BILL ANALYSIS                                                                                                                                                                                                    Ó






                             SENATE COMMITTEE ON HEALTH
                          Senator Ed Hernandez, O.D., Chair

          BILL NO:       AB 485
          AUTHOR:        Gomez
          AMENDED:       September 6, 2013
          HEARING DATE:  January 15, 2014
          CONSULTANT:    Marchand

           SUBJECT  :  In-home supportive services.
           
          SUMMARY  :  Requires the new statewide California In-Home  
          Supportive Services Authority to assume responsibility for  
          bargaining with recognized employee organizations representing  
          in-home supportive services providers effective January 1, 2014,  
          and de-links this Statewide Authority from implementation of the  
          Coordinated Care Initiative so that the Statewide Authority is  
          permanent regardless of what happens with the Coordinated Care  
          Initiative.

          Existing law:
          1.Establishes the Medi-Cal program, administered by the  
            Department of Health Care Services (DHCS), under which  
            qualified low-income individuals receive health care services.  
            Establishes a schedule of benefits for Medi-Cal beneficiaries,  
            which includes in-home supportive services (IHSS).  IHSS  
            services include housecleaning, meal preparation, laundry,  
            grocery shopping, personal care services (including bathing,  
            bowel and bladder care, and grooming), accompaniment to  
            medical appointments, and protective supervision for the  
            mentally impaired.

          2.Establishes a demonstration project, subject to federal  
            approval, in up to eight counties, known as the Coordinated  
            Care Initiative (CCI).  The CCI is intended to better serve  
            the state's low-income seniors and persons with disabilities  
            by integrating delivery of medical, behavioral, and long-term  
            care services.

          3.Requires dual eligible beneficiaries (those eligible for both  
            Medicare and Medi-Cal), as one of the components of the CCI,  
            to be assigned as mandatory enrollees in Medi-Cal managed care  
            health plans for their Medi-Cal and Medicare benefits in  
            counties participating in the CCI demonstration project, with  
            specified exceptions.  This component of the CCI is known as  
            Cal MediConnect.
                                                         Continued---



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          4.Requires, as an additional component of the CCI, that all  
            Medi-Cal long-term services and supports, which include IHSS,  
            be services that are covered under managed care health plan  
            contracts and be available only through managed care health  
            plans to beneficiaries residing in counties participating in  
            the CCI demonstration project, with specified exceptions.   
            Requires the director of DHCS to consult with the Legislature,  
            the Center for Medicare and Medicaid Services, and  
            stakeholders when determining the implementation date of this  
            requirement.

          5.Establishes the California IHSS Authority (Statewide  
            Authority) as a joint powers authority, composed of two county  
            officials who serve at the pleasure of the Governor, and the  
            directors of DHCS, the Department of Social Services, and the  
            Department of Finance.

          6.Requires the Statewide Authority to be the entity authorized  
            to meet and confer regarding wages and benefits with  
            recognized employee organizations for IHSS providers  
            commencing after the "county implementation date."  The  
            "county implementation date" occurs when a county that is one  
            of the CCI demonstration counties is notified by the Director  
            of DHCS that the enrollment of eligible Medi-Cal  
            beneficiaries, as specified, has been completed in that  
            county.

          7.Requires the Director of Finance, at least 30 days prior to  
            enrollment of beneficiaries into the CCI, to estimate the  
            amount of net General Fund savings obtained from the CCI.   
            Requires the CCI to be suspended immediately if the Director  
            of Finance estimates the CCI will not generate net General  
            Fund savings, and specifies that various statutes become  
            inoperative if the CCI is suspended, including provisions  
            creating the Statewide Authority.

          8.Requires, beginning July 1, 2012, all counties to have a  
            County IHSS Maintenance of Effort (MOE), as specified, which  
            the counties pay in lieu of paying the non-federal share of  
            IHSS costs, as specified. Also requires the MOE to be paid in  
            lieu of a county's share of the costs of negotiated wage and  
            benefit increases. Makes these MOE provisions inoperative, and  
            reverts counties back to the otherwise specified share of  
            cost, if the CCI becomes inoperative.
          




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          This bill:
          1.Requires the Statewide Authority to assume responsibility for  
            bargaining with the recognized employee organizations  
            representing IHSS providers, as specified in the IHSS  
            Employer-Employee Relations Act, in all counties as of January  
            1, 2014, rather than in a county participating in the CCI  
            demonstration project upon notification by the director of  
            DHCS that the enrollment of eligible Medi-Cal beneficiaries  
            has been completed in that county, as specified.

