BILL ANALYSIS Ó
AB 784
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Date of Hearing: May 18, 2011
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
AB 784 (Yamada) - As Amended: May 9, 2011
Policy Committee: HealthVote:17-0
Urgency: No State Mandated Local Program:
No Reimbursable: No
SUMMARY
This bill requires that two newly constructed Veteran's Homes in
Lancaster and Ventura that are equipped to provide adult day
health services be considered for inclusion as service
providers, in the event of the elimination of Adult Day Health
Center (ADHC) services as an optional Medi-Cal benefit and
enactment of a new successor program.
FISCAL EFFECT
1)Unknown fiscal effect on the Medi-Cal program. ADHC has been
eliminated as a Medi-Cal state optional benefit. The design
and funding of a new program through which ADHC-like services
would potentially be provided is currently being discussed.
2)If the proposed new program was operated through a federal
waiver, as is being discussed, it would likely have a capped
enrollment and the addition of new facilities would not affect
the overall number of beneficiaries. However, if ADHC was
maintained as a Medi-Cal benefit, the cost could be up to $1
million (50% GF) annually based on the initial expected number
of enrollees.
3)Minor state costs to DPH to license and certify two new
facilities, paid for through licensure fees.
COMMENTS
1)Rationale. This bill is intended to permit two ADHCs operated
by the California Department of Veterans Affairs (CDVA) to
become eligible to participate in a proposed new program to
provide adult day health services to eligible veterans, upon
AB 784
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enactment of the proposed program. According to the author,
these facilities were under construction before a moratorium
was placed on the certification of new ADHCs, and well before
ADHC was proposed for elimination as a Medi-Cal optional
benefit.
2)Adult Day Health Care (ADHC) provides social, therapeutic, and
health services such as medication management, rehabilitation,
and meals that are intended to delay or prevent the
institutionalization of individuals who could remain in the
community. Many of these services are also provided
individually through Medi-Cal on a fee-for-service basis.
About 37,000 Medi-Cal beneficiaries currently receive ADHC
services. The ADHC benefit is considered optional by the
federal government and states are therefore not required to
provide such care as part of their Medicaid programs.
3)ADHC Recent History . In order to control escalating costs
associated with the ADHC benefit, DHCS imposed a moratorium on
new ADHC certification in 2004. In his 2009-10 budget, the
governor proposed eliminating ADHC as an optional Medi-Cal
benefit, but this was rejected by the Legislature. Again in
2010-11, the new governor proposed eliminating the benefit.
This budget solution was again rejected, but the Budget
Conference Committee proposed a compromise that would
eliminate ADHC but establish a successor program, operated
through a federal waiver, with a much more narrow focus on
adults of high medical acuity at high risk of
institutionalization. The compromise also appropriates
roughly half of the funding spent on ADHC ($170 million (50%
GF)) to transition individuals receiving ADHC services to
other Medi-Cal services, including the successor program.
Analysis Prepared by : Lisa Murawski / APPR. / (916) 319-2081