CSAC Bulletin Article

Health and Human Services 05/13/2011

Foster Care Awareness Month Activities Inundate the Capitol 

More than 30 foster youth gathered on the West Steps of the State Capitol Building to kick off the“Take a Foster Youth to the Capitol” day on Wednesday. 

The youth were matched with a legislator for the day and shadowed them to capitol events, including legislative committees and meetings. Several legislators, including Assembly Members Holly Mitchell, Jim Beall, K.H. “Katcho” Achadjian and Senator Carol Liu, welcomed the youth at the West Steps and encouraged them to ask their legislators plenty of questions. 

The youth and youth advocates took the opportunity to continue raising awareness about the plight of California’s 60,000 foster children and youth, and how the previous Administration’s $80 million in vetoes to Child Welfare Services for two years running have devastated the support system vulnerable children and youth depend upon.

The “Take a Foster Youth to the Capitol” day was one of several Foster Care Awareness Month events. On Tuesday, the Assembly Select Committee on Foster Care held a joint oversight hearing highlighting the recent cuts to foster care and child welfare services. On Thursday, Senator Carol Liu presented a resolution declaring the month of May “Foster Care Awareness Month” in California. 

Child Welfare Services

AB 823 (Dickinson) – Support
As Amended on April 28, 2011

AB 823, by Assembly Member Roger Dickinson, would create a California Children’s Cabinet tasked with ensuring better coordination and delivery of services to our children and their families. 

The bill would specifically create the Children’s Cabinet of California and give Governor Jerry Brown the authority to appoint the members. All state agencies that have jurisdiction over the well-being of children and families would be included, and the Cabinet must meet by March 1, 2012. This model is similar to Children’s Cabinets in approximately 20 states throughout the country, and will expand the existing Child Welfare Council (CWC) and State Interagency Team (SIT) models to align public resources for the healthy growth and development of all children and youth in California. 

By coordinating the continuum of children’s services in California and working to streamline and maximize available state and federal funding, counties believe that the creation of a California Children’s Cabinet will have long-term social and economic benefits for all residents. It is for these reasons that CSAC supports the bill. The Assembly Appropriations Committee placed AB 823 on the Suspense File on May 11. 

AB 846 (Bonilla) – Support
As Amended on March 31, 2011

AB 846, by Assembly Member Susan Bonilla, would provide assistance to foster youth who may have been victims of identity theft.

AB 846 is clean up to AB 2985 by Assembly Member Bill Maze (Statutes of 2006), which required county child welfare and probation agencies to request consumer credit disclosures on all foster youth turning 16 and to refer a foster youth to a credit counseling organization upon any indication of negative credit or evidence of identity theft. Specifically, AB 846 clarified that the request may be made by the state or a county and authorizes the requesting entity to refer the youth directly to a governmental or nonprofit organization that provides information and assistance with identify theft and other credit problems.

The Assembly Appropriations Committee passed SB 846 on May 11. CSAC supports the bill.

Foster Youth

AB 709 (Brownley) – Support
As Amended on April 6, 2011

AB 709, by Assembly Member Julia Brownley, would ensure the timely enrollment of foster youth who must transfer to a new school. 

Existing law requires a school to immediately enroll a foster child, even if the child is unable to produce the records normally required for enrollment. This includes previous academic records, proof of residency, and medical records. However, existing law does not address the requirement to produce proof of immunization or a vaccination history prior to enrollment. AB 709 addresses this discrepancy by allowing schools to waive the vaccination record requirement for foster youth. 

CSAC supports the bill, which was passed by the Assembly Education Committee on March 30 and the Assembly Human Services Committee on May 10. It now goes to the Assembly Floor. 

Adult Protective Services

AB 518 (Wagner) – Support
As Amended on March 23, 2011

AB 518, by Assembly Member Donald Wagner, would continue to protect elder and dependent adults from financial abuse by eliminating the sunset date on the reporting of suspected abuse by financial institutions.

Counties support AB 518, which is now on the Assembly Floor. 

AB 1288 (Gordon) – Support
As Amended May 4, 2011 

AB 1288, by Assembly Member Rich Gordon, would protect the assets of vulnerable seniors or dependent adults from misuse and fraud while a conservatorship petition is pending in court. 

Assembly Bill 1288 specifically would extend the period of time in which a public guardian or conservator may petition to protect the assets of seniors and dependent adults from 15 to 30 days. The bill also would expand the scope of the possession or control of property by the guardian to include assets held in the name of a proposed conservatee’s trust.

Counties often encounter these issues during Adult Protective Services investigations, and it is challenging to complete a petition for conservatorship within 15 days. AB 1288 is a common sense, simple measure to provide appointed guardians a suitable amount of time and authority to protect the assets of vulnerable seniors and dependent adults. It is for these reasons that CSAC, Urban Counties Caucus, Regional Council of Rural Counties, and County Welfare Directors Association support AB 1288. The Assembly Judiciary Committee passed the measure on May 10.

Health and Public Health

SB 616 (DeSaulnier) – Support
As Amended on April 26, 2011

SB 616, by Senator Mark DeSaulnier, would promote the state’s efforts to receive federal health prevention program funds. 

Senate Bill 616 specifically directs the Department of Health Care Services (DHCS) to pursue new federal health prevention grants that were enacted as part of the federal Patient Protection and Affordable Care Act (Public Law 111-148). That Act authorizes the Centers for Medicare and Medicaid (CMS) to create the Medicaid Incentives for Prevention of Chronic Diseases Program (MIPCDP). The new program will send funding to states to provide nonfinancial incentives to beneficiaries who participate in prevention programs. 

