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Sharing of Meal Applications For Medi-Cal


Nutrition Services Division

To: National School Lunch Program Sponsors, Public School Districts, County Superintendents of Schools

Number: 03-115

Attention: District Superintendents, Food Service Directors, District Child Development Center Directors, School Health Administrators

Date: July 2003

Subject: Optional Sharing of National Lunch Program Meal Applications For Medi-Cal Purposes

Reference: Assembly Bill 59, Chapter 894, Statutes of 2001:Health programs: eligibility; California Education Code Sections 49557, 49558

This Management Bulletin provides information regarding the implementation of Assembly Bill (AB) 59 (Chapter 894, Statutes of 2001), which amended California Education Code (EC) Sections 49557, 49557.2, and 49558. Effective July 1, 2003, school districts and county superintendents of schools may voluntarily implement a process to share a child’s National School Lunch Program (NSLP) Application for Free and Reduced Price Meals with the Medi-Cal program.

AB 59 permits families to apply for Medi-Cal benefits for their children approved for free meals by providing optional information and parental consent on the NSLP application. Under a process called Express Enrollment, authorized by AB 59 and developed by the California Department of Health Services (CDHS), the NSLP application can be used by school districts and county offices of education (COE) to certify a child temporarily eligible for Medi-Cal until the county Medi-Cal office makes a full eligibility determination.

A school district/COE that wishes to share information on a child’s NSLP application with Medi-Cal and participate in Express Enrollment must first contact the county Medi-Cal office to begin collaboration, enter into a Memorandum of Understanding (MOU) with the county Medi-Cal office, and modify its NSLP application.

Pilot Districts

The California Endowment (TCE) awarded two-year funding grants totaling $1.6 million to pilot Express Enrollment at certain schools in Fresno Unified, Los Angeles Unified, Redwood City and San Diego Unified School Districts. The districts were chosen by TCE through a commissioned proposal process based on their stated interest, geographic location, and history with health insurance outreach and enrollment efforts. The districts will implement Express Enrollment in the 2003/04 and 2004/05 school years, using the TCE funds to revise the National School Lunch Program application, process the applications for Express Enrollment, educate parents and school personnel about Express Enrollment, and develop an evaluation mechanism.

Express Enrollment is also being pilot tested in the Alum Rock Union Elementary School District in Santa Clara County through a partnership of Consumers Union and The David and Lucile Packard Foundation. No state funding is being provided to the pilot sites.

TCE has also funded The Children’s Partnership to provide assistance, materials development, and training to Express Enrollment sites. We encourage you to visit The Children's Partnership Web site at http://www.childrenspartnership.org/.

For additional information and to follow the pilot districts’ experiences and progress. The Children’s Partnership is also maintaining a list of districts interested in implementing Express Enrollment in the 2004-05 school year. Interested districts should send an email to frontdoor@childrenspartnership.org.

Confidentiality

The United States Department of Agriculture regulations and California Education Code Section 49558 govern the confidentiality of information that households provide when applying for free and reduced-priced meals. AB 59 amended EC Section 49557.2 to permit schools to release information provided on an NSLP application approved for free meals only if the parent/guardian consents to release of the information. If consent is given, per EC section 49557.2(a)(1)(B), a district can release the NSLP application only to the entity responsible for making the temporary eligibility determination under Express Enrollment and to the county Medi-Cal office. As authorized by AB 59, CDHS has designated school districts/COEs participating in the NSLP responsible for determining children’s temporary Medi-Cal eligibility. Participating districts/COEs will designate personnel or contractors to perform these activities.

Confidentiality protections include:

Memorandum of Understanding

A district/COE choosing to implement Express Enrollment must work collaboratively and enter into a MOU with its county Medi-Cal office. The MOU should set forth the roles and responsibilities of each agency and specify the information-sharing process. A district should follow its usual protocol for obtaining MOU approvals.

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Changes to National School Lunch Application

The California Department of Education (CDE), in coordination with CDHS, developed a revised Application for Free and Reduced Price Meals for the 2003-2004 School Year and Letter to Households About the National School Lunch Program for 2003-2004 for the pilot districts to use during the test year. The revised application allows the parent/guardian of a child eligible for free school meals to provide consent for the district to share the NSLP application with district staff designated to undertake Express Enrollment and the local Medi-Cal office. The revised letter to households provides additional information about confidentiality and the option to apply for Medi-Cal benefits.

To facilitate AB 59 implementation, the revised Application for Free and Reduced Price Meals also requests the following additional information:

  1. Child’s date of birth;
  2. Relationship of each household member to the child; and
  3. Request for income and household size information for categorically eligible children.

The above information is optional for school meal benefits, but is required for Medi-Cal purposes. A district may use CDE’s prototype NSLP application and letter or may develop its own. If the district develops it own forms, CDE will review and approve them prior to implementation of Express Enrollment.

CDE cautions school districts/COEs that the primary purpose of the school lunch program is to provide free and reduced-priced meals to all eligible students, and the application should not act to deter participation in the NSLP.

Maintenance of Parental Consent Forms

Schools do not need to retain the parental consent form in the students’ files. AB 59 amended EC Section 49075 to permit districts/COEs that share information on the NSLP application to maintain the parental consent (whether it is part of the application itself or located in a separate document) “in the manner most useful to the administration of the school lunch program.” School districts do not need to change the way they maintain NSLP applications; they need only retain the parents’ written consent for releasing information to Medi-Cal with the NSLP application.

Funding

State funding has not been provided to support this information-sharing program. Districts interested in implementing this program will want to explore other available funding options. Possible sources of funding include foundation grants, Proposition 10 Commissions, and Medi-Cal Administrative Activities federal funding. Cafeteria funds are not available for this effort, as they can be used only for activities to directly support school meal programs.

Implementation for 2004-05 School Year

During the 2003-04 school year, the pilot districts will provide information about how Express Enrollment worked, improvements needed, and changes required to streamline the process. CDE will use their input to develop guidance and prototype forms for the 2004-05 school year. If you have an interest in Express Enrollment, it will be important to contact your county as soon as possible for planning information.

Additional Information

Visit The Children's Partnership Web site at http://www.childrenspartnership.org/our-work/family-friendly-enrollment/express-lane-eligibility or, for more information about ELE in California, contact Jenny Catlove, Health Policy Manager, The Children's Partnership, at jkattlove@childrenspartnership.org or 310-270-7167.

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Questions:   School Nutrition Programs Unit | 800-952-5609
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