BILL NUMBER: AB 96	AMENDED
	BILL TEXT

	AMENDED IN SENATE  APRIL 6, 2011
	AMENDED IN SENATE  MARCH 14, 2011

INTRODUCED BY    Committee on Budget   (
  Blumenfield (Chair), Alejo, Allen, Brownley,
Buchanan, Butler, Cedillo, Chesbro, Dickinson, Feuer, Gordon,
Huffman, Mitchell, Monning, and Swanson   )
  Assembly Member   Blumenfield 

                        JANUARY 10, 2011

    An act to amend Section 9205 of the Family Code, to amend
Section 1417.2 of the Health and Safety Code, and to amend Sections
10533, 11253.5, 11265.2, 11266.5, 11320.15, 11320.3, 11320.32,
11322.63, 11325.71, 11329.5, 11450, 11450.02, 11454.5, 11487,
12301.3, 12301.4, 12302.25, 14132.97, 15525, and 17021 of, to amend
and repeal Sections 11327.5 and 11454 of, to add Sections 11323.25,
11450.025, 11454.2, 12200.03, 12309.1, 14132.956, and 14132.957 to,
to add and repeal Section 11334.8 of, to repeal Sections 11320.2 and
11322.64 of, to repeal Article 3.3 (commencing with Section 11330) of
Chapter 2 of Part 3 of Division 9 of, to repeal and add Sections
12301.03 and 12301.05 of, and to repeal, amend, and add Section
11451.5 of, the Welfare and Institutions Code, relating to human
services, making an appropriation therefor, and declaring the urgency
thereof, to take effect immediately, bill related to the budget.
  An   act to add Chapter 8.6 (commencing with
Section 14515) to Part 3 of Division 9 of the Welfare and
Institutions Code, relating to Medi-Cal, and declaring the urgency
thereof, to take effect immediately. 


	LEGISLATIVE COUNSEL'S DIGEST


   AB 96, as amended,  Committee on Budget  
Blumenfield  .  Human services.   Adult day
health care.  
   Existing law establishes the Medi-Cal program, administered by the
State Department of Health Care Services, under which health care
services are provided to qualified, low-income persons. The Medi-Cal
program is, in part, governed and funded by federal Medicaid Program
provisions. Existing law, the Adult Day Health Medi-Cal Law,
establishes adult day health care (ADHC) services as a Medi-Cal
benefit for Medi-Cal beneficiaries who meet certain criteria. 

