2010 California Code
Welfare and Institutions Code
Article 7. In-home Supportive Services

12300.  (a) The purpose of this article is to provide in every
county in a manner consistent with this chapter and the annual Budget
Act those supportive services identified in this section to aged,
blind, or disabled persons, as defined under this chapter, who are
unable to perform the services themselves and who cannot safely
remain in their homes or abodes of their own choosing unless these
services are provided.
   (b) Supportive services shall include domestic services and
services related to domestic services, heavy cleaning, personal care
services, accompaniment by a provider when needed during necessary
travel to health-related appointments or to alternative resource
sites, yard hazard abatement, protective supervision, teaching and
demonstration directed at reducing the need for other supportive
services, and paramedical services which make it possible for the
recipient to establish and maintain an independent living
arrangement.
   (c) Personal care services shall mean all of the following:
   (1) Assistance with ambulation.
   (2) Bathing, oral hygiene, and grooming.
   (3) Dressing.
   (4) Care and assistance with prosthetic devices.
   (5) Bowel, bladder, and menstrual care.
   (6) Repositioning, skin care, range of motion exercises, and
transfers.
   (7) Feeding and assurance of adequate fluid intake.
   (8) Respiration.
   (9) Assistance with self-administration of medications.
   (d) Personal care services are available if these services are
provided in the beneficiary's home and other locations as may be
authorized by the director. Among the locations that may be
authorized by the director under this paragraph is the recipient's
place of employment if all of the following conditions are met:
   (1) The personal care services are limited to those that are
currently authorized for a recipient in the recipient's home and
those services are to be utilized by the recipient at the recipient's
place of employment to enable the recipient to obtain, retain, or
return to work. Authorized services utilized by the recipient at the
recipient's place of employment shall be services that are relevant
and necessary in supporting and maintaining employment. However,
workplace services shall not be used to supplant any reasonable
accommodations required of an employer by the Americans with
Disabilities Act (42 U.S.C. Sec. 12101 et seq.; ADA) or other legal
entitlements or third-party obligations.
   (2) The provision of personal care services at the recipient's
place of employment shall be authorized only to the extent that the
total hours utilized at the workplace are within the total personal
care services hours authorized for the recipient in the home.
Additional personal care services hours may not be authorized in
connection with a recipient's employment.
   (e) Where supportive services are provided by a person having the
legal duty pursuant to the Family Code to provide for the care of his
or her child who is the recipient, the provider of supportive
services shall receive remuneration for the services only when the
provider leaves full-time employment or is prevented from obtaining
full-time employment because no other suitable provider is available
and where the inability of the provider to provide supportive
services may result in inappropriate placement or inadequate care.
   These providers shall be paid only for the following:
   (1) Services related to domestic services.
   (2) Personal care services.
   (3) Accompaniment by a provider when needed during necessary
travel to health-related appointments or to alternative resource
sites.
   (4) Protective supervision only as needed because of the
functional limitations of the child.
   (5) Paramedical services.
   (f) To encourage maximum voluntary services, so as to reduce
governmental costs, respite care shall also be provided. Respite care
is temporary or periodic service for eligible recipients to relieve
persons who are providing care without compensation.
   (g) A person who is eligible to receive a service or services
under an approved federal waiver authorized pursuant to Section
14132.951, or a person who is eligible to receive a service or
services authorized pursuant to Section 14132.95, shall not be
eligible to receive the same service or services pursuant to this
article. In the event that the waiver authorized pursuant to Section
14132.951, as approved by the federal government, does not extend
eligibility to all persons otherwise eligible for services under this
article, or does not cover a service or particular services, or does
not cover the scope of a service that a person would otherwise be
eligible to receive under this article, those persons who are not
eligible for services, or for a particular service under the waiver
or Section 14132.95 shall be eligible for services under this
article.
   (h) (1) All services provided pursuant to this article shall be
equal in amount, scope, and duration to the same services provided
pursuant to Section 14132.95, including any adjustments that may be
made to those services pursuant to subdivision (e) of Section
14132.95.
   (2) Notwithstanding any other provision of this article, the rate
of reimbursement for in-home supportive services provided through any
mode of service shall not exceed the rate of reimbursement
established under subdivision (j) of Section 14132.95 for the same
mode of service unless otherwise provided in the annual Budget Act.
   (3) The maximum number of hours available under Section 14132.95,
Section 14132.951, and this section, combined, shall be 283 hours per
month. Any recipient of services under this article shall receive no
more than the applicable maximum specified in Section 12303.4.



