CSAC Bulletin Article

Health and Human Services 08/10/2012


AB 1560 (Fuentes) – Support
As Amended on May 25, 2012

AB 1560, by Assembly Member Felipe Fuentes, will help low-income families who are eligible for the state’s Medi-Cal program to also receive CalFresh nutritional benefits. 

Specifically, AB 1560 would waive the gross income test for any individual who receives, or is eligible to receive, Medi-Cal medical benefits. The measure would also allow those who live in households with those who receive or are eligible to receive Medi-Cal benefits to qualify for the CalFresh program. 

CSAC supports AB 1560, which was placed on the Suspense File by the Senate Appropriations Committee on August 6. 

AB 1640 (Mitchell) – Support
As Amended on May 25, 2012

AB 1640, by Assembly Member Holly Mitchell, would change the state’s CalWORKs statute to allow for pregnant women (with no other children in the household) to become eligible for CalWORKs basic needs grants and full-scope 1931(b) Medi-Cal benefits upon verification of a pregnancy.
CSAC supports AB 1640. On August 6, the Senate Appropriations Committee placed AB 1640 on their Suspense File due to concerns about state costs.


AB 540 (Beall) – Support
As Amended on August 15, 2011

AB 540, by Assembly Member Jim Beall, would allow counties to draw down federal funding for providing confidential alcohol and drug screening and brief intervention services to pregnant women and women of childbearing age who also qualify for Medi-Cal benefits. 

AB 540 would provide counties with a much-needed federal revenue stream – at no cost to the state – for these valuable services, and this is why CSAC supports the bill. The Senate Appropriations Committee heard AB 540 on August 15 in 2011 and placed it on the Suspense File. Assembly Member Beall is working to remove it from the Suspense File and let the Senate vote on the measure before the end of the 2-year legislative session on August 31. Counties who have supported the measure should re-submit letters of support to the Senate Appropriations Committee as soon as possible.

Health Care Reform

SB 677 (Hernandez) – Support 
As Amended on May 23, 2011

SB 677, by Senator Edward Hernandez, would implement two provisions of the federal Affordable Care Act (ACA) related to determining eligibility for the Medicaid program. The measure would implement the new federal income standards – the modified adjusted gross income (MAGI) – for determining Medi-Cal eligibility. Additionally, the measure would eliminate the asset test for determining Medi-Cal eligibility. Both of these eligibility changes would become effective January 1, 2014, in conjunction with the effective date of the ACA.

Counties have long supported efforts to simplify the Medi-Cal program, such as elimination of the asset test. We believe that program simplification increases program efficiency. Reducing complicated eligibility tests at the time when over a million Californians will become newly eligible for Medi-Cal will assist with easing enrollment.
CSAC, along with the Urban Counties Caucus (UCC), County Welfare Directors Association (CWDA), California Mental Health Directors Association (CMHDA), and the County Health Executives Association of California (CHEAC), have joined together to take a support position on SB 677. The Assembly Appropriations Committee placed SB 677 on their Suspense File on August 8. 

SB 703 (Hernandez) – Support
As Amended on June 15, 2012

SB 703, by Senator Ed Hernandez, would allow the state to create a Basic Health Plan (BHP), a more affordable insurance option for low-income adults who fall into the income “gap” between Medi-Cal eligibility and being able to afford commercial health plan premiums. 

The BHP would cover individuals earning between 133 percent and 200 percent of the Federal Poverty Level, and offer an equal level of benefits to commercial health plans available in the California Health Benefits Exchange. 

The CSAC Executive Committee voted to support SB 703 on August 2. County supervisors believe a BHP will allow low-income individuals to affordably purchase health insurance, thereby lowering the number of uninsured adults in California. Clearly, those who participate in the BHP will also see improved health outcomes. Finally, from a county perspective, a BHP option will help reduce the spiraling uncompensated care costs that many public hospitals and local health clinics are currently experiencing. 
SB 703 was amended on June 25 and is currently on the Assembly Appropriations Committee’s Suspense File. CSAC sent a letter of support for SB 703 and asking that it be moved to the Assembly Floor. 

