Bill Text: CA AB1085 | 2023-2024 | Regular Session | Enrolled

California Assembly Bill 1085

Bill Title: Medi-Cal: housing support services.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Vetoed) 2024-01-25 - Consideration of Governor's veto stricken from file. [AB1085 Detail]

Download: California-2023-AB1085-Enrolled.html

Enrolled September 18, 2023

Passed IN Senate September 12, 2023

Passed IN Assembly September 13, 2023

Amended IN Senate September 08, 2023

Amended IN Senate September 01, 2023

Amended IN Senate June 15, 2023

Amended IN Assembly March 27, 2023

CALIFORNIA LEGISLATURE— 2023–2024 REGULAR SESSION

Assembly Bill

No. 1085

Introduced by Assembly Member Maienschein

February 15, 2023

An act to amend Section 14124.16 of the Welfare and Institutions Code, relating to Medi-Cal.

LEGISLATIVE COUNSEL'S DIGEST

AB 1085, Maienschein. Medi-Cal: housing support services.

Existing law establishes 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, subject to implementation of the California Advancing and Innovating Medi-Cal (CalAIM) initiative, authorizes a Medi-Cal managed care plan to elect to cover community supports approved by the department as cost effective and medically appropriate in a comprehensive risk contract that are in lieu of applicable Medi-Cal state plan services. Under existing law, community supports that the department is authorized to approve include, among other things, housing transition navigation services, housing deposits, and housing tenancy and sustaining services.

Existing law, subject to an appropriation, requires the department to complete an independent analysis to determine whether network adequacy exists to obtain federal approval for a covered Medi-Cal benefit that provides housing support services. Existing law requires that the analysis take into consideration specified information, including the number of providers in relation to each region’s or county’s number of people experiencing homelessness. Existing law requires the department to report the outcomes of the analysis to the Legislature by January 1, 2024.

This bill would delete the requirement for the department to complete that analysis, and instead would make housing support services for specified populations a covered Medi-Cal benefit when the department has begun a specified evaluation required under the CalAIM Waiver Special Terms and Conditions, and the Legislature has made an appropriation for purposes of the housing support services. The bill would require the department to seek federal approval for the housing support services benefit, as specified. Under the bill, subject to an appropriation by the Legislature, a Medi-Cal beneficiary would be eligible for those services if they either experience homelessness or are at risk of homelessness. Under the bill, the services would include housing transition and navigation services, housing deposits, and housing tenancy and sustaining services, as defined.

The bill would authorize the department to implement, interpret, or make specific this section, in whole or in part, by means of all-county letters, plan letters, provider bulletins, information notices, or similar instruction, and to enter into exclusive or nonexclusive contracts, or amend existing contracts for its purposes, as specified. The bill would authorize these provisions to be modified by the department to the extent necessary to meet the requirements of federal law or regulations, to obtain federal approval, or to enhance the probability that federal approval can be obtained, as specified.

Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO

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

SECTION 1.

Section 14124.16 of the Welfare and Institutions Code is amended to read:

14124.16.

(a) (1) Subject to utilization controls, housing support services for the populations identified in paragraph (4) shall be a covered Medi-Cal benefit in an applicable fiscal year when both of the following conditions are met:

(A) The department has begun the evaluation required by the Centers for Medicare and Medicaid Services under the California Advancing and Innovating Medi-Cal Waiver Special Terms and Conditions.

(B) The Legislature has passed an appropriation for the subject fiscal year for this express purpose.

(2) The department shall seek federal approval of a covered Medi-Cal benefit for housing support services no earlier than January 1, 2025 and no later than July 1, 2026.

(3) Upon implementation of a federally approved covered Medi-Cal benefit for housing support services, housing support services shall no longer be community supports that a Medi-Cal managed care plan may elect to cover.

(4) Subject to an appropriation by the Legislature for this purpose, a Medi-Cal beneficiary shall be eligible for housing support services if they meet either of the following criteria:

(A) The beneficiary is currently experiencing homelessness.

(B) The beneficiary is at risk of homelessness.

(b) Housing support services include all of the following:

(1) Housing transition and navigation services.

(2) Housing deposits.

(3) Housing tenancy and sustaining services.

