CALIFORNIA LEGISLATURE 20172018 REGULAR SESSION Assembly Bill No. 2233Introduced by Assembly Member KalraFebruary 13, 2018 An act to add Section 14132.265 to the Welfare and Institutions Code, relating to Medi-Cal.LEGISLATIVE COUNSEL'S DIGESTAB 2233, as introduced, Kalra. Medi-Cal: Assisted Living Waiver program.Existing law establishes 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 requires the State Department of Health Services to develop a federal waiver program to test the efficacy of providing an assisted living benefit to beneficiaries under the Medi-Cal program. Existing law requires that the benefit include, but not be limited to, the care and supervision activities specified for residential care facilities for the elderly. Existing law requires implementation of the program only to the extent federal financial participation is available and funds are appropriated or otherwise available for the program.This bill would require the department to submit to the federal Centers for Medicare and Medicaid Services a request for renewal of the Assisted Living Waiver program with specified amendments. The bill would require, as part of the amendments, additional slots, as specified, in the 15 counties where the waiver program is currently in operation. The waiver amendments would also require the department to expand the program on a statewide basis, as specified. The waiver amendments would, among other things, authorize assessments to be conducted by trained individuals, visits to be conducted on an as-needed and quarterly basis, and the provision of certain accommodations to account for the needs of dementia care residents.The bill would also require the department to authorize eligibility for share-of-cost Medi-Cal beneficiaries, and to modify its provider reimbursement tier, as specified, while also maintaining the waiver programs budget-neutral provisions.The bill would condition implementation of the waiver amendments on obtaining the necessary federal approvals and on the availability of federal financial participation. The bill would require implementation of the waiver amendments to commence within 6 months of the departments receipt of authorization for the necessary resources, as specified.The bill would also make legislative findings and declarations relating to the Assisted Living Waiver program.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO Bill TextThe people of the State of California do enact as follows:SECTION 1. The Legislature finds and declares all of the following:(a) In 1999, the United States Supreme Court ruled in the case of Olmstead v. L.C. (1999) 527 U.S. 581, finding that the unnecessary institutionalization of people with disabilities is a violation of the Americans with Disabilities Act of 1990 (ADA), thereby establishing the right of individuals with disabilities to receive services in the most integrated setting.(b) To meet the intent of the Olmstead decision, it is the states obligation to ensure that individuals have access to an array of necessary services and supports that meet each persons needs and preferences, regardless of age or degree of disability.(c) The Assisted Living Waiver program has provided a valuable alternative to institutionalization for individuals who would otherwise reside in a facility but prefer to remain in a community-based setting and cannot afford the costs of assisted living. Demand for the Assisted Living Waiver program has outpaced supply and operates with a waiting list of approximately 2500 individuals across 15 counties, including the Counties of Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara, and Sonoma.(d) Despite the demand for the Assisted Living Waiver program, a number of challenges prevent the program from realizing its potential, including lack of available providers, lack of awareness of the program, low reimbursement rates that hamper provider participation, lack of availability across the remaining 43 counties that do not participate in the program, and ineffective administrative requirements.(e) According to the 2017 Long-Term Services and Supports Scorecard, almost 11 percent of Californias 101,000 nursing home residents, or 11,000 individuals, are identified as having low-care needs. These individuals could be cared for in the community, or in assisted living settings, as an alternative to institutionalization. However, for many of those individuals, either the opportunities to transition do not exist or these individuals are unaware of the alternatives.(f) As part of Californias efforts to realize its commitment to the Olmstead decision, availability of slots under the Assisted Living Waiver program should be increased, while also addressing the programmatic issues impacting its effectiveness.SEC. 2. Section 14132.265 is added to the Welfare and Institutions Code, immediately following Section 14132.26, to read:14132.265. (a) The department shall submit to the federal Centers for Medicare and Medicaid Services a request for renewal of the Assisted Living Waiver program described in Section 14132.26, with all of the following amendments to the program components:(1) Additional slots in the 15 counties where the waiver program is currently in operation. The department shall increase the number of slots beyond the currently authorized 3,700 to 10,000, to address the waiting list, while expanding the number of available slots on an annual basis. Before submission of the waiver renewal request, the department shall notify the appropriate fiscal and policy committees of the Legislature of the number of waiver slots included in the waiver renewal request along with supportive data for those slots. A report submitted to the Legislature pursuant to this paragraph shall be submitted in compliance with Section 9795 of the Government Code.