BILL NUMBER: SB 73	CHAPTERED
	BILL TEXT

	CHAPTER  34
	FILED WITH SECRETARY OF STATE  JUNE 30, 2011
	APPROVED BY GOVERNOR  JUNE 30, 2011
	PASSED THE SENATE  JUNE 28, 2011
	PASSED THE ASSEMBLY  JUNE 28, 2011
	AMENDED IN ASSEMBLY  JUNE 28, 2011
	AMENDED IN ASSEMBLY  MARCH 25, 2011
	AMENDED IN ASSEMBLY  MARCH 14, 2011

INTRODUCED BY   Committee on Budget and Fiscal Review

                        JANUARY 10, 2011

   An act to add Sections 4792, 12301.07, and 14105.09 to the Welfare
and Institutions Code, relating to health and human services, and
making an appropriation therefor, to take effect immediately, bill
related to the budget.



	LEGISLATIVE COUNSEL'S DIGEST


   SB 73, Committee on Budget and Fiscal Review. Health and human
services.
    (1) Existing law, the Lanterman Developmental Disabilities
Services Act, authorizes the State Department of Developmental
Services to contract with regional centers to provide services and
supports to individuals with developmental disabilities.
   This bill would, if a specified provision of the Budget Act of
2011 is operative, state the intent of the Legislature for the
department to identify up to $100 million in General Fund savings
from the developmental services system, as prescribed. This bill
would authorize the department to utilize input from prescribed
workgroups. This bill would require, as prescribed, the department to
report to the Joint Legislative Budget Committee within 10 days of
the specified reduction as directed within the Budget Act of 2011.
   (2) 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 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 prescribed.
   Existing law established a similar reduction in authorized IHSS
service hours, which becomes operative only if a specified medication
machine pilot project does not achieve a designated amount of
savings to the General Fund, as determined by the Department of
Finance, and also authorizes 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 with specified provisions, in order to have all or
part of the service hour reduction restored.
   Existing law also requires the department to implement a 3.6%
reduction in service hours to each IHSS recipient, until July 1,
2012.
   This bill, effective January 1, 2012, would impose an additional
20% service hour reduction on IHSS recipients, which would be
operative only if a designated provision of the Budget Act of 2011
becomes operative, and would establish an IHSS Care Supplement
process for any individual who is notified of a reduction in service
hours under the bill, but who believes he or she is at serious risk
of out-of-home placement unless all or part of the reduction is
restored.
   (3) 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.
   This bill would, effective on or after January 1, 2012, if a
specified provision of the Budget Act of 2011 is operative, apply
specified payment reductions to managed care health plans that
contract with the department and to other specified contracts.
   (4) This bill would appropriate $1,000 to the State Department of
Health Care Services for administration.
   (5) 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.  Section 4792 is added to the Welfare and Institutions
Code, to read:
   4792.  (a) This section of law shall only be operative if
subdivision (b) of Section 3.94 of the Budget Act of 2011 is
operative. It is the intent of the Legislature for the department to
identify up to one hundred million dollars ($100,000,000) in General
Fund savings from within the overall developmental services system,
including any savings or reductions within state administrative
support, operation of the developmental centers, and operation of the
regional centers, including administration and the purchase of
services where applicable if subdivision (b) of Section 3.94 of the
Budget Act of 2011 is operative. A variety of strategies, including,
but not limited to, savings attributable to caseload adjustments,
changes in expenditure trends, unexpended contract funds, or other
administrative savings or restructuring can be applied to this
reduction with the intent of keeping reductions as far away as
feasible from consumer's direct needs, services, and supports,
including health, safety, and quality of life.
   (b) The department may utilize input from workgroups comprised of
consumers and family members, consumer-focused advocacy groups,
service provider representatives, regional center representatives,
developmental center representatives, other stakeholders, and staff
of the Legislature, to develop General Fund savings proposals as
necessary.
   (c) If subdivision (b) of Section 3.94 of the Budget Act of 2011
is operative, and the department is directed to identify up to one
hundred million dollars ($100,000,000) in General Fund savings from
within the developmental services system, any savings or reductions
identified shall be reported to the Joint Legislative Budget
Committee within 10 days of the reduction as directed within Section
3.94 of the Budget Act of 2011.
  SEC. 2.  Section 12301.07 is added to the Welfare and Institutions
Code, to read:
   12301.07.  (a) (1) Notwithstanding any other provision of law, if
Section 3.94 of the Budget Act of 2011 becomes operative, the
department shall implement a 20-percent reduction in authorized hours
of service to each in-home supportive services recipient as
specified in this section, effective January 1, 2012, which shall be
applied to the recipient's hours as authorized pursuant to his or her
most recent assessment.
   (2) The reduction required by this section shall not preclude any
reassessment to which a recipient would otherwise be entitled.
However, hours authorized pursuant to a reassessment shall be subject
to the reduction required by this section.
   (3) For those recipients who have a documented unmet need,
excluding protective supervision, because of the limitations
contained in Section 12303.4, this reduction shall be applied first
to the unmet need before being applied to the authorized hours. If
the recipient believes he or she will be at serious risk of
out-of-home placement as a consequence of the reduction, the
recipient may apply for a restoration of the reduction of authorized
service hours, pursuant to subdivision (f).
   (4) A recipient of services under this article may direct the
manner in which the reduction of hours is applied to the recipient's
previously authorized services.
   (5) The reduction in service hours made pursuant to paragraph (2)
shall not apply to in-home supportive services recipients who also
receive services under Section 9560, subdivision (t) of Section
14132, and Section 14132.99.
   (b) The department shall work with the counties to develop a
process to allow for counties to preapprove IHSS Care Supplements
described in subdivision (f), to the extent that the process is
permissible under federal law. The preapproval process shall be
subject to the following conditions:
   (1) The preapproval process shall rely on the criteria for
assessing IHSS Supplemental Care applications, developed pursuant to
