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 introduced, 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 would instead require the head of household for an assistance unit receiving aid to provide the county human services agency with documentation that each child in the assistance unit who is 5 years of age or younger has received all age-appropriate immunizations. The bill would require the county to review the California Immunization Registry before requiring a recipient to provide documentation that the immunization has been performed. The bill would require the county to send notice of the requirement to submit documentation, as specified, to the assistance unit if the county has not verified that those children have been immunized within 45 days of determination or redetermination of eligibility for aid. The bill would revise the information required for the notice, as specified. The bill would instead only prohibit the needs of the head of household in the assistance unit from being considered in determining the grant amount if the documentation is not received within 6 months after notice of the requirement to submit documentation has been given, and would permit the grant to be restored once the county receives the documentation or determines that there is good cause for not providing the documentation. The bill would require a county to provide transportation services necessary to ensure immunization of a child. 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.
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.
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.

SEC. 3.

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

11265.8.
 (a) (1) A head of household for an assistance unit receiving aid under this chapter shall provide the county human services agency with documentation that all children in the assistance unit who are five years of age or younger and are not enrolled in public 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 human services agency an affidavit that the immunizations are contrary to the applicant’s or recipient’s beliefs.
(2) Before requiring a recipient to submit documentation required by paragraph (1), a county shall secure documentation, if available, verifying whether a child described in paragraph (1) has received all age-appropriate immunizations, by reviewing the California Immunization Registry established pursuant to Section 120440 of the Health and Safety Code.
(3) If the documentation of immunization required by paragraph (1) or allowed by paragraph (2) is not secured by the county human services agency within 45 days of determination or redetermination of eligibility for aid under this chapter, the county shall give notice to the assistance unit that sets forth the requirement to submit immunization documentation pursuant to paragraph (1) and contains the information required by subdivision (c). The county shall provide transportation services necessary to ensure immunization of a child described in paragraph (1).
(4) If an assistance unit has not provided the documentation of immunization required by paragraph (1) within six months after receiving a notice described in subdivision (c), and the county has not secured documentation pursuant to paragraph (2), the needs of the head of household in the assistance unit shall not be considered in determining the grant to the assistance unit under Section 11450. The grant shall be restored on the date that the required documentation is received by the county or at any time that the county determines that there is good cause for not providing the documentation. Good cause shall include, but not be limited to, homelessness, domestic violence, lack of transportation, lack of money for transportation, and lack of immunization providers in the county. Participation in family stabilization or an early home visiting program administered by the county human services agency shall also constitute good cause.
(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 immunize children in the assistance unit and to submit documentation to the county that those children are immunized pursuant to subdivision (a). The notice shall contain the information required by subdivision (c).
(c) A notice detailing the obligation to submit documentation of age-appropriate immunization for all children in the assistance unit who are five years of age or younger 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 may file an affidavit claiming that the immunizations are contrary to the applicant’s or recipient’s beliefs, with a postage-paid envelope that the applicant or recipient can return to the county human services agency.
(d) The department shall track, maintain, and publish on its Internet Web site information concerning the number of sanctions imposed under this section, the number of families affected by the sanctions, and the counties where sanctioned families live. Information provided under this subdivision shall be subject to applicable state and federal confidentiality laws and regulations.

SEC. 4.

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

SEC. 5.

 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.