BILL ANALYSIS
AB 2968
Page 1
ASSEMBLY THIRD READING
AB 2968 (Leno)
As Amended May 23, 2006
Majority vote
HEALTH 12-0 APPROPRIATIONS 14-2
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|Ayes:|Chan, Aghazarian, Berg, |Ayes:|Chu, Bass, Berg, |
| |Dymally, Frommer, Jones, | |Calderon, |
| |Lieu, Montanez, | |De La Torre, Karnette, |
| |Nakanishi, Negrete | |Klehs, Leno, Nakanishi, |
| |McLeod, | |Nation, Oropeza, |
| |Ridley-Thomas, Strickland | |Ridley-Thomas, Saldana, |
| | | |Yee |
|-----+--------------------------+-----+--------------------------|
| | |Nays:|Haynes, Walters |
| | | | |
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SUMMARY : Requires the Department of Health Services (DHS) to
develop and implement a program to provide a community-living
support benefit (benefit), as specified, for Medi-Cal
beneficiaries who are residents of San Francisco (SF) and would
otherwise be homeless, living in shelters, or institutionalized.
Specifically, this bill :
1)Requires DHS to develop and implement a program to provide a
community-living support program for Medi-Cal beneficiaries,
to the extent federal financial participation is available,
and requires DHS to submit any waiver application,
modification of any existing waiver, or amendment to the
state's Medicaid plan, necessary to provide this benefit.
2)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, including but not limited
to, assisted living units, residential care facilities for
the elderly, publicly funded senior and disabled housing
projects, or supportive housing sites that serve
chronically homeless individuals; and,
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b) Access to community-living support services provided or
coordinated at the community-based housing site, including
but not limited, personal care and health services, such as
are required in a licensed residential care facility for
the elderly, and support services, as defined in existing
law relating to supportive housing programs.
3)Requires that individuals be eligible for the benefit
established by this bill if they are Medi-Cal eligible, and a
resident of SF, who would otherwise be homeless, living in
shelters or institutionalized, and who meet one or both of the
following criteria:
a) DHS determines that he or she would benefit from
supportive housing as defined in the California Statewide
Supportive Housing Initiative Act (SHIA); and,
b) DHS determines that he or she is eligible for placement
in a skilled nursing or intermediate care facility.
4)Requires DHS to seek to maximize resources for community-based
housing by coordinating the community-living support benefits
with existing efforts to coordinate care, improve health
outcomes, and reduce long-term care costs for the targeted
population.
5)Requires, as a condition of implementation of the project
established in this bill, the Board of Supervisors of the City
and County of SF to adopt a resolution providing county funds
for use by the state to match federal Medicaid funds for the
project and for any costs associated with implementing and
monitoring the waiver.
6)Includes legislative findings stating that due to the unique
circumstances facing Medi-Cal recipients in the City and
County of SF, who are residing in community-based housing,
special legislation, rather than a general statute, is
necessary.
EXISTING LAW :
1)Provides for the Medi-Cal program, administered by DHS, and
under which qualified low-income persons receive health care
benefits, subject to applicable state and federal laws.
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2)Establishes the Residential Care Facilities for the Elderly
Act (RCFEs) under which facilities licensed by Department of
Social Services (DSS) provide varying levels of protective
supervision, personal care, or health-related services to
persons 60 years of age or older, but also to persons under 60
years of age with compatible needs.
3)Establishes SHIA, which defines supportive housing as housing
for low income adults with specified health and mental health
conditions, but also including families with children, elderly
persons, young adults aging out of the foster care system,
individuals exiting from institutional settings, veterans, or
homeless people. Supportive housing for these purposes has no
limit on length of stay, is occupied by the target population,
and is linked to onsite or offsite services that assist the
tenant to retain the housing, improve his or her health
status, maximize their ability to live and, when possible, to
work, in the community.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, no state fiscal effect as its provisions would only
apply upon a request by SF using its own funds to pay for waiver
implementation, monitoring and services.
COMMENTS : According to the author, this bill is needed 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 RCFEs, and continues to do so.
However, according to the sponsors, the Mayor of SF and SF
Department of Public Health, the need exceeds city resources.
This bill will provide access to a Medicaid funded "wraparound,"
allowing SF to offer many 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 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 their contribution and Medi-Cal funds to serve
residents in the community instead of at LHH.
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Analysis Prepared by : Deborah Kelch / HEALTH / (916) 319-2097
FN: 0014593