BILL NUMBER: AB 577	INTRODUCED
	BILL TEXT


INTRODUCED BY   Assembly Member Bonnie Lowenthal

                        FEBRUARY 25, 2009

   An act to amend Section 1580.1 of the Health and Safety Code, and
to amend Sections 14590 and 14591 of the Welfare and Institutions
Code, relating to the elderly.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 577, as introduced, Bonnie Lowenthal. Program for All-Inclusive
Care for the Elderly.
   Existing law establishes the federal Medicaid program,
administered by each state, California's version of which is the
Medi-Cal program. The Medi-Cal program, which is administered by the
State Department of Health Care Services under the direction of the
Director of Health Care Services, provides qualified low-income
persons with health care services.
   Existing federal law establishes the Programs 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 permits states to implement the PACE program as a
Medicaid state option.
   Existing state law authorizes the director to establish the
California Program of All-Inclusive Care for the Elderly, and to
contract with up to 10 demonstration projects to develop risk-based
long-term care pilot programs, and establishes PACE program services
as a covered benefit of the Medi-Cal program.
   Existing law authorizes the State Department of Health Care
Services, and as applicable, the California Department of Aging, to
grant exemptions to entities contracting with the department under
the PACE program from certain provisions relating to adult day health
centers.
   This bill would make technical, nonsubstantive changes to the
above provisions.
   Vote: majority. Appropriation: no. Fiscal committee: no.
State-mandated local program: no.


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

  SECTION 1.  Section 1580.1 of the Health and Safety Code is amended
to read:
   1580.1.  The State Department of Health  Care  Services,
and as applicable, the California Department of Aging, may grant to
entities contracting with the State Department of Health  Care
 Services under the PACE program, as defined in Chapter 8.75
(commencing with Section 14590) of Part 3 of Division 9 of the
Welfare and Institutions Code, exemptions from the provisions
contained in this chapter in accordance with the requirements of
Section 100315.
  SEC. 2.  Section 14590 of the Welfare and Institutions Code is
amended to read:
   14590.  The Legislature finds and declares that:
   (1) Community-based services to the frail elderly are often
uncoordinated, fragmented, inappropriate, or insufficient to meet the
needs of frail elderly who are at risk of institutionalization,
often resulting in unnecessary placement in nursing homes.
   (2) Steadily increasing health care costs for the frail elderly
provide incentive to develop programs providing quality services at
reasonable costs.
   (3) Capitated "risk-based" financing provides an alternative to
the traditional fee-for-service payment system by providing a fixed,
per capita monthly payment for a package of health care services and
requiring the provider to assume financial responsibility for cost
overruns.
   (4) On Lok Senior Health Services began as a federal and state
demonstration program in 1973 to test whether comprehensive
community-based services could be provided to the frail elderly at no
greater cost than nursing home care.
   (5) Since 1983, On Lok Senior Health Services of San Francisco has
successfully provided a comprehensive package of services and
operated within a cost-effective, capitated risk-based financing
system.
   (6) Recognizing On Lok's success, Congress passed Legislation in
1986 and 1987 encouraging the expansion of capitated long-term care
programs by permitting federal Medicare and Medicaid waivers to be
granted indefinitely to On Lok and authorizing the  Health
Care Financing Administration   federal Centers for
Medicare and Medicaid Services  to grant waivers in up to 10 new
sites throughout the nation in order to replicate the On Lok model.
   (7) In California, numerous agencies have expressed interest in
developing programs similar to On Lok and will need the cooperation
of the State Department of Health  Care  Services to
successfully obtain the necessary available federal waivers to
develop risk-based capitated long-term care demonstration programs.
   (8) Through the development of these demonstration programs, the
viability of a cost-effective statewide program offering quality
long-term care services can be evaluated.
   (9) To achieve maximum cost effectiveness in demonstration
projects under this chapter, an expedited contract process is
necessary.
  SEC. 3.  Section 14591 of the Welfare and Institutions Code is
amended to read:
   14591.  The State Director of Health  Care Services may
establish the California Program of All-Inclusive Care for the
Elderly, to promote the development of community-based, risk-based
capitated, long-term care programs.