BILL NUMBER: AB 1682 CHAPTERED
BILL TEXT
CHAPTER 90
FILED WITH SECRETARY OF STATE JULY 12, 1999
APPROVED BY GOVERNOR JULY 12, 1999
PASSED THE ASSEMBLY JUNE 16, 1999
PASSED THE SENATE JUNE 15, 1999
AMENDED IN SENATE JUNE 15, 1999
INTRODUCED BY Assembly Members Honda, Villaraigosa, and Shelley and
Senators Peace and Burton
MARCH 18, 1999
An act to amend Section 16262.5 of the Government Code, to amend
Sections 12301.6, 12303.4, 14132.95, and 17600 of, to add Sections
12301.3, 12301.4, 12301.8, and 12302.25 to, and to repeal Sections
12302.7 and 17600.110 of, the Welfare and Institutions Code, relating
to human services, and declaring the urgency thereof, to take effect
immediately.
LEGISLATIVE COUNSEL'S DIGEST
AB 1682, Honda. Human services.
Existing law provides for the county-administered In-Home
Supportive Services (IHSS) program, under which qualified aged,
blind, and disabled persons are provided with services in order to
permit them to remain in their own homes and avoid
institutionalization.
Existing law provides until June 30, 1998, that the reimbursement
of counties meeting certain conditions shall not be reduced for the
state share of the nonfederal costs for the administration of the
In-Home Supportive Services program.
This bill would extend the operative period of that provision
until June 30, 2001.
Existing law permits services to be provided under the IHSS
program either through the employment of individual providers, a
contract between the county and an entity for the provision of
services, the creation by the county of a public authority, or a
contract between the county and a nonprofit consortium.
Existing law provides that when any increase in provider wages or
benefits is negotiated or agreed to by a public authority or
nonprofit consortium, the county shall use county-only funds to fund
both the county's share and the state's share, including employment
taxes, of any increase in IHSS costs, unless otherwise provided for
by law.
This bill would delete this provision, and would, instead, provide
that the annual costs for any public authority or nonprofit
consortium shall be shared by the state and county according to
provisions of existing law.
The bill would also authorize counties to designate funds to be
used to increase provider wages and benefits for the provision of
IHSS services through a nonprofit consortium or public authority or
through a 3-year contract with various providers, and would provide
for the reimbursement of any county that expends county funds in an
amount at least equal to the reduction during the fiscal year in the
county's share of cost that results from federal financial
participation in services provided to medically needy aged, blind,
and disabled persons, for the cost of the increase in wages and
benefits that exceeds the reduction in the county share of cost.
This bill would require each county to act as, or establish, an
employer for in-home supportive service personnel for purposes of
provisions of statutory law regarding employer-employee relations and
would require the department to establish a timetable for
implementation of that requirement. This bill would also require
each county that has not established a public authority for the
provision of IHSS services to establish an advisory committee and
would require the advisory committee in each county to provide
recommendations on certain modes of service to be utilized in the
county for in-home supportive services.
Because counties are responsible for administration of the IHSS
program and participate in the funding of that program, this bill, by
requiring counties to appoint an advisory committee, would result in
a state-mandated local program.
Existing law provides that any county may contract on a
nonexclusive basis with any qualified individual, organization,
entity, or entities to provide or arrange for in-home supportive
services, and specifies that the contracts may provide for a mode of
service delivery under which the contractor is financially at risk
for providing all in-home supportive services identified as necessary
by the county to enrolled beneficiaries in the county.
This bill would repeal that provision.
Existing law establishes limits on the number of hours of services
that may be provided to eligible recipients under the IHSS program.
This bill would revise those limitations.
Existing law provides for the establishment of the Sales Tax
Account in the continuously appropriated Local Revenue Fund for the
allocation of sales and use tax revenues to local government,
includes the In-Home Supportive Services Registry Model Subaccount in
the Sales Tax Account of that fund, and provides that money in the
In-Home Supportive Services Registry Model Subaccount shall be
available for allocation by the Controller for purposes of funding
the provision of in-home supportive services through a county
contract with a nonprofit consortium or a public authority created
for that purpose.
This bill would eliminate the In-Home Supportive Services Registry
Model Subaccount from the Sales Tax Account in the Local Revenue
Fund, and would transfer any funds in the account to the General
Fund.
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, including the creation of a State Mandates Claims Fund
to pay the costs of mandates that do not exceed $1,000,000 statewide
and other procedures for claims whose statewide costs exceed
$1,000,000.
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.
This bill would declare that it is to take effect immediately as
an urgency statute.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 16262.5 of the Government Code is amended to
read:
16262.5. (a) Notwithstanding any other provision of law, until
June 30, 2001, the reimbursement of counties meeting one of the
following conditions shall not be reduced for the state share of the
nonfederal costs for the administration of the In-Home Supportive
Services program.
(1) County-imposed funding reductions in the 1999-2000 or 2000-01
fiscal year prevent a county from fully funding the county share of
the nonfederal administrative costs of the programs identified in
subdivision (a).
