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AB-426 In-Home Supportive Services program.(2019-2020)

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Date Published: 03/25/2019 09:00 PM
AB426:v97#DOCUMENT

Amended  IN  Assembly  March 25, 2019
Amended  IN  Assembly  March 04, 2019

CALIFORNIA LEGISLATURE— 2019–2020 REGULAR SESSION

Assembly Bill No. 426


Introduced by Assembly Member Maienschein

February 07, 2019


An act to amend Section 12301.1 of, and to repeal Section 12309.1 of, the Welfare and Institutions Code, relating to public social services.


LEGISLATIVE COUNSEL'S DIGEST


AB 426, as amended, Maienschein. In-Home Supportive Services program.
Existing law provides for the county-administered In-Home Supportive Services (IHSS) program, under which qualified aged, blind, and disabled persons are provided with services to permit them to remain in their own homes. Existing law requires a county welfare department to assess each recipient’s continuing monthly need for in-home supportive services at varying intervals, but at least once every 12 months. Existing law authorizes a county to reassess a recipient’s need for services at a time interval of less than 12 months from a recipient’s initial intake or last assessment if the county social worker has information indicating that the recipient’s need for services is expected to decrease in less than 12 months.
This bill would require a reduction of a recipient’s monthly authorized number of service hours to be based solely on a verified change of a recipient’s medical condition, a change in the recipient’s living arrangements, household composition or a change in another household member’s use of services that impacts the calculation of the recipient’s prorated service hours, a documented change in the recipient’s functionality, a change in the recipient’s circumstances, a change in the law, law that affects the assessment of needed services, or an error in computing a recipient’s monthly authorized number of service hours. hours that has been documented by the county.
Under existing law, the Medi-Cal program provides services similar to those offered through the IHSS program, to eligible individuals, with these services known as personal care option services. Existing law requires an applicant for, or recipient of, either of these in-home supportive services, as a condition of receiving these services, to obtain a certification from a licensed health care professional, as specified, declaring that the applicant or recipient is unable to perform some activities of daily living independently, and that without services to assist the applicant or recipient with activities of daily living, the applicant or recipient is at risk of placement in out-of-home care.
This bill would repeal that requirement to obtain a certification from a licensed health care professional as a condition of receiving in-home supportive services.
To the extent that the bill would impose additional duties on counties, the bill would impose a state-mandaS  

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


SECTION 1.

 Section 12301.1 of the Welfare and Institutions Code is amended to read:

