BILL NUMBER: AB 925 CHAPTERED
BILL TEXT
CHAPTER 1088
FILED WITH SECRETARY OF STATE SEPTEMBER 29, 2002
APPROVED BY GOVERNOR SEPTEMBER 29, 2002
PASSED THE SENATE AUGUST 30, 2002
PASSED THE ASSEMBLY AUGUST 30, 2002
AMENDED IN SENATE AUGUST 29, 2002
AMENDED IN SENATE AUGUST 26, 2002
AMENDED IN SENATE AUGUST 19, 2002
AMENDED IN SENATE JUNE 29, 2002
AMENDED IN SENATE JUNE 28, 2001
AMENDED IN ASSEMBLY JUNE 4, 2001
AMENDED IN ASSEMBLY APRIL 23, 2001
AMENDED IN ASSEMBLY APRIL 3, 2001
INTRODUCED BY Assembly Member Aroner
(Coauthors: Assembly Members Havice, Negrete McLeod, Pavley, and
Strom-Martin)
(Coauthors: Senators Romero and Vasconcellos)
FEBRUARY 23, 2001
An act to add Sections 12803.6, 12803.65, and 12803.7 to the
Government Code, to add Division 10 (commencing with Section 18000)
to the Unemployment Insurance Code, and to amend Sections 12300 and
14132.95 of, and to add Sections 14007.95 and 14132.955 to, the
Welfare and Institutions Code, relating to disabilities.
LEGISLATIVE COUNSEL'S DIGEST
AB 925, Aroner. Employment of persons with disabilities.
Existing law contains various programs to assist persons with
disabilities to obtain employment.
This bill would require the California Health and Human Services
Agency and the Labor and Workforce Development Agency, using existing
resources, to create a sustainable, comprehensive strategy to
accomplish various goals aimed at bringing persons with disabilities
into employment.
The bill would require the Governor to rename and authorize the
existing California Governor's Committee on Employment of Disabled
Persons, as the "California Governor's Committee on Employment of
People with Disabilities," would require the committee to be
established in the Labor and Workforce Development Agency, and would
specify the membership and duties of the committee.
The bill would also require the committee, to the extent that
funds are available, to make grants to counties and local workforce
investment boards in order to develop local strategies for enhancing
employment opportunities for people with disabilities, and to fund
comprehensive local and regional benefits planning and outreach
programs to assist persons with disabilities in removing barriers to
work.
Existing law contains various programs for job training and
employment investment. Among other things, provisions are made for
local workforce investment boards. In addition, a State Workforce
Investment Board has been established in accordance with federal law.
This bill would require each local workforce investment board to
establish at least one comprehensive one-stop career center and would
impose various requirements related to ensuring that those one-stop
centers provide universal access to services pursuant to the federal
Workforce Investment Act of 1998 for persons with disabilities.
The bill would also require that, if permitted by federal law, the
California Workforce Investment Board and local workforce investment
boards include persons with disabilities.
Existing law provides for the Medi-Cal program, administered by
the State Department of Health Services, under which qualified
low-income persons are provided with health care services.
Existing law specifies procedures under which personal care
services meeting certain conditions, when provided to a categorically
needy person, as defined, are a covered Medi-Cal benefit to the
extent federal financial participation is available. Under existing
law, these provisions become inoperative on July 1, 2002, and as of
January 1, 2003, are repealed.
This bill would require these personal care services to include
services in the recipient's place of employment, under specified
conditions. By expanding the scope of personal care services, the
bill would create a state-mandated local program. The bill would
also delete the inoperative and repeal dates described above, thereby
making these Medi-Cal benefit coverage provisions operative on and
after January 1, 2003.
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, including the creation of a State Mandates Claims Fund
to pay the costs of mandates that do not exceed $1,000,000 statewide
and other procedures for claims whose statewide costs exceed
$1,000,000.
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 these
statutory provisions.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature finds and declares all of the
following:
(a) Historically, federal programs for adults with disabilities
have encouraged dependency on income supports and have created
barriers to employment and economic self-sufficiency. Even in strong
economic times, adults with disabilities have had limited options
and faced major barriers to achieve economic self-sufficiency,
resulting in prolonged reliance upon public assistance programs and
an unacceptably high unemployment rates statewide.
(b) Federal laws enacted during the 1990's offered significant
public policies and fiscal incentives designed to assist states to
restructure workforce development programs into integrated workforce
investment systems that will respond to the employment, training, and
education needs of its citizens.
