BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 2274
                                                                  Page  1


          ASSEMBLY THIRD READING
          AB 2274 (Beall)
          As Introduced  February 18, 2010
          Majority vote 

           HUMAN SERVICES      4-1         APPROPRIATIONS      10-5        
           
           ----------------------------------------------------------------- 
          |Ayes:|Beall, Ammiano, Hall,     |Ayes:|Fuentes, Ammiano, Coto,   |
          |     |Swanson                   |     |Davis, Bonnie Lowenthal,  |
          |     |                          |     |Hall, Skinner, Solorio,   |
          |     |                          |     |Torlakson, Hill           |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Tom Berryhill             |Nays:|Conway, Harkey, Miller,   |
          |     |                          |     |Nielsen, Norby            |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Allows an In-Home Supportive Services (IHSS) recipient  
          who receives services from an entity authorized by a federal  
          Section 1115 Medicaid waiver, subject to program requirements,  
          to select any qualified person to provide the services, and  
          defines "qualified person" to include an employee of such an  
          entity who is available and eligible to provide the services.

           EXISTING LAW  : 

          1)Establishes the IHSS program to provide personal services and  
            home care for eligible poor, aged, blind and disabled  
            individuals to enable recipients to remain in their own homes  
            and avoid institutionalization.

          2)Provides that IHSS recipients who receive services through a  
            contract or managed care provider may, subject to program  
            requirements, select any qualified provider who is an employee  
            of the contract or managed care provider.

           FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee, "[a]ny costs associated with this legislation should  
          be minor and absorbable within existing resources." 

           COMMENTS :  The IHSS Program helps pay for services so that the  
          elderly, disabled, or blind individuals can remain in their own  
          homes and avoid institutionalization.  IHSS services include,  
          but are not limited to, housecleaning, meal preparation,  








                                                                  AB 2274
                                                                  Page  2


          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 people with mental impairments.

          IHSS recipients have the right to choose their personal workers.  
           Most IHSS recipients receive care services from an individual  
          provider.  Some recipients, however, receive services through  
          contract or managed care providers.  Current law provides that,  
          in those instances, the recipieint nonetheless may, subject to  
          program requirements, select any qualified person to provide  
          IHSS services.

          California is currently in the process of renewing its "Section  
          1115" Medicaid waiver, which is due to expire on July 31, 2010.   
          As part of the 2009-10 Budget, ABx4 6 was enacted to slow the  
          long-term Medi-Cal expenditure growth rate through significant  
          restructuring of the Medi-Cal program.  This legislation commits  
          the Department of Health Care Services to pursuing a Section  
          1115 waiver that will restructure the organization and delivery  
          of health care for populations that include the most medically  
          vulnerable, high cost Medi-Cal beneficiaries with complex  
          chronic conditions, co-morbidities, and the highest needs for  
          on-going health care.
            
          The specifics of California's new Section 1115 waiver have yet  
          to be determined.  It is likely, however, that IHSS will be  
          included as a component of any coordinated systems of care under  
          the new waiver.  This bill simply ensures that the right of  
          recipients to choose their provider will not be interrupted or  
          interfered with through any new program model that may be  
          authorized under California's new Section 1115 waiver.
           

          Analysis Prepared by  :    Eric Gelber / HUM. S. / (916) 319-2089 

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