          2.De-links the Statewide Authority and related provisions from  
            the CCI, thereby making these provisions permanent, by  
            deleting language that renders these provisions inoperative if  
            the Director of Finance determines that the CCI will not  
            generate net General Fund savings and therefore renders the  
            CCI inoperative.

          3.De-links from the CCI, and thereby makes permanent, a  
            provision establishing an IHSS MOE requirement for all  
            counties in lieu of their share of non-federal costs, by  
            deleting language that renders the MOE provision inoperative  
            if the CCI is rendered inoperative.

          4.De-links from the CCI, and thereby makes permanent, a  
            provision of law requiring each county's IHSS MOE to count  
            toward its share of cost of negotiated wage and benefit  
            increases.

          5.Conforms various provisions of law to the new January 1, 2014,  
            implementation date of the Statewide Authority by removing  
            reference to the county implementation dates.  

          6.Eliminates from the list of codes that will become  
            inoperative, if the CCI is rendered inoperative because of a  
            lack of General Fund savings, various codes relating to the  
            Statewide Authority, including those that establish the IHSS  
            Employer-Employee Relations Act, establish and define the  
            duties of the Statewide Authority, and require all counties to  
            have a county IHSS MOE.

          7.Makes other technical and conforming changes.

           FISCAL EFFECT  :  This bill has not been analyzed by a fiscal  
          committee.





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           PRIOR VOTES  :  
          Senate Human Services:4 - 2
           
          COMMENTS :  
           1.Author's statement.  According to the author, this bill is  
            necessary because ongoing delays to the implementation of the  
            State's CCI have resulted in delays in the creation of the  
            IHSS Statewide Authority and the transfer of employer  
            responsibilities in IHSS from the local level to the state  
            level. This bill would sever the link between the CCI and  
            collective bargaining in the IHSS program, and would require  
            the IHSS Statewide Authority to assume the employer  
            responsibility for collective bargaining in all 58 counties in  
            California beginning in January.

          2.Background on IHSS.  The IHSS program is a Medi-Cal benefit,  
            which provides services that enable the recipient to remain in  
            their home.  The IHSS program provides personal care services  
            to approximately 420,000 qualified low-income individuals who  
            are aged, blind, or disabled. Services include tasks like  
            feeding, bathing, bowel and bladder care, meal preparation and  
            clean-up, laundry, and paramedical care. These services  
            frequently help program recipients to avoid or delay more  
            expensive and less desirable institutional care settings. The  
            average annual cost of services per IHSS client is estimated  
            to be $12,000 for 2012-13.

          County social workers determine IHSS eligibility and perform  
            case management after conducting a standardized in-home  
            assessment of an individual's ability to perform activities of  
            daily living. Based on authorized hours and services, IHSS  
            recipients are responsible for hiring, firing, and directing  
            their IHSS provider(s). In the majority of cases, recipients  
            choose a relative to provide care. In 2012, there were around  
            380,000 IHSS providers with hourly wages varying by county and  
            ranging from $8.00 to $12.20 per hour. Prior to July 1, 2012,  
            county public authorities or nonprofit consortia were  
            designated as "employers of record" for collective bargaining  
            purposes on a statewide basis, while the state administered  
            payroll and benefits. Pursuant to 2012-13 trailer bill  
            language, however, collective bargaining responsibilities in  
            the eight counties participating in the CCI will start to  
            shift to an IHSS Authority administered by the state.
               
          3.Background on the Coordinated Care Initiative.  The Budget Act  
            of 2012 enacted the CCI (also called Cal MediConnect), a  




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            framework for integrating delivery of medical, behavioral and  
            long-term care services through a single health plan for  
            persons eligible for both Medicare and Medi-Cal.  The CCI is  
            currently limited to the following eight demonstration  
            counties: Alameda, Los Angeles, Orange, San Diego, San Mateo,  
            Riverside, San Bernardino, and Santa Clara. As part of the  
            CCI, persons receiving long-term services and supports, such  
            as IHSS, are required to be enrolled in a managed care plan to  
            receive these services. Approximately 65 percent of IHSS  
            recipients reside in the demonstration counties. 

