Amended in Assembly August 28, 2015

Amended in Senate June 2, 2015

Amended in Senate April 7, 2015

Senate Bill No. 199

Introduced by Senator Hall

(Principal coauthor: Senator Beall)

(Coauthor: Senator Anderson)

(Coauthors: Assembly Members Bonilla, begin insert Dababneh, Cristina end insert begin insert  Garcia, end insert Gonzalez, Lackey, Rodriguez, Steinorth, and Waldron)

February 10, 2015

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

LEGISLATIVE COUNSEL’S DIGEST

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 up to 2 hours per month of 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 1.  

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

12300.  

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

(b) Supportive services shall include domestic services and
services related to domestic services, heavy cleaning, personal
care services, accompaniment by a provider when needed during
necessary travel to health-related appointments or to alternative
resource sites, yard hazard abatement, protective supervision, up
to two hours per month of assistance in reading and completing
financial and other documents for a recipient who is blind, teaching
and demonstration directed at reducing the need for other
supportive services, and paramedical services that make it possible
for the recipient to establish and maintain an independent living
arrangement.

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

(1) Assistance with ambulation.

(2) Bathing, oral hygiene, and grooming.

(3) Dressing.

(4) Care and assistance with prosthetic devices.

(5) Bowel, bladder, and menstrual care.

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

(7) Feeding and assurance of adequate fluid intake.

(8) Respiration.

(9) Assistance with self-administration of medications.

(d) Personal care services are available if these services are
provided in the beneficiary’s home and other locations as may be
authorized by the director. Among the locations that may be
authorized by the director under this subdivision is the recipient’s
place of employment if all of the following conditions are met:

(1) The personal care services are limited to those that are
currently authorized for a recipient in the recipient’s home and
those services are to be utilized by the recipient at the recipient’s
place of employment to enable the recipient to obtain, retain, or
return to work. Authorized services utilized by the recipient at the
recipient’s place of employment shall be services that are relevant
and necessary in supporting and maintaining employment.
However, workplace services shall not be used to supplant any
reasonable accommodations required of an employer by the federal
Americans with Disabilities Act of 1990 (42 U.S.C. Sec. 12101
et seq.; ADA) or other legal entitlements or third-party obligations.

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

(e) When supportive services are provided by a person who has
the legal duty pursuant to the Family Code to provide for the care
of his or her child who is the recipient, the provider of supportive
services shall receive remuneration for the services only when the
provider leaves full-time employment or is prevented from
obtaining full-time employment because no other suitable provider
is available and when the inability of the provider to provide
supportive services may result in inappropriate placement or
inadequate care.

These providers shall be paid only for the following:

(1) Services related to domestic services.

(2) Personal care services.

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

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

(5) Paramedical services.

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

(g) A person who is eligible to receive a service or services
under an approved federal waiver authorized pursuant to Section
14132.951, or a person who is eligible to receive a service or
services authorized pursuant to Section 14132.95, shall not be
eligible to receive the same service or services pursuant to this
article. In the event that the waiver authorized pursuant to Section
14132.951, as approved by the federal government, does not extend
eligibility to all persons otherwise eligible for services under this
article, or does not cover a service or particular services, or does
not cover the scope of a service that a person would otherwise be
eligible to receive under this article, those persons who are not
eligible for services, or for a particular service under the waiver
or Section 14132.95 shall be eligible for services under this article.

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

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

(3) The maximum number of hours available under Section
14132.95, Section 14132.951, and this section, combined, shall
be 283 hours per month. Any recipient of services under this article
shall receive no more than the applicable maximum specified in
Section 12303.4.

(i) The Director of Health Care Services shall, by January 1,
2017, seek all federal approvals necessary to ensure that Medicaid
funds may be used in implementing the begin delete amendments to this section
made by the act that added this subdivision during the 2015-16
Regular Session of the Legislature. These amendments include end delete
begin insert service to blind recipients specified in subdivision (b). The service
includes end insert assistance in reading and completing financial and other
documents for a recipient who is begin delete blind. end delete

begin delete (j) end delete begin delete   end delete begin delete The end delete begin insert blind. The end insert authorization to provide the service begin delete added by
the amendments to this section made by the act that added this
subdivision during the 2015-16 Regular Session of the Legislature end delete
begin insert to blind recipients specified in subdivision (b) end insert shall become
operative on January 1, 2017. Provision of the service shall be
implemented only if, and to the extent that, federal financial
participation is available, and any necessary federal approvals have
been obtained.

begin delete

(k) Pursuant to Sections 12300.5 and 12301.6, the state and
counties shall be immune from any liability, including negligence
or intentional torts of providers, associated with the delivery of
the service specified in subdivision (b) that includes assistance in
reading and completing financial documents for recipients who
are blind.

(l) (1) 

end delete

begin insert (j) end insert begin insert   end insert Notwithstanding the rulemaking provisions of the
Administrative Procedure Act (Chapter 3.5 (commencing with
Section 11340) of Part 1 of Division 3 of Title 2 of the Government
Code), until emergency regulations are filed with the Secretary of
State, the department may implement the begin delete amendments made to
this section by the act that added this subdivision during the
2015-16 Regular Session of the Legislature end delete begin insert service to blind
recipients specified in subdivision (b) end insert through all-county letters
or similar instructions from the begin delete director. end delete

begin delete (2) end delete begin delete   end delete begin delete On end delete begin insert director. On end insert or before January 1, 2018, the department
shall adopt regulations to implement the begin delete amendments to this section
made by the act that added this subdivision during the 2015-16
Regular Session of the Legislature. end delete begin insert service to blind recipients
specified in subdivision (b). end insert The initial adoption, amendment, or
repeal of a regulation authorized by this subdivision is deemed to
address an emergency, for purposes of Sections 11346.1 and
11349.6 of the Government Code, and the department is hereby
exempted for that purpose from the requirements of subdivision
(b) of Section 11346.1 of the Government Code. After the initial
adoption, amendment, or repeal of an emergency regulation
pursuant to this section, the department may twice request approval
from the Office of Administrative Law to readopt the regulation
as an emergency regulation pursuant to Section 11346.1 of the
Government Code. The department shall adopt final regulations
on or before January 1, 2019.

SEC. 2.  

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