BILL ANALYSIS                                                                                                                                                                                                    



          SENATE COMMITTEE ON APPROPRIATIONS
                             Senator Ricardo Lara, Chair
                            2015 - 2016  Regular  Session

          AB 97 (Weber) - In-home supportive services:  provider wages
          
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          |Version: March 26, 2015         |Policy Vote: HUMAN S. 5 - 0     |
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          |Urgency: No                     |Mandate: No                     |
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          |Hearing Date: July 6, 2015      |Consultant: Jolie Onodera       |
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          This bill meets the criteria for referral to the Suspense File.




          Bill  
          Summary:  AB 97 would require the Case Management Information  
          and Payrolling System (CMIPS II) for the In-Home Supportive  
          Services (IHSS) program to be reprogrammed to enable managed  
          health care plans to pay a provider for additional services  
          authorized for IHSS recipients in participating counties of the  
          Coordinated Care Initiative (CCI), as specified.


          Fiscal  
          Impact:  
           One-time costs of $6 million ($3 million General Fund) for  
            reprogramming of CMIPS II and ongoing costs of $1 million  
            ($0.5 million General Fund).
           Potential increase in county administrative costs (Federal  
            Fund/General Fund) to enter data from two payroll systems into  
            the CMIPS II database in order to differentiate between  
            authorized hours for IHSS and by managed health care plans. 







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           Potential increase in IHSS program costs (General Fund) for  
            overtime and related activities, to the extent issuing a  
            single payroll check to providers for both IHSS authorized  
            hours and hours authorized by managed health care plans  
            triggers the requirements under the federal Fair Labor  
            Standards Act (FLSA) and the federal rule is upheld. 


          Background:  Existing law provides that the Department of Social Services  
          (DSS) is responsible for procuring and implementing a new Case  
          Management Information and Payrolling System (CMIPS II) for IHSS  
          and establishes minimum functionalities that are required to be  
          provided by the system including payroll and management  
          information, the ability to calculate wage and benefit  
          deductions, and coordinate benefits information and processing  
          with the California Medicaid Management Information System.
          Existing law declares the intent of the Legislature that managed  
          care health plans may authorize personal care services and  
          related domestic services in addition to the hours authorized  
          under IHSS, which managed care health plans shall be responsible  
          for paying at no share of cost to the county. Legislative intent  
          additionally states that the Department of Health Care Services,  
          in consultation with DSS, shall be required to develop policies  
          and procedures for these additional benefits, which managed care  
          health plans may authorize. (Welfare and Institutions Code   
          14186(b)(6)(B).)




          Proposed Law:  
           This bill requires CMIPS II to be programmed to enable the  
          system to do all of the following:
           Receive payments from managed care health plans for the  
            additional personal care service hours and related domestic  
            service hours authorized by the managed care health plan.

           Issue a single payroll check to providers that covers both  
            the hours authorized under IHSS and the hours authorized by  
            the managed care health plan, as specified.



           Differentiate between IHSS authorized hours and the hours  








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            authorized by the managed care health plan for purposes of  
            federal reimbursement and to enable managed care health  
            plans to track the effect of providing the additional  
            benefits.




          Related  
          Legislation:  The 2015-16 Budget Conference Committee took an  
          action to include a similar proposal. This provision was not  
          included, however, in the final budget bill, AB 93 (Committee on  
          Budget and Fiscal Review) Chapter 10/2015 or the human services  
          budget trailer bill, SB 79 (Committee on Budget and Fiscal  
          Review) Chapter 20/2015, signed by the Governor.
          Staff Comments:  The DSS has indicated one-time costs of $6  
          million ($3 million General Fund) for the reprogramming of CMIPS  
          II as specified in this measure and ongoing costs of $1 million  
          ($0.5 million General Fund).
          
          In order to differentiate between the number of authorized hours  
          for IHSS and authorized by managed health care plans as required  
          under the provisions of this measure, county social workers  
          could incur additional workload to enter data from two payroll  
          systems into the CMIPS II database. The magnitude of the  
          increase in IHSS administrative costs would be dependent on the  
          additional time required to input the required information and  
          the number of cases impacted, which is unknown at this time. SB  
          1036 (Chapter 45/2012) altered the historical county  
          contribution of IHSS funding by enacting a county IHSS  
          maintenance of effort (MOE), which replaced the county  
          contribution of 17.5 percent with a requirement that counties  
          generally maintain their Fiscal Year (FY) 2011-12 expenditure  
          level for IHSS program costs as of FY 2012-13, to be adjusted  
          annually for inflation beginning in FY 2014-15. As a result, all  
          increases in the non-federal share of IHSS costs above the  
          county IHSS MOE are now borne by the General Fund. 

          Additionally, the provisions of this measure could potentially  
          result in a significant increase in future IHSS program costs  
          (Federal Fund/General Fund) for overtime and related activities,  
          to the extent issuing a single payroll check to providers for  
          both IHSS authorized hours and hours authorized by managed  
          health care plans triggers the requirements under the federal  








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          FLSA, assuming the federal rule is upheld. In the absence of  
          data regarding the number of recipients eligible to receive  
          additional hours in the pilot counties and the applicable number  
          of authorized hours, the magnitude of this impact cannot be  
          determined at this time.



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