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SB-1355 Medi-Cal: in-home supportive services: redetermination.(2023-2024)

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Date Published: 04/25/2024 09:00 PM
SB1355:v96#DOCUMENT

Amended  IN  Senate  April 25, 2024
Amended  IN  Senate  April 15, 2024
Amended  IN  Senate  April 03, 2024

CALIFORNIA LEGISLATURE— 2023–2024 REGULAR SESSION

Senate Bill
No. 1355


Introduced by Senator Wahab
(Coauthor: Senator Rubio)

February 16, 2024


An act to add Section 14005.256 to the Welfare and Institutions Code, relating to Medi-Cal.


LEGISLATIVE COUNSEL'S DIGEST


SB 1355, as amended, Wahab. Medi-Cal: in-home supportive services: redetermination.
Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services, including in-home supportive services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law generally requires a county to redetermine a Medi-Cal beneficiary’s eligibility to receive Medi-Cal benefits every 12 months and whenever the county receives information about changes in a beneficiary’s circumstances that may affect their eligibility for Medi-Cal benefits.
Existing law provides for the In-Home Supportive Services (IHSS) program, administered by the State Department of Social Services and counties, under which qualified aged, blind, and disabled persons are provided with supportive services in order to permit them to remain in their own homes. Existing law authorizes certain Medi-Cal beneficiaries to receive IHSS as a covered Medi-Cal benefit.
This bill would, to the extent that any necessary federal approvals are obtained, and federal financial participation is available and not otherwise jeopardized, require an IHSS recipient to be continuously eligible for Medi-Cal for 3 years, if they have a fixed income, and would prohibit a redetermination of Medi-Cal eligibility before 3 years, except as specified. The bill would make the implementation of its provisions contingent upon the department obtaining all necessary federal approvals, the department determining that systems have been programmed to implement these provisions, and the Legislature has appropriated funding to implement these provisions after a determination that ongoing General Fund resources are available to support the ongoing implementation of these provisions. To the extent the bill would increase county duties in administrating the IHSS program, the bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: YES  

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


SECTION 1.

 Section 14005.256 is added to the Welfare and Institutions Code, immediately following Section 14005.255, to read:

14005.256.
 (a) (1) A recipient of in-home support services provided pursuant to Article 7 (commencing with Section 12300) of Chapter 3 shall be continuously eligible for Medi-Cal for three years, if they have a fixed income.
(2) A redetermination of Medi-Cal eligibility, as specified in Section 14005.37, shall not be conducted before three years, unless the department or county possesses facts indicating that the recipient has new income, the recipient has requested voluntary disenrollment, the recipient is deceased, the recipient is no longer a state resident, or the recipient’s original enrollment was based on a state or county error or on fraud, abuse, or perjury attributed to the recipient.
(3) The date of redetermination shall be three years from the most recent Medi-Cal determination.
(4) A Medi-Cal recipient may still request a Medi-Cal redetermination prior to the end of the three-year continuous eligibility period.
(b) (1) Implementation of this section is contingent on all of the following conditions:
(A) All necessary federal approvals have been obtained by the department pursuant to subdivision (c).
(B) The Legislature has appropriated funding to implement this section after a determination that ongoing General Fund resources are available to support the ongoing implementation of this section.
(C) The department has determined that systems have been programmed to implement this section.
(2) The department shall issue a declaration certifying the date that all conditions in paragraph (1) have been met. The department shall post the declaration on its the department’s internet website and provide a copy of the declaration to the Secretary of State, the Secretary of the Senate, the Chief Clerk of the Assembly, and the Legislative Counsel.
(c) This section shall be implemented only to the extent that any necessary federal approvals are obtained, and federal financial participation is available and not otherwise jeopardized.
(d) Notwithstanding 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 section, in whole or in part, through all-county letters or similar instructions, without taking any further regulatory action, until such time that the department can promulgate regulations.

SEC. 2.

 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.