Medi-Cal: CalWORKs: eligibility.

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 federal law provides for allocation of federal funds through the federal Temporary Assistance for Needy Families (TANF) block grant program to eligible states. Existing law provides for the California Work Opportunity and Responsibility to Kids (CalWORKs) program, under which, through a combination of state and county funds and federal funds received through the TANF program, each county provides cash assistance and other benefits to qualified low-income families. Existing law, to the extent required by specified federal provisions, requires that a family who was receiving aid under the CalWORKs program in at least 3 of the 6 months immediately preceding the month in which that family became ineligible for that assistance due to income from employment, or other specified reasons, to remain eligible for health care services under the Medi-Cal program during the immediately succeeding 6-month period. Existing law, in conformance with federal law, requires the department to offer those beneficiaries the option of remaining eligible for health care services under the Medi-Cal program for an additional period of 6 months. Existing federal law authorizes a state to elect to treat any reference to the initial 6-month extension period as a reference to a 12-month period, in which case the federal provisions relating to the additional 6-month extension do not apply. This bill would require the department, commencing January 1, 2019, to implement the option available under the above-described federal law to replace the initial 6-month extension period with a 12-month initial eligibility period, making the federal and state provisions relating to the additional 6-month extension inapplicable. The bill would also make conforming changes to related provisions. Because counties are responsible for making eligibility determinations under the Medi-Cal program, by revising eligibility requirements, this bill would impose a state-mandated local program. 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.