BILL NUMBER: AB 96 ENROLLED
BILL TEXT
PASSED THE SENATE JUNE 10, 2011
PASSED THE ASSEMBLY JUNE 15, 2011
AMENDED IN SENATE JUNE 8, 2011
AMENDED IN SENATE APRIL 6, 2011
AMENDED IN SENATE MARCH 14, 2011
INTRODUCED BY Committee on Budget
JANUARY 10, 2011
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, making an appropriation therefor, to take effect
immediately, bill related to the budget.
LEGISLATIVE COUNSEL'S DIGEST
AB 96, Committee on Budget. Keeping Adults Free from Institutions
program.
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 provides, to the extent permitted by federal
law, that adult day health care (ADHC) be excluded from coverage
under the Medi-Cal program.
This bill would provide that it is the intent of the Legislature
to create the Keeping Adults Free from Institutions (KAFI) program,
which shall be a new program to provide services in the community
that are designed to prevent institutionalization, and that the KAFI
program be established as quickly as possible to minimize any
disruption in services resulting from the elimination of ADHC as a
Medi-Cal benefit. This bill would prohibit the KAFI program from
being implemented until federal approval is obtained, and provide
that the KAFI program is to be implemented only to the extent that
federal financial participation is available. This bill would require
the department to submit, on or before September 1, 2011, an
application to the federal Centers for Medicare and Medicaid Services
(CMS) to implement the KAFI program. This bill would require the
KAFI program to utilize licensed adult day health centers to provide
a well-defined scope of specified services for Medi-Cal beneficiaries
who have been assessed to be at significant risk of
institutionalization. This bill would require the department to
consult with interested stakeholders and the Legislature in
developing the application to CMS and would authorize the department
to implement these provisions by means of a state plan amendment or
federal waiver, or combination thereof.
This bill would appropriate $1,000 to the department for
administration.
This bill would declare that it is to take effect immediately as a
bill providing for appropriations related to the Budget Bill.
Appropriation: yes.
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 to create the
Keeping Adults Free from Institutions (KAFI) program, which shall be
a new program to provide services in the community that are designed
to prevent institutionalization.
(b) It is the intent of the Legislature that the KAFI program
allow recipients of adult day health care pursuant to Chapter 8.7
(commencing with Section 14520), who are at the greatest risk of
institutionalization, to be given immediate priority to transition to
the new program.
(c) It is the intent of the Legislature that the KAFI program be
established as quickly as possible to minimize any disruption in
services resulting from the elimination of adult day health care as a
Medi-Cal optional benefit.
14516. (a) On or before September 1, 2011, the department shall
submit an application to the federal Centers for Medicare and
Medicaid Services (CMS) to implement the Keeping Adults Free from
Institutions (KAFI) program. This program shall utilize licensed
adult day health centers, as defined in subdivision (b) of Section
1570.7 of the Health and Safety Code, to provide a well-defined scope
of medical, behavioral health, and social services for Medi-Cal
beneficiaries who have been assessed using evidence-based risk
factors to be at significant risk of institutionalization, including
admission or readmission to an institutional setting in the absence
of community-based services. The KAFI program shall achieve all of
the following:
(1) Promote person-centered care planning.
(2) Work in coordination with existing state programs, including
other federal waivers and pilot projects that have, as one of their
goals, to delay or prevent inappropriate or personally undesirable
institutionalization.
(3) Emphasize partnership between the participant, the participant'
s family, the personal health care provider, and other community care
providers in working toward maintaining personal independence.
(4) Facilitate the beneficiary's choice to the extent feasible.
(b) The department may implement this chapter by means of a state
plan amendment or federal waiver, or a combination thereof, as
necessary to accomplish the intent of this chapter. The department
shall seek to maximize the availability of federal financial
participation for implementation of this chapter under the terms of
any existing waivers or state plan provisions, through amendment of
any existing waivers or state plan provisions, or by means of a new
waiver or state plan amendment, or any combination thereof.
(c) In developing the application to CMS pursuant to this section,
the department shall consult with interested stakeholders and the
Legislature.
(d) Notwithstanding the Administrative Procedure Act (Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 3 of Title 2 of
the Government Code), the department may implement this chapter
through all-county letters or similar instructions, without taking
regulatory action. Prior to issuing any letter or similar instruction
authorized pursuant to this subdivision, the department shall notify
and consult with stakeholders, including advocates, providers, and
beneficiaries, in implementing, interpreting, or making specific this
chapter.
14516.5. (a) The director shall seek any necessary federal
approvals for the implementation of the KAFI program. The KAFI
program shall not be implemented until federal approval is obtained
and shall be implemented only to the extent that federal financial
participation is available.
(b) Implementation of the KAFI program is subject to an
appropriation in the annual Budget Act.
SEC. 2. The sum of one thousand dollars ($1,000) is hereby
appropriated from the General Fund to the State Department of Health
Care Services for administration.
SEC. 3. This act is a bill providing for appropriations related to
the Budget Bill within the meaning of subdivision (e) of Section 12
of Article IV of the California Constitution, has been identified as
related to the budget in the Budget Bill, and shall take effect
immediately.