BILL NUMBER: SB 349	INTRODUCED
	BILL TEXT


INTRODUCED BY   Senator Walters

                        FEBRUARY 20, 2013

   An act to add Section 14132.993 to the Welfare and Institutions
Code, relating to Medi-Cal.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 349, as introduced, Walters. Home- and community-based services
waiver for the developmentally disabled: sheltered work.
   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 federal law provides for
various home- and community-based services waivers.
   This bill would require a provider of sheltered work under a
specified home- and community-based services waiver to demonstrate
that the provider is transitioning at least 20 percent of its clients
annually into integrated, individualized employment settings, with
or without support, in order to get reimbursed under the waiver.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  The Legislature finds and declares all of the
following:
   (a) It is good public policy to increase the number of
Californians with developmental disabilities who pay taxes and are
self-sufficient and involved in their communities.
   (b) Individuals with developmental disabilities can and would
prefer to work and are entitled to the supports and services
necessary to do so.
   (c) The Americans with Disabilities Act recognizes the rights of
people with developmental disabilities to live, recreate, and work in
integrated, community-based settings. Title II of the Americans with
Disabilities Act requires states to provide qualified individuals
with disabilities with services and programs in the most integrated
setting appropriate to their needs.
   (d) People with developmental disabilities are an important and
largely untapped employment and economic resource.
   (e) Research demonstrates that wages and hours worked increase
dramatically as individuals move from sheltered or facility-based
employment to integrated employment, and suggests that other benefits
include an increase in earnings and taxes paid, reduced reliance on
publicly funded services, expanded social relationships, heightened
self-determination, and more typical job acquisitions and job roles.
   (f) Increasing integrated and gainful employment opportunities for
people with developmental disabilities requires collaboration and
cooperation by state and local agencies, including, but not limited
to, the State Department of Developmental Services and regional
centers, the State Council on Developmental Disabilities, the
Employment Development Department, the Department of Rehabilitation,
and the State Department of Education.
   (g) Working-age Californians who have developmental disabilities
have an unemployment rate as high as 80 percent and traditional
approaches to increase employment rates through training and employer
outreach have not been sufficient to solve this problem.
   (h) The federal Centers for Medicare and Medicaid Services states
that Medicaid-financed prevocational services to sheltered workshops
are "not an end point, but a time limited  although no specific
limit is given] service for the purpose of helping someone obtain
competitive employment."
   (i) Sheltered workshops are not doing what the Medicaid Program is
paying them to do. Between 2007 and 2010, sheltered workshops in
California transitioned less than 5 percent of workers into
integrated employment.
  SEC. 2.  Section 14132.993 is added to the Welfare and Institutions
Code, to read:
   14132.993.  (a) In order for a provider of sheltered work to be
reimbursed under the home- and community-based waiver for the
developmentally disabled under Section 1915(c) of the federal Social
Security Act (42 U.S.C. Sec. 1396n(c)), the provider shall
demonstrate that the provider is transitioning at least 20 percent of
its clients annually into integrated, individualized employment
settings, with or without support.
   (b) For the purposes of this section, "sheltered work" also means
"facility-based employment" or "center-based employment."
   (c) The department shall seek any necessary federal approvals to
implement this section.