CSAC Bulletin Article

Health and Human Services 08/17/2012


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, but the Senate Appropriations Committee held the measure on August 16. 

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 16, the Senate Appropriations Committee passed AB 1640, and it now goes to the Senate Floor. 

AB 1691 (Lowenthal, B.) – Support
As Introduced on February 15, 2012

AB 1691, by Assembly Member Bonnie Lowenthal, would allow non-English speaking CalWORKs recipients, which include refugees and other legal immigrants, to participate in English as a Second Language (ESL) instruction for eight months. Time spent in ESL instruction would count as a core activity and counties would have the option of extending ESL participation for up to 12 months on a case-by-case basis. 

CSAC supports AB 1691, but the Senate Appropriations Committee placed it on their Suspense File on June 26 and held it in committee on August 16. 

AB 1970 (Skinner) – Support
As Amended on August 6, 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. 
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. 
CSAC supports AB 1970. Unfortunately, it was held by the Senate Appropriations Committee on August 16. 

AB 2352 (Hernández) – Support
As Introduced on February 24, 2012

AB 2352, by Assembly Member Roger Hernández, would allow CalWORKs applicants and recipients to own reliable cars by deleting the requirement that counties assess the value of a motor vehicle when determining or redetermining CalWORKs eligibility. 

AB 2352 is similar to last year’s AB 1182, which was vetoed by the Governor. Counties believe that this change will promote work participation and self-sufficiency among low-income California families and eventually help CalWORKs recipients move off of public aid. It is for these reasons that we support Assembly Member Hernández’s measure again this year. 
CSAC supports AB 2352, but the Senate Appropriations Committee held the measure on August 16. It is effectively dead for this legislative session.

Child Welfare Services/Foster Care

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 was passed by the Senate Appropriations Committee on August 16. It goes next to the Senate 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. 

The Senate Appropriations Committee passed AB 1712 as amended on August 16. It goes next to the Senate Floor.

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 passed SB 677 out of their committee on August 16. It now goes to the Assembly Floor. 

SB 703 (Hernandez) – Support
As Amended on June 25, 2012

SB 703, by Senator Ed Hernandez, would have allowed 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.
The Assembly Appropriations Committee declined to move SB 703 off of the Suspense File on August 16. 

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 passed SB 970 on August 16, and it now goes to the Assembly Floor.

Emergency Medical Services (EMS)

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

AB 1944, by Assembly Member Mike Gatto, would have given 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 declined to move AB 1944 from their Suspense File on August 16. 
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 passed SB 1391 on August 16 and it now goes to the Assembly Floor.


AB 43 (Monning) – Support
As Amended on May 27, 2011

AB 43, by Assembly Member William Monning, would require the state Department of Health Care Services to begin planning for the transition of individuals into Medi-Cal as required in 2014 by the federal Affordable Care Act. 

AB was recently taken off of the Inactive File and continues to move through the policy committee process. 

Specifically, AB 43 requires state planning to transition adults from county-run Low Income Health Plans (LIHP), established under California’s Bridge to Reform Section 1115 Medicaid Demonstration waiver approved in 2010, into Medi-Cal. The Department would be required to submit the plan to the federal government.

Counties are supportive of developing a plan to transition the LIHP enrollees into Medi-Cal. CSAC has been working with Assembly Member Monning’s staff to develop language that broadens the transition plan. This language ensures that individuals served in counties that may ultimately choose not to develop an LIHP, as well as individuals who might not be eligible for a county’s LIHP, for example, due to income slightly above the set limits, be included in transition planning. We understand this language will be amended into the bill and appreciate the author’s willingness to work with us.

Counties also support the bill’s ambitious timeline, i.e. erecting an eligibility process for transitioning LIHP participants to Medi-Cal by July 1, 2013, but recognize the technical realities associated with achieving it may be challenging. Counties will be critical partners in providing Medi-Cal eligibility determinations and enrolling individuals in the Medi-Cal program. It will be important for counties to have a role in this process, along with other key stakeholders. 

Counties look forward to working with the Legislature to achieve the goal of developing a realistic and robust transition plan for expanding Medi-Cal under the Affordable Care Act in 2014. CSAC, along with the Urban Counties Caucus, County Welfare Directors Association, and County Health Executives Association of California support AB 43. The Senate Appropriations Committee passed AB 43 on August 16 and it now goes to the Senate Floor.

Public Health

AB 2266 (Mitchell) – Support
As Amended on August 16, 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, and the Senate Appropriations Committee passed it as amended on August 16.

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