(2) Geographic availability of slots on a statewide basis. The department shall expand the waiver program beyond the existing counties to enable its availability on a statewide basis. The statewide expansion shall be phased in on a scheduled basis throughout the waiver programs five-year term.(3) Administrative and provider requirements. The department shall include within the waiver renewal request all of the following provisions:(A) Authorize assessments to be conducted by trained individuals, including registered nurses, licensed vocational nurses, individuals with a Masters degree in social work, geriatric care managers, or a related field.(B) Authorize visits be conducted on an as-needed and quarterly basis, instead of a monthly basis.(C) Authorize semi-private bedrooms and bathrooms or kitchenettes in order to account for the needs of dementia care residents.(D) Consider revising the requirement that nursing staff be either on call or employed by the facility, in order to allow for greater provider participation.(4) Eligibility. The department shall permit eligibility for share-of-cost Medi-Cal beneficiaries who do not qualify for full-scope Medi-Cal eligibility.(5) Provider reimbursement. The department shall modify its provider reimbursement tier to ensure sufficient participation from providers with the daily rate for each tier not less than the rate in 201718 fiscal year, while also maintaining the waiver programs budget-neutral provisions. The provider reimbursement methodology shall include a tier specific to provision of memory care.(b) (1) The department shall implement this section only to the extent federal financial participation is available and only if any necessary federal approvals have been obtained.(2) Upon federal approval of the waiver renewal request with the amendments described in this section, implementation of the amended waiver program shall commence within six months of the department receiving authorization for the necessary resources to provide the services to additional waiver program participants.
CALIFORNIA LEGISLATURE 20172018 REGULAR SESSION Assembly Bill No. 2233Introduced by Assembly Member KalraFebruary 13, 2018 An act to add Section 14132.265 to the Welfare and Institutions Code, relating to Medi-Cal.LEGISLATIVE COUNSEL'S DIGESTAB 2233, as introduced, Kalra. Medi-Cal: Assisted Living Waiver program.Existing law establishes 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 requires the State Department of Health Services to develop a federal waiver program to test the efficacy of providing an assisted living benefit to beneficiaries under the Medi-Cal program. Existing law requires that the benefit include, but not be limited to, the care and supervision activities specified for residential care facilities for the elderly. Existing law requires implementation of the program only to the extent federal financial participation is available and funds are appropriated or otherwise available for the program.This bill would require the department to submit to the federal Centers for Medicare and Medicaid Services a request for renewal of the Assisted Living Waiver program with specified amendments. The bill would require, as part of the amendments, additional slots, as specified, in the 15 counties where the waiver program is currently in operation. The waiver amendments would also require the department to expand the program on a statewide basis, as specified. The waiver amendments would, among other things, authorize assessments to be conducted by trained individuals, visits to be conducted on an as-needed and quarterly basis, and the provision of certain accommodations to account for the needs of dementia care residents.The bill would also require the department to authorize eligibility for share-of-cost Medi-Cal beneficiaries, and to modify its provider reimbursement tier, as specified, while also maintaining the waiver programs budget-neutral provisions.The bill would condition implementation of the waiver amendments on obtaining the necessary federal approvals and on the availability of federal financial participation. The bill would require implementation of the waiver amendments to commence within 6 months of the departments receipt of authorization for the necessary resources, as specified.The bill would also make legislative findings and declarations relating to the Assisted Living Waiver program.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO
CALIFORNIA LEGISLATURE 20172018 REGULAR SESSION
Assembly Bill No. 2233
Introduced by Assembly Member KalraFebruary 13, 2018
Introduced by Assembly Member Kalra
February 13, 2018
An act to add Section 14132.265 to the Welfare and Institutions Code, relating to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
## LEGISLATIVE COUNSEL'S DIGEST
AB 2233, as introduced, Kalra. Medi-Cal: Assisted Living Waiver program.
