BILL ANALYSIS                                                                                                                                                                                                    �



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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  

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