Health and Human Services 08/12/2011
IHSS Fraud Prevention Funding On Hold Pending Potential Trigger Cuts
The Department of Social Services notified counties in July that
the $10 million included in the Budget Act of 2011 for county
investigation and program integrity efforts related to In-Home
Supportive Services is subject to the Act’s “trigger cuts”
mechanism.
What this means is that the $10 million will not be released to
counties if the state’s revenues fall $1 billion below revenue
projections included in the Budget Act. Should the state’s
revenue track with projections, the “trigger cuts” will not
materialize and counties would receive funding for the IHSS fraud
program in January 2012. Under that scenario, counties would be
permitted to claim expenses retroactive to July 1, 2011. However,
should the trigger cuts occur, no funding will be available for
county costs after June 30, 2011.
Counties are encouraged to continue to prepare, approve, and
submit fraud prevention proposals to the Adult Programs Division
of the Department of Social Services no later than October 28,
2011.
Governor Brown Vetoes Adult Day Health Care Look-A-Like Bill
Governor Jerry Brown vetoed AB 96, a budget bill that would have
recreated the Adult Day Health Care program under the name of
“Keeping Adults Free from Institutions”, or KAFI, on July
25.
The Adult Day Health Care (ADHC) program was eliminated by the
Governor through his line-item veto authority in June, when he
deleted budget language that required expenditure of $85 million
to transition Adult Day Health Care enrollees to other Medi-Cal
services and to a new federal waiver program.
Proponents of the ADHC program then moved AB 96 through the
Legislature, which would have created KAFI based on the ADHC
model. AB 96 landed on the Governor’s desk on July 14 and he
vetoed it on July 25.
The Governor noted that the state cannot afford the ADHC program
at this time, but that his Department of Health Care Services
(DHCS) recently extended the ADHC benefit through administrative
action until December 1, 2011, with federal funding approval. He
also signed SB 91, which will allow adult day health centers to
continue to operate after the fee-for-services payments under
Medi-Cal expire.
The Governor has directed DHCS to work with the Legislature,
stakeholders, managed care plans, and home- and community-based
service providers to ensure a smooth transition to appropriate
services for beneficiaries. The first stakeholder meeting was
held this week, on August 9, and is supposed to be the first in a
series of meetings on the topic. However, additional meetings
have not yet been scheduled at the time of this
writing.
Resources:
Read the DHCS transition plan for ADHC.
Read Governor Brown’s AB 96 veto message.
Emergency Medical Services
AB 210 (Solorio) – Pending
As Proposed to be Amended
AB 210, by Assembly Member Jose Solorio, would amend what is
commonly known as Section 201 (Health and Safety Code Section
1797.201-224) of the Emergency Medical Services (EMS) System and
the Pre-Hospital Emergency Medical Care Personnel Act (EMS Act)
to require grandfathered EMS transportation providers to enter
into a written agreement with their respective Local Emergency
Medical Services Agency (LEMSA) by 2014.
AB 210 is intended to address Section 201 issues surrounding
regulatory authority, local control, and operational control in
local EMS systems. The bill also includes an attempt to create a
standard set of definitions for Section 201.
AB 210 was originally envisioned as a vehicle for the
recommendations of a state Emergency Medical Services Commission
subcommittee, but that committee has not fully reached consensus
on its provisions. However, a stakeholder group comprised of the
California Professional Firefighters, ambulance services, fire
chiefs, cities and local EMS administrators has continued to meet
as the bill moves through the legislative process. CSAC is
maintaining a pending position while stakeholders continue their
work on reaching a consensus.
The counties of San Joaquin and Tulare have opposed earlier
versions of the bill, and it is proposed to be amended next when
the Legislature returns to Sacramento. Mono County is seeking an
amendment to exempt counties smaller than 50,000 residents from
the bill’s provisions, and the Emergency Medical Services
Administrators’ Association of California (EMSAAC) has
recommended that it be made a two-year bill, which will give
stakeholders more time to work on the language. CSAC has
maintained a “pending” position on AB 210 and will closely review
the recent proposed amendments once they appear in
print.
AB 210 is scheduled to be heard by the Senate Appropriations
Committee on August 15.
AB 717 (Ammiano) – Support
As Amended June 29, 2011
AB 717, by Assembly Member Tom Ammiano, would improve the use and
operation of the Child Abuse Central Index (CACI).
The CACI is a tool used by county child welfare agencies when
conducting investigations and hiring of staff. However, because
of the sensitive information within the system, CACI has been the
target of litigation throughout the years. A result of some of
that litigation is a due process structure for persons listed on
the CACI. AB 717, as amended, will improve due process by, among
other things, affording all persons listed in CACI the right to
request a due process hearing if they have not already had the
opportunity to do so. AB 717 would also help streamline the
system by permitting “inconclusive” reports to be purged. Also,
AB 717 would allow the Department of Justice to purge all reports
in CACI where the person listed has reached 100 years of
age.
CSAC has changed our position to support due to the recent
amendments clarifying the due process and “inconclusive” report
process. The Senate Appropriations Committee will hear AB 717 on
August 15.