BILL ANALYSIS Ó
AB 1436
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CONCURRENCE IN SENATE AMENDMENTS
AB
1436 (Burke)
As Amended September 4, 2015
Majority vote
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|ASSEMBLY: |76-0 |(May 26, 2015) |SENATE: |40-0 | (September 10, |
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Original Committee Reference: HUM. S.
SUMMARY: Allows In-Home Supportive Services applicants and
recipients to designate an authorized representative.
Specifically, this bill:
1) Defines "authorized representative" to mean an individual
who is appointed by an In-Home Supportive Services (IHSS)
applicant or recipient in order to represent that applicant
or recipient for purposes related to the IHSS program, as
specified.
2) Allows an IHSS applicant or recipient to designate an
authorized representative for specified purposes on a form
that, among other things, specifies an effective time period
determined by the department.
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3) Requires the county to retain the authorized representative
form in the applicant or recipient's case file, as specified.
4) Specifies that an IHSS applicant or recipient shall
determine the duties to be provided by the authorized
representative and that these duties may be changed or
revoked at any time by the applicant or recipient.
5) Prohibits the authorized representative designation from
authorizing representation at an administrative hearing
conducted by the department.
6) Requires the authorized representative to have a
responsibility to act in the client's best interest, and
prohibits him or her from having any other power to act on
behalf of the applicant or recipient, except as specified,
and prohibits the representative from acting in lieu of the
applicant or recipient.
7) Exempts an applicant's or recipient's legal representative
with the legal authority to act on behalf of the applicant or
recipient, as specified, from the requirement to complete an
authorized representative form.
8) Permits a legal representative to designate an authorized
representative for an applicant or recipient, as specified.
9) Prohibits anyone, except for a legal representative as
specified, prevented from being an IHSS provider due to past
criminal convictions, as well as individuals granted certain
exemptions to serve as a provider despite past criminal
convictions, as specified, from serving as an authorized
representative.
10)Permits the authorized representative, if so instructed by
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the IHSS recipient, to sign timesheets for services rendered
on behalf of the recipient, but disallows the authorized
representative who is a care provider from signing his or her
own timesheet unless the provider has legal authority, as
specified.
11)Directs the Department of Social Services (DSS), in
consultation with stakeholders, as specified, to develop a
standardized statewide form, as specified, and procedures
related to the designation of an authorized representative.
12)Allows DSS to implement and administer the provisions of
authorized representatives through all-county letters or
similar instructions until regulations are adopted.
The Senate amendments:
1)Prohibit the authorized representative designation from
authorizing representation at an administrative hearing
conducted by the department.
2)Remove the prohibition on an individual becoming an authorized
representative if he or she has been found to have perpetrated
a substantiated report of abuse or neglect against of child or
an elder or dependent adult.
3)Make other technical amendments.
EXISTING LAW:
1)Establishes the IHSS program to provide supportive services,
including domestic, protective supervision, personal care, and
paramedical services as specified, to individuals who are
aged, blind, or living with disabilities, and who are unable
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to perform the services themselves or remain safely in their
homes without receiving these services. (Welfare and
Institutions Code (WIC) Section 12300 et seq.)
2)Specifies requirements regarding IHSS provider timesheets,
including that both provider and recipient must sign the
timesheet to verify the accuracy of information. (WIC Section
12301.25)
3)Authorizes counties to contract with a nonprofit consortium or
establish a public authority for the provision of IHSS
services. Requires nonprofit consortia and public authorities
to, among other things, establish a registry to assist
recipients in locating IHSS providers, and to investigate the
background and qualifications of potential providers, as
specified. (WIC Section 12301.6)
4)Maintains an IHSS recipient's right to hire, fire, and
supervise the work of any IHSS provider, regardless of the
employer responsibilities of a public authority or nonprofit
consortium, as specified. (WIC Sections 12301.6 and 12302.25)
5)Requires counties to perform a background check on individuals
applying to become IHSS providers, and stipulates
circumstances under which individuals shall be excluded from
becoming an IHSS provider, as well as circumstances under
which such an exclusion might be waived, as specified. (WIC
Sections 12305.86 and 12305.87)
FISCAL EFFECT: According to the Senate Appropriations
Committee, this bill may result in the following costs:
1)One-time costs potentially in excess of $50,000 (General Fund)
to DSS to develop and adopt regulations. One-time costs to
develop the standardized statewide form are estimated to be
minor.
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2)Potential 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.
3)Potential increase in IHSS program costs (Federal Fund/General
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.
COMMENTS:
In-Home Supportive Services: The IHSS program enables
low-income individuals who are at least 65 years old, living
with disabilities, or blind to remain in their own homes by
paying for care providers to assist with personal care services
(such as toileting, bathing, and grooming), domestic and related
services (meal preparation, housecleaning, and the like),
paramedical services, and protective supervision. Approximately
470,000 Californians receive IHSS, with approximately 99%
receiving it as a Medicaid benefit.
When an individual is determined eligible for IHSS services by a
county social worker, he or she is authorized for a certain
number of hours of care. IHSS recipients are responsible for
hiring, firing, directing, and supervising their IHSS workers.
These responsibilities include some administrative duties, such
as scheduling and signing timesheets; however, the state handles
payroll. As of April 2015, there were about 409,000 IHSS
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providers in the state; approximately 73% were relatives and an
estimated 52% were live-in. Providers must complete an
enrollment process, including submitting fingerprint images for
a criminal background check and participating in a provider
orientation prior to receiving payment for services.
Authorized representatives: A number of programs administered
by the state allow for, and set forth definitions and
designation procedures regarding, authorized representatives in
order to facilitate recipients' full participation in programs.
These authorized representatives are permitted, within specified
limits, to act on behalf of program applicants and participants
typically for purposes of applying for services and other
required program activities.
For example, WIC Section 14014.5 defines "authorized
representative" for purposes of the Medi-Cal program and directs
the Department of Health Care Services and the California Health
Benefit Exchange to implement policies and prescribe materials
to ensure the protection and privacy of applicants and
recipients who appoint such a representative. Additionally, DSS
Manual of Policies and Procedures Section 63.402-6 outlines
rules and processes regarding the appointment of authorized
representatives by applicants for and recipients of CalFresh
food stamp benefits.
Need for this bill: According to the author, "IHSS program
recipients are the employer of their care provider for purposes
of hiring/firing, training, supervising, scheduling and signing
their timesheet. Similarly, whether to designate an authorized
representative and who to designate would be their decision.
For consumers who struggle with the maze of programmatic rules
and complex paperwork, allowing them to designate an authorized
representative to work on their behalf will give them the
support they need to continue to direct services in their own
homes and remain independent."
Analysis Prepared by: Daphne Hunt / HUM. S.
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/ (916) 319-2089 FN: 0002379