BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SB 199|
|Office of Senate Floor Analyses | |
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VETO
Bill No: SB 199
Author: Hall (D), et al.
Enrolled: 8/28/15
Vote: 21
SENATE HUMAN SERVICES COMMITTEE: 5-0, 3/24/15
AYES: McGuire, Berryhill, Hancock, Liu, Nguyen
SENATE APPROPRIATIONS COMMITTEE: 7-0, 5/28/15
AYES: Lara, Bates, Beall, Hill, Leyva, Mendoza, Nielsen
SENATE FLOOR: 40-0, 6/3/15
AYES: Allen, Anderson, Bates, Beall, Berryhill, Block,
Cannella, De León, Fuller, Gaines, Galgiani, Glazer, Hall,
Hancock, Hernandez, Hertzberg, Hill, Hueso, Huff, Jackson,
Lara, Leno, Leyva, Liu, McGuire, Mendoza, Mitchell, Monning,
Moorlach, Morrell, Nguyen, Nielsen, Pan, Pavley, Roth, Runner,
Stone, Vidak, Wieckowski, Wolk
SENATE FLOOR: 40-0, 9/2/15
AYES: Allen, Anderson, Bates, Beall, Berryhill, Block,
Cannella, De León, Fuller, Gaines, Galgiani, Glazer, Hall,
Hancock, Hernandez, Hertzberg, Hill, Hueso, Huff, Jackson,
Lara, Leno, Leyva, Liu, McGuire, Mendoza, Mitchell, Monning,
Moorlach, Morrell, Nguyen, Nielsen, Pan, Pavley, Roth, Runner,
Stone, Vidak, Wieckowski, Wolk
ASSEMBLY FLOOR: 80-0, 9/1/15 - See last page for vote
SUBJECT: In-home supportive services: reading services for
blind and visually impaired recipients
SOURCE: California Association of Public Authorities for IHSS
California Council of the Blind
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UWDA/AFSCME
DIGEST: This bill expands the scope of personal care services
provided within the In-Home Supportive Services (IHSS) program
to include up to two hours per month of assisting in reading and
completing financial and other documents for a recipient who is
blind. It requires those services to be implemented beginning on
January 1, 2017, only if federal financial participation is
available, and establishes that states and counties are immune
from liability in delivering these services.
ANALYSIS:
Existing law:
1)Establishes the IHSS program to provide in-home domestic
supportive and personal care services for aged, blind or
disabled individuals living at or below the poverty level for
the purpose of enabling IHSS consumers to avoid
institutionalization and remain safely in their homes with
supportive services. (WIC 12300 et seq.)
2)Defines the scope of supportive services available under the
IHSS program to include 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, teaching and demonstration directed at reducing
the need for other supportive services, and paramedical
services which make it possible for the recipient to establish
and maintain an independent living arrangement. (WIC 12300
(b))
3)Defines the scope of personal care services available under
the IHSS program to include:
Assistance with ambulation.
Bathing, oral hygiene, and grooming.
Dressing.
Care and assistance with prosthetic devices.
Bowel, bladder, and menstrual care.
Repositioning, skin care, range of motion exercises, and
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transfers.
Feeding and assurance of adequate fluid intake.
Respiration.
Assistance with self-administration of medications. (WIC
12300 (c))
1)Requires the California Department of Social Services (CDSS),
in consultation with county welfare departments to establish
and implement statewide hourly task guidelines and
instructions to provide counties with a standard tool for
consistently and accurately assessing service needs and
authorizing service hours to meet those needs. (WIC 12301.2)
2)Permits certain IHSS recipients with high care needs, as
specified, to receive up to 283 hours of IHSS services per
month. (WIC 12303.4(b))
3)Requires county welfare agencies to provide eligible visually
impaired or blind IHSS recipients information and referral to
non-profit services that provide reading services. (WIC
12304.6)
4)Provides that counties and the state shall be immune from any
liability resulting from the administration of the IHSS
program due to the negligence or intentional torts of the
individual provider. (WIC 12301.6 and 12300.5)
5)Pursuant to federal law, defines legal blindness as persons
with central visual acuity of 20/200 or less in the stronger
eye, while wearing a correcting lens or glasses; or a
limitation in the field of vision in the better eye, so that:
There is contraction of peripheral visual fields to 10
degrees from the point of fixation, or
The widest diameter of the visual field subtends an
angle no greater than 20 degrees, or
There is a contraction of peripheral visual fields to 20
percent or less visual field efficiency (Sec. 1614 (42
U.S.C. 1382c))
This bill:
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1)Expands the scope of personal care services provided within
the IHSS program to include up to two hours per month of
assistance in reading and completing financial and other
documents for a recipient who is blind.
2)Requires the Director of Health Care Services, by January 1,
2017, to seek all federal approvals necessary to ensure that
Medicaid funds may be used in implementing service to blind
recipients provided for under the bill.
3)Makes the provisions of this bill operative beginning in
January 1, 2017, only if federal financial participation is
available.
4)Permits CDSS to implement the bill through all-county letters
or similar instructions from the director.
5)Requires CDSS to adopt emergency regulations by January 1,
2018, and to adopt final regulations on or before January 1,
2019.
Background
In Home Supportive Services Program (IHSS). The IHSS program was
established in 1973 as an alternative to institutional care, and
evolved in the context of a growing "independent living" civil
rights movement led by persons with disabilities. The program
has experienced continuous growth following the U.S. Supreme
Court decision Olmstead v. L.C. in 1999 which established the
rights of people with disabilities to receive services in the
most integrated setting possible to "provide individuals with
disabilities opportunities to live their lives like individuals
without disabilities" under the Americans With Disabilities Act
(ADA).
