Senate BillNo. 199

Introduced by Senator Hall

(Principal coauthor: Senator Beall)

(Coauthors: Assembly Members Bonilla, Lackey, Rodriguez, and Waldron)

February 10, 2015

An act to amend Section 12300 of the Welfare and Institutions Code, relating to public social services.


SB 199, as introduced, Hall. In-home supportive services: reading services for blind and visually impaired recipients.

Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, and under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid Program provisions.

Existing law provides for the county-administered In-Home Supportive Services (IHSS) program, under which, either through employment by the recipient, or by or through contract by the county, qualified aged, blind, and disabled persons receive services enabling them to remain in their own homes. Existing law requires the provision of personal care services under the Medi-Cal program to eligible IHSS recipients. Under existing law, county welfare departments are required to provide visually impaired applicants and recipients with information on, and referral services to, entities that provide reading services to visually impaired persons. Existing law defines “supportive services” for purposes of the IHSS program.

This bill would, commencing January 1, 2017, include within the definition of supportive services assistance in reading and completing financial and other documents for a recipient of services under the IHSS program who is blind. By expanding the scope of available services under the IHSS program, this bill would impose a state-mandated local program. The bill would also require the Director of Health Care Services to seek any federal approvals necessary to ensure that Medicaid funds may be used in implementing this provision. The bill would authorize the department to implement the provision through all-county letters or similar instructions from the director until emergency regulations are filed, and would require the adoption of emergency regulations by January 1, 2018, and final regulations by January 1, 2019, to implement this provision, as specified.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to these statutory provisions.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes.

The people of the State of California do enact as follows:

P2    1


Section 12300 of the Welfare and Institutions
is amended to read:



(a) The purpose of this article is to provide in every
4county in a manner consistent with this chapter and the annual
5Budget Act those supportive services identified in this section to
6aged, blind, or disabled persons, as defined under this chapter,
7who are unable to perform the services themselves and who cannot
8safely remain in their homes or abodes of their own choosing unless
9these services are provided.

10(b) Supportive services shall include domestic services and
11services related to domestic services, heavy cleaning, personal
12care services, accompaniment by a provider when needed during
13necessary travel to health-related appointments or to alternative
14resource sites, yard hazard abatement, protective supervision,
15teaching and demonstration directed at reducing the need for other
16supportive services,begin delete andend delete paramedical servicesbegin delete whichend deletebegin insert thatend insert make it
17possible for the recipient to establish and maintain an independent
P3    1living arrangementbegin insert, and assistance in reading and completing
2financial and other documents, for up to two hours per month, for
3a recipient who is blind, when that assistance is necessary for the
4recipient to remain in his or her home, or abode of his or her own
5choosing, as defined by the departmentend insert

6(c) Personal care services shall mean all of the following:

7(1) Assistance with ambulation.

8(2) Bathing, oral hygiene, and grooming.

9(3) Dressing.

10(4) Care and assistance with prosthetic devices.

11(5) Bowel, bladder, and menstrual care.

12(6) Repositioning, skin care, range of motion exercises, and

14(7) Feeding and assurance of adequate fluid intake.

15(8) Respiration.

16(9) Assistance with self-administration of medications.

17(d) Personal care services are available if these services are
18provided in the beneficiary’s home and other locations as may be
19authorized by the director. Among the locations that may be
20authorized by the director under thisbegin delete paragraphend deletebegin insert subdivisionend insert is the
21recipient’s place of employment if all of the following conditions
22are met:

23(1) The personal care services are limited to those that are
24currently authorized for a recipient in the recipient’s home and
25those services are to be utilized by the recipient at the recipient’s
26place of employment to enable the recipient to obtain, retain, or
27return to work. Authorized services utilized by the recipient at the
28recipient’s place of employment shall be services that are relevant
29and necessary in supporting and maintaining employment.
30However, workplace services shall not be used to supplant any
31reasonable accommodations required of an employer by the
32Americans with Disabilities Act (42 U.S.C. Sec. 12101 et seq.;
33ADA) or other legal entitlements or third-party obligations.

34(2) The provision of personal care services at the recipient’s
35place of employment shall be authorized only to the extent that
36the total hours utilized at the workplace are within the total personal
37care services hours authorized for the recipient in the home.
38Additional personal care services hours may not be authorized in
39connection with a recipient’s employment.

P4    1(e) begin deleteWhere end deletebegin insertWhen end insertsupportive services are provided by a person
2begin delete havingend deletebegin insert who hasend insert the legal duty pursuant to the Family Code to
3provide for the care of his or her child who is the recipient, the
4provider of supportive services shall receive remuneration for the
5services only when the provider leaves full-time employment or
6is prevented from obtaining full-time employment because no
7other suitable provider is available andbegin delete whereend deletebegin insert whenend insert the inability
8of the provider to provide supportive services may result in
9inappropriate placement or inadequate care.

