BILL ANALYSIS �
AB 1552
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ASSEMBLY THIRD READING
AB 1552 (Lowenthal)
As Amended May 23, 2014
2/3 vote. Urgency
HEALTH 18-0 AGING 6-0
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|Ayes:|Pan, Maienschein, |Ayes:|Wagner, Lowenthal, Daly, |
| |Ammiano, Holden, Bonilla, | |Gray, Grove, Levine |
| |Bonta, Ch�vez, Chesbro, | | |
| |Gomez, Gonzalez, | | |
| |Roger Hern�ndez, Mansoor, | | |
| |Nazarian, Nestande, | | |
| |Patterson, Ridley-Thomas, | | |
| |Wagner, Wieckowski | | |
| | | | |
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APPROPRIATIONS 16-0
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|Ayes:|Gatto, Bigelow, | | |
| |Bocanegra, Bradford, Ian | | |
| |Calderon, Campos, Eggman, | | |
| |Gomez, Holden, Jones, | | |
| |Linder, Pan, Quirk, | | |
| |Ridley-Thomas, Wagner, | | |
| |Weber | | |
|-----+--------------------------+-----+--------------------------|
| | | | |
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SUMMARY : Establishes the Community-Based Adult Services (CBAS)
program as a Medi-Cal benefit to be provided at licensed adult
day health care (ADHC) centers. Specifically, this bill :
1)Requires CBAS to be included as a covered service in contracts
with all Medi-Cal managed care (MCMC) plans, with standards,
eligibility criteria, and provisions that are at least equal
to those contained in the current Bridge to Reform Waiver.
2)Requires CBAS providers to be enrolled as providers in
California's Bridge to Reform Demonstration and meet the
licensing and other standards required of ADHC providers.
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3)Requires CBAS to be licensed as ADHC centers and certified by
the California Department of Aging (CDA) as CBAS providers
pursuant to a participant's individualized plan of care, as
developed by the center's multidisciplinary team.
4)Requires CBAS to be available as a MCMC benefit in counties
where the California Department of Health Care Services (DHCS)
has implemented MCMC and to be provided as a fee-for-service
Medi-Cal benefit in counties that have not implemented MCMC,
and for individuals who are exempt from or ineligible for
managed care enrollment.
5)Contains an urgency clause to ensure that the provisions of
this bill go into immediate effect upon enactment.
FISCAL EFFECT : According to the Assembly Appropriations
Committee:
1)Assuming federal approval is granted, annual costs to DHCS for
continuation of CBAS as a Medi-Cal benefit of approximately
$300 million total annually, and growing in future years (50%
General Fund/50% federal). Since the special terms and
conditions of a related federal waiver specifies CBAS must be
operational through August 31, 2014, 2014-15 costs for 10
additional months of service are expected to be approximately
$250 million (50% General Fund/50% federal).
2)Minor administrative costs (50% General Fund/50% federal) to
DHCS to secure federal approval.
3)Currently incurred costs to the Department of Public Health
(DPH) associated with the licensure of ADHCs, and CDA
associated with certifying facilities, would continue to be
incurred. If not for the continuation of CBAS through this
bill or another mechanism, there would likely be a reduction
in the number of ADHC providers, reducing licensure workload
for DPH and certification workload for CDA.
COMMENTS : According to the author, this bill ensures that
thousands of frail Californians who rely upon adult day health
programs today and those who will need this service in the
future will be able to remain independent and free of
institutionalization for as long as possible. The author states
that without this bill, CBAS will not be offered in Medi-Cal
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beyond August 31, 2014, meaning that many frail elderly and
disabled adults will be without these community-based services.
DHCS, DPH, and CDA jointly administer CBAS, which offers
services to eligible older adults and/or adults with
disabilities to restore or maintain their capacity for self-care
and delay or prevent inappropriate institutionalization. CBAS
services include: an individual assessment; professional
nursing services; physical, occupational, and speech therapies;
mental health services; therapeutic activities; social services;
personal care; meals; nutritional counseling; and transportation
to and from the participant's residence and the CBAS center.
CBAS replaced ADHC as a Medi-Cal benefit. ADHC is a licensed
community-based day care program providing participants with
registered nursing care, physical, occupational and speech
language pathology therapies, therapeutic activities and social
services. Medi-Cal ADHC was eliminated in 2011 because of the
state budget crisis. A subsequent lawsuit, Esther Darling, et
al. v. Toby Douglas, et al., (No.C-09-03798) contested the
elimination. In November of 2011, the state reached a
settlement agreement with the plaintiffs that created CBAS as a
Medi-Cal benefit.
CBAS providers support this bill explaining that CBAS services
help frail people live in their own homes by managing their care
and providing services and without this program many CBAS
participants' needs would be unmet. AARP argues CBAS helps
Californians with disabilities or chronic illnesses to continue
to live in their own homes with dignity and independence, and
that the program also helps family caregivers balance their
other responsibilities with the care they provide for loved.
The Congress of California Seniors states without this bill, the
lives of many frail elderly people will be disrupted as they are
forced into nursing homes and the State of California will incur
much greater expense for their institutionalized care.
There is no known opposition.
Analysis Prepared by : Roger Dunstan / HEALTH / (916) 319-2097
FN: 0003757
AB 1552
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