| 1 | 1 | | CALIFORNIA LEGISLATURE 20192020 REGULAR SESSION Assembly Bill No. 2409Introduced by Assembly Member KalraFebruary 18, 2020 An act to add Sections 14132.265 and 14132.266 to the Welfare and Institutions Code, relating to Medi-Cal.LEGISLATIVE COUNSEL'S DIGESTAB 2409, 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 Care Services to develop a federal waiver program, known as the Assisted Living 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 the care and supervision activities specified for residential care facilities for the elderly, and conditions the implementation of the program to the extent federal financial participation is available and funds are appropriated or otherwise available for the program.This bill would, subject to the department obtaining federal approval and on the availability of federal financial participation, require the department to submit to the federal Centers for Medicare and Medicaid Services a request for an amendment of the Assisted Living Waiver program to increase its provider reimbursement tiers to compensate for mandatory minimum wage increases. The bill would require the department, before submitting the waiver amendment request, to conduct open in-person meetings with stakeholders, and to release a draft of the proposed waiver amendments for stakeholder comment. The bill would require the department to establish requirements and procedures to allow a person on the Assisted Living Waiver programs waiting list to know their position on the waiting list. If the Assisted Living Waiver program is combined with, or converted to, another program or programs providing for Medicaid home and community-based services, the bill would require these requirements to apply to the combined or converted 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. 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 an amendment of the Assisted Living Waiver program, as described in Section 14132.26, to increase its provider reimbursement tiers to compensate for mandatory minimum wage increases that came into effect in 2007, 2008, 2014, and 2016, that were not reflected in the reimbursement tiers. The department shall continue to adjust the reimbursement tiers to compensate for future mandatory minimum wage increases to ensure sufficient participation from providers.(b) 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.SEC. 2. Section 14132.266 is added to the Welfare and Institutions Code, to read:14132.266. (a) The department shall establish requirements and procedures to ensure that any person on the Assisted Living Waiver programs waiting list each month is able to know their position on the waiting list and when they are likely to reach the top of the waiting list. The department shall clearly indicate methodologies and prioritizations used in selecting persons from the waiting list, including any priorities based on imminent risk of institutionalization, current residence in a nursing home, care needs, or county of residence. If the Assisted Living Waiver program is combined with, or converted to, another program or programs providing for Medicaid home and community-based services, the requirements of this subdivision shall apply to the combined or converted program.(b) (1) As part of the federal waiver application or renewal process for the Assisted Living Waiver program, the department shall conduct open in-person meetings in the northern, central, and southern areas of the state with stakeholders, including consumers, providers, and families of consumers, and shall receive input on the design and oversight of the program. The department shall also seek written feedback from stakeholders. The department shall give at least a 30-day notice of each of the in-person meetings, and at least a 30-day notice of the opportunity to submit written feedback.(2) Before submitting a waiver application or renewal request, the department shall notify the public and release a draft of the proposed application or renewal request for stakeholder comment. The release of the draft shall allow for at least a 30-day comment period, and shall precede the submission of the application or renewal request to the federal Centers for Medicare and Medicaid Services by at least 60 days. Upon submitting an application or renewal request to the federal Centers for Medicare and Medicaid Services, the department shall concurrently notify the public and release a copy of the application or renewal request.(3) If the Assisted Living Waiver program is combined with, or converted to, another program or programs providing for Medicaid home and community-based services, the requirements of this subdivision shall apply to the combined or converted program. |
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| 3 | 3 | | CALIFORNIA LEGISLATURE 20192020 REGULAR SESSION Assembly Bill No. 2409Introduced by Assembly Member KalraFebruary 18, 2020 An act to add Sections 14132.265 and 14132.266 to the Welfare and Institutions Code, relating to Medi-Cal.LEGISLATIVE COUNSEL'S DIGESTAB 2409, 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 Care Services to develop a federal waiver program, known as the Assisted Living 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 the care and supervision activities specified for residential care facilities for the elderly, and conditions the implementation of the program to the extent federal financial participation is available and funds are appropriated or otherwise available for the program.This bill would, subject to the department obtaining federal approval and on the availability of federal financial participation, require the department to submit to the federal Centers for Medicare and Medicaid Services a request for an amendment of the Assisted Living Waiver program to increase its provider reimbursement tiers to compensate for mandatory minimum wage increases. The bill would require the department, before submitting the waiver amendment request, to conduct open in-person meetings with stakeholders, and to release a draft of the proposed waiver amendments for stakeholder comment. The bill would require the department to establish requirements and procedures to allow a person on the Assisted Living Waiver programs waiting list to know their position on the waiting list. If the Assisted Living Waiver program is combined with, or converted to, another program or programs providing for Medicaid home and community-based services, the bill would require these requirements to apply to the combined or converted program.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO |
