[Nfbc-info] Proposed legislation would allow IHSS to provide reader service to blind consumers

[Bryan Bashin]

Chuck,

I've long sought this legislation.  It makes no sense for counties to assign a chore worker to  an impoverished blind person to wash their  dishes, do their laundry -- all of which are easily done ourselves -- but be prevented from reading mail and helping with paperwork.  This legislation fixes this strange process.  I hope NFBC can be a strong supporter of this.

Bryan Bashin


-----Original Message-----
From: Nfbc-info [mailto:nfbc-info-bounces at nfbnet.org] On Behalf Of Charles Krugman via Nfbc-info
Sent: Wednesday, March 04, 2015 9:35 AM
To: NFBC
Subject: [Nfbc-info] Proposed legislation would allow IHSS to provide reader service to blind consumers

The following is a summary of SB 199 which if enacted would allow people receiving in home supportive services who are blind to have reader services provided. So far this legislation is being supported by CCB and the United Domestic Workers Union. Because funds are provided from Medicaid funds the process for implementation would also acquire approval from the Federal government.
ChuckSenate BillNo. 199

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Introduced by Senator Hall
(Principal coauthor: Senator Beall)
(Coauthors: Assembly Members Bonilla, Lackey, Rodriguez, and Waldron) February 10, 2015

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An act to amend Section 12300 of the Welfare and Institutions Code, relating to public social services. 
LEGISLATIVE COUNSEL’S DIGEST
SB 199, as introduced, Hall. In-home supportive services: reading services for blind and visually impaired recipients. 

Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, and under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid Program provisions.

Existing law provides for the county-administered In-Home Supportive Services (IHSS) program, under which, either through employment by the recipient, or by or through contract by the county, qualified aged, blind, and disabled persons receive services enabling them to remain in their own homes. Existing law requires the provision of personal care services under the Medi-Cal program to eligible IHSS recipients. Under existing law, county welfare departments are required to provide visually impaired applicants and recipients with information on, and referral services to, entities that provide reading services to visually impaired persons. Existing law defines “supportive services” for purposes of the IHSS program.

This bill would, commencing January 1, 2017, include within the definition of supportive services assistance in reading and completing financial and other documents for a recipient of services under the IHSS program who is blind. By expanding the scope of available services under the IHSS program, this bill would impose a state-mandated local program. The bill would also require the Director of Health Care Services to seek any federal approvals necessary to ensure that Medicaid funds may be used in implementing this provision. The bill would authorize the department to implement the provision through all-county letters or similar instructions from the director until emergency regulations are filed, and would require the adoption of emergency regulations by January 1, 2018, and final regulations by January 1, 2019, to implement this provision, as specified.

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 these statutory provisions.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes. 

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

P2    1 
SECTION 1.  
Section 12300 of the Welfare and Institutions 2Code is amended to read:

3
12300.  
(a) The purpose of this article is to provide in every 4county in a manner consistent with this chapter and the annual 5Budget Act those supportive services identified in this section to 6aged, blind, or disabled persons, as defined under this chapter, 7who are unable to perform the services themselves and who cannot 8safely remain in their homes or abodes of their own choosing unless 9these services are provided.

10(b) Supportive services shall include domestic services and 11services related to domestic services, heavy cleaning, personal 12care services, accompaniment by a provider when needed during 13necessary travel to health-related appointments or to alternative 14resource sites, yard hazard abatement, protective supervision, 15teaching and demonstration directed at reducing the need for other 16supportive services,begin delete andend delete paramedical servicesbegin delete whichend deletebegin insert thatend insert make it 17possible for the recipient to establish and maintain an independent 
P3    1living arrangementbegin insert, and assistance in reading and completing 
2financial and other documents, for up to two hours per month, for 3a recipient who is blind, when that assistance is necessary for the 4recipient to remain in his or her home, or abode of his or her own 5choosing, as defined by the departmentend insert.

6(c) Personal care services shall mean all of the following:

7(1) Assistance with ambulation.

8(2) Bathing, oral hygiene, and grooming.

9(3) Dressing.

10(4) Care and assistance with prosthetic devices.

11(5) Bowel, bladder, and menstrual care.

12(6) Repositioning, skin care, range of motion exercises, and 13transfers.

14(7) Feeding and assurance of adequate fluid intake.

15(8) Respiration.

16(9) Assistance with self-administration of medications.

17(d) Personal care services are available if these services are 18provided in the beneficiary’s home and other locations as may be 19authorized by the director. Among the locations that may be 20authorized by the director under thisbegin delete paragraphend deletebegin insert subdivisionend insert is the 21recipient’s place of employment if all of the following conditions 22are met:

23(1) The personal care services are limited to those that are 24currently authorized for a recipient in the recipient’s home and 25those services are to be utilized by the recipient at the recipient’s 26place of employment to enable the recipient to obtain, retain, or 27return to work. Authorized services utilized by the recipient at the 28recipient’s place of employment shall be services that are relevant 29and necessary in supporting and maintaining employment. 
30However, workplace services shall not be used to supplant any 31reasonable accommodations required of an employer by the 32Americans with Disabilities Act (42 U.S.C. Sec. 12101 et seq.;
33ADA) or other legal entitlements or third-party obligations.