10These providers shall be paid only for the following:

11(1) Services related to domestic services.

12(2) Personal care services.

13(3) Accompaniment by a provider when needed during necessary
14travel to health-related appointments or to alternative resource

16(4) Protective supervision only as needed because of the
17functional limitations of the child.

18(5) Paramedical services.

19(f) To encourage maximum voluntary services, so as to reduce
20governmental costs, respite care shall also be provided. Respite
21care is temporary or periodic service for eligible recipients to
22relieve persons who are providing care without compensation.

23(g) A person who is eligible to receive a service or services
24under an approved federal waiver authorized pursuant to Section
2514132.951, or a person who is eligible to receive a service or
26services authorized pursuant to Section 14132.95, shall not be
27eligible to receive the same service or services pursuant to this
28article. In the event that the waiver authorized pursuant to Section
2914132.951, as approved by the federal government, does not extend
30eligibility to all persons otherwise eligible for services under this
31article, or does not cover a service or particular services, or does
32not cover the scope of a service that a person would otherwise be
33eligible to receive under this article, those persons who are not
34eligible for services, or for a particular service under the waiver
35or Section 14132.95 shall be eligible for services under this article.

36(h) (1) All services provided pursuant to this article shall be
37equal in amount, scope, and duration to the same services provided
38pursuant to Section 14132.95, including any adjustments that may
39be made to those services pursuant to subdivision (e) of Section
40 14132.95.

P5    1(2) Notwithstanding any other provision of this article, the rate
2of reimbursement for in-home supportive services provided through
3any mode of service shall not exceed the rate of reimbursement
4established under subdivision (j) of Section 14132.95 for the same
5mode of service unless otherwise provided in the annual Budget

7(3) The maximum number of hours available under Section
814132.95, Section 14132.951, and this section, combined, shall
9be 283 hours per month. Any recipient of services under this article
10shall receive no more than the applicable maximum specified in
11Section 12303.4.

begin insert

12(i) The Director of Health Care Services shall, by January 1,
132017, seek all federal approvals necessary to ensure that Medicaid
14funds may be used in implementing the amendments to this section
15made by the act that added this subdivision during the 2015-16
16Regular Session of the Legislature. These amendments include
17assistance in reading and completing financial and other
18documents for a recipient who is blind.

end insert
begin insert

19(j) The authorization to provide the service added by the
20amendments to this section made by the act that added this
21subdivision during the 2015-16 Regular Session of the Legislature
22shall become operative on January 1, 2017. Provision of the service
23shall be implemented only if, and to the extent that, federal
24financial participation is available, and any necessary federal
25approvals have been obtained.

end insert
begin insert

26(k) The state and counties shall be immune from any liability,
27including negligence or intentional torts of providers, associated
28with the delivery of the service specified in subdivision (b) that
29includes assistance in reading and completing financial documents
30for recipients who are blind.

end insert
begin insert

31(l) (1) Notwithstanding the rulemaking provisions of the
32Administrative Procedure Act (Chapter 3.5 (commencing with
33Section 11340) of Part 1 of Division 3 of Title 2 of the Government
34Code), until emergency regulations are filed with the Secretary of
35State, the department may implement the amendments made to this
36section by the act that added this subdivision during the 2015-16
37Regular Session of the Legislature through all-county letters or
38similar instructions from the director.

end insert
begin insert

39(2) On or before January 1, 2018, the department shall adopt
40regulations to implement the amendments to this section made by
P6    1the act that added this subdivision during the 2015-16 Regular
2Session of the Legislature. The initial adoption, amendment, or
3repeal of a regulation authorized by this subdivision is deemed to
4address an emergency, for purposes of Sections 11346.1 and
511349.6 of the Government Code, and the department is hereby
6exempted for that purpose from the requirements of subdivision
7(b) of Section 11346.1 of the Government Code. After the initial
8adoption, amendment, or repeal of an emergency regulation
9pursuant to this section, the department may twice request approval
10from the Office of Administrative Law to readopt the regulation
11as an emergency regulation pursuant to Section 11346.1 of the
12Government Code. The department shall adopt final regulations
13on or before January 1, 2019.

end insert

SEC. 2.  

If the Commission on State Mandates determines that
15this act contains costs mandated by the state, reimbursement to
16local agencies and school districts for those costs shall be made
17pursuant to Part 7 (commencing with Section 17500) of Division
184 of Title 2 of the Government Code.