(2) Application for relief under Section 16262 and this section
was approved in a prior fiscal year for which relief is sought
pursuant to these sections and the level of county match available is
at least the amount specified in the application for that same
fiscal year subject to the restrictions contained in subdivision (b).
(b) Subdivision (a) shall be subject to the following
restrictions:
(1) The reduction imposed upon departments within a county
responsible for administering the program referred to in subdivision
(a) shall be proportionate to the average reduction in county funds
for administrative activities imposed on all other departments within
a county, except departments funded with revenue from Section 35 of
Article XIII of the California Constitution and the county
departments of health services. The county board of supervisors
shall certify that the reductions are imposed proportionately.
(2) If a county reduces the department responsible for
administering the program referred to in subdivision (a), and makes
reductions that exceed the average reduction of any other county
departments, with the exception of departments funded with revenue
from Section 35 of Article XIII of the California Constitution, and
the county departments of health services, then the state allocation
for that program shall be reduced by the same percentage.
(3) The state share of nonfederal costs for county administration
allocated to a county for the administration of the programs referred
to in subdivision (a) shall be limited to the 1999-2000 or 2000-01
fiscal year allocations as determined by the State Department of
Social Services in compliance with current allocation formulas as
adjusted pursuant to paragraph (2).
(4) No reduction in county administrative costs authorized by this
section shall result in any increased cost to the state General
Fund.
(5) No reduction in county administrative costs authorized by this
section shall result in any decrease in county assistance payments
in the program referred to in subdivision (a).
(6) The maximum rate reduction shall not exceed 15 percent of the
required county match. For counties that received fiscal relief in
either the 1995-96 or 1996-97 fiscal year, the county match shall be
the greater of 50 percent of the required county match for the year
relief is being requested, or alternatively, the county match
approved in either the 1995-96 or 1996-97 fiscal year.
(c) Counties requesting relief under this section shall apply to
the State Department of Social Services on or before October 31 of
the fiscal year for which relief is sought pursuant to this section.
SEC. 2. Section 12301.3 is added to the Welfare and Institutions
Code, to read:
12301.3. (a) Each county shall appoint an in-home supportive
services advisory committee that shall be comprised of not more than
11 individuals. No less than 50 percent of the membership of the
advisory committee shall be individuals who are current or past users
of personal assistance services paid for through public or private
funds or as recipients of services under this article.
(b) Prior to the appointment of members to a committee required by
subdivision (a), the county board of supervisors shall solicit
recommendations for qualified members through a fair and open process
that includes the provision of reasonable written notice to, and
reasonable response time by, members of the general public and
interested persons and organizations.
(c) The advisory committee shall submit recommendations to the
county board of supervisors on the preferred mode or modes of service
to be utilized in the county for in-home supportive services.
(d) Any county that has established a governing body, as provided
in subdivision (b) of Section 12301.6 shall be deemed to be in
compliance with this section.
SEC. 3. Section 12301.4 is added to the Welfare and Institutions
Code, to read:
12301.4. Each advisory committee established pursuant to Section
12301.3 or 12301.6 shall provide ongoing advice and recommendations
regarding in-home supportive services to the county board of
supervisors, any administrative body in the county that is related to
the delivery and administration of in-home supportive services, and
the governing body and administrative agency of the public authority,
nonprofit consortium, contractor, and public employees.
SEC. 4. Section 12301.6 of the Welfare and Institutions Code is
amended to read:
12301.6. (a) Notwithstanding Sections 12302 and 12302.1, a county
board of supervisors may, at its option, elect to do either of the
following:
(1) Contract with a nonprofit consortium to provide for the
delivery of in-home supportive services.
(2) Establish, by ordinance, a public authority to provide for the
delivery of in-home supportive services.
(b) (1) To the extent that a county elects to establish a public
authority pursuant to paragraph (2) of subdivision (a), the enabling
ordinance shall specify the membership of the governing body of the
public authority, the qualifications for individual members, the
manner of appointment, selection, or removal of members, how long
they shall serve, and other matters as the board of supervisors deems
necessary for the operation of the public authority.
(2) A public authority established pursuant to paragraph (2) of
subdivision (a) shall be both of the following:
(A) An entity separate from the county, and shall be required to
file the statement required by Section 53051 of the Government Code.
(B) A corporate public body, exercising public and essential
governmental functions and that has all powers necessary or
convenient to carry out the delivery of in-home supportive services,
including the power to contract for services pursuant to Sections
12302 and 12302.1 and that makes or provides for direct payment to a
provider chosen by the recipient for the purchase of services
pursuant to Sections 12302 and 12302.2. Employees of the public
authority shall not be employees of the county for any purpose.
(3) (A) As an alternative, the enabling ordinance may designate
the board of supervisors as the governing body of the public
authority.
(B) Any enabling ordinance that designates the board of
supervisors as the governing body of the public authority shall also
specify that no fewer than 50 percent of the membership of the
advisory committee shall be individuals who are current or past users
of personal assistance services paid for through public or private
funds or recipients of services under this article.
