CDCAN LOGO DISABILITY RIGHTS NEWS REPORT
California Disability Community Action Network
Advocacy Without Borders: One Community
REPORT #123-2008  -  JUNE 3, 2008 -TUESDAY
REPLY TO: MARTY OMOTO 
martyomoto@rcip.com   website:   www.cdcan.us
 
REMEMBERING PHIL PARKER OF TTSR (TRAINING TOWARD SELF RELIANCE) WHO PASSED AWAY UNEXPECTEDLY THIS PAST WEEKEND - HE WAS A TREMENDOUS ADVOCATE AND WORKER FOR ADULTS WITH DEVELOPMENTAL DISABILITIES. HE WAS LOVED AND WILL BE MISSED. 
 
California Legislature
* SB 483 MEDI-CAL ELIGIBILITY BILL AMENDED
* IMPLEMENTS FEDERAL ELIGIBILITY CHANGES
* EFFECTIVE DATE WHEN REGULATIONS ADOPTED
* BILL NOT YET SET FOR HEARING OFFICIALLY
Eligibility Changes Will Have Major Impact on Hundreds of Thousands of Seniors, People With Disabilities On Medi-Cal or Applying for Medi-Cal
 
SACRAMENTO (CDCAN) - SB 483 by Sen. Sheila Kuehl (Democrat - Santa Monica, 23rd District) that would implement long delayed major changes on Medi-Cal eligibility required by the passage in February 2006 by the federal "Deficit Reduction Act" (DRA), was amended June 2, with a hearing likely in Assembly Health Committee either on June 10th, and possibly June 17th.   The new version of the bill became available this afternoon, and is available on the CDCAN website at www.cdcan.us
 
The June 2, 2008 amendments took out changes that would have impacted existing State laws requiring life insurance agents to provide disclosures, and also inserted a paragraph that clarifies that the eligibility changes apply prospectively from the date that State regulations are adopted and filed with the Secretary of State. 
 
The bill is currently in Assembly Appropriations Committee, but is expected to be officially referred back to Assembly Health Committee this week.  No hearing date however has been officially announced.  The bill was last amended on May 5, 2008. 
Note: CDCAN will be scheduling a special CDCAN Townhall Telemeeting on this bill and other Medi-Cal related issues.  Watch for CDCAN Report or go to the CDCAN website at www.cdcan.us
 
SB 483 Will Have Major Impact on for Hundreds of Thousands of Seniors, People With Disabilities
* SB 483 changes to Medi-Cal eligibility, will have major impact on the rights of hundreds of thousands of seniors and people with disabilities. 
 
* Most of the changes were originally proposed by the Department of Health Cares Services and included in the May 5, 2008 amendments of the bill, and are meant to put the State in compliance with  key provisions of the federal 2005 "Deficit Reduction Act" by the US Congress and signed by the President in February 2006. The June 2, 2008 amendments clarify those amendments in one case - and take out a proposed change in another. 
 
* The bill, if it passes and is signed by the Governor - which is likely, will go into effect January 1, 2009, but new amendments in the bill make it clear that the provisions of the bill will take effect prospectively (and not retroactively to when the bill was enacted or when the original Deficit Reduction Act was passed by Congress) from the date regulations are actually adopted by the State and filed with the Secretary of State.  The amendments of June 2, 2008 include this new change in the bill:
 
"It is the intent of the Legislature that the provisions of this act shall apply prospectively to any individual to whom the act applies commencing from the date regulations adopted pursuant to this act are filed with the Secretary
of State."   
 
Original Version of Bill Raised Home Exemption
The original version of the bill as introduced February 22, 2007, simply raised from $500,000 to $750,000, the equity interest in a home that can be exempted for persons who seek eligibility for Medi-Cal long term care services.  The home was totally exempt, prior to the 2005 Deficit Reduction Act passed by Congress in February 2006 and signed by President Bush.
 
California Medi-Cal officials have said that state law needed to be changed in order to implement the changes in the 2005 Deficit Reduction Act related to the home and other related issues.  Until that happens, according to state officials, current Medi-Cal eligibility policies still apply. 
 
Previous amendments in May were proposed by the Department of Health Care Services, which oversees the Medi-Cal program.  Many stakeholder groups, including California NAELA, California Disability Community Action Network, California Advocates for Nursing Home Reform, Gray Panthers,  Resources for Independent Living, Training Toward Self Reliance, Older Women's League, and several other groups have been working on the bill.
 
