CALIFORNIA LEGISLATURE 20192020 REGULAR SESSION Assembly Bill No. 781Introduced by Assembly Member MaienscheinFebruary 19, 2019 An act to amend Section 14132.10 of the Welfare and Institutions Code, relating to Medi-Cal. LEGISLATIVE COUNSEL'S DIGESTAB 781, as introduced, Maienschein. Medi-Cal: family respite care.Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive healthcare services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law provides that pediatric day healthcare is a covered benefit under the Medi-Cal program and that pediatric day healthcare does not include inpatient long-term care or family respite care.This bill would specify that pediatric day healthcare services may be provided at any time of the day and on any day of the week, so long as the total number of authorized hours is not exceeded.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: NO Local Program: NO Bill TextThe people of the State of California do enact as follows:SECTION 1. Section 14132.10 of the Welfare and Institutions Code is amended to read:14132.10. (a) (1) Pediatric day health care healthcare provided by a health facility licensed under paragraph (11) of subdivision (a) of Section 1250.1 of the Health and Safety Code is a covered benefit under this chapter subject to terms, conditions, and utilization controls developed by the department. Pediatric day care daycare does not include inpatient long-term care or family respite care.(2) Pediatric day healthcare services may be provided at any time of the day and on any day of the week, so long as the total number of authorized hours is not exceeded.(b) The department shall publish emergency regulations for pediatric day health care healthcare services by October 1, 1997. These regulations shall reimburse providers at a rate that shall be determined by the department, consistent with efficiency, economy, and quality of care until a new rate is determined on the basis of a cost study conducted by the department.(c) Coverage for pediatric day health care healthcare services shall be available only to the extent that no additional net program costs are incurred.(d) The department shall not approve a request for authorization of pediatric day health care healthcare when the beneficiary for whom the authorization is requested is an inpatient in a licensed health care healthcare facility.(e) The department shall not approve a request for authorization of pediatric day care daycare if the department determines that the total cost incurred by the Medi-Cal program for providing pediatric day health care healthcare services and all other medically necessary services to the individual beneficiary is greater than the total cost incurred by the Medi-Cal program in providing medically equivalent services at the beneficiarys otherwise appropriate level of institutional or home care.(f) Coverage for pediatric day health care healthcare services shall be available only to the extent that federal financial participation in the cost of providing these services is available pursuant to a federally approved state plan amendment including those services as a Medi-Cal program benefit.
CALIFORNIA LEGISLATURE 20192020 REGULAR SESSION Assembly Bill No. 781Introduced by Assembly Member MaienscheinFebruary 19, 2019 An act to amend Section 14132.10 of the Welfare and Institutions Code, relating to Medi-Cal. LEGISLATIVE COUNSEL'S DIGESTAB 781, as introduced, Maienschein. Medi-Cal: family respite care.Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive healthcare services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law provides that pediatric day healthcare is a covered benefit under the Medi-Cal program and that pediatric day healthcare does not include inpatient long-term care or family respite care.This bill would specify that pediatric day healthcare services may be provided at any time of the day and on any day of the week, so long as the total number of authorized hours is not exceeded.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: NO Local Program: NO
CALIFORNIA LEGISLATURE 20192020 REGULAR SESSION
Assembly Bill No. 781
Introduced by Assembly Member MaienscheinFebruary 19, 2019
Introduced by Assembly Member Maienschein
February 19, 2019
An act to amend Section 14132.10 of the Welfare and Institutions Code, relating to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
## LEGISLATIVE COUNSEL'S DIGEST
AB 781, as introduced, Maienschein. Medi-Cal: family respite care.
Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive healthcare services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law provides that pediatric day healthcare is a covered benefit under the Medi-Cal program and that pediatric day healthcare does not include inpatient long-term care or family respite care.This bill would specify that pediatric day healthcare services may be provided at any time of the day and on any day of the week, so long as the total number of authorized hours is not exceeded.
Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive healthcare services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law provides that pediatric day healthcare is a covered benefit under the Medi-Cal program and that pediatric day healthcare does not include inpatient long-term care or family respite care.
This bill would specify that pediatric day healthcare services may be provided at any time of the day and on any day of the week, so long as the total number of authorized hours is not exceeded.
