BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 2274
                                                                  Page  1

          Date of Hearing:   April 28, 2010

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Felipe Fuentes, Chair

                 AB 2274 (Beall) - As Introduced:  February 18, 2010 

          Policy Committee:                              Human  
          ServicesVote:4 - 1 

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              

           SUMMARY  

          This bill allows an In-Home Supportive Services (IHSS) recipient  
          who receives services from an entity authorized by the Medicaid  
          Independence Plus waiver (the 1115 waiver) to select any  
          qualified person to provide the services.

           FISCAL EFFECT  

          Any costs associated with this legislation should be minor and  
          absorbable within existing resources. 

           COMMENTS  

           1)Purpose  . California is currently in the process of renewing  
            its "Section 1115" Medicaid Independence Plus waiver, which is  
            due to expire on July 31, 2010.  These federal waivers  
            authorize demonstration programs to assist individuals in  
            avoiding institutionalization and maximizing the efficient use  
            of community services and supports.  IHSS recipients with  
            parent or spouse providers receive services under California's  
            current Section 1115 waiver.

            The specifics of California's new Section 1115 waiver have yet  
            to be determined.  The sponsor of this bill, Services  
            Employees International Union (SEIU), notes, however, that  
            "major changes to programs made within short time frames--the  
            1115 waiver amendments are on a course for summer 2010--can  
            result in accidental omissions that potentially harm people  
            who rely on the programs being changed."  Thus, the author  
            says, this bill simply ensures that the right of recipients to  
            choose their provider will not be interrupted or interfered  








                                                                  AB 2274
                                                                  Page  2

            with through any new program model that may be authorized  
            under California's new Section 1115 waiver.

           2)In-Home Supportive Services Program . The IHSS Program helps  
            pay for services so elderly, disabled, or blind individuals  
            can remain in their own homes. To be eligible, an applicant  
            must be over 65 years of age, disabled, or blind. Disabled  
            children are also eligible. IHSS is considered an alternative  
            to out-of-home care, such as nursing homes or board and care  
            facilities. 

            IHSS services are: housecleaning, meal preparation, laundry,  
            grocery shopping, personal care services (such as bowel and  
            bladder care, bathing, grooming and paramedical services),  
            accompaniment to medical appointments, and protective  
            supervision for the mentally impaired. IHSS consists of four  
            programs, including: Personal Care Services Program (PCSP),  
            IHSS Plus Waiver Program (IPW), IHSS Residual Program (IRP),  
            and Medi-Cal Waiver Personal Care Program (MWPCS). The PCSP,  
            IPW, and IRP are administered at the county level by county  
            welfare departments and at the state level by the Adult  
            Programs Division within CDSS. The Medi-Cal Waiver Personal  
            Care Services (MWPCS) Program is administered through  
            Department of Health Care Services. A portion of the costs for  
            IHSS services are paid by federal funding. The entire program  
            consists of over 400,000 recipients and about 325,000 IHSS  
            workers. 


           Analysis Prepared by  :    Julie Salley-Gray / APPR. / (916)  
          319-2081