12300.1.  As used in Section 12300 and in this article, "supportive
services" include those necessary paramedical services that are
ordered by a licensed health care professional who is lawfully
authorized to do so, which persons could provide for themselves but
for their functional limitations. Paramedical services include the
administration of medications, puncturing the skin or inserting a
medical device into a body orifice, activities requiring sterile
procedures, or other activities requiring judgment based on training
given by a licensed health care professional. These necessary
services shall be rendered by a provider under the direction of a
licensed health care professional, subject to the informed consent of
the recipient obtained as a part of the order for service. Any and
all references to Section 12300 in any statute heretofore or
hereafter enacted shall be deemed to be references to this section.
All statutory references to the supportive services specified in
Section 12300 shall be deemed to include paramedical services.




12300.2.  In any in-home supportive services action concerning the
amount of in-home supportive services to be provided, the department
shall send a notice of the action to each recipient. The recipient
shall also receive a description of each specific task authorized and
the number of hours allotted. In the case of reassessment, the
recipient shall receive an identification of hours for tasks
increased or reduced and the difference from previous hours
authorized.


12301.  (a) The intent of the Legislature in enacting this article
is to provide supplemental or additional services to the social and
rehabilitative services in Article 6 (commencing with Section 12250)
of this chapter. The Legislature further intends that necessary
in-home supportive services shall be provided in a uniform manner in
every county based on individual need consistent with this chapter
and, for the 1992-93 fiscal year the appropriation provided for those
services in the Budget Act, in the absence of alternative in-home
supportive services provided by an able and willing individual or
local agency at no cost to the recipient, except as required under
Section 12304.5. An able spouse who is available to assist the
recipient shall be deemed willing to provide at no cost any services
under this article except nonmedical personal services and
paramedical services. When a spouse leaves full-time employment or is
prevented from obtaining full-time employment because no other
suitable provider is available and where the inability of the
provider to provide supportive services may result in inappropriate
placement or inadequate care, the spouse shall also be paid for
accompaniment when needed during necessary travel to health-related
appointments and protective supervision.
   (b) Each county shall be notified of its allocation and projected
caseload by July 31 of each fiscal year, or 30 days after the
enactment of the Budget Act, whichever occurs later.
   (c) This section shall remain operative until July 1, 1993, and on
and after that date, shall remain inoperative until July 1, 1994, at
which date, this section shall become operative.



12301.03.  (a) Notwithstanding any other provision of law, effective
October 1, 1992, and for the remainder of the 1992-93 fiscal year,
unless additional funds become available earlier for IHSS from the
personal care option, the department shall implement a 12 percent
reduction in hours of service to each recipient of services under
this article. For those recipients who have a documented unmet need
because of the limitations contained in Section 12303.4, this
reduction shall be applied first to the unmet need before being
applied to the hours to be authorized. If the recipient believes he
or she will be at serious risk of out-of-home placement as a
consequence of the reduction, the recipient may apply for a
restoration of reduction pursuant to Section 12301.05.
   (b) It is the intent of the Legislature to encourage counties, to
the extent possible, to achieve reductions in a manner that least
disrupts the continuity of services to recipients. Counties are
further encouraged, to the extent possible, to assist recipients in
locating supplemental services, such as congregate or home-delivered
meals, and to assist providers in obtaining additional hours of
employment to mitigate the impact of reductions upon them.
   (c) Notice of the reduction required by subdivision (a) shall be
provided to each recipient and shall include the following
information:
   (1) The amount of hours the recipient received prior to the
reduction and the amount of hours the recipient is to receive as a
result of the reduction.
   (2) The reason for the reduction.
   (3) A statement that the reduction shall be effective through June
30, 1993, unless additional funds become available earlier for IHSS
as a result of provision of Personal Care services.
   (4) How all or part of the reduction may be restored as set forth
in Section 12301.05 if the recipient believes he or she will be at
serious risk of out-of-home placement as a consequence of the
reduction.
   (d) Notice of the reduction shall be provided to providers as
expeditiously as possible by the Controller, in consultation with the
department.
   (e) Notwithstanding Section 11004, in any proceeding pursuant to
Section 10950 where it has been determined that the sole issue was
the reduction required by this section, any aid paid pending the
hearing shall be recoverable as an overpayment.