Existing law establishes 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 requires the State Department of Health Services to develop a federal waiver program to test the efficacy of providing an assisted living benefit to beneficiaries under the Medi-Cal program. Existing law requires that the benefit include, but not be limited to, the care and supervision activities specified for residential care facilities for the elderly. Existing law requires implementation of the program only to the extent federal financial participation is available and funds are appropriated or otherwise available for the program.This bill would require the department to submit to the federal Centers for Medicare and Medicaid Services a request for renewal of the Assisted Living Waiver program with specified amendments. The bill would require, as part of the amendments, additional slots, as specified, in the 15 counties where the waiver program is currently in operation. The waiver amendments would also require the department to expand the program on a statewide basis, as specified. The waiver amendments would, among other things, authorize assessments to be conducted by trained individuals, visits to be conducted on an as-needed and quarterly basis, and the provision of certain accommodations to account for the needs of dementia care residents.The bill would also require the department to authorize eligibility for share-of-cost Medi-Cal beneficiaries, and to modify its provider reimbursement tier, as specified, while also maintaining the waiver programs budget-neutral provisions.The bill would condition implementation of the waiver amendments on obtaining the necessary federal approvals and on the availability of federal financial participation. The bill would require implementation of the waiver amendments to commence within 6 months of the departments receipt of authorization for the necessary resources, as specified.The bill would also make legislative findings and declarations relating to the Assisted Living Waiver program.
Existing law establishes 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 requires the State Department of Health Services to develop a federal waiver program to test the efficacy of providing an assisted living benefit to beneficiaries under the Medi-Cal program. Existing law requires that the benefit include, but not be limited to, the care and supervision activities specified for residential care facilities for the elderly. Existing law requires implementation of the program only to the extent federal financial participation is available and funds are appropriated or otherwise available for the program.
This bill would require the department to submit to the federal Centers for Medicare and Medicaid Services a request for renewal of the Assisted Living Waiver program with specified amendments. The bill would require, as part of the amendments, additional slots, as specified, in the 15 counties where the waiver program is currently in operation. The waiver amendments would also require the department to expand the program on a statewide basis, as specified. The waiver amendments would, among other things, authorize assessments to be conducted by trained individuals, visits to be conducted on an as-needed and quarterly basis, and the provision of certain accommodations to account for the needs of dementia care residents.
The bill would also require the department to authorize eligibility for share-of-cost Medi-Cal beneficiaries, and to modify its provider reimbursement tier, as specified, while also maintaining the waiver programs budget-neutral provisions.
The bill would condition implementation of the waiver amendments on obtaining the necessary federal approvals and on the availability of federal financial participation. The bill would require implementation of the waiver amendments to commence within 6 months of the departments receipt of authorization for the necessary resources, as specified.
The bill would also make legislative findings and declarations relating to the Assisted Living Waiver program.
