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AB-1992 CalWORKs eligibility: immunizations.(2017-2018)

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Date Published: 06/19/2018 04:00 AM
AB1992:v96#DOCUMENT

Amended  IN  Senate  June 18, 2018
Amended  IN  Assembly  May 25, 2018
Amended  IN  Assembly  March 13, 2018

CALIFORNIA LEGISLATURE— 2017–2018 REGULAR SESSION

Assembly Bill No. 1992


Introduced by Assembly Member Chu

February 01, 2018


An act to repeal and add Section 11265.8 of the Welfare and Institutions Code, relating to CalWORKs.


LEGISLATIVE COUNSEL'S DIGEST


AB 1992, as amended, Chu. CalWORKs eligibility: immunizations.
Existing law requires each county to provide cash assistance and other social services to needy families through the California Work Opportunity and Responsibility to Kids (CalWORKs) program using federal Temporary Assistance to Needy Families block grant program, state, and county funds. Under existing law, all applicants for or recipients of CalWORKs are required to ensure and provide documentation that each child in the assistance unit who is not required to be enrolled in school has received all age-appropriate immunizations, except as specified. If the documentation is not provided within the required time period, existing law prohibits the needs of all parents or caretaker relatives in the assistance unit from being considered in determining the grant to the assistance unit until the required documentation is provided. Existing law requires a notice of the obligation to secure immunizations to be given to the applicant or recipient at the time of application and at the next redetermination of eligibility for aid, and specifies information to be required in the notice.
This bill, commencing July 1, 2019, would instead require a county human services agency to obtain or receive documentation that each child in an assistance unit who is not required to be enrolled in school has received all age-appropriate immunizations, except as specified. The bill would require the county to review the California Immunization Registry before requiring an applicant or recipient to provide documentation that a child has received all age-appropriate immunizations. The bill would require the county to send notice of the requirement to submit documentation, as specified, to the applicant or recipient. The bill would revise the information required for the notice, as specified, including requiring the notice to advise the applicant or recipient of the right to request and receive nonmedical transportation services through the Medi-Cal managed care plan. The bill would permit withhold $50 per month from the grant if the county has not secured the documentation and would require the assistance unit to be paid the withheld funds, up to $500, and the grant to be restored once the county receives the documentation or determines that there is good cause for not providing the documentation. Because the bill would increase the duties of a county relative to sending notice of the requirement to submit documentation of immunization and providing transportation services to ensure immunization, the bill would impose a state-mandated local program. The bill would require the department, on a quarterly basis, to track, maintain, and publish on its Internet Web site specified county information regarding penalties imposed as a result of the bill.
This bill would require the department to implement the bill through an all-county letter of similar instruction from the director, which the bill would require to be issued by July 1, 2019.
Existing law continuously appropriates moneys from the General Fund to defray a portion of county costs under the CalWORKs program.
This bill would provide that the continuous appropriation would not be made for the purposes of implementing the bill.
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.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: YES  

The people of the State of California do enact as follows:


SECTION 1.

 The Legislature finds and declares the following:
(a) Researchers who study immunization habits of American families have found that when children living in deep poverty are not immunized, it is most often because their parents are disconnected from the health care system and lack the resources to ensure immunization.
(b) Research also shows that immunization rates increase when low-income parents are informed about immunization and supported in securing free immunizations for their children.
(c) There is no evidence that the current state law, which denies aid to parents whose children are not immunized, improves the immunization rate. The research described above suggests that this policy may even impair the ability of parents to immunize their children or produce verification of immunization to county human services agencies or other human services providers.
(d) It is the intent of the Legislature in enacting this act to improve the health outcomes of young children living in a home that receives assistance through the CalWORKs program by increasing their rates of immunization.
SEC. 2.Section 11265.8 of the Welfare and Institutions Code, as added by Section 4 of Chapter 691 of the Statutes of 2017, is repealed.

SEC. 2.

 Section 11265.8 of the Welfare and Institutions Code, as added by Section 4 of Chapter 691 of the Statutes of 2017, is amended to read:

11265.8.
 (a) All applicants for aid under this chapter, within 30 days of the determination of eligibility for Medi-Cal benefits under Chapter 7 (commencing with Section 14000), and 45 days for applicants already eligible for benefits under Chapter 7 (commencing with Section 14000), and all recipients of aid under this chapter within 45 days of a full or financial redetermination of eligibility for aid under this chapter, shall provide documentation that all children in the assistance unit not required to be enrolled in school have received all age appropriate immunizations, unless it has been medically determined that an immunization for a child is not appropriate or the applicant or recipient has filed with the county welfare department an affidavit that the immunizations are contrary to the applicant’s or recipient’s beliefs. If the county determines that good cause exists for not providing the required documentation due to lack of reasonable access to immunization services, the period shall be extended by an additional 30 days. A circumstance that shall constitute good cause includes, but is not limited to, the applicant or recipient does not have reasonable access to immunization services due to a situation of domestic violence. If the documentation is not provided within the required time period, the needs of all parents or caretaker relatives in the assistance unit shall not be considered in determining the grant to the assistance unit under Section 11450 until the required documentation is provided. The department shall track and maintain information concerning the number of sanctions imposed under this section.
(b) At the time of application and at the next redetermination of eligibility for aid under this chapter, all applicants and recipients shall be given notice advising them of their obligation to secure the immunizations required in subdivision (a). The notice shall also contain all of the following:
(1) The Recommended Childhood Immunization Schedule, United States, and the Recommended Immunization Schedule for Children Not Immunized on Schedule in the First Year of Life, as appropriate, approved by the Advisory Committee on Immunization Practices, the American Academy of Pediatrics, and the American Academy of Family Physicians.
(2) A description of how to obtain the immunizations through a fee-for-service provider that accepts Medi-Cal, a Medi-Cal managed care plan, a county public health clinic, or any other source that may be available in the county as appropriate.
(3) A statement that the applicant or recipient may file an affidavit claiming that the immunizations are contrary to the applicant’s or recipient’s beliefs.