CDCAN SUMMARY OF JUNE 2, 2008 AMENDMENTS
 
EFFECTIVE DATE OF SB 483
CDCAN COMMENT: Included in the June 2, 2008 amendments was a clarifying provision that makes it clear when the provisions of the bill go into effect - prospectively after the adoption of State regulations filed with the Secretary of State and not when the bill is enacted or when regulations are proposed.  This is something that advocates wanted - and wanted clarified. The May 5, 2008 amendments mentioned that the effective date of  the bill was prospective - but it was not clear if that meant the bill's enactment or when regulations were proposed or when regulations were adopted.  The June 2, 2008 amendments make it clear it is when State regulations are adopted.
The following paragraph was part of the June 2, 2008 amendments:
 
SEC. 13.   It is the intent of the Legislature that the provisions of this act shall apply prospectively to any
individual to whom the act applies commencing from the date regulations adopted pursuant to this act are filed with the Secretary of State.    
 
LIFE INSURANCE AGENT DISCLOSURE - DELETED
CDCAN COMMENT: The other major change caused by the June 2, 2008 amendments was the complete deletion of all references related to life insurance agent disclosures. 
 
Those disclosures are already required under current State law - but the May 5, 2008 amendments wanted to expand it to include not just seniors but people with disabilities. 
 
The change - proposed last August by the Department of Health Care Services and included in the May 5, 2008 amendments, was not something that was required under the federal "Deficit Reduction Act". 
 
VALUE OF HOME (EQUITY) AND ELIGIBILITY (NO CHANGE)
CDCAN COMMENT: The June 2, 2008 amendments contained no changes to these provisions other than the overall effective date (see above)
 
* Would define "equity interest" in a person's home (principal place of residence) that means the lesser of the following:
 (1) The assessed value of the principal residence determined under the most recent tax assessment, less any encumbrances of record.
(2)  The appraised value of the principal residence determined by a qualified real estate appraiser who has been retained by the\ applicant or beneficiary, less any encumbrances of record.
* Would supersede current State law and as except as provided in the bill, that an person is not eligible for Medi-Cal home and facility care if his or her equity (value) interest in their principal residence (home) exceeds $750,000.
* Would require that no later than December 31, 2011,  and each year thereafter, this amount shall be increased based on the percentage increase in the consumer price index for all urban consumers (all items, United States city average), rounded to the nearest one thousand dollars ($1,000).
 
EXEMPTIONS ON VALUE OF HOME (EQUITY) (NO CHANGE)
CDCAN COMMENT: The June 2, 2008 amendments contained no changes to these provisions other than the overall effective date (see above)
 
* The bill would provide for exemption of this to a person if any of the following circumstances exist:   
(1) The spouse of the individual or the individual's child who is under 21 years of age, or who is blind or who has a disability, as defined in paragraph (3) of subsection (a) of Section 1382c of Title 42 of the United States Code, is lawfully residing in the individual's home.
* The individual was determined eligible for medical assistance for home and facility care based on an application filed before January 1, 2006.
 
HARDSHIP WAIVER (NEW: INCLUSION OF EFFECTIVE DATE)
CDCAN COMMENT: The June 2nd amendments made one change to the issue of hardship waivers specifically, by adding that the adoption date of related State regulations is one of the factors to consider in granting a hardship waiver.  This is something that advocates wanted clarified. 
 
SB 483 would require that the Department of Health Care Services make a determination that ineligibility for medical assistance for home and facility care would result in demonstrated hardship on the individual including but not be limited to any of the following:
1.  The individual has been determined eligible for medical assistance for home and facility care based on an application filed on or after January 1, 2006, and before the date that  regulations adopted pursuant or relating to this section have been certified with the Secretary of State.
2. The deprivation of medical assistance for home and facility care would cause an endangerment to the life or health of the individual.
3. The denial of medical assistance for home and facility care would result in the eviction of the individual from a nursing home.
4. The individual is otherwise eligible for the Medi-Cal program and unable to obtain home and facility care without Medi-Cal.
5. The denial of medical assistance for home and facility care would cause the individual to be unable to remain at home or in  the  community and would hasten or cause the individual's entry into a medical or long-term care institution.
6. The individual would be deprived of food, clothing, shelter, or other necessities of life.
 
ANNUITIES (NO CHANGE)
CDCAN COMMENT: The May 5, 2008 included provisions impacting annuities, and the June 2, 2008 amendments made no changes to those provisions, except overall, these provisions - and all other provisions of the bill, are effective prospectively from the effective date of related State regulations adopted and filed with the Secretary of State. 
 
* Would require an individual, as a condition of eligibility for medical assistance for home and facility care, to
disclose a description of any interest that the individual or his or her spouse has in an annuity, as specified.
* Would require the State, as an operation of law, to become a "remainder beneficiary" of certain annuities, as described, unless the individual notifies the state in writing that he or she prohibits the state from becoming a remainder beneficiary, as provided, and would require the department to inform an individual and his or her spouse of this fact at the time of the individual's application or redetermination of Medi-Cal eligibility.
* If an individual or his or her spouse notifies the state in writing that he or she prohibits the state from becoming a remainder beneficiary to his or her annuity, the bill would require the annuity to be treated as a transfer of assets for less than fair market value for purposes of determining Medi-Cal eligibility. 
 
 
 
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