BILL NUMBER: SB 199	ENROLLED
	BILL TEXT

	PASSED THE SENATE  SEPTEMBER 2, 2015
	PASSED THE ASSEMBLY  SEPTEMBER 1, 2015
	AMENDED IN ASSEMBLY  AUGUST 28, 2015
	AMENDED IN SENATE  JUNE 2, 2015
	AMENDED IN SENATE  APRIL 7, 2015

INTRODUCED BY   Senator Hall
   (Principal coauthor: Senator Beall)
   (Coauthor: Senator Anderson)
   (Coauthors: Assembly Members Bonilla, Dababneh, Cristina Garcia,
Gonzalez, Lackey, Rodriguez, Steinorth, and Waldron)

                        FEBRUARY 10, 2015

   An act to amend Section 12300 of the Welfare and Institutions
Code, relating to public social services.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 199, Hall. In-home supportive services: reading services for
blind and visually impaired recipients.
   Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Care Services, and
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 law provides for the county-administered In-Home
Supportive Services (IHSS) program, under which, either through
employment by the recipient, or by or through contract by the county,
qualified aged, blind, and disabled persons receive services
enabling them to remain in their own homes. Existing law requires the
provision of personal care services under the Medi-Cal program to
eligible IHSS recipients. Under existing law, county welfare
departments are required to provide visually impaired applicants and
recipients with information on, and referral services to, entities
that provide reading services to visually impaired persons. Existing
law defines "supportive services" for purposes of the IHSS program.
   This bill would, commencing January 1, 2017, include within the
definition of supportive services up to 2 hours per month of
assistance in reading and completing financial and other documents
for a recipient of services under the IHSS program who is blind. By
expanding the scope of available services under the IHSS program,
this bill would impose a state-mandated local program. The bill would
also require the Director of Health Care Services to seek any
federal approvals necessary to ensure that Medicaid funds may be used
in implementing this provision. The bill would authorize the
department to implement the provision through all-county letters or
similar instructions from the director until emergency regulations
are filed, and would require the adoption of emergency regulations by
January 1, 2018, and final regulations by January 1, 2019, to
implement this provision, as specified.
   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 these
statutory provisions.