   This bill would provide that it is the intent of the Legislature
to provide for an orderly conversion of ADHC from a Medi-Cal benefit
to a program operating under a specified waiver. This bill would
require the department to establish the Keeping Adults Free from
Institutions (KAFI) program for the purposes of transitioning
individuals from the ADHC program to a program under a waiver or to
any other supportive services, if appropriate. The bill would require
the department to take all appropriate action to obtain expedited
approval from the federal Centers for Medicare and Medicaid Services
to convert the ADHC program to a federal waiver.  
   This bill would declare that it is to take effect immediately as
an urgency statute.  
   Existing law contains various provisions relating to the
disclosure of personal information between adoptees and their
biological siblings, the implementation of which is delayed until
July 1, 2011.  
   This bill would delay implementation of these provisions, until
July 1, 2012.  
   Existing law establishes the State Health Facilities Citation
Penalties Account into which moneys derived from civil penalties for
violations of state law are deposited. Moneys in this account may be
used, upon appropriation by the Legislature, for the protection of
health or property of residents of long-term health care facilities,
as specified.  
   Existing law, the Mello-Granlund Older Californians Act,
establishes the Office of the State Long-Term Care Ombudsman in the
California Department of Aging. Existing law requires the department
to allocate all federal and state funds for local ombudsman programs
according to a specified schedule.  
   This bill, upon appropriation by the Legislature, would include
the costs associated with the Long-Term Care Ombudsman Program among
the uses of the moneys in the State Health Facilities Citation
Penalties Account.  
   Existing federal law provides for allocation of federal funds
through the federal Temporary Assistance for Needy Families (TANF)
block grant program to eligible states. Existing law provides for the
California Work Opportunity and Responsibility to Kids (CalWORKs)
program under which, through a combination of state and county funds
and federal funds received through the TANF program, each county
provides cash assistance and other benefits to qualified low-income
families.  
   Existing law requires the State Department of Social Services,
commencing July 1, 2011, to establish a CalWORKs county peer review
process. Existing law requires the department to implement the
process statewide no later than July 1, 2012.  
   This bill instead would require the department to establish the
peer review process commencing July 1, 2013, and to implement the
process statewide no later than July 1, 2014.  
   Existing law provides that a parent or caretaker relative shall
not be eligible for CalWORKs aid when he or she has received aid for
a cumulative total of 60 months. Existing law excludes any month in
which certain conditions exist from being counted as a month of
receipt of aid for these purposes.  
   This bill would revise the requirements for providing aid under
the CalWORKs program, including reducing the existing time limits on
receipt of aid with a 48-month limit for parents and caregiver
relatives, except as specified. The bill would make conforming
changes, including but not limited to eliminating self-sufficiency
reviews, and revising provisions relating to sanctions and general
assistance, to reflect the shortened CalWORKs time limits. The bill
would apply the revised time limits to all months of CalWORKs aid
received on and after January 1, 1998, except as specified. The bill
would make the time limit revisions operative on the first day of the
first calendar month following 90 days after the effective date of
the bill, or June 1, 2011, whichever is later.  
   This bill would require county welfare departments to provide a
specified notice regarding the revised time limit requirements, thus
imposing a state-mandated local program.  
   Existing law provides that when aid under the CalWORKs program is
repaid to a county or recovered by a county, the state is entitled to
a share of the amount received or recovered, proportionate to the
amount of state funds paid. If funds advanced by the federal
government were paid, existing law entitles the federal government to
a share of the amount received or recovered, proportionate to the
amount of federal funds paid. Existing law excepts from the above
requirement designated payments from noncustodial parents for child
or spousal support with respect to whom a specified assignment of
support rights has been made, and requires those payments to be paid
directly to the local child support agency and not to the family.
 
   This bill would delete the exception for child and spousal
support. It would entitle the state to the entire amount of any aid
repaid to the state, except where federal and county funds were paid,
in which case the federal government would remain entitled to a
proportionate share of the amount received or recovered and the
county would remain entitled to its proportionate share, except for
county funds received or recovered during the 2011-12 fiscal year,
which would be retained by the state.  
   Existing law requires the State Department of Social Services to
administer a voluntary Temporary Assistance Program (TAP) to provide
cash assistance and other benefits to specified current and future
CalWORKs recipients who meet the exemption criteria for participation
in welfare-to-work activities and are not single parents who have a
child under one year of age. Existing law requires the TAP to
commence no later than October 1, 2012.  
   This bill would delay the commencement date of the TAP until
October 1, 2014.  
   Existing law makes specified findings and declarations with
respect to the effect of decreased funding for CalWORKs for the
2009-10 and 2010-11 fiscal years. In connection with this decreased
funding, existing law extends certain exemptions from months counted
as a month of receipt of aid, and allows counties to redirect funding
between specified employment assistance and substance abuse
treatment programs during the specified fiscal years. 

