BILL ANALYSIS
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THIRD READING
Bill No: AB 369
Author: Yamada (D), et al
Amended: 8/24/09 in Senate
Vote: 21
SENATE HEALTH COMMITTEE : 11-0, 7/08/09
AYES: Alquist, Strickland, Aanestad, Cedillo, Cox,
DeSaulnier, Leno, Maldonado, Negrete McLeod, Pavley, Wolk
SENATE APPROPRIATIONS COMMITTEE : 12-0, 8/27/09
AYES: Kehoe, Cox, Corbett, Denham, Hancock, Leno, Oropeza,
Price, Runner, Walters, Wyland, Yee
NO VOTE RECORDED: Wolk
ASSEMBLY FLOOR : 78-0, 6/3/09 - See last page for vote
SUBJECT : Adult day health care centers
SOURCE : California Association for Adult Day Services
DIGEST : This bill exempts two veterans facilities (one
in Ventura and one in Lancaster) from the moratorium
prohibiting the enrollment of adult day health care centers
into the Medi-Cal program.
ANALYSIS :
Existing law:
1. Establishes Adult Day Health Care (ADHC) services as a
CONTINUED
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Medi-Cal benefit for Medi-Cal beneficiaries who
generally meet certain criteria, including being 18
years of age or older, having a request for ADHC
services from a health care provider, having one or more
chronic or postacute medical, cognitive, or mental
health conditions, and having functional impairments in
two or more activities of daily living, instrumental
activities of daily living, or one or more of each, and
requires assistance or supervision in performing these
activities.
2. Authorizes Department of Health Care Services (DHCS) to
implement a one-year moratorium on the certification and
enrollment into the Medi-Cal program of new ADHC centers
on a statewide basis or within a geographic area,
subject to certain limitations.
3. Permits the director of DHCS to extend this moratorium,
if necessary, to coincide with the implementation date
of the ADHC centers waiver.
4. Exempts certain applicants from this moratorium.
This bill exempts from the ADHC moratorium two veterans'
facilities (one in Ventura and one in Lancaster) run by the
California Department of Veterans Affairs (CDVA).
Background
ADHC is an organized day program of therapeutic, social and
health activities and services provided to elderly persons
or other persons with physical or mental impairments for
the purpose of restoring or maintaining optimal capacity
for self-care. Under federal law, ADHC services are an
"optional benefit" for states to provide. The Adult Day
Health Medi-Cal Law establishes adult day health care
services as a Medi-Cal benefit for Medi-Cal beneficiaries
who meet certain criteria. Specifically, ADHC services are
provided to Medi-Cal beneficiaries who have medical or
psychiatric impairments who have a written request for ADHC
services from a physician, a multi-disciplinary team
assessment, a signed participation agreement, and approval
from DHCS. ADHC centers must provide rehabilitation
services (physical, occupational and speech therapy
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services), medical services supervised by the participant's
personal physician or staff physician, nursing service,
psychiatric and psychological services, medical social
services, planned recreational and social activities, and
non-medical transportation (if necessary) to and from
participants' homes. There are over 300 ADHC centers that
are Medi-Cal providers throughout California. Expenditures
in 2008-09 for ADHC services were $409 million ($204.7
million General Fund [GF]). The average number of monthly
users of ADHC services in 2008-09 was 36,586.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
According to the Senate Appropriations Committee analysis:
Fiscal Impact (in thousands)
Major Provisions 2009-10 2010-11
2011-12 Fund
CDVA budget offset $0 $135 $120General
(savings)
Medi-Cal benefits $0 $105 $120 General/
(costs) $0 $135 $120 Federal
SUPPORT : (Verified 8/27/09)
California Association for Adult Day Services (source)
Aging Services of California
California Alliance for Retired Americans
California Commission on Aging
Congress of California Seniors
Yolo Adult Day Health Center
OPPOSITION : (Verified 8/27/09)
Department of Finance
ARGUMENTS IN SUPPORT : The California Association for
Adult Day Services (CAADS) argues that ADHC is a
cornerstone in the long-term care continuum and will play a
vital role within the campuses operated by CDVA. CAADS
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argues that the ability of these two veteran-focused ADHC
centers to pursue their Medi-Cal certification is critical
to their planned operations. CAADS argues this bill will
conserve limited operating funds by bringing in federal
dollars for veterans eligible for Medi-Cal. CAADS points
out that if CDVA provides services without Medi-Cal
certification, all expenses for Medi-Cal-eligible veterans
will come from CDVA's operating funds, leaving federal
dollars on the table. CAADS concludes that in the current
budget environment, it makes sense to maximize all sources
of non-state GF.
ASSEMBLY FLOOR :
AYES: Adams, Ammiano, Anderson, Arambula, Beall, Bill
Berryhill, Tom Berryhill, Blakeslee, Blumenfield,
Brownley, Buchanan, Caballero, Charles Calderon, Carter,
Chesbro, Conway, Cook, Coto, Davis, De La Torre, De Leon,
DeVore, Duvall, Emmerson, Eng, Evans, Feuer, Fletcher,
Fong, Fuentes, Fuller, Furutani, Gaines, Galgiani,
Garrick, Gilmore, Hagman, Hall, Harkey, Hayashi,
Hernandez, Hill, Huber, Huffman, Jeffries, Jones, Knight,
Krekorian, Lieu, Logue, Bonnie Lowenthal, Ma, Mendoza,
Miller, Monning, Nava, Nestande, Niello, Nielsen, John A.
Perez, V. Manuel Perez, Portantino, Price, Ruskin, Salas,
Saldana, Silva, Skinner, Smyth, Solorio, Audra
Strickland, Swanson, Torlakson, Torres, Torrico, Tran,
Villines, Bass
NO VOTE RECORDED: Block, Yamada
CTW:ABdo 8/28/09 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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