One Stop for Health & Nutrition
June 2014
www.transformcalfresh.org
Alliance to Transform CalFresh
 Members:
 Founding: 2011, to transform CalFresh participation by 2016
 Approach:
–
–
–
–
Data driven
Consumer focused
“Statewideness”
Alignment, wherever possible
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ATC Goal for California:
75% CalFresh Participation by 2016
 Strategy #1: Maximize ACA and dual-enroll families –
most low-income families are eligible for both!
 Strategy #2: Reduce churn, to keep eligible people
connected to food.
 Strategy #3: Deliver same day customer service, to
make sure all eligible families get the food they need and
qualify for asap.
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The ACA Opportunity for
CalFresh
“How can California be the
best at signing
people up for health coverage and the worst
at signing those same people up for food
assistance?”
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The ACA Opportunity for
CalFresh
 More People eligible for Medi-Cal as of Jan
2014 (up to 138% FPL), so now most lowincome people under 65 are income-eligible for
both MC and CF.
 More Customer Service (e.g., call center
networks between counties).
 More Outreach, promotion, and application
assistance.
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Why One Stop
for Health & Nutrition?
 Less red tape for families who are seeking help
if can tell story once (i.e., apply, verify, interview
for CF, etc).
 Greater chance families will get (and keep) both
supports as long as eligible and in need.
 Greater enrollment in CF and MC boosts federal
stimulus in local economy (e.g. grocery stores)
and relieves pressure on local charities.
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Why One Stop
for Health & Nutrition?
 Less work for counties to dually enroll in one
stop (once can re-engineer process and re-train
workers to integrate intake and case mgmt...)
– Can leverage Express Lane: enroll in CF and
“express” onto MC (see ACWDL 14-06 here)
– Plus, State budget increases gross income eligibility
for CF to 200% (net still 100%), so more working
families with high expenses will get CF (and health)
 Less burden on other county emergency
services
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What are the Opportunities
for your County?
1. New goals:
 More (X) eligible people who are participating in
Medi-Cal also participating in CalFresh
 More (Y) eligible people who are participating in
CalFresh also participating in Medi-Cal
 Overall, more (Z) eligible people in need of food
participating in CalFresh
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County Opportunities, cont’d
2. New strategies:
– Integrated intake so families get both CF & MC in “one
stop” (and case management), especially with a) Express
Lane from CF to MC and b) new gross income test to
200% for CF
– Targeted in-reach to health: Assistance to MC enrollees
targeted as eligible for CF, and vice-versa (and other
programs like school meals and WIC)
– Integrated outreach: New combined outreach projects
with CBOs for CF and health for harder-to-reach groups
3. New plans:
– Plus, can provide updated, data-driven “County
Participation Plan” for CalFresh to CDSS and Legislature.
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Data You Can Use:
Set Your Goal
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Data You Can Use:
Track Your Progress

Your County’s Dual Enrollment Rates & Total Participation Numbers
from CDSS’s new Data Dashboard for CalFresh
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Context
 Talk to your county about this data and what the
best, most current data they have for MC/CF
enrollment show is happening in your county.
 CDSS Data Dashboard is still waiting on best
MC data since many MC apps still “pending.”
 Rates of dual enrollment may well drop in 1Q
2014, as people surge onto Medi-Cal, some
ACA challenges continue at all levels, and
counties need time to catch up with CF and truly
integrate intake.
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Action Steps – Every County
1) Set a specific goal with/for your county based on
your baseline to maximize dual enrollment in MC
and CF -- either adopt the CBPP rates or calculate
a specific number to add to CF from MC.
2) Identify strategies already in use and to add – for
example, in-reach to MC lists, with a simplified CF
app; Express Lane to MC at CF intake, per ACWDL
14-06; integrated outreach for both.
3) Track data for progress -- in both dual enrollment
and overall participation -- focusing on trend by end
of year, to allow for ACA roll-out and new data
collection.
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ATC Action Steps – State Level
 Tracking the Dual Enrollment Data statewide, quarterly – ATC & All
 Supporting new Integrated Application from Covered CA to
CF/Counties – CHHS Agency proposal coming to California Health
Exchange Board before August 2014 deadline (to build by
December 2015 deadline)
 Promoting on-going Express Lane from CF to MC by counties – ATC
working with DHCS, CDSS, and CWDA to track use
 Advocating for Reverse Express Lane from MC to CF – CDSS
proposal to USDA pending
 Aligning reporting of MC and CF – SB 1002 pending in legislature
(WCLP & CFPA, co-sponsors)
 Advocating for federal & state policy alignment (e.g., verifications,
telephonic signature for CF, interview for CF) – ongoing...