## Digest Key
## Bill Text
The people of the State of California do enact as follows:SECTION 1. The Legislature finds and declares all of the following:(a) In 1999, the United States Supreme Court ruled in the case of Olmstead v. L.C. (1999) 527 U.S. 581, finding that the unnecessary institutionalization of people with disabilities is a violation of the Americans with Disabilities Act of 1990 (ADA), thereby establishing the right of individuals with disabilities to receive services in the most integrated setting.(b) To meet the intent of the Olmstead decision, it is the states obligation to ensure that individuals have access to an array of necessary services and supports that meet each persons needs and preferences, regardless of age or degree of disability.(c) The Assisted Living Waiver program has provided a valuable alternative to institutionalization for individuals who would otherwise reside in a facility but prefer to remain in a community-based setting and cannot afford the costs of assisted living. Demand for the Assisted Living Waiver program has outpaced supply and operates with a waiting list of approximately 2500 individuals across 15 counties, including the Counties of Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara, and Sonoma.(d) Despite the demand for the Assisted Living Waiver program, a number of challenges prevent the program from realizing its potential, including lack of available providers, lack of awareness of the program, low reimbursement rates that hamper provider participation, lack of availability across the remaining 43 counties that do not participate in the program, and ineffective administrative requirements.(e) According to the 2017 Long-Term Services and Supports Scorecard, almost 11 percent of Californias 101,000 nursing home residents, or 11,000 individuals, are identified as having low-care needs. These individuals could be cared for in the community, or in assisted living settings, as an alternative to institutionalization. However, for many of those individuals, either the opportunities to transition do not exist or these individuals are unaware of the alternatives.(f) As part of Californias efforts to realize its commitment to the Olmstead decision, availability of slots under the Assisted Living Waiver program should be increased, while also addressing the programmatic issues impacting its effectiveness.SEC. 2. Section 14132.265 is added to the Welfare and Institutions Code, immediately following Section 14132.26, to read:14132.265. (a) The department shall submit to the federal Centers for Medicare and Medicaid Services a request for renewal of the Assisted Living Waiver program described in Section 14132.26, with all of the following amendments to the program components:(1) Additional slots in the 15 counties where the waiver program is currently in operation. The department shall increase the number of slots beyond the currently authorized 3,700 to 10,000, to address the waiting list, while expanding the number of available slots on an annual basis. Before submission of the waiver renewal request, the department shall notify the appropriate fiscal and policy committees of the Legislature of the number of waiver slots included in the waiver renewal request along with supportive data for those slots. A report submitted to the Legislature pursuant to this paragraph shall be submitted in compliance with Section 9795 of the Government Code.(2) Geographic availability of slots on a statewide basis. The department shall expand the waiver program beyond the existing counties to enable its availability on a statewide basis. The statewide expansion shall be phased in on a scheduled basis throughout the waiver programs five-year term.(3) Administrative and provider requirements. The department shall include within the waiver renewal request all of the following provisions:(A) Authorize assessments to be conducted by trained individuals, including registered nurses, licensed vocational nurses, individuals with a Masters degree in social work, geriatric care managers, or a related field.(B) Authorize visits be conducted on an as-needed and quarterly basis, instead of a monthly basis.(C) Authorize semi-private bedrooms and bathrooms or kitchenettes in order to account for the needs of dementia care residents.(D) Consider revising the requirement that nursing staff be either on call or employed by the facility, in order to allow for greater provider participation.(4) Eligibility. The department shall permit eligibility for share-of-cost Medi-Cal beneficiaries who do not qualify for full-scope Medi-Cal eligibility.(5) Provider reimbursement. The department shall modify its provider reimbursement tier to ensure sufficient participation from providers with the daily rate for each tier not less than the rate in 201718 fiscal year, while also maintaining the waiver programs budget-neutral provisions. The provider reimbursement methodology shall include a tier specific to provision of memory care.(b) (1) The department shall implement this section only to the extent federal financial participation is available and only if any necessary federal approvals have been obtained.(2) Upon federal approval of the waiver renewal request with the amendments described in this section, implementation of the amended waiver program shall commence within six months of the department receiving authorization for the necessary resources to provide the services to additional waiver program participants.