(c) Since 1998, employment-focused reforms for adults with
disabilities in the workforce have been enacted into Medicare,
medicaid, the Supplemental Security Income Program (SSI), the Social
Security Disability Insurance Program (SSDI), and with respect to
programs administered by the United States Department of Labor, and
the United States Department of Education.
(d) The federal Workforce Investment Act of 1998 (WIA), (Public
Law 105-220) redesigned major federal public employment programs, and
included a requirement that services for employers and employees be
centered in accessible, community-based one-stop centers.
(e) The federal Ticket to Work and Work Incentives Improvement Act
of 1999, (Public Law 106-170) increased opportunities for states to
remove and minimize barriers to employment for people with
disabilities by improving access to health care coverage available
under Medicare and medicaid.
(f) Beginning February 1, 2002, the Social Security Ticket to Work
program (TTW) began a state-by-state phase in period nationally,
allowing SSI and SSDI beneficiaries to receive a "ticket" from the
Social Security Administration that can be assigned for employment
services to a wider pool of rehabilitation, employment, or other
employment support service providers. The Ticket to Work program
(TTW) is scheduled for implementation in California in July 2003.
(g) The programs and consumer options provided under Public Law
106-170 are based upon public policies that respect the rights of
consumers to control decisions related to health care,
rehabilitation, and employment within the framework of independent
living principles and guidelines that include, but are not limited
to, providing consumers of these services with an array of choices to
promote independence and financial stability.
(h) California took a significant step forward in removing
barriers to work for Californians with disabilities when it enacted
Chapter 820 of the Statutes of 1999 (Assembly Bill 155, introduced by
Assembly Member Migden, which has been referred to as the "250%
California Working Disabled Program" or "CWD") under which any
employed individual who is disabled and whose countable income, as
determined pursuant to Section 14007.9 of the Welfare and
Institutions Code, does not exceed 250 percent of the federal poverty
level shall be eligible for Medi-Cal benefits, subject to the
payment of sliding-scale premiums set by the State Department of
Health Services. Two years after its implementation, CWD program
enrollment is just above 500, which is significantly below budgeted
projections.
(i) California received a "Medicaid Infrastructure Grant" (MIG)
that is expected to continue for a second year, and that allows the
State Department of Health Services to administer the California
Health Incentive Improvement Project with the assistance of a project
steering committee in order to bolster the state's efforts to
conduct outreach, research, and analysis related to the
implementation of Chapter 820 of the Statutes of 1999.
(j) California will have the opportunity to coordinate its
activities with privately funded initiatives to identify potential
cost savings that could be achieved if California adopted additional
policies available to the state through the federal Balanced Budget
Act of 1997 and the Ticket to Work and Work Incentives Improvement
Act, including, but not limited to, raising the income standard,
changing rules related to disregarding or exempting resources,
providing adjustments to the amount of premiums paid on a sliding
scale, including adjustments based on the amount paid for other
health insurance, and providing an allowance for coverage for up to
18 months in the case of loss of employment.
(k) The California Governor's Committee on Employment of Disabled
Persons, through its staff and volunteers, promotes in the private
and public sectors understanding and information on employment
supports and benefits for people with disabilities who transition
from benefits as the sole source of income to gainful employment.
SEC. 2. Section 12803.6 is added to the Government Code, to read:
12803.6. (a) The Governor shall authorize the secretary of the
Labor and Workforce Development Agency, in collaboration with the
secretary of the California Health and Human Services Agency, to make
available the expertise of state employees and programs to support
the employment-related needs of individuals with disabilities. Using
existing resources, the agencies shall develop a sustainable,
comprehensive strategy to do all of the following:
(1) Bring adults with disabilities into gainful employment at a
rate that is as close as possible to that of the general adult
population.
(2) Support the goals of equality of opportunity, full
participation, independent living, and economic self-sufficiency for
these individuals.
(3) Ensure that state government is a model employer of
individuals with disabilities.
(4) Support state coordination with, and participation in,
benefits planning training and information dissemination projects
supported by private foundations and federal grants.
(b) (1) The Labor and Workforce Development Agency shall monitor
and enforce implementation of Section 188 of the federal Workforce
Investment Act of 1998 (29 U.S.C. Sec. 2938), and shall require local
workforce investment boards to report as follows:
(A) By July 1, 2003, each local workforce investment board shall
report to the Labor and Workforce Development Agency or its
designated department on the steps it has taken to ensure compliance
with Section 188 of the federal Workforce Investment Act of 1998 (29
U.S.C. Sec. 2938), in regard to the provisions as they apply to
persons with disabilities.
