BILL ANALYSIS Ó
AB 1235
Page 1
ASSEMBLY THIRD READING
AB
1235 (Gipson)
As Amended June 1, 2015
Majority vote
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|Committee |Votes |Ayes |Noes |
| | | | |
| | | | |
|----------------+------+--------------------+---------------------|
|Health |19-0 |Bonta, Maienschein, | |
| | |Bonilla, Burke, | |
| | |Chávez, Chiu, | |
| | |Gomez, Gonzalez, | |
| | | | |
| | | | |
| | |Roger Hernández, | |
| | |Lackey, Nazarian, | |
| | |Patterson, | |
| | | | |
| | | | |
| | |Ridley-Thomas, | |
| | |Rodriguez, | |
| | |Santiago, | |
| | |Steinorth, | |
| | |Thurmond, Waldron, | |
| | |Wood | |
| | | | |
|----------------+------+--------------------+---------------------|
|Appropriations |17-0 |Gomez, Bigelow, | |
| | |Bonta, Calderon, | |
AB 1235
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| | |Chang, Daly, | |
| | |Eggman, Gallagher, | |
| | | | |
| | | | |
| | |Eduardo Garcia, | |
| | |Gordon, Holden, | |
| | |Jones, Quirk, | |
| | |Rendon, Wagner, | |
| | |Weber, Wood | |
| | | | |
| | | | |
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SUMMARY: Defines a home upkeep allowance (HUA), require an HUA to
be available to specified long-term care (LTC) facility
recipients, and allow specified LTC facility residents to include
the transitional costs of establishing a home in their personal
needs allowance, as specified. Specifically, this bill:
1)Defines an HUA as the "allowance of home maintenance" in federal
regulation and the amount for the "upkeep and maintenance of the
home" described in existing law.
2)Requires the HUA to be available to Medi-Cal beneficiaries who
receive LTC.
3)Requires a transitional personal needs fund, as defined by
federal regulation, to be available to LTC recipients covered
under this bill.
4)Requires an HUA, as defined by federal regulation, to be
available to LTC recipients covered under this bill.
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5)Requires an HUA to be made available to a LTC facility resident
who intends to return to his or her home, as specified.
6)Allows the transitional costs of establishing home to be
included in the personal needs allowance for all long-term
facility residents who do not have a home but intend to leave a
facility and establish a home in the community, as specified.
7)Requires the Department of Health Care Services to perform
outreach activities to LTC residents, and to promulgate
regulations regarding this bill's provisions, as specified.
FISCAL EFFECT: This bill, as amended, has not yet been analyzed
by a fiscal committee.
COMMENTS:
1)Purpose Of This Bill. The author states the reason why many
individuals stay in nursing facilities indefinitely is in part
because the current HUA is insufficient to sustain the cost of
basic living needs. The author explains that the HUA is
underutilized due to the high cost of living in California, as
compared to other states, and the lack of affordable housing
programs. The author concludes that with the increase in the
HUA, this bill will improve the quality of life for Medi-Cal
recipients in nursing homes and provide greater opportunities
for individuals to transfer back into the community.
2)Background. Maintaining or establishing a home in the community
is a major obstacle for Medicaid beneficiaries who want to
return home after admission to an institution. Medicaid
eligibility rules give states the flexibility to support this
goal and allow states to exempt income to maintain a home. The
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HUA is a Medi-Cal deduction for qualifying Medi-Cal
beneficiaries who are living in, or will be living in, a nursing
home or other medical facility. The HUA currently allows
beneficiaries to keep $209 per month of their monthly income for
maintenance and upkeep of their homes while they are temporarily
residing in the nursing home other medical facility. The HUA
can be allowed for up to a six month period from the date the
beneficiary enters the nursing home. To qualify for the HUA, a
beneficiary must meet all of the following requirements:
a) Intend to leave the nursing facility and to return home
within six months of the date the individual begins living in
the nursing home;
b) Obtain a written medical statement from the individual's
doctor certifying that he or she will be able to return home
within six months;
c) The spouse or family of the individual must not live in
the home; and,
d) The home must be maintained for the individual's return.
Medically needy Medi-Cal beneficiaries who enter a nursing
facility apply all their income above a personal needs allowance
to the cost of care. State regulations allow beneficiaries to
retain 133% of the in-kind value of housing for one person if
the applicant or beneficiary has been living alone in the home.
3)Support. On the previous version of the bill, Disability Rights
California, the sponsor of the bill, states the current
allowance given to LTC facility residents for the maintenance of
their homes is insufficient and highlights the rate has not been
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updated since the 1970's. The sponsor states the allowance is
too restrictive and does not meet the needs of LTC residents.
4)Opposition. With the proposed amendments to this bill, there is
no known opposition to this bill.
5)Policy Comments.
a) The proposed amendments define the HUA as the "allowance
for home maintenance" under federal regulation and the amount
for the "upkeep and maintenance of the home" described in
existing law. The proposed amendments do not specify how the
HUA will be determined between these two amounts; the author
may wish to consider clarifying changes in a future
committee. In addition, the proposed amendments do not
specify which code section the "upkeep and maintenance of
home" amount refers to; the author may wish to make a
technical change to refer to the specific code section in
California statute for this amount.
b) The proposed amendments to this bill reference current
federal regulations. All regulations are subject to change
by the respective federal or state agencies and departments;
if the regulations referenced in the proposed amendments are
modified, those changes would have a direct impact on this
bill's provisions. The author may wish to amend the bill
such that there are no direct references to federal or state
regulations.
c) The proposed amendments to this bill require an HUA to be
provided to all LTC facility residents who intend to leave a
facility and either return to his or her existing home, or
establish a new home in the community. However the proposed
language does not specify which entity would be responsible
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for determining if a LTC facility resident does in fact
intend to leave the facility, and what factors would be
considered in that determination. The author may wish to
amend the bill to specify these considerations.
d) The proposed amendments require the transitional costs of
establishing a home to be included in the personal needs
allowance for a LTC facility resident, and allow the resident
to establish a transitional personal needs fund for this
purpose. Allowing the resident to maintain and establish his
or her own fund may lead to potential conflicts of interest
or other logistical challenges; the author may wish to
consider if another entity would be more appropriate to
maintain this fund.
Analysis Prepared by:
An-Chi Tsou / HEALTH / (916) 319-2097 FN: 0000831