DISABILITY
RIGHTS NEWS REPORT
California
Disability Community Action Network
Advocacy Without Borders: One
Community
REPORT #127-2008 -
JUNE 19, 2008 - THURSDAY
REPLY
TO: MARTY OMOTO
martyomoto@rcip.com
website: www.cdcan.us
CALIFORNIA LEGISLATURE
* Major SB 483 Medi-Cal
Eligibility Bill
* Amended In Assembly June 18th
* Set For Hearing Assembly Health
6/24
* Major Impact to Seniors, People
with Disabilities
Implements Major Changes to
Medi-Cal Eligibility Required by 2005 Federal Deficit Reduction Act
SACRAMENTO (CDCAN) - With the State budget
deficit still unresolved and the end of the budget year fast
approaching, the Legislature faces another major deadline of June 27th
to pass bills out of policy committees in both houses. Policy
committees - like Assembly and Senate Health Committees, will be
holding their final hearings for the 2008 session next week, with many
major and controversial bills scheduled for hearing.
One of those major bills, SB 483 by Sen. Sheila
Kuehl (Democrat - Santa Monica, 23rd District) that would make
changes to existing State laws in order to 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 yesterday (June 18th) in the Assembly. The bill is set for
hearing on:
June 24, 2008 (Tuesday) at 1:30 PM
Assembly Health Committee
State Capitol, Room 4202.
The latest copy of the bill as amended June 18th is
available for viewing or downloading on the CDCAN website at www.cdcan.us,
along with the previous CDCAN Report covering it).
The June 18, 2008 amendments made no major
changes other than to add two paragraphs in virtually every
section of the bill (instead of just one section) that each of SB
483 provisions would take effect, if regulations were needed,
upon adoption of those state regulations (and not when the bill became
effective or the effective dates in the federal 2005 Deficit Reduction
Act.
The issue of effective dates are crucial - and
something that disability and senior advocates wanted clarified in
earlier versions of the bill - because of the tremendous potential
impact on eligibility for tens of thousands of people with
disabilities and seniors. It would also clarify the situation for
community based organizations and other providers who provide
advocacy, information and referrals to those seeking Medi-Cal program
eligibility assistance and information, and also for the counties who
administer the day to day Medi-Cal program eligibility.
Previous June 2 Amendment Deleted Changes
to Life Insurance Disclosures
Previous amendments to the bill on June 2, 2008 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 June 18, 2008 amendments makes no mention of
life insurance disclosures.
Before the June 18th amendments, the bill was
previously amended on June 2, 2008 and before that on May 5, 2008.
Note: CDCAN will be scheduling a special CDCAN
Townhall Telemeeting on this bill and other Medi-Cal related issues,
including State budget issues related to Medi-Cal, including status of
at least two class action lawsuits.
Watch for CDCAN Report or go to the
CDCAN website at www.cdcan.us
Several Other Important Health Bills Set
For Hearing Next Week
In addition to SB 483, several other important
health related bills impacting people with disabilities, mental health
needs, seniors, their families, support workers and others are set for
hearing on June 24th, before the Assembly Health Committee's final
full scale committee hearing for the 2008 session. See separate
CDCAN Report later today for details (bills listed in the color red
indicate legislation that has received a lot of attention and support
or controversy)
* SB 462 (Torlakson) Hospice Providers -
Licensed Hospice Facilities
* SB 1198 (Kuehl)
Health Care Coverage: Durable Medical Equipment
* SB 1440 (Kuehl) Health Care
Coverage: Benefits
* SB 1553 (Lowenthal) Health
Care Service Plans
* SB 1563 (Perata)
Health Care Insurance: Autism (Pervasive Developmental Disorders)
* SB 1738 (Steinberg)
Medi-Cal: Frequent Users of Health Care Pilot Program
On June 25, Wednesday at 1:30 PM, the
Senate Health Committee, State Capitol, Room 112 (note room change),
chaired by Sen. Sheila Kuehl, will hold its final full scale committee
hearing for the year with these important bills scheduled for hearing
that impact people with disabilities, mental health needs, seniors,
their families, support workers and others (see separate CDCAN Report
