BILL ANALYSIS                                                                                                                                                                                                    






                                 SENATE HEALTH
                               COMMITTEE ANALYSIS
                        Senator Elaine K. Alquist, Chair


          BILL NO:       SB 998                                       
          S
          AUTHOR:        Liu and Alquist                              
          B
          AMENDED:       April 5, 2010                               
          HEARING DATE:  April 14, 2010                               
          9
          CONSULTANT:                                                 
          9
          Bain                                                        
          8              
                                     SUBJECT
                                         
                   Long-term care:  assessment and planning. 

                                     SUMMARY  

          Requires the Department of Health Care Services (DHCS), in  
          consultation with a stakeholder group, to develop or  
          identify a long-term care assessment tool for use in case  
          management.  Additionally, requires each county to  
          establish a long-term care case management program for  
          persons who are Medi-Cal recipients or applicants or  
          individuals eligible for both Medicare and Medi-Cal and who  
          are residing in a long-term health care facility, who apply  
          for admission to a long-term health care facility or are at  
          imminent risk of being placed in a long-term health care  
          facility.

                             CHANGES TO EXISTING LAW  

          Existing federal law:
          Authorizes the federal Secretary of the Department of  
          Health and Human Services to award, on a competitive basis,  
          grants to states for demonstration projects under the Money  
          Follows the Person demonstration program (MFP demonstration  
          program).  The MFP demonstration program is designed to  
          achieve the following objectives with respect to  
          institutional and home and community-based long-term care  
          services under state Medicaid programs to:

                                                         Continued---



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           Increase the use of home- and community-based (HCB),  
            rather than institutional, long-term care services,  
            referred to as "rebalancing."

           Eliminate barriers or mechanisms (whether in state law,  
            the state Medicaid plan, the state budget, or otherwise),  
            that prevent or restrict the flexible use of Medicaid  
            funds to enable Medicaid-eligible individuals to receive  
            support for appropriate and necessary long-term services  
            in the settings of their choice, referred to as "money  
            follows the person."


           Increase the ability of the state Medicaid program to  
            assure continued provision of home- and community-based  
            long-term care services to eligible individuals who  
            choose to transition from an institutional to a community  
            setting, referred to as "continuity of service."


           Ensure that procedures are in place (at least comparable  
            to those required under the qualified HCB program) to  
            provide quality assurance for eligible individuals  
            receiving Medicaid home- and community-based long-term  
            care services and to provide for continuous quality  
            improvement in such services, referred to as "quality  
            assurance and quality improvement."


          Individuals eligible under an MFP demonstration project are  
          Medi-Cal beneficiaries who reside (and who have resided,  
          for a period of not less than 90 consecutive days) in an  
          inpatient facility and for who, but for the provision of  
          home- and community-based long-term care services, the  
          individual would continue to require the level of care  
          provided in an inpatient facility.


          Existing state law:
          Requires each hospital to have a written discharge planning  
          policy and process.  This policy must require that  
          appropriate arrangements for post-hospital care (including,  
          but not limited to, care at home, in a skilled nursing or  
          intermediate care facility, or from a hospice), are made  
          prior to discharge for those patients who are likely to  
          suffer adverse health consequences upon discharge if there  




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          is no adequate discharge planning.  

          Requires a hospital to provide every patient anticipated to  
          be in need of long-term care at the time of discharge with  
          contact information for at least one public or nonprofit  
          agency or organization dedicated to providing information  
          or referral services relating to community-based long-term  
          care options in the patient's county of residence and  
          appropriate to the needs and characteristics of the  
          patient.  At a minimum, this information must include  
          contact information for the area agency on aging (AAA)  
          serving the patient's county of residence, local  
          independent living centers, or other information  
          appropriate to the needs and characteristics of the  
          patient. 