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| 9 | 9 | | CALIFORNIA LEGISLATURE 20192020 REGULAR SESSION |
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| 11 | 11 | | Assembly Bill |
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| 13 | 13 | | No. 2409 |
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| 15 | 15 | | Introduced by Assembly Member KalraFebruary 18, 2020 |
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| 17 | 17 | | Introduced by Assembly Member Kalra |
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| 18 | 18 | | February 18, 2020 |
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| 19 | 19 | | |
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| 20 | 20 | | An act to add Sections 14132.265 and 14132.266 to the Welfare and Institutions Code, relating to Medi-Cal. |
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| 21 | 21 | | |
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| 22 | 22 | | LEGISLATIVE COUNSEL'S DIGEST |
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| 23 | 23 | | |
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| 24 | 24 | | ## LEGISLATIVE COUNSEL'S DIGEST |
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| 25 | 25 | | |
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| 26 | 26 | | AB 2409, as introduced, Kalra. Medi-Cal: Assisted Living Waiver program. |
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| 27 | 27 | | |
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| 28 | 28 | | 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 Care Services to develop a federal waiver program, known as the Assisted Living 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 the care and supervision activities specified for residential care facilities for the elderly, and conditions the implementation of the program to the extent federal financial participation is available and funds are appropriated or otherwise available for the program.This bill would, subject to the department obtaining federal approval and on the availability of federal financial participation, require the department to submit to the federal Centers for Medicare and Medicaid Services a request for an amendment of the Assisted Living Waiver program to increase its provider reimbursement tiers to compensate for mandatory minimum wage increases. The bill would require the department, before submitting the waiver amendment request, to conduct open in-person meetings with stakeholders, and to release a draft of the proposed waiver amendments for stakeholder comment. The bill would require the department to establish requirements and procedures to allow a person on the Assisted Living Waiver programs waiting list to know their position on the waiting list. If the Assisted Living Waiver program is combined with, or converted to, another program or programs providing for Medicaid home and community-based services, the bill would require these requirements to apply to the combined or converted program. |
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| 30 | 30 | | 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. |
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| 31 | 31 | | |
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| 32 | 32 | | Existing law requires the State Department of Health Care Services to develop a federal waiver program, known as the Assisted Living 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 the care and supervision activities specified for residential care facilities for the elderly, and conditions the implementation of the program to the extent federal financial participation is available and funds are appropriated or otherwise available for the program. |
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| 33 | 33 | | |
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| 34 | 34 | | This bill would, subject to the department obtaining federal approval and on the availability of federal financial participation, require the department to submit to the federal Centers for Medicare and Medicaid Services a request for an amendment of the Assisted Living Waiver program to increase its provider reimbursement tiers to compensate for mandatory minimum wage increases. The bill would require the department, before submitting the waiver amendment request, to conduct open in-person meetings with stakeholders, and to release a draft of the proposed waiver amendments for stakeholder comment. The bill would require the department to establish requirements and procedures to allow a person on the Assisted Living Waiver programs waiting list to know their position on the waiting list. If the Assisted Living Waiver program is combined with, or converted to, another program or programs providing for Medicaid home and community-based services, the bill would require these requirements to apply to the combined or converted program. |
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| 35 | 35 | | |
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| 36 | 36 | | ## Digest Key |
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| 38 | 38 | | ## Bill Text |