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ATC Toolkit for County Advocates
 Website for all tools: onestophealthnutrition.org
 “The ACA Opportunity for CalFresh” Fact Sheet
 “County Leaders and CalFresh: Three Steps ”
Fact Sheet
 CDSS Data Dashboard Quarterly Updates
 “How to use Dashboard” guide
 Blog with updates
 Links to resources (DHCS’s ACWDL on Express
Lane, SDHC’s Outreach Report)
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County Advocates at Work
 Alameda – Allison Pratt, Alameda County
Community Food Bank
 Los Angeles – Yolie Anguiano & Alexis
Fernandez, California Food Policy Advocates
 San Francisco – Teri Olle, SF-Marin Food Bank
 San Diego – Amanda Schultz, San Diego
Hunger Coalition
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Setting Goals for CalFresh Participation
in Alameda County
 Strong desire among leadership at Social
Services Agency and political support
 SSA is making dual enrollment a priority
 Linking with current initiatives to generate
excitement and support for new goals
– County Supervisor Wilma Chan’s “New War on
Poverty”
• Workgroup includes community organizations and SSA
leadership
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Pursuing an In-reach Strategy
in Alameda County
 Food Bank has 11 year history of applying varied
outreach strategies
 For our in-reach strategy, we partnered with SSA
to design and send a mailer to 58,000
households receiving MediCal, but not CalFresh
– 4% return, double the normal benchmark for success
– High number of applications with 90% approval rate
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Looking Ahead...
In Alameda County
 More in-reach; we’ve found this strategy to be
very cost-effective compared to our other large
campaigns.
– Current campaign includes 80,000 MediCal
households and 10,000 households ageing out of
WIC
• Mailing will be dropped in batches to control flow
 Other way to reach this population include
mapping and focusing on certain
neighborhoods, residences and businesses.
 Can we send a simplified application instead?
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Coalition of Advocates Identified
Priority Strategies to Increase Dual
Enrollment in Los Angeles County
Nutrition for LA Families Coalition’s
Priorities for Dual Enrollment:
 “In-reach” to programs with similar
eligibility requirements
 Improve the electronic referral process
from CalHEERs (Covered California)
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In-reach in LA County
DPSS electronic data
management system identifies
residents that are likely
CalFresh based on income
information provided for other
programs
For example, Medi-Cal only
households with no share-ofcost
CalFresh solicitation Letter sent
to inform them of potential
CalFresh eligibility
Letter highlights potential
CalFresh benefit amount
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Referrals from Covered CA
for CalFresh to LA County
DPSS Current Process
 Send informative CalFresh mailer to those
individuals who requested a referral to CalFresh
 Mailer highlights CalFresh enrollment options (e.g.
online)
Advocates’ Request
 DPSS seamlessly initiates a pre-populated
application for CalFresh and sends to individuals
who requested referral to CalFresh
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Ongoing Advocacy
in LA County
 As county continues to promote health care
enrollment, keep DPSS engaged in
implementing additional in-reach strategies &
solidifying a process for CalFresh referrals.
 Start a dialogue with the Board of Supervisors to
gain support for increased CalFresh participation
and maximized dual enrollment.
Questions? Contact
Yolie Anguiano at 213.482.8200 ext. 202 or yolanda@cfpa.net
Alexis Fernandez at 510.433.1122 ext. 111 or alexis@cfpa.net
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New Strategy
in San Francisco County
Outbound recruitment of targeted individuals
“Reach out to individual people instead of waiting for them to
come to us.”
Target:
 Medi-Cal
–9,000 clients under 130% FPL and not on CalFresh
Free School Meals:
–11,000 students on Free School Meals are not enrolled in CalFresh but
are eligible
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Current Budget Prospects
in San Francisco County
Mayor’s proposed $2.1 million for FY 14-15 Mayor’s
Budget
(+ FY13-14 approved supplemental budget)
will fund:
 Two Outreach Teams of Eligibility Workers
– Focus
on Medi-Cal recipients, school children, and community-based
enrollment (such as successful “CalFresh in a Day”)
– First dedicated outreach staff in a decade
– Each team = 8 EWs and 1 supervisor
Food Security Task Force’s requested $195 thousand in
“Add Backs” would fund:
 CBO Outreach and Application Assistance at
community venues and to targeted individuals
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Advocate Priorities
in San Diego County
 Implementation of AB 191: San Diego County
HHSA proactively created work-arounds to
implement AB191, raising the gross income test to
200% FPL for households with Medi-Cal recipients
(note new state budget now broadens to all at 200%
FPL)
 Express Lane Enrollment: San Diego County
HHSA is working to ensure that Express Lane
Enrollment is being implemented, maximizing dual
enrollment in CalFresh and Medi-Cal. HHSA is
currently in the process of updating county program
guide materials and will be providing continued staff
training opportunities.
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Links
 One Stop for Health & Nutrition Toolkit
www.onestophealthnutrition.org
 CDSS Data Dashboard for CalFresh
http://www.cdsscounties.ca.gov/foodstamps
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Contacts
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Kim McCoy Wade kim@mccoywade.org
Allison Pratt apratt@accfb.org
Yolie Anguiano yolanda@cfpa.net
Alexis Fernandez alexis@cfpa.net
Teri Olle tolle@sfmfoodbank.org
Amanda Schultz amanda@hungeraction.net
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Coming Soon...
More ATC Webinars & Toolkits on
Key Strategies to
Transform CalFresh Participation
 #2: Reducing “Churn” by Eligible People
 #3: Providing Same Day Service
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Q&A
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The Alliance would like to thank its
funders:
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