12301.05.  Any aged, blind, or disabled individual who is eligible
for services under this chapter who has had his or her services
reduced under subdivision (a) of Section 12301.03 but who believes he
or she is at serious risk of out-of-home placement unless all or
part of the reduction is restored may apply for an IHSS care
supplement. Where there is such an application within 10 days of
receiving the reduction notice or prior to the implementation of the
reduction, the IHSS shall continue until the county finds that the
recipient does or does not require restoration of any hours through
the IHSS care supplement. If the recipient disagrees with the county'
s determination concerning the need for the IHSS care supplement, the
recipient may request a hearing on that determination. However,
there will be no aid paid pending in that case.
   (b) For purposes of subdivision (a), an individual is in serious
risk of out-of-home placement only if (1) the individual meets the
criteria for long-term care services as set forth in the Manual of
Criteria for Medi-Cal Authorization published by the State Department
of Health Services (January 1, 1982, last amended September, 1991),
or (2) the individual cannot summon emergency assistance.
   (c) The county shall give a high priority to prompt screening of
these persons to determine their need for IHSS Care Supplement.




12301.06.  (a) (1) Notwithstanding any other provision of law,
except as provided in subdivision (d), the department shall implement
a 3.6-percent reduction in hours of service to each recipient of
services under this article which shall be applied to the recipient's
hours as authorized pursuant to the most recent assessment. This
reduction shall be effective 90 days after the enactment of the act
that adds this section. The reduction required by this section shall
not preclude any reassessment to which a recipient would otherwise be
entitled. However, hours authorized pursuant to a reassessment shall
be subject to the 3.6-percent reduction required by this section.
   (2) A recipient of services under this article may direct the
manner in which the reduction of hours is applied to the recipient's
previously authorized services.
   (3) For those individuals who have a documented unmet need
excluding protective supervision because of the limitations on
authorized hours under Section 12303.4, the reduction shall be taken
first from the documented unmet need.
   (b) (1) The reduction in hours of service pursuant to subdivision
(a) shall cease to be implemented on July 1, 2012.
   (2) It is the intent of the Legislature that on July 1, 2012,
services shall be restored to the level authorized pursuant to the
recipient's most recent assessment, and increased by the previously
deducted 3.6 percent.
   (c) The notice of action informing the recipient of the reduction
pursuant to subdivision (a) shall be mailed at least 30 days prior to
the reduction going into effect. The notice of action shall be
understandable to the recipient and translated into all languages
spoken by a substantial number of the public served by the In-Home
Supportive Services program, in accordance with Section 7295.2 of the
Government Code. The notice shall not contain any recipient
financial or confidential identifying information other than the
recipient's name, address, and Case Management Information and
Payroll System (CMIPS) client identification number, and shall
include, but not be limited to, all of the following information:
   (1) The aggregate number of authorized hours before the reduction
pursuant to subdivision (a) and the aggregate number of authorized
hours after the reduction.
   (2) That the recipient may direct the manner in which the
reduction of authorized hours is applied to the recipient's
previously authorized services.
   (3) That the reduction of hours shall remain in effect until July
1, 2012, at which time service hours shall be restored to the
recipient's authorized level, based on the most recent assessment,
and increased by the previously deducted 3.6 percent.
   (d) A recipient shall have all appeal rights otherwise provided
for under Chapter 7 (commencing with Section 10950) of Part 2.
   (e) (1) Notwithstanding the rulemaking provisions of the
Administrative Procedure Act (Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code),
the department may implement and administer this section through
all-county letters or similar instructions from the department.
   (f) This section shall become inoperative on July 1, 2012, and, as
of January 1, 2013, this section is repealed, unless a later enacted
statute that is enacted before January 1, 2013, deletes or extends
the dates on which it becomes inoperative and is repealed.