          Establishes the Medi-Cal program, administered by the  
          Department of Health Care Services (DHCS), under which  
          health care services are provided to qualified low-income  
          persons.  Existing law establishes a schedule of benefits  
          under the Medi-Cal Program, which includes many types of  
          services, including skilled nursing facilities services,  
          adult day health care, and home- and community-based  
          services approved by the federal government, to the extent  
          that federal financial participation is available for those  
          services under federal waivers.

          Authorizes DHCS to use utilization controls in Medi-Cal but  
          limits the utilization controls to specified activities.   
          One of the authorized utilization controls is prior  
          authorization (typically through a treatment authorization  
          request or "TAR").  Prior authorization is approval by DHCS  
          of a specified service in advance of the rendering of that  
          service based upon a determination of medical necessity. 

          Requires DHCS to establish a targeted case management  
          program, and authorizes DHCS to conduct a program of  
          aggressive case management of elective, non-emergency acute  
          care hospital admissions for the purpose of reducing both  
          the numbers and duration of acute care hospital stays by  
          Medi-Cal beneficiaries where it is expected to be  
          cost-effective.  The latter program is known as the Medical  
          Case Management Program.

          This bill:
          This bill makes various legislative findings and  




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          declarations regarding California's older adult population,  
          including that the services for older adults exist in an  
          uncoordinated patchwork of programs, the need for a state  
          strategic plan on long-term care services, that other  
          states have invested in a coordinated approach for  
          long-term care and home- and community-based services.   
          This bill would make several statements of legislative  
          intent, including intent to establish an integrated system  
          of long-term care that will enable older adults and adults  
          with long-term care needs to remain at home whenever  
          possible and live in the least restrictive environment with  
          autonomy, dignity and choice whenever possible.
           
          Long-Term Care Assessment Tool
          This bill would require DHCS to initiate a process, in  
          collaboration with specified stakeholders, to develop or  
          identify no later than July 1, 2012, a tool for the  
          uniform, long-term care services assessment of individuals  
          in order to assist eligible consumers in finding long-term  
          care services of their choice.

          The uniform long-term care services assessment tool is  
          required to assist eligible consumers in making informed  
          choices about home and community options for individuals  
          who are hospitalized and likely to need long-term care,  
          individuals who reside in an institution, or individuals in  
          the community who are likely to need long-term care.

          DHCS would be authorized to develop or identify the  
          uniform, long-term care services assessment without meeting  
          the rule-making requirements of the Administrative  
          Procedure Act, so long as at least one 30-day public  
          comment period is used.

          DHCS would be required, in collaboration with the  
          stakeholders, to establish training standards for case  
          management and for the use of the uniform long-term care  
          services assessment tool as part of the long-term care case  
          management program established by this bill.

          In developing the uniform long-term care services  
          assessment tool, DHCS and the stakeholders in the  
          development process must consider several factors for  
          inclusion in the assessment tool, including the long-term  
          care programs for which the individual is or may become  
          eligible.  Examples of factors to be considered include the  




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          individual's strengths, limitations, and preferences,  
          preferred living situation/environment, physical health,  
          functional and cognitive abilities, available informal  
          supports and other paid/unpaid resources, need for case  
          management and referrals to programs and services, barriers  
          that prevent the individual from living at home, in the  
          community, or in a less restrictive environment, and the  
          individual's plan of care needs, which can include an  
          enumerated list of conditions, needs, risks, goals and  
          behaviors.

          DHCS and the stakeholders would be required to evaluate  
          whether existing federal, state, or county assessment tools  
          or information systems and processes can be used,  
          integrated, or further developed, taking into account  
          specified factors if DHCS decides not to develop its own  
          uniform, long-term care services assessment.