for more details):
* AB 10 (De La Torre) Children's
Hospital Bond Act of 2008 (Urgency)
* AB 368 (Carter) Hearing Aids
* AB 501 (Swanson) Pharmaceutical
Devices
* AB 1057 (Beall) Adult Health Coverage
Expansion Program
* AB 1951 (Hayashi) Suicide
Prevention Hotlines
* AB 2124 (Beall) Medi-Cal: Alcohol and
Drug Screening & Brief Intervention Services
* AB 2328 (Price) Skilled Nursing
Facilities: Notice of Sale
* AB 2381 (Mullin) Stem Cell Research
* AB 2543 (Berg) Geriatric and Gerontology
Workforce Expansion Act
* AB 2549 (Hayashi) Health Care Coverage:
Rescission
* AB 2747 (Berg) End
of Life Care
* AB 2842 (Berg) Solicitation: Unfair
Business Practices
* AB 2875 (Lieber) Public Social Services
Recipients: Medi-Cal Eligibility Pilot Project
* AB 3083 (Committee on Veterans Affairs)
Mental Health: Veterans
* AJR 54 (Laird) State Children's Health
Insurance Program
Bills - including SB 483, that pass out of either
Senate or Assembly Health Committee, go to either the Senate or
Assembly Appropriations Committee, and if reported out of those
committees in August, will go to the floors for final votes.
June 24th Public Testimony Limited - But
Letters Welcome
Public testimony for SB 483 (and for any
bill set for hearing in the Assembly Health Committee), is often
limited by the chair, Assemblymember Mervyn Dymally (Democrat -
Los Angeles, 52nd District) to two persons for and against a bill at
the hearing (with testimony among those people limited to a 2 to
3 minutes). All other persons who are present would be limited
to simply stating their name and position on the bill.
Another effective way of letting the Assembly
Health Committee know of your position is to write a letter to be
included in the committee analysis on the bill and also to write
letters to the entire committee (address to the chair and copy the
committee members) so that members from both parties can have your
letter.
Assembly Health Committee Analysis
* Every committee has staff that provide for the
committee members an analysis of each bill - that explains the purpose
of the bill, some history and previous legislation, the reason of the
author in putting forward the bill, and sometimes concerns outlined by
those supporting or opposing the bill.
* Also listed are those organizations who have sent
in letters, by the deadline (which has passed already for the June
24th Assembly Health Committee hearing) to be included in the
analysis, who are for or against the bill. Analysis are used by
committee members to help determine their positions and votes and to
help their staff people raise questions or concerns.
* People can still send in letters after the
deadline for the analysis - directly to committee members,
raising concerns or indicating support. CDCAN will issue the fax
and addresses of each committee member later today.
Assembly Health Committee Analysis Deadline for
Letters
The deadline to be included in the committee
analysis in time for the June 24th hearing was Wednesday (June 18th)
however people can still send in letters to committee members and the
committee chair to let them know of their position on the bill and any
concerns.
Where to Send Letters
STEP 1: The Assembly Health Committee staff person
who is handling the bill is Scott Bain, the principal consultant to
the Assembly Health Committee (the committee has a chief consultant,
and 3 consultants to handle bills). Address the letter to:
Assemblymember Mervyn Dymally, Assembly Health
Committee Chair
Assembly Health Committee Office
State Capitol - Room 6005
Sacramento, CA 95814
CDCAN STEP 2: In addressing your letter,
address it as above in the actual letter, and ALSO include the
following between the address and the salutation - this helps
the committee staff know immediately what bill the letter is referring
to - and also will help in getting the letter to the right staff
person.
Re: SB 483 - Medi-Cal (support or oppose
or whatever position you have)
CDCAN STEP 3: Fax or hand deliver or send (by US
Mail) your letter as soon as possible. As mentioned, the deadline to
be included in the committee analysis has passed, but you
can still send in letters AFTER this deadline directly to committee
members however, and that is useful, because sometimes they will refer
to the letters they get in addition to reading a committee analysis on
the bill.
