California Assembly Bill AB963 Amended / Bill

 BILL NUMBER: AB 963AMENDED BILL TEXT AMENDED IN ASSEMBLY APRIL 28, 2009 AMENDED IN ASSEMBLY APRIL 2, 2009 INTRODUCED BY Assembly Member Ammiano FEBRUARY 26, 2009 An act to add Sections 14012.6, 14012.7, and 14012.8 to the Welfare and Institutions Code, relating to Medi-Cal. LEGISLATIVE COUNSEL'S DIGEST AB 963, as amended, 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   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,  counties, representatives from the Statewide Automated Welfare System (SAWS) consortia, consumer advocates, and other stakeholder groups  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.  This bill would provide that 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 requirements to return and sign a periodic report or annual form for the next scheduled period in the Medi-Cal program. The bill would provide that 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.  This bill would provide that an individual or family that submits and signs a Food Stamp Program application through any method accepted by the Food Stamp Program shall be deemed to have met the requirement to submit and sign a Medi-Cal application. The bill would provide that if the information an applicant submits in the Food Stamp Program application is sufficient to establish Medi-Cal eligibility, the county shall enroll the applicant into the Medi-Cal program. The bill would require the department to develop a procedure to, among other things, give applicants the opportunity to opt out of being enrolled in the Medi-Cal program based on information given in his or her Food Stamp Program application. By modifying the Medi-Cal eligibility determination process, this bill would increase the responsibilities of the counties in the administration of the Medi-Cal program, thereby imposing a state-mandated local program. The bill would require the department to issue comprehensive implementing instructions for policies and procedures, as specified, for the aforementioned provisions, on or before March 1, 2011. This bill would require the department to establish procedures and guidelines for  pre-populated   prepopulated  renewal forms for all potential and current Medi-Cal beneficiaries. The  pre-populated   prepopulated  renewal form and procedures  shall   would  be used for all beneficiaries whose Medi-Cal renewal is not accomplished pursuant to the  aforementioned enrollment   renewal  procedures  established pursuant to this bill  . The bill would require the procedures and guidelines to  be phased in statewide   include a timeline for phasing in the prepopulated renewal forms statewide, beginning January 2011, and fully phasing in the prepopulated renewal forms  by January 2012. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to these statutory provisions. Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes. 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 and sign 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) 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   all-county  letters or similar instructions. After implementation by  all county   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) An individual or family that submits and signs a Food Stamp Program application through any method accepted by the Food Stamp Program shall be deemed to have met the requirement to submit and sign a Medi-Cal application. (b) If information an applicant submits in the Food Stamp Program application is sufficient to establish Medi-Cal eligibility, the county shall enroll the applicant into the Medi-Cal program. (c) For an applicant who is not enrolled into the Medi-Cal program based upon information provided in his or her Food Stamp Program application, the county shall make every reasonable effort to gather information available to the county that is relevant to the applicant' s Medi-Cal eligibility prior to contacting the applicant. The county shall follow the same process used for redeterminations of eligibility described in subdivisions (e) to (g), inclusive, of Section 14005.37 to attempt to establish Medi-Cal eligibility. (d) All Medi-Cal applicants whose Medi-Cal eligibility is established pursuant to this section shall have their eligibility established for the greatest period of time allowed under this chapter and all scheduled renewal dates or reporting dates, if any, shall be set accordingly from the date the Medi-Cal applicant submits his or her Food Stamp Program application. 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. (e) The procedures described in this section shall be conducted by electronic means to the greatest extent possible and shall be developed according to subdivision (h). (f) The information shared pursuant to this section shall not be used for any other purposes except as set out in this section. (g) This section shall supplement, not supplant, the requirements already in effect pursuant to subdivision (e) of Section 14005.37. (h) 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   all-county  letters or similar instructions. After implementation by  all county   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 applicants 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 application and enrollment procedure in order to minimize manual workload. (3) Develop procedural protections to ensure that applicants experience no delay in coverage and no diminution of their rights under this chapter. (4) Develop a procedure whereby applicants for benefits under the Food Stamp Program are informed about the benefits of the Medi-Cal program and are given an opportunity to opt out of Medi-Cal enrollment, as described in subdivision (b). The opt out procedure shall be minimally burdensome to the applicant. The county shall presume the applicant wants to be enrolled in the Medi-Cal program unless the applicant expressly opts out verbally, in writing, or electronically, and the county documents the opt out in the case file. SEC. 3. Section 14012.8 is added to the Welfare and Institutions Code, to read: 14012.8. (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  pre-populated   prepopulated  renewal forms for all potential and current Medi-Cal beneficiaries. (b) The  pre-populated   prepopulated  renewal form and procedures shall be used for all beneficiaries whose Medi-Cal renewal is not accomplished through the renewal procedures set forth in Sections 14012.6 and 14012.7. Periodic reporting forms, if any, shall also be created in accordance with this subdivision. (c) The department shall use the  pre-populated   prepopulated  renewal form 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   the   prepopulated renewal forms  statewide, beginning in January 2011, and fully phasing in the  procedure   prepopulated renewal forms  by January 2012. SEC. 4. If the Commission on State Mandates determines that this act contains costs mandated by the state, reimbursement to local agencies and school districts for those costs shall be made pursuant to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of the Government Code.