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| 40 | 40 | | The people of the State of California do enact as follows:SECTION 1. 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 an amendment of the Assisted Living Waiver program, as described in Section 14132.26, to increase its provider reimbursement tiers to compensate for mandatory minimum wage increases that came into effect in 2007, 2008, 2014, and 2016, that were not reflected in the reimbursement tiers. The department shall continue to adjust the reimbursement tiers to compensate for future mandatory minimum wage increases to ensure sufficient participation from providers.(b) 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.SEC. 2. Section 14132.266 is added to the Welfare and Institutions Code, to read:14132.266. (a) The department shall establish requirements and procedures to ensure that any person on the Assisted Living Waiver programs waiting list each month is able to know their position on the waiting list and when they are likely to reach the top of the waiting list. The department shall clearly indicate methodologies and prioritizations used in selecting persons from the waiting list, including any priorities based on imminent risk of institutionalization, current residence in a nursing home, care needs, or county of residence. If the Assisted Living Waiver program is combined with, or converted to, another program or programs providing for Medicaid home and community-based services, the requirements of this subdivision shall apply to the combined or converted program.(b) (1) As part of the federal waiver application or renewal process for the Assisted Living Waiver program, the department shall conduct open in-person meetings in the northern, central, and southern areas of the state with stakeholders, including consumers, providers, and families of consumers, and shall receive input on the design and oversight of the program. The department shall also seek written feedback from stakeholders. The department shall give at least a 30-day notice of each of the in-person meetings, and at least a 30-day notice of the opportunity to submit written feedback.(2) Before submitting a waiver application or renewal request, the department shall notify the public and release a draft of the proposed application or renewal request for stakeholder comment. The release of the draft shall allow for at least a 30-day comment period, and shall precede the submission of the application or renewal request to the federal Centers for Medicare and Medicaid Services by at least 60 days. Upon submitting an application or renewal request to the federal Centers for Medicare and Medicaid Services, the department shall concurrently notify the public and release a copy of the application or renewal request.(3) If the Assisted Living Waiver program is combined with, or converted to, another program or programs providing for Medicaid home and community-based services, the requirements of this subdivision shall apply to the combined or converted program. |
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| 42 | 42 | | The people of the State of California do enact as follows: |
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| 44 | 44 | | ## The people of the State of California do enact as follows: |
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| 46 | 46 | | SECTION 1. 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 an amendment of the Assisted Living Waiver program, as described in Section 14132.26, to increase its provider reimbursement tiers to compensate for mandatory minimum wage increases that came into effect in 2007, 2008, 2014, and 2016, that were not reflected in the reimbursement tiers. The department shall continue to adjust the reimbursement tiers to compensate for future mandatory minimum wage increases to ensure sufficient participation from providers.(b) 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. |
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| 48 | 48 | | SECTION 1. Section 14132.265 is added to the Welfare and Institutions Code, immediately following Section 14132.26, to read: |
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| 49 | 49 | | |
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| 50 | 50 | | ### SECTION 1. |
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| 51 | 51 | | |
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| 52 | 52 | | 14132.265. (a) The department shall submit to the federal Centers for Medicare and Medicaid Services a request for an amendment of the Assisted Living Waiver program, as described in Section 14132.26, to increase its provider reimbursement tiers to compensate for mandatory minimum wage increases that came into effect in 2007, 2008, 2014, and 2016, that were not reflected in the reimbursement tiers. The department shall continue to adjust the reimbursement tiers to compensate for future mandatory minimum wage increases to ensure sufficient participation from providers.(b) 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. |
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| 53 | 53 | | |
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| 54 | 54 | | 14132.265. (a) The department shall submit to the federal Centers for Medicare and Medicaid Services a request for an amendment of the Assisted Living Waiver program, as described in Section 14132.26, to increase its provider reimbursement tiers to compensate for mandatory minimum wage increases that came into effect in 2007, 2008, 2014, and 2016, that were not reflected in the reimbursement tiers. The department shall continue to adjust the reimbursement tiers to compensate for future mandatory minimum wage increases to ensure sufficient participation from providers.(b) 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. |
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| 56 | 56 | | 14132.265. (a) The department shall submit to the federal Centers for Medicare and Medicaid Services a request for an amendment of the Assisted Living Waiver program, as described in Section 14132.26, to increase its provider reimbursement tiers to compensate for mandatory minimum wage increases that came into effect in 2007, 2008, 2014, and 2016, that were not reflected in the reimbursement tiers. The department shall continue to adjust the reimbursement tiers to compensate for future mandatory minimum wage increases to ensure sufficient participation from providers.(b) 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. |
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| 60 | 60 | | 14132.265. (a) The department shall submit to the federal Centers for Medicare and Medicaid Services a request for an amendment of the Assisted Living Waiver program, as described in Section 14132.26, to increase its provider reimbursement tiers to compensate for mandatory minimum wage increases that came into effect in 2007, 2008, 2014, and 2016, that were not reflected in the reimbursement tiers. The department shall continue to adjust the reimbursement tiers to compensate for future mandatory minimum wage increases to ensure sufficient participation from providers. |
