BILL NUMBER: AB 420 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY APRIL 10, 2007
INTRODUCED BY Assembly Member Wolk
FEBRUARY 16, 2007
An act to amend Section 12694 of the Insurance Code, relating to
maternal and child health.
LEGISLATIVE COUNSEL'S DIGEST
AB 420, as amended, Wolk. California Special Supplemental
Nutrition Program for Women, Infants, and Children: gateway system.
Existing law, the California Special Supplemental Food Program for
Women, Infants, and Children (WIC), authorizes establishment of a
statewide program, administered by the State Department of Health
Services, for providing nutritional food supplements to low-income
pregnant women, low-income postpartum and lactating women, and
low-income infants and children under 5 years of age, who have been
determined to be at nutritional risk. The program, which implements a
program authorized under existing federal law, provides for the
redemption of nutrition coupons by recipients at any authorized
retail food vendor. Effective July 1, 2007, responsibility for the
administration of the above-mentioned provisions will be transferred
to the State Department of Public Health.
Existing law also requires the Managed Risk Medical Insurance
Board and the department, in collaboration with WIC program offices
and other designated entities, to design, promulgate, and implement
policies and procedures for an automated enrollment gateway system to
obtain presumptive eligibility for, and to facilitate application
for enrollment in, the Medi-Cal program and the Healthy Families
Program for children applying to the WIC program. Existing law
requires the WIC gateway system to be constructed with the capacity
to be used by entities operating the WIC program.
This bill would require all WIC local agencies that serve large
numbers of participants and a high proportion of uninsured
participants, as specified, to use the WIC gateway system only to the
extent funding is available, as specified, and would permit all
other local WIC agencies to use the WIC gateway system at their
option.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 12694 of the Insurance Code is amended to read:
12694. (a) The board and the department, in collaboration with
program offices for the California Special Supplemental Food Program
for Women, Infants, and Children (WIC or the WIC program), local WIC
agencies, counties in their capacity of making Medi-Cal eligibility
determinations, advocates, information technology specialists, and
other stakeholders, shall design, promulgate, and implement policies
and procedures for an automated enrollment gateway system developed
by the department and the board that performs, but is not limited to
performing, the following functions:
(1) To the extent that federal financial participation is
available, allowing children applying to the WIC program to submit a
simple electronic application to simultaneously obtain presumptive
eligibility for the Medi-Cal Program and Healthy Families Program
under Title XIX (42) (42 U.S.C. 1396 et
seq.) and Title XXI (42 U.S.C. 1397aa et seq.) of the Social
Security Act and apply for enrollment into the Medi-Cal program or
the Healthy Families Program with the consent of their parent or
guardian.
(2) Modify the existing WIC enrollment system to obtain the
minimum required data for enrollment in the Medi-Cal Program and
Healthy Families Program in order to provide an electronic
transactional platform that is connected to the simple electronic
application referenced in paragraph (1) and allowing for an interface
between that application, the Medi-Cal Eligibility Data System
(MEDS), and the Medi-Cal program or the Healthy Families Program, as
relevant.
(3) Providing an automated real-time connection with MEDS for the
purpose of checking an applicant's enrollment status.
(4) Allowing for the electronic transfer of information to the
Medi-Cal program or the Healthy Families Program, as relevant, for
the purpose of making the final eligibility determination.
(5) Checking, as relevant, available government databases for the
purpose of electronically receiving information that is necessary to
allow the Medi-Cal program or the Healthy Families Program to
complete the eligibility determination. The department and the
Managed Risk Medical Insurance Board shall comply with all applicable
privacy and confidentiality provisions under federal and state law.
(b) The automated enrollment gateway system shall be constructed
with the capacity to be used by entities operating the WIC program.
Those WIC local agencies that serve a large number of participants
and those that serve a high proportion of uninsured participants, at
levels designated by the stakeholders
entities provided for in subdivision (a), shall be required to
use the automated enrollment gateway system to the extent funding
provided in subdivision (k) is sufficient to accomplish the tasks of
participation. All other WIC local agencies may use the WIC gateway
system at their option.
(c) The WIC application process shall be modified to provide an
electronic application described in subdivision (a), which shall
contain the information necessary to apply for the automated
enrollment gateway system, supplemented by information required to
apply for enrollment into the Medi-Cal program or the Healthy
Families Program.
(d) Benefits for applicants opting to simultaneously obtain
presumptive eligibility for enrollment under this section shall
continue until a final eligibility determination is made for the
Medi-Cal program or the Healthy Families Program pursuant to Section
14011.8 of the Welfare and Institutions Code.
(e) Operation of the automated enrollment gateway system for the
WIC program shall occur within a timely and appropriate period as
determined by the department and the board, in consultation with the
stakeholders as provided in subdivision (a) subject to a specific
appropriation being provided for that purpose in the Budget Act or in
subsequent legislation. The automated enrollment gateway system
shall comply with all applicable confidentiality and privacy
protection in federal and state law and regulation.
(f) The WIC program shall collect income and residency information
necessary for the Medi-Cal program and the Healthy Families Program
documentation requirements for applications submitted through the
automated enrollment gateway system. To the extent allowed by the
federal government, the Medi-Cal and Healthy Families programs shall
rely on income information obtained by WIC and upon the income
verification process performed by WIC. The Medi-Cal and Healthy
Families programs shall collect and verify citizenship and
immigration information as required under those programs.
(g) Consistent with the provisions of this section, the Medi-Cal
and Healthy Families programs may collect additional information
needed to verify eligibility in those programs.
(h) Counties shall accept and process for a Medi-Cal eligibility
determination applications provided by the WIC gateway system and
ensure timely processing of these applications and a timely
eligibility determination and ending of presumptive eligibility.
(i) The presumptive eligibility benefits provided under this
section shall be identical to the benefits provided to children who
receive full-scope Medi-Cal benefits without a share of cost, and
shall only be made available through a Medi-Cal provider.
(j) The confidentiality and privacy protections set forth in
Sections 10850 and 14100.2 of the Welfare and Institutions Code and
all other confidentiality and privacy protections in federal and
state law and regulation shall apply to all children and families
using the automated enrollment gateway system as described in this
section.
(k) The state shall promote and offer support to the WIC program
for the use of the simple electronic application and the automated
enrollment gateway system. Participation in the automated enrollment
gateway system shall be required only to the extent that sufficient
financial assistance is made available to support the additional
training, staff time, administration, and other expenditures required
by a WIC local agency to use the gateway. This financial assistance
can be made available by public and private entities.
(l) The board shall seek approval of any amendments to the state
plan necessary to implement this section, in accordance with Title
XXI (42 U.S.C. Sec. 1397aa et seq.) of the federal Social Security
Act.
(m) The department shall seek approval of any amendments to the
state plan necessary to implement this section, in accordance with
Title XIX (42 U.S.C. 1396 et seq.) of the federal Social Security
Act. Notwithstanding any other provision of law, only when all
necessary federal approvals have been obtained shall this section be
implemented.