BILL ANALYSIS �
SB 1440
Page 1
Date of Hearing: June 17, 2014
ASSEMBLY COMMITTEE ON VETERANS AFFAIRS
Sharon Quirk-Silva, Chair
SB 1440 (Wolk) - As Amended: April 22, 2014
SENATE VOTE : 34-0
SUBJECT : Veterans' homes: fees and charges.
SUMMARY : Reduces the fees paid to the Veterans Home by
non-veteran spouses. Specifically, this bill : Mandates that
the fee structure for nonveteran spouses residing in state
Veterans Home shall be the same fees and charges as paid by the
veteran members of the Home and subject to the same
prohibitions.
EXISTING LAW :
1)Provides for the establishment and operation of the Veterans
Home of California, within the California Department of
Veterans Affairs (CalVet), at various sites for aged and
disabled veterans and their nonveteran spouses, who meet
certain eligibility requirements.
2)Requires members (residents) of the homes to pay fees and
charges, as determined by CalVet.
3)Prohibits the total of a member's fees and charges for
specified types of care in any fiscal year from exceeding a
specified percentage of the member's annual income.
4)Requires nonveteran spouses. who become members of the home on
or after July 1, 2009, to pay fees and charges based on
either:
a) The level of care, as specified; or
b) An amount equal to the annual amount of federal per diem
received for a veteran member in domiciliary care,
whichever is greater, as provided.
FISCAL EFFECT : Unknown at this time.
COMMENTS :
Funding for the annual operating expenses of the veterans homes
comes from the State's General Fund, and any additional revenues
that the Veterans Homes Division receives are subsequently
remitted to the General Fund. These additional sources of
SB 1440
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revenue primarily consist of reimbursements from five sources:
1)Medicare, a federally funded program which pays hospital
inpatient and outpatient care, and some skilled nursing care;
2)Medi-Cal, funded by the federal and state governments, which
pays skilled nursing facility daily rates and various
healthcare costs;
3)Member fees, which veterans' home residents pay in accordance
with their income and level of care;
4)So-called "aid and attendance," which are federal payments for
veterans who need personal care assistance; and
5)The U.S. Department of Veterans Affairs (VA), which pays a per
diem rate for each veteran in the homes.
Member fee amounts are determined by CalVet, and that
determination takes into account those times when the costs of a
resident's care (e.g. dental care, acute medical care, etc.)
exceed the basic fee.
Under existing law, the total of the individual member's fees
and charges for any fiscal year shall not be greater than:
1)Forty-seven and one-half percent of the member's annual income
for domiciliary care.
2)Fifty-five percent of the member's annual income for
residential care for the elderly or assisted living.
3)Sixty-five percent of the member's annual income for
intermediate care.
4)Seventy percent of the member's annual income for skilled
nursing care.
Most veteran members are eligible to have the federal VA make
per diem payments to the state that help reduce costs to state
taxpayers. The federal VA manages the "State Veterans Home
Program," a grant program that provides federal assistance to
states by (a) participating in a percentage of the cost of
construction of state veterans homes and (b) paying per diem for
ongoing provision of care to eligible veterans residing in
federally recognized state veterans homes. The per diem is the
approved daily rate established by the VA to reimburse state
homes for providing specified levels of care to eligible
veterans.
In the 2009-10 Budget Act, the Legislature instituted a major
General Fund policy adjustment that affected home resident fees.
SB 1440
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Specifically, it increased the amount of fees collected from
home residents from $17.2 million to $20 million - an increase
of $2.8 million.
Previously, residents paid fees based on a percentage of their
income, up to a dollar cap, with the percentage and cap
increasing as the level of care increases. The 2009 budget
proposal increased resident fees by:
1)Removing the dollar caps;
2)Increasing the percentage for the Residential Care for the
Elderly (RCFE); and
3)Revising the fee structure for nonveteran spouses to more
accurately reflect their share of costs because they are
ineligible for the federal per diem payments.
As a result of the 2009 Budget change, nonveteran spouses, who
become members of a veterans home on or after July 1, 2009, are
treated differently than veteran members. Nonveteran spouses now
pay fees and charges based either on (1) the level of care they
receive or (2) an amount equal to the annual federal per diem
received for a veteran member in domiciliary care, whichever is
greater. (The level-of-care payment is almost always equal or
higher than the per diem amount.) If the nonveteran member's
income is less than the annual amount of federal per diem for a
veteran member in domiciliary care, the nonveteran member shall
pay a maximum of 90% of his or her annual income.
1)SB 1440 would reverse the 2009 Budget Act language that
requires new nonveteran spouses to pay based on level of care
instead of the scaled income caps that protect the incomes of
veteran members. The 2009 legislation was part of the
Legislature's broad attempt to address the state's fiscal
crisis. Should SB 1440 pass this policy committee, it is
likely to undergo the same fiscal scrutiny that the identical
AB 488 (Cook, 2011) did in Assembly Appropriations.
2)Related Legislation:
AB 488 (Cook, held Assembly Approps, 2011) mandates that
nonveteran spouses living in the home shall pay the same fees
and charges as the veteran spouse.
REGISTERED SUPPORT / OPPOSITION :
Support
SB 1440
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Allied Council, Yountville Veterans Home
Opposition
None on file.
Analysis Prepared by : John J. Spangler / V. A. / (916)
319-3550