   This bill would extend the above provisions to apply to specified
decreases in CalWORKs funding for the 2011-12 fiscal year. The bill
would authorize a county to revise a specified welfare-to-work
exemption in order to implement the county's portion of this funding
reduction.  
   Existing law requires recipients of aid under the CalWORKs program
who are under 19 years of age who are pregnant or custodial parents
to participate in certain educational programs, which are referred to
as the Cal-Learn Program. Under existing law, a Cal-Learn Program
participant is entitled to monetary supplements or bonuses, as
specified, for maintaining satisfactory educational progress, and
successfully completing high school or a California high school
equivalency examination.  
   This bill would make the Cal-Learn Program inoperative from July
1, 2011, to June 30, 2012, inclusive, with the exception of the
payment of supplements and bonuses to eligible participants. These
provisions making the Cal-Learn Program inoperative would be repealed
on July 1, 2012, as specified. The bill would repeal related
inoperative provisions. This bill would authorize implementation of
the Cal-Learn provisions by all-county letters or similar
instructions from the department, pending the adoption, by July 1,
2012, of emergency regulations.  
   Existing law requires certain participants in the CalWORKs program
to participate in certain welfare-to-work activities, which may
include, but are not limited to, subsidized employment in either the
public or private sector. Existing law requires the department to pay
50% of the wage subsidy to counties that include these activities
within their welfare-to-work activities, subject to prescribed
limitations. Existing law also requires the department, no later than
January 10, 2011, to report to the Legislature on the outcomes of
implementing these provisions.  
   This bill would revise the requirements relating to the state's
financial participation in subsidized employment programs, including
requiring the department to pay 50%, less $56, of the total wage
costs, as defined, of an employee for whom a wage subsidy is paid, as
opposed to a percentage of the wage subsidy alone. The bill would
establish maximum state contribution standards for subsidized wage
program participants receiving CalWORKs benefits, for participants
who have exceeded applicable time limits for receipt of aid, and for
those who are participating in subsidized employment as a part of
continuing welfare-to-work services provided by a county to former
CalWORKs participants who have become employed, as specified.
 
   This bill would specify applicable income exemption and work
requirements when an assistance unit applies for CalWORKs benefits
after a participant's subsidized employment ends.  
   Existing law establishes maximum aid grant amounts to be provided
under the CalWORKs program, subject to specified adjustments.
Existing law reduces the maximum aid payments in effect on September
1, 2007, by 4%, commencing July 1, 2009.  
   This bill would reduce the maximum aid payments in effect on July
1, 2009, by an additional 8%, and would authorize implementation of
this reduction by all-county letters or similar instructions from the
State Department of Social Services, pending the adoption of
regulations, as specified. The bill would require 3 subsequent 5%
reductions to the computed aid grants for assistance units that do
not include an aided adult, in the 61st, 73rd, and 85th cumulative
months of aid. The bill would exempt assistance units in which all
parents or caretaker relatives in the assistance unit are disabled
and receiving SSI/SSP benefits from these subsequent reductions.
 
   Existing law provides that certain amounts are exempt from the
calculation of income of the family for purposes of determining
eligibility for benefits under the CalWORKs program. These exempt
amounts include $225 of disability-based unearned income, and an
amount of otherwise exempt earned income that is determined based on
the amount of disability-based unearned income, as specified.
 
   This bill would revise the above earned income calculation when
the amount of disability-based unearned income is less than $225, to
exempt the total amount of the disability-based unearned income plus
the lesser of (1) $112 of earned income that is not otherwise exempt,
or (2) the amount of otherwise nonexempt earned income that
represents the difference between the amount of unearned
disability-based income and $225, and 50% of any additional earned
income.  
   Existing law provides for the State Supplementary Program for the
Aged, Blind and Disabled (SSP), which requires the State Department
of Social Services to contract with the United States Secretary of
Health and Human Services to make payments to SSP recipients to
supplement Supplemental Security Income (SSI) payments made available
pursuant to the federal Social Security Act. State payment levels
for SSI/SSP recipients are established in accordance with prescribed
requirements. Existing law also establishes the Medi-Cal program,
which is partially governed and funded pursuant to the federal
Medicaid Program.  
   This bill would require SSI/SSP rates for individuals to be
reduced to equal the minimum amount required by the federal Social
Security Act in order to maintain the state's eligibility for federal
Medicaid funding, subject to prescribed exceptions. The bill would
make this reduction effective on the first day of the first month
following 90 days after the effective date of the bill. 

