Amended in Assembly March 19, 2013

California Legislature—2013–14 Regular Session

Assembly Bill No. 784

Introduced by Assembly Member Weber

February 21, 2013

An act to begin delete amend end delete begin insert add end insert Section begin delete 12300 of end delete begin insert 12331 to end insert the Welfare and Institutions Code, relating to public social services.

LEGISLATIVE COUNSEL’S DIGEST

AB 784, as amended, Weber. In-Home Supportive begin delete Services. end delete begin insert Services: provider health care benefits. end insert

Existing law provides for the county-administered In-Home Supportive Services begin insert (IHSS) end insert program, under which qualified aged, blind, and disabled persons are provided with services in order to permit them to remain in their own homes and avoid institutionalization. begin insert Under existing law, the state, a county, a public authority, a nonprofit consortium, or an IHSS recipient may be considered the employer of an IHSS provider. end insert

begin insert

Existing federal law, the federal Patient Protection and Affordable Care Act (PPACA), enacts various health care coverage market reforms that take effect January 1, 2014. Among other things, PPACA imposes an assessment on certain employers who fail to offer to their full-time employees and their dependents the opportunity to enroll in minimum essential coverage under an eligible employer-sponsored plan.

end insert

This bill would begin delete make a technical, nonsubstantive change to these provisions. end delete begin insert establish an advisory committee on the impact of PPACA on health care benefits for providers of IHSS providers and would provide for the appointment of members to the committee by the Governor, the Speaker of the Assembly, and the Senate Committee on Rules, as specified. The bill would require the advisory committee to provide advice on the appropriate employer in the IHSS program to provide health care benefits to IHSS providers under PPACA. end insert

Vote: majority. Appropriation: no. Fiscal committee:  begin delete no end delete begin insert yes end insert . State-mandated local program: no.

The people of the State of California do enact as follows:

begin insert

begin insert SECTION 1. end insert   

end insert

begin insert Section 12331 is added to the end insert begin insert Welfare and
Institutions Code end insert begin insert , to read: end insert

begin insert

begin insert 12331. end insert   

(a) There shall be established a 13-member advisory
committee to assess the impact of the federal Patient Protection
and Affordable Care Act on health care benefits for in-home
supportive services providers. At least 50 percent of the
membership of the advisory committee shall be individuals who
are current or past users of personal assistance services paid for
through public or private funds or as recipients of in-home
supportive services.

(1) At least two members of the advisory committee shall be
current or former providers of in-home supportive services.

(2) Individuals who represent organizations that advocate for
people with disabilities or seniors may be appointed to the advisory
committee.

(3) Individuals from labor organizations that are designated
representatives of IHSS providers shall be appointed to the
advisory committee.

(b) The Governor shall appoint seven members, the Speaker of
the Assembly shall appoint three members, and the Senate
Committee on Rules shall appoint three members.

(c) Prior to appointment of the members to the advisory
committee, the Governor, the Speaker of the Assembly, and the
Senate Committee on Rules shall consult with labor organizations
and organizations that advocate for seniors and persons with
disabilities regarding these appointments.

(d) The advisory committee established pursuant to subdivision
(a) shall provide advice on the appropriate employer under the
In-Home Supportive Services program to provide health care
benefits to in-home supportive services providers under the Patient
Protection and Affordable Care Act.

end insert

begin delete

SECTION 1.  

Section 12300 of the Welfare and Institutions Code
is amended to read:

12300.  

(a) The purpose of this article is to provide in every
county in a manner consistent with this chapter and the annual
Budget Act those supportive services identified in this section to
aged, blind, or disabled persons, as defined under this chapter,
who are unable to perform the services themselves and who cannot
safely remain in their homes or abodes of their own choosing unless
these services are provided.

