BILL ANALYSIS Ó
SENATE COMMITTEE ON APPROPRIATIONS
Senator Ricardo Lara, Chair
2015 - 2016 Regular Session
AB 664 (Dodd) - Medi-Cal: universal assessment tool report
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|Version: June 25, 2015 |Policy Vote: HEALTH 8 - 0 |
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|Urgency: No |Mandate: No |
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|Hearing Date: August 17, 2015 |Consultant: Brendan McCarthy |
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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
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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
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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.
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