Assembly Health Committee Fax: (916) 319–2197
Attention: Scott Bain, Principal Consultant,
Assembly Health Committee
CDCAN STEP 4: Be SURE to send also copy of your
letter (for or against) also to the author of the bill:
Sen. Sheila Kuehl
State Capitol
Sacramento, CA 95814
Sen. Kuehl Capitol Office Fax: (916) 324-4823
Assembly Health Committee Members
The Assembly Health Committee has 17 members -
and it takes 9 votes to pass a bill out of committee. Most
observers feel that SB 483, as amended June 18th (and previously on
June 2nd and May 5th), should have little trouble passing out of
this committee
DEMOCRATIC MEMBERS
Assemblymembers Dymally (chair), Berg, Carter, De
La Torre, De Leon, Hancock, Hayashi, Hernandez, Jones, Lieber, Ma,
Salas
REPUBLICAN MEMBERS
Assemblymembers Nakanishi (vice chair), Emmerson,
Gaines, Huff and Audra Strickland
SB 483 Will Have Major Impact on for Hundreds
of Thousands of Seniors, People With Disabilities
* SB 483, if passed, will make changes to Medi-Cal
eligibility that 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 Care Services, which oversees the
State's Medicaid program (called "Medi-Cal" in
California).
* The bulk of those changes were 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 clarified, in one
paragraph, that the bill would take effect upon adoption of State
regulations, and also deleted the entire section dealing with making
changes to the existing State laws regarding life insurance
disclosures.
* The June 18, 2008 amendments clarify even
further - for each section of the bill - that if state
regulations are needed, the Department of Health Care Services must
use the normal process - and not emergency regulations. The
effective dates for each section of the bill will be from the point
after any effective date of State regulations that are adopted and
not retroactively (meaning from the date back) to when SB
483 was enacted or when the original Deficit Reduction Act was
passed by Congress.
* The bill also contains (and repeated in several
other sections) a sentence regarding availability of federal
matching funds: "This section shall be implemented
pursuant to the requirements of Title XIX of the federal Social
Security Act (42 U.S.C. Sec. 1396 et seq.), and any regulations
adopted pursuant to that act, and only to the extent that federal
financial participation is available."
Original Introduced Version of Bill
Raised Home Exemption
* As reported in previous CDCAN
Reports, 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 however have
said that State law needed to be changed in order to implement many
of the major 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 SB 483 AND
JUNE 18, 2008 AMENDMENTS
EFFECTIVE DATE OF SB 483
JUNE 18, 2008 AMENDMENTS IMPACT
ADDS EFFECTIVE DATE & USE
OF REGULATIONS
* Included in the June 18, 2008 amendments
for every section of the bill, are two (sometimes three) paragraphs
that indicate that the bill takes effect upon the adoption of State
regulations, if state regulations are needed, and that the normal -
not emergency - regulatory process will be used.
CDCAN COMMENT
* The previous amendments - June 2, 2008
amendments included a provision that made it clear that 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, and the June 18th amendments
took it a step further by including that provision in every section
of the bill.
LIFE INSURANCE AGENT DISCLOSURE
DELETED BY JUNE 2, 2008 AMENDMENTS
JUNE 18, 2008 AMENDMENTS: NO CHANGES
CDCAN COMMENT:
* The June 2, 2008 amendments completely deleted of all
references related to making any changes to existing State law
dealing with life insurance agent disclosures.
* Those disclosures are already required under current State
law for seniors, but the May 5, 2008 amendments wanted to expand
it to include people with disabilities.
* This was originally 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".
* The June 18, 2008 amendments made no mention of life
insurance disclosures and this section remains deleted from the
bill.
CONTINUING CARE RETIREMENT COMMUNITY
JUNE 18, 2008 AMENDMENTS
IMPACT
ADDS EFFECTIVE DATE & USE
OF REGULATIONS
* The June 18, 2008 amendments does not change
any of the provisions in the section about continuing care
retirement communities but adds in the same effective date
and also the same sentences about the need for State regulations
and the additional line regarding federal funding as follows:
. (c) This section shall be implemented pursuant to the requirements of Title XIX of the federal Social Security Act (42 U.S.C. Sec. 1396 et seq.), and any regulations adopted pursuant to that act, and only to the extent required by federal law, and only to the extent that federal financial participation is available.
