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SB-398 Acquired brain trauma.(2017-2018)

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Date Published: 03/23/2018 09:00 PM
SB398:v97#DOCUMENT

Amended  IN  Assembly  March 23, 2018
Amended  IN  Senate  April 06, 2017

CALIFORNIA LEGISLATURE— 2017–2018 REGULAR SESSION

Senate Bill No. 398

Introduced by Senator Monning

February 15, 2017

An act to amend Sections 4353, 4354.5, 4355, 4357, and 4357.1 and 4355 of, and to repeal Sections 4359 and Section 14132.992 of, and to repeal and add Section 4359 of, the Welfare and Institutions Code, relating to acquired brain trauma.


LEGISLATIVE COUNSEL'S DIGEST


SB 398, as amended, Monning. Acquired brain trauma.
(1) Existing law requires the Department of Rehabilitation to administer a program of services for persons with acquired traumatic brain injury. Under that program, service providers develop and utilize an individual service plan to identify the needs of consumers and deliver, either directly or by arrangement, coordinated services designed to meet those needs. Existing law authorizes the department to make grants from the funds in the Traumatic Brain Injury Fund to service providers for the purpose of carrying out the program and requires the department to pursue all sources of federal financial participation. Existing law makes these provisions inoperative on July 1, 2019.
This bill would instead make that program operative indefinitely. until July 1, 2024. The bill would also make various changes to the program, including requiring the department to pursue all available sources of funding and by authorizing the department to require that service providers meet specified program and operational certification standards in order to receive ongoing funding.
(2) Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, pursuant to which medical benefits are provided to public assistance recipients and certain other low-income persons. The Medi-Cal program is partially governed and funded by federal Medicaid provisions.
Existing law requires the department, by March 1, 2011, to submit to the federal Centers for Medicare and Medicaid Services a home- and community-based services waiver application or an amendment of the state plan for home- and community-based services, to serve at least 100 adults with acquired traumatic brain injuries who otherwise would require care in a Medi-Cal funded nursing facility or an intermediate care facility for persons with developmental disabilities.
This bill would repeal that provision requiring the submission of a waiver application or an amendment of the state plan.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

The people of the State of California do enact as follows:


SECTION 1.

 Section 4353 of the Welfare and Institutions Code is amended to read:

4353.
 The Legislature finds and declares all of the following:
(a) There is a large population of persons who have suffered traumatic brain injuries resulting in significant functional impairment. The annual number of brain injuries is greater than the rates of breast cancer, heart attack, lung cancer, HIV and AIDS, spinal cord injuries, and multiple sclerosis combined.
(b) Roughly 28 percent of all brain injuries are due to a fall, and 20 percent are due to motor vehicle accidents. Those injuries attributable to motor vehicle accidents, however, account for the greatest number of hospitalizations.
(c) There is a lack of awareness of the problems associated with brain injury as a chronic health condition resulting in a significant absence of community reintegration services for persons with brain injuries, including, but not limited to, in-home and out-of-home services, respite care, placement programs, counseling, cognitive rehabilitation, transitional living, and vocational rehabilitation services.
(d) Although there are currently a number of different programs attempting to meet the needs of the persons with brain injuries in the field of community reintegration, there is no clearly defined ultimate responsibility vested in any single state agency. Nothing in this section shall be construed to This section does not mandate services for persons with acquired traumatic brain injury through county and city programs.
(e) While formal standards of care exist for both medical and rehabilitative models within the system of brain injury care, the same cannot be said with regard to community reintegration services. Currently, there is no programmatic coordination among agencies to facilitate the provision of a continuing range of services appropriate for persons with traumatic brain injuries.
(f) There is a serious gap in postacute care services for the life of the brain injury survivor, resulting in incomplete recovery of functional potential.
(g) Due to the problems referred to in this section, the state is not adequately meeting the needs of persons with brain injuries by enabling them to return to work and to lead productive lives.

SEC. 2.

 Section 4354.5 of the Welfare and Institutions Code is amended to read:

4354.5.
 The Legislature finds and declares all of the following:
(a) Traumatic brain injuries have a long-term impact on the survivors, their families, caregivers, and support systems.
(b) Long-term care consumers experience great differences in service levels, eligibility criteria, and service availability, resulting in inappropriate and expensive care that fails to be responsive to their needs.
(c) To the maximum extent feasible, the department shall pursue all available sources of funding.
(d) If new sources of funding are secured that will permit expanding the existing Traumatic Brain Injury Program, the department shall fund an array of appropriate services and assistance to adults 18 years of age and older with traumatic brain injuries in those areas of the state with the greatest need.
(e) Implementation of this chapter shall be consistent with the state’s public policy strategy to design a coordinated services delivery system pursuant to Article 4.05 (commencing with Section 14139.05) of Chapter 7 of Part 3 of Division 9.

SEC. 3.