12301.1.  (a) The department shall adopt regulations establishing a
uniform range of services available to all eligible recipients based
upon individual needs. The availability of services under these
regulations is subject to the provisions of Section 12301 and county
plans developed pursuant to Section 12302.
   (b) The county welfare department shall assess each recipient's
continuing need for supportive services at varying intervals as
necessary, but at least once every 12 months.
   (c) (1) Notwithstanding subdivision (b), at the county's option,
assessments may be extended, on a case-by-case basis, for up to six
months beyond the regular 12-month period, provided that the county
documents that all of the following conditions exist:
   (A) The recipient has had at least one reassessment since the
initial program intake assessment.
   (B) The recipient's living arrangement has not changed since the
last annual reassessment and the recipient lives with others, or has
regular meaningful contact with persons other than his or her service
provider.
   (C) The recipient or, if the recipient is a minor, his or her
parent or legal guardian, or if incompetent, his or her conservator,
is able to satisfactorily direct the recipient's care.
   (D) There has been no known change in the recipient's supportive
service needs within the previous 24 months.
   (E) No reports have been made to, and there has been no
involvement of, an adult protective services agency or agencies since
the county last assessed the recipient.
   (F) The recipient has not had a change in provider or providers
for at least six months.
   (G) The recipient has not reported a change in his or her need for
supportive services that requires a reassessment.
   (H) The recipient has not been hospitalized within the last three
months.
   (2) If some, but not all, of the conditions specified in paragraph
(1) of subdivision (c) are met, the county may consider other
factors in determining whether an extended assessment interval is
appropriate, including, but not limited to, involvement in the
recipient's care of a social worker, case manager, or other similar
representative from another human services agency, such as a regional
center or county mental health program, or communications, or other
instructions from a physician or other licensed health care
professional that the recipient's medical condition is unlikely to
change.
   (3) A county may reassess a recipient's need for services at a
time interval of less than 12 months from a recipient's initial
intake or last assessment if the county social worker has information
indicating that the recipient's need for services is expected to
decrease in less than 12 months.
   (d) A county shall assess a recipient's need for supportive
services any time that the recipient notifies the county of a need to
adjust the supportive services hours authorized, or when there are
other indications or expectations of a change in circumstances
affecting the recipient's need for supportive services.
   (e) (1) Notwithstanding the rulemaking provisions of the
Administrative Procedure Act, Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code,
until emergency regulations are filed with the Secretary of State,
the department may implement this section through all-county letters
or similar instructions from the director. The department shall adopt
emergency regulations implementing this section no later than
September 30, 2005, unless notification of a delay is made to the
Chair of the Joint Legislative Budget Committee prior to that date.
The notification shall include the reason for the delay, the current
status of the emergency regulations, a date by which the emergency
regulations shall be adopted, and a statement of need to continue use
of all-county letters or similar instructions. Under no
circumstances shall the adoption of emergency regulations be delayed,
or the use of all-county letters or similar instructions be
extended, beyond June 30, 2006.
   (2) The adoption of regulations implementing this section shall be
deemed an emergency and necessary for the immediate preservation of
the public peace, health, safety, or general welfare. The emergency
regulations authorized by this section shall be exempt from review by
the Office of Administrative Law. The emergency regulations
authorized by this section shall be submitted to the Office of
Administrative Law for filing with the Secretary of State and shall
remain in effect for no more than 180 days by which time final
regulations shall be adopted. The department shall seek input from
the entities listed in Section 12305.72 when developing all-county
letters or similar instructions and the regulations.



12301.15.  Effective January 1, 2010, the application for in-home
supportive services shall contain a notice to the recipient that his
or her provider or providers will be given written notice of the
recipient's authorized services and full number of services hours
allotted to the recipient. The application shall inform recipients of
the Medi-Cal toll-free telephone fraud hotline and Internet Web site
for reporting suspected fraud or abuse in the provision or receipt
of supportive services.



12301.2.  (a) (1) The department, in consultation and coordination
with county welfare departments and in accordance with Section
12305.72, shall establish and implement statewide hourly task
guidelines and instructions to provide counties with a standard tool
for consistently and accurately assessing service needs and
authorizing service hours to meet those needs.
   (2) The guidelines shall specify a range of time normally required
for each supportive service task necessary to ensure the health,
safety, and independence of the recipient. The guidelines shall also
provide criteria to assist county workers to determine when an
individual's service need falls outside the range of time provided in
the guidelines.
   (3) In establishing the guidelines the department shall consider,
among other factors, adherence to universal precautions, existing
utilization patterns and outcomes associated with different levels of
utilization, and the need to avoid cost shifting to other government
program services. During the development of the guidelines the
department may seek advice from health professionals such as public
health nurses or physical or occupational therapists.
   (b) A county shall use the statewide hourly task guidelines when
conducting an individual assessment or reassessment of an individual'
s need for supportive services.
   (c) Subject to the limits imposed by Section 12303.4, counties
shall approve an amount of time different from the guideline amount
whenever the individual assessment indicates that the recipient's
needs require an amount of time that is outside the range provided
for in the guidelines. Whenever task times outside the range provided
in the guidelines are authorized the county shall document the need
for the authorized service level.
   (d) The department shall adopt regulations to implement this
section by June 30, 2006. The department shall seek input from the
entities listed in Section 12305.72 when developing the regulations.