   Existing law provides for the In-Home Supportive Services (IHSS)
program, under which, either through employment by the recipient, or
by or through contract by the county, qualified aged, blind, and
disabled persons receive services enabling them to remain in their
own homes. Counties are responsible for the administration of the
IHSS program. Under the Medi-Cal program, similar services are
provided to eligible individuals, with these services known as
personal care option services.  
   Existing law, with certain exceptions, requires each county to
appoint an IHSS advisory committee of 11 members, establishes the
qualifications of its members, and sets forth its duties. Existing
law makes counties eligible for state reimbursement of administrative
costs of the committee. Existing law requires each county to
consider the advice of the committee prior to making policy and IHSS
funding decisions.  
   This bill would delete the provisions requiring establishment of
the committee, would instead authorize appointment of an IHSS
advisory committee, would delete provisions requiring state
reimbursement for the costs of the committee, and would make
conforming changes.  
   This bill would require the State Department of Health Care
Services to establish a medication machine pilot project for certain
at-risk Medi-Cal recipients, as specified, and would designate the
duties of the department in this regard. The bill would require the
Department of Finance to perform specified functions and make related
notifications, in connection with determining and evaluating savings
to the General Fund as a result of the implementation of the pilot
project. The bill would authorize the State Department of Health Care
Services to terminate the pilot project under designated
circumstances.  
   Existing law authorized an individual who was eligible for IHSS
services in the 1992-93 fiscal year, and who had his or her services
reduced pursuant to specified provisions, but who believed that he or
she was at serious risk of out-of-home placement unless all or part
of the reduced hours were restored, to apply for an IHSS Care
Supplement, as specified.  
   This bill would recast and revise these provisions, to instead
require, if the medication machine pilot project established pursuant
to the bill does not result in specified General Fund savings, as
determined by the Department of Finance, a reduction in authorized
hours of service to all recipients of in-home supportive services, as
specified, which would be operative on October 1, 2012, or the first
day of the first month following 90 days after the effective date of
the bill, whichever is later. The bill would authorize an individual
whose services have been reduced, and who believes that he or she is
at serious risk of out-of-home placement, to submit an IHSS Care
Supplement application, in accordance specified provisions, in order
to have all or part of the service hour reduction restored. 

   This bill would revise the definition of "waiver personal care
services" received by certain recipients under the Medi-Cal program,
to distinguish those services from other categories of personal care
services provided under the Medi-Cal program, and would prohibit
waiver personal care services from replacing any hours of services
authorized or reduced pursuant to the other service categories.
 
   This bill would require an applicant or recipient of in-home
supportive services to obtain a certification from a licensed health
care professional, as specified, as a condition of receiving those
services. The bill would require the State Department of Social
Services, in consultation with the State Department of Health Care
Services, to develop a standard certification form for this purpose.
The bill would delay implementation of these certification provisions
until the receipt of specified federal approval, under prescribed
circumstances. To the extent that implementation of the certification
requirement would increase county duties in implementing the In-Home
Supportive Services program, this bill would impose a state-mandated
local program.  
   Existing federal law authorizes states to exercise an option to
amend the state Medicaid plan to provide home- and community-based
attendant services and supports, as specified.  
   This bill would require the department to assess and determine the
cost efficiency of exercising the federal option to provide home-
and community-based attendant services and supports. The bill would
require the department, if the department determines that exercise of
the federal option would be cost efficient, to establish a
development and implementation council, with specified membership,
and to consult and collaborate with the council in exercising the
federal option. This bill would authorize services and supports under
the option to be rendered under the administrative direction of
other state departments in accordance with the state plan amendment,
as specified. This bill would authorize implementation of these
provisions by all-county letters or similar instructions from the
director, pending the adoption of emergency regulations, as
specified.  
   Existing law requires the State Department of Social Services to
establish a Work Incentive Nutritional Supplement (WINS) program,
under which each county is required to provide a $40 monthly
additional food assistance benefit for each eligible food stamp
household, as defined. The bill would require the state to pay the
counties 100% of the cost of WINS benefits, using funds that qualify
for the state's Temporary Assistance for Needy Families (TANF)
program maintenance of effort requirements, as specified. Existing
law prohibits WINS benefits from being paid before October 1, 2012,
and requires full implementation of the program on or before April 1,
2013.  
   This bill would extend the time for payment of WINS benefits to
commence to October 1, 2013, and the time for full implementation of
the program to April 1, 2014.  
   Existing law authorizes the director to implement the WINS program
by all-county letters by March 1, 2012, pending the adoption of
emergency regulations.  
   This bill would extend the time for issuance of all-county letters
to March 1, 2013.  
   Existing law requires the department to convene a workgroup on or
before December 1, 2011, comprised of designated representatives, to
consider the progress of the WINS automation effort in tandem with a
preassistance employment readiness system (PAERS) program and any
other program options that may provide offsetting benefits to the
caseload reduction credit in the CalWORKs program. Existing law
prohibits full implementation of the WINS program until the workgroup
is convened.  
   This bill would extend the date by which the department is
required to establish the WINS/PAERS workgroup to December 1, 2012,
and would make conforming changes.  
   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.  
   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 California Constitution authorizes the Governor to declare a
fiscal emergency and to call the Legislature into special session for
that purpose. Governor Schwarzenegger issued a proclamation
declaring a fiscal emergency, and calling a special session for this
purpose, on December 6, 2010. Governor Brown issued a proclamation on
January 20, 2011, declaring and reaffirming that a fiscal emergency
exists and stating that his proclamation supersedes the earlier
proclamation for purposes of that constitutional provision. 

