BILL NUMBER: AB 2025 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY MARCH 18, 2014
INTRODUCED BY Assembly Member Dickinson
FEBRUARY 20, 2014
An act to amend Section 14005.40 of the Welfare and Institutions
Code, relating to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
AB 2025, as amended, Dickinson. Medi-Cal: program for aged and
disabled persons.
Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Care Services, under
which qualified low-income individuals receive health care services.
The Medi-Cal program is, in part, governed and funded by federal
Medicaid Program provisions. Existing law requires the department to
exercise its option under federal law to implement a program for aged
and disabled person, persons, as
described. Existing law provides that an individual under these
provisions shall satisfy certain financial eligibility requirements,
including, among other things, that his or her countable income does
not exceed an income standard equal to 100% of the applicable federal
poverty level, plus an income disregard of $230 for an
individual, or $310 in the case of a couple, as prescribed
except that the income standard determined may not be
less than SSI/SSP payment level for a disabled individual or couple,
as applicable .
This bill would instead provide that the individual's countable
income shall not exceed an income standard equal to 138% of the
applicable federal poverty level.
This bill would increase those income disregard amounts to $369
for an individual, or $498 in the case of a couple, and require that
the income disregards be adjusted annually. The bill would provide,
however, that the income standard determined may not be less than the
SSI/SSP payment level the individual or couple, as applicable,
receives or would receive as a disabled or blind individual or
couple.
Because counties are required to make Medi-Cal eligibility
determinations and this bill would expand Medi-Cal eligibility, the
bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that, if the Commission on State Mandates
determines that the bill contains costs mandated by the state,
reimbursement for those costs shall be made pursuant to these
statutory provisions.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 14005.40 of the Welfare and Institutions Code
is amended to read:
14005.40. (a) To the extent federal financial participation is
available, the department shall exercise its option under Section
1902(a)(10)(A)(ii)(X) of the federal Social Security Act (42 U.S.C.
Sec. 1396a(a)(10)(A)(ii)(X)), to implement a program for aged and
disabled persons as described in Section 1902(m) of the federal
Social Security Act (42 U.S.C. Sec. 1396a(m)(1)).
(b) To the extent federal financial participation is available,
the blind shall be included within the definition of disabled for the
purposes of the program established in this section.
(c) An individual shall satisfy the financial eligibility
requirement of this program if all of the following conditions are
met:
(1) Countable income, as determined in accordance with Section
1902(m) of the federal Social Security Act (42 U.S.C. Sec. 1396a(m)),
does not exceed an income standard equal to 138
100 percent of the applicable federal poverty level,
plus an income disregard of three hundred sixty-nine dollars ($369)
for an individual, or in the case of a couple, four hundred ninety-
eight dollars ($498), except that the income
standard so determined shall not be less than the SSI/SSP payment
level for the individual receives or would
receive as a disabled or blind individual or, in the
case of a couple, the SSI/SSP payment level for
the couple receives or would receive as a disabled or
blind couple.
(2) The income disregard amounts in paragraph (1) are based on the
2014 federal poverty levels, so that the income standard plus the
income disregard totals 138 percent of the federal poverty level. The
income disregard amounts shall be adjusted annually and applied when
the federal poverty levels take effect in order to maintain the
income standard at 138 percent of the federal poverty level, except
that the income standard shall not be less than the SSI/SSP payment
level the individual receives or would receive as a disabled or blind
individual, or in the case of a couple, the SSI/SSP payment level
the couple receives or would receive as a disabled or blind couple.
(2)
(3) (A) For the purposes of calculating countable
income under this section, an income exemption shall be applied as
necessary to adjust the SSI/SSP payment level as used in this section
so that it is the same as the SSI/SSP payment level that was in
place on May 1, 2009.
(B) This additional income exemption shall cease to be implemented
when the SSI/SSP payment levels increase beyond those in effect on
May 1, 2009.