(C) If the enabling ordinance designates the board of supervisors
as the governing body of the public authority, it shall also require
the appointment of an advisory committee of not more than 11
individuals who shall be designated in accordance with subparagraph
(B).
(D) Prior to making designations of committee members pursuant to
subparagraph (C), or governing body members in accordance with
paragraph (4), the board of supervisors shall solicit recommendations
of qualified members of either the governing body of the public
authority or of any advisory committee through a fair and open
process that includes the provision of reasonable, written notice to,
and a reasonable response time by, members of the general public and
interested persons and organizations.
(4) If the enabling ordinance does not designate the board of
supervisors as the governing body of the public authority, the
enabling ordinance shall require the membership of the governing body
to meet the requirements of subparagraph (B) of paragraph (3).
(c) (1) Any public authority created pursuant to this section
shall be deemed to be the employer of in-home supportive services
personnel referred to recipients under paragraph (3) of subdivision
(d) within the meaning of Chapter 10 (commencing with Section 3500)
of Division 4 of Title 1 of the Government Code. Recipients shall
retain the right to hire, fire, and supervise the work of any in-home
supportive services personnel providing services to them.
(2) (A) Any nonprofit consortium contracting with a county
pursuant to this section shall be deemed to be the employer of
in-home supportive services personnel referred to recipients pursuant
to paragraph (3) of subdivision (d) for the purposes of collective
bargaining over wages, hours, and other terms and conditions of
employment.
(B) Recipients shall retain the right to hire, fire, and supervise
the work of any in-home supportive services personnel providing
services for them.
(3) (A) The annual cost for any public authority or nonprofit
consortium created pursuant to this section shall be shared by the
state and the counties as prescribed in Section 12306.
(B) No increase in wages or benefits negotiated or agreed to
pursuant to this section shall take effect unless and until, prior to
its implementation, the department has obtained the approval of the
State Department of Health Services for the increase pursuant to a
determination that it is consistent with federal law and to ensure
federal financial participation for the services under Title XIX of
the federal Social Security Act.
(d) A public authority established pursuant to this section or a
nonprofit consortium contracting with a county pursuant to this
section, when providing for the delivery of services under this
article by contract in accordance with Sections 12302 and 12302.1 or
by direct payment to a provider chosen by a recipient in accordance
with Sections 12302 and 12302.2, shall comply with and be subject to,
all statutory and regulatory provisions applicable to the respective
delivery mode.
(e) Any nonprofit consortium contracting with a county pursuant to
this section or any public authority established pursuant to this
section shall provide for all of the following functions under this
article, but shall not be limited to those functions:
(1) The provision of assistance to recipients in finding in-home
supportive services personnel through the establishment of a
registry.
(2) Investigation of the qualifications and background of
potential personnel.
(3) Establishment of a referral system under which in-home
supportive services personnel shall be referred to recipients.
(4) Providing for training for providers and recipients.
(5) Performing any other functions related to the delivery of
in-home supportive services.
(6) Ensuring that the requirements of the personal care option
pursuant to Subchapter 19 (commencing with Section 1396) of Chapter 7
of Title 42 of the United States Code are met.
(f) (1) Any nonprofit consortium contracting with a county
pursuant to this section or any public authority created pursuant to
this section shall be deemed not to be the employer of in-home
supportive services personnel referred to recipients under this
section for purposes of liability due to the negligence or
intentional torts of the in-home supportive services personnel.
(2) In no case shall a nonprofit consortium contracting with a
county pursuant to this section or any public authority created
pursuant to this section be held liable for action or omission of any
in-home supportive services personnel whom the nonprofit consortium
or public authority did not list on its registry or otherwise refer
to a recipient.
(3) Counties and the state shall be immune from any liability
resulting from their implementation of this section in the
administration of the In-Home Supportive Services program. Any
obligation of the public authority or consortium pursuant to this
section, whether statutory, contractual, or otherwise, shall be the
obligation solely of the public authority or nonprofit consortium,
and shall not be the obligation of the county or state.
(g) Any nonprofit consortium contracting with a county pursuant to
this section shall ensure that it has a governing body that complies
with the requirements of subparagraph (B) of paragraph (3) of
subdivision (b) or an advisory committee that complies with
subparagraphs (B) and (C) of paragraph (3) of subdivision (b).
(h) Recipients of services under this section may elect to receive
services from in-home supportive services personnel who are not
referred to them by the public authority or nonprofit consortium.
Those personnel shall be referred to the public authority or
nonprofit consortium for the purposes of wages, benefits, and other
terms and conditions of employment.
(i) Nothing in this section shall be construed to affect the state'
s responsibility with respect to the state payroll system,
unemployment insurance, or workers' compensation and other provisions
of Section 12302.2 for providers of in-home supportive services.