(d) To the extent that regulations are necessary to implement this section, the department shall promulgate regulations using the nonemergency regulatory process described in Article 5 (commencing with Section 11346) of Chapter 3.5 of Part 1 of Division 3 of the Government Code.
(e) It is the intent of the Legislature that the provisions of this section 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.
. (c) This section shall be implemented pursuant to the requirements of Title XIX of the federal Social Security Act (42 U.S.C. Sec. 1396 et seq.), and any regulations adopted pursuant to that act, and only to the extent required by federal law, and only to the extent that federal financial participation is available.
(d) To the extent that regulations are necessary to implement this section, the department shall promulgate regulations using the nonemergency regulatory process described in Article 5 (commencing with Section 11346) of Chapter 3.5 of Part 1 of Division 3 of the Government Code.
(e) It is the intent of the Legislature that the provisions of this section 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.
CDCAN COMMENT:
* The section that deals with continuing care retirement
communities was originally added into the bill with the May 5,
2008 amendments which applies to anyone who is residing in a
continuing care retirement community as defined in paragraph
(11) of subdivision (c) of Section 1771 of the Health and Safety
Code, pursuant to a continuing care contract, that collects an
entrance fee from its residents upon admission.
* The May 5, 2008 amendments (which were not changed by the
June 2 or June 18, 2008 amendments) provided that for the
State to determine a person's eligibility for Medi-Cal,
that person's entrance fee shall be considered a resource
available to the person, if all of the following apply:
(1) The individual has the ability to use the entrance fee, or
the contract provides that the entrance fee may be used, to
pay for care if other resources or income of the individual
are insufficient to pay for care.
(2) The individual is eligible for a refund of any remaining
entrance fee when he or she dies or terminates his or her
contract with, and leaves, the continuing care retirement
community.
(3) The entrance fee does not confer an ownership interest in
the continuing care retirement community.
VALUE OF HOME (EQUITY) AND
ELIGIBILITY
06/18/08 AMENDMENT IMPACT:
ADDS EFFECTIVE DATE & USE
OF REGULATIONS
* The June 18, 2008 amendments contained no
changes Section 4 of the bill which deals with the
value (equity) of a person's home and their eligibility for
Medi-Cal - changes required by the federal 2005 Deficit
Reduction Act, but does add a paragraph dealing with
effective dates and State regulations as follows:
(f) To the extent that
regulations are necessary to implement this section [Section
4], the department [of Health Care Services] shall
promulgate regulations using the nonemergency regulatory
process described in Article 5 (commencing with Section
11346) of Chapter 3.5 of Part 1 of Division 3 of the
Government Code.
(g) It is the intent of the Legislature that the provisions of this section 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
(g) It is the intent of the Legislature that the provisions of this section 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
CDCAN COMMENT:
* Even with the exemptions, this
represents a major change to Medi-Cal eligibility, which
under current State law (and previous federal law),
exempts the home.
* This section defines
"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 (Medi-Cal) beneficiary, less any encumbrances of
record.
* Would change current State law by requiring that a 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, but does provided for "hardship waivers" from this requirement.
* Would change current State law by requiring that a 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, but does provided for "hardship waivers" from this requirement.
* 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 TO HOME EQUITY
AND ELIGIBILITY
06/18/08 AMENDMENT IMPACT:
ADDS EFFECTIVE DATE & USE OF
REGULATIONS
* The June 18, 2008 amendments contained no
changes to Section 4 of the bill dealing with
exemptions to the home equity rule on Medi-Cal eligibility but
did the following:
(f) To the extent that
regulations are necessary to implement this section [Section
4], the department [of Health Care Services] shall promulgate
regulations using the nonemergency regulatory process
described in Article 5 (commencing with Section 11346) of
Chapter 3.5 of Part 1 of Division 3 of the Government Code.
(g) It is the intent of the Legislature that the provisions of this section 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.
(g) It is the intent of the Legislature that the provisions of this section 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.
