BILL NUMBER: AB 2968 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY APRIL 25, 2006
AMENDED IN ASSEMBLY APRIL 5, 2006
INTRODUCED BY Assembly Member Leno
FEBRUARY 24, 2006
An act to add Section 14132.24 to the Welfare and Institutions
Code, relating to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
AB 2968, as amended, Leno Medi-Cal: community-living support
benefit.
Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Services and under
which qualified low-income persons receive health care benefits,
including certain residential care benefits. The Medi-Cal program is,
in part, governed and funded by federal Medicaid provisions.
This bill would require the department to develop and implement a
program to provide a community-living support benefit to eligible
Medi-Cal beneficiaries. It would require the department to submit any
federal documentation that is necessary to provide this benefit, and
to implement the benefit only to the extent that federal financial
participation is available. The bill would require that the benefit
include reimbursement for an array of health-related and psychosocial
services provided or coordinated at community-based housing sites,
and access to certain community-living support services provided or
coordinated at those sites. Eligibility for the benefit would be
limited to persons who are eligible for Medi-Cal, who are residents
of San Francisco who would otherwise be homeless, living in shelters,
or institutionalized, and who meet at least one of 2 other criteria.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature finds and declares all of the
following:
(a) Medi-Cal eligible persons who are residents of San Francisco,
who would otherwise be homeless, living in shelters, or
institutionalized, and who reside in community-based housing should
have access to crucial health services that may reduce their use of
acute psychiatric and medical services or institutionalized long-term
care services.
(b) Community-based housing is noninstitutional residential
housing linked to either community-based or site-based health-related
and psychosocial services.
(c) Under the existing Medi-Cal program, reimbursement for
providing an array of health-related and psychosocial services to
Medi-Cal eligible residents in assisted living is complicated, is
sometimes not available, and, when available, frequently results in
the services being provided in more expensive institutional settings.
(d) A designated Medi-Cal reimbursement rate structure for
community-living support services that assist beneficiaries who would
otherwise be homeless, living in shelters, or institutionalized
would expand community-based options for beneficiaries who would
otherwise require costly institutional care.
SEC. 2. Section 14132.24 is added to the Welfare and Institutions
Code, to read:
14132.24. (a) The department shall develop and implement a
program to provide a community-living support benefit to eligible
Medi-Cal beneficiaries. The department shall submit any waiver
application, modification of any existing waiver, or amendment to the
Medicaid state plan, that is necessary to provide this benefit, and
shall implement the benefit only to the extent that federal financial
participation is available.
(b) The community-living support benefit shall include both of the
following:
(1) (A) Reimbursement for an array of
health-related and psychosocial services provided or coordinated at
community-based housing sites that enable beneficiaries to remain in
the least restrictive and most homelike environment while receiving
the health-related services, including personal care and psychosocial
services, necessary to protect their health and well-being. These
community-based housing units may include, but are not limited to,
assisted living units, as defined in Section 1771 of the
Health and Safety Code the living area or unit within
a facility that is specifically designed to provide ongoing assisted
living services , licensed residential care facilities for the
elderly, publicly funded senior and disabled housing projects, or
supportive housing sites that serve chronically homeless individuals
with chronic or disabling health conditions.
(B) For purposes of this section, "assisted living services"
includes, but is not limited to, assistance with personal activities
of daily living, including dressing, feeding, toileting, bathing,
grooming, mobility, and associated tasks, to help provide for and
maintain physical and psychological comfort.
(2) Access to community-living support services provided or
coordinated at the community-based housing site, including, but not
limited to, the personal care and health services specified in
paragraph (8) of subdivision (a) of Section 1788 of the Health and
Safety Code, and the health related support services
specified in Section 53290 of the Health and Safety Code.
(c) An individual shall be eligible for the community-living
support benefit if he or she is eligible for the Medi-Cal program, is
a resident of San Francisco who would otherwise be homeless, living
in shelters, or institutionalized, and meets one or both of the
following criteria:
(1) The department determines that he or she would benefit from
supportive housing, as defined in subdivision (c) of Section 53260 of
the Health and Safety Code.
(2) The department determines that he or she is eligible for
placement in a skilled nursing facility, as defined in subdivision
(c) of Section 1250 of the Health and Safety Code, or an intermediate
care facility, as defined in subdivision (d) of that section.
(d) The department shall seek to maximize resources for
community-based housing by coordinating the community -living support
benefit with existing efforts to coordinate care, improve health
outcomes, and reduce long-term care costs for the targeted
population.
(e) The City and County of San Francisco may provide county funds
for use by the state to match federal Medicaid funds to receive
federal funds for services provided under the waiver specified in
this section to limit additional state costs.
SEC. 3. Due to the unique circumstances facing Medi-Cal recipients
in the City and County of San Francisco who reside in
community-based housing, the Legislature hereby finds and declares
that a general statute cannot be made applicable within the meaning
of Section 16 of Article IV of the California Constitution.
Therefore, the special legislation contained within Section 2 of this
act is necessarily applicable only to the City and County of San
Francisco.