 Section 4355 of the Welfare and Institutions Code is amended to read:

4355.
 (a) On or before January 1, 2020, July 1, 2024, the department shall determine requirements related to service delivery, uniform data collection, and other aspects of program administration, in addition to those specified in Section 4357, that service providers participating in the traumatic brain injury program must meet. This may include, but is not limited to, the following: requiring service providers to be approved as community reintegration programs eligible to serve consumers.

(1)The department may require that service providers be approved as community reintegration programs eligible to serve consumers.

(2)The department may require that service providers meet program and operational certification standards developed by the department in order to receive ongoing funding.

(b) On or before January 1, 2020, July 1, 2024, the department shall do all of the following:
(1) Determine the level of funding necessary to permit a service provider to meet all applicable requirements and adequately serve its designated service area.
(2) Determine the number of sites that can be supported with available funding.
(3) If funding is available, solicit applications from new organizations interested in and qualified to provide services pursuant to this chapter, and select those best qualified to do so, with priority given to applicants that have proven experience in providing effective community reintegration services to persons with acquired traumatic brain injuries, including, but not limited to, supported living services, caregiver support, and family and community education.
(c) The department shall meet periodically with traumatic brain injury service providers for discussion of topics, including, but not limited to, the development and implementation of performance standards and data collection processes, eligibility requirements, program administration, pursuit of funding, and refinement of the traumatic brain injury continuum of care.

SEC. 4.Section 4357 of the Welfare and Institutions Code is amended to read:
4357.

(a)Service providers shall identify the needs of consumers and deliver services designed to meet those needs.

(b)Service providers shall match not less than 20 percent of the amount granted, with the exception of funds used for mentoring. The required match may be cash or in-kind contributions, or a combination of both, from the sites or any cooperating agency. In-kind contributions may include, but shall not be limited to, staff and volunteer services.

(c)Service providers shall provide at least 51 percent of their services under the grant to individuals who are Medi-Cal eligible or who have no other identified third-party funding source.

(d)(1)Service providers shall provide, directly or by arrangement, a coordinated service model to include all of the following:

(A)Supported living services.

(B)Community reintegration services.

(C)Vocational supportive services.

(D)Information, referral, and, as needed, assistance in identifying, accessing, utilizing, and coordinating all services needed by individuals with traumatic brain injury and their families.

(E)Public and professional education designed to facilitate early identification of persons with brain injury, prompt referral of these persons to appropriate services, and improvement of the system of services available to them.

(2)The model shall be designed and modified with advice from consumers and their families, and shall be accessible to the population in need, taking into account transportation, linguistic, and cultural factors.

(e)Service providers shall develop and utilize an individual service plan which will allow consumers to move from intensive medical rehabilitation or highly structured living arrangements to increased levels of independence and employment. The goals and priorities of each consumer shall be an integral part of his or her service plan.

(f)Service providers shall seek all third-party reimbursements for which consumers are eligible and shall utilize all services otherwise available to consumers at no cost, including vocational rehabilitation services provided by the department. However, grantees may utilize grant dollars for the purchase of nonreimbursed services or services otherwise unavailable to consumers.

(g)Service providers shall endeavor to serve a population that is broadly representative with regard to race and ethnicity of the population with traumatic brain injury in their geographical service area, undertaking outreach activities as needed to achieve this goal.

(h)Service providers shall maintain a broad network of relationships with local groups of brain injury survivors and families of survivors, as well as local providers of health, social, and vocational services to individuals with traumatic brain injury and their families. The sites shall work cooperatively with these groups and providers to improve and develop needed services and to promote a well-coordinated service system, taking a leadership role as necessary.

(i)Service providers shall furnish uniform data to the department pursuant to subdivision (a) of Section 4355 as necessary to monitor and evaluate the program.

SEC. 5.Section 4357.1 of the Welfare and Institutions Code is amended to read:
4357.1.

(a)The department may make grants from the funds in the Traumatic Brain Injury Fund, established in Section 4358, to service providers for the purpose of carrying out the programs detailed in this chapter.

(b)Contracts or grants awarded pursuant to this chapter, including contracts required for administration or ancillary services in support of programs, shall be exempt from the requirements of the Public Contract Code and the State Administrative Manual, and from approval by the Department of General Services.

(c)Grants awarded to service providers pursuant to this chapter shall be subject to open competition every three years, unless the department elects to extend one or more grants and delay competition for those grants by a maximum of two additional years.

(d)If funding is available, new service providers shall be awarded grants as outlined in the department’s strategic plan.

SEC. 6.SEC. 4.

 Section 4359 of the Welfare and Institutions Code is repealed.

SEC. 5.

 Section 4359 is added to the Welfare and Institutions Code, to read:

4359.
 This chapter shall become inoperative on July 1, 2024, and, as of January 1, 2025, is repealed.

SEC. 7.SEC. 6.

 Section 14132.992 of the Welfare and Institutions Code is repealed.