CDCAN COMMENT:
* This section is very important to
disability, mental health and senior advocates because it outlines exemptions
to the home equity requirements for certain persons who
otherwise would not be eligible for Medi-Cal. .
* SB 483 (as amended on May 5, 2008 and unchanged
by the 06/18/08 amendments), exempts from the home equity
requirements a person applying for Medi-Cal (or being "redetermined")
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.
(2) The individual was determined eligible for
medical assistance for home and facility care based on an
application filed before January 1, 2006.
(3) The Department of Health Care Services determines
that ineligibility for Medi-Cal's home and facility care would
result in demonstrated hardship on the individual, defined as (but
not limited to) any of the following circumstances:
(A) The individual was receiving home and
facility care prior to January 1, 2006.
(B) The individual has been determined to be
eligible for Medi-Cal home and facility care based on an
application filed on or after January 1, 2006, and before the date
that State regulations adopted pursuant to this section are
certified with the Secretary of State.
(C) The individual purchased and received benefits under a long-term care insurance policy certified by the Department of Health Care Services' California Partnership for Long-Term Care Program.
(C) The individual purchased and received benefits under a long-term care insurance policy certified by the Department of Health Care Services' California Partnership for Long-Term Care Program.
(D) The individual's equity interest in their
principal residence (home) exceeds the equity interest limit as
provided in subdivision (b), but would not exceed the equity
interest limit under that subdivision if it had been increased by
using the quarterly House Price Index (HPI) for California,
published by the Office of Federal Housing Enterprise Oversight (OFHEO).
(E) The Medi-Cal applicant or beneficiary has
been denied a home equity loan by at least three lending
institutions, or is ineligible for any one Federal Housing
Administration (FHA) approved loan or reverse
mortgage.
mortgage.
(F) The Medi-Cal applicant or beneficiary, with
good cause, is unable to provide verification of the equity value
(G) The Medi-Cal applicant or beneficiary meets
the criteria set forth in subdivision (b) of Section 14015.1.
ASSET TRANSFERS
06/18/08 AMENDMENTS IMPACT:
ADDS EFFECTIVE DATE & USE OF
REGULATIONS
* The June 18, 2008 amendments contained no
changes Section 8 of the bill which deals with the how
Medi-Cal eligibility is impacted by transfer of a person's assets,
does add a paragraph dealing with effective dates and State
regulations as follows:
(f) To the extent that
regulations are necessary to implement this section, the department
[Health Care Services] shall promulgate regulations using the
nonemergency regulatory process described in Article 5 (commencing
with Section 11346) of Chapter 3.5 of Part 1 of Division 3 of the Government Code.
(g) It is the intent of the Legislature that the provisions of this section 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.
with Section 11346) of Chapter 3.5 of Part 1 of Division 3 of the Government Code.
(g) It is the intent of the Legislature that the provisions of this section 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.
Note: the following sentence was already in
the bill: "(e) This section shall be implemented pursuant to
the requirements of Title XIX of the federal Social Security Act (42
U.S.C. Sec. 1396 et seq.) and any regulations adopted pursuant to
that act, and only to the extent that federal financial
participation is available."
CDCAN COMMENT:
* SB 483 (as amended on May 5, 2008 and unchanged
by the 06/18/08 amendments) would change current State law regarding
transfer of a person's assets and Medi-Cal eligibility
* The transfer or gift of assets, including
income and resources, for less than fair market value shall,
pursuant to the
requirements of Title XIX of the federal Social Security Act and any State regulations adopted pursuant to that act, result in a period of ineligibility for medical assistance for home and facility care, which may include partial months of ineligibility, applied in accordance with federal law.
* Any items, including notes, loans, life estates, or annuities that are held and distributed in a manner that is not in conformity\ with the requirements of Title XIX of the federal Social Security Act and State regulations adopted pursuant to that act, shall be treated as a transferred asset and may result in a period of ineligibility .
requirements of Title XIX of the federal Social Security Act and any State regulations adopted pursuant to that act, result in a period of ineligibility for medical assistance for home and facility care, which may include partial months of ineligibility, applied in accordance with federal law.