          DHCS would be required, in collaboration with the  
          stakeholder groups, to develop recommended best practices  
          under which individuals who receive the uniform long-term  
          care services assessment and express a preference for  
          living at home or in another community-based setting, may  
          also receive all of the following:

           A comprehensive community services plan, to be developed  
            with the individual and, as appropriate, the individual's  
            representative.
           Information about the availability of services that could  
            meet the individual's needs, as set forth in the  
            community services plan, and an explanation of the cost  
            to the individual of the available in-home and community  
            services in relation to long-term health care facility  
            care.
           Information on retention of Supplemental Security  
            Income-State Supplementary Plan benefits, rental  
            assistance vouchers, home modification allowances, or  
            home maintenance allowances, and any other financial  
            supports that would assist the individual in maintaining  
            his or her home during a hospital or nursing facility  
            stay.
           An opportunity for discussion, evaluation, and ongoing  
            involvement with a case manager or counselor.

          Case Management
          This bill would require each county, with assistance from  




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          DHCS, to establish a long-term care case management program  
          for persons who are Medi-Cal recipients or applicants or  
          individuals eligible for both Medicare and Medi-Cal who are  
          residing in a long-term health care facility, or who apply  
          for admission to a long-term health care facility or are at  
          imminent risk of being placed in a long-term health care  
          facility.

          Requires counties, in establishing the long-term care case  
          management program, to identify one or more county  
          departments or nonprofit organizations, or a combination of  
          the two, to provide case management.  Counties can contract  
          with nonprofit organizations for this purpose, including  
          independent living centers, AAAs, providers of multipurpose  
          senior services, linkages, aging and disability resource  
          connections programs, and public authorities.

          Requires DHCS to provide guidance to counties to promote  
          the provision of case management services in ways that  
          maximize federal financial participation.  Additionally,  
          DHCS is authorized to contract directly with nonprofit  
          organizations, or a combination of departments and  
          nonprofit organizations, in lieu of a particular county or  
          counties, upon the request of a county or counties, to  
          satisfy the case management requirements.

          Requires counties to identify eligible individuals who need  
          support services in order to live at home or in the  
          community, and to arrange for the provision of those  
          services to the extent that the services are not provided  
          by any other program, and to the extent that the provision  
          of these services would allow them to live safely at home  
          or in the community. 

          Of these eligible individuals, the county would be required  
          to give first priority to individuals who have been, or are  
          expected to be, residents of a long-term health care  
          facility for more than 21 days, but who can reasonably be  
          expected to return home or to the community if case  
          management services are provided.  The next priority must  
          be given to individuals who are referred by a hospital who  
          may be diverted from care at a long-term health care  
          facility if case management services are provided, and for  
          individuals who request and are eligible for case  
          management services in order to avoid being placed in a  
          long-term health care facility, either from the community  




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          or home setting.

          Services that are required to be provided through the case  
          management program must include, but are not limited to, a  
          specified list of services.  These services include  
          identifying (until the uniform, long-term care services  
          assessment is either developed or identified) any barriers  
          to the individual's return to or remainder at home or in  
          the community, enrolling/assisting in home- and  
          community-based programs, developing and executing a care  
          plan, ensuring the coordination of health and social  
          services that meet the individual's needs, coordinating  
          home maintenance or renovations to accommodate an  
          individual's disability or infirmity, arranging for the  
          payment of a home upkeep allowance for the individual,  
          applying for rental assistance vouchers or other retention  
          of income, follow-up services to ensure that an  
          individual's ongoing or changing needs are being met, and  
          community-reentry training or independent living training  
          for the individual, if necessary.

          A copy of the assessment must be provided to the  
          individual, if requested.

          The county or its designee would be required to assign case  
          managers to each long-term health care facility located  
          within the county, and to notify each of these long-term  
          health care facilities of any changes in personnel.  Case  
          managers and those doing the assessment are prohibited from  
          being employees of a long-term health care facility or a  
          hospital, and are required to meet the training standards  
          established by the stakeholder group.

          Individuals designated as a case manager would be required  
          to have access to any long-term health care facility in  
          order to provide case management services.  Failure to  
          provide this access can result in the imposition of an  
          administrative penalty against the long-term health care  
          facility.