(B) By October 31, 2003, each local workforce investment board
that chooses to participate in the federal Ticket to Work and
Self-Sufficiency program shall report to the California Workforce
Investment Board on its readiness to meet the eligibility standards
to serve as an employment network under the federal Ticket to Work
and Self-Sufficiency program (Section 1148(f), Part A, Title XI of
the Social Security Act, 42 U.S.C. Section 1320b-19).
(2) The Labor and Workforce Development Agency shall report its
findings, based on the reports described in subparagraph (A) of
paragraph (1), to the Governor and the Legislature.
SEC. 3. Section 12803.65 is added to the Government Code, to read:
12803.65. (a) The Governor shall rename and establish, in the
Labor and Workforce Development Agency, the existing California
Governor's Committee on Employment of Disabled Persons as the
"California Governor's Committee on Employment of People with
Disabilities" or "CGCEPD."
(b) (1) The California Governor's Committee on Employment of
People with Disabilities shall include, but not be limited to, the
following:
(A) Four individuals with disabilities representing disabled
persons, two appointed by the Governor and one each appointed by the
Senate Committee on Rules and the Speaker of the Assembly, each for a
three-year term.
(B) The Directors of the Employment Development Department, State
Department of Health Services, State Department of Mental Health,
State Department of Developmental Services, State Department of
Social Services, and Department of Rehabilitation, and the Chair of
the State Independent Living Council.
(C) Representatives from the State Department of Health Services'
California Health Incentive Improvement Project.
(D) A representative from the California Workforce Investment
Board.
(E) Representatives from any other department or program that may
have a role in increasing the capacity of state programs to support
the employment-related needs of individuals with disabilities.
(F) A representative from a local one-stop or local workforce
investment board, to be appointed by the Governor.
(G) A business representative with experience in employing persons
with disabilities, to be appointed by the Governor.
(2) The members of the California Governor's Committee on
Employment of People with Disabilities shall select a chair from
among the members, and shall hold open meetings no less than
quarterly.
(c) The California Governor's Committee on Employment of People
with Disabilities shall consult with and advise the Labor and
Workforce Development Agency and the California Health and Human
Services Agency on all issues related to full inclusion in the
workforce of persons with disabilities, including development of the
comprehensive strategy required pursuant to Section 12803.6 and
implementation of the grant program established pursuant to Section
12803.7.
(d) The California Governor's Committee on Employment of People
with Disabilities shall also:
(1) Coordinate and provide leadership, as necessary, with regard
to efforts to increase inclusion in the workforce of persons with
disabilities.
(2) Report annually to the Legislature and the Governor on the
employment status of Californians with disabilities.
(e) The California Governor's Committee on Employment of People
with Disabilities shall provide support to the State Workforce
Investment Board and the local one-stop centers in their efforts to
achieve full compliance with Sections 18002, 18004, 18006, and 18008
of the Unemployment Insurance Code, and shall identify the extent to
which any one-stops are not in full compliance with those sections
and the reasons for the lack of compliance, including the need for
additional resources.
(f) The California Governor's Committee on Employment of People
with Disabilities shall meet quarterly with the California Health
Incentive Improvement Project, administered by the State Department
of Health Services, and the project's steering committee, to the
extent funding for the project continues and the activities of the
California Governor's Committee on Employment of People with
Disabilities are not inconsistent with the charge of the California
Health Incentive Improvement Project.
(g) Using existing funding, the California Governor's Committee on
Employment of People with Disabilities shall facilitate, promote,
and coordinate collaborative dissemination of information on
employment supports and benefits, which shall include the Ticket to
Work program and health benefits, to individuals with disabilities,
consumers of public services, employers, service providers, and state
and local agency staff.
(h) Using existing funding, the California Governor's Committee on
Employment of People with Disabilities shall receive primary
administrative and staff support from the State Employment
Development Department.
SEC. 4. Section 12803.7 is added to the Government Code, to read:
12803.7. The California Governor's Committee on Employment of
People with Disabilities, in conjunction with the Department of
Rehabilitation, pursuant to Section 12803.65 and to the extent that
funds are available, shall make grants available to counties and
local workforce investment boards, through collaborative efforts of
public agencies and private organizations, including organizations
that serve people with disabilities, to accomplish both of the
following purposes:
(a) To develop local strategies, including, but not limited to,
regular cross-agency staff training, for enhancing employment
opportunities for individuals with disabilities.
(b) To fund comprehensive local or regional benefits planning and
outreach programs to assist individuals with disabilities in removing
barriers to work.
