BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 2968
                                                                  Page  1

          Date of Hearing:   May 17, 2006

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                   Judy Chu, Chair

                    AB 2968 (Leno) - As Amended:  April 25, 2006 

          Policy Committee:                              HealthVote:12-0

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              No

           SUMMARY  


          As proposed to be amended, this bill requires the Department of  
          Health Services (DHS) to develop and implement a program to  
          provide a community-living support benefit to eligible Medi-Cal  
          beneficiaries in San Francisco.  Specifically, this bill:


          1)Requires the community-living support benefit to include both  
            of the following:


             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 health-related services,  
               including personal care and psychosocial services,  
               necessary to protect their health and well-being.  


             b)   Access to community-living support services provided or  
               coordinated at the community-based housing site, including,  
               but not limited to, personal care, health services and  
               health-related support services.


          2)Makes an individual 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: 








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             a)   DHS determines that he or she would benefit from  
               supportive housing.


             b)   DHS determines that he or she is eligible for placement  
               in a skilled nursing facility (SNF) or an intermediate care  
               facility (ICF).


          3)Requires DHS to 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. 

           
          FISCAL EFFECT  

          As proposed to be amended, this bill would have no state fiscal  
          effect as its provisions would only apply upon a request by San  
          Francisco using its own funds to pay for waiver implementation,  
          monitoring and services.

           COMMENTS  


           1)Purpose  .  This bill is jointly sponsored by the San Francisco  
            Mayor's Office and the San Francisco Department of Public  
            Health to allow SF City and County to offer community-based  
            alternatives to residents of Laguna Honda Hospital (LHH) or  
            those at risk of institutionalization.  


          The author points out that SF has experience providing financial  
            supplements to keep people in community alternatives, such as  
            residential care facilities for the elderly.  However, the  
            need exceeds city resources, and this bill will provide access  
            to a Medicaid funded "wraparound," which would allow SF to  
            offer more SF residents a community alternative to admission  
            to LHH.  

          The sponsors state that this bill will result in bundling  
            medical and support services, such as personal care, case  








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            management and mental health together in an all inclusive  
            rate, not unlike the nursing home rate.  According to the  
            sponsors, SF currently pays an additional $95 per day for  
            Medi-Cal residents in LHH, and is willing to continue to do  
            that, but needs the flexibility to use the combination of its  
            own contribution and Medi-Cal funds to serve residents in the  
            community instead of at LHH.

           2)Proposed Amendment  .  The author has agreed to amend this bill  
            to have it take effect upon adoption of a resolution by the  
            county board of supervisors, and to have the county provide  
            county funds for the state match for implementation,  
            monitoring and services provided under the waiver.


           


           


           Analysis Prepared by  :    Scott Bain / APPR. / (916) 319-2081