          This bill allows a hospital to make a referral to the  
          designated case manager when it has a patient who will be  
          referred to a long-term health care facility and the  
          hospital anticipates that the placement will be needed for  
          more than 21 days.  A hospital can also make a referral  
          when it has a patient it believes can return home upon  




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          discharge, if certain services or modifications can be made  
          that the case manager can arrange, if the patient would  
          require a referral to a long-term care facility if those  
          modifications or services are not made.

          Provisions Affecting Long-Term Care Facilities
          Requires a long-term health care facility to inform the  
          designated case manager assigned to that facility when a  
          new patient or resident who is admitted and has been, or is  
          expected to be, a resident for 21 days or who has expressed  
          a preference for living at home or in the community and may  
          need assistance in identifying and securing home- and  
          community-based services.  Eligible individuals are  
          individuals who meet the following:  Individuals who are  
          Medi-Cal applicants or recipients, applicants or  
          individuals eligible for both Medicare and Medi-Cal who are  
          residing in a long-term health care facility or who apply  
          for admission to a long-term health care facility or are at  
          imminent risk of being placed in a long-term health care  
          facility.

          Referrals may be made before a patient has been a resident  
          for 21 days if it is likely that without assistance from  
          the case manager, the patient will not be able to return  
          home in fewer than 21 days from admission.  Referrals must  
          be made on or before the 21st day of a patient's residence.

          This bill would require, commencing January 1, 2012, a  
          long-term health care facility, as defined, to display at  
          least one poster, in an area accessible to residents,  
          advertising the telephone number of the facility's  
          designated case manager.  The poster must be developed in  
          consultation with the designated case manager and DHCS. 

          This bill would prohibit a long-term health care facility  
          that admits a new patient, or an individual eligible for  
          case management under this bill, that has not made a  
          referral to case management, from receiving reimbursement  
          until the referral has been made.  This bill would prohibit  
          the facility from being reimbursed for those days during  
          which a referral should have been made, but was not made.   
          This requirement would take effect January 1, 2013.
          
          Hospital Discharge Information
          This bill would specify that the existing contact  
          information hospitals must provide to patients anticipated  




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          to be in need of long-term care at the time of discharge on  
          public or nonprofit agency or organizations providing  
          referral services relating to community-based long-term  
          care options must be provided both orally and in writing.   
          Additionally, this bill would require this information to  
          be provided to the patient, and, if applicable, the  
          patient's authorized representative, at the earliest  
          possible opportunity prior to discharge. 

          Budget expenditure baseline for long-term care services
          This bill would require the Department of Finance  
          (Finance), with the assistance of the California Health and  
          Human Services Agency and subject to review by the  
          Legislative Analyst's Office (LAO), to establish a baseline  
          of expenditures for long-term health care facility care  
          based on the average of state and county expenditures for  
          the services in the 2008-09, 2009-10, and 2010-11 fiscal  
          years.  This information is to be used to determine the  
          amounts that are saved each subsequent year from  
          implementation of this bill.  This bill would require  
          Finance, subject to review by the LAO, to provide an  
          estimate of the state savings realized from placing  
          individuals who would otherwise be placed in, or  
          transferred to, a long-term health care facility in a home  
          or to a less restrictive environment when the budget for  
          home- and community-based services is considered by the  
          appropriate budget committees of the Legislature.

          Report to the Legislature
          This bill requires DHCS, in consultation with the Office of  
          Statewide Health Planning and Development, to report to the  
          Legislature the total number of long-term care services  
          assessments performed in the state, along with all of the  
          following:

           The total number of assessments of individuals from the  
            community.
           The total number of assessments of individuals in nursing  
            facilities and hospitals.
           The total number of individuals assessed who were placed  
            in community care.
           The total number of individuals assessed who were  
            diverted from nursing home placement.
           The total number of individuals assessed who were not  
            able to be diverted, and why.





