BILL NUMBER: AB 1235	INTRODUCED
	BILL TEXT


INTRODUCED BY   Assembly Member Gipson

                        FEBRUARY 27, 2015

   An act relating to Medi-Cal.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 1235, as introduced, Gipson. Long-term care: home upkeep
allowance.
   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 provisions. Qualified individuals under the Medi-Cal program
include medically needy persons and medically needy family persons
who meet the required eligibility criteria, including applicable
income requirements.
   Existing law requires the department to establish income levels
for maintenance need at the lowest levels that reasonably permit a
medically needy individual to meet his or her basic needs for food,
clothing, and shelter, and for which federal financial participation
will still be provided under applicable federal law. In calculating
the income of a medically needy individual in a medical institution
or nursing facility, or a person receiving institutional or
noninstitutional services from a Program of All-Inclusive Care for
the Elderly organization, the required monthly maintenance amount
includes, among other things, an amount providing for the upkeep and
maintenance of the individual's home. This amount is also referred to
as the home upkeep allowance.
   Existing law authorizes the Director of Health Care Services to
adopt, amend, or repeal reasonable rules and regulations to carry out
the purposes and intent of the Medi-Cal program, that are not
inconsistent with any state statute. The department has adopted
regulatory requirements relating to the determination of the above
home upkeep allowance.
   This bill would declare the intent of the Legislature to enact
legislation to prohibit the use of in-kind value of housing as a
basis for calculating the home upkeep allowance for a patient in
long-term care and prohibit eligibility for the allowance from being
based on the date when patient status is established, and to require
the calculation for the allowance to be based on the actual cost of
maintaining the patient's home. The bill would declare the intent of
the Legislature to enact legislation to require the department to
adopt conforming regulations, and to notify specified parties of
those regulatory changes. The bill would declare the Legislature's
intent to enact legislation to require the department to advise
appropriate Medi-Cal patients of the availability of the home upkeep
allowance.
   Vote: majority. Appropriation: no. Fiscal committee: no.
State-mandated local program: no.


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

  SECTION 1.  (a) It is the intent of the Legislature to enact
legislation to do all of the following, with respect to the Medi-Cal
home upkeep allowance that may be available to long-term care
residents:
   (1) Prohibit the use of in-kind value of housing as a basis for
calculating the home upkeep allowance for a patient in long-term
care.
   (2) Prohibit eligibility for the allowance being based on the date
when patient status is established.
   (3) Require the calculation for the allowance to be based on the
actual cost of maintaining the patient's home.
   (b) It is the intent of the Legislature to enact legislation to
require the State Department of Health Care Services to do all of the
following:
   (1)  Adopt or revise regulations to reflect the requirements of
paragraphs (1) to (3), inclusive, of subdivision (a).
   (2) Notify all Medi-Cal branches, eligibility workers, long-term
care facilities, hospital discharge planners, and organizations
receiving state funds to assist nursing home residents, of the new
regulatory requirements.
   (3) Ensure that all Medi-Cal patients who are discharged to or
residing in a long-term care facility are informed of the
availability of the allowance.