* Any items, including notes, loans, life estates, or annuities that are held and distributed in a manner that is not in conformity\ with the requirements of Title XIX of the federal Social Security Act and State regulations adopted pursuant to that act, shall be treated as a transferred asset and may result in a period of ineligibility .
HARDSHIP WAIVER
06/18/08 AMENDMENTS IMPACT:
ADDS EFFECTIVE DATE & USE
OF REGULATIONS
* The June 18, 2008 amendments contained no
changes Section 9 of the bill which deals with the how
Medi-Cal hardship waivers but does add a paragraph dealing with
effective dates and State regulations as follows:
(e) To the extent that regulations
are necessary to implement this section, the department [of
Health Care Services] shall promulgate regulations using
the nonemergency regulatory process described in Article 5
(commencing with Section 11346) of Chapter 3.5 of Part 1 of
Division 3 of the Government Code.
(f) It is the intent of the Legislature that the provisions of this section 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.
Note: the following sentence is already in the bill: "(d) This section shall be implemented pursuant to the requirements of Title XIX of the federal Social Security Act (42 U.S.C. Sec. 1396 et seq.) and any regulations adopted pursuant to that act, and only to the extent that federal financial participation is available."
(f) It is the intent of the Legislature that the provisions of this section 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.
Note: the following sentence is already in the bill: "(d) This section shall be implemented pursuant to the requirements of Title XIX of the federal Social Security Act (42 U.S.C. Sec. 1396 et seq.) and any regulations adopted pursuant to that act, and only to the extent that federal financial participation is available."
CDCAN COMMENT:
* This section is very important to disability,
mental health and senior advocates because it outlines
"hardship waivers" for persons who might otherwise not be
eligible for Medi-Cal.
* SB 483 (as amended May 5, 2008 and with June 2,
2008 amendments that added that the adoption date of related State
regulations could be one of the factors to consider granting a
hardship waiver) would require that the Department of Health Care
Services shall consider, at the initial Medi-Cal application or
redetermination, whether an "undue hardship" (as defined
in this bill) exists prior to finding that the Medi-Cal applicant or
recipient is subject to a period of ineligibility for Medi-Cal
assistance for home and facility care.
* No person shall be subject to a period of
ineligibility for Medi-Cal assistance for home and facility
care at the time of the initial application or redetermination if
the Department of Health Care Services determines that an undue
hardship exists.
* The bill would require that the Department of
Health Care Services make a determination that ineligibility
for Medi-Cal 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.
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.
MEDI-CAL FAIR HEARINGS - UNDUE
HARDSHIP
06/18/08 AMENDMENTS IMPACT:
ADDS EFFECTIVE DATE & USE
OF REGULATIONS
* The June 18, 2008 amendments contained no
changes Section 10 of the bill dealing with Medi-Cal fair
hearings but does add a paragraph dealing with effective
dates and State regulations as follows:
(d) This section shall be
implemented pursuant to the requirements of Title XIX of the federal
Social Security Act (42 U.S.C. 1396 et seq.), and any regulations
adopted pursuant to that act, and only to the extent that federal
financial participation is available.
(e) To the extent that
regulations are necessary to implement this section, the department
[of Health Care Services] shall promulgate regulations using
the nonemergency regulatory process described in Article 5
(commencing\ with Section 11346) of Chapter 3.5 of Part 1 of
Division 3 of the Government Code.
(f) It is the intent of the
Legislature that the provisions of this section 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.
CDCAN COMMENT
* SB 483, (as amended May 5, 2008 and unchanged
by 06/18/08 amendments), following the federal Social Security Act,
would provide that any of the following persons may request a fair
hearing on the issue of "undue hardship" and their
eligibility for Medi-Cal:
(1) An individual requesting or
receiving Medi-Cal assistance for home and facility care.
(2) A personal representative of an individual requesting or receiving Medi-Cal assistance for home and facility care.
(2) A personal representative of an individual requesting or receiving Medi-Cal assistance for home and facility care.
(3) The facility in which the
individual requesting or receiving Medi-Cal assistance for home and
facility care is residing, with the consent of that individual or
the personal representative of that individual.