SEC. 5. Division 10 (commencing with Section 18000) is added to
the Unemployment Insurance Code, to read:
DIVISION 10. EMPLOYMENT ASSISTANCE FOR WORKERS WITH
DISABILITIES
18000. (a) It is the purpose of this division to ensure that
workforce preparation services provided through California's one-stop
centers, including information and services provided electronically,
are accessible to employers and jobseekers with disabilities.
(b) It is further the intent of the Legislature that one-stop
centers provide appropriate services to individuals with disabilities
to enhance their employability.
(c) It is further the intent of the Legislature that, in order to
achieve the goals specified in subdivisions (a) and (b), local
workforce investment boards plan for and report on services to
jobseekers and employers with disabilities, including the
implementation of the federal Ticket to Work program for those local
workforce investment boards and one-stop centers that choose to
implement the Ticket to Work program in their local workforce
investment areas.
18002. Each local workforce investment board shall establish at
least one comprehensive one-stop career center in each local
workforce investment area. These one-stop centers shall ensure
access to services pursuant to Section 134(d) of the federal
Workforce Investment Act of 1998 (29 U.S.C. Sec. 2864(d)), including
services for persons with disabilities, including, but not limited
to, all of the following:
(a) Outreach, intake, and orientation.
(b) Initial assessments of skills, aptitudes, abilities, and need
for support services.
(c) Program eligibility determinations.
(d) Information on the local, regional, and national labor market.
(e) Information on filing for unemployment insurance.
(f) Access to intensive services as needed, including, but not
limited to, comprehensive and specialized assessments of skill levels
and service needs, development of individual employment plans, group
counseling, individual counseling and career planning, case
management for participants seeking training services under
subdivision (g), and short-term prevocational services, such as
learning, communication, interview, and other jobseeking and work
related skills to help prepare individuals for unsubsidized
employment and training.
(g) Training services, including, but not limited to, occupational
skills training, on-the-job training, workplace training and
cooperative education programs, private sector training programs,
skills upgrade and retraining, entrepreneurial training, job
readiness training, adult education, and literacy activities combined
with training, and customized training.
18004. The local workforce investment boards shall schedule and
conduct regular performance reviews of their one-stop centers to
determine whether the centers and providers are providing effective
and meaningful opportunities for persons with disabilities to
participate in the programs and activities of the centers and
providers.
18006. One-stop center counselor staff shall provide accurate
information to beneficiaries of Supplemental Security Income and the
State Supplemental Program and Social Security Disability Insurance
on the implications of work for these individuals. The information
shall include, but not be limited to, referrals to appropriate
benefits' planners. One-stop center counselor staff shall also
provide accurate information to individuals with disabilities on how
they may gain access to Medi-Cal benefits pursuant to Section 14007.9
of the Welfare and Institutions Code.
18008. In order to ensure that one-stop career centers operated
by local workforce investment boards meet the needs of workers and
employers with disabilities, the Governor shall ensure that
evaluations conducted pursuant to Sections 134 (a)(2)(B)(ii) and (v)
of the federal Workforce Investment Act of 1998 (29 U.S.C. Sec. 2864
(a)(2)(B)(ii) and (v)), address how local one-stop centers provide
all of the following:
(a) Full access to workforce development services for their
disabled community.
(b) Assistive technology to ensure access to services.
(c) Staff training on assessment and service strategies for
jobseekers and employers with disabilities.
(d) Representation of the disability community in program planning
and service delivery.
(e) The development of regional employment networks to participate
in the federal Ticket to Work program and the role of the local
board and one-stop centers in the Ticket to Work program.
18010. The California Workforce Investment Board shall report to
the Governor and the Legislature by September 30, 2004, on the status
of one-stop services to individuals with disabilities and
implementation of the federal Ticket to Work program in California.
18012. If permitted by federal law, the California Workforce
Investment Board and local workforce investment boards shall include
persons with disabilities or their representatives, with a particular
effort to include such persons who are not employees of state or
local government.
SEC. 6. Section 12300 of the Welfare and Institutions Code is
amended to read:
12300. (a) The purpose of this article is to provide in every
county in a manner consistent with this chapter and the annual Budget
Act those supportive services identified in this section to aged,
blind, or disabled persons, as defined under this chapter, who are
unable to perform the services themselves and who cannot safely
remain in their homes or abodes of their own choosing unless these
services are provided.
(b) Supportive services shall include domestic services and
services related to domestic services, heavy cleaning, personal care
services, accompaniment by a provider when needed during necessary
travel to health-related appointments or to alternative resource
sites, yard hazard abatement, protective supervision, teaching and
demonstration directed at reducing the need for other supportive
services, and paramedical services which make it possible for the
recipient to establish and maintain an independent living
arrangement.