The people of the State of California do enact as follows:
## The people of the State of California do enact as follows:
SECTION 1. The Legislature finds and declares all of the following:(a) In 1999, the United States Supreme Court ruled in the case of Olmstead v. L.C. (1999) 527 U.S. 581, finding that the unnecessary institutionalization of people with disabilities is a violation of the Americans with Disabilities Act of 1990 (ADA), thereby establishing the right of individuals with disabilities to receive services in the most integrated setting.(b) To meet the intent of the Olmstead decision, it is the states obligation to ensure that individuals have access to an array of necessary services and supports that meet each persons needs and preferences, regardless of age or degree of disability.(c) The Assisted Living Waiver program has provided a valuable alternative to institutionalization for individuals who would otherwise reside in a facility but prefer to remain in a community-based setting and cannot afford the costs of assisted living. Demand for the Assisted Living Waiver program has outpaced supply and operates with a waiting list of approximately 2500 individuals across 15 counties, including the Counties of Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara, and Sonoma.(d) Despite the demand for the Assisted Living Waiver program, a number of challenges prevent the program from realizing its potential, including lack of available providers, lack of awareness of the program, low reimbursement rates that hamper provider participation, lack of availability across the remaining 43 counties that do not participate in the program, and ineffective administrative requirements.(e) According to the 2017 Long-Term Services and Supports Scorecard, almost 11 percent of Californias 101,000 nursing home residents, or 11,000 individuals, are identified as having low-care needs. These individuals could be cared for in the community, or in assisted living settings, as an alternative to institutionalization. However, for many of those individuals, either the opportunities to transition do not exist or these individuals are unaware of the alternatives.(f) As part of Californias efforts to realize its commitment to the Olmstead decision, availability of slots under the Assisted Living Waiver program should be increased, while also addressing the programmatic issues impacting its effectiveness.
SECTION 1. The Legislature finds and declares all of the following:(a) In 1999, the United States Supreme Court ruled in the case of Olmstead v. L.C. (1999) 527 U.S. 581, finding that the unnecessary institutionalization of people with disabilities is a violation of the Americans with Disabilities Act of 1990 (ADA), thereby establishing the right of individuals with disabilities to receive services in the most integrated setting.(b) To meet the intent of the Olmstead decision, it is the states obligation to ensure that individuals have access to an array of necessary services and supports that meet each persons needs and preferences, regardless of age or degree of disability.(c) The Assisted Living Waiver program has provided a valuable alternative to institutionalization for individuals who would otherwise reside in a facility but prefer to remain in a community-based setting and cannot afford the costs of assisted living. Demand for the Assisted Living Waiver program has outpaced supply and operates with a waiting list of approximately 2500 individuals across 15 counties, including the Counties of Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara, and Sonoma.(d) Despite the demand for the Assisted Living Waiver program, a number of challenges prevent the program from realizing its potential, including lack of available providers, lack of awareness of the program, low reimbursement rates that hamper provider participation, lack of availability across the remaining 43 counties that do not participate in the program, and ineffective administrative requirements.(e) According to the 2017 Long-Term Services and Supports Scorecard, almost 11 percent of Californias 101,000 nursing home residents, or 11,000 individuals, are identified as having low-care needs. These individuals could be cared for in the community, or in assisted living settings, as an alternative to institutionalization. However, for many of those individuals, either the opportunities to transition do not exist or these individuals are unaware of the alternatives.(f) As part of Californias efforts to realize its commitment to the Olmstead decision, availability of slots under the Assisted Living Waiver program should be increased, while also addressing the programmatic issues impacting its effectiveness.
SECTION 1. The Legislature finds and declares all of the following:
### SECTION 1.
(a) In 1999, the United States Supreme Court ruled in the case of Olmstead v. L.C. (1999) 527 U.S. 581, finding that the unnecessary institutionalization of people with disabilities is a violation of the Americans with Disabilities Act of 1990 (ADA), thereby establishing the right of individuals with disabilities to receive services in the most integrated setting.
(b) To meet the intent of the Olmstead decision, it is the states obligation to ensure that individuals have access to an array of necessary services and supports that meet each persons needs and preferences, regardless of age or degree of disability.
(c) The Assisted Living Waiver program has provided a valuable alternative to institutionalization for individuals who would otherwise reside in a facility but prefer to remain in a community-based setting and cannot afford the costs of assisted living. Demand for the Assisted Living Waiver program has outpaced supply and operates with a waiting list of approximately 2500 individuals across 15 counties, including the Counties of Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara, and Sonoma.
(d) Despite the demand for the Assisted Living Waiver program, a number of challenges prevent the program from realizing its potential, including lack of available providers, lack of awareness of the program, low reimbursement rates that hamper provider participation, lack of availability across the remaining 43 counties that do not participate in the program, and ineffective administrative requirements.
