14005.125.
(a) It is the intent of the Legislature to prevent homelessness for long-term care Medi-Cal beneficiaries who are temporarily residing in a skilled nursing facility and are no longer able to pay their housing expenses due to diverting their income toward share of cost.(b) (1) For purposes of this section, “home upkeep allowance” means the “allowance for home maintenance,” as described in Section 435.725(d) of Title 42 of the Code of Federal Regulations and the amount for the “upkeep and maintenance of the home,” described in paragraph (2) of subdivision (d) of Section 14005.12.
(2) The home upkeep allowance shall be available to long-term care facility
residents who are Medi-Cal recipients and meet the requirements of this section.
(3) A long-term care facility resident who intends to leave the facility and return to their existing home shall be provided with a home upkeep allowance as follows:
(A) The allowance shall be set aside from the income that otherwise would be applied toward the resident’s Medi-Cal share of cost for residing in the facility.
(B) The allowance shall be based on the actual minimum cost of maintaining the resident’s home, including, but not limited to, mortgage or rent, property taxes, utilities, and required insurance.
(C) The allowance shall be deducted for not more than six months and shall be available only if a physician has certified that the resident is likely to return
to their home within six months.
(4) If a long-term care facility resident does not have a home, but intends to leave the facility and establish a home in the community, the facility shall refer them to available home-based and community-based services programs.
(5) On or before July 1, 2023, the department shall seek federal approval to implement the requirements of this subdivision. This subdivision shall be implemented only if, and to the extent that, federal financial participation is available and any necessary federal approvals have been obtained.
(c) (1) An allowance shall not be approved if the resident has received a home upkeep allowance for a full six-month period during a continuous period of institutionalization.
(2) If the resident receives a home upkeep allowance for fewer than six months during the same continuous period of institutionalization, a home upkeep allowance may be approved for any remaining portion of the maximum six-month period.
(d) In implementing this section, the department shall undertake all of the following information and outreach activities:
(1) Include information on the existence and availability of the home upkeep allowance in the “Notice Regarding Standards for Medi-Cal Eligibility” provided for in Section 14006.4.
(2) Add questions to the “Additional Income and Property Information Needed for Medi-Cal” (MC 604 IPS) form to provide applicants an opportunity to apply for the home upkeep allowance.
(3) Notify all Medi-Cal
branches, eligibility workers, long-term care facilities, hospital discharge planners, and organizations receiving state funds to nursing home residents of the existence and availability of the home upkeep allowance.
(4) Inform residents in all Medi-Cal funded long-term care facilities of the existence and availability of the home upkeep allowance.
(e) (1) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department, without taking any further regulatory action, shall implement, interpret, or make specific this section by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions until the time regulations are adopted.
(2) The department shall adopt regulations within two years of
implementation of this section, in accordance with the requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.
(3) Beginning six months after the effective date of this section, notwithstanding Section 10231.5 of the Government Code, the department shall provide a status report to the Legislature on a semiannual basis, in compliance with Section 9795 of the Government Code, until regulations have been adopted.