BILL ANALYSIS Ó
SENATE COMMITTEE ON APPROPRIATIONS
Senator Ricardo Lara, Chair
2015 - 2016 Regular Session
AB 1436 (Burke) - In-home supportive services: authorized
representative
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|Version: May 6, 2015 |Policy Vote: HUMAN S. 5 - 0 |
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|Urgency: No |Mandate: No |
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|Hearing Date: July 6, 2015 |Consultant: Jolie Onodera |
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This bill meets the criteria for referral to the Suspense File.
Bill
Summary: AB 1436 would authorize an applicant for, or recipient
of, the In-Home Supportive Services (IHSS) program to designate
an individual to act as his or her authorized representative for
purposes of the IHSS program, as specified.
Fiscal
Impact:
One-time costs potentially in excess of $50,000 (General Fund)
to the Department of Social Services (DSS) to develop and
adopt regulations. One-time costs to develop the standardized
statewide form are estimated to be minor.
Potentially significant increase in IHSS administrative costs
(Federal Fund/General Fund) for counties to review agreement
forms, verify eligibility of authorized representatives for
cases not requiring a written appointment, and potentially
issue additional notices similar to the process in the
Medi-Cal program.
Potential increase in IHSS program costs (Federal Fund/General
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Fund) related to more successful enrollment and provision of
services from assistance in the application and
redetermination process, to the extent representatives are
able to better represent and/or communicate the actual needs
of applicants and recipients. Increases in IHSS program costs
could be offset in whole or in part to the extent individuals
would have otherwise not been able to remain in their own
homes but would require more costly facility care.
Background: The In-Home Supportive Services (IHSS) program provides
in-home custodial care to aged, blind, and disabled individuals
who meet specified eligibility criteria. Eligible IHSS
recipients receive such services as housecleaning, meal
preparation, laundry, grocery shopping, personal care services,
accompaniment to medical appointments, and protective
supervision.
Eligibility for the IHSS program is determined by county social
workers who conduct a standardized in-home assessment and
periodic re-assessments of an individual's ability to perform
specific activities of daily living. Under existing law, an
authorized representative may be designated in the Medi-Cal
program in order to facilitate recipients' full participation in
the program. These authorized representatives are permitted,
within specified limits, to act on behalf of the applicant or
participant for purposes of applying for services and other
program activities. Additionally, DSS regulations outline
processes regarding the appointment of authorized
representatives in the CalFresh program.
Authorized representatives are currently allowable under
specified provisions of the IHSS program. For example, an
authorized representative may sign a provider timesheet on
behalf of a recipient, however, the recipient cannot assign the
provider as the timesheet signatory due to conflict of interest
(SOC 839). This bill would provide a statutory definition of
"authorized representative" and provide greater specificity
regarding the scope of involvement in program activities for a
designated authorized representative.
Proposed Law:
This bill would authorize a competent IHSS applicant or
recipient to designate an individual as his or her authorized
AB 1436 (Burke) Page 2 of
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representative for purposes of the IHSS program, as follows:
Defines "authorized representative" as an individual who is
appointed in writing, on a form designated by the DSS, by a
competent person who is an applicant for or recipient of IHSS,
to act in place or on behalf of the applicant or recipient for
purposes related to the program, including, but not limited
to, accompanying, assisting, or representing the applicant in
the application process, or the recipient in directing the
services received, and in the redetermination of eligibility
process.
Requires the duties to be provided by the authorized
representative to be specified by the applicant or recipient
and may be changed or revoked at any time by the applicant or
recipient.
Provides that the authorized representative shall have a legal
responsibility to act in the client's best interest.
Provides that legal documentation of authority to act on
behalf of the applicant or recipient under state law,
including, but not limited to, a court order establishing
legal guardianship or a valid power of attorney to make health
care decisions, shall serve in place of a written appointment
by the applicant or recipient.
Authorizes the authorized representative to sign timesheets
for services rendered on the recipient's behalf, if specified
to do so by the recipient. However, an authorized
representative who is the IHSS provider of services for the
recipient may not sign his or her own timesheet unless one of
the following applies:
o The provider is a parent, guardian, or other
person having legal custody of a minor recipient.
o The provider is legally authorized to act on
behalf of the applicant or recipient under state law.
Provides that an individual having legal authority to
act on behalf of an applicant or recipient may also specify
an individual other than himself or herself to act on
behalf of the applicant or recipient if that individual
elects to do so.
Prohibits an individual who is prevented from being an
IHSS provider of services due to criminal history from
serving as an authorized representative for an applicant or
recipient.
Prohibits an individual who has been granted a criminal
record exemption to serve as an IHSS provider, as
specified, from serving as an authorized representative for
an applicant or recipient.
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Prohibits an individual from serving as an authorized
representative if he or she is found to have perpetrated a
substantiated report of abuse or neglect against a child or
an elder or dependent adult.
Requires DSS, in consultation with the DHCS, the County
Welfare Directors Association of California,
representatives of applicants for and recipients of IHSS
services, and representatives of IHSS providers, to develop
a standardized statewide form and procedures for
effectuating the designation of an authorized
representative.
Requires the standard agreement form to include a
notification regarding the requirements of the provisions
of this bill and a statement that by signing the agreement,
the individual named as an authorized representative agrees
to abide by those requirements.
Related
Legislation: None applicable.
Staff
Comments: To the extent regulations are developed, the DSS
could incur one-time costs potentially in excess of $50,000. The
one-time cost to develop the standardized statewide form is
estimated to be minor.
This bill provides that the duties to be provided by the
designated authorized representative are to be specified by the
applicant or recipient and may be changed or revoked at any time
by the applicant or recipient. It is not clear that the
standardized statewide form to be utilized to indicate
appointment of an authorized representative would also include
the specific responsibilities and duties to be provided by the
authorized representative, as specified by the applicant or
recipient. To the extent an additional form is required,
additional county administrative workload may be required to
review and verify this information.
Further, in the absence of an additional/separate form
indicating IHSS applicant- or recipient-approved duties, it is
unclear how it can be determined and verified that the
duties/responsibilities of authorized representatives who do not
require a written appointment (those with legal documentation of
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authority to act on behalf of the applicant/recipient under
state law - legal guardians, conservatorships, power of
attorney) are consistent with the IHSS applicant's or
recipient's wishes.
With regard to authorized representatives in the Medi-Cal
program, existing law requires all program notices, including,
but not limited to, those related to the application,
redetermination, or actions taken by the agency, to be sent to
the applicant or beneficiary, and to the authorized
representative if authorized by the applicant or beneficiary.
While not specifically stated in the bill, to the extent the
procedures developed for IHSS authorized representatives are
similar, IHSS administrative costs could potentially increase.
Under WIC § 14014.5, the implementation of authorized
representatives under the Medi-Cal program is subject to the
availability of federal financial participation and any
necessary federal approvals. It is unclear whether a similar
provision would be appropriate and/or necessary under the
provisions of this bill.
To the to the extent authorized representatives are able to
better represent and/or communicate the actual needs of
applicants and recipients, HSS program costs could increase due
to more successful enrollment and the provision of additional
services from assistance in the application and redetermination
process. Increases in IHSS program costs could be offset in
whole or in part by cost savings to the extent individuals would
have otherwise not been able to remain in their own homes,
requiring more costly care.
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