(c) Personal care services shall mean all of the following:
(1) Assistance with ambulation.
(2) Bathing, oral hygiene, and grooming.
(3) Dressing.
(4) Care and assistance with prosthetic devices.
(5) Bowel, bladder, and menstrual care.
(6) Repositioning, skin care, range of motion exercises, and
transfers.
(7) Feeding and assurance of adequate fluid intake.
(8) Respiration.
(9) Assistance with self-administration of medications.
(d) Personal care services are available if these services are
provided in the beneficiary's home and other locations as may be
authorized by the director. Among the locations that may be
authorized by the director under this paragraph is the recipient's
place of employment if all of the following conditions are met:
(1) The personal care services are limited to those that are
currently authorized for a recipient in the recipient's home and
those services are to be utilized by the recipient at the recipient's
place of employment to enable the recipient to obtain, retain, or
return to work. Authorized services utilized by the recipient at the
recipient's place of employment shall be services that are relevant
and necessary in supporting and maintaining employment. However,
workplace services shall not be used to supplant any reasonable
accommodations required of an employer by the Americans with
Disabilities Act (42 U.S.C. Sec. 12101 et seq.; ADA) or other legal
entitlements or third-party obligations.
(2) The provision of personal care services at the recipient's
place of employment shall be authorized only to the extent that the
total hours utilized at the workplace are within the total personal
care services hours authorized for the recipient in the home.
Additional personal care services hours may not be authorized in
connection with a recipient's employment.
(e) Where supportive services are provided by a person having the
legal duty pursuant to the Family Code to provide for the care of his
or her child who is the recipient, the provider of supportive
services shall receive remuneration for the services only when the
provider leaves full-time employment or is prevented from obtaining
full-time employment because no other suitable provider is available
and where the inability of the provider to provide supportive
services may result in inappropriate placement or inadequate care.
These providers shall be paid only for the following:
(1) Services related to domestic services.
(2) Personal care services.
(3) Accompaniment by a provider when needed during necessary
travel to health-related appointments or to alternative resource
sites.
(4) Protective supervision only as needed because of the
functional limitations of the child.
(5) Paramedical services.
(f) To encourage maximum voluntary services, so as to reduce
governmental costs, respite care shall also be provided. Respite
care is temporary or periodic service for eligible recipients to
relieve persons who are providing care without compensation.
(g) A person who is eligible to receive a personal care service or
an ancillary service provided pursuant to Section 14132.95 shall not
be eligible to receive that same service pursuant to this article.
(h) (1) All services provided pursuant to this article shall be
equal in amount, scope, and duration to the same services provided
pursuant to Section 14132.95, including any adjustments that may be
made to those services pursuant to subdivision (e) of Section
14132.95.
(2) Notwithstanding any other provision of this article, the rate
of reimbursement for in-home supportive services provided through any
mode of service shall not exceed the rate of reimbursement
established under subdivision (j) of Section 14132.95 for the same
mode of service unless otherwise provided in the annual Budget Act.
(3) Any recipient receiving services under both Section 14132.95
and this article shall receive no more than 283 hours of service per
month, combined, and any recipient of services under this article
shall receive no more than the applicable maximum specified in
Section 12303.4.
SEC. 7. Section 14007.95 is added to the Welfare and Institutions
Code, to read:
14007.95. The department shall report to the Governor and the
Legislature any information the department gathers from the
California Health Improvement Project, or from any other public or
private sources, that may explain the low participation rates in the
optional program provided pursuant to Section 14007.9 and any
recommendations from the department on actions the state may take to
increase participation by eligible persons in a manner that is cost
effective for the state and beneficial for the participants.
SEC. 8. Section 14132.95 of the Welfare and Institutions Code is
amended to read:
SEC. 8. Section 14132.95 of the Welfare and Institutions Code is
amended to read:
14132.95. (a) Personal care services, when provided to a
categorically needy person as defined in Section 14050.1 is a covered
benefit to the extent federal financial participation is available
if these services are:
(1) Provided in the beneficiary's home and other locations as may
be authorized by the director subject to federal approval.
(2) Authorized by county social services staff in accordance with
a plan of treatment.
(3) Provided by a qualified person.
(4) Provided to a beneficiary who has a chronic, disabling
condition that causes functional impairment that is expected to last
at least 12 consecutive months or that is expected to result in death
within 12 months and who is unable to remain safely at home without
the services described in this section.
