Bill Text: CA AB97 | 2015-2016 | Regular Session | Amended

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

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Bill Title: In-home supportive services: provider wages.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Vetoed) 2016-01-15 - Consideration of Governor's veto stricken from file. [AB97 Detail]

Download: California-2015-AB97-Amended.html

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BILL NUMBER: AB 97	AMENDED
	BILL TEXT

	AMENDED IN SENATE  AUGUST 31, 2015
	AMENDED IN ASSEMBLY  MARCH 26, 2015

INTRODUCED BY   Assembly Member Weber

                        JANUARY 8, 2015

   An act to amend Section 12317 of the Welfare and Institutions
Code, relating to in-home supportive services.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 97, as amended, Weber. In-home supportive services: provider
wages.
   Existing law establishes the county-administered In-Home
Supportive Services (IHSS) program, under which qualified aged,
blind, and disabled persons are provided with services in order to
permit them to remain in their own homes and avoid
institutionalization. Existing law establishes 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 law provides, as part of the Coordinated Care Initiative,
that not sooner than March 1, 2013, all Medi-Cal long-term services
and supports, including IHSS, are required to be services that are
covered under managed care health plan contracts and to be available
only through managed care health plans to beneficiaries residing in
Coordinated Care Initiative counties, except for the provided
exemptions. Existing law allows managed care health plans to
authorize personal care services and related domestic services in
addition to the hours authorized for IHSS by existing law. Existing
law requires the managed care health plans to be responsible for
paying for these services at no share of cost to the county.
   This bill would require the State Department of Social Services to
program its Case Management Information and Payroll System to be
able to receive payments from managed care health plans for these
 additional  personal care service and related
domestic service hours, to issue a  single  payroll
check to  providers,  providers of personal care
service hours and related domestic service hours, which shall not
include payment of wages for service hours provided pursuant to other
specified provisions,  and to  track and 
differentiate between the two types of authorized hours.
   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 12317 of the Welfare and Institutions Code is
amended to read:
   12317.  (a) The State Department of Social Services shall be
responsible for procuring and implementing a new Case Management
Information and Payroll System (CMIPS) for the In-Home Supportive
Services Program and Personal Care Services Program (IHSS/PCSP). This
section shall not be interpreted to transfer any of the IHSS/PCSP
policy responsibilities from the State Department of Social Services
or the State Department of Health Care Services.
   (b) At a minimum, the new system shall provide case management,
payroll, and management information in order to support the
IHSS/PCSP, and shall do all of the following:
   (1) Provide current and accurate information in order to manage
the IHSS/PCSP caseload.
   (2) Calculate accurate wage and benefit deductions.
   (3) Provide management information to monitor and evaluate the
IHSS/PCSP.
   (4) Coordinate benefits information and processing with the
California Medicaid Management Information System.
   (5) In order to implement subparagraph (B) of paragraph (6) of
subdivision (b) of Section 14186, the system shall be programmed to
enable it to do all of the following:
   (A) Receive payments from managed care health plans for the
 additional  personal care service hours and related
domestic service hours authorized by the managed care health
 plan.   plan, which are separate and distinct
from in-home supportive service hours authorized pursuant to this
article and Sections 14132.95, 14132.952, and 14132.956. 
   (B) Issue a  single  payroll check to providers
 that covers both the hours authorized pursuant to Article 7
(commencing with Section 12300) and the hours authorized by the
managed care health plan pursuant to subparagraph (B) of paragraph
(6) of subdivision (b) of Section 14186.   of personal
care service hours and related domestic service hours   for
services rendered pursuant to subparagraph (B) of paragraph (6) of
subdivision (b) of Section 14186, which shall not include payment of
wages for services provided pursuant to this article and Sections
14132.95, 14132.952, and 14132.956. 
   (C)  Differentiate between hours authorized pursuant to
Article 7 (commencing with Section 12300) and   Track
and differentiate between  the hours authorized  by
  pursuant to this article and Sections 14132.95,
14132.952, and 14132.956, and the hours authorized by  the
managed care health plan pursuant to subparagraph (B) of paragraph
(6) of subdivision (b) of Section 14186  for purposes of
federal reimbursement and  to enable managed care health
plans to track the effect of providing the additional benefits.
   (c) The new system shall be consistent with current state and
federal laws, shall incorporate technology that can be readily
enhanced and modernized for the expected life of the system, and, to
the extent possible, shall employ open architectures and standards.
   (d) By August 31, 2004, the State Department of Social Services
shall begin a fair and open competitive procurement for the new
CMIPS. All state agencies shall cooperate with the State Department
of Social Services and the California Health and Human Services
Agency Data Center to expedite the procurement, design, development,
implementation, and operation of the new CMIPS.
   (e) The State Department of Social Services, with any necessary
assistance from the State Department of Health Care Services, shall
seek all federal approvals and waivers necessary to secure federal
financial participation and system design approval of the new system.

   (f) The new CMIPS shall include features to strengthen fraud
prevention and detection, as well as to reduce overpayments. Program
requirements shall include, but shall not be limited to, the ability
to readily identify out-of-state providers, recipient hospital stays
that are five days or longer, and excessive hours paid to a single
provider, and to match recipient information with death reports. This
functionality shall be available by April 1, 2010, and implemented
statewide by July 1, 2011.