BILL ANALYSIS                                                                                                                                                                                                    �





                                                                  AB 96

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          GOVERNOR'S VETO
          AB 96 (Budget Committee)
          As Amended  June 8, 2011
          2/3 vote.  Budget Bill Appropriation Takes Effect Immediately
           
           
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          |ASSEMBLY:  |     |(February 22,   |SENATE: |24-15|(June 10,      |
          |           |     |2011)           |        |     |2011)          |
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               (vote not relevant)

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          |ASSEMBLY:  |54-24|(June 15, 2011) |        |     |               |
          |           |     |                |        |     |               |
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          SUMMARY :  Contains necessary statutory changes to achieve savings 
          assumed in the 2011 Budget Act for the Department of Health Care 
          Services (DHCS).

           The Senate amendments  delete the Assembly version of this bill, and 
          instead:

          1)Create a new Adult Day Health Care (ADHC) program, to be operated 
            under a federal Medicaid Waiver, as follows:

             a)   Express legislative intent:  1) to create the Keeping Adults 
               Free from Institutions (KAFI) program, to provide community 
               services that prevent institutionalization; 2) that the KAFI 
               program allow recipients of ADHC to be given priority in 
               transitioning; and, 3) the KAFI program be established as 
               quickly as possible;

             b)   Require the DHCS to submit an application for a federal 
               waiver, to implement the KAFI program, by September 1, 2011;

             c)   Require the KAFI program to utilize licensed adult day 
               health centers to provide medical, behavioral health, and 
               social services to Medi-Cal beneficiaries who are at high risk 
               of institutionalization;










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             d)   Authorize the DHCS to implement the KAFI program by way of a 
               state plan amendment, federal waiver, or both; and,

             e)   Require federal approval, federal financial participation, 
               and an appropriation in the Annual Budget Act for 
               implementation of KAFI.

          1)Add an appropriation allowing this bill to take effect immediately 
            upon enactment.

           AS PASSED BY THE ASSEMBLY  , this bill expresses the intent of the 
            Legislature to enact
          statutory changes relating to the 2011 Budget Act.
           
          GOVERNOR'S VETO MESSAGE  :

               The bill would recreate, under a different name, the 
               same Adult Day Health Care (ADHC) program that was 
               eliminated as a Medi-Cal optional benefit through the 
               2011-12 Budget Act.  While my Administration deeply 
               shares the goal of "Keeping Adults Free from 
               Institutions," creating a new ADHC look-alike program 
               at this juncture is unnecessary and untimely.  It does 
               not address the immediate need to transition ADHC 
               beneficiaries to other home and community-based 
               services that can meet their needs, and would cause 
               confusion for both consumers and providers about when 
               an ill-defined "KAFI" program would be available. 

               In order to ensure that ADHC beneficiaries do not face 
               the risk of unnecessary institutionalization when the 
               benefit expires, my Administration is currently 
               working with adult day health centers, managed care 
               plans, and local community-based organizations to 
               ensure that needed medical services and home and 
               community-based services are available.  Additionally, 
               in order to ensure that there is enough time for 
               transition to such services, the Department of Health 
               Care Services recently extended the ADHC benefit 
               through administrative action until December 1, 2011, 










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               with federal funding approval.

               Given the importance of these transition efforts, I am 
               directing the Department of Health Care Services to 
               work with the Legislature, stakeholders, managed care 
               plans, and home and community-based services providers 
               to ensure that ADHC beneficiaries will have a smooth 
               transition to appropriate services, and those who are 
               most at risk of institutionalization have access to 
               services that will help them remain in the community.  


               Care in an integrated setting will be part of 
               Administration's plan to improve long-term care.  To 
               the extent that adult day health care-type services 
               can become part of an integrated continuum of care, my 
               Administration will work to bring such providers into 
               the conversation on how these services can efficiently 
               and effectively delivered for the benefit of 
               consumers.  

               For this reason, I am signing Senate Bill 91, which 
               will allow adult day health centers to continue to 
               operate after the fee-for-service payments under 
               Medi-Cal expire.  This will allow adult day health 
               centers to be considered a care option as part of an 
               integrated delivery system, or for consumers who wish 
               to access services apart from Medi-Cal.  


           Analysis Prepared by  :   Andrea Margolis / BUDGET / (916) 319-2099


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