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          This reporting requirement sunsets January 1, 2015.

          Waiver and State Plan Amendments
          This bill would require DHCS to pursue any additional  
          necessary Medicaid waivers and state plan amendments to  
          ensure federal financial participation in funding increases  
          to home- and community-based services, including, but not  
          limited to, in-home supportive services and adult day  
          health care, home maintenance and home modification  
          allowances, as well as training and employment of  
          individuals who will conduct the uniform long-term care  
          assessments and case management or counseling of  
          individuals eligible or at-risk of needing long-term care.

          This bill would require DHCS, in collaboration with  
          stakeholders, to submit to the Legislature a financing plan  
          for providing long-term care services under this bill by  
          July 1, 2011.  

          Medi-Cal treatment authorization requests
          This bill would authorize the stakeholder group to review  
          the Medi-Cal treatment authorization requests (TAR) process  
          and recommend to DHCS ways to improve the role of the TAR  
          process in assisting those who wish to return home from a  
          long-term health care facility.  This bill requires DHCS,  
          in collaboration with the stakeholders, by December 1,  
          2011, to submit to the Legislature recommended changes, to  
          the TAR process to promote the more rapid movement of  
          residents of long-term health care facilities to the home  
          and community, the restructuring of long-term care  
          reimbursement to provide reimbursement for a coordinated  
          program of home and community-based services in lieu of  
          reimbursement for services provided in a skilled nursing  
          facility, when this program would allow an individual to  
          remain in or return to a community setting, and  
          reimbursement for hospital, skilled nursing, and  
          rehabilitation care, so that this care will be provided at  
          levels sufficient to ensure beneficiary access to optimal  
          medical and functional recovery and to provide patient and  
          caregiver education directed toward successful transition  
          to the community setting.

          Definition of long-term health care facility
          This bill would define for purposes of this bill, a  
          long-term health care facility to include the following: 





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           A skilled nursing facility;
           An intermediate care facility;
                 An intermediate care facility/developmentally disabled;
           An intermediate care facility/developmentally disabled  
            habilitative;
           An intermediate care facility/developmentally disabled  
            nursing; and,
           A congregate living health facility.




                                  FISCAL IMPACT  

          This bill has not been analyzed by a fiscal committee.   
          This bill prohibits the case management-related provisions,  
          the requirement that Finance establish a expenditure  
          baseline for long-term health care facility care, and the  
          DHCS report to the Legislature on long-term care services  
          assessments from being implemented unless the Director of  
          DHCS certifies that the collection of federal funds, other  
          revenue from restructuring of reimbursements, penalties,  
          and fines, or private funds, is sufficient to fund the  
          implementation of long-term care services assessments, case  
          management or counseling, and services under this bill.

                            BACKGROUND AND DISCUSSION  

          According to the author, persons in need of long-term care  
          in California often want to stay in their own home or  
          return to their home as soon as possible after surgery or  
          an incident such as a broken hip.  There are many services  
          available to help them, including discharge planning at  
          acute care hospitals and skilled nursing facilities,  
          in-home supportive services (IHSS), the multi-services  
          senior services program, adult day programs, and others.   
          However, for the most part, the aged or disabled  
          individuals must navigate these sets of services alone.   
          Each service may require its own assessment, have its own  
          offices, or depend on the individual to know about the  
          service and make it work.  

          According to the author, this bill has several purposes but  
          its primary goal is to reduce the length of stay in skilled  
          nursing facilities of aged and disabled persons through the  
          provision of case management and transition services,  




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          borrowing elements from long-term care services offered in  
          Oregon and Washington.  The author states there is some  
          evidence from other states that case management and  
          transition services reduce usage of skilled nursing  
          facilities, and home and community based services tend to  
          be significantly less expensive, which the author believes  
          will result in cost savings.  The author states a secondary  
          goal of this measure is to bring stakeholders together to  
          review assessments of persons in skilled nursing  
          facilities, or at risk of going to a skilled nursing  
          facility, to determine what home- and community-based  
          services those persons would need in order to avoid moving  
          to a skilled nursing facility or to reduce the time needed  
          for such a facility placement.  