Any county that elects to provide in-home supportive services
pursuant to this section shall be responsible for any increased costs
to the in-home supportive services case management, information, and
payrolling system attributable to that election. The department
shall collaborate with any county that elects to provide in-home
supportive services pursuant to this section prior to implementing
the amount of financial obligation for which the county shall be
responsible.
(j) To the extent permitted by federal law, personal care option
funds, obtained pursuant to Subchapter 19 (commencing with Section
1396) of Chapter 7 of Title 42 of the United States Code, along with
matching funds using the state and county sharing ratio established
in subdivision (c) of Section 12306, or any other funds that are
obtained pursuant to Subchapter 19 (commencing with Section 1396) of
Chapter 7 of Title 42 of the United States Code, may be used to
establish and operate an entity authorized by this section.
(k) Notwithstanding any other provision of law, the county, in
exercising its option to establish a public authority, shall not be
subject to competitive bidding requirements. However, contracts
entered into by either the county, a public authority, or a nonprofit
consortium pursuant to this section shall be subject to competitive
bidding as otherwise required by law.
(l) (1) The department may adopt regulations implementing this
section as emergency regulations in accordance with Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 3 of Title 2 of
the Government Code. For the purposes of the Administrative
Procedures Act, the adoption of the regulations shall be deemed an
emergency and necessary for the immediate preservation of the public
peace, health and safety, or general welfare. Notwithstanding
Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3
of Title 2 of the Government Code, these emergency regulations shall
not be subject to the review and approval of the Office of
Administrative Law.
(2) Notwithstanding subdivision (h) of Section 11364.1 and Section
11349.6 of the Government Code, the department shall transmit these
regulations directly to the Secretary of State for filing. The
regulations shall become effective immediately upon filing by the
Secretary of State.
(3) Except as otherwise provided for by Section 10554, the Office
of Administrative Law shall provide for the printing and publication
of these regulations in the California Code of Regulations.
Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1
of Division 3 of Title 2 of the Government Code, these regulations
shall not be repealed by the Office of Administrative Law and shall
remain in effect until revised or repealed by the department.
(m) (1) In the event that a county elects to form a nonprofit
consortium or public authority pursuant to subdivision (a) before the
State Department of Health Services has obtained all necessary
federal approvals pursuant to paragraph (3) of subdivision (j) of
Section 14132.95, all of the following shall apply:
(A) Subdivision (c) shall apply only to those matters that do not
require federal approval.
(B) The second sentence of subdivision (g) shall not be operative.
(C) The nonprofit consortium or public authority shall not provide
services other than those specified in paragraphs (1), (2), (3),
(4), and (5) of subdivision (d).
(2) Paragraph (1) shall become inoperative when the State
Department of Health Services has obtained all necessary federal
approvals pursuant to paragraph (3) of subdivision (j) of Section
14132.95.
(n) (1) One year after the effective date of the first approval by
the department granted to the first public authority, the Bureau of
State Audits shall commission a study to review the performance of
that public authority.
(2) The study shall be submitted to the Legislature and the
Governor not later than two years after the effective date of the
approval specified in subdivision (a). The study shall give special
attention to the health and welfare of the recipients under the
public authority, including the degree to which all required services
have been delivered, out-of-home placement rates, prompt response to
recipient complaints, and any other issue the director deems
relevant.
(3) The report shall make recommendations to the Legislature and
the Governor for any changes to this section that will further ensure
the well-being of recipients and the most efficient delivery of
required services.
(o) Commencing July 1, 1997, the department shall provide annual
reports to the appropriate fiscal and policy committees of the
Legislature on the efficacy of the implementation of this section,
and shall include an assessment of the quality of care provided
pursuant to this section.
SEC. 5. Section 12301.8 is added to the Welfare and Institutions
Code, to read:
12301.8. (a) Increases in provider wages and benefits for the
provision of services pursuant to Section 12301.6 or 12302.1 may be
made in a manner appropriate to the entities or contracts described
in those sections. For the 1999-2000 fiscal year, and for each
fiscal year thereafter, any county that expends county funds in an
amount at least equal to the reduction during the fiscal year in the
county's share of cost that results from federal financial
participation in services provided to medically needy aged, blind,
and disabled persons after the implementation of the state plan
amendment pursuant to subdivision (p) of Section 14132.95 shall be
reimbursed for the cost of the increase in wages and benefits that
exceeds the reduction in the county share of cost and is necessary to
meet the established rates. This provision does not apply to any
wage increase necessary to meet federal or state minimum wage
requirements. For the 1999-2000 fiscal year, the reduction in the
county's share of cost during the fiscal year shall also include any
reduction that occurred in the 1998-99 fiscal year due to the
implementation of the state plan amendments pursuant to subdivision
(p) of Section 14132.95, unless the county has used the savings
during the 1998-99 fiscal year to pay for provider wages and benefit
increases. This subdivision applies solely to public authority,
nonprofit consortium, and contract employees who provide services
pursuant to Sections 12301.6 and 12302.1.