(b) An individual with a pending undue hardship appeal who is subject to a period of ineligibility pursuant to this article shall receive Medi-Cal assistance for home and facility care for a maximum of 30 bed-hold days.
(c) This section in SB 483 does not alter or limit the right of Medi-Cal applicants or recipients to obtain a state hearing in under Chapter 7 (commencing with Section 10950) of Part 2.
(b) An individual with a pending undue hardship appeal who is subject to a period of ineligibility pursuant to this article shall receive Medi-Cal assistance for home and facility care for a maximum of 30 bed-hold days.
(c) This section in SB 483 does not alter or limit the right of Medi-Cal applicants or recipients to obtain a state hearing in under Chapter 7 (commencing with Section 10950) of Part 2.
ANNUITIES
06/18/08
AMENDMENTS IMPACT:
ADDS EFFECTIVE DATE & USE
OF REGULATIONS
* The June 18, 2008 amendments contained no
changes Section 5, 6 and 7 of the bill dealing
with annuities and Medi-Cal eligibility but does add a
paragraph dealing with effective dates and State regulations
as follows:
(d) To the extent that regulations are necessary to
implement this section, the department [of Health Care
Services] shall promulgate regulations using the nonemergency
regulatory process described in Article 5 (commencing with
Section 11346) of Chapter 3.5 of Part 1 of Division 3 of the
Government Code.
(e) It is the intent of the Legislature that the provisions of this section 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.
(e) It is the intent of the Legislature that the provisions of this section 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.
Note: the following sentence is already in the bill: "(c)
This section shall be implemented pursuant to the requirements
of Title XIX of the federal Social Security Act (42 U.S.C.
Sec. 1396 et seq.) and any regulations adopted pursuant to
that act, and only to the extent that federal financial
participation is available."
CDCAN COMMENT:
* SB 483 (as amended May 5, 2008 and unchanged by
amendments of June 2 or 18, 2008) 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, regardless of
whether the annuity is irrevocable or is treated as income or as a
resource.
* 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 of Health Care Services 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.
* 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 of Health Care Services 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.
* This section of the bill shall only apply
to the following annuities:
(1) Those purchased on or after February 8, 2006.
(2) Those purchased before February 8, 2006, and
subjected to a transaction that occurred on or after February 8,
2006 ("transactions" are defined in the bill)
* Any provision in any annuity subject to this
section that has the effect of restricting the right of the state to
become a remainder beneficiary is void.
* Makes many other requirements related to
annuities (see details in latest version of SB 483).
URGENT!!!!
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Townhall Telemeetings, reports and alerts and other activities cannot continue without your help!
CDCAN Disability Rights News Reports, Telemeetings & other Events
Advocacy Without Borders - ONE Community:
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disabilities, seniors, mental health needs & others,
organizations, policy makers across California
This report - and the CDCAN townhall telemeetings, and other events and
projects are for all of them and for promoting advocacy without borders
toward unified action. We are one community.
To respond to this report reply to: Marty Omoto at martyomoto@rcip.com
CDCAN website: www.cdcan.us
To continue the CDCAN website, the CDCAN News Reports. sent out
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media across California and to continue the CDCAN Townhall Telemeetings
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USC UCEDD.
MANY MANY THANKS to Alta California Regional Center, FEAT (Families for
Early Autism Treatment), Friends of Children with Special Needs, Life
Steps, Easter Seals California, Parents Helping Parents, UCP of Los
Angeles and Ventura Counties, Work Training, Foothill Autism Alliance,
Arc Contra Costa, Pause4Kids, Manteca CAPS, Training Toward Self
Reliance, UCP, California NAELA, Californians for Disability Rights, Inc
(CDR) including CDR chapters, CHANCE Inc, , Strategies To Empower People
(STEP), Harbor Regional Center, Tri-Counties Regional Center, Asian
American parents groups, Resources for Independent Living and many other
Independent Living Centers, several regional centers, People First
chapters, IHSS workers, other self advocacy and family support groups,
developmental center families, adoption assistance program families and
children, and others across California