## Digest Key
## Bill Text
The people of the State of California do enact as follows:SECTION 1. Section 14132.10 of the Welfare and Institutions Code is amended to read:14132.10. (a) (1) Pediatric day health care healthcare provided by a health facility licensed under paragraph (11) of subdivision (a) of Section 1250.1 of the Health and Safety Code is a covered benefit under this chapter subject to terms, conditions, and utilization controls developed by the department. Pediatric day care daycare does not include inpatient long-term care or family respite care.(2) Pediatric day healthcare services may be provided at any time of the day and on any day of the week, so long as the total number of authorized hours is not exceeded.(b) The department shall publish emergency regulations for pediatric day health care healthcare services by October 1, 1997. These regulations shall reimburse providers at a rate that shall be determined by the department, consistent with efficiency, economy, and quality of care until a new rate is determined on the basis of a cost study conducted by the department.(c) Coverage for pediatric day health care healthcare services shall be available only to the extent that no additional net program costs are incurred.(d) The department shall not approve a request for authorization of pediatric day health care healthcare when the beneficiary for whom the authorization is requested is an inpatient in a licensed health care healthcare facility.(e) The department shall not approve a request for authorization of pediatric day care daycare if the department determines that the total cost incurred by the Medi-Cal program for providing pediatric day health care healthcare services and all other medically necessary services to the individual beneficiary is greater than the total cost incurred by the Medi-Cal program in providing medically equivalent services at the beneficiarys otherwise appropriate level of institutional or home care.(f) Coverage for pediatric day health care healthcare services shall be available only to the extent that federal financial participation in the cost of providing these services is available pursuant to a federally approved state plan amendment including those services as a Medi-Cal program benefit.
The people of the State of California do enact as follows:
## The people of the State of California do enact as follows:
SECTION 1. Section 14132.10 of the Welfare and Institutions Code is amended to read:14132.10. (a) (1) Pediatric day health care healthcare provided by a health facility licensed under paragraph (11) of subdivision (a) of Section 1250.1 of the Health and Safety Code is a covered benefit under this chapter subject to terms, conditions, and utilization controls developed by the department. Pediatric day care daycare does not include inpatient long-term care or family respite care.(2) Pediatric day healthcare services may be provided at any time of the day and on any day of the week, so long as the total number of authorized hours is not exceeded.(b) The department shall publish emergency regulations for pediatric day health care healthcare services by October 1, 1997. These regulations shall reimburse providers at a rate that shall be determined by the department, consistent with efficiency, economy, and quality of care until a new rate is determined on the basis of a cost study conducted by the department.(c) Coverage for pediatric day health care healthcare services shall be available only to the extent that no additional net program costs are incurred.(d) The department shall not approve a request for authorization of pediatric day health care healthcare when the beneficiary for whom the authorization is requested is an inpatient in a licensed health care healthcare facility.(e) The department shall not approve a request for authorization of pediatric day care daycare if the department determines that the total cost incurred by the Medi-Cal program for providing pediatric day health care healthcare services and all other medically necessary services to the individual beneficiary is greater than the total cost incurred by the Medi-Cal program in providing medically equivalent services at the beneficiarys otherwise appropriate level of institutional or home care.(f) Coverage for pediatric day health care healthcare services shall be available only to the extent that federal financial participation in the cost of providing these services is available pursuant to a federally approved state plan amendment including those services as a Medi-Cal program benefit.
SECTION 1. Section 14132.10 of the Welfare and Institutions Code is amended to read:
### SECTION 1.
14132.10. (a) (1) Pediatric day health care healthcare provided by a health facility licensed under paragraph (11) of subdivision (a) of Section 1250.1 of the Health and Safety Code is a covered benefit under this chapter subject to terms, conditions, and utilization controls developed by the department. Pediatric day care daycare does not include inpatient long-term care or family respite care.(2) Pediatric day healthcare services may be provided at any time of the day and on any day of the week, so long as the total number of authorized hours is not exceeded.(b) The department shall publish emergency regulations for pediatric day health care healthcare services by October 1, 1997. These regulations shall reimburse providers at a rate that shall be determined by the department, consistent with efficiency, economy, and quality of care until a new rate is determined on the basis of a cost study conducted by the department.(c) Coverage for pediatric day health care healthcare services shall be available only to the extent that no additional net program costs are incurred.(d) The department shall not approve a request for authorization of pediatric day health care healthcare when the beneficiary for whom the authorization is requested is an inpatient in a licensed health care healthcare facility.(e) The department shall not approve a request for authorization of pediatric day care daycare if the department determines that the total cost incurred by the Medi-Cal program for providing pediatric day health care healthcare services and all other medically necessary services to the individual beneficiary is greater than the total cost incurred by the Medi-Cal program in providing medically equivalent services at the beneficiarys otherwise appropriate level of institutional or home care.(f) Coverage for pediatric day health care healthcare services shall be available only to the extent that federal financial participation in the cost of providing these services is available pursuant to a federally approved state plan amendment including those services as a Medi-Cal program benefit.