(1) “At risk of homelessness” has the same meaning as set forth in Section 91.5 of Title 24 of the Code of Federal Regulations, unless otherwise defined by the department in regulation, all-county letter, plan letter, provider bulletin, information notice, or similar instruction.

(2) “Community supports” has the same meaning as set forth in paragraph (1) of subdivision (i) of Section 14184.206.

(3) “Department” means the State Department of Health Care Services.

(4) “Homelessness” as it corresponds to the term “homeless” has the same meaning as set forth in Section 578.3 of Title 24 of the Code of Federal Regulations, as that section read on January 1, 2023, except that an individual shall continue to be considered “homeless” when living in or exiting an institutional setting, even if residing in that institutional setting for longer than 90 days, so long as they were homeless prior to residency.

(5) “Housing transition and navigation services” means evidence-based and best practices that provide outreach to, and engage with, people experiencing homelessness in order to facilitate participation in the program and assist with transitioning to housing. The term includes the following services:

(A) Assisting beneficiaries with obtaining local, state, or federal rental assistance or subsidies, and in locating permanent housing with private market landlords or property managers who are willing to accept rental assistance.

(B) Assisting beneficiaries in completing housing applications for permanent housing, including obtaining documentation needed to access permanent housing.

(D) Assisting beneficiaries with applying for benefits to afford their housing.

(E) Ensuring that the living environment is safe and ready for move-in.

(F) Assisting and arranging for the details of the move, including identifying resources to assist with moving expenses.

(G) Developing a housing support crisis plan that includes prevention and early intervention when housing is jeopardized.

(H) Assisting the beneficiary to develop skills vital to maintaining permanent housing, including understanding and developing a budget, negotiating a lease, and building a good relationship with a prospective landlord.

(6) “Housing deposits” means one-time expenses for move-in, such as security deposits, payment of utility arrears and startup, and necessary furniture costs.

(7) “Housing tenancy and sustaining services” means services that preserve and maintain a person’s housing within their community, including any of the following:

(A) Early identification and intervention of actions that may jeopardize housing security.

(B) Education and training on the rights and responsibilities of the tenant and the landlord.

(D) Assistance in resolving disputes with landlords and neighbors to reduce the risk of eviction.

(E) Advocacy and linkage with community resources to prevent eviction when housing may become jeopardized.

(F) Care coordination and advocacy with health care professionals.

(G) Assistance with a housing recertification process.

(H) Coordinating with the tenant to review and update a housing support and crisis plan.

(I) Assistance with applying for benefits to retain housing.

(J) Educating tenants about their benefits and the need for a stable source of income to maintain housing.

(K) Coordinating with, and linking individuals to, services and service providers in the community that can assist with maintaining stable housing.

(L) Providing supported employment services.

(M) Providing skills training on how to maintain a safe and healthy home environment.

(8) “Supportive employment services” means individualized services provided to individuals with disabilities to obtain and keep competitive employment. Supportive employment services include all of the following:

(A) Assistance with completing an employment application.

(B) Identifying potential workplace accommodations that may be required.

(D) Assistance with transportation needs.

(E) Coordinating vocational training.

(F) Assistance with developing skills to maintain stable employment.

(d) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement, interpret, or make specific this section, in whole or in part, by means of all-county letters, plan letters, provider bulletins, information notices, or similar instruction, without taking further regulatory action. The department shall seek stakeholder input at least two weeks before issuing guidance pursuant to this authority.

(e) This section shall be implemented only to the extent that any necessary federal approvals are obtained, and federal financial participation is available and not otherwise jeopardized.

(f) For purposes of implementing this section, the department may enter into exclusive or nonexclusive contracts, or amend existing contracts, on a bid or negotiated basis. Contracts entered into or amended pursuant to this subdivision shall be exempt from Chapter 6 (commencing with Section 14825) of Part 5.5 of Division 3 of Title 2 of the Government Code, Section 19130 of the Government Code, Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code, and the State Administrative Manual, and shall be exempt from the review or approval of any division of the Department of General Services.

(g) (1) Any provision of this section may be modified by the department to the extent necessary to meet the requirements of federal law or regulations, to obtain federal approval, or to enhance the probability that federal approval can be obtained, provided the modifications do not violate the spirit and intent of the section.

(2) If the department determines that a modification is necessary pursuant to paragraph (1), the department shall consult with stakeholders to the extent practical, and notify the Legislature of expected modifications.