BILL ANALYSIS                                                                                                                                                                                                    �




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair


          SB 1503 (Steinberg) - In Home Supportive Services
          
          Amended: April 9, 2012          Policy Vote: Health 6-3
          Urgency: No                     Mandate: No
          Hearing Date: May 7, 2012       Consultant: Brendan McCarthy
          
          This bill does not meet the criteria for referral to the 
          Suspense File.
          
          
          Bill Summary: SB 1503 would require the Department of Health 
          Care Services and the Department of Social Services to convene a 
          stakeholder group to plan for the integration of long-term 
          services and supports.

          Fiscal Impact: Absorbable costs to convene the stakeholder group 
          and develop plans. The two departments have already initiated an 
          extensive stakeholder group to consider issues relating to the 
          integration of long-term services and supports pursuant to the 
          dual-eligible demonstration project (see below). The 
          requirements of this bill should be absorbable within those 
          efforts.

          Background: The current system for providing support and 
          services to low-income, disabled, and senior Californians is 
          divided amongst many different programs. The State Medi-Cal 
          program covers hospital services, physician services, 
          prescription drugs, and skilled nursing services. The federal 
          Medicare program covers hospital, physician, and prescription 
          drug services, but not skilled nursing services. The In Home 
          Supportive Services Program provides services designed to keep 
          participants in their own homes and out of skilled nursing 
          facilities. There are a large number of individuals that are 
          "dual-eligible" for Medi-Cal and Medicare and many of these 
          people are also eligible for In Home Supportive Services.

          Proposed Law: SB 1503 would require the Department of Health 
          Care Services and the Department of Social Services to convene a 
          stakeholder group to plan for the integration of long-term 
          services and supports. Among other things, the bill requires the 
          plan to build incentives into care delivery models so that 
          in-home and community services are the first option, coordinate 








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          care between programs, maintain a consumer's right to hire and 
          fire home care providers, and require county social workers to 
          continue to assess consumer needs for in-home care.

          Related Legislation: SB 208 (Steinberg) Chapter 714 of 2010 
          authorizes a four county demonstration project to integrate 
          services provided by Medicare and Medi-Cal for dual-eligibles. 

          Staff Comments: The Governor's budget proposal includes 
          proposals to expand the four county, dual-eligible demonstration 
          project statewide over the next three years, require long-term 
          supports and services to be provided through managed care, and 
          mandatorily enroll Medi-Cal beneficiaries in managed care 
          statewide.