The IHSS program is operated as benefit under the Medi-Cal
program, providing in-home services to more than 460,000
qualified low-income individuals who are aged, blind, or
disabled. Currently, of approximately 464,402 IHSS recipients,
an estimated two percent of consumers are visually impaired or
blind (approximately 10,153 consumers). County welfare agencies
administer the program under CDSS oversight and county social
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workers determine eligibility and assess eligible consumers to
determine the allowable services and number of allotted hours
following a standardized in-home assessment.
Legal Blindness and the Americans With Disabilities Act. Title
16 of the Social Security Act defines legal blindness a central
visual acuity of 20/200 or less in the stronger eye, while
wearing a correcting lens or glasses; or a limitation in the
field of vision in the better eye, so that:
1)There is contraction of peripheral visual fields to 10 degrees
from the point of fixation, or
2)The widest diameter of the visual field subtends an angle no
greater than 20 degrees, or
3)There is a contraction of peripheral visual fields to 20
percent or less visual field efficiency.
Titles II and III of the ADA require that government and private
sector organizations must provide print materials in an
alternative format for people with visual impairment.
Specifically, Section 36.303, Title III of the ADA provides, "A
public accommodation shall furnish appropriate auxiliary aids
and services where necessary to ensure effective communication
with individuals with disabilities." These print materials can
include billing statements, financial statements, personnel
manuals and business cards.
According to the U.S. Department of Justice, Civil Rights
Division, in practice this means that the ADA requires that
effective communication not exclude people with disabilities -
which in the case of visually impaired or blind persons may
require businesses and government to provide information
verbally or in braille. However, it states the law does not
require any measure that would cause an undue financial or
administrative burden.
Braille and Visual Aid Technologies. The National Braille Press
states that braille literacy rates for school-age blind children
have declined from greater than 50 percent in the 1960s to only
12 percent today. Academic research on braille literacy
suggests that a significant reason for the decline has been the
growing popularity of magnification equipment or use of large
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print in cases when a blind child has some residual vision.
Children with some residual vision account for approximately 85
percent of blind children.
Certain degenerative conditions, such as glaucoma and
degenerative myopia, have an onset early in childhood with
vision worsening over time. Low-vision students, in particular
those with degenerative visual impairments, are at risk for not
receiving appropriate braille instruction while some level of
sight remains.
An ADA handbook published by the University of California notes
that not all blind people read braille and that "typically,
people who have lost their vision later in life tend to rely on
speech output as their access strategy." The handbook notes
alternative adaptive equipment, such as magnified display of a
computer screen, screen reader software, braille input devices
and other equipment may be useful, though costly and
inaccessible for low-income individuals with visual impairments
or blindness, particularly among those whose sole source of
income is SSI/SSP.
FISCAL EFFECT: Appropriation: No Fiscal
Com.:YesLocal: Yes
According to the Assembly Appropriations Committee, this bill
will incur one-time costs to CDSS in 2015-16 of up to $1.7
million (GF/Federal Fund), and up to $3.0 million on-going to
fund additional authorized IHSS provider hours for services to
9,710 IHSS recipients who are blind, assuming all potential
recipients are authorized for an additional two hours per month.
These costs will be lower to the extent that not all potential
recipients are authorized for this service or are authorized for
less than two hours. Additionally, the analysis states there are
unknown but potentially significant one-time automation costs
(GF/Federal Fund) and minor one-time costs to DHCS to submit the
request for federal approval of this service.
SUPPORT: (Verified9/1/15)
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California Association of Public Authorities for IHSS,
(co-source)
California Council of the Blind (co-source)
UWDA/AFSCME (co-source)
AARP
American Federation of State, County and Municipal Employees
California Commission on Aging
California Communities United Institute
California Senior Legislature
Congress of California Seniors
Justice in Aging
Personal Assistance Services Council
SEIU California
OPPOSITION: (Verified9/1/15)
None received
GOVERNOR'S VETO MESSAGE:
I am returning Senate Bill 199 without my signature.
This bill would authorize, for blind In-Home Supportive
Services recipients, up to two hours per month of
assistance in completing financial documents.
Before considering any expansion in this program, the state
must find a permanent funding source to support the hours
and activities that are authorized under current law.
ASSEMBLY FLOOR: 80-0, 9/1/15
AYES: Achadjian, Alejo, Travis Allen, Baker, Bigelow, Bloom,
Bonilla, Bonta, Brough, Brown, Burke, Calderon, Campos, Chang,
Chau, Chávez, Chiu, Chu, Cooley, Cooper, Dababneh, Dahle,
Daly, Dodd, Eggman, Frazier, Beth Gaines, Gallagher, Cristina
Garcia, Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez,
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Gordon, Gray, Grove, Hadley, Harper, Roger Hernández, Holden,
Irwin, Jones, Jones-Sawyer, Kim, Lackey, Levine, Linder,
Lopez, Low, Maienschein, Mathis, Mayes, McCarty, Medina,
Melendez, Mullin, Nazarian, Obernolte, O'Donnell, Olsen,
Patterson, Perea, Quirk, Rendon, Ridley-Thomas, Rodriguez,
Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting,
Wagner, Waldron, Weber, Wilk, Williams, Wood, Atkins
Prepared by:Mark Teemer / HUMAN S. / (916) 651-1524
11/4/15 14:05:58
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