SB 970 (de Léon) – Support
As Amended on May 29, 2012

SB 970, as amended on May 24 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.

The Assembly Appropriations Committee placed SB 970 on the Suspense File on August 8.

Public Health 

AB 2109 (Pan) – Support
As Amended on June 20, 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 Senate Appropriations Committee on August 6. It now goes to the Senate Floor. 

AB 2266 (Mitchell) – Support
As Amended on June 25, 2012 

AB 2266, by Assembly Member Holly Mitchell, would allow California to leverage significant federal funding create a patient-centered “health home” program for Medi-Cal beneficiaries who are frequent hospital users. 

Specifically, the measure would allow California to utilize a 90 percent federal funding match for two years under the Affordable Care Act to create a comprehensive program for frequent hospital users. The program would include comprehensive engagement and case management, hospital discharge planning, assistance with accessing social services, and other proven strategies to stabilize and effectively treat frequent hospital users. The program goal is to stabilize – and even increase – the health of frequent hospital users while reducing their utilization of costly medical care. 

Currently, 12 counties fund or manage home health programs for frequent hospital users, and have realized medical cost savings as a result. By allowing hospitals, community clinics, and behavioral health care providers to offer health home services, we believe counties and the state can achieve significant cost savings for the sickest and most expensive users of hospital care – all without incurring state costs for erecting a health home program.

CSAC supported AB 2266, but the Senate Appropriations Committee placed it on their Suspense File on August 6 due to concerns about state costs.

Child Welfare Services/Foster Care

SB 1319 (Liu) – Support
As Amended on June 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, crisis nurseries 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 Assembly Appropriations Committee passed SB 1319 on August 8 and it now goes to the Assembly Floor. 

AB 1712 (Beall) – Support
As Amended on August 6, 2012

AB 1712, by Assembly Member Jim Beall, is a technical clean up measure relating to 2010’s Fostering Connections to Success Act. The Act extended foster care services to youth up to age 21 and helps the state draw down additional foster care funding from the federal government. 

AB 1712 was created with input from counties, foster family agencies, and myriad other stakeholders, all with a singular goal in mind: To make foster care services as accessible and efficient as possible for all youth and non-minor dependents that need them. 

AB 1712 was amended in the Senate Appropriations Committee on August 6, and will be heard again by the committee on August 13.

CalFresh (Formerly SNAP, Food Stamps)

SB 1391 (Liu) – Support
As Amended on August 6, 2012

SB 1391, by Senator Carol Liu, would establish procedures for recovering CalFresh overissuances of more than $125 in accordance with federal law. 

The new procedures would apply to current and former CalFresh recipients and would help streamline the collection process for overissuances resulting from administrative errors, while keeping the existing regulatory structure for cases of inadvertent household error, intentional program violation, and fraud in place.

Counties and County Welfare Directors support raising the threshold for recovering CalFresh overissuances to $125 because it will allow our eligibility workers to focus on the more egregious instances while also providing more time for caseload work. 

The author and sponsor (Western Center on Law and Poverty) of the measure are also working with counties to establish a realistic implementation timeline, possibly October 2012. 

CSAC, along with the County Welfare Directors Association, support SB 1391, which was passed by the Assembly Human Services Committee on June 26. The Assembly Appropriations Committee placed SB 1391 on the Suspense File on August 8. 

Emergency Medical Services (EMS)

AB 1944 (Gatto) – Oppose
As Amended on June 28, 2012

AB 1944, by Assembly Member Mike Gatto, would give employers increased authority over disciplinary investigations and actions for paramedics in their employ. 

Counties are concerned that AB 1944 would weaken the authority of local and state EMS agency medical directors to protect patients from individuals that pose a threat to the public’s health and safety, regardless of employer. 

CSAC, along with the County Health Executives Association of California (CHEAC), oppose the measure. The Senate Appropriations Committee placed AB 1944 on their Suspense File on August 6 due to concerns about state costs.

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