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 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:
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, teaching
4and demonstration directed at reducing the need for other
5supportive services, paramedical services that make it possible
6for the recipient to establish and maintain an independent living
begin delete arrangement, and assistance in reading and completing financial
8and other documents, for up to two hours per month, for a recipient
9who is blind, when that assistance is necessary for the recipient to
10remain in his or her home, or abode of his or her own choosing,
11as defined by the department.end delete
12(c) Personal care services shall mean all of the following:
13(1) Assistance with ambulation.
14(2) Bathing, oral hygiene, and grooming.
16(4) Care and assistance with prosthetic devices.
17(5) Bowel, bladder, and menstrual care.
18(6) Repositioning, skin care, range of motion exercises, and
20(7) Feeding and assurance of adequate fluid intake.
22(9) Assistance with self-administration of medications.
23(d) Personal care services are available if these services are
24provided in the beneficiary’s home and other locations as may be
25authorized by the director. Among the locations that may be
26authorized by the director under this subdivision is the recipient’s
27place of employment if all of the following conditions are met:
28(1) The personal care services are limited to those that are
29currently authorized for a recipient in the recipient’s home and
30those services are to be utilized by the recipient at the recipient’s
31place of employment to enable the recipient to obtain, retain, or
32return to work. Authorized services utilized by the recipient at the
33recipient’s place of employment shall be services that are relevant
34and necessary in supporting and maintaining employment.
35However, workplace services shall not be used to supplant any
36reasonable accommodations required of an employer by the federal
37Americans with Disabilities Act of 1990 (42 U.S.C. Sec. 12101
38et seq.; ADA) or other legal entitlements or third-party obligations.
39(2) The provision of personal care services at the recipient’s
40place of employment shall be authorized only to the extent that
P4 1the total hours utilized at the workplace are within the total personal
2care services hours authorized for the recipient in the home.
3Additional personal care services hours may not be authorized in
4connection with a recipient’s employment.
5(e) When supportive services are provided by a person who has
6the legal duty pursuant to the Family Code to provide for the care
7of his or her child who is the recipient, the provider of supportive
8services shall receive remuneration for the services only when the
9provider leaves full-time employment or is prevented from
10obtaining full-time employment because no other suitable provider
11is available and when the inability of the provider to provide
12supportive services may result in inappropriate placement or
14These providers shall be paid only for the following:
15(1) Services related to domestic services.
16(2) Personal care services.
17(3) Accompaniment by a
provider when needed during necessary
18travel to health-related appointments or to alternative resource
20(4) Protective supervision only as needed because of the
21functional limitations of the child.
22(5) Paramedical services.
23(f) To encourage maximum voluntary services, so as to reduce
24governmental costs, respite care shall also be provided. Respite
25care is temporary or periodic service for eligible recipients to
26relieve persons who are providing care without compensation.
27(g) A person who is eligible to receive a service or services
28under an approved federal waiver authorized pursuant to Section
2914132.951, or a person who is eligible to receive a service or
30services authorized pursuant to Section 14132.95, shall not be
31eligible to receive the same service or services pursuant to this
32article. In the event that the waiver authorized pursuant to Section
3314132.951, as approved by the federal government, does not extend
34eligibility to all persons otherwise eligible for services under this
35article, or does not cover a service or particular services, or does
36not cover the scope of a service that a person would otherwise be
37eligible to receive under this article, those persons who are not
38eligible for services, or for a particular service under the waiver
39or Section 14132.95 shall be eligible for services under this article.
P5 1(h) (1) All services provided pursuant to this article shall be
2equal in amount, scope, and duration to the same services provided
3pursuant to Section 14132.95, including any adjustments that may
4be made to those services pursuant to subdivision (e) of Section
6(2) Notwithstanding any other provision of this article, the rate
7of reimbursement for in-home supportive services provided through
8any mode of service shall not exceed the rate of reimbursement
9established under subdivision (j) of Section 14132.95 for the same
10mode of service unless otherwise provided in the annual Budget
12(3) The maximum number of hours available under Section
1314132.95, Section 14132.951, and this section, combined, shall
14be 283 hours per month. Any recipient of services under this article
15shall receive no more than the applicable maximum specified in
17(i) The Director of Health Care Services shall, by January 1,
182017, seek all federal approvals necessary to ensure that Medicaid
19funds may be used in implementing the amendments to this section
20made by the act that added this subdivision during the 2015-16
21Regular Session of the Legislature. These amendments include
22assistance in reading and completing financial and other documents
23for a recipient who is blind.
24(j) The authorization to provide the service added by the
25amendments to this section made by the act that added this
26subdivision during the 2015-16 Regular Session of the Legislature
27shall become operative on January 1, 2017. Provision of the service
28shall be implemented only if, and to the extent that, federal
29financial participation is available, and any necessary federal
30approvals have been obtained.
31(k) Pursuant to Sections 12300.5 and 12301.6, the state and
32 counties shall be immune from any liability, including negligence
33or intentional torts of providers, associated with the delivery of
34the service specified in subdivision (b) that includes assistance in
35reading and completing financial documents for recipients who
37(l) (1) Notwithstanding the rulemaking provisions of the
38Administrative Procedure Act (Chapter 3.5 (commencing with
39Section 11340) of Part 1 of Division 3 of Title 2 of the Government
40Code), until emergency regulations are filed with the Secretary of
P6 1State, the department may implement the amendments made to
2this section by the act that added this subdivision during the
32015-16 Regular Session of the Legislature through all-county
4letters or similar instructions from the director.
5(2) On or before January 1, 2018, the department shall adopt
6regulations to implement the amendments to this section made by
7the act that added this subdivision during the 2015-16 Regular
8Session of the Legislature. The initial adoption, amendment, or
9repeal of a regulation authorized by this subdivision is deemed to
10address an emergency, for purposes of Sections 11346.1 and
1111349.6 of the Government Code, and the department is hereby
12exempted for that purpose from the requirements of subdivision
13(b) of Section 11346.1 of the Government Code. After the initial
14adoption, amendment, or repeal of an emergency regulation
15pursuant to this section, the department may twice request approval
16from the Office of Administrative Law to readopt the regulation
17as an emergency regulation pursuant to Section 11346.1 of the
18Government Code. The department shall adopt final regulations
19on or before January 1, 2019.
If the Commission on State Mandates determines that
21this act contains costs mandated by the state, reimbursement to
22local agencies and school districts for those costs shall be made
23pursuant to Part 7 (commencing with Section 17500) of Division
244 of Title 2 of the Government Code.