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

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Date Published: 09/17/2018 09:00 PM

Senate Bill No. 398

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

[ Approved by Governor  September 14, 2018. Filed with Secretary of State  September 14, 2018. ]


SB 398, 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 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.
(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 4353 of the Welfare and Institutions Code is amended to read:

 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. 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:

 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:

 (a) On or before 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, requiring service providers to be approved as community reintegration programs eligible to serve consumers.
(b) On or before 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 4359 of the Welfare and Institutions Code is repealed.

SEC. 5.

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

 This chapter shall become inoperative on July 1, 2024, and, as of January 1, 2025, is repealed.

SEC. 6.

 Section 14132.992 of the Welfare and Institutions Code is repealed.