BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1593
                                                                  Page  1

          Date of Hearing:   April 14, 2010

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Felipe Fuentes, Chair

                 AB 1593 (Yamada) - As Introduced:  January 4, 2010 

          Policy Committee:                              Health Vote:18-0

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              

           SUMMARY  

          This bill exempts two veterans' homes located in Lancaster and  
          Ventura from a current law moratorium on the licensing of new  
          Adult Day Health Care(ADHC) programs. 

           FISCAL EFFECT  

          Annual costs in the range of $450,000 (50% GF) to provide ADHC  
          services to 40 Medi-Cal eligible individuals eventually enrolled  
          in the two veterans homes addressed in this bill. Annual costs  
          per ADHC participant are $11,000. The two facilities addressed  
          in this bill are currently under construction.

           COMMENTS  

           1)Rationale  . This bill, sponsored by the California Association  
            for Adult Day Services (CAADS), modifies a moratorium placed  
            on ADHC expansion. The moratorium was established by SB 1103  
            (Committee on Budget), Chapter 228, Statutes of 2004. The  
            moratorium has been extended since it was established to hold  
            program costs steady and increase oversight over various  
            enrollment and payment issues. 

           2)Background  . ADHC are licensed community-based day care  
            programs providing a variety of health, therapeutic, and  
            social services to elderly and disabled adults at risk of  
            being placed in a nursing home. There are over 300 ADHC  
            centers statewide serving from 25 to 275 individuals at each  
            site. Approximately 37,000 clients are served statewide and  
            total caseload has declined by approximately 13% since the  
            moratorium has been place.
           
          3)Budget Proposals and Actions  . The governor's 2010-11 budget  
            contains a proposal to eliminate ADHC as a Medi-Cal benefit  






                                                                  AB 1593
                                                                  Page  2

            and other budget proposals to reduce costs if ADHC is not  
            eliminated. The 2009-10 Budget Act included $28 million (GF)  
            in savings associated with several changes: a) a three-day per  
            week cap on services (a court injunction has prevented this  
            change), b) standards on medical necessity (a court injunction  
            has prevented this change), c) on-site treatment authorization  
            requests, and d) a freeze on provider rates as of August 2009.

           4)Related Legislation  . AB 369 (Yamada) in 2009 was nearly  
            identical to this bill and was vetoed due to cost concerns and  
            because the facilities are still under construction. The veto  
            message also encouraged the author to pursue action through  
            the budget process. 
           Analysis Prepared by  :    Mary Ader / APPR. / (916) 319-2081