BILL NUMBER: AB 2968	CHAPTERED
	BILL TEXT

	CHAPTER  830
	FILED WITH SECRETARY OF STATE  SEPTEMBER 30, 2006
	APPROVED BY GOVERNOR  SEPTEMBER 30, 2006
	PASSED THE ASSEMBLY  AUGUST 24, 2006
	PASSED THE SENATE  AUGUST 22, 2006
	AMENDED IN SENATE  AUGUST 16, 2006
	AMENDED IN ASSEMBLY  MAY 23, 2006
	AMENDED IN ASSEMBLY  APRIL 25, 2006
	AMENDED IN ASSEMBLY  APRIL 5, 2006

INTRODUCED BY   Assembly Member Leno

                        FEBRUARY 24, 2006

   An act to add Section 14132.24 to the Welfare and Institutions
Code, relating to Medi-Cal.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 2968, Leno  Medi-Cal: community-living support benefit.
   Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Services and under
which qualified low-income persons receive health care benefits,
including certain residential care benefits. The Medi-Cal program is,
in part, governed and funded by federal Medicaid provisions.
   This bill would require the department to develop and implement a
program to provide a community-living support benefit to eligible
Medi-Cal beneficiaries. It would require the department to submit any
federal documentation that is necessary to provide this benefit, and
to implement the benefit only to the extent that federal financial
participation is available. The bill would require that the benefit
include reimbursement for an array of health-related and psychosocial
services provided or coordinated at community-based housing sites,
and access to certain community-living support services provided or
coordinated at those sites. Eligibility for the benefit would be
limited to persons who are eligible for Medi-Cal, who are residents
of San Francisco who would otherwise be homeless, living in shelters,
or institutionalized, and who meet at least one of 2 other criteria.
The bill would condition implementation of these provisions upon
adoption of a resolution by the Board of Supervisors of the City and
County of San Francisco providing for county funds for specified
purposes related to the program.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:


  SECTION 1.  The Legislature finds and declares all of the
following:
   (a) Medi-Cal eligible persons who are residents of San Francisco,
who would otherwise be homeless, living in shelters, or
institutionalized, and who reside in community-based housing should
have access to crucial health services that may reduce their use of
acute psychiatric and medical services or institutionalized long-term
care services.
   (b) Community-based housing is noninstitutional residential
housing linked to either community-based or site-based health-related
and psychosocial services.
   (c) Under the existing Medi-Cal program, reimbursement for
providing an array of health-related and psychosocial services to
Medi-Cal eligible residents in assisted living is complicated, is
sometimes not available, and, when available, frequently results in
the services being provided in more expensive institutional settings.

   (d) A designated Medi-Cal reimbursement rate structure for
community-living support services that assist beneficiaries who would
otherwise be homeless, living in shelters, or institutionalized
would expand community-based options for beneficiaries who would
otherwise require costly institutional care.
  SEC. 2.  Section 14132.24 is added to the Welfare and Institutions
Code, to read:
   14132.24.  (a) The department shall develop and implement a
program to provide a community-living support benefit to eligible
Medi-Cal beneficiaries. The department shall submit any waiver
application, modification of any existing waiver, or amendment to the
Medicaid state plan, that is necessary to provide this benefit, and
shall implement the benefit only to the extent that federal financial
participation is available.
   (b) The community-living support benefit shall include both of the
following:
   (1) (A) Reimbursement for an array of health-related and
psychosocial services provided or coordinated at community-based
housing sites that enable beneficiaries to remain in the least
restrictive and most homelike environment while receiving the
health-related services, including personal care and psychosocial
services, necessary to protect their health and well-being. These
community-based housing units may include, but are not limited to,
the living area or unit within a facility that is specifically
designed to provide ongoing assisted living services, licensed
residential care facilities for the elderly, publicly funded senior
and disabled housing projects, or supportive housing sites that serve
chronically homeless individuals with chronic or disabling health
conditions.
   (B) For purposes of this section, "assisted living services"
includes, but is not limited to, assistance with personal activities
of daily living, including dressing, feeding, toileting, bathing,
grooming, mobility, and associated tasks, to help provide for and
maintain physical and psychological comfort.
   (2) Access to community-living support services provided or
coordinated at the community-based housing site, including, but not
limited to, the personal care and health services specified in
paragraph (8) of subdivision (a) of Section 1788 of the Health and
Safety Code, and the health related support services specified in
Section 53290 of the Health and Safety Code.
   (c) Services available through the community-living support
benefit shall not duplicate services available through the Medi-Cal
state plan, other Medi-Cal waivers, or other programs financed by the
state.
   (d) An individual shall be eligible for the community-living
support benefit if he or she is eligible for the Medi-Cal program, is
a resident of San Francisco who would otherwise be homeless, living
in shelters, or institutionalized, and meets one or both of the
following criteria:
   (1) The State Department of Mental Health determines that he or
she would benefit from supportive housing, as defined in subdivision
(c) of Section 53260 of the Health and Safety Code.
   (2) The department determines that he or she is eligible for
placement in a skilled nursing facility, as defined in subdivision
(c) of Section 1250 of the Health and Safety Code, or an intermediate
care facility, as defined in subdivision (d) of that section.
   (e) The department may modify the eligibility criteria specified
in subdivision (d), if needed, to qualify the community-living
support benefit for federal financial participation.
   (f) The department shall seek to maximize resources for
community-based housing by coordinating the community-living support
benefit with existing efforts to coordinate care, improve health
outcomes, and reduce long-term care costs for the targeted
population.
   (g) This section shall be implemented only upon adoption of a
resolution by the Board of Supervisors of the City and County of San
Francisco providing county funds for use by the state to match
federal Medicaid funds to receive federal funds for services provided
under the waiver specified in this section, and for any costs
associated with implementing and monitoring the waiver, to limit
additional state costs.
  SEC. 3.  Due to the unique circumstances facing Medi-Cal recipients
in the City and County of San Francisco who reside in
community-based housing, the Legislature hereby finds and declares
that a general statute cannot be made applicable within the meaning
of Section 16 of Article IV of the California Constitution.
Therefore, the special legislation contained within Section 2 of this
act is necessarily applicable only to the City and County of San
Francisco.