          Related to CCI, a 2012-13 budget trailer bill (SB 1036 (Budget  
            and Fiscal Review Committee), Chapter 45, Statutes of 2012)  
            shifted collective bargaining responsibilities from local  
            county public authorities or non-profit consortia in the  
            demonstration counties to the new Statewide Authority, with  
            specified members and an advisory committee. SB 1036 also  
            created an IHSS MOE funding requirements for counties, which  
            replaced the previously existing county share of non-federal  
            funding of 35 percent. Further, SB 1036 shifted collective  
            bargaining responsibilities from local county public  
            authorities or non-profit consortia in the demonstration  
            counties to the new Statewide Authority, with specified  
            members and an advisory committee. Under the trailer bill  
            language, this shift occurs in each county once enrollment  
            into managed care pursuant to the CCI has been completed. DHCS  
            anticipates that this shift will begin in April 2014.

          4.Double referral.  This bill was heard in the Senate Human  
            Services Committee on September 11, 2013, and passed with a  
            4-2 vote.

          5.Prior legislation. SB 1008 (Budget and Fiscal Review  
            Committee), Chapter 33, Statutes of 2012, implement the Duals  
            Demonstration Pilot Projects, including integration of  
            long-term services and supports.

          SB 1036 (Budget and Fiscal Review Committee), Chapter 45,  
            Statutes of 2012, was a human services budget trailer bill  
            that contained the necessary statutory changes to implement  
            the human services provisions related to the integration of  
            home and community based and long-term care services,  
            including IHSS, into Medi-Cal managed care, as specified in  
            the Budget Act of 2012.





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          SB 94 (Budget and Fiscal Review Committee), Chapter 37, Statutes  
            of 2013, enacted changes to existing law regarding the CCI and  
            de-linked CCI components to allow the mandatory enrollment of  
            Medi-Cal and Medicare beneficiaries (dual eligible) into  
            Medi-Cal managed care, the integration of long-term services  
            and supports into managed care plans, and the commencement of  
            the IHSS Statewide Authority, to proceed separately from the  
            CCI Duals Demonstration Project.
          
          6.Support.  This bill is co-sponsored by the American Federation  
            of State, County and Municipal Employees (AFSCME), the Service  
            Employee International Union (SEIU) California, the United  
            Domestic Workers/AFSCME Local 3930 (UDW), and the California  
            United Homecare Workers Local 4034 AFSCME/SEIU.  The  
            proponents state that the Budget Act of 2012 planned for CCI  
            enrollment in eight counties to begin no earlier than March  
            2013, but that it is now slated to begin no earlier than April  
            2014, a delay of more than a year.  Additionally, there is no  
            plan in place to expand beyond the eight counties.  Proponents  
            state that this bill effectively de-links the transition to  
            state level collective bargaining from every other aspect of  
            the CCI and allows state level bargaining to begin in all 58  
            counties in a timely manner.
            
          7.Expanding beyond the eight demonstration counties.  Under  
            current law, the Statewide Authority will become the  
            bargaining entity for IHSS providers only in a county that is  
            one of the eight CCI demonstration counties, and only when the  
            director of DHCS determines that enrollment into managed care  
            plans has been completed for the Medi-Cal beneficiaries in  
            that county.  While the intent may have always been to  
            eventually have the Statewide Authority become the bargaining  
            entity to negotiate with providers in all 58 counties, the  
            current statutory structure only provides a pathway for the  
            eight CCI demonstration counties.  This bill not only speeds  
            up the effective date of the Statewide Authority in the eight  
            demonstration counties to January 1, 2015, it also applies it  
            to the remaining 50 counties.

          8.Policy Comment. The previous contents of this bill were  
            deleted and the current provisions were amended into this bill  
            on September 6, 2013.  The effect of this bill is to change an  
            agreement reached as part of the 2012 Budget Act, and modified  
            as part of the 2013 Budget Act.  Having the Statewide  
            Authority assume the bargaining authority across all 58  
            counties, coupled with making the county MOE in lieu of their  




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            share of cost permanent, will have the effect of shifting  
            significant cost pressure from the counties to the state.  As  
            described in comment 7) above, this bill is taking an idea  
            that is currently scheduled to be demonstrated in eight  
            counties, and applying it statewide before any of the  
            demonstration counties are up and running.
               
          9.Amendment to change implementation date. As currently drafted,  
            this bill takes effect on January 1, 2014.  This date should  
            be changed to January 1, 2015. 

           SUPPORT AND OPPOSITION  :
          Support:  American Federation of State, County and Municipal  
                    Employees (co-sponsor)
                    Service Employees International Union (co-sponsor)
                    United Domestic Workers/AFSCME Local 3930 (co-sponsor)
                    California United Homecare Workers Local 4034  
                    AFSCME/SEIU (co-sponsor)
                    
          Oppose:   None received



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