BILL ANALYSIS Ó SENATE COMMITTEE ON APPROPRIATIONS Senator Ricardo Lara, Chair 2015 - 2016 Regular Session AB 664 (Dodd) - Medi-Cal: universal assessment tool report ----------------------------------------------------------------- | | | | | | ----------------------------------------------------------------- |--------------------------------+--------------------------------| | | | |Version: June 25, 2015 |Policy Vote: HEALTH 8 - 0 | | | | |--------------------------------+--------------------------------| | | | |Urgency: No |Mandate: No | | | | |--------------------------------+--------------------------------| | | | |Hearing Date: August 17, 2015 |Consultant: Brendan McCarthy | | | | ----------------------------------------------------------------- This bill meets the criteria for referral to the Suspense File. Bill Summary: AB 664 would extend existing provisions of law until December 31, 2017, requiring the Department of Health Care Services and other state agencies to develop a universal assessment tool that could be used to assess the need for home and community based services by seniors and persons with disabilities. The bill would also require the Department to report to the Legislature on the lessons learned from the authorized pilot project using the universal assessment tool. Fiscal Impact: No significant costs are anticipated by extending the statutory sunset on the authority to develop the universal assessment tool and conduct a pilot project using it. One-time costs of between $500,000 and $1,000,000 are anticipated for the Department of Health Care Services to conduct an evaluation of the universal assessment tool pilot project (General Fund and federal funds). The Department AB 664 (Dodd) Page 1 of ? indicates that it will either conduct the evaluation internally or contract with an independent organization. Background: Under state and federal law, the Department of Health Care Services operates the Medi-Cal program, which provides health care coverage to low income individuals, families, and children. Medi-Cal provides coverage to childless adults and parents with household incomes up to 138% of the federal poverty level and to children with household incomes up to 266% of the federal poverty level. The federal government provides matching funds that vary from 50% to 90% of expenditures depending on the category of beneficiary. As part of the Medi-Cal program, the state offers home and community based services to seniors and persons with disabilities, with the intent of using less costly services provided in the community to avoid more costly institutional care. Home and community based services offered in the state include In-Home Supportive Services (IHSS), Multipurpose Senior Services Program (MSSP), and Community-Based Adult Services (CBAS). In order for a Medi-Cal beneficiary to qualify for home and community based services, their needs must be assessed. Historically, each of the home and community based services programs has used a separate assessment tool to determine what services and how many hours of services an individual needs to remain in the community. The process of conducting an assessment is usually done in person and takes considerable time. Having each of the programs use separate assessments, even though an individual may qualify for more than one of the programs, is administratively inefficient and burdensome to beneficiaries. As part of the 2012 Budget Act, the Legislature approved the development of the Coordinated Care Initiative, which seeks to combine Medi-Cal, Medicare, and long-term services and supports (such as IHSS) into a single managed care benefit for seniors and persons with disabilities. As part of the authorization of the Coordinated Care Initiative, the Legislature directed the Department of Health Care Services, the Department of Social Services, and the Department of Aging to work with stakeholders to develop a universal assessment tool for determining a beneficiary's need for home and community based services. Current law authorizes the Department of Health Care Services to conduct a pilot project using the newly developed universal AB 664 (Dodd) Page 2 of ? assessment tool in two to four counties in which the Coordinated Care Initiative is being implemented. Current law sunsets the authority to develop and pilot the universal assessment tool on July 1, 2017. The departments are currently in the process of developing the universal assessment tool and the pilot project has not yet begun. Proposed Law: AB 664 would extend existing provisions of law until December 31, 2017, requiring the Department of Health Care Services and other state agencies to develop a universal assessment tool that could be used to assess the need for home and community based services by seniors and persons with disabilities. The bill would also require the Department to report to the Legislature on the lessons learned from the authorized pilot project using the universal assessment tool. The report on the outcomes and lessons learned would be due to the Legislature by January 1, 2017. Staff Comments: The universal assessment tool has not been developed (although the departments have developed an early draft tool). According to the departments, actual implementation of the pilot project is not expected to occur until July 2016. It does not seem likely that the pilot project could take place and a meaningful evaluation of the results of that pilot be completed by January 1, 2017. -- END -- AB 664 (Dodd) Page 3 of ?