12301.1.
 (a) The department shall adopt regulations establishing a uniform range of services available to all eligible recipients based upon individual needs. The availability of services under these regulations is subject to the provisions of Section 12301 and county plans developed pursuant to Section 12302.
(b) (1) The county welfare department shall assess each recipient’s continuing monthly need for in-home supportive services at varying intervals as necessary, but at least once every 12 months. The results of this assessment of monthly need for hours of in-home supportive services shall be divided by 4.33, to establish a recipient’s weekly authorized number of hours of in-home supportive services, subject to any of the following, as applicable:
(A) Within the limit of the assessed monthly need for hours of in-home supportive services, a county welfare department may adjust the authorized weekly hours of a recipient for any particular week for known recurring or periodic needs of the recipient.
(B) Within the limit of the assessed monthly need for hours of in-home supportive services, a county welfare department may temporarily adjust the authorized weekly hours of a recipient at the request of the recipient, to accommodate unexpected extraordinary circumstances, including, but not limited to, a situation arising out of a natural disaster.
(C) In addition to the flexibility provided to a recipient pursuant to subparagraph (C) of paragraph (4) of subdivision (b) of Section 12300.4, a recipient may request the county welfare department to adjust the weekly authorized hours of services to exceed 40 hours of weekly authorized hours of services per week, within the recipient’s total monthly authorized hours of services. A request for adjustment may be made retroactive to the hours actually worked. The county welfare department shall not unreasonably withhold approval of a recipient request made pursuant to this subparagraph.
(2) For purposes of subparagraph (C) of paragraph (1), and prior to its implementation, the State Department of Social Services shall develop a process for requests made pursuant to that subparagraph. The process shall include all of the following:
(A) The procedure, standards, and timeline for making a request to adjust the authorized weekly hours of service for a recipient described in this section.
(B) The language to be used for notices about the process.
(C) Provisions for adjustments to authorization, and for authorization after services have been provided, when the criteria for approval have been met.
(D) A requirement that the opportunity for a revision to the limitations of this section shall be discussed at each annual reassessment, and also may be authorized by the county welfare department outside of the reassessment process.
(3) Recipients shall be timely informed of their total monthly and weekly authorized hours.
(4) The weekly authorization of services defined in this section shall be used solely for the purposes of ensuring compliance with the federal Fair Labor Standards Act and its implementing regulations.
(5) Notwithstanding the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), the department may implement, interpret, or make specific this subdivision by means of all-county letters, or similar instructions, without taking any regulatory action.
(c) (1) Notwithstanding subdivision (b), at the county’s option, assessments may be extended, on a case-by-case basis, for up to six months beyond the regular 12-month period, provided that the county documents that all of the following conditions exist:
(A) The recipient has had at least one reassessment since the initial program intake assessment.
(B) The recipient’s living arrangement has not changed since the last annual reassessment and the recipient lives with others, or has regular meaningful contact with persons other than the recipient’s service provider.
(C) The recipient or, if the recipient is a minor, the recipient’s parent or legal guardian, or if incompetent, the recipient’s conservator, is able to satisfactorily direct the recipient’s care.
(D) There has not been a known change in the recipient’s supportive service needs within the previous 24 months.
(E) A report has not been made to, and there has been no involvement of, an adult protective services agency or agencies since the county last assessed the recipient.
(F) The recipient has not had a change in provider or providers for at least six months.
(G) The recipient has not reported a change in need for supportive services that requires a reassessment.
(H) The recipient has not been hospitalized within the last three months.
(2) If some, but not all, of the conditions specified in paragraph (1) are met, the county may consider other factors in determining whether an extended assessment interval is appropriate, including, but not limited to, involvement in the recipient’s care of a social worker, case manager, or other similar representative from another human services agency, including a regional center or county mental health program, or communications, or other instructions from a physician or other licensed health care professional that the recipient’s medical condition is unlikely to change.
(3) (A) A county may reassess a recipient’s need for services at a time interval of less than 1font> functionality.
(iv) A change in the law, or an law that affects the assessment of needed services.
(v) An error in computing a recipient’s monthly authorized number of service hours. hours that has been documented by the county.
(d) A county shall assess a recipient’s need for supportive services any time that the recipient notifies the county of a need to adjust the supportive services hours authorized, or if there are other indications or expectations of a change in circumstances affecting the recipient’s need for supportive services.
(e) (1) Notwithstanding the rulemaking provisions of the Administrative Procedure Act, Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, until emergency regulations are filed with the Secretary of State, the department may implement this section through all-county letters or similar instructions from the director. The department shall adopt emergency regulations implementing this section no later than September 30, 2005, unless notification of a delay is made to the Chair of the Joint Legislative Budget Committee prior to that date. The notification shall include the reason for the delay, the current status of the emergency regulations, a date by which the emergency regulations shall be adopted, and a statement of need to continue use of all-county letters or similar instructions. The adoption of emergency regulations shall not be delayed, or the use of all-county letters or similar instructions be extended, beyond June 30, 2006.
(2) The adoption of regulations implementing this section shall be deemed an emergency and necessary for the immediate preservation of the public peace, health, safety, or general welfare. The emergency regulations authorized by this section are exempt from review by the Office of Administrative Law. The emergency regulations authorized by this section shall be submitted to the Office of Administrative Law for filing with the Secretary of State and shall remain in effect for no more than 180 days by which time final regulations shall be adopted. The department shall seek input from the entities listed in Section 12305.72 when developing all-county letters or similar instructions and the regulations.

SEC. 2.

 Section 12309.1 of the Welfare and Institutions Code is repealed.

SEC. 3.

 If the Commission on State Mandates determines that this act contains costs mandated by the state, reimbursement to local agencies and school districts for those costs shall be made pursuant to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of the Government Code.