Today's Law As Amended

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



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 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 inoperative  on July 1, 2018. 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 first obtain, or then 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 particular child is not appropriate.
(2) 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) Only if the county human services agency has tried and is unable to secure the documentation described in paragraph (1) using the California Immunization Registry pursuant to paragraph (2), the applicant or recipient shall submit 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 45 days of determination or redetermination of eligibility for aid under this chapter, the county shall provide another copy of the notice described in subdivision (c).
(B) Applicants for aid shall be deemed in compliance with this section the first day of the month after 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). A determination of good cause extends the 45-day period described in subparagraph (A), during which time, the applicant or recipient shall submit 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, documentation of any age-appropriate immunization shall be obtained pursuant to subdivision (a).
(c) If required by paragraph (3) or (4) 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 Medi-Cal covers nonmedical transportation services for children who receive Medi-Cal benefits to receive the immunizations described in paragraph (1) of subdivision (a).
(d) 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. 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.