(C) Notwithstanding Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code, the
department shall implement this paragraph by means of an all-county
letter or similar instruction without taking regulatory action.
(3)
(4) Countable resources, as determined in accordance
with Section 1902(m) of the federal Social Security Act (42 U.S.C.
Sec. 1396a(m)), do not exceed the maximum levels established in that
section.
(d) The financial eligibility requirements provided in subdivision
(c) may be adjusted upwards to reflect the cost of living in
California, contingent upon appropriation in the annual Budget Act.
(e) Notwithstanding Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code, the
department shall implement this section by means of all-county
letters or similar instructions, and without taking regulatory
action. Thereafter, the department shall adopt regulations in
accordance with the requirements of Chapter 3.5 (commencing with
Section 11340) of Part 1 of Division 3 of Title 2 of the Government
Code.
(f) For purposes of calculating income under this section during
any calendar year, increases in social security benefit payments
under Title II of the federal Social Security Act (42 U.S.C. Sec. 401
et seq.) arising from cost-of-living adjustments shall be
disregarded commencing in the month that these social security
benefit payments are increased by the cost-of-living adjustment
through the month before the month in which a change in the federal
poverty level requires the department to modify the income standard
described in subdivision (c).
(g) (1) For purposes of this section the following definitions
apply:
(A) "SSI" means the federal Supplemental Security Income program
established under Title XVI of the federal Social Security Act.
(B) "Income standard" means the applicable income standard
specified in subdivision (c) , including the augmentations
specified in paragraphs (1) and (2) of that subdivision .
(C) The board and care "personal care services" or "PCS" deduction
refers to an income disregard that is applied to a resident in a
licensed community care facility in lieu of the board and care
deduction (equal to the amount by which the basic board and care rate
exceeds the income standard in subparagraph (B), of
paragraph (1) of subdivision (g)) (B)) when the
PCS deduction is greater than the board and care deduction.
(2) (A) For purposes of this section, the SSI recipient retention
amount is the amount by which the SSI maximum payment amount to an
individual residing in a licensed community care facility exceeds the
maximum amount that the state allows community care facilities to
charge a resident who is an SSI recipient.
(B) For the purposes of this section, the personal and incidental
needs deduction for an individual residing in a licensed community
care facility is either of the following:
(i) If the board and care deduction is applicable to the
individual, the amount, not to exceed the amount by which the SSI
recipient retention amount exceeds twenty dollars ($20), nor to be
less than zero, by which the sum of the amount which the individual
pays to his or her licensed community care facility and the SSI
recipient retention amount exceed the sum of the individual's income
standard, the individual's board and care deduction, and twenty
dollars ($20).
(ii) If the PCS deduction specified in paragraph (1) of
subdivision (g) is applicable to the individual, an amount, not to
exceed the amount by which the SSI recipient retention amount exceeds
twenty dollars ($20), nor to be less than zero, by which the sum of
the amount which the individual pays to his or her community care
facility and the SSI recipient retention amount exceed the sum of the
individual's income standard, the individual's PCS deduction ,
and twenty dollars ($20).
(3) In determining the countable income under this section of an
individual residing in a licensed community care facility, the
individual shall have deducted from his or her income the amount
specified in subparagraph (B) of paragraph (2).
(h) No later than one month after the effective date of
subdivision (g), the department shall submit to the federal
medicaid Medicaid administrator a state plan
amendment seeking approval of the income deduction specified in
paragraph (3) of subdivision (g), and of federal financial
participation for the costs resulting from that income deduction.
(i) The deduction prescribed by paragraph (3) of subdivision (g)
shall be applied no later than the first day of the fourth month
after the month in which the department receives approval for the
federal financial participation specified in subdivision (h). Until
approval for federal financial participation is received, there shall
be no deduction under paragraph (3) of subdivision (g).
SEC. 2. If the Commission on State Mandates determines that this
act contains costs mandated by the state, reimbursement to local
agencies and school districts for those costs shall be made pursuant
to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of
the Government Code.