(b) The department shall reimburse counties for the cost of
increased wages and benefits that exceed the amount of the reduction
in the county's share of cost as determined pursuant to subdivision
(a), provided that amount is not greater than the county's actual
cost.
(c) Except as specifically set forth in subdivision (a), this
section is not otherwise intended to alter the cost sharing described
in Sections 12301.6 and 12306.
SEC. 6. Section 12302.25 is added to the Welfare and Institutions
Code, to read:
12302.25. (a) On or before January 1, 2003, each county shall act
as, or establish, an employer for in-home supportive service
providers under Section 12302.2 for the purposes of Chapter 10
(commencing with Section 3500) of Division 4 of Title 1 of the
Government Code and other applicable state or federal laws. Each
county may utilize a public authority or nonprofit consortium as
authorized under Section 12301.6, the contract mode as authorized
under Sections 12302 and 12302.1, county administration of the
individual provider mode as authorized under Sections 12302 and
12302.2 for purposes of acting as, or providing, an employer under
Chapter 10 (commencing with Section 3500) of Division 4 of Title 1 of
the Government Code, county civil service personnel as authorized
under Section 12302, or mixed modes of service authorized pursuant to
this article and may establish regional agreements in establishing
an employer for purposes of this subdivision for providers of in-home
supportive services. Within 30 days of the effective date of this
section, the department shall develop a timetable for implementation
of this subdivision to ensure orderly compliance by counties.
Recipients of in-home supportive services shall retain the right to
choose the individuals that provide their care and to recruit,
select, train, reject, or change any provider under the contract mode
or to hire, fire, train, and supervise any provider under any other
mode of service. Upon request of a recipient, and in addition to a
county's selected method of establishing an employer for in-home
supportive service providers pursuant to this subdivision, counties
with an IHSS caseload of more than 500 shall be required to offer an
individual provider employer option.
(b) Nothing in this section shall prohibit any negotiations or
agreement regarding collective bargaining or any wage and benefit
enhancements.
(c) Nothing in this section shall be construed to affect the state'
s responsibility with respect to the state payroll system,
unemployment insurance, or workers' compensation and other provisions
of Section 12302.2 for providers of in-home supportive services.
(d) Prior to implementing subdivision (a), a county shall
establish an advisory committee as required by Section 12301.3 and
solicit recommendations from the advisory committee on the preferred
mode or modes of service to be utilized in the county for in-home
supportive services.
(e) Each county shall take into account the advice and
recommendations of the in-home supportive services advisory
committee, as established pursuant to Section 12301.3, prior to
making policy and funding decisions about the program on an ongoing
basis.
(f) In implementing and administering this section, no county,
public authority, nonprofit consortium, contractor, or a combination
thereof, that delivers in-home supportive services shall reduce the
hours of service for any recipient below the amount determined to be
necessary under the uniform assessment guidelines established by the
department.
(g) Any agreement between a county and an entity acting as an
employer under subdivision (a) shall include a provision that
requires that funds appropriated by the state for wage increases for
in-home supportive services providers be used exclusively for that
purpose. Counties or the state may undertake audits of the entities
acting as employers under the terms of subdivision (a) to verify
compliance with this subdivision.
SEC. 7. Section 12302.7 of the Welfare and Institutions Code is
repealed.
SEC. 8. Section 12303.4 of the Welfare and Institutions Code is
amended to read:
12303.4. (a) Any aged, blind, or disabled individual who is
eligible for assistance under this chapter or Chapter 4 (commencing
with Section 12500), and who is not described in Section 12304, shall
receive services under this article which do not exceed the maximum
of 195 hours per month.
(b) Any aged, blind, or disabled individual who is eligible for
assistance under this chapter or Chapter 4 (commencing with Section
12500), who is in need, as determined by the county welfare
department, of at least 20 hours per week of the services defined in
Section 12304, shall be eligible to receive services under this
article, the total of which shall not exceed a maximum of 283 hours
per month.
SEC. 9. Section 14132.95 of the Welfare and Institutions Code is
amended to read:
14132.95. (a) Personal care services, when provided to a
categorically needy person as defined in Section 14050.1 is a covered
benefit to the extent federal financial participation is available
if these services are:
(1) Provided in the beneficiary's home and other locations as may
be authorized by the director subject to federal approval.
(2) Authorized by county social services staff in accordance with
a plan of treatment.
(3) Provided by a qualified person.
(4) Provided to a beneficiary who has a chronic, disabling
condition that causes functional impairment that is expected to last
at least 12 consecutive months or that is expected to result in death
within 12 months and who is unable to remain safely at home without
the services described in this section.
(b) The department shall seek federal approval of a state plan
amendment necessary to include personal care as a medicaid service
pursuant to subdivision (f) of Section 440.170 of Title 42 of the
Code of Federal Regulations. For any persons who meet the criteria
specified in subdivision (a) or (p), but for whom federal financial
participation is not available, eligibility shall be available
pursuant to Article 7 (commencing with Section 12300) of Chapter 3,
if otherwise eligible.
