Bill Text: CA AB2262 | 2021-2022 | Regular Session | Introduced
Bill Title: In-home supportive services: needs assessment.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2022-05-19 - In committee: Held under submission. [AB2262 Detail]
Download: California-2021-AB2262-Introduced.html
CALIFORNIA LEGISLATURE—
2021–2022 REGULAR SESSION
Assembly Bill
No. 2262
| Introduced by Assembly Member Calderon |
February 16, 2022 |
An act to amend Section 12301.1 of the Welfare and Institutions Code, relating to in-home supportive services.
LEGISLATIVE COUNSEL'S DIGEST
AB 2262, as introduced, Calderon.
In-home supportive services: needs assessment.
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, and disabled persons are provided with services in order to permit them to remain in their own homes. Existing law requires a county welfare department to assess each recipient’s continuing monthly need for in-home supportive services at varying intervals as necessary, but at least once every 12 months. Existing law authorizes the county to extend an assessment for up to 6 months beyond the regular 12-month period if the county documents that certain conditions exist, including that the recipient has had at least one reassessment since the initial program intake assessment and there has not been a known change in the recipient’s supportive service needs within the previous 24 months.
This bill would eliminate the authority of the county to extend the annual assessment beyond 12 months and, instead, would require the department to establish an alternative annual reassessment process for recipients with stable needs. The bill would define “a recipient with stable needs” as a recipient who is 18 years of age or older, who has at least one active provider, and who had at least one initial in-person assessment and one in-person reassessment, and the most recent reassessment did not indicate an assessed need that changed more than 25% from the prior assessment. The bill would allow the alterative annual reassessment to be conducted by telephone, by video, or in-person, at the choice of the recipient, unless certain factors exist that trigger an in-person reassessment, as specified. Under the bill a recipient who is qualified to receive the alternative annual reassessment would be allowed to receive the alternative annual reassessment for 2 consecutive
years.
This bill would require the department to provide implementation instructions and forms to counties on the alternative annual reassessment process on or before October 1, 2023, and would require counties to implement the alternative annual reassessment process beginning on January 1, 2024, or when automation to support the alternative annual reassessment process is available through the Case Management Information and Payrolling System, whichever date is later.
By imposing additional duties on counties, the bill would impose a state-mandated local program.
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 12301.1 of the Welfare and Institutions Code is amended to read:12301.1.
(a) The department shall adopt regulations establishing a uniform range of services available to all eligible recipients based upon individual needs. The availability of services under these regulations is subject to the provisions of Section 12301 and county plans developed pursuant to Section 12302.(b) (1) The county welfare department shall assess each recipient’s continuing monthly need for in-home supportive services at varying intervals as necessary, but at least once every 12 months. The assessment may be conducted as a full assessment or may be conducted pursuant to the alternative annual reassessment process described in subdivision (d).
The results of this assessment of monthly need for hours of in-home supportive services shall be divided by 4.33, to establish a recipient’s weekly authorized number of hours of in-home supportive services, subject to any of the following, as applicable:
(A) Within the limit of the assessed monthly need for hours of in-home supportive services, a county welfare department may adjust the authorized weekly hours of a recipient for any particular week for known recurring or periodic needs of the recipient.
(B) Within the limit of the assessed monthly need for hours of in-home supportive services, a county welfare department may temporarily adjust the authorized weekly hours of a recipient at the request of the recipient, to accommodate unexpected extraordinary circumstances, including, but not limited to, a situation arising out of a natural disaster.
(C) In addition to the flexibility provided to a recipient pursuant to subparagraph (C) of paragraph (4) of subdivision (b) of Section 12300.4, a recipient may request the county welfare department to adjust his or her their weekly authorized hours of services to exceed 40 hours of weekly authorized hours of services per week, within his or her their total monthly authorized hours of services. A request for adjustment may be made retroactive to the hours actually worked. The county welfare department shall not unreasonably withhold approval of a recipient request made
pursuant to this subparagraph.
(2) For purposes of subparagraph (C) of paragraph (1), and prior to its implementation, the State Department of Social Services
department shall develop a process for requests made pursuant to that subparagraph. The process shall include all of the following:
(A) The procedure, standards, and timeline for making a request to adjust the authorized weekly hours of service for a recipient described in this section.
(B) The language to be used for notices about the process.
(C) Provisions for adjustments to authorization, and for authorization after services have been provided, when if the criteria for approval have been met.
(D) A requirement that the
opportunity for a revision to the limitations of this section shall be discussed at each annual reassessment, and also may be authorized by the county welfare department outside of the reassessment process.
(3) Recipients shall be timely informed of their total monthly and weekly authorized hours.
(4) The weekly authorization of services defined in this section shall be used solely for the purposes of ensuring compliance with the federal Fair Labor Standards Act and its implementing regulations.
(5) 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 subdivision by means of all-county letters, or similar instructions, without
taking any regulatory action.
(c) (1) Notwithstanding subdivision (b), at the county’s option, assessments may be extended, on a case-by-case basis, for up to six months beyond the regular 12-month period, provided that the county documents that all of the following conditions exist:
(A) The recipient has had at least one reassessment since the initial program intake assessment.
(B) The recipient’s living arrangement has not changed since the last annual reassessment and the recipient lives with others, or has regular meaningful contact with persons other than his or her the recipient’s service
provider.
(C) The recipient or, if the recipient is a minor, his or her
the recipient’s parent or legal guardian, or if incompetent, his or her the recipient’s conservator, is able to satisfactorily direct the recipient’s care.
(D) There has not been a known change in the recipient’s supportive service needs within the previous 24 months.
(E) A report has not been made to, and there has been no involvement of, an adult protective services agency or agencies since the county last assessed the recipient.