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| 62 | 62 | | (b) 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. |
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| 63 | 63 | | |
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| 64 | 64 | | SEC. 2. Section 14132.266 is added to the Welfare and Institutions Code, to read:14132.266. (a) The department shall establish requirements and procedures to ensure that any person on the Assisted Living Waiver programs waiting list each month is able to know their position on the waiting list and when they are likely to reach the top of the waiting list. The department shall clearly indicate methodologies and prioritizations used in selecting persons from the waiting list, including any priorities based on imminent risk of institutionalization, current residence in a nursing home, care needs, or county of residence. If the Assisted Living Waiver program is combined with, or converted to, another program or programs providing for Medicaid home and community-based services, the requirements of this subdivision shall apply to the combined or converted program.(b) (1) As part of the federal waiver application or renewal process for the Assisted Living Waiver program, the department shall conduct open in-person meetings in the northern, central, and southern areas of the state with stakeholders, including consumers, providers, and families of consumers, and shall receive input on the design and oversight of the program. The department shall also seek written feedback from stakeholders. The department shall give at least a 30-day notice of each of the in-person meetings, and at least a 30-day notice of the opportunity to submit written feedback.(2) Before submitting a waiver application or renewal request, the department shall notify the public and release a draft of the proposed application or renewal request for stakeholder comment. The release of the draft shall allow for at least a 30-day comment period, and shall precede the submission of the application or renewal request to the federal Centers for Medicare and Medicaid Services by at least 60 days. Upon submitting an application or renewal request to the federal Centers for Medicare and Medicaid Services, the department shall concurrently notify the public and release a copy of the application or renewal request.(3) If the Assisted Living Waiver program is combined with, or converted to, another program or programs providing for Medicaid home and community-based services, the requirements of this subdivision shall apply to the combined or converted program. |
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| 66 | 66 | | SEC. 2. Section 14132.266 is added to the Welfare and Institutions Code, to read: |
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| 68 | 68 | | ### SEC. 2. |
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| 70 | 70 | | 14132.266. (a) The department shall establish requirements and procedures to ensure that any person on the Assisted Living Waiver programs waiting list each month is able to know their position on the waiting list and when they are likely to reach the top of the waiting list. The department shall clearly indicate methodologies and prioritizations used in selecting persons from the waiting list, including any priorities based on imminent risk of institutionalization, current residence in a nursing home, care needs, or county of residence. If the Assisted Living Waiver program is combined with, or converted to, another program or programs providing for Medicaid home and community-based services, the requirements of this subdivision shall apply to the combined or converted program.(b) (1) As part of the federal waiver application or renewal process for the Assisted Living Waiver program, the department shall conduct open in-person meetings in the northern, central, and southern areas of the state with stakeholders, including consumers, providers, and families of consumers, and shall receive input on the design and oversight of the program. The department shall also seek written feedback from stakeholders. The department shall give at least a 30-day notice of each of the in-person meetings, and at least a 30-day notice of the opportunity to submit written feedback.(2) Before submitting a waiver application or renewal request, the department shall notify the public and release a draft of the proposed application or renewal request for stakeholder comment. The release of the draft shall allow for at least a 30-day comment period, and shall precede the submission of the application or renewal request to the federal Centers for Medicare and Medicaid Services by at least 60 days. Upon submitting an application or renewal request to the federal Centers for Medicare and Medicaid Services, the department shall concurrently notify the public and release a copy of the application or renewal request.(3) If the Assisted Living Waiver program is combined with, or converted to, another program or programs providing for Medicaid home and community-based services, the requirements of this subdivision shall apply to the combined or converted program. |
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| 72 | 72 | | 14132.266. (a) The department shall establish requirements and procedures to ensure that any person on the Assisted Living Waiver programs waiting list each month is able to know their position on the waiting list and when they are likely to reach the top of the waiting list. The department shall clearly indicate methodologies and prioritizations used in selecting persons from the waiting list, including any priorities based on imminent risk of institutionalization, current residence in a nursing home, care needs, or county of residence. If the Assisted Living Waiver program is combined with, or converted to, another program or programs providing for Medicaid home and community-based services, the requirements of this subdivision shall apply to the combined or converted program.