(c) Subdivision (a) shall not be implemented unless the department
has obtained federal approval of the state plan amendment described
in subdivision (b), and the Department of Finance has determined, and
has informed the department in writing, that the implementation of
this section will not result in additional costs to the state
relative to state appropriation for in-home supportive services under
Article 7 (commencing with Section 12300) of Chapter 3, in the
1992-93 fiscal year.
(d) (1) For purposes of this section, personal care services shall
mean all of the following:
(A) Assistance with ambulation.
(B) Bathing, oral hygiene and grooming.
(C) Dressing.
(D) Care and assistance with prosthetic devices.
(E) Bowel, bladder, and menstrual care.
(F) Skin care.
(G) Repositioning, range of motion exercises, and transfers.
(H) Feeding and assurance of adequate fluid intake.
(I) Respiration.
(J) Paramedical services.
(K) Assistance with self-administration of medications.
(2) Ancillary services including meal preparation and cleanup,
routine laundry, shopping for food and other necessities, and
domestic services may also be provided as long as these ancillary
services are subordinate to personal care services. Ancillary
services may not be provided separately from the basic personal care
services.
(e) (1) (A) After consulting with the State Department of Social
Services, the department shall adopt emergency regulations to
establish the amount, scope, and duration of personal care services
available to persons described in subdivision (a) in the fiscal year
whenever the department determines that General Fund expenditures for
personal care services provided under this section and expenditures
of both General Fund moneys and federal funds received under Title XX
of the federal Social Security Act for services pursuant to Article
7 (commencing with Section 12300) of Chapter 3, are expected to
exceed the General Fund appropriation and the federal appropriation
under Title XX of the federal Social Security Act provided for the
1992-93 fiscal year pursuant to Article 7 (commencing with Section
12300) of Chapter 3, as it read on June 30, 1992, as adjusted for
caseload growth or as increased in the Budget Act or appropriated by
statute. At least 30 days prior to filing these regulations with the
Secretary of State, the department shall give notice of the expected
content of these regulations to the fiscal committees of both houses
of the Legislature.
(B) In establishing the amount, scope, and duration of personal
care services, the department shall ensure that General Fund
expenditures for personal care services provided for under this
section and expenditures of both General Fund moneys and federal
funds received under Title XX of the federal Social Security Act for
services pursuant to Article 7 (commencing with Section 12300) of
Chapter 3, do not exceed the General Fund appropriation and the
federal appropriation under Title XX of the federal Social Security
Act provided for the 1992-93 fiscal year pursuant to Article 7
(commencing with Section 12300) of Chapter 3, as it read on June 30,
1992, as adjusted for caseload growth or as increased in the Budget
Act or appropriated by statute.
(C) For purposes of this subdivision, "caseload growth" means an
adjustment factor determined by the department based on (1) growth in
the number of persons eligible for benefits under Chapter 3
(commencing with Section 12000) on the basis of their disability, (2)
the average increase in the number of hours in the program
established pursuant to Article 7 (commencing with Section 12300) of
Chapter 3 in the 1988-89 to 1992-93 fiscal years, inclusive, due to
the level of impairment, and (3) any increase in program costs that
is required by an increase in the mandatory minimum wage.
(2) In establishing the amount, scope, and duration of personal
care services pursuant to this subdivision, the department may define
and take into account, among other things:
(A) The extent to which the particular personal care services are
essential or nonessential.
(B) Standards establishing the medical necessity of the services
to be provided.
(C) Utilization controls.
(D) A minimum number of hours of personal care services that must
first be assessed as needed as a condition of receiving personal care
services pursuant to this section.
The level of personal care services shall be established so as to
avoid, to the extent feasible within budgetary constraints, medical
out-of-home placements.
(3) To the extent that General Fund expenditures for services
provided under this section and expenditures of both General Fund
moneys and federal funds received under Title XX of the federal
Social Security Act for services pursuant to Article 7 (commencing
with Section 12300) of Chapter 3 in the 1992-93 fiscal year, adjusted
for caseload growth, exceed General Fund expenditures for services
provided under this section and expenditures of both General Fund
moneys and federal funds received under Title XX of the federal
Social Security Act for services pursuant to Article 7 (commencing
with Section 12300) of Chapter 3 in any fiscal year, the excess of
these funds shall be expended for any purpose as directed in the
Budget Act or as otherwise statutorily disbursed by the Legislature.
(f) Services pursuant to this section shall be rendered, under the
administrative direction of the State Department of Social Services,
in the manner authorized in Article 7 (commencing with Section
12300) of Chapter 3, for the In-Home Supportive Services program. A
provider of personal care services shall be qualified to provide the
service and shall be a person other than a member of the family. For
purposes of this section, a family member means a parent of a minor
child or a spouse.
(g) A beneficiary who is eligible for assistance under this
section shall receive services that do not exceed 283 hours per month
of personal care services.
(h) Personal care services shall not be provided to residents of
facilities licensed by the department, and shall not be provided to
residents of a community care facility or a residential care facility
for the elderly licensed by the Community Care Licensing Division of
the State Department of Social Services.
