SB 199, as amended, 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
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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:
Section 12300 of the Welfare and Institutions
2Code 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
P3 1resource sites, yard hazard abatement, protective supervision,
2teaching and demonstration directed at reducing the need for other
3supportive services, paramedical services that make it possible for
4the recipient to establish and maintain an independent living
5arrangement, and assistance in reading and completing financial
6and other documents, for up to two hours per month, for a recipient
7who is blind, when that assistance is necessary for the recipient to
8remain in his or her home, or abode of his or her own choosing,
9as defined by the department.
10(c) Personal care services shall mean all of the following:
11(1) Assistance with ambulation.
12(2) Bathing, oral hygiene, and grooming.
14(4) Care and assistance with prosthetic devices.
15(5) Bowel, bladder, and menstrual care.
16(6) Repositioning, skin care, range of motion exercises, and
18(7) Feeding and assurance of adequate fluid intake.
20(9) Assistance with self-administration of medications.
21(d) Personal care services are available if these services are
22provided in the beneficiary’s home and other locations as may be
23authorized by the director. Among the locations that may be
24authorized by the director under this subdivision is the recipient’s
25place of employment if all of the following conditions are met:
26(1) The personal care services are limited to those that are
27currently authorized for a recipient in the recipient’s home and
28those services are to be utilized by the recipient at the recipient’s
29place of employment to enable the recipient to obtain, retain, or
30return to work. Authorized services utilized by the recipient at the
31recipient’s place of employment shall be services that are relevant
32and necessary in supporting and maintaining employment.
33However, workplace services shall not be used to supplant any
34reasonable accommodations required of an employer by the
35 Americans with Disabilities Act (42 U.S.C. Sec. 12101 et
36seq.; ADA) or other legal entitlements or third-party obligations.
37(2) The provision of personal care services at the recipient’s
38place of employment shall be authorized only to the extent that
39the total hours utilized at the workplace are within the total personal
40care services hours authorized for the recipient in the home.
P4 1Additional personal care services hours may not be authorized in
2connection with a recipient’s employment.
3(e) When supportive services are provided by a person who has
4the legal duty pursuant to the Family Code to provide for the care
5of his or her child who is the recipient, the provider of supportive
6services shall receive remuneration for the services only when the
7provider leaves full-time employment or is prevented from
8obtaining full-time employment because no other suitable provider
9is available and when the inability of the provider to provide
10supportive services may result in inappropriate placement or
12These providers shall be paid only for the following:
13(1) Services related to domestic services.
14(2) Personal care services.
15(3) Accompaniment by a provider when needed during necessary
16travel to health-related appointments or to alternative resource
18(4) Protective supervision only as needed
because of the
19functional limitations of the child.
20(5) Paramedical services.
21(f) To encourage maximum voluntary services, so as to reduce
22governmental costs, respite care shall also be provided. Respite
23care is temporary or periodic service for eligible recipients to
24relieve persons who are providing care without compensation.
25(g) A person who is eligible to receive a service or services
26under an approved federal waiver authorized pursuant to Section
2714132.951, or a person who is eligible to receive a service or
28services authorized pursuant to Section 14132.95, shall not be
29eligible to receive the same service or services pursuant to this
30article. In the event that the waiver authorized pursuant to Section
3114132.951, as approved by the federal government, does not extend
32eligibility to all persons otherwise eligible for services under this
33article, or does not cover a service or particular services, or does
34not cover the scope of a service that a person would otherwise be
35eligible to receive under this article, those persons who are not
36eligible for services, or for a particular service under the waiver
37or Section 14132.95 shall be eligible for services under this article.
38(h) (1) All services provided pursuant to this article shall be
39equal in amount, scope, and duration to the same services provided
40pursuant to Section 14132.95, including any adjustments that may
P5 1be made to those services pursuant to subdivision (e) of Section
3(2) Notwithstanding any other provision of this article, the rate
4of reimbursement for in-home supportive services provided through
5any mode of service shall not exceed the rate of reimbursement
6established under subdivision (j) of Section 14132.95 for the same
7mode of service unless otherwise provided in the annual Budget
9(3) The maximum number of hours available under Section
1014132.95, Section 14132.951, and this section, combined, shall
11be 283 hours per month. Any recipient of services under this article
12shall receive no more than the applicable maximum specified in
14(i) The Director of Health Care Services shall, by January 1,
152017, seek all federal approvals necessary to ensure that Medicaid
16funds may be used in implementing the amendments to this section
17made by the act that added this subdivision during the 2015-16
18Regular Session of the Legislature. These amendments include
19assistance in reading and completing financial and other documents
20for a recipient who is blind.
21(j) The authorization to provide the service added by the
22amendments to this section made by the act that added this
23subdivision during the 2015-16 Regular Session of the Legislature
24shall become operative on January 1, 2017. Provision of the service
25shall be implemented only if, and to the extent that, federal
26financial participation is available, and any necessary federal
27approvals have been obtained.
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29and counties shall be immune from any liability, including
30negligence or intentional torts of providers, associated with the
31delivery of the service specified in subdivision (b) that includes
32assistance in reading and completing financial documents for
33recipients who are blind.
34(l) (1) Notwithstanding the rulemaking provisions of the
35Administrative Procedure Act (Chapter 3.5 (commencing with
36Section 11340) of Part 1 of Division 3 of Title 2 of the Government
37Code), until emergency regulations are filed with the Secretary of
38State, the department may implement the amendments made to
39this section by the act that added this subdivision during the
P6 12015-16 Regular Session of the Legislature through all-county
2letters or similar instructions from the director.
3(2) On or before January 1, 2018, the department shall adopt
4regulations to implement the amendments to this section made by
5the act that added this subdivision during the 2015-16 Regular
6Session of the Legislature. The initial adoption, amendment, or
7repeal of a regulation authorized by this subdivision is deemed to
8address an emergency, for purposes of Sections 11346.1 and
911349.6 of the Government Code, and the department is hereby
10exempted for that purpose from the requirements of subdivision
11(b) of Section 11346.1 of the Government Code. After the initial
12adoption, amendment, or repeal of an emergency regulation
13pursuant to this section, the department may twice request approval
14from the Office of Administrative Law to readopt the regulation
15as an emergency regulation pursuant to Section 11346.1 of the
16Government Code. The department shall adopt final regulations
17on or before January 1, 2019.
If the Commission on State Mandates determines that
19this act contains costs mandated by the state, reimbursement to
20local agencies and school districts for those costs shall be made
21pursuant to Part 7 (commencing with Section 17500) of Division
224 of Title 2 of the Government Code.