(b) (1) As part of the federal waiver application or renewal process for the Assisted Living Waiver program, the department shall conduct open in-person meetings in the northern, central, and southern areas of the state with stakeholders, including consumers, providers, and families of consumers, and shall receive input on the design and oversight of the program. The department shall also seek written feedback from stakeholders. The department shall give at least a 30-day notice of each of the in-person meetings, and at least a 30-day notice of the opportunity to submit written feedback.(2) Before submitting a waiver application or renewal request, the department shall notify the public and release a draft of the proposed application or renewal request for stakeholder comment. The release of the draft shall allow for at least a 30-day comment period, and shall precede the submission of the application or renewal request to the federal Centers for Medicare and Medicaid Services by at least 60 days. Upon submitting an application or renewal request to the federal Centers for Medicare and Medicaid Services, the department shall concurrently notify the public and release a copy of the application or renewal request.(3) If the Assisted Living Waiver program is combined with, or converted to, another program or programs providing for Medicaid home and community-based services, the requirements of this subdivision shall apply to the combined or converted program. |
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| 74 | 74 | | 14132.266. (a) The department shall establish requirements and procedures to ensure that any person on the Assisted Living Waiver programs waiting list each month is able to know their position on the waiting list and when they are likely to reach the top of the waiting list. The department shall clearly indicate methodologies and prioritizations used in selecting persons from the waiting list, including any priorities based on imminent risk of institutionalization, current residence in a nursing home, care needs, or county of residence. If the Assisted Living Waiver program is combined with, or converted to, another program or programs providing for Medicaid home and community-based services, the requirements of this subdivision shall apply to the combined or converted program.(b) (1) As part of the federal waiver application or renewal process for the Assisted Living Waiver program, the department shall conduct open in-person meetings in the northern, central, and southern areas of the state with stakeholders, including consumers, providers, and families of consumers, and shall receive input on the design and oversight of the program. The department shall also seek written feedback from stakeholders. The department shall give at least a 30-day notice of each of the in-person meetings, and at least a 30-day notice of the opportunity to submit written feedback.(2) Before submitting a waiver application or renewal request, the department shall notify the public and release a draft of the proposed application or renewal request for stakeholder comment. The release of the draft shall allow for at least a 30-day comment period, and shall precede the submission of the application or renewal request to the federal Centers for Medicare and Medicaid Services by at least 60 days. Upon submitting an application or renewal request to the federal Centers for Medicare and Medicaid Services, the department shall concurrently notify the public and release a copy of the application or renewal request.(3) If the Assisted Living Waiver program is combined with, or converted to, another program or programs providing for Medicaid home and community-based services, the requirements of this subdivision shall apply to the combined or converted program. |
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| 78 | 78 | | 14132.266. (a) The department shall establish requirements and procedures to ensure that any person on the Assisted Living Waiver programs waiting list each month is able to know their position on the waiting list and when they are likely to reach the top of the waiting list. The department shall clearly indicate methodologies and prioritizations used in selecting persons from the waiting list, including any priorities based on imminent risk of institutionalization, current residence in a nursing home, care needs, or county of residence. If the Assisted Living Waiver program is combined with, or converted to, another program or programs providing for Medicaid home and community-based services, the requirements of this subdivision shall apply to the combined or converted program. |
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| 80 | 80 | | (b) (1) As part of the federal waiver application or renewal process for the Assisted Living Waiver program, the department shall conduct open in-person meetings in the northern, central, and southern areas of the state with stakeholders, including consumers, providers, and families of consumers, and shall receive input on the design and oversight of the program. The department shall also seek written feedback from stakeholders. The department shall give at least a 30-day notice of each of the in-person meetings, and at least a 30-day notice of the opportunity to submit written feedback. |
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| 82 | 82 | | (2) Before submitting a waiver application or renewal request, the department shall notify the public and release a draft of the proposed application or renewal request for stakeholder comment. The release of the draft shall allow for at least a 30-day comment period, and shall precede the submission of the application or renewal request to the federal Centers for Medicare and Medicaid Services by at least 60 days. Upon submitting an application or renewal request to the federal Centers for Medicare and Medicaid Services, the department shall concurrently notify the public and release a copy of the application or renewal request. |
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| 84 | 84 | | (3) If the Assisted Living Waiver program is combined with, or converted to, another program or programs providing for Medicaid home and community-based services, the requirements of this subdivision shall apply to the combined or converted program. |
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