(i) Subject to any limitations that may be imposed pursuant to
subdivision (e), determination of need and authorization for services
shall be performed in accordance with Article 7 (commencing with
Section 12300) of Chapter 3.
(j) (1) To the extent permitted by federal law, reimbursement
rates for personal care services shall be equal to the rates in each
county for the same mode of services in the In-Home Supportive
Services program pursuant to Article 7 (commencing with Section
12300) of Chapter 3, plus any increase provided in the annual Budget
Act for personal care services rates or included in a county budget
pursuant to paragraph (2).
(2) (A) The department shall establish a provider reimbursement
rate methodology to determine payment rates for the individual
provider mode of service that does all of the following:
(i) Is consistent with the functions and duties of entities
created pursuant to Section 12301.6.
(ii) Makes any additional expenditure of state general funds
subject to appropriation in the annual Budget Act.
(iii) Permits county-only funds to draw down federal financial
participation consistent with federal law.
(B) This ratesetting method shall be in effect in time for any
rate increases to be included in the annual Budget Act.
(C) The department may, in establishing the ratesetting method
required by subparagraph (A), do both of the following:
(i) Deem the market rate for like work in each county, as
determined by the Employment Development Department, to be the cap
for increases in payment rates for individual practitioner services.
(ii) Provide for consideration of county input concerning the rate
necessary to ensure access to services in that county.
(D) If an increase in individual practitioner rates is included in
the annual Budget Act, the state-county sharing ratio shall be as
established in Section 12306. If the annual Budget Act does not
include an increase in individual practitioner rates, a county may
use county-only funds to meet federal financial participation
requirements consistent with federal law.
(3) (A) By November 1, 1993, the department shall submit a state
plan amendment to the federal Health Care Financing Administration to
implement this subdivision. To the extent that any element or
requirement of this subdivision is not approved, the department shall
submit a request to the federal Health Care Financing Administration
for any waivers as would be necessary to implement this subdivision.
(B) The provider reimbursement ratesetting methodology authorized
by the amendments to this subdivision in the 1993-94 Regular Session
of the Legislature shall not be operative until all necessary federal
approvals have been obtained.
(k) (1) The State Department of Social Services shall, by
September 1, 1993, notify the following persons that they are
eligible to participate in the personal care services program:
(A) Persons eligible for services pursuant to the Pickle
Amendment, as adopted October 28, 1976.
(B) Persons eligible for services pursuant to subsection (c) of
Section 1383c of Title 42 of the United States Code.
(2) The State Department of Social Services shall, by September 1,
1993, notify persons to whom paragraph (1) applies and who receive
advance payment for in-home supportive services that they will
qualify for services under this section without a share of cost if
they elect to accept payment for services on an arrears rather than
an advance payment basis.
(l) An individual who is eligible for services subject to the
maximum amount specified in subdivision (b) of Section 12303.4 shall
be given the option of hiring his or her own provider.
(m) The county welfare department shall inform in writing any
individual who is potentially eligible for services under this
section of his or her right to the services.
(n) It is the intent of the Legislature that this entire section
be an inseparable whole and that no part of it be severable. If any
portion of this section is found to be invalid, as determined by a
final judgment of a court of competent jurisdiction, this section
shall become inoperative.
(o) Paragraphs (2) and (3) of subdivision (a) shall be implemented
so as to conform to federal law authorizing their implementation.
(p) (1) Personal care services shall be provided as a covered
benefit to a medically needy aged, blind, or disabled person, as
defined in subdivision (a) of Section 14051, to the same extent and
under the same requirements as they are provided under subdivision
(a) of this section to a categorically needy, aged, blind, or
disabled person, as defined in subdivision (a) of Section 14050.1,
and to the extent that federal financial participation is available.
(2) The department shall seek federal approval of a state plan
amendment necessary to include personal care services described in
paragraph (1) as a medicaid service pursuant to subdivision (f) of
Section 440.170 of Title 42 of the Code of Federal Regulations.
(3) In the event that the Department of Finance determines that
expenditures of both General Fund moneys for personal care services
provided under this subdivision to medically needy aged, blind, or
disabled persons together with expenditures of both General Fund
moneys and federal funds received under Title XX of the federal
Social Security Act for all aged, blind, and disabled persons
receiving in-home supportive services pursuant to Article 7
(commencing with Section 12300) of Chapter 3, in the 2000-01 fiscal
year or in any subsequent fiscal year, are expected to exceed the
General Fund appropriation and the federal appropriation received
under Title XX of the federal Social Security Act for expenditures
for all aged, blind, and disabled persons receiving in-home
supportive services provided in the 1999-2000 fiscal year pursuant to
Article 7 (commencing with Section 12300) of Chapter 3, as it read
on June 30, 1998, as adjusted for caseload growth or as changed in
the Budget Act or by statute or regulation, then this subdivision
shall cease to be operative on the first day of the month that begins
after the expiration of a period of 30 days subsequent to a
notification in writing by the Director of the Department of Finance
to the chairperson of the committee in each house that considers
appropriations, the chairpersons of the committees and the
appropriate subcommittees in each house that consider the State
Budget, and the Chairperson of the Joint Legislative Budget
Committee.
