Asian Law Alliance
CA WIC Association
California Association of Food Banks
California Center for Public Health Advocacy
California Children's Health Coverage Coalition
California Coverage and Health Initiatives
California Hunger Advocacy Coalition
California Partnership
Center for Nutrition & Activity Promotion-CalFresh Outreach
Children Now
Children's Defense Fund-California
Children's Partnership
Coalition of California Welfare Rights Organization
Community Food and Justice Coalition
Congress of California Seniors
Greenlining Institute
Health Access California
Hunger Advocacy Network
Los Angeles Regional Food Bank
National Health Law Program
PICO California
Redwood Empire Food Bank
San Diego Hunger Coalition
San Francisco Living Wage Coalition
SF-Marin Food Bank
St. Anthony Foundation
United Ways of California
United Ways of Fresno and Stanislaus Counties
Opposition
None on file.
Analysis Prepared by : Roger Dunstan / HEALTH / (916) 319-2097