BILL NUMBER: AB 1434	INTRODUCED
	BILL TEXT


INTRODUCED BY   Assembly Member Dymally

                        FEBRUARY 23, 2007

   An act to add Section 14132.455 to the Welfare and Institutions
Code, relating to Medi-Cal.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 1434, as introduced, Dymally. Medi-Cal: home health care
services.
   Existing law establishes the Medi-Cal program, administered by the
State Department of Health Care Services, under which basic health
care services are covered, including home health agency services.
   This bill would require the department to implement a ratesetting
system, subject to federal approval and the availability of federal
funds, that reflects the costs and services associated with quality
home health agency services, pursuant to specified criteria.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


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

  SECTION 1.  Section 14132.455 is added to the Welfare and
Institutions Code, to read:
   14132.455.  (a) It is the intent of the Legislature to devise a
Medi-Cal home health agency service reimbursement methodology that
more effectively ensures individual access to appropriate home health
agency services, promotes quality home health services, advances
decent wages and benefits for home health agency workers, supports
provider compliance with all applicable state and federal
requirements, encourages administrative efficiency, and provides for
annual rate increases to reflect changes in the cost of furnishing
quality home health agency services.
   (b) As used in this section, "home health agency services" means
those services referenced in subdivisions (j) and (t) of Section
14132.
   (c) The department shall, in accordance with subdivision (d),
implement a ratesetting system, subject to federal approval and the
availability of federal funds, that reflects the costs and services
associated with quality home health agency services. This ratesetting
system shall be effective commencing on July 1, 2008, and shall be
implemented commencing on the first day of the month following
federal approval. The department may retroactively, to the extent
permitted by law, increase and make payment of rates to home health
agencies.
   (d) The department shall establish rates pursuant to this article
for home health agency services as follows:
   (1) (A) For home health agency services that are reimbursed by the
department on a per-visit allowance, the department shall set rates
that reflect 100 percent of the statewide average projected cost for
a visit by a registered nurse, licensed vocational nurse, physical
therapist, occupational therapist, speech language therapist, medical
social worker, or certified home health aide to a home health agency
patient, including appropriate direct and indirect costs applicable
to those visits. The department shall establish rates on the basis of
the home health agency cost data reported in the most recent
available home health agency Medicare cost reports, projected to the
rate year beginning July 1, 2007, by use of the Medicare market
basket index.
   (B) The department shall update the per-visit rates annually. As
often as appropriate to take into account cost changes applicable to
home health services, and at least once every three years, the
department shall conduct an analysis of the home health agency cost
data reported in the most recent available home health agency
Medicare cost reports, and establish updated rates for home health
agency visits by projecting that data to the rate year by use of the
Medicare market basket index.
   (C) For rate years when the department does not revise the
per-visit rates pursuant to the methodology set forth in subparagraph
(B), the department shall update the previous year rates to the rate
year to reflect the increase in the Medicare market basket index.
   (2) (A) For home health agency services that are reimbursed by the
department on a hourly basis, the department shall set hourly rates
that reflect 100 percent of the statewide average projected hourly
salary for a registered nurse, licensed vocational nurse, physical
therapist, occupational therapist, speech language therapist, medical
social worker, or certified home health aide. The department shall
establish rates on the basis of a current salary survey, and project
hourly salaries to the rate year beginning July 1, 2007, by use of
the Medicare market basket index. The department shall then add 50
percent to those salary amounts to reimburse home health agencies for
payroll taxes, workers' compensation, transportation, administrative
overhead, and other costs.
   (B) The department shall update the hourly rates annually. As
often as appropriate to take into account cost changes applicable to
home health agency services, and at least once every three years, the
department shall conduct or use the results of a current salary
survey, plus 30 percent and establish updated hourly rates for home
health agency services by projecting this data to the rate year by
use of the Medicare market basket index.
   (C) For rate years when the department does not revise the hourly
rates pursuant to the methodology set forth in subparagraph (B), the
department shall update the previous year rates to the rate year to
reflect the increase in the Medicare market basket index.