Bill Text: CA AB1005 | 2023-2024 | Regular Session | Amended
Bill Title: In-home supportive services: terminal illness diagnosis.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Engrossed) 2023-09-01 - In committee: Held under submission. [AB1005 Detail]
Download: California-2023-AB1005-Amended.html
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Amended
IN
Senate
June 21, 2023 |
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Amended
IN
Assembly
May 18, 2023 |
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Amended
IN
Assembly
April 18, 2023 |
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Amended
IN
Assembly
March 23, 2023 |
CALIFORNIA LEGISLATURE—
2023–2024 REGULAR SESSION
Assembly Bill
No. 1005
| Introduced by Assembly Member Alvarez |
February 15, 2023 |
An act to add Section 442.9 to the Health and Safety Code, and to add Section 12309.2 to the Welfare and Institutions Code, relating to in-home supportive services.
LEGISLATIVE COUNSEL'S DIGEST
AB 1005, as amended, Alvarez.
In-home supportive services: terminal illness diagnosis.
Existing law establishes the In-Home Supportive Services (IHSS) program, administered by the State Department of Social Services and counties, under which qualified aged, blind, or disabled persons are provided with supportive services in order to permit them to remain in their own homes.
As a condition of receiving services under the IHSS program, existing law requires an applicant or recipient to obtain a certification from a licensed health care professional declaring that the applicant or recipient is unable to perform some activities of daily living independently, and that without services to assist the applicant or recipient with activities of daily living, the applicant or recipient is at risk of placement in out-of-home care. Existing law requires that the certification be received prior to service authorization, except under certain
circumstances. Existing law requires the department to develop a standard certification form, as specified, and to identify alternative documentation, including, but not limited to, hospital or nursing facility discharge plans, containing the required information.
Existing law sets forth various provisions relating to end-of-life care. When a health care provider makes a diagnosis that a patient has a terminal illness, existing law generally requires the health care provider, upon request, to provide the patient or another person authorized to make health care decisions with comprehensive information and counseling regarding legal end-of-life care options.
This bill would, before the discharge of a patient diagnosed with a terminal illness, from an acute care
hospital of a Medi-Cal beneficiary, require the diagnosing health care provider hospital’s designated case manager or discharge planner to evaluate the patient’s need for posthospital services and ability to access those services. This bill would require the hospital’s case manager or discharge planner to ask the patient or authorized person if they are interested in receiving information about the IHSS program. program if that patient is anticipated to need in-home personal care. If interest is expressed, the bill would require the health care provider to disclose
hospital’s case manager or discharge planner to provide to the patient or authorized person the information, including the IHSS eligibility criteria how to initiate the application process and the option for a family member to provide care as an IHSS provider subject to the IHSS provider enrollment conditions.
If the patient seeks to apply for services under the IHSS program, the bill would require the health care provider to provide a copy hospital case manager or discharge planner to communicate to the patient’s primary care physician the patient’s interest in applying for IHSS
services to support the timely completion of the health care certification form and to complete the applicable portion before the patient’s discharge. form.
Existing law sets forth various conditions on the number of hours of service authorized for an IHSS provider, with a modified number based on exemptions for a provider who is related to the recipients whom the provider serves, as specified.
Existing law requires the county welfare department to assess each IHSS recipient’s continuing monthly need for in-home supportive services at varying intervals as necessary, but at least once every 12 months, with exceptions. Under existing law, the results of this assessment of monthly need for IHSS hours are divided
by 4.33, to establish a recipient’s weekly authorized number of IHSS hours, as specified.
Under this bill, if a patient diagnosed with a terminal illness seeks to apply for services under the IHSS program, and receives a health care certification form that is completed by a health care provider, the patient would be authorized to request to have the application expedited by the county.
This bill would require counties, to the extent feasible, to consider expediting applications of patients who have been diagnosed with a terminal illness and who have requested their application be expedited. By creating additional duties for county officials, the bill would impose a state-mandated local program.
The bill would authorize the department to implement these provisions through all-county letters or similar instructions, until regulations are adopted. The bill would condition
implementation of these provisions on receipt of any necessary federal approvals and the availability of federal financial participation for purposes of providing in-home supportive services under the Medi-Cal program or other related provisions.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.
Digest Key
Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YESBill Text
The people of the State of California do enact as follows:
SECTION 1.
Section 442.9 is added to the Health and Safety Code, to read:442.9.
(a) It is the intent of the Legislature that this section be implemented in conjunction with implementation of Section 12309.2 of the Welfare and Institutions Code.(b) Before the discharge of a patient from an acute care hospital of a Medi-Cal beneficiary diagnosed with a terminal illness, the diagnosing health care provider hospital’s designated case manager or
discharge planner shall evaluate the patient’s likely need for posthospital services and their ability to access those services. For patients anticipated to need in-home personal care, the hospital case manager or discharge planner shall ask the patient, or another person authorized to make health care decisions for the patient, if they are interested in receiving information about the in-home supportive services (IHSS) program (Article 7 (commencing with Section 12300) of Chapter 3 of Part 3 of Division 9 of the Welfare and Institutions Code). If the patient or authorized person expresses interest in receiving the IHSS information, the diagnosing health care provider hospital case manager or discharge planner shall disclose
provide to the patient or authorized person the information, including the IHSS eligibility criteria how to initiate the application process and the option for a family member to provide care as an IHSS provider subject to the IHSS provider enrollment conditions set forth in that article.
(c) If the patient seeks to apply for services under the IHSS program, the health care provider shall provide a copy hospital case manager or discharge planner shall, as appropriate, communicate to the patient’s
primary care physician the patient’s interest in applying for IHSS services to support the timely completion of the health care certification form (SOC 873 or its successor), as described in Section 12309.1 of the Welfare and Institutions Code, and shall complete the health care provider’s portion of that form before the patient’s discharge. Code.
SEC. 2.
Section 12309.2 is added to the Welfare and Institutions Code, to read:12309.2.
(a) (1) The Legislature finds and declares that the purpose of this section is to provide a more streamlined, automatic application process for a patient who has been diagnosed with a terminal illness, who meets all of the IHSS eligibility criteria, and who is interested in receiving services under the IHSS program.(2) It is the intent of the Legislature that this section be implemented in conjunction with implementation of Section 442.9 of the Health and Safety Code.
(b) If a patient diagnosed with a terminal illness seeks to apply for services under the IHSS program, and receives a
health care certification form (SOC 873 or its successor), as described in Section 12309.1, that is completed by a health care provider, the patient may request to have their application expedited by the county.
(c) To the extent feasible, counties shall consider expediting the applications of patients who have been diagnosed with a terminal illness and who have requested that their application be expedited.
(d) For purposes of this section, “terminal illness” has the same meaning as interpreted for Part 1.8 (commencing with Section 442) of Division 1 of the Health and Safety Code.
(e) Notwithstanding the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code), the department may implement, interpret, or make specific this section by means of all-county letters or similar instructions, until regulations are adopted.
(f) This section shall be implemented only to the extent that any necessary federal approvals are obtained and federal financial participation is available for purposes of providing in-home supportive services pursuant to Section 14132.95, 14132.952, 14132.956, or 14132.97, or pursuant to other applicable provisions.
