BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 1703
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          ASSEMBLY THIRD READING
          AB 1703 (Hall)
          As Amended  May 23, 2014
          Majority vote 

           HUMAN SERVICES      6-0         APPROPRIATIONS      14-0        
           
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          |Ayes:|Stone, Maienschein,       |Ayes:|Gatto, Bigelow,           |
          |     |Ammiano,                  |     |Bocanegra, Bradford, Ian  |
          |     |Ian Calderon, Garcia,     |     |Calderon, Campos, Eggman, |
          |     |Hall                      |     |Gomez, Holden, Linder,    |
          |     |                          |     |Pan, Quirk,               |
          |     |                          |     |Ridley-Thomas, Weber      |
          |-----+--------------------------+-----+--------------------------|
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Adds to the list of authorized In-Home Supportive  
          Services (IHSS) assistance in reading and completing financial  
          and other documents for a blind or visually impaired IHSS  
          recipient. 

           FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee:

          1)$900,000 in additional wages to IHSS providers.  (Based on 50%  
            of the approximately 10,000 visually impaired or blind  
            individuals receiving IHSS services being authorized for this  
            service and receiving about 1.5 hours per month in reading  
            assistance.)

          2)Unknown costs to provide reading services to IHSS recipients  
            who have "another disability that affects his or her ability  
            to read."

          3)Unknown, but likely minor, costs to counties for social  
            workers to add eligibility determination for reading services  
            to the IHSS in-home assessment.

           COMMENTS  :    

          Background on IHSS:  The IHSS program is a Medi-Cal benefit,  
          providing personal care services to over 460,000 qualified  
          low-income individuals who are aged, blind, or disabled.  The  








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          purpose of the IHSS program is to provide eligible individuals  
          with an array of personal care and domestic aide services to  
          allow them to remain in their homes, as opposed to receiving  
          care in an institutional facility, such as an adult care home or  
          nursing home.  According to the Department of Social Services  
          (DSS), there are approximately 464,402 IHSS recipients, 10,153,  
          or two percent of whom are visually impaired or blind.

          The IHSS program is administered by CWAs, in coordination with  
          DSS, whose social workers determine IHSS eligibility and perform  
          case management after conducting a standardized in-home  
          assessment of an individual's ability to perform activities of  
          daily living.  Based upon the assessment, IHSS providers are  
          authorized to provide an array of daily supportive services,  
          including "paramedical services," which medical services that  
          are to be rendered under the direction of a licensed health care  
          professional. Based on authorized hours and services, IHSS  
          recipients are responsible for hiring, firing, and directing  
          their IHSS provider(s).  About 70% of IHSS recipients receive  
          their care from a family member or relative provider.  In order  
          to become an IHSS provider, an individual must undergo a  
          criminal background check, attend a provider orientation, and  
          meet other requirements.

          Limited availability and access to written information for the  
          blind and visually impaired:  Considered a low incidence  
          disability under federal and state law, persons who are blind or  
          visually impaired face a number of challenges in obtaining,  
          navigating and acquiring information.  Due to their visual  
          impairment, many require either access to audio reading  
          technology or braille services in order to conduct daily tasks,  
          such as shopping, reading and understanding instructions,  
          overseeing their own personal finances, and otherwise living  
          self-sufficiently.  Unfortunately, the types of services and  
          methods available to the visually impaired to help them access  
          and understand written information are limited, especially for  
          those who do not have the resources to afford them.

          Adding to these challenges is the significant decline in the use  
          of braille and the costs associated with accessing written  
          information in braille.  According to the National Braille  
          Press, only 12% of legally blind individuals can read braille,  
          in contrast to 50% of blind individuals who could do so in the  
          1960s.  The costs can be substantial.  For example, academic  








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          textbooks in braille can cost over $1,000 and can be significant  
          in size.  Although more affordable than braille, electronic  
          means of acquiring information is also costly for the blind or  
          visually impaired.  Many look to digital audio files, reading  
          software such as text-to-speech programs, and audio files,  
          however, availability of this technology is limited, as well.   
          For visually impaired individuals, lacking the means and  
          resources to acquire evolving technology that can help them read  
          written information can result in limited access to information  
          considered necessary to conduct day-to-day tasks.  This  
          especially rings true for IHSS recipients who are blind or  
          visually impaired due to their lack of income and the  
          limitations on their IHSS providers to provide them reading  
          assistance. 

          Previous legislation:  This bill is a reintroduction of AB 238  
          (Beall) of 2007, which was passed by the Legislature but vetoed  
          by then Governor Schwarzenegger.  Stating his reasoning for his  
          veto, the Governor wrote:

               I strongly support the In-Home Supportive Services  
               (IHSS) program which provides services to low-income  
               aged, blind or disabled persons so they can remain  
               safely in homes.  My Administration has worked hard to  
               secure more than 1.7 billion in federal funds to  
               protect these important services.  However, I cannot  
               support expanding the program's scope to include  
               reading services.  This expansion would add more than  
               one million dollars in new costs at a time of ongoing  
               budget challenges.  We must balance our need for  
               important program services with our fiscal reality.

           
          Analysis Prepared by  :    Chris Reefe / HUM. S. / (916) 319-2089 


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