Senate Bill 616 affirms California’s intention to apply for these grants to focus the state’s efforts on the Medi-Cal (Medicaid) population. Since the MIPPCDP grants specifically require participants to demonstrate changes in health risk and/or the adoption of healthy behaviors, the state’s plan to target Medi-Cal beneficiaries is a classic win-win situation: draw down federal funding to improve the health outcomes of the state’s low-income population, thereby reducing the state’s medical costs and improving the quality of life for this same population.

CSAC has taken a strong position in support of the federal Prevention and Public Health fund programs. Our Board of Directors adopted the attached resolution in support of the federal program on March 10, and counties intend to serve as core partners in the development of new community prevention and chronic disease programs in order to improve the health of all Americans.

Counties understand that DHCS has already indicated interest in the grants to the federal government, and SB 616 will help build momentum for these efforts. It is for these reasons that CSAC supports SB 616. The Senate Appropriations Committee placed SB 616 on their Suspense File on May 9.

Medi-Cal

AB 43 (Monning) – Support
As Amended on April 25, 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. 

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 Assembly Appropriations Committee placed AB 43 on their Suspense File on May 4. 

AB 540 (Beall) – Support
As Amended on April 7, 2011

AB 540, by Assembly Member Jim Beall, would allow California 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. 

By implementing the Medi-Cal Alcohol and Drug Screening and Brief Intervention Services Program, AB 540 would create a voluntary-participation program for the counties to provide the non-federal match. The bill would then enable the state to draw down federal revenue for counties that are already providing these services. For every local dollar invested, California could receive a dollar match from the federal government. Furthermore, the bill clarifies that SBI services would be targeted to pregnant women and women of childbearing age, and all participation would be both voluntary and confidential. 

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 Assembly Appropriations Committee placed AB 540 on their Suspense File on May 4. 

SB 677 (Hernandez) – Support in Concept
As Amended on March 22, 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.

However, states do not yet know how the federal government will change underlying Medicaid rules to implement the ACA. Counties anticipate that more direction will be forthcoming from the federal government that will clarify how to structure the eligibility changes within California. Pending this federal guidance, counties have taken a support in concept position on Senator Hernandez’s SB 677. The Senate Appropriations Committee placed SB 677 on the Suspense File on May 9. 

CalWORKs

AB 959 (Jones) – Support
As Amended on April 12, 2011

AB 959, by Assembly Member Brian Jones, will increase efficiency in the CalWORKs and CalFresh programs by allowing for a one-month grace period during the discontinuance process. 

Assembly Bill 959 is a San Diego county-sponsored measure that is aimed at increasing efficiency at the county level by allowing county eligibility staff to restore eligibility for cases that have been discontinued due to missing information if that information is received within 30 days of the discontinuance notice. 

Counties believe that AB 959 will simply reduce the number of CalWORKs and CalFresh applications processed at the local level and save the time and effort of both county staff and program recipients. The Assembly Appropriations Committee placed AB 959 on their Suspense File on May 4. 

Mental Health

AB 1297 (Chesbro) – Support
As Introduced on February 18, 2011

AB 1297, a bill by Assembly Member Wesley Chesbro, would ensure timely federal reimbursement to counties for providing Specialty Mental Health Managed Care services. 

Specifically, AB 1297 would align the state’s requirements for the Specialty Medi-Cal Mental Health Managed Care program with existing federal requirements by utilizing federal Medicaid Upper Payment Limits instead of the state’s current Statewide Maximum Allowances (SMAs) system. The SMAs system has been frozen since Fiscal Year 2006-07, and counties have incurred significant costs for serving eligible populations during this time. AB 1297 would allow counties to recover these costs from the federal government, all without impacting the state’s General Fund. 

AB 1297 also eliminates the state’s current 15 percent limit on reimbursement for administrative costs. Counties already certify the full public expenditure of funds in order to draw down federal matching funds, and, under AB 1297, counties would be fully reimbursed by the federal government for the cost of providing services. 

Lastly, AB 1297 would expand the timeframe for submitting Specialty Medi-Cal Mental Health Managed Care claims from the state’s six months to the federal standard of 12 months. We believe that this provision will give counties the flexibility in submitting claims that complex health care scenarios demand. 

AB 1297 will both streamline and enhance counties’ ability to draw down federal reimbursements for Specialty Medi-Cal Mental Health Managed Care services – all at no cost to the state’s General Fund. The bill is sponsored by the California Mental Health Directors Association; the measure passed off the Assembly Floor yesterday. AB 1297 is in the Senate awaiting committee assignments. 

In-Home Supportive Services

SB 930 (Evans) – Support
As Introduced on February 18, 2011

Senate Bill 930, by Senator Noreen Evans, would eliminate the requirements for counties to collect the fingerprints of each IHSS consumer and have both providers and consumers to submit fingerprints on each IHSS timesheet (a provision of current law that is scheduled to go into effect on July 1 of this year). The bill would also repeal statute that prohibits providers from using a Post Office Box (P.O. Box) for IHSS forms, including for paychecks. 

For these reasons, CSAC supports SB 930. The Senate Appropriations Committee passed the measure on May 9, and it now goes to the Senate Floor.

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