(e) According to the 2017 Long-Term Services and Supports Scorecard, almost 11 percent of Californias 101,000 nursing home residents, or 11,000 individuals, are identified as having low-care needs. These individuals could be cared for in the community, or in assisted living settings, as an alternative to institutionalization. However, for many of those individuals, either the opportunities to transition do not exist or these individuals are unaware of the alternatives.
(f) As part of Californias efforts to realize its commitment to the Olmstead decision, availability of slots under the Assisted Living Waiver program should be increased, while also addressing the programmatic issues impacting its effectiveness.
SEC. 2. Section 14132.265 is added to the Welfare and Institutions Code, immediately following Section 14132.26, to read:14132.265. (a) The department shall submit to the federal Centers for Medicare and Medicaid Services a request for renewal of the Assisted Living Waiver program described in Section 14132.26, with all of the following amendments to the program components:(1) Additional slots in the 15 counties where the waiver program is currently in operation. The department shall increase the number of slots beyond the currently authorized 3,700 to 10,000, to address the waiting list, while expanding the number of available slots on an annual basis. Before submission of the waiver renewal request, the department shall notify the appropriate fiscal and policy committees of the Legislature of the number of waiver slots included in the waiver renewal request along with supportive data for those slots. A report submitted to the Legislature pursuant to this paragraph shall be submitted in compliance with Section 9795 of the Government Code.(2) Geographic availability of slots on a statewide basis. The department shall expand the waiver program beyond the existing counties to enable its availability on a statewide basis. The statewide expansion shall be phased in on a scheduled basis throughout the waiver programs five-year term.(3) Administrative and provider requirements. The department shall include within the waiver renewal request all of the following provisions:(A) Authorize assessments to be conducted by trained individuals, including registered nurses, licensed vocational nurses, individuals with a Masters degree in social work, geriatric care managers, or a related field.(B) Authorize visits be conducted on an as-needed and quarterly basis, instead of a monthly basis.(C) Authorize semi-private bedrooms and bathrooms or kitchenettes in order to account for the needs of dementia care residents.(D) Consider revising the requirement that nursing staff be either on call or employed by the facility, in order to allow for greater provider participation.(4) Eligibility. The department shall permit eligibility for share-of-cost Medi-Cal beneficiaries who do not qualify for full-scope Medi-Cal eligibility.(5) Provider reimbursement. The department shall modify its provider reimbursement tier to ensure sufficient participation from providers with the daily rate for each tier not less than the rate in 201718 fiscal year, while also maintaining the waiver programs budget-neutral provisions. The provider reimbursement methodology shall include a tier specific to provision of memory care.(b) (1) The department shall implement this section only to the extent federal financial participation is available and only if any necessary federal approvals have been obtained.(2) Upon federal approval of the waiver renewal request with the amendments described in this section, implementation of the amended waiver program shall commence within six months of the department receiving authorization for the necessary resources to provide the services to additional waiver program participants.
SEC. 2. Section 14132.265 is added to the Welfare and Institutions Code, immediately following Section 14132.26, to read:
