BILL NUMBER: AB 963INTRODUCED BILL TEXT INTRODUCED BY Assembly Member Ammiano FEBRUARY 26, 2009 An act to add Sections 14012.6 and 14012.7 to the Welfare and Institutions Code, relating to Medi-Cal. LEGISLATIVE COUNSEL'S DIGEST AB 963, as introduced, Ammiano. Medi-Cal eligibility. Existing law creates various programs to provide health care services to persons who have limited incomes and meet various eligibility requirements, including, but not limited to, the Medi-Cal program, which is administered by the State Department of Health Care Services, and under which qualified low-income individuals receive health care benefits. Existing law also provides for the Food Stamp Program, under which food stamps are allocated by each county in accordance with federal requirements, and the CalWORKS program, under which each county provides cash assistance and other benefits to qualified low-income families and individuals who meet specified eligibility criteria. Under existing law, the Food Stamp Program and the CalWORKs program are administered at the state level by the State Department of Social Services. This bill would require the department, in consultation with the State Department of Social Services, to make necessary technological and policy changes to update the data sharing, computer programming, and administrative procedures, as provided, to ensure the continuation of Medi-Cal benefits when a beneficiary reports a change in circumstances to the Food Stamp Program or the CalWORKs program that would continue Medi-Cal eligibility. The bill would declare these provisions to be declaratory of existing law. The bill would require the department to issue comprehensive implementing instructions for policies and procedures, as specified, for this administrative transition, on or before March 1, 2011. This bill would require the department to establish procedures and guidelines for an electronic enrollment or renewal application with all relevant eligibility information that provides for the electronic enrollment or renewal of all potential and current Medi-Cal beneficiaries. The electronic enrollment or renewal application shall be used for all beneficiaries whose Medi-Cal enrollment or renewal is not accomplished pursuant to the administrative procedures. The bill would require the procedures and guidelines to be phased in statewide by January 2012. Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. Section 14012.6 is added to the Welfare and Institutions Code, to read: 14012.6. (a) (1) The department, in consultation with the State Department of Social Services, counties, representatives from the Statewide Automated Welfare System (SAWS) consortia, consumer advocates, and other stakeholder groups, shall make all necessary technological and policy changes to update data sharing, computer programming, and administrative procedures, to ensure that Medi-Cal is continued when a Medi-Cal beneficiary reports a change in circumstances to the Food Stamp Program or the CalWORKs program that would continue Medi-Cal eligibility. (2) Nothing in this section shall increase the frequency of the reporting requirements in the Medi-Cal program or amend the counties' obligation to redetermine Medi-Cal eligibility and follow all due process requirements prior to terminating Medi-Cal benefits. (3) A beneficiary's failure to complete a periodic report or annual renewal requirement in the CalWORKs program or Food Stamp Program shall not result in termination or redetermination of Medi-Cal eligibility. (4) This subdivision is declaratory of existing law. Implementation of this subdivision shall not be delayed in order to implement the other provisions of this section. (b) A beneficiary who completes a periodic report or annual renewal form in the CalWORKs program or Food Stamp Program shall be deemed to have met the requirement to return a periodic report or annual renewal form for the next scheduled period in the Medi-Cal program. (c) If information a beneficiary submits in the CalWORKs program or Food Stamp Program periodic reporting or annual renewal process is sufficient to continue Medi-Cal eligibility, the county shall deem the beneficiary to have met the Medi-Cal annual redetermination requirement in Section 14012. These Medi-Cal beneficiaries shall have their eligibility continued for the greatest period of time allowed under this chapter and all scheduled renewal dates or reporting dates, if any, shall be reset accordingly from the date of redetermination. Nothing in this section affects a beneficiary's responsibility to report changes to the county that affect Medi-Cal eligibility within 10 days of their occurrence. (d) The procedures described in this section shall be conducted by electronic means to the greatest extent possible and shall be developed according to subdivision (g). (e) Use of the information shared pursuant to this section shall not be used for any other purposes except as set out in this section. (f) This section shall supplement, not supplant, the requirements already in effect pursuant to subdivision (e) of Section 14005.37. (g) The department, in conjunction with counties, the State Department of Social Services, and representatives of the SAWS consortia, consumers, and other affected stakeholder groups, shall conduct a planning process and develop administrative enrollment and renewal policies and procedures, to be implemented by all county letters or similar instructions. After implementation by all county letters or similar instructions, the department shall adopt regulations in accordance with the requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code. Comprehensive implementing instructions shall be issued no later than March 1, 2011. The policies and procedures shall do all of the following: (1) Establish appropriate data sharing procedures and safeguards that do not require any additional consent from beneficiaries for the information sharing pursuant to this section and that meet confidentiality and privacy requirements in the Medi-Cal program. (2) Give priority to the programming changes necessary to enable the SAWS consortia to automate this enrollment and renewal procedure in order to minimize manual workload. (3) Develop procedural protections to ensure that beneficiaries experience no disruption in coverage and no diminution of their rights under this chapter. SEC. 2. Section 14012.7 is added to the Welfare and Institutions Code, to read: 14012.7. (a) The department, in conjunction with counties and representatives of the Statewide Automated Welfare System (SAWS) consortia, consumers, and other affected stakeholder groups, shall establish procedures and guidelines for an electronic enrollment or renewal application with all relevant eligibility information that provides for the electronic enrollment or renewal of all potential and current Medi-Cal beneficiaries. (b) The electronic enrollment or renewal application shall be used for all beneficiaries whose Medi-Cal enrollment or renewal is not accomplished through the enrollment and renewal procedures set forth in Section 14012.6. Periodic reporting forms, if any, shall also be electronically created in accordance with this subdivision. (c) The department shall use the electronic enrollment or renewal application as the annual reaffirmation form required under Section 14012. (d) The procedures and guidelines established pursuant to this section shall include a timeline for phasing in this procedure statewide, beginning in January 2011, and fully phasing in the procedure by January 2012.