BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  SB 1036
                                                                  Page  1


          SENATE THIRD READING
          SB 1036 (Budget and Fiscal Review Committee)
          As Amended  June 25, 2012
          Majority vote.  Budget Bill Appropriation Takes Effect 
          Immediately 

           SENATE VOTE  :Vote not relevant  
           
           SUMMARY  :  Makes statutory changes necessary to implement 
          portions of the 2012-13 Budget as it relates to the Duals 
          Demonstration Project and Long-Term Services and Supports 
          Integration.  Specifically,  this bill  :
          
          1)Incorporates and preserves the In-Home Supportive Services 
            (IHSS) program into the Duals Demonstration Project.  The 
            demonstration project will enable individuals to receive a 
            continuum of services that maximizes access to, and 
            coordination of, benefits between the Medi-Cal and Medicare 
            programs, with the continuum of long-term services and 
            supports and behavioral health services. 

          2)Commences the demonstration project with an eight-county pilot 
            and folds in the IHSS program as counties transition, 
            retaining the consumer's ability to direct and control care.  

          3)Authorizes integration of long-term services and supports in 
            order to improve consumer health and well-being, and to 
            maximize the availability of home- and community based 
            services to consumers.  

          4)Maintains the key social model components of the IHSS program 
            and refocuses the health care delivery system to include the 
            social model as a primary component of coordinated care 
            delivery.

          5)Provides that, no sooner than March 1, 2013, the IHSS program 
            shall be a Medi-Cal benefit available through managed care 
            health plans in a county that is participating in the Duals 
            Demonstration Project.  Requires that this transition occur 
            over 12 months.

          6)Ensures that access to and payment for services for 
            individuals who meet the current eligibility criteria for the 
            IHSS program will be maintained.  Requires that IHSS be 








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            provided in accordance with current law set out pursuant to 
            Code Section 12300 et seq.  

          7)Preserves a consumer's right to be the employer, to select, 
            engage, direct, supervise, schedule, and terminate IHSS 
            providers in accordance with current law.  

          8)Creates a 13-member consumer advisory committee at the state 
            level to provide ongoing advice and recommendations regarding 
            the IHSS program.  Provides that at least 50% of the 
            membership of the advisory committee shall be individuals who 
            are current or past consumers of personal assistance services 
            paid for through public or private funds or as current 
            consumers of services under this article.  Membership will 
            include current or former providers, and individuals who 
            represent organizations that advocate for people with 
            disabilities or seniors.

          9)Requires the consumer's consent to address a care coordination 
            team as it is being considered during the Duals Demonstration 
            Project.  

          10)Continues to require all quality assurance provisions, and 
            other data and standards requirements as specified, related to 
            the Department of Social Services (DSS) implementation of the 
            IHSS program to apply, including state and federal quality 
            assurance requirements.  

          11)Contains provisions to continue IHSS services with the 
            consumer empowered to direct and control their care and to 
            transition certain functions to the state level.  Preserves 
            the consumer's right to the appeal process as set forth in 
            current law.

          12)Maintains current law provisions requiring background checks 
            for prospective providers.  

          13)Authorizes the Department of Health Care Services (DHCS), the 
            DSS, and the California Department of Aging (CDA) to establish 
            a stakeholder workgroup process to develop the universal 
            assessment process including a universal assessment tool for 
            home and community based services.  The universal assessment 
            process would be designed and tested in order to be used for 
            all home and community based services.  Directs the 








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            stakeholder group to build upon the IHSS uniform assessment 
            process and hourly task guidelines, the Multipurpose Senior 
            Services Program (MSSP) assessment process, and other 
            appropriate home and community-based assessment tools.  
            Includes a list of issues and criteria for the stakeholder 
            workgroup to consider in developing the universal assessment 
            process and tool. 

          14)Requires the DHCS and the DSS to report to the Legislature 
            regarding the progress of the workgroup in developing the 
            universal assessment process.  Authorizes the design, testing 
            and pilot implementation of the process and tool.  

          15)Redefines the county share-of-cost provisions in the IHSS 
            program and instead creates a county Maintenance of Effort 
            (MOE) to preserve base funding for the IHSS program.  Creates 
            a base level of funding necessary for the IHSS program.  
            Provides an adjustment factor in the future of 3.5%.  

          16)Modifies the county MOE in the case of lower-than-expected 
            1991 realignment funding and requires the Department of 
            Finance (DOF) to notify the appropriate legislative fiscal 
            committees and the California State Association of Counties 
            (CSAC) by May 14 of each year whether the factor will apply 
            for the following year.  Requires the county MOE to be 
            adjusted to reflect local modifications to agreements.  
            Defines which sharing ratios apply pertaining to local 
            modifications.  Makes inoperative the county MOE under certain 
            conditions as decided by the Director of the DHCS.

          17)Gives discretion to the Director of the DHCS to make these 
            provisions inoperative based on certain criteria.

          18)Requires the DSS to develop in consultation with the DHCS and 
            in collaboration with stakeholders a training curriculum for 
            providers for which participation is voluntary and for which 
            there shall be no state costs.  Preserves the IHSS consumer's 
            right to train his or her individual provider.  

          19)Makes this measure contingent on enactment of the 
            health-related portions of the Duals Demonstration Project and 
            Long-Term Services and Supports Integration contained in SB 
            1008 or AB 1468.









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          20)Contains an appropriation allowing this bill to take effect 
            immediately upon enactment.


           Analysis Prepared by  :    Nicole Vazquez / BUDGET / (916) 
          319-2099


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