Bill Text: CA AB471 | 2013-2014 | Regular Session | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Local government: redevelopment: successor agencies to redevelopment agencies.

Spectrum: Partisan Bill (Democrat 7-0)

Status: (Passed) 2014-02-18 - Chaptered by Secretary of State - Chapter 1, Statutes of 2014. [AB471 Detail]

Download: California-2013-AB471-Introduced.html

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BILL NUMBER: AB 471	INTRODUCED
	BILL TEXT


INTRODUCED BY   Assembly Member Atkins

                        FEBRUARY 19, 2013

   An act to amend Section 14593 of the Welfare and Institutions
Code, relating to Medi-Cal.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 471, as introduced, Atkins. Medi-Cal: Program of All-Inclusive
Care for the Elderly.
   Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Care Services, under
which qualified low-income individuals receive health care services.
The Medi-Cal program is, in part, governed and funded by federal
Medicaid Program provisions. Existing federal law establishes the
Program of All-Inclusive Care for the Elderly (PACE), which provides
specified services for older individuals so that they may continue
living in the community. Federal law authorizes states to implement
the PACE program as a Medicaid state option.
   Existing state law establishes the California Program for
All-Inclusive Care for the Elderly and establishes PACE program
services as a covered benefit of the Medi-Cal program. Existing law
authorizes the department to enter into contracts with up to 15 PACE
organizations, as defined, to implement the PACE program, as
specified.
   This bill would delete the provision that limits the number of
contracts with PACE organizations to 15.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 14593 of the Welfare and Institutions Code is
amended to read:
   14593.  (a)  (1)    The
department may enter into contracts with public or private nonprofit
organizations for implementation of the PACE program, and also may
enter into separate contracts with PACE organizations, to fully
implement the single state agency responsibilities assumed by the
department in those contracts, Section 14132.94, and any other state
requirement found necessary by the department to provide
comprehensive community-based, risk-based, and capitated long-term
care services to California's frail elderly. 
   (2) The department may enter into separate contracts as specified
in subdivision (a) with up to 15 PACE organizations. 
   (b) The requirements of the PACE model, as provided for pursuant
to Section 1894 (42 U.S.C. Sec. 1395eee) and Section 1934 (42 U.S.C.
Sec. 1396u-4) of the federal Social Security Act, shall not be waived
or modified. The requirements that shall not be waived or modified
include all of the following:
   (1) The focus on frail elderly qualifying individuals who require
the level of care provided in a nursing facility.
   (2) The delivery of comprehensive, integrated acute and long-term
care services.
   (3) The interdisciplinary team approach to care management and
service delivery.
   (4) Capitated, integrated financing that allows the provider to
pool payments received from public and private programs and
individuals.
   (5) The assumption by the provider of full financial risk.
   (6) The provision of a PACE benefit package for all participants,
regardless of source of payment, that shall include all of the
following:
   (A) All Medicare-covered items and services.
   (B) All Medicaid-covered items and services, as specified in the
state's Medicaid plan.
   (C) Other services determined necessary by the interdisciplinary
team to improve and maintain the participant's overall health status.

   (c) Sections 14002, 14005.12, 14005.17, and 14006 shall apply when
determining the eligibility for Medi-Cal of a person receiving the
services from an organization providing services under this chapter.
   (d) Provisions governing the treatment of income and resources of
a married couple, for the purposes of determining the eligibility of
a nursing-facility certifiable or institutionalized spouse, shall be
established so as to qualify for federal financial participation.
   (e) (1) The department shall establish capitation rates paid to
each PACE organization at no less than 90 percent of the
fee-for-service equivalent cost, including the department's cost of
administration, that the department estimates would be payable for
all services covered under the PACE organization contract if all
those services were to be furnished to Medi-Cal beneficiaries under
the fee-for-service Medi-Cal program provided for pursuant to Chapter
7 (commencing with Section 14000).
   (2)  This subdivision shall be implemented only to the extent that
federal financial participation is available.
   (f) Contracts under this chapter may be on a nonbid basis and
shall be exempt from Chapter 2 (commencing with Section 10290) of
Part 2 of Division 2 of the Public Contract Code.