(b) Supportive services shall include domestic services and
services related to domestic services, heavy cleaning, personal
care services, accompaniment by a provider when needed during
necessary travel to health-related appointments or to alternative
resource sites, yard hazard abatement, protective supervision,
teaching and demonstration directed at reducing the need for other
supportive services, and paramedical services that make it possible
for the recipient to establish and maintain an independent living
arrangement.

(c) Personal care services shall mean all of the following:

(1) Assistance with ambulation.

(2) Bathing, oral hygiene, and grooming.

(3) Dressing.

(4) Care and assistance with prosthetic devices.

(5) Bowel, bladder, and menstrual care.

(6) Repositioning, skin care, range of motion exercises, and
transfers.

(7) Feeding and assurance of adequate fluid intake.

(8) Respiration.

(9) Assistance with self-administration of medications.

(d) Personal care services are available if these services are
provided in the beneficiary’s home and other locations as may be
authorized by the director. Among the locations that may be
authorized by the director under this paragraph is the recipient’s
place of employment if all of the following conditions are met:

(1) The personal care services are limited to those that are
currently authorized for a recipient in the recipient’s home and
those services are to be utilized by the recipient at the recipient’s
place of employment to enable the recipient to obtain, retain, or
return to work. Authorized services utilized by the recipient at the
recipient’s place of employment shall be services that are relevant
and necessary in supporting and maintaining employment.
However, workplace services shall not be used to supplant any
reasonable accommodations required of an employer by the
Americans with Disabilities Act (42 U.S.C. Sec. 12101 et seq.;
ADA) or other legal entitlements or third-party obligations.

(2) The provision of personal care services at the recipient’s
place of employment shall be authorized only to the extent that
the total hours utilized at the workplace are within the total personal
care services hours authorized for the recipient in the home.
Additional personal care services hours may not be authorized in
connection with a recipient’s employment.

(e) Where supportive services are provided by a person having
the legal duty pursuant to the Family Code to provide for the care
of his or her child who is the recipient, the provider of supportive
services shall receive remuneration for the services only when the
provider leaves full-time employment or is prevented from
obtaining full-time employment because no other suitable provider
is available and where the inability of the provider to provide
supportive services may result in inappropriate placement or
inadequate care.

These providers shall be paid only for the following:

(1) Services related to domestic services.

(2) Personal care services.

(3) Accompaniment by a provider when needed during necessary
travel to health-related appointments or to alternative resource
sites.

(4) Protective supervision only as needed because of the
functional limitations of the child.

(5) Paramedical services.

(f) To encourage maximum voluntary services, so as to reduce
governmental costs, respite care shall also be provided. Respite
care is temporary or periodic service for eligible recipients to
relieve persons who are providing care without compensation.

(g) A person who is eligible to receive a service or services
under an approved federal waiver authorized pursuant to Section
14132.951, or a person who is eligible to receive a service or
services authorized pursuant to Section 14132.95, shall not be
eligible to receive the same service or services pursuant to this
article. In the event that the waiver authorized pursuant to Section
14132.951, as approved by the federal government, does not extend
eligibility to all persons otherwise eligible for services under this
article, or does not cover a service or particular services, or does
not cover the scope of a service that a person would otherwise be
eligible to receive under this article, those persons who are not
eligible for services, or for a particular service under the waiver
or Section 14132.95 shall be eligible for services under this article.

(h) (1) All services provided pursuant to this article shall be
equal in amount, scope, and duration to the same services provided
pursuant to Section 14132.95, including any adjustments that may
be made to those services pursuant to subdivision (e) of Section
14132.95.

(2) Notwithstanding any other provision of this article, the rate
of reimbursement for in-home supportive services provided through
any mode of service shall not exceed the rate of reimbursement
established under subdivision (j) of Section 14132.95 for the same
mode of service unless otherwise provided in the annual Budget
Act.

(3) The maximum number of hours available under Section
14132.95, Section 14132.951, and this section, combined, shall
be 283 hours per month. Any recipient of services under this article
shall receive no more than the applicable maximum specified in
Section 12303.4.

end delete