BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  AB 614
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          CONCURRENCE IN SENATE AMENDMENTS
          AB 614 (Chávez)
          As Amended  August 21, 2014
          Majority vote
           
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          |ASSEMBLY:  |     |(April 25,      |SENATE: |34-0 |(August 25,    |
          |           |     |2013)           |        |     |2014)          |
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               (vote not relevant)

          Original Committee Reference:    V.A.  

           SUMMARY  :  Eliminates the requirement that certain Veterans Home  
          residents pay, to the California Department of Veterans Affairs  
          (CDVA), any Aid and Attendance benefits they receive from the  
          United States Department of Veterans Affairs (USDVA) and  
          prohibits the CDVA from charging certain fees as specified.

           The Senate amendments  delete the Assembly version of this bill,  
          and instead:

          1)Eliminate the requirement that certain Veterans Home residents  
            veterans who have a USDVA service-connected disability rating  
            of 70% or greater pay, to the CDVA, any Aid and Attendance  
            benefits they receive from the USDVA.

          2)Prohibits CDVA, when receiving the "super per diem rate" paid  
            by USDVA for veterans who have a USDVA service-connected  
            disability rating of 70% or greater, from charging a so-called  
            "member fee" to such veterans.

          3)Deems that the super per diem rate is deemed to cover all  
            costs of state care to veterans who have a USDVA  
            service-connected disability rating of 70% or greater.

           EXISTING LAW  :

          1)Provides for the establishment and operation of the Veterans  
            Home of California, within the CDVA, at various sites  
            (collectively the "homes") for aged and disabled veterans and  
            their nonveteran spouses, who meet certain eligibility  
            requirements.

          2)Requires members (residents) of the homes to pay fees and  








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            charges, as determined by CalVet.

          3)Provides for the homes to receive federal per diem payments  
            from the USDVA, which help compensate the state veterans homes  
            for the costs of care.

          4)Provides for the homes to receive an increased per-diem (super  
            per diem) for those residents who have a USDVA  
            service-connected disability rating of 70% or greater.

          5)Provides for the homes to receive federal "aid and attendance"  
            payments from the USDVA on behalf of eligible veterans, who  
            need levels of care exceeding provision of basic domiciliary  
            services.

           FISCAL EFFECT :  According to the Senate Appropriations  
          Committee, pursuant to Senate Rule 28.8, negligible state costs.
           COMMENTS  :  Federal regulations (Code of Federal Regualtions  
          Title 38, Chapter 1, Part 51 Subpart C, Section 51.41) govern  
          how the USDVA and a state veterans home enter into a contract or  
          provider agreement through which the USDVA will make payments,  
          including per diem payments, toward each eligible veteran's  
          care.  The regulations state that eligible veterans are those  
          who: are in need of nursing home care for a USDVA adjudicated  
          service-connected disability, or, have a singular or combined  
          rating of 70% or more based on one or more service-connected  
          disabilities or a rating of total disability based on individual  
          unemployability and are in need of nursing home care.  
           
          The regulations also provide:  "The State home shall not charge  
          any individual, insurer, or entity (other than USDVA) for the  
          nursing home care paid for by USDVA under a USDVA provider  
          agreement."

          According to the Senate Veterans Affairs Committee:

               CDVA understands this to mean that it may not charge  
               member fees of any resident veteran with a 70 percent  
               or higher VA rating. The justification for the federal  
               exemption rule is that, for those veterans, the  
               federal VA pays a "super per diem" that is 4-5 times  
               greater than the normal per diem, and that should be  
               considered sufficient to pay for a 70 percent-plus  
               veteran's full cost of care.  They have been  
               administratively complying with this regulation, but  








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               believe they need a state statute exempting 70  
               percent-plus veterans from the statutory requirement  
               to pay member fees.  This bill would conform state law  
               with federal regulations by modifying MVC [Military  
               and Veterans Code] Section 1012.3.

          This bill also amends Military Veterans Code (MVC) Section  
          1012.2, which requires that the federal VA's aid and attendance  
          payments - for a veteran residing in a state veterans home -  
          ends up in the hands of the state home to help ensure that state  
          taxpayers are partially compensated for the cost of care to the  
          veteran resident.  Under federal regulations, when a 70%-plus  
          veteran receives the super per diem payments, the aid and  
          attendance payments are stopped.  This bill modifies MVC Section  
          1012.2 to reflect the impact of the federal policy.

          Related Legislation

          SB 1440 (Wolk) of the current legislative session, alters the  
          fee structure for nonveteran spouses residing in state veterans  
          homes; requires nonveteran spouses to pay the same fees and  
          charges as paid by the veteran members of the home and subject  
          to the same prohibitions.  This bill and SB 1440 may be double  
          jointed depending on the outcome of their next legislative  
          hearings.

          AB 488 (Cook) of 2011:  Identical to SB 1440. 


           Analysis Prepared by  :    John Spangler / V.A. / (916) 319-3550


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