(b) The department shall seek federal approval of a state plan
amendment necessary to include personal care as a medicaid service
pursuant to subdivision (f) of Section 440.170 of Title 42 of the
Code of Federal Regulations. For any persons who meet the criteria
specified in subdivision (a) or (p), but for whom federal financial
participation is not available, eligibility shall be available
pursuant to Article 7 (commencing with Section 12300) of Chapter 3,
if otherwise eligible.
(c) Subdivision (a) shall not be implemented unless the department
has obtained federal approval of the state plan amendment described
in subdivision (b), and the Department of Finance has determined, and
has informed the department in writing, that the implementation of
this section will not result in additional costs to the state
relative to state appropriation for in-home supportive services under
Article 7 (commencing with Section 12300) of Chapter 3, in the
1992-93 fiscal year.
(d) (1) For purposes of this section, personal care services shall
mean all of the following:
(A) Assistance with ambulation.
(B) Bathing, oral hygiene and grooming.
(C) Dressing.
(D) Care and assistance with prosthetic devices.
(E) Bowel, bladder, and menstrual care.
(F) Skin care.
(G) Repositioning, range of motion exercises, and transfers.
(H) Feeding and assurance of adequate fluid intake.
(I) Respiration.
(J) Paramedical services.
(K) Assistance with self-administration of medications.
(2) Ancillary services including meal preparation and cleanup,
routine laundry, shopping for food and other necessities, and
domestic services may also be provided as long as these ancillary
services are subordinate to personal care services. Ancillary
services may not be provided separately from the basic personal care
services.
(e) (1) (A) After consulting with the State Department of Social
Services, the department shall adopt emergency regulations to
establish the amount, scope, and duration of personal care services
available to persons described in subdivision (a) in the fiscal year
whenever the department determines that General Fund expenditures for
personal care services provided under this section and expenditures
of both General Fund moneys and federal funds received under Title XX
of the federal Social Security Act for services pursuant to Article
7 (commencing with Section 12300) of
Chapter 3, are expected to exceed the General Fund
appropriation and the federal appropriation under Title XX of the
federal Social Security Act provided for the 1992-93 fiscal year
pursuant to Article 7 (commencing with Section 12300) of Chapter 3,
as it read on June 30, 1992, as adjusted for caseload growth or as
increased in the Budget Act or appropriated by statute. At least 30
days prior to filing these regulations with the Secretary of State,
the department shall give notice of the expected content of these
regulations to the fiscal committees of both houses of the
Legislature.
(B) In establishing the amount, scope, and duration of personal
care services, the department shall ensure that General Fund
expenditures for personal care services provided for under this
section and expenditures of both General Fund moneys and federal
funds received under Title XX of the federal Social Security Act for
services pursuant to Article 7 (commencing with Section 12300) of
Chapter 3, do not exceed the General Fund appropriation and the
federal appropriation under Title XX of the federal Social Security
Act provided for the 1992-93 fiscal year pursuant to Article 7
(commencing with Section 12300) of Chapter 3, as it read on June 30,
1992, as adjusted for caseload growth or as increased in the Budget
Act or appropriated by statute.
(C) For purposes of this subdivision, "caseload growth" means an
adjustment factor determined by the department based on (1) growth in
the number of persons eligible for benefits under Chapter 3
(commencing with Section 12000) on the basis of their disability, (2)
the average increase in the number of hours in the program
established pursuant to Article 7 (commencing with Section 12300) of
Chapter 3 in the 1988-89 to 1992-93 fiscal years, inclusive, due to
the level of impairment, and (3) any increase in program costs that
is required by an increase in the mandatory minimum wage.
(2) In establishing the amount, scope, and duration of personal
care services pursuant to this subdivision, the department may define
and take into account, among other things:
(A) The extent to which the particular personal care services are
essential or nonessential.
(B) Standards establishing the medical necessity of the services
to be provided.
(C) Utilization controls.
(D) A minimum number of hours of personal care services that must
first be assessed as needed as a condition of receiving personal care
services pursuant to this section.
The level of personal care services shall be established so as to
avoid, to the extent feasible within budgetary constraints, medical
out-of-home placements.
(3) To the extent that General Fund expenditures for services
provided under this section and expenditures of both General Fund
moneys and federal funds received under Title XX of the federal
Social Security Act for services pursuant to Article 7 (commencing
with Section 12300) of Chapter 3 in the 1992-93 fiscal year, adjusted
for caseload growth, exceed General Fund expenditures for services
provided under this section and expenditures of both General Fund
moneys and federal funds received under Title XX of the federal
Social Security Act for services pursuant to Article 7 (commencing
with Section 12300) of Chapter 3 in any fiscal year, the excess of
these funds shall be expended for any purpose as directed in the
Budget Act or as otherwise statutorily disbursed by the Legislature.
