AB 1042 — Medi-Cal: beneficiary maintenance needs: home upkeep allowances: transitional needs funds.

Summary

Existing law provides for 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. The Medi-Cal program is, in part, governed and funded by federal Medicaid provisions. Qualified individuals under the Medi-Cal program include medically needy persons and medically needy family persons who meet the required eligibility criteria, including applicable income requirements. Existing law requires the department to establish income levels for maintenance need at the lowest levels that reasonably permit a medically needy person to meet their basic needs for food, clothing, and shelter, and for which federal financial participation will still be provided under applicable federal law. In calculating the income of a medically needy person in a medical institution or nursing facility, or a person receiving institutional or noninstitutional services from a Program of All-Inclusive Care for the Elderly organization, the required monthly maintenance amount includes an amount providing for the upkeep and maintenance of the person's home. This amount is also referred to as the home upkeep allowance. Existing law requires that the maintenance of need amount provide for personal and incidental needs in an amount not less than $35 for a person in a medical institution or nursing facility, or for a person receiving institutional or noninstitutional services from a Program of All-Inclusive Care for the Elderly organization. Existing law authorizes the Director of Health Care Services to adopt, amend, or repeal reasonable rules and regulations to carry out the purposes and intent of the Medi-Cal program, that are not inconsistent with any state statute. The department has adopted regulatory requirements relating to the determination of the home upkeep allowance described above. This bill would establish eligibility and other requirements for providing the home upkeep allowance or a transitional needs fund to Medi-Cal patients residing in a long-term care facility. The bill would prescribe general and specific requirements for both facility residents who intend to leave the facility and return to an existing home, who would receive the home upkeep allowance, and for residents who do not have a home but intend to leave the facility and establish a new home, who could establish a transitional needs fund for the purpose of meeting the transitional costs of establishing a home. The bill would require the department to implement, subject to federal approval and federal financial participation, these provisions by means of various instructions, including provider bulletins, to adopt regulations within 5 years of implementation of these provisions, and to provide a status report to the Legislature on a semiannual basis until regulations have been adopted. The bill would require the department to inform appropriate long-term care facility residents and notify specified personnel and health care facilities of the existence and availability of the home upkeep allowance and the transitional needs fund. Because counties are required to make Medi-Cal eligibility determinations, and this bill would impose new eligibility requirements for purposes of these allowances, this 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.

Bill Text

• Amended 06/13/19 - Amended Senate Current pdf June 13, 2019
• Introduced 02/21/19 - Introduced pdf February 21, 2019
• AB1042 View text html

Action History

1. August 30, 2019

   In committee: Held under submission.

2. August 12, 2019

   In committee: Referred to APPR. suspense file.

3. July 10, 2019

   From committee: Do pass and re-refer to Com. on APPR. with recommendation: To Consent Calendar. (Ayes 8. Noes 0.) (July 10). Re-referred to Com. on APPR.

4. June 13, 2019

   From committee chair, with author's amendments: Amend, and re-refer to committee. Read second time, amended, and re-referred to Com. on HEALTH.

5. June 12, 2019

   Referred to Com. on HEALTH.

6. May 30, 2019

   In Senate. Read first time. To Com. on RLS. for assignment.

7. May 29, 2019

   Read third time. Passed. Ordered to the Senate. (Ayes 78. Noes 0. Page 2073.)

8. May 20, 2019

   Read second time. Ordered to third reading.

9. May 16, 2019

   From committee: Do pass. (Ayes 18. Noes 0.) (May 16).

10. April 24, 2019

    In committee: Set, first hearing. Referred to APPR. suspense file.

11. April 03, 2019

    From committee: Do pass and re-refer to Com. on APPR. (Ayes 15. Noes 0.) (April 2). Re-referred to Com. on APPR.

12. March 07, 2019

    Referred to Com. on HEALTH.

13. February 22, 2019

    From printer. May be heard in committee March 24.

14. February 21, 2019

    Read first time. To print.

Sponsors

• Wood · Primary

Votes

Subjects