          This bill is the result of a series of meetings, from  
          August 2009 through the winter of 2009, of various experts  
          and legislative staff, followed by joint hearings earlier  
          this year of the Senate Committee on Human Services and the  
          Senate Subcommittee on Aging and Long-Term Care and a  
          follow-up meeting in March of those who provided testimony  
          at the February hearing.

          Background
          California has more persons age 65 and older than other  
          states and the population of this age group is growing.  In  
          2007, California was home to 4 million persons age 65 and  
          older or representing 11 percent of the state's population.  
           In 2010, the number of Californians age 65 and older is  
          projected to increase to 4.4 million or 14.7 percent, and  
          is projected to increase to 8.3 million or 17.8 percent of  
          all Californians in 2030.  
          Approximately 2.4 million persons in California report  
          having two or more disabilities and an estimated 400,000  
          plus have intellectual or developmental disabilities.

          Long-term care services generally address an individual's  
          health, social, and personal needs, and are provided in  
          institutional care settings (for example, skilled nursing  
          facilities) and through community-based providers ranging  
          from nonmedical residential care facilities to services  
          such as transportation and meals to help individuals remain  
          in their homes instead of being placed in an facility.   
          Long-term care services are provided not only to the  
          elderly (age 65 and older), but also to younger persons  
          with developmental, mental, and/or physical disabilities.   




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          Many of the persons eligible for long-term care services  
          use multiple services provided by a variety of programs  
          operated by many state departments.  Within California, the  
          Departments of Aging (CDA), Health Care Services, Social  
          Services, Developmental Services, Mental Health,  
          Rehabilitation, and Veterans Affairs directly administer  
          long-term care programs.

          A recent report found California's current long-term care  
          delivery system is organized by program rather than by  
          person.  California's services for older adults and  
          individuals with disabilities are covered through programs  
          managed by multiple state agencies and organizations.  Tens  
          of thousands of persons receive services from multiple  
          programs, while others shift between programs in complex  
          passages resulting in costs and consumer outcomes that are  
          rarely studied since no one department is responsible for  
          the entirety of a person's care and services. 

          Report on Home- and Community-Based Long-Term Care
          In November 2009, a report entitled, "Home and  
          Community-Based Long-Term Care: Recommendations to Improve  
          Access for Californians" was released.  That study was  
          commissioned under the California Community Choices Project  
          to improve the understanding of the financial and  
          structural barriers to increasing consumer access to home-  
          and community-based services and to provide recommendations  
          for improving the structure and management of funding for  
          long-term care services and supports in California.  The  
          authors of the report (Mollica and Hendrickson) made  
          recommendations for improving the financing and delivery of  
          long-term care services in California based on interviews  
          with state officials, state staff and stakeholders, data  
          obtained from the state and other sources, as well as  
          reviews of statutes, regulations and previous related  
          reports.  

          The authors stated that California spends more than $10  
          billion annually on long-term care, and the majority of the  
          funds pay for services in the community.  The programs that  
          cover the services for adults with physical disabilities  
          and older adults appear to function independently with  
          separate delivery systems and management structures.   
          Consumers must contact different organizations for each  
          program, and only persons with developmental disabilities  
          are able to contact a single entity, receive information  




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          about their options, assess their service needs and access  
          the appropriate service.  

          The report recommends that California develop a strategic  
          plan that describes which populations, services and  
          programs will be addressed by the strategic plan, and  
          describes the mission, values and goals for its long-term  
          living services and supports programs. The report also  
          contains 28 specific recommendations requiring state  
          statutory change or administrative action.