subdivision (f).
   (2) Preapproval shall be granted only to individuals who would
otherwise be granted a full restoration of their hours pursuant to
subdivision (f).
   (3) With respect to existing recipients as of the effective date
of this section, all efforts shall be made to ensure that counties
complete the process on or before a specific date, as determined by
the department, in consultation with counties in order to allow for
the production, printing, and mailing of notices to be issued to
remaining recipients who are not granted preapproval and who thereby
are subject to the reduction pursuant to this section.
   (4) The department shall work with counties to determine how to
apply a preapproval process with respect to new applicants to the
IHSS program who apply after the effective date of this section.
   (c) The notice of action informing each recipient who is not
preapproved for an IHSS Care Supplement pursuant to subdivision (b)
shall be mailed at least 15 days prior to the reduction going into
effect. The notice of action shall be understandable to the recipient
and translated into all languages spoken by a substantial number of
the public served by the In-Home Supportive Services program, in
accordance with Section 7295.2 of the Government Code. The notice
shall not contain any recipient financial or confidential identifying
information other than the recipient's name, address, and Case
Management Information and Payroll System (CMIPS) client
identification number, and shall include, but not be limited to, all
of the following information:
   (1) The aggregate number of authorized hours before the reduction
pursuant to paragraph (1) of subdivision (a) and the aggregate number
of authorized hours after the reduction.
   (2) That the recipient may direct the manner in which the
reduction of authorized hours is applied to the recipient's
previously authorized services.
   (3) How all or part of the reduction may be restored, as set forth
in subdivision (f), if the recipient believes he or she will be at
serious risk of out-of-home placement as a consequence of the
reduction.
   (d) The department shall inform providers of any reduction to
recipient hours through a statement on provider timesheets, after
consultation with counties.
   (e) The IHSS Care Supplement application process described in
subdivision (f) shall be completed before a request for a state
hearing is submitted. If the IHSS Care Supplement application is
filed within 15 days of the notice of action required by subdivision
(c), or before the effective date of the reduction, the recipient
shall be eligible for aid paid pending. A revised notice of action
shall be issued by the county following evaluation of the IHSS Care
Supplement application.
   (f) Any aged, blind, or disabled individual who is eligible for
services under this chapter who receives a notice of action
indicating that his or her services will be reduced under subdivision
(a) but who believes he or she is at serious risk of out-of-home
placement unless all or part of the reduction is restored may submit
an IHSS Care Supplement application. When a recipient submits an IHSS
Care Supplement application within 15 days of receiving the
reduction notice or prior to the implementation of the reduction, the
recipient's in-home supportive services shall continue at the level
authorized by the most recent assessment, prior to any reduction,
until the county finds that the recipient does or does not require
restoration of any hours through the IHSS Care Supplement. If the
recipient disagrees with the county's determination concerning the
need for the IHSS Care Supplement, the recipient may request a
hearing on that determination.
   (1) The department shall develop an assessment tool, in
consultation with stakeholders, to be used by the counties to
determine if a recipient is at serious risk of out-of-home placement
as a consequence of the reduction of services pursuant to this
section. The assessment tool shall be developed utilizing standard of
care criteria for relevant out-of-home placements that serve
individuals who are aged, blind, or who have disabilities and who
would qualify for IHSS if living at home, including, but not limited
to, criteria set forth in Chapter 7.0 of the Manual of Criteria for
Medi-Cal Authorization published by the State Department of Health
Care Services, as amended April 15, 2004, and the IHSS uniform
assessment guidelines.
   (2) Counties shall give a high priority to prompt screening of
persons specified in this section to determine their need for an IHSS
Care Supplement.
   (g) (1) Notwithstanding the rulemaking provisions of 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 and administer this section through
all-county letters or similar instruction from the department until
regulations are adopted. The department shall adopt emergency
regulations implementing this section no later than March 1, 2013.
The department may readopt any emergency regulation authorized by
this section that is the same as or substantially equivalent to an
emergency regulation previously adopted under this section.
   (2) The initial adoption of emergency regulations implementing
this section and the one readoption of emergency regulations
authorized by this subdivision shall be deemed an emergency and
necessary for the immediate preservation of the public peace, health,
safety, or general welfare. Initial emergency regulations and the
one readoption of emergency regulations authorized by this section
shall be exempt from review by the Office of Administrative Law. The
initial emergency regulations and the one readoption of emergency
regulations authorized by this section shall be submitted to the
Office of Administrative Law for filing with the Secretary of State
and each shall remain in effect for no more than 180 days, by which
time final regulations may be adopted.
   (h) If the Director of Health Care Services determines that
federal approval is necessary to implement this section, this section
shall be implemented only after any state plan amendments required
pursuant to Section 14132.95 are approved.
  SEC. 3.  Section 14105.09 is added to the Welfare and Institutions
Code, to read:
   14105.09.  Notwithstanding any other provision of law, if
subdivision (b) of Section 3.94 of the Budget Act of 2011 is
operative, effective on or after January 1, 2012, the payment
reductions in Sections 14105.07, 14105.192, 14126.033, 14131.05, and
14131.07 shall apply to managed care health plans that contract with
the department pursuant to Chapter 8.75 (commencing with Section
14590) and to contracts with the Senior Care Action Network and AIDS
Healthcare Foundation, to the extent that the services are provided
through any of these contracts, payments shall be reduced by the
actuarial equivalent amount of the payment reductions pursuant to
contract amendments or change orders effective on July 1, 2011, or
thereafter.
  SEC. 4.  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. 5.  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.