   This bill would state that it addresses the fiscal emergency
declared and reaffirmed by the Governor by proclamation issued on
January 20, 2011, pursuant to the California Constitution. 

   This bill would declare that it is to take immediate effect as an
urgency statute and a bill providing for appropriations related to
the Budget Bill. 
   Vote: 2/3. Appropriation:  yes   no  .
Fiscal committee: yes. State-mandated local program:  yes
 no  .


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

   SECTION 1.    Chapter 8.6 (commencing with Section
14515) is added to Part 3 of Division 9 of the   Welfare and
Institutions Code   , to read:  
      CHAPTER 8.6.  KEEPING ADULTS FREE FROM INSTITUTIONS


   14515.  (a) It is the intent of the Legislature in enacting this
chapter to provide for an orderly conversion of adult day health care
(ADHC) from a Medi-Cal benefit under Chapter 7 (commencing with
Section 14000) of this part, to a program operating under a Section
1915(c) waiver under the federal Social Security Act (42 U.S.C. 1396n
(c)), so that approval by the federal Centers for Medicare and
Medicaid Services (CMS) to eliminate ADHC as a state plan benefit is
concurrent with CMS approval of the waiver. It is the intent of the
Legislature to establish and continue a community-based system of
quality adult day health care services that will accomplish all of
the following:
   (1) Ensure that elderly persons and adults with disabilities will
not be institutionalized prematurely and inappropriately.
   (2) Provide appropriate health and social services designed to
maintain elderly persons in their own communities.
   (3) Establish adult day health care centers in locations easily
accessible to persons who are economically disadvantaged.
   (4) Encourage the establishment of rural alternative adult day
health care centers that are designed to make adult day health care
accessible to elderly persons and adults with disabilities living in
rural areas.
   (b) The department shall establish the Keeping Adults Free from
Institutions (KAFI) program for the purposes of transitioning
individuals from the ADHC program to a program under a Section 1915
(c) waiver or to any other supportive services, if appropriate.
   (c) The department shall take all appropriate action to obtain
expedited approval by CMS to convert the ADHC program to a Section
1915(c) waiver. 
   SEC. 2.    This act is an urgency statute necessary
for the immediate preservation of the public peace, health, or safety
within the meaning of Article IV of the Constitution and shall go
into immediate effect. The facts constituting the necessity are:
 
   In order for the provisions of this act to be implemented at the
earliest possible time and thereby avoid a gap in services to
beneficiaries of adult day health care, it is necessary that this act
take effect immediately.  All matter omitted in this version of
the bill appears in the bill as amended in the Senate, March 14,
2011. (JR11)