          In testimony before the Senate Human Services Committee and  
          the Senate Subcommittee on Aging and Long-Term Care, one of  
          the report authors (Hendrickson) testified that nursing  
          home transition work is a significant and cost-effective  
          way for states to reduce their long-term living  
          expenditures. Transition is the practice of sending persons  
          into nursing homes, identifying residents who want to  
          leave, and then helping them secure alternative housing and  
          services outside of the nursing home.  Hendrickson noted  
          that, while there is a 25-year debate on whether or not  
          expanding Medicaid home and community-based services is  
          cost effective, there is agreement by most that helping  
          persons leave nursing homes is cost effective, especially  
          when the community costs are controlled.

          Arguments in support
          The California Association of Area Agencies on Aging (C4A),  
          representing the 33 AAAs throughout California, writes in  
          support that it believes that in order for California to  
          adequately meet the challenges of serving an aging  
          population, it is essential that we establish an integrated  
          system of long-term care that will enable older persons to  
          remain at home in the least restrictive environment, and  
          this bill is a major step in that direction.

          The California Retired Teachers Association writes in  
          support that there is currently no assurance that placement  
          in long-term care is always the best or most appropriate  
          placement, or that the care facility in which the  
          individual is being placed is the most appropriate care  
          facility for that individual.  CRTA argues the assessment  
          process and methodology required to be developed by this  
          bill would assist not only the individuals being placed in  
          long-term care, but also the institutions that are making  
          the placements.




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          Oppose unless amended
          Aging Services of California is opposed to this bill unless  
          it is amended to: (a) clarify who pays for the resident's  
          assessment prior to admission to a SNFl (b) exempt  
          continuing care retirement communities (CCRCs) from being  
          required to assess CCRC residents going into a SNF; and,  
          (c) delete the provisions of this bill allowing the  
          Administrative Procedures Act (APA) regulatory process to  
          be bypassed.  ASC argues that because CCRC residents will  
          go from a SNF to either independent or assisted living at  
          the CCRC, the purpose of the assessment is moot.  Finally,  
          Aging Services argues the APA gives the public the right to  
          be fully involved in a statute's implementation, and it  
          does not support legislation that waives these important  
          procedures rights.

          Support if amended
          The California Hospital Association (CHA) writes that it  
          supports the intent of the bill as currently written, but  
          CHA believes the current language requires additional  
          amendments which it recommends.  CHA's most significant  
          concern relates to the discussion of the development of a  
          tool for the assessment of individuals.  CHA argues the  
          goals of this legislation would be served more effectively  
          by requiring the development of a process for the  
          identification of individuals that may benefit from  
          community case management services and the assessment of  
          individual barriers to that individual's transition to a  
          community setting.  CHA argues it is concerned the current  
          language places too much emphasis on the clinical and  
          functional assessments of individuals, and not on community  
          resources and barriers to transition.  CHA indicates it is  
          committed to continuing to work together, and with  
          continued discussion and agreement on its amendments, it  
          looks forward to being able to support this bill in its  
          final form.

          The California Foundation for Independent Living Centers  
          (CFILC) writes that it supports the aims of this bill, it  
          appreciates the stakeholder process and the inclusion of  
          the stakeholder amendments in this measure.  CFILC writes  
          that it would support this bill if it were amended, arguing  
          that CFILC feels the provisions allowed designated service  
          providers who are performing transition services to have  
          direct access to facility residents should be strengthened,  




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          and the mechanism for connecting a resident who wishes to  
          leave a nursing home with a transition service provider  
          should be further specified.  

