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 SB 1036 Page 2 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 SB 1036 Page 3 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. SB 1036 Page 4 20)Contains an appropriation allowing this bill to take effect immediately upon enactment. Analysis Prepared by : Nicole Vazquez / BUDGET / (916) 319-2099 FN: 0004206