Welfare in California
Welfare in California consists of federal welfare programs which are often at least partially administered by state and county agencies, and several independent programs, which are usually administered by the counties.
Federal-state-county programs consist of:
- MediCal, the California Medicaid program
- CalFresh, the California Supplemental Nutrition Assistance Program (SNAP / food stamp) program
- CalWORKs, the California Temporary Assistance for Needy Families (TANF) program
- the State Supplementation Program (SSP or SSI/SSP), the state supplement to the federal Supplemental Security Income (SSI) program
- the California Healthy Families Program (HFP), the California Children's Health Insurance Program (CHIP) program
- the Access for Infants and Mothers Program (AIM)
- the Low Income Health Program (LIHP), a California demonstration program composed of:
- the Medicaid Coverage Expansion (MCE), similar to the ObamaCare expansion of Medicaid coverage to individuals with incomes up to 133% of the Federal Poverty Level (FPL)
- the Health Care Coverage Initiative (HCCI), similar to the Basic Health Program (BHP) of the PPACA whereby coverage is expanded to individuals with incomes from 133% to 200% of the Federal Poverty Level.
Federal-state-county-city-special district programs consist of:
- Public housing
State-county programs consist of:
- Indigent medical services
- California Medical Service Program (CMSP)
- Medically Indigent Service Program (MISP)
- General assistance
CalWIN is an online, real-time computer program that supports the administration of public assistance programs in California and has been used in 18 California counties since 2005. CalWIN runs eligibility and benefit determinations and case maintenance, application registration, and statistical reporting functions.
The California Medical Assistance Program (Medi-Cal or MediCal) is the name of the California implementation of the federal Medicaid program serving low-income families, seniors, persons with disabilities, children in foster care, pregnant women, low-income undocumented children <http://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/sb-75.aspx> and certain low-income adults. It is jointly administered by the California Department of Health Care Services (DHCS) and the Centers for Medicare and Medicaid Services (CMS), with many services implemented at the local level mainly by the counties of California. Approximately 8.8 million citizens were enrolled in Medi-Cal for at least 1 month in 2009-10, or about 23% of California's population.
The Medi-Cal program does not have open enrollment. It is a year-round program in which one can apply anytime. <http://www.dhcs.ca.gov/formsandpubs/publications/opa/Pages/QnAAffordableCareAct.aspx>
A recent survey of Medi-Cal members by the California Healthcare Foundation (CHCF) found that 90% of respondents rate Medi-Cal as a good or very good program. Medi-Cal emphasizes prevention-oriented health care that promotes health and well-being and works to ensure members receive the right care at the right time.<http://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/Medi-CalFAQs2014a.aspx>
The California Work Opportunities and Responsibility to Kids (CalWORKs) program is the California implementation of the federal welfare-to-work Temporary Assistance for Needy Families (TANF) program that gives cash aid and services to eligible needy California families.
CalFresh is the California implementation of the federal Supplemental Nutrition Assistance Program (SNAP), formerly known as the Food Stamp program, which provides financial assistance for purchasing food for those in poverty in California.
State Supplementation Program
The State Supplementation Program (SSP or SSI/SSP), also known as the Supplemental Nutrition Assistance Program (SNAP, CalFresh) cash-out program, is the state supplement to the federal Supplemental Security Income (SSI) program and provides state funded supplemental food benefits to SSI recipients in lieu of SNAP benefits. SSI recipients in states that provide state supplements to SSI are ineligible for SNAP/CalFresh pursuant to 7 U.S.C. § 2015(g).
Healthy Families Program
The California Healthy Families Program (HFP) was the California implementation of the federal Children's Health Insurance Program (CHIP) that provides low cost insurance that provides health, dental, and vision coverage to children who do not have insurance and do not qualify for no-cost Medi-Cal. As a result of the 2012-2013 budget deal, the HFP is being discontinued and Medi-Cal requirements were lowered so that HFP patients now qualify for Medi-Cal. Nearly 900,000 children were moved from the HFP into Medi-Cal beginning in 2013.
Access for Infants and Mothers Program
The Access for Infants and Mothers Program (AIM) provides low cost health insurance coverage to middle income pregnant women who don’t already have health insurance and whose income is too high to qualify for Medi-Cal.
Low Income Health Program
The Low Income Health Program (LIHP), also called "The Bridge to Reform", is a demonstration project under § 1115 of the Social Security Act (42 U.S.C. § 1315) that allows the counties to optionally expand primary medical coverage to certain uninsured, low-income adults, and mirror several components of the Patient Protection and Affordable Care Act (PPACA), informally referred to as ObamaCare. In 2014, when the ObamaCare provisions come into effect, participants will automatically be enrolled in the California Medical Assistance Program (Medi-Cal or MediCal), California's Medicaid program.
It is composed of 2 separate programs: the Medicaid Coverage Expansion for individuals with incomes up to 133% of the Federal Poverty Level (FPL), and the Health Care Coverage Initiative is similar to the Basic Health Program (BHP) of the PPACA whereby coverage is expanded to individuals with incomes from 133% to 200% of the Federal Poverty Level.
