CSAC Bulletin Article

Health and Human Services 05/04/2012

Assembly Hears HHS Realignment Issues

The Assembly Budget Subcommittee No. 1, chaired by Assembly Member Holly Mitchell, met on Wednesday to broadly discuss 2011 Realignment issues now that the first version of the relevant budget Trailer Bill Language (TBL) has been released. The Subcommittee left all issues open pending the release of the May Revision Budget, but heard concerns from advocates about Drug Medi-Cal program funding and county flexibility in offering the Transitional Housing Program Plus (THPP) for foster youth aged 18 to 21. 

The following are links to the relevant trailer bill language by issue area:

Affordable Care Act Grants for Health Center Renovation and Construction Released

The United States Health and Human Services Department awarded $122 million in Affordable Care Act (ACA) grants to California for the construction or renovation of community health centers. 

The grants, part of the ACA’s capital investment in health infrastructure provisions, will go to 63 health centers and facilities in California and range from $492,00 to $5 million. Grantees estimate that the grants will allow them to serve approximately 166,504 new patients in California.


SB 970 (de Léon) – Support
As Amended on April 17, 2012

SB 970, as introduced by Assembly Member Kevin de Léon, would help integrate the process for applying for public programs such as CalFresh and CalWORKs with the new online health coverage application process that is under development by the state. 

SB 970 would build on California’s existing service integration by ensuring that people applying for health coverage through CalHEERS can also begin the application process for other public programs, including CalFresh and CalWORKs. A comprehensive stakeholder workgroup, including representatives from county human services departments, among others, would be established by the bill to review whether additional programs should be included in the process.

SB 970 also provides that if a health program renewal form has the necessary information to renew eligibility for CalWORKs or CalFresh, that the renewal for those other programs is satisfied. This is important not only to ensure that applying for and retaining eligibility for multiple programs does not become more difficult after 2014, but so that the state can continue working towards full participation in federally funded human services and work support programs. 

Finally, SB 970 would maximize enrollment into health coverage by enabling CalFresh recipients who are uninsured to allow the information in their CalFresh case file to be used to file an application for health coverage. This will ensure that as many eligible individuals and families as possible get the health coverage they need through the Medi-Cal expansion and subsidies in the Exchange. 

The Author amended SB 970 on March 29, but the Assembly Appropriations Committee placed it on the Suspense File on April 30 due to concern about the cost. 

SB 1060 (Hancock) – Support
As Introduced on February 13, 2012

SB 1060, by Senator Loni Hancock, would allow parents who have been convicted of a drug-related felony and completed a government-recognized treatment program to qualify for CalWORKs program employment services and benefits. 

Senator Hancock’s SB 1060 would allow California to join with 13 other states in opting out of the federal lifetime ban on receiving Temporary Assistance to Needy Families (TANF grants – CalWORKs here in California) funding for those with past drug felonies. California already allows those with certain drug-related felonies to receive Supplementary Nutrition Assistance Program (SNAP or food stamps, called CalFresh in California) benefits. 

Counties believe that SB 1060 provides an important tool for counties post-2011 realignment. By removing the lifetime ban on receiving CalWORKs benefits for parents convicted of drug-related felonies, counties will be able to provide employment activities and services to recipients with the goal of achieving employment and self sufficiency, as well as safely reintegrating them back into our communities. Additionally, CalWORKs grants are primarily used by families towards housing costs. Access to CalWORKs will provide parents assistance with housing – a key component necessary to get and retain a job.

Counties believe that in the long-tern SB 1060 would assist in reducing recidivism, saving our counties, the state, and communities significant social and fiscal costs. The Senate Appropriations Committee placed SB 1060 on the Suspense File on April 30 due to concern about the costs of the measure. 

AB 1970 (Skinner) – Support
As Amended on April 19, 2012

AB 1970, by Assembly Member Nancy Skinner, would streamline the eligibility structure across the CalWORKs, CalFresh, and Medi-Cal programs.

This measure, titled the Social Services Modernization and Efficiency Act of 2012, would conform eligibility requirements for the above programs to existing federal law, allow recipients to choose electronic forms for certain types of communication, interviews, and notices, and simplifies the interview process for people in immediate need of benefits. The measure will also codify the practice of recertifying CalFresh households at the end of their Traditional CalFresh Period to prevent lapses in nutritional benefits. 
Counties also support the provision requiring the state to make state plans for changes in service to the federal government electronically available, and Assembly Member Skinner recently amended the bill to ensure that individuals with small children are not penalized if they are meeting the federal 20-hour work requirement in CalWORKs. 

Taken all together, these small modernization changes will streamline human service programs for recipients and counties, and serve to illustrate the efficiencies to be gained from the careful use of technology. The Assembly passed AB 1970 on May 3 and it now goes to the Senate. 

Child Welfare Services/Foster Care

SB 1279 (Wolk) – Support
As Amended on April 9, 2012

SB 1279, by Senator Lois Wolk, would authorize the Department of Social Services to receive information from other systems about outcomes for children who have left foster care. 

CSAC, along with the County Welfare Directors Association (CWDA), support the continued evolution of outcome measurements for children who have left foster care, and support SB 1279. The Senate Appropriations Committee placed SB 1279 on the Suspense File on April 30 due to concern about the costs.

SB 1319 (Liu) – Support
As Amended on April 11, 2012

SB 1319, by Senator Carol Liu, is a highly technical measure that would make three small changes to existing law, but it will streamline certain components of the foster care system for the foster family homes, agencies, and treatment facilities that treat and house our state’s most vulnerable children.

