California Legislature—2015–16 Regular Session

Assembly BillNo. 488

Introduced by Assembly Member Gonzalez

February 23, 2015

An act to amend Section 14132.24 of the Welfare and Institutions Code, relating to Medi-Cal.


AB 488, as introduced, Gonzalez. Medi-Cal: community-living support benefits.

Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services, and 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 develop and implement a program to provide a community-living support benefit to eligible Medi-Cal beneficiaries. Existing law requires the community-living support benefit to include reimbursement for an array of health-related and psychological services provided or coordinated at community-based housing sites, and access to community-living support services provided or coordinated at the community-based housing site.

This bill would make technical, nonsubstantive changes to this provision.

Vote: majority. Appropriation: no. Fiscal committee: no. State-mandated local program: no.

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

P2    1


Section 14132.24 of the Welfare and Institutions
is amended to read:



(a) The department shall develop and implement a
4program to provide a community-living support benefit to eligible
5Medi-Cal beneficiaries. The department shall submit any waiver
6application, modification of any existing waiver, or amendment
7to the Medicaid state plan, that is necessary to provide this benefit,
8and shall implement the benefit only to the extent that federal
9financial participation is available.

10(b) The community-living support benefit shall include both of
11the following:

12(1) (A) Reimbursement for an array of health-related and
13psychosocial services provided or coordinated at community-based
14housing sites that enable beneficiaries to remain in the least
15 restrictive and most homelike environment while receiving the
16health-related services, including personal care and psychosocial
17services, necessary to protect their health and well-being. These
18community-based housing units may include, but are not limited
19to, the living area or unit within a facility that is specifically
20designed to provide ongoing assisted living services, licensed
21residential care facilities for the elderly, publicly funded senior
22and disabled housing projects, or supportive housing sites that
23serve chronically homeless individuals with chronic or disabling
24health conditions.

25(B) For purposes of this section, “assisted living services”
26includes, but is not limited to, assistance with personal activities
27of daily living, including dressing, feeding, toileting, bathing,
28grooming, mobility, and associated tasks, to help provide for and
29maintain physical and psychological comfort.

30(2) Access to community-living support services provided or
31coordinated at the community-based housing site, including, but
32not limited to, the personal care and health services specified in
33paragraph (8) of subdivision (a) of Section 1788 of the Health and
34Safety Code, and the health related support services specified in
35begin insert formerend insert Section 53290 of the Health and Safety Code.

36(c) Services available through the community-living support
37benefit shall not duplicate services available through the Medi-Cal
P3    1state plan, other Medi-Cal waivers, or other programs financed by
2the state.

3(d) An individual shall be eligible for the community-living
4support benefit if he or she is eligible for the Medi-Cal program,
5is a resident of San Francisco who would otherwise be homeless,
6living in shelters, or institutionalized, and meets one or both of the
7following criteria:

8(1) The department determines that he or she would benefit
9from supportive housing, as defined in subdivision (c) ofbegin insert formerend insert
10 Section 53260 of the Health and Safety Code.

11(2) The department determines that he or she is eligible for
12placement in a skilled nursing facility, as defined in subdivision
13(c) of Section 1250 of the Health and Safety Code, or an
14intermediate care facility, as defined in subdivision (d) of that

16(e) The department may modify the eligibility criteria specified
17in subdivision (d), if needed, to qualify the community-living
18support benefit for federal financial participation.

19(f) The department shall seek to maximize resources for
20community-based housing by coordinating the community-living
21support benefit with existing efforts to coordinate care, improve
22health outcomes, and reduce long-term care costs for the targeted

24(g) This section shall be implemented only upon adoption of a
25resolution by the Board of Supervisors of the City and County of
26San Francisco providing county funds for use by the state to match
27federal Medicaid funds to receive federal funds for services
28provided under the waiver specified in this section, and for any
29costs associated with implementing and monitoring the waiver, to
30limit additional state costs.