14132.10. (a) (1) Pediatric day health care healthcare provided by a health facility licensed under paragraph (11) of subdivision (a) of Section 1250.1 of the Health and Safety Code is a covered benefit under this chapter subject to terms, conditions, and utilization controls developed by the department. Pediatric day care daycare does not include inpatient long-term care or family respite care.(2) Pediatric day healthcare services may be provided at any time of the day and on any day of the week, so long as the total number of authorized hours is not exceeded.(b) The department shall publish emergency regulations for pediatric day health care healthcare services by October 1, 1997. These regulations shall reimburse providers at a rate that shall be determined by the department, consistent with efficiency, economy, and quality of care until a new rate is determined on the basis of a cost study conducted by the department.(c) Coverage for pediatric day health care healthcare services shall be available only to the extent that no additional net program costs are incurred.(d) The department shall not approve a request for authorization of pediatric day health care healthcare when the beneficiary for whom the authorization is requested is an inpatient in a licensed health care healthcare facility.(e) The department shall not approve a request for authorization of pediatric day care daycare if the department determines that the total cost incurred by the Medi-Cal program for providing pediatric day health care healthcare services and all other medically necessary services to the individual beneficiary is greater than the total cost incurred by the Medi-Cal program in providing medically equivalent services at the beneficiarys otherwise appropriate level of institutional or home care.(f) Coverage for pediatric day health care healthcare services shall be available only to the extent that federal financial participation in the cost of providing these services is available pursuant to a federally approved state plan amendment including those services as a Medi-Cal program benefit.
14132.10. (a) (1) Pediatric day health care healthcare provided by a health facility licensed under paragraph (11) of subdivision (a) of Section 1250.1 of the Health and Safety Code is a covered benefit under this chapter subject to terms, conditions, and utilization controls developed by the department. Pediatric day care daycare does not include inpatient long-term care or family respite care.(2) Pediatric day healthcare services may be provided at any time of the day and on any day of the week, so long as the total number of authorized hours is not exceeded.(b) The department shall publish emergency regulations for pediatric day health care healthcare services by October 1, 1997. These regulations shall reimburse providers at a rate that shall be determined by the department, consistent with efficiency, economy, and quality of care until a new rate is determined on the basis of a cost study conducted by the department.(c) Coverage for pediatric day health care healthcare services shall be available only to the extent that no additional net program costs are incurred.(d) The department shall not approve a request for authorization of pediatric day health care healthcare when the beneficiary for whom the authorization is requested is an inpatient in a licensed health care healthcare facility.(e) The department shall not approve a request for authorization of pediatric day care daycare if the department determines that the total cost incurred by the Medi-Cal program for providing pediatric day health care healthcare services and all other medically necessary services to the individual beneficiary is greater than the total cost incurred by the Medi-Cal program in providing medically equivalent services at the beneficiarys otherwise appropriate level of institutional or home care.(f) Coverage for pediatric day health care healthcare services shall be available only to the extent that federal financial participation in the cost of providing these services is available pursuant to a federally approved state plan amendment including those services as a Medi-Cal program benefit.
14132.10. (a) (1) Pediatric day health care healthcare provided by a health facility licensed under paragraph (11) of subdivision (a) of Section 1250.1 of the Health and Safety Code is a covered benefit under this chapter subject to terms, conditions, and utilization controls developed by the department. Pediatric day care daycare does not include inpatient long-term care or family respite care.
(2) Pediatric day healthcare services may be provided at any time of the day and on any day of the week, so long as the total number of authorized hours is not exceeded.
(b) The department shall publish emergency regulations for pediatric day health care healthcare services by October 1, 1997. These regulations shall reimburse providers at a rate that shall be determined by the department, consistent with efficiency, economy, and quality of care until a new rate is determined on the basis of a cost study conducted by the department.
(c) Coverage for pediatric day health care healthcare services shall be available only to the extent that no additional net program costs are incurred.
(d) The department shall not approve a request for authorization of pediatric day health care healthcare when the beneficiary for whom the authorization is requested is an inpatient in a licensed health care healthcare facility.
(e) The department shall not approve a request for authorization of pediatric day care daycare if the department determines that the total cost incurred by the Medi-Cal program for providing pediatric day health care healthcare services and all other medically necessary services to the individual beneficiary is greater than the total cost incurred by the Medi-Cal program in providing medically equivalent services at the beneficiarys otherwise appropriate level of institutional or home care.
(f) Coverage for pediatric day health care healthcare services shall be available only to the extent that federal financial participation in the cost of providing these services is available pursuant to a federally approved state plan amendment including those services as a Medi-Cal program benefit.