### SEC. 2.
14132.265. (a) The department shall submit to the federal Centers for Medicare and Medicaid Services a request for renewal of the Assisted Living Waiver program described in Section 14132.26, with all of the following amendments to the program components:(1) Additional slots in the 15 counties where the waiver program is currently in operation. The department shall increase the number of slots beyond the currently authorized 3,700 to 10,000, to address the waiting list, while expanding the number of available slots on an annual basis. Before submission of the waiver renewal request, the department shall notify the appropriate fiscal and policy committees of the Legislature of the number of waiver slots included in the waiver renewal request along with supportive data for those slots. A report submitted to the Legislature pursuant to this paragraph shall be submitted in compliance with Section 9795 of the Government Code.(2) Geographic availability of slots on a statewide basis. The department shall expand the waiver program beyond the existing counties to enable its availability on a statewide basis. The statewide expansion shall be phased in on a scheduled basis throughout the waiver programs five-year term.(3) Administrative and provider requirements. The department shall include within the waiver renewal request all of the following provisions:(A) Authorize assessments to be conducted by trained individuals, including registered nurses, licensed vocational nurses, individuals with a Masters degree in social work, geriatric care managers, or a related field.(B) Authorize visits be conducted on an as-needed and quarterly basis, instead of a monthly basis.(C) Authorize semi-private bedrooms and bathrooms or kitchenettes in order to account for the needs of dementia care residents.(D) Consider revising the requirement that nursing staff be either on call or employed by the facility, in order to allow for greater provider participation.(4) Eligibility. The department shall permit eligibility for share-of-cost Medi-Cal beneficiaries who do not qualify for full-scope Medi-Cal eligibility.(5) Provider reimbursement. The department shall modify its provider reimbursement tier to ensure sufficient participation from providers with the daily rate for each tier not less than the rate in 201718 fiscal year, while also maintaining the waiver programs budget-neutral provisions. The provider reimbursement methodology shall include a tier specific to provision of memory care.(b) (1) The department shall implement this section only to the extent federal financial participation is available and only if any necessary federal approvals have been obtained.(2) Upon federal approval of the waiver renewal request with the amendments described in this section, implementation of the amended waiver program shall commence within six months of the department receiving authorization for the necessary resources to provide the services to additional waiver program participants.
14132.265. (a) The department shall submit to the federal Centers for Medicare and Medicaid Services a request for renewal of the Assisted Living Waiver program described in Section 14132.26, with all of the following amendments to the program components:(1) Additional slots in the 15 counties where the waiver program is currently in operation. The department shall increase the number of slots beyond the currently authorized 3,700 to 10,000, to address the waiting list, while expanding the number of available slots on an annual basis. Before submission of the waiver renewal request, the department shall notify the appropriate fiscal and policy committees of the Legislature of the number of waiver slots included in the waiver renewal request along with supportive data for those slots. A report submitted to the Legislature pursuant to this paragraph shall be submitted in compliance with Section 9795 of the Government Code.(2) Geographic availability of slots on a statewide basis. The department shall expand the waiver program beyond the existing counties to enable its availability on a statewide basis. The statewide expansion shall be phased in on a scheduled basis throughout the waiver programs five-year term.(3) Administrative and provider requirements. The department shall include within the waiver renewal request all of the following provisions:(A) Authorize assessments to be conducted by trained individuals, including registered nurses, licensed vocational nurses, individuals with a Masters degree in social work, geriatric care managers, or a related field.(B) Authorize visits be conducted on an as-needed and quarterly basis, instead of a monthly basis.(C) Authorize semi-private bedrooms and bathrooms or kitchenettes in order to account for the needs of dementia care residents.(D) Consider revising the requirement that nursing staff be either on call or employed by the facility, in order to allow for greater provider participation.(4) Eligibility. The department shall permit eligibility for share-of-cost Medi-Cal beneficiaries who do not qualify for full-scope Medi-Cal eligibility.(5) Provider reimbursement. The department shall modify its provider reimbursement tier to ensure sufficient participation from providers with the daily rate for each tier not less than the rate in 201718 fiscal year, while also maintaining the waiver programs budget-neutral provisions. The provider reimbursement methodology shall include a tier specific to provision of memory care.(b) (1) The department shall implement this section only to the extent federal financial participation is available and only if any necessary federal approvals have been obtained.(2) Upon federal approval of the waiver renewal request with the amendments described in this section, implementation of the amended waiver program shall commence within six months of the department receiving authorization for the necessary resources to provide the services to additional waiver program participants.