(f) Services pursuant to this section shall be rendered, under the
administrative direction of the State Department of Social Services,
in the manner authorized in Article 7 (commencing with Section
12300) of Chapter 3, for the In-Home Supportive Services program. A
provider of personal care services shall be qualified to provide the
service and shall be a person other than a member of the family. For
purposes of this section, a family member means a parent of a minor
child or a spouse.
(g) A beneficiary who is eligible for assistance under this
section shall receive services that do not exceed 283 hours per month
of personal care services.
(h) Personal care services shall not be provided to residents of
facilities licensed by the department, and shall not be provided to
residents of a community care facility or a residential care facility
for the elderly licensed by the Community Care Licensing Division of
the State Department of Social Services.
(i) Subject to any limitations that may be imposed pursuant to
subdivision (e), determination of need and authorization for services
shall be performed in accordance with Article 7 (commencing with
Section 12300) of Chapter 3.
(j) (1) To the extent permitted by federal law, reimbursement
rates for personal care services shall be equal to the rates in each
county for the same mode of services in the In-Home Supportive
Services program pursuant to Article 7 (commencing with Section
12300) of Chapter 3, plus any increase provided in the annual Budget
Act for personal care services rates or included in a county budget
pursuant to paragraph (2).
(2) (A) The department shall establish a provider reimbursement
rate methodology to determine payment rates for the individual
provider mode of service that does all of the following:
(i) Is consistent with the functions and duties of entities
created pursuant to Section 12301.6.
(ii) Makes any additional expenditure of state general funds
subject to appropriation in the annual Budget Act.
(iii) Permits county-only funds to draw down federal financial
participation consistent with federal law.
(B) This ratesetting method shall be in effect in time for any
rate increases to be included in the annual Budget Act.
(C) The department may, in establishing the ratesetting method
required by subparagraph (A), do both of the following:
(i) Deem the market rate for like work in each county, as
determined by the Employment Development Department, to be the cap
for increases in payment rates for individual practitioner services.
(ii) Provide for consideration of county input concerning the rate
necessary to ensure access to services in that county.
(D) If an increase in individual practitioner rates is included in
the annual Budget Act, the state-county sharing ratio shall be as
established in Section 12306. If the annual Budget Act does not
include an increase in individual practitioner rates, a county may
use county-only funds to meet federal financial participation
requirements consistent with federal law.
(3) (A) By November 1, 1993, the department shall submit a state
plan amendment to the federal Health Care Financing Administration to
implement this subdivision. To the extent that any element or
requirement of this subdivision is not approved, the department shall
submit a request to the federal Health Care Financing Administration
for any waivers as would be necessary to implement this subdivision.
(B) The provider reimbursement ratesetting methodology authorized
by the amendments to this subdivision in the 1993-94 Regular Session
of the Legislature shall not be operative until all necessary federal
approvals have been obtained.
(k) (1) The State Department of Social Services shall, by
September 1, 1993, notify the following persons that they are
eligible to participate in the personal care services program:
(A) Persons eligible for services pursuant to the Pickle
Amendment, as adopted October 28, 1976.
(B) Persons eligible for services pursuant to subsection (c) of
Section 1383c of Title 42 of the United States Code.
(2) The State Department of Social Services shall, by September 1,
1993, notify persons to whom paragraph (1) applies and who receive
advance payment for in-home supportive services that they will
qualify for services under this section without a share of cost if
they elect to accept payment for services on an arrears rather than
an advance payment basis.
(l) An individual who is eligible for services subject to the
maximum amount specified in subdivision (b) of Section 12303.4 shall
be given the option of hiring his or her own provider.
(m) The county welfare department shall inform in writing any
individual who is potentially eligible for services under this
section of his or her right to the services.
(n) It is the intent of the Legislature that this entire section
be an inseparable whole and that no part of it be severable. If any
portion of this section is found to be invalid, as determined by a
final judgment of a court of competent jurisdiction, this section
shall become inoperative.
(o) Paragraphs (2) and (3) of subdivision (a) shall be implemented
so as to conform to federal law authorizing their implementation.
(p) (1) Personal care services shall be provided as a covered
benefit to a medically needy aged, blind, or disabled person, as
defined in subdivision (a) of Section 14051, to the same extent and
under the same requirements as they are provided under subdivision
(a) of this section to a categorically needy, aged, blind, or
disabled person, as defined in subdivision (a) of Section 14050.1,
and to the extent that federal financial participation is available.
