BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                            



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                                 UNFINISHED BUSINESS


          Bill No:  SB 1002
          Author:   De León (D)
          Amended:  8/18/14
          Vote:     21


          PRIOR VOTES NOT RELEVANT

           ASSEMBLY FLOOR  :  77-0, 8/20/14 - See last page for vote


           SUBJECT  :    Low-income individuals:  eligibility determinations

           SOURCE  :     Author


           DIGEST  :    This bill requires the Department of Health Care  
          Services (DHCS) 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.  This bill similarly requires  
          the Department of Social Services (DSS) 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.  This bill requires DSS to consult with  
          stakeholders in the implementation of these provisions.

           Assembly Amendments  delete the Senate version of the bill  
          relating to aligning Medi-Cal eligibility periods with CalFresh  
          certification periods and add the current language.

           ANALYSIS  :    
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          Existing law:

          1.Provides for the federal Supplemental Nutrition Assistance  
            Program, 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.

          2.Requires DHCS 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.

          This bill:

          1.Makes the following legislative findings and declarations:

             A.   Approximately 35% of Medi-Cal recipients are potentially  
               eligible to receive CalFresh benefits, but are not  
               currently receiving those benefits.

             B.   Only 77% of CalFresh recipients are currently enrolled  
               in Medi-Cal despite the fact that the eligibility income  
               threshold for Medi-Cal is higher than it is for CalFresh.

             C.   Recent collaboration between DSS, DHCS, and county human  
               services agencies has resulted in the Express Lane  
               Enrollment Project, which is an effort to utilize  
               information in a CalFresh case file to determine  
               eligibility for Medi-Cal. 

             D.   The Express Lane Enrollment Project has been very  
               successful, resulting in more than 222,000 CalFresh  
               recipients being enrolled into Medi-Cal.

             E.   It is the intent of the Legislature in enacting this act  
               to streamline enrollment and eligibility certification  
               processes and procedures for CalFresh and Medi-Cal, both at  
               initial enrollment and at renewal, to improve access to  
               CalFresh and Medi-Cal, and to reduce administrative burdens  
               on county agencies and applicant households.

          1.Requires DHCS to seek any federal waivers necessary to use the  

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            eligibility information of individuals who have been  
            determined eligible for Medi-Cal to determine or redetermine  
            their CalFresh eligibility.

          2.Requires DSS to consult with stakeholders in the  
            implementation of these provisions. 

           FISCAL EFFECT :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No

          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  
            $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  

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            for CalFresh, unknown, potentially significant ongoing costs  
            for increased CalFresh benefits (federal funds).  Actual costs  
            would depend on the terms of the waiver.  

           
          ASSEMBLY FLOOR :  77-0, 8/20/14
          AYES:  Achadjian, Alejo, Allen, Ammiano, Bigelow, Bloom,  
            Bocanegra, Bonilla, Bonta, Bradford, Brown, Buchanan, Ian  
            Calderon, Campos, Chau, Chávez, Chesbro, Conway, Cooley,  
            Dababneh, Dahle, Daly, Dickinson, Eggman, Fong, Fox, Frazier,  
            Beth Gaines, Garcia, Gatto, Gomez, Gonzalez, Gordon, Gorell,  
            Gray, Hagman, Hall, Harkey, Roger Hernández, Holden, Jones,  
            Jones-Sawyer, Levine, Linder, Logue, Lowenthal, Maienschein,  
            Mansoor, Medina, Melendez, Mullin, Muratsuchi, Nazarian,  
            Nestande, Olsen, Pan, Patterson, Perea, John A. Pérez, V.  
            Manuel Pérez, Quirk, Quirk-Silva, Rendon, Ridley-Thomas,  
            Rodriguez, Salas, Skinner, Stone, Ting, Wagner, Waldron,  
            Weber, Wieckowski, Wilk, Williams, Yamada, Atkins
          NO VOTE RECORDED:  Donnelly, Grove, Vacancy


          JL:e  8/20/14   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  NONE RECEIVED

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