The technical changes in the measure were proposed by San Bernardino County and are supported by the County Welfare Directors Association. The Senate Appropriations Committee determined that it had no state costs, so it has been sent directly to the Senate Floor. 

SB 1432 (Steinberg) – Pending
As Amended on April 26, 2012

SB 1432, by Senate President pro Tempore Darrell Steinberg, is a measure supported by children’s advocates to impose additional state oversight over the child welfare services (CWS) system, which was realigned to counties in 2011. 

CSAC, along with the County Welfare Directors Association, have concerns about the measure. The Assembly Human Services Committee heard, amended, and passed SB 1432 on April 25. The measure will be heard next by the Assembly Appropriations Committee. 

AB 1707 (Ammiano) – Support
As Amended on March 13, 2012

AB 1707, by Assembly Member Tom Ammiano, would amend the Child Abuse Central Index (CACI) statute to automatically remove the name of a person who is listed as a perpetrator of child abuse after 10 years if the incident occurred when the perpetrator was under 18 years old at the time of the incident. The perpetrator’s name would only be removed if no subsequent reportable incidents have occurred. AB 1707 would also modify CACI notice requirements to require the Department of Justice to report any listings involving a minor under the jurisdiction of a juvenile court to the minor’s attorney. 

CSAC supports AB 1707, which is on the Assembly Floor. 

AB 1751 (Pan) – Support
As Introduced on February 17, 2012

AB 1751, by Assembly Member Richard Pan, would enable county child welfare agencies and probation officers to access child support information in order to locate noncustodial parents who could provide a stable placement for children who would otherwise be placed into foster care due to abuse or neglect.

CSAC, along with the County Welfare Directors Association, support the measure, which was passed by the Assembly Judiciary Committee on April 17. The Assembly Appropriations Committee passed AB 1751 on May 1 and it now goes to the Assembly Floor.

Public Health

SB 1517 (Wolk) – Support
As Amended on April 9, 2012

SB 1517, by Senator Lois Wolk, would ensure that the County Medical Services Program (CMSP) may continue to provide health care services to low-income Californians in thirty-four rural counties. 

On January 1 of this year, CMSP launched Path2Health, an innovative health care program for adults aged 18 to 64 whose income is at or below 100 percent of the Federal Poverty Level. Path2Health is CMSP’s version of a county Low-Income Health Program (LIHP) authorized under the state’s Section 1115 Medicaid “Bridge to Reform” Waiver, and it allows CMSP to draw down federal funding for serving this new population of adults. Path2Health is a critical piece of the health care safety net in rural counties, providing integrated and innovative health care that includes behavioral health and substance abuse services. 

However, the cash flow process for CMSP – which relies on 1991 Realignment funding and general fund contributions from each of its member counties – does not align with federal reimbursement schedules under the Waiver. Hence the need for Senator Wolk’s SB 1517, which would authorize a loan of up to $30 million dollars to CMSP from the California Department of Finance to “smooth” the cash flow process. Senate Bill 1517 also allows CMSP to consolidate the schedule of participation fees contributed by each county from 12 annual payments to 10. 

CSAC supports SB 1517, which will be heard in the Senate Appropriations Committee on May 7. 

AB 2002 (Cedillo) – Oppose
As Amended on April 30, 2012

AB 2002 by Assembly Member Gil Cedillo, would expand the definition of a safety net provider in instances where a Medi-Cal beneficiary must be automatically assigned to a managed care plan. 

Assembly Member Cedillo’s AB 2002 seeks to add plan-owned clinics, certain medical groups, and independent practice associations to the definition of safety net providers, which would disrupt the current Auto Assignment Incentive Program selection process by crowding out existing safety net providers. Furthermore, AB 2002 comes at a pivotal time for the Medi-Cal program as approach the implementation of the federal Affordable Care Act. Both the California Department of Health Care Services and the state’s Health Benefits Exchange are currently working with stakeholder groups, including the Legislature, to develop a system to handle the expansion of Medi-Cal to some 3 million Californians in 2014. In light of those ongoing efforts, counties believe that any changes to the plan assignment process must occur within that framework, rather than a stand-alone measure that will benefit specific plans at the expense of existing safety net providers.

CSAC, along with the County Health Executives Association of California (CHEAC), oppose AB 2002. It has not yet been set for hearing in the Assembly Appropriations Committee. 

AB 2109 (Pan) – Support
As Amended on April 23, 2012

AB 2109, by Assembly Member Richard Pan, would require a parent or guardian seeking an immunization personal belief exemption for their child to provide a document signed by themselves and a licensed health care practitioner acknowledging that the parent or guardian has been informed by the health care practitioner of the benefits and risks of immunization as well as the health risks associated with communicable diseases. 
CSAC and the County Health Executives Association of California (CHEAC) support AB 2109, which was passed by the Assembly Appropriations Committee on May 1. It goes next to the Assembly Floor.

Adult Protective Services

AB 2149 (Butler) – Support
As Introduced on February 23, 2012 

AB 2149, by Assembly Member Betsy Butler, would allow victims of elder abuse to continue to contact, cooperate with or file a claim of elder abuse regardless of whether a civil settlement action has been rendered. 
AB 2149 failed passage in the Assembly Judiciary Committee on April 10, but the Assembly Aging and Long-Term Care Committee passed it on May 1. It now goes to the Assembly Floor.

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