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

  SECTION 1.  Section 12300 of the Welfare and Institutions Code is
amended to read:
   12300.  (a) The purpose of this article is to provide in every
county in a manner consistent with this chapter and the annual Budget
Act those supportive services identified in this section to aged,
blind, or disabled persons, as defined under this chapter, who are
unable to perform the services themselves and who cannot safely
remain in their homes or abodes of their own choosing unless these
services are provided.
   (b) Supportive services shall include domestic services and
services related to domestic services, heavy cleaning, personal care
services, accompaniment by a provider when needed during necessary
travel to health-related appointments or to alternative resource
sites, yard hazard abatement, protective supervision, up to two hours
per month of assistance in reading and completing financial and
other documents for a recipient who is blind, teaching and
demonstration directed at reducing the need for other supportive
services, and paramedical services that make it possible for the
recipient to establish and maintain an independent living
arrangement.
   (c) Personal care services shall mean all of the following:
   (1) Assistance with ambulation.
   (2) Bathing, oral hygiene, and grooming.
   (3) Dressing.
   (4) Care and assistance with prosthetic devices.
   (5) Bowel, bladder, and menstrual care.
   (6) Repositioning, skin care, range of motion exercises, and
transfers.
   (7) Feeding and assurance of adequate fluid intake.
   (8) Respiration.
   (9) Assistance with self-administration of medications.
   (d) Personal care services are available if these services are
provided in the beneficiary's home and other locations as may be
authorized by the director. Among the locations that may be
authorized by the director under this subdivision is the recipient's
place of employment if all of the following conditions are met:
   (1) The personal care services are limited to those that are
currently authorized for a recipient in the recipient's home and
those services are to be utilized by the recipient at the recipient's
place of employment to enable the recipient to obtain, retain, or
return to work. Authorized services utilized by the recipient at the
recipient's place of employment shall be services that are relevant
and necessary in supporting and maintaining employment. However,
workplace services shall not be used to supplant any reasonable
accommodations required of an employer by the federal Americans with
Disabilities Act of 1990 (42 U.S.C. Sec. 12101 et seq.; ADA) or other
legal entitlements or third-party obligations.
   (2) The provision of personal care services at the recipient's
place of employment shall be authorized only to the extent that the
total hours utilized at the workplace are within the total personal
care services hours authorized for the recipient in the home.
Additional personal care services hours may not be authorized in
connection with a recipient's employment.
   (e) When supportive services are provided by a person who has the
legal duty pursuant to the Family Code to provide for the care of his
or her child who is the recipient, the provider of supportive
services shall receive remuneration for the services only when the
provider leaves full-time employment or is prevented from obtaining
full-time employment because no other suitable provider is available
and when the inability of the provider to provide supportive services
may result in inappropriate placement or inadequate care.
   These providers shall be paid only for the following:
   (1) Services related to domestic services.
   (2) Personal care services.
   (3) Accompaniment by a provider when needed during necessary
travel to health-related appointments or to alternative resource
sites.
   (4) Protective supervision only as needed because of the
functional limitations of the child.
   (5) Paramedical services.
   (f) To encourage maximum voluntary services, so as to reduce
governmental costs, respite care shall also be provided. Respite care
is temporary or periodic service for eligible recipients to relieve
persons who are providing care without compensation.
   (g) A person who is eligible to receive a service or services
under an approved federal waiver authorized pursuant to Section
14132.951, or a person who is eligible to receive a service or
services authorized pursuant to Section 14132.95, shall not be
eligible to receive the same service or services pursuant to this
article. In the event that the waiver authorized pursuant to Section
14132.951, as approved by the federal government, does not extend
eligibility to all persons otherwise eligible for services under this
article, or does not cover a service or particular services, or does
not cover the scope of a service that a person would otherwise be
eligible to receive under this article, those persons who are not
eligible for services, or for a particular service under the waiver
or Section 14132.95 shall be eligible for services under this
article.
   (h) (1) All services provided pursuant to this article shall be
equal in amount, scope, and duration to the same services provided
pursuant to Section 14132.95, including any adjustments that may be
made to those services pursuant to subdivision (e) of Section
14132.95.
   (2) Notwithstanding any other provision of this article, the rate
of reimbursement for in-home supportive services provided through any
mode of service shall not exceed the rate of reimbursement
established under subdivision (j) of Section 14132.95 for the same
mode of service unless otherwise provided in the annual Budget Act.
   (3) The maximum number of hours available under Section 14132.95,
Section 14132.951, and this section, combined, shall be 283 hours per
month. Any recipient of services under this article shall receive no
more than the applicable maximum specified in Section 12303.4.
   (i) The Director of Health Care Services shall, by January 1,
2017, seek all federal approvals necessary to ensure that Medicaid
funds may be used in implementing the service to blind recipients
specified in subdivision (b). The service includes assistance in
reading and completing financial and other documents for a recipient
who is blind. The authorization to provide the service to blind
recipients specified in subdivision (b) shall become operative on
January 1, 2017. Provision of the service shall be implemented only
if, and to the extent that, federal financial participation is
available, and any necessary federal approvals have been obtained.
   (j) 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 the service to blind recipients
specified in subdivision (b) through all-county letters or similar
instructions from the director. On or before January 1, 2018, the
department shall adopt regulations to implement the service to blind
recipients specified in subdivision (b). The initial adoption,
amendment, or repeal of a regulation authorized by this subdivision
is deemed to address an emergency, for purposes of Sections 11346.1
and 11349.6 of the Government Code, and the department is hereby
exempted for that purpose from the requirements of subdivision (b) of
Section 11346.1 of the Government Code. After the initial adoption,
amendment, or repeal of an emergency regulation pursuant to this
section, the department may twice request approval from the Office of
Administrative Law to readopt the regulation as an emergency
regulation pursuant to Section 11346.1 of the Government Code. The
department shall adopt final regulations on or before January 1,
2019.
  SEC. 2.  If the Commission on State Mandates determines that this
act contains costs mandated by the state, reimbursement to local
agencies and school districts for those costs shall be made pursuant
to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of
the Government Code.