(2) The department shall seek federal approval of a state plan
amendment necessary to include personal care services described in
paragraph (1) as a medicaid service pursuant to subdivision (f) of
Section 440.170 of Title 42 of the Code of Federal Regulations.
(3) In the event that the Department of Finance determines that
expenditures of both General Fund moneys for personal care services
provided under this subdivision to medically needy aged, blind, or
disabled persons together with expenditures of both General Fund
moneys and federal funds received under Title XX of the federal
Social Security Act for all aged, blind, and disabled persons
receiving in-home supportive services pursuant to Article 7
(commencing with Section 12300) of Chapter 3, in the 2000-01 fiscal
year or in any subsequent fiscal year, are expected to exceed the
General Fund appropriation and the federal appropriation received
under Title XX of the federal Social Security Act for expenditures
for all aged, blind, and disabled persons receiving in-home
supportive services provided in the 1999-2000 fiscal year pursuant to
Article 7 (commencing with Section 12300) of Chapter 3, as it read
on June 30, 1998, as adjusted for caseload growth or as changed in
the Budget Act or by statute or regulation, then this subdivision
shall cease to be operative on the first day of the month that begins
after the expiration of a period of 30 days subsequent to a
notification in writing by the Director of the Department of Finance
to the chairperson of the committee in each house that considers
appropriations, the chairpersons of the committees and the
appropriate subcommittees in each house that consider the State
Budget, and the Chairperson of the Joint Legislative Budget
Committee.
(4) Solely for purposes of paragraph (3), caseload growth means an
adjustment factor determined by the department based on:
(A) Growth in the number of persons eligible for benefits under
Chapter 3 (commencing with Section 12000) on the basis of their
disability.
(B) The average increase in the number of hours in the program
established pursuant to Article 7 (commencing with Section 12300) of
Chapter 3 in the 1994-95 to 1998-99 fiscal years, inclusive, due to
the level of impairment.
(C) Any increase in program cost that is required by an increase
in hourly costs pursuant to the Budget Act or statute.
(5) In the event of a final judicial determination by any court of
appellate jurisdiction or a final determination by the Administrator
of the federal Centers for Medicare and Medicaid Services that
personal care services must be provided to any medically needy person
who is not aged, blind, or disabled, then this subdivision shall
cease to be operative on the first day of the first month that begins
after the expiration of a period of 30 days subsequent to a
notification in writing by the Director of Finance to the chairperson
of the committee in each house that considers appropriations, the
chairpersons of the committees and the appropriate subcommittees in
each house that consider the State Budget, and the Chairperson of the
Joint Legislative Budget Committee.
(6) If this subdivision ceases to be operative, all aged, blind,
and disabled persons who would have received or been eligible to
receive in-home supportive services pursuant to Article 7 (commencing
with Section 12300) of Chapter 3, but for receiving services under
this subdivision, shall be eligible immediately upon this section
becoming inoperative for services pursuant to Article 7 (commencing
with Section 12300) of Chapter 3.
(7) The department shall implement this subdivision on April 1,
1999, but only if the department has obtained federal approval of the
state plan amendments described in paragraph (2) of this
subdivision.
SEC. 9. Section 14132.955 is added to the Welfare and Institutions
Code, to read:
14132.955. Personal care services that are provided pursuant to
Section 14132.95 shall include services in the recipient's place of
employment if both of the following conditions are met:
(a) The personal care services are limited to those that are
currently authorized for the recipient in the recipient's home and
those services are to be utilized by the recipient at the recipient's
place of employment to enable the recipient to obtain, retain, or
return to, work. Authorized services utilized by the recipient at
the recipient's place of employment shall be services that are
relevant and necessary in supporting and maintaining employment.
However, work place services shall not be used to supplant any
reasonable accommodations required of an employer by the Americans
with Disabilities Act (42 U.S.C. Sec. 12101 et seq.) or other legal
entitlements or third-party obligations.
(b) The provision of personal care services at the recipient's
place of employment shall be authorized only to the extent that the
total hours utilized at the work place are within the total personal
care services hours authorized for the recipient in the home.
Additional personal care services hours may not be authorized in
connection with a recipient's employment.
SEC. 10. Notwithstanding Section 17610 of the Government Code, 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. If the statewide cost of the claim for
reimbursement does not exceed one million dollars ($1,000,000),
reimbursement shall be made from the State Mandates Claims Fund.