Implementation by each county is optional.
Since 1933, California law has required counties to provide relief to the poor, including health care services and general assistance.
General Assistance and General Relief
Every county and every city and county shall relieve and support all incompetent, poor, indigent persons, and those incapacitated by age, disease, or accident, lawfully resident therein, when such persons are not supported and relieved by their relatives or friends, by their own means, or by state hospitals or other state or private institutions.
It has been said that the "provision of general assistance is inconsistent, fragmented, and widely differentiated", with aid ranging from $160 per month in Santa Barbara County to $360 in neighboring Ventura County. In Orange County, aid was $277 per month as of July 2012 and capped at three months per 12-month period for residents deemed employable.
California has provided some form of general assistance since the mid-1800s, and much of the language can be traced back to the Pauper Act of 1901. San Francisco Proposition N of 2002, colloquially known as Care Not Cash, was a San Francisco ballot measure sponsored by Supervisor Gavin Newsom designed to cut the money given in the General Assistance programs to homeless people in exchange for shelters and other forms of services.
County indigent medical programs can be categorized as California Medical Service Program (CMSP) and Medically Indigent Service Program (MISP) counties. There are 34 CMSP counties and 24 MISP counties. The CMSP county programs are largely managed by the state, whereas MISP counties manage their own programs with their own rules and regulations. Many patients from both the CMSP and MISP county programs are expected to transition to county LIHP / MCE / HCCI programs and eventually to Medi-Cal / Medicaid when the ObamaCare provisions take effect in 2014.
On 1 September 1937 President Franklin D. Roosevelt signed the Housing Act of 1937, sometimes called the Wagner-Steagall Act, which provided for subsidies to be paid from the U.S. government to local public housing agencies (LHA's) to improve living conditions for low-income families. On 21 March 1938 Governor Frank Merriam signed multiple laws including the Housing Authorities Law and the Housing Cooperation Law that establishes a housing authority in every city and county in California, and allows for the establishment of joint powers area housing authorities. The Housing and Community Development Act of 1974 signed by President Gerald Ford later amended the Housing Act of 1937 and created Section 8 housing, now known as the Housing Choice Voucher program, for the payment of rent assistance to private landlords on behalf of low-income households.
One of the primary purposes of housing authorities is to manage Section 8 housing, but other activities include Community Development Block Grant (CDBG) entitlements and HOME Investment Partnerships Program (HOME) funding. The California Department of Housing and Community Development (HCD) Housing Assistance Program (HAP) acts as the local housing authority for 12 rural counties: Alpine, Amador, Calaveras, Colusa, Glenn, Inyo, Modoc, Mono, Sierra, Siskiyou, Trinity, and Tuolumne. Some other examples of local and area housing authorities include the:
- Housing Authority of the County of Los Angeles (HACoLA) within the Los Angeles County Community Development Department (CDC)
- Housing Authority of the City of Los Angeles (HACLA)
- Housing Authority of the County of San Diego (HACSD)
- Orange County Housing Authority (OCHA)
- Housing Authority of the County of Riverside (HARivCo)
- Housing Authority of the County of San Bernardino (HACSB)
- Housing Authority of the County of Santa Clara (HACSC)
- San Francisco Housing Authority (SFHA)
- Oakland Housing Authority (OHA)
- Housing Authority of the City of Fresno and the Housing Authority of Fresno County
- Housing Authority of the County of Alameda (HACA)
- Sacramento Housing and Redevelopment Agency (SHRA)
- Housing Authority of the City of Long Beach (HACLB)
- Irvine Campus Housing Authority (ICHA) of the Regents of the University of California for the campus of UC Irvine
- Bartolone, Pauline. "Healthy Families Kids Will Move To Medi-Cal under New Budget Deal". KPBS News. California Capitol Network.
- Rubenstein, Grace (6 March 2012). "Four Sacramento area counties prepare for early test of Obama's health care overhaul". Sacramento Bee.
- AB 342, Statutes of 2010, Chapter 723; codified at Welfare and Institutions Code § 15909.1
- "Understanding County Health Services in California: A Brief Overview". Institute for Local Government. Retrieved 2012-10-08.
- California Welfare and Institutions Code § 17000
- Murphy, Stacey Heneage (2008). The Politics of Benevolence: Homeless Policy in San Francisco (Ph.D.). ProQuest. pp. 122–123. OCLC 436318619.
- Yeung, Bernice (9 October 2012). "Orange County revamps assistance for indigent following lawsuit". California Watch.
- Mooney v. Pickett, 4 Cal. 3d 669
- California Statutes 1901, p. 636
- "County Programs for the Medically Indigent in California" (PDF). California HealthCare Foundation. 1 October 2009. Retrieved 20 November 2012.
- Health and Safety Code §§ 34200 et. seq. Health and Safety Code §§ 34500 et. seq.