BILL ANALYSIS Ó
SB 1002
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SENATE THIRD READING
SB 1002 (De León)
As Amended August 18, 2014
Majority vote
SENATE VOTE :34-0
HEALTH 17-0 APPROPRIATIONS 12-0
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|Ayes:|Pan, Maienschein, |Ayes:|Gatto, Bocanegra, |
| |Bonilla, Bonta, Chesbro, | |Bradford, |
| |Gomez, Gonzalez, | |Ian Calderon, Campos, |
| |Roger Hernández, | |Eggman, Gomez, Holden, |
| |Lowenthal, Mansoor, | |Pan, Quirk, |
| |Nazarian, Nestande, | |Ridley-Thomas, Weber |
| |Patterson, Ridley-Thomas, | | |
| |Rodriguez, Wagner, | | |
| |Wieckowski | | |
| | | | |
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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) certification period, when a county determines or
recertifies CalFresh eligibility.
FISCAL EFFECT : According to the Assembly Appropriations
Committee:
1)Unknown, significant one-time administrative costs to counties
to incorporate new rules into existing redetermination
procedures. Counties are funded by DHCS to process Medi-Cal
eligibility, but are currently reimbursed on a historical and
negotiated basis, not on a time-basis or per-case basis.
Therefore, increased county administrative costs will result
in additional one-time cost pressure to the state, but the
additional costs will not be funded directly, so there is no
direct state cost impact. On a longer-term basis, the new
rules are not likely to have a significant ongoing fiscal
impact on administrative costs.
2)Information Technology costs, potentially in the range of
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$600,000 General Fund ((GF)/federal), to program required
changes in to the three Medi-Cal eligibility systems used by
county offices.
3)By increasing the time period for which an individual is
continuously enrolled in Medi-Cal, this bill is likely to
increase costs for Medi-Cal benefits. Precise estimates are
unavailable, but the increased costs could potentially be in
the tens of millions of dollars (GF/federal). For example,
assuming this bill allows 1 million people get an average of
an extra week of Medi-Cal benefits at a cost of $43 per week,
$43 million total funds (GF/federal).
4)One-time staff costs to DHCS and the Department of Social
Services to develop a waiver proposal in the range of $200,000
(GF/federal).
5)If the administration is able to secure a waiver to use a
Medi-Cal determination to determine or redetermine eligibility
for CalFresh, unknown, potentially significant ongoing costs
for increased CalFresh benefits (federal funds). Actual costs
would depend on the terms of the waiver.
COMMENTS : 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, 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.
Counties perform Medi-Cal, California Work Opportunity and
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Responsibility to Kids (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.
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 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.
Analysis Prepared by : Roger Dunstan / HEALTH / (916) 319-2097
SB 1002
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