          Position pending
          The California Association of Health Facilities (CAHF)  
          writes that it appreciates being part of the dialogue on  
          this bill, but CAHF has yet to take a formal position on  
          the bill because, as a work-in-progress, it is not sure  
          where some key elements will end up. CAHF supports  
          strengthening case management, and believes creating a  
          uniform assessment tool is also a step in the right  
          direction but expresses concern about the language allowing  
          DHCS to develop a single assessment tool without going  
          through the regulatory process.  CAHF also argues the data  
          and report on expenditures required in the bill also  
          considers only savings when facility costs are compared to  
          community/home long term care services, and it is possible  
          that medical care of an individual in the community may be  
          more expensive than in a facility, and this should be taken  
          into consideration as part of the analysis.  Finally, CAHF  
          has continuing concerns about the actual implementation of  
          this bill and the desire of other advocacy groups to fund  
          community-based care with resources diverted from  
          institutional services.  CAHF argues the entire continuum  
          of long-term care - including nursing facility and home-  
          and community-based services - must be adequately funded.  

          Prior legislation
          AB 3019 (Daucher) of 2006, which was sponsored by the  
          then-Department of Health Services and supported by the  
          Department of Aging as part of the Governor's 2006-07  
          long-term care budget proposals, would have required the  
          California Health and Human Services Agency, in  
          consultation with technical advisers and stakeholders, to  
          develop the Community Options and Assessment Protocol  
          (COAP), to minimize duplication and redundancy of multiple  
          assessments for home- and community-based services and  
          connect consumers with appropriate program services under  
          the protocol.  AB 3019 defined COAP to mean an information  
          gathering tool and protocol that would facilitate  
          assessments and referrals across home- and community-based  
          services and programs and that would document basic  
          personal information, functional and supportive needs,  
          personal preferences for services, caregiver needs, and  
          that augments available medical assessment information.  




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          AB 3019 would also have appropriated $593,000 from the  
          General Fund and $594,000 in federal funds to Agency for  
          the purpose of implementing COAP, to fund a staff position  
          for two years, and a technical expert contractor to develop  
          deliverables related to the requirements of AB 3019.  AB  
          3019 was held on the Senate Appropriations Suspense file,  
          and the COAP has not subsequently been funded.
          



          SB 633 (Alquist), Chapter 472, Statutes of 2007 requires a  
            hospital to provide every patient
          anticipated to be in need of long-term care at the time of  
            discharge, with contact information 
          or at least one public or nonprofit agency or organization  
            dedicated to providing information 
          or referral services relating to community-based long-term  
            care options in the patient's  
          county of residence and appropriate to the needs and  
            characteristics of the patient. 
          At a minimum, this information must include contact  
            information for the AAA serving the 
          patient's county of residence, local independent living  
            centers, or other information 
          appropriate to the needs and characteristics of the patient.
          
                                     COMMENTS
                                         
           Clarifying drafting issues  .  
          The requirements of this measure that are placed on  
          hospitals and long-term care facilities should be moved  
          from their placement in the Welfare and Institutions Code  
          to the Health and Safety Code to ensure that these  
          provisions are enforced by the California Department of  
          Public Health, which licenses and regulates these  
          facilities.  

          The provisions of this bill referring to Medi-Cal TARS  
          should also reference Section 14133 as that section is the  
          main utilization control section.  

          The provisions of this measure prohibiting reimbursement to  
          a long-term care facility that has not made a referral to  
          the case manager are intended to be aimed at Medi-Cal  




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          reimbursement, but the bill as drafted, prohibits payment  
          from other payer sources.  An amendment is needed to limit  
          the nonpayment provision to Medi-Cal reimbursement and not  
          other payer sources.

          The provisions of this bill establishing the eligibility  
          for the long-term care management program will be clarified  
          to be individuals who are Medi-Cal recipients or  
          applicants, or are individuals eligible for both Medicare  
          and Medi-Cal, and who meet at least one of the following:

           Are residing in a long-term health care facility; 
           Are individuals who apply for admission to a long-term  
            health care facility; or, 
           Are individuals who are at imminent risk of being placed  
            in a long-term health care facility.
           
                                    POSITIONS  


          Support:  California Association of Area Agencies on Aging
                     California Retired Teachers Association
          
          Oppose:  Aging Services of California (unless amended)  


                                   -- END --