14132.265. (a) The department shall submit to the federal Centers for Medicare and Medicaid Services a request for renewal of the Assisted Living Waiver program described in Section 14132.26, with all of the following amendments to the program components:(1) Additional slots in the 15 counties where the waiver program is currently in operation. The department shall increase the number of slots beyond the currently authorized 3,700 to 10,000, to address the waiting list, while expanding the number of available slots on an annual basis. Before submission of the waiver renewal request, the department shall notify the appropriate fiscal and policy committees of the Legislature of the number of waiver slots included in the waiver renewal request along with supportive data for those slots. A report submitted to the Legislature pursuant to this paragraph shall be submitted in compliance with Section 9795 of the Government Code.(2) Geographic availability of slots on a statewide basis. The department shall expand the waiver program beyond the existing counties to enable its availability on a statewide basis. The statewide expansion shall be phased in on a scheduled basis throughout the waiver programs five-year term.(3) Administrative and provider requirements. The department shall include within the waiver renewal request all of the following provisions:(A) Authorize assessments to be conducted by trained individuals, including registered nurses, licensed vocational nurses, individuals with a Masters degree in social work, geriatric care managers, or a related field.(B) Authorize visits be conducted on an as-needed and quarterly basis, instead of a monthly basis.(C) Authorize semi-private bedrooms and bathrooms or kitchenettes in order to account for the needs of dementia care residents.(D) Consider revising the requirement that nursing staff be either on call or employed by the facility, in order to allow for greater provider participation.(4) Eligibility. The department shall permit eligibility for share-of-cost Medi-Cal beneficiaries who do not qualify for full-scope Medi-Cal eligibility.(5) Provider reimbursement. The department shall modify its provider reimbursement tier to ensure sufficient participation from providers with the daily rate for each tier not less than the rate in 201718 fiscal year, while also maintaining the waiver programs budget-neutral provisions. The provider reimbursement methodology shall include a tier specific to provision of memory care.(b) (1) The department shall implement this section only to the extent federal financial participation is available and only if any necessary federal approvals have been obtained.(2) Upon federal approval of the waiver renewal request with the amendments described in this section, implementation of the amended waiver program shall commence within six months of the department receiving authorization for the necessary resources to provide the services to additional waiver program participants.
14132.265. (a) The department shall submit to the federal Centers for Medicare and Medicaid Services a request for renewal of the Assisted Living Waiver program described in Section 14132.26, with all of the following amendments to the program components:
(1) Additional slots in the 15 counties where the waiver program is currently in operation. The department shall increase the number of slots beyond the currently authorized 3,700 to 10,000, to address the waiting list, while expanding the number of available slots on an annual basis. Before submission of the waiver renewal request, the department shall notify the appropriate fiscal and policy committees of the Legislature of the number of waiver slots included in the waiver renewal request along with supportive data for those slots. A report submitted to the Legislature pursuant to this paragraph shall be submitted in compliance with Section 9795 of the Government Code.
(2) Geographic availability of slots on a statewide basis. The department shall expand the waiver program beyond the existing counties to enable its availability on a statewide basis. The statewide expansion shall be phased in on a scheduled basis throughout the waiver programs five-year term.
(3) Administrative and provider requirements. The department shall include within the waiver renewal request all of the following provisions:
(A) Authorize assessments to be conducted by trained individuals, including registered nurses, licensed vocational nurses, individuals with a Masters degree in social work, geriatric care managers, or a related field.
(B) Authorize visits be conducted on an as-needed and quarterly basis, instead of a monthly basis.
(C) Authorize semi-private bedrooms and bathrooms or kitchenettes in order to account for the needs of dementia care residents.
(D) Consider revising the requirement that nursing staff be either on call or employed by the facility, in order to allow for greater provider participation.
(4) Eligibility. The department shall permit eligibility for share-of-cost Medi-Cal beneficiaries who do not qualify for full-scope Medi-Cal eligibility.
(5) Provider reimbursement. The department shall modify its provider reimbursement tier to ensure sufficient participation from providers with the daily rate for each tier not less than the rate in 201718 fiscal year, while also maintaining the waiver programs budget-neutral provisions. The provider reimbursement methodology shall include a tier specific to provision of memory care.
(b) (1) The department shall implement this section only to the extent federal financial participation is available and only if any necessary federal approvals have been obtained.
(2) Upon federal approval of the waiver renewal request with the amendments described in this section, implementation of the amended waiver program shall commence within six months of the department receiving authorization for the necessary resources to provide the services to additional waiver program participants.