BILL ANALYSIS Ó
AB 1518
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ASSEMBLY THIRD READING
AB
1518 (Committee on Aging and Long-Term Care)
As Amended April 27, 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 | |
| | | | |
|----------------+------+---------------------+---------------------|
|Aging |6-0 |Brown, Gipson, Gray, | |
| | |Levine, Lopez, | |
| | |Mathis | |
| | | | |
|----------------+------+---------------------+---------------------|
|Appropriations |17-0 |Gomez, Bigelow, | |
| | |Bonta, Calderon, | |
| | |Chang, Daly, Eggman, | |
| | |Gallagher, | |
AB 1518
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| | | | |
| | | | |
| | |Eduardo Garcia, | |
| | |Gordon, Holden, | |
| | |Jones, Quirk, | |
| | |Rendon, Wagner, | |
| | |Weber, Wood | |
| | | | |
| | | | |
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SUMMARY: Requires the Department of Health Care Services (DHCS)
to authorize an additional 5,000 slots beyond current standards
for home and community-based patients, and updates requirements to
the Nursing Facility/Acute Hospital (NF/AH) Waiver, as specified.
Provides this bill only be implemented to the extent that DHCS can
demonstrate fiscal neutrality within the DHCS budget and
implementation is contingent on federal approval. Specifically,
this bill:
1)Requires, by January 1, 2016, nursing home facilities to
authorize an additional 5,000 slots beyond those currently
authorized for home and community-based NF/AH Waiver. Requires
DHCS to consider specified factors to calculate the need for,
and seek federal approval of, additional slots to the waiver.
2)Updates requirements regarding the NF/AH Waiver to expedite the
Waiver application process and clarify level of care for
patients, as specified.
3)Requires DHCS to ensure a seamless transition for patients
receiving private duty in-home nursing provided through the
Early Periodic Screening, Diagnosis and Treatment program to
medically necessary in-home nursing once a patient turns 21
years of age.
4)Adds new services to the NF/AH Waiver and adjusts the cost
limitation category of the Waiver to use an aggregate cost limit
AB 1518
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formula, as specified.
FISCAL EFFECT: According to the Assembly Appropriations
Committee:
1)One-time administrative costs in the range of $100,000 (General
Fund (GF)/federal) DHCS to apply for a waiver amendment and seek
federal approval, and to establish new policies and procedures
related to the bill's requirements, such as assessment of
imminent risk and determinations of level of care.
2)Though a comprehensive budget neutrality analysis and assessment
of unmet need for waiver services is not available, it is
assumed total costs for Medi-Cal benefits will be cost-neutral,
as the bill specifies. Within the overall budget neutrality, it
is expected the state will incur unknown annual costs, likely in
the hundreds of thousands of dollars (GF/federal), for
additional state staff to conduct assessments for waiver
eligibility on an expedited basis, as well as significant cost
savings to the extent individuals are cared for at home instead
of in a facility.
COMMENTS: According to the author, California's NF/AH Waiver
program does not currently meet the needs of seniors and youth
with disabilities who wish to receive services at home, and avoid
nursing homes and other institutions. The author states that
home-based services are typically less expensive, more desirable
to the clients and their families, and consistent with state and
federal priorities; however current state policies and limited
funding and flexibility prevent individuals from being moved from
institutions to home-based care. In addition, the author asserts
that upon turning 21, many individuals, who received home care
prior to their 21st birthday, are forced into institutions because
they become ineligible due to age restrictions for specified
services.
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Disability Rights California, the sponsor of this bill, states the
current NF/AH waiver offers much less money for home-based care
than the state pays for care in comparable institutions. The
sponsor points to the individual cost limit structure, outdated
cost limits, a lengthy waiver approval process, and a risk of
discontinued services for individuals who qualify for Early and
Periodic Screening, Diagnostic, and Treatment services, as
evidence for the need for this bill. Supporters assert this bill
provides people with disabilities, including young people and
seniors, more opportunities to receive long-term services and
supports in their own homes and communities rather than forcing
them into less desirable, unneeded and more expensive
institutional settings. They also state this bill will reflect in
state budget savings, as home-based services are less expensive
than comparable institutional services.
There is no opposition to this bill.
Analysis Prepared by:
An-Chi Tsou / HEALTH / (916) 319-2097 FN: 0000766