BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 2968
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          ASSEMBLY THIRD READING
          AB 2968 (Leno)
          As Amended May 23, 2006
          Majority vote 

           HEALTH              12-0        APPROPRIATIONS      14-2        
           
           ----------------------------------------------------------------- 
          |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           |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           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  

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