Existing law establishes various public social services programs under the jurisdiction of the State Department of Social Services, including, among others, the California Work Opportunity and Responsibility to Kids (CalWORKs) program, the CalFresh program, the California Food Assistance Program (CFAP) , the In-Home Supportive Services (IHSS) program, and the Cash Assistance Program for Immigrants (CAPI) .
Existing law establishes 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 services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, requires a health care service plan to provide an enrollee who has been displaced or whose health may otherwise be affected by a state of emergency, as declared by the Governor, or a health emergency, as declared by the State Public Health Officer, with access to medically necessary health care services, as specified.
This bill would require the State Department of Social Services, for purposes of CalWORKs, CalFresh, CFAP, IHSS, and CAPI, and the State Department of Health Care Services, for Medi-Cal purposes, to provide continuous eligibility for the applicable programs to a recipient or beneficiary who has been displaced by, or who has otherwise been affected by, a state of emergency or a health emergency, as described above.
Under the bill, the continuous eligibility would maintain a recipient's or beneficiary's current scope of benefits under the applicable program for at least 90 calendar days starting from the proclamation or declaration, whichever one is later, and would continue through at least the conclusion of the proclamation or declaration, whichever one is later. The bill would require the 2 departments to implement the continuous eligibility through automated programming of eligibility systems, with notifications, as specified.
The bill would require a county to immediately restore eligibility for the applicable program for any recipient or beneficiary whose eligibility was discontinued and who informs the county that they have been impacted as described above, without requesting any further verifications from the recipient or beneficiary.
In the case of CalWORKs, CalFresh, CFAP, IHSS, and CAPI, if a recipient fails to submit a semiannual report or an annual redetermination or recertification of eligibility, if applicable, the bill would require the county to determine that the recipient had good cause for failing to submit that information. The bill would set forth related provisions for the county, the State Department of Social Services, and the Director of Social Services.
Under the bill, these provisions would be implemented only to the extent not in conflict with federal law. The bill would authorize the Director of Social Services or the Director of Health Care Services to issue county directives regarding compliance with these provisions.
By creating new duties for counties with regard to eligibility for the above-described programs, the bill would impose a state-mandated local program.
Existing law continuously appropriates moneys from the General Fund to defray a portion of county costs under the CalWORKs program.
This bill would instead provide that the continuous appropriation would not be made for purposes of implementing these provisions.
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 the statutory provisions noted above.