(F) The recipient has not had a change in provider or providers for at least six months.
(G) The
recipient has not reported a change in his or her
their need for supportive services that requires a reassessment.
(H) The recipient has not been hospitalized within the last three months.
(2) If some, but not all, of the conditions specified in paragraph (1) are met, the county may consider other factors in determining whether an extended assessment interval is appropriate, including, but not limited to, involvement in the recipient’s care of a social worker, case manager, or other similar representative from another human services agency, such as a regional center or county mental health program, or communications, or other instructions from a physician or other licensed health care professional that the recipient’s medical condition is unlikely to change.
(3) This subdivision shall become inoperative on January 1, 2024, or when automation to support the alternative annual reassessment process pursuant to subdivision (d) is available through the Case Management Information and Payrolling System, whichever date is later.
(d) The department, with input from counties and stakeholders, shall establish an alternative annual reassessment process for recipients with stable needs. The department shall provide implementation instructions and forms, including translated forms, to counties on the alternative annual reassessment process on or before October 1, 2023. Counties shall implement the alternative annual reassessment process beginning on January 1, 2024, or when automation to support this alternative process is available through the Case Management Information and Payrolling System, whichever date is later.
(1) For
purposes of this subdivision, “a recipient with stable needs” is defined as a recipient who is 18 years of age or older, who has at least one active provider, and who had at least one initial in-person assessment and one in-person reassessment, and the most recent reassessment did not indicate an assessed need that changed more than 25 percent from the prior assessment.
(2) An annual reassessment for a recipient with stable needs shall be conducted pursuant to the alternative annual reassessment process unless the recipient requests a full assessment pursuant to paragraph (6). Except as provided in paragraph (5), the alterative annual reassessment may be conducted by telephone, by video, or in-person, at the choice of the recipient.
(3) The alternative annual reassessment process shall include all of the
following:
(A) A prepopulated form that includes basic identifying information about the recipient, the number of authorized hours, any alternative resources, and household composition.
(B) A simple questionnaire that will be used to collect information during the alternative annual reassessment that includes, but is not limited to, questions regarding all of the following:
(i) Changes in medication or health care providers.
(ii) Changes in IHSS providers or caregiver supports.
(iii) Any new alternative resources or changes in alternative resources.
(iv) Changes in household composition.
(v) Changes in needs and whether current needs are being met.
(4) (A) The prepopulated form and the questionnaire shall be sent by the county welfare department to the recipient in advance of the scheduled reassessment.
(B) The department shall make the form and questionnaire available in all Medi-Cal threshold languages.
(C) The responses collected from the questionnaire during the alternative annual reassessment shall be documented in the Case Management Information and Payrolling System.
(5) The county social worker may consider certain factors that, if present, may trigger an in-person
reassessment, including the following factors:
(A) The recipient has been referred to the adult protective services program within the last 12 months, or an investigation is being conducted concerning the recipient, if known.
(B) The recipient has been referred to the district attorney or the department for allegations of fraud within the last 12 months, or an investigation is being conducted concerning fraud by the recipient, if known.
(C) The recipient is under a conservatorship or public guardianship.
(D) Other factors that indicate the recipient would benefit from an in-person home visit as defined by local county policy, including, but not limited to, significant changes in the recipient’s memory, orientation, or judgment.
(6) A recipient retains the right to refuse the alternative annual reassessment and choose the full reassessment. The county welfare department shall establish a process to safeguard and honor the recipient’s choice of reassessment and shall document the recipient’s choice.
(7) A recipient who is qualified to receive the alternative annual reassessment may receive the alternative annual reassessment for two consecutive years, and every third year, the recipient shall receive the full annual reassessment.
(8) The department shall consult with the County Welfare Directors Association of California and counties regarding the automation necessary to support implementation of this subdivision and shall prioritize these changes for automation.
(9) The department
shall conduct ongoing evaluation and oversight of the alternative annual reassessment process to ensure the process adequately assesses the needs of recipients and that the process is equitably available to recipients based on county residence, race, ethnicity, language, age, disability, sexual orientation, and gender identity. Demographic data pertaining to the utilization of the alternative annual reassessment process shall be made public.
(3)
(e) A county may reassess a recipient’s need for services at a time interval of less than 12 months from a recipient’s initial intake or last assessment if the county social worker has information indicating
that the recipient’s need for services is expected to decrease in less than 12 months.
(d)
(f) A county shall assess a recipient’s need for supportive services any time that the recipient notifies the county of a need to adjust the supportive services hours authorized, or if there are other indications or expectations of a change in circumstances affecting the recipient’s need for supportive services.
(e)(1)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, until emergency regulations are filed with the Secretary of State, the department may implement this section through all-county letters or similar instructions from the director. The department shall adopt
emergency regulations implementing this section no later than September 30, 2005, unless notification of a delay is made to the Chair of the Joint Legislative Budget Committee prior to that date. The notification shall include the reason for the delay, the current status of the emergency regulations, a date by which the emergency regulations shall be adopted, and a statement of need to continue use of all-county letters or similar instructions. The adoption of emergency regulations shall not be delayed, or the use of all-county letters or similar instructions be extended, beyond June 30, 2006.
(2)The adoption of regulations implementing this section shall be deemed an emergency and necessary for the immediate preservation of the public peace, health, safety, or general welfare. The emergency regulations authorized by this section are exempt from review by the Office of Administrative Law. The emergency regulations authorized by this section
shall be submitted to the Office of Administrative Law for filing with the Secretary of State and shall remain in effect for no more than 180 days by which time final regulations shall be adopted. The department shall seek input from the entities listed in Section 12305.72 when developing all-county letters or similar instructions and the regulations.