(4) Solely for purposes of paragraph (3), caseload growth means an
adjustment factor determined by the department based on:
(A) Growth in the number of persons eligible for benefits under
Chapter 3 (commencing with Section 12000) on the basis of their
disability.
(B) The average increase in the number of hours in the program
established pursuant to Article 7 (commencing with Section 12300) of
Chapter 3 in the 1994-95 to 1998-99 fiscal years, inclusive, due to
the level of impairment.
(C) Any increase in program cost that is required by an increase
in hourly costs pursuant to the Budget Act or statute.
(5) In the event of a final judicial determination by any court of
appellate jurisdiction or a final determination by the Administrator
of the federal Health Care Financing Administration that personal
care services must be provided to any medically needy person who is
not aged, blind, or disabled, then this subdivision shall cease to be
operative on the first day of the first month that begins after the
expiration of a period of 30 days subsequent to a notification in
writing by the Director of Finance to the chairperson of the
committee in each house that considers appropriations, the
chairpersons of the committees and the appropriate subcommittees in
each house that consider the State Budget, and the Chairperson of the
Joint Legislative Budget Committee.
(6) If this subdivision ceases to be operative, all aged, blind,
and disabled persons who would have received or been eligible to
receive in-home supportive services pursuant to Article 7 (commencing
with Section 12300) of Chapter 3, but for receiving services under
this subdivision, shall be eligible immediately upon this section
becoming inoperative for services pursuant to Article 7 (commencing
with Section 12300) of Chapter 3.
(7) The department shall implement this subdivision on April 1,
1999, but only if the department has obtained federal approval of the
state plan amendments described in paragraph (2) of this
subdivision.
(q) This section shall become inoperative on July 1, 2002, and, as
of January 1, 2003, is repealed, unless a later enacted statute,
which becomes effective on or before January 1, 2003, deletes or
extends the dates on which it becomes inoperative and is repealed.
SEC. 10. Section 17600 of the Welfare and Institutions Code is
amended to read:
17600. (a) There is hereby created the Local Revenue Fund, which
shall have all of the following accounts:
(1) The Sales Tax Account.
(2) The Vehicle License Fee Account.
(3) The Vehicle License Collection Account.
(4) The Sales Tax Growth Account.
(5) The Vehicle License Fee Growth Account.
(b) The Sales Tax Account shall have all of the following
subaccounts:
(1) The Mental Health Subaccount.
(2) The Social Services Subaccount.
(3) The Health Subaccount.
(c) The Sales Tax Growth Account shall have all of the following
subaccounts:
(1) The Caseload Subaccount.
(2) The Base Restoration Subaccount.
(3) The Indigent Health Equity Subaccount.
(4) The Community Health Equity Subaccount.
(5) The Mental Health Equity Subaccount.
(6) The State Hospital Mental Health Equity Subaccount.
(7) The County Medical Services Subaccount.
(8) The General Growth Subaccount.
(9) The Special Equity Subaccount.
(d) Notwithstanding Section 13340 of the Government Code, the
Local Revenue Fund is hereby continuously appropriated, without
regard to fiscal years, for the purpose of this chapter.
(e) The Local Revenue Fund shall be invested in the Surplus Money
Investment Fund and all interest earned shall be distributed in
January and July among the accounts and subaccounts in proportion to
the amounts deposited into each subaccount, except as provided in
subdivision (f).
(f) If a distribution required by subdivision (e) would cause a
subaccount to exceed its limitations imposed pursuant to any of the
following, the distribution shall be made among the remaining
subaccounts in proportion to the amounts deposited into each
subaccount in the six prior months:
(1) Subdivision (a) of Section 17605.
(2) Paragraph (1) of subdivision (a) of Section 17605.05.
(3) Subdivision (b) of Section 17605.10.
(4) Subdivision (c) of Section 17605.10.
SEC. 11. Section 17600.110 of the Welfare and Institutions Code is
repealed.
SEC. 12. The unencumbered amount residing in the In-Home
Supportive Services Registry Subaccount of the Sales Tax Account of
the Local Revenue Fund on January 1, 2000, shall be transferred to
the General Fund.
SEC. 13. Notwithstanding Section 17610 of the Government Code, 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. If the statewide cost of the claim for
reimbursement does not exceed one million dollars ($1,000,000),
reimbursement shall be made from the State Mandates Claims Fund.
SEC. 14. This act is an urgency statute necessary for the
immediate preservation of the public peace, health, or safety within
the meaning of Article IV of the Constitution and shall go into
immediate effect. The facts constituting the necessity are:
In order to make timely adjustments in the process of
implementation of the State Budget for the 1999-2000 fiscal year, it
is necessary that this act take effect immediately.