(c)This section shall become operative on July 1, 2018.

(c) This section shall become inoperative on July 1, 2019, and, as of January 1, 2020, is repealed.

SEC. 3.

 Section 11265.8 is added to the Welfare and Institutions Code, to read:

11265.8.
 (a) (1) A county human services agency shall obtain or receive documentation that all children in an assistance unit who are not required to be enrolled in school have received all age-appropriate immunizations, unless it has been medically determined that an immunization for a child is not appropriate.
(2) Before requiring an applicant for, or recipient of, aid under this chapter to submit the documentation described in paragraph (1), a county human services agency shall first review the California Immunization Registry established pursuant to Section 120440 of the Health and Safety Code and attempt to verify that a child has received all age-appropriate immunizations.
(3) If the county human services agency is unable to secure the documentation described in paragraph (1) using the California Immunization Registry pursuant to paragraph (2), the applicant or recipient shall supply the documentation. In order to inform the applicant or recipient of this obligation and support compliance, the county human services agency shall provide the applicant or recipient with a notice as described in subdivision (c).
(4) (A) If the county has not secured, either through review of the California Immunization Registry or from an applicant or recipient, the documentation described in paragraph (1) within six months of application for, or redetermination of, determination or redetermination of eligibility for aid under this chapter, the needs of all parents or caretaker relatives shall not be considered in determining fifty dollars ($50) per month shall be withheld from the grant to the assistance unit under Section 11450.
(B) The funds withheld pursuant to subparagraph (A) shall be paid to the assistance unit, in an amount not to exceed five hundred dollars ($500), and treated as a lump-sum payment for purposes of Section 11157, and the grant shall be restored to its full amount amount, on the date that either of the following occurs:
(i) The documentation described in paragraph (1) is obtained or received by the county human services agency.
(ii) The county determines that good cause exists for not providing the documentation described in paragraph (1). Reasons for good cause shall include, but not be limited to, homelessness, domestic violence, lack of transportation, lack of money for transportation, scarcity of immunization providers in the county, or participation in family stabilization or an early home visiting program administered by the county human services agency.
(b) At the time of application and at the next redetermination of eligibility for aid under this chapter, all applicants and recipients shall be given a notice as described in subdivision (c).
(c) Pursuant to paragraph (3) of subdivision (a) and subdivision (b), a county human services agency shall provide an applicant for or recipient of aid under this chapter a notice detailing the obligation to submit documentation of age-appropriate immunization for all children described in paragraph (1) of subdivision (a). The notice shall include all of the following information:
(1) The Recommended Childhood Immunization Schedule, United States, and the Recommended Immunization Schedule for Children Not Immunized on Schedule in the First Year of Life, as appropriate, approved by the Advisory Committee on Immunization Practices, the American Academy of Pediatrics, and the American Academy of Family Physicians.
(2) A description of how to obtain the immunizations through a provider that accepts Medi-Cal, a Medi-Cal managed care plan, a county public health clinic, and other providers of no-cost child immunizations available in the county.
(3) A statement that the applicant or recipient has the right to request and receive nonmedical transportation services through his or her Medi-Cal managed care plan necessary to ensure immunization of a child described in paragraph (1) of subdivision (a). The statement shall also include state-developed information regarding how the applicant or recipient may receive nonmedical transportation services from the Medi-Cal managed care plan.
(d) The department, on a quarterly basis, shall track, maintain, and publish on its Internet Web site information detailing, by county, the number of penalties imposed under this section and the number of assistance units with at least one penalty. Information provided under this subdivision shall be subject to applicable state and federal confidentiality laws and regulations.
(e) This section shall become operative on July 1, 2019.

SEC. 4.

 Notwithstanding the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), the State Department of Social Services shall implement this act through an all-county letter of similar instruction from the director. The all-county letter or similar instruction shall be issued by July 1, 2019.

SEC. 5.

 No appropriation pursuant to Section 15200 of the Welfare and Institutions Code shall be made for purposes of implementing this act.

SEC. 6.

 If the Commission on State Mandates determines that this act contains costs mandated by the state, reimbursement to local agencies and school districts for those costs shall be made pursuant to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of the Government Code.