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