34(2) The provision of personal care services at the recipient’s 35place of employment shall be authorized only to the extent that 36the total hours utilized at the workplace are within the total personal 37care services hours authorized for the recipient in the home. 
38Additional personal care services hours may not be authorized in 39connection with a recipient’s employment.

P4    1(e) begin deleteWhere end deletebegin insertWhen end insertsupportive services are provided by a person
2begin delete havingend deletebegin insert who hasend insert the legal duty pursuant to the Family Code to 3provide for the care of his or her child who is the recipient, the 4provider of supportive services shall receive remuneration for the 5services only when the provider leaves full-time employment or 6is prevented from obtaining full-time employment because no 7other suitable provider is available andbegin delete whereend deletebegin insert whenend insert the inability 8of the provider to provide supportive services may result in 9inappropriate placement or inadequate care.

10These providers shall be paid only for the following:

11(1) Services related to domestic services.

12(2) Personal care services.

13(3) Accompaniment by a provider when needed during necessary 14travel to health-related appointments or to alternative resource 15sites.

16(4) Protective supervision only as needed because of the 17functional limitations of the child.

18(5) Paramedical services.

19(f) To encourage maximum voluntary services, so as to reduce 20governmental costs, respite care shall also be provided. Respite 21care is temporary or periodic service for eligible recipients to 22relieve persons who are providing care without compensation.

23(g) A person who is eligible to receive a service or services 24under an approved federal waiver authorized pursuant to Section 2514132.951, or a person who is eligible to receive a service or 26services authorized pursuant to Section 14132.95, shall not be 27eligible to receive the same service or services pursuant to this 28article. In the event that the waiver authorized pursuant to Section 2914132.951, as approved by the federal government, does not extend 30eligibility to all persons otherwise eligible for services under this 31article, or does not cover a service or particular services, or does 32not cover the scope of a service that a person would otherwise be 33eligible to receive under this article, those persons who are not 34eligible for services, or for a particular service under the waiver 35or Section 14132.95 shall be eligible for services under this article.

36(h) (1) All services provided pursuant to this article shall be 37equal in amount, scope, and duration to the same services provided 38pursuant to Section 14132.95, including any adjustments that may 39be made to those services pursuant to subdivision (e) of Section
40 14132.95.

P5    1(2) Notwithstanding any other provision of this article, the rate 
2of reimbursement for in-home supportive services provided through 3any mode of service shall not exceed the rate of reimbursement 4established under subdivision (j) of Section 14132.95 for the same 5mode of service unless otherwise provided in the annual Budget 6Act.

7(3) The maximum number of hours available under Section 814132.95, Section 14132.951, and this section, combined, shall 9be 283 hours per month. Any recipient of services under this article 10shall receive no more than the applicable maximum specified in 11Section 12303.4.

begin insert
12(i) The Director of Health Care Services shall, by January 1, 132017, seek all federal approvals necessary to ensure that Medicaid 14funds may be used in implementing the amendments to this section 15made by the act that added this subdivision during the 2015-16 16Regular Session of the Legislature. These amendments include 17assistance in reading and completing financial and other 18documents for a recipient who is blind.

end insertbegin insert
19(j) The authorization to provide the service added by the 20amendments to this section made by the act that added this 21subdivision during the 2015-16 Regular Session of the Legislature 22shall become operative on January 1, 2017. Provision of the service 23shall be implemented only if, and to the extent that, federal 24financial participation is available, and any necessary federal 25approvals have been obtained.

end insertbegin insert
26(k) The state and counties shall be immune from any liability, 27including negligence or intentional torts of providers, associated 28with the delivery of the service specified in subdivision (b) that 29includes assistance in reading and completing financial documents 30for recipients who are blind. 

end insertbegin insert
31(l) (1) Notwithstanding the rulemaking provisions of the 32Administrative Procedure Act (Chapter 3.5 (commencing with 33Section 11340) of Part 1 of Division 3 of Title 2 of the Government 34Code), until emergency regulations are filed with the Secretary of 35State, the department may implement the amendments made to this 36section by the act that added this subdivision during the 2015-16 37Regular Session of the Legislature through all-county letters or 38similar instructions from the director.

end insertbegin insert
39(2) On or before January 1, 2018, the department shall adopt 40regulations to implement the amendments to this section made by 
P6    1the act that added this subdivision during the 2015-16 Regular 
2Session of the Legislature. The initial adoption, amendment, or 3repeal of a regulation authorized by this subdivision is deemed to 4address an emergency, for purposes of Sections 11346.1 and
511349.6 of the Government Code, and the department is hereby 6exempted for that purpose from the requirements of subdivision
7(b) of Section 11346.1 of the Government Code. After the initial 8adoption, amendment, or repeal of an emergency regulation 9pursuant to this section, the department may twice request approval 10from the Office of Administrative Law to readopt the regulation 11as an emergency regulation pursuant to Section 11346.1 of the 12Government Code. The department shall adopt final regulations 13on or before January 1, 2019.

end insert
14
SEC. 2.  
If the Commission on State Mandates determines that 15this act contains costs mandated by the state, reimbursement to 16local agencies and school districts for those costs shall be made 17pursuant to Part 7 (commencing with Section 17500) of Division
184 of Title 2 of the Government Code.



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