12301.21.  (a) The department shall, in consultation and
coordination with the county welfare departments and in accordance
with Section 12305.72, develop for statewide use a standard form on
which to obtain certification by a physician or other appropriate
medical professional as determined by the department of a person's
need for protective supervision.
   (b) At the time of an initial assessment at which a recipient's
potential need for protective supervision has been identified, the
county shall request that a person requesting protective supervision
submit the certification to the county. The county shall use the
certification in conjunction with other pertinent information to
assess the person's need for protective supervision. The
certification submitted by the person shall be considered as one
indicator of the need for protective supervision, but shall not be
determinative. In the event that the person fails to submit the
certification, the county shall make its determination of need based
upon other available evidence.
   (c) At the time of reassessment of a person receiving authorized
protective supervision, the county shall determine the need to obtain
a new certification. The county may request another certification
from a recipient if determined necessary. The county shall document
the basis for its determination in the recipient's case file.
   (d) (1) Notwithstanding the rulemaking provisions of the
Administrative Procedure Act, Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code,
until emergency regulations are filed with the Secretary of State,
the department may implement this section through all-county letters
or similar instructions from the director. The department shall adopt
emergency regulations implementing this chapter no later than
September 30, 2005, unless notification of a delay is made to the
Chair of the Joint Legislative Budget Committee prior to that date.
The notification shall include the reason for the delay, the current
status of the emergency regulations, a date by which the emergency
regulations shall be adopted, and a statement of need to continue use
of all-county letters or similar instructions. Under no
circumstances shall the adoption of emergency regulations be delayed,
or the use of all-county letters or similar instructions be
extended, beyond June 30, 2006.
   (2) The adoption of regulations implementing this section shall be
deemed an emergency and necessary for the immediate preservation of
the public peace, health, safety, or general welfare. The emergency
regulations authorized by this section shall be exempt from review by
the Office of Administrative Law. The emergency regulations
authorized by this section shall be submitted to the Office of
Administrative Law for filing with the Secretary of State and shall
remain in effect for no more than 180 days by which time final
regulations shall be promulgated. The department shall seek input
from the entities listed in Section 12305.72 when developing
all-county letters or similar instructions and the regulations.



12301.22.  On or before December 31, 2011, the department, in
consultation with county welfare departments and other stakeholders,
shall develop a process to ensure that a provider of services under
this article receives a list specifying the approved duties to be
performed for each recipient under the provider's care and a complete
list of supportive service tasks available under the IHSS program.




12301.24.  (a) Effective November 1, 2009, all prospective providers
must complete a provider orientation at the time of enrollment, as
developed by the department, in consultation with counties, which
shall include, but is not limited to, all of the following:
   (1) The requirements to be an eligible IHSS provider.
   (2) A description of the IHSS program.
   (3) The rules, regulations, and provider-related processes and
procedures, including timesheets.
   (4) The consequences of committing fraud in the IHSS program.
   (5) The Medi-Cal toll-free telephone fraud hotline and Internet
Web site for reporting suspected fraud or abuse in the provision or
receipt of supportive services.
   (b) In order to complete provider enrollment, at the conclusion of
the provider orientation, all applicants shall sign a statement
specifying that the provider agrees to all of the following:
   (1) He or she will provide to a recipient the authorized services.
   (2) He or she has received a demonstration of, and understands,
timesheet requirements, including content, signature, and
fingerprinting, when implemented.
   (3) He or she shall cooperate with state or county staff to
provide any information necessary for assessment or evaluation of a
case.
   (4) He or she understands and agrees to program expectations and
is aware of the measures that the state or county may take to enforce
program integrity.
   (5) He or she has attended the provider orientation and
understands that failure to comply with program rules and
requirements may result in the provider being terminated from
providing services through the IHSS program.
   (c) Between November 1, 2009, and June 30, 2010, all current
providers shall receive the information described in this section.
Following receipt of this information, a provider shall submit a
signed agreement, consistent with the requirements of this section,
to the appropriate county office.
   (d) The county shall indefinitely retain this statement in the
provider's file. Refusal of the provider to sign the statement
described in subdivision (b) shall result in the provider being
ineligible to receive payment for the provision of services and
participate as a provider in the IHSS program.



12301.25.  (a) Notwithstanding any other provision of law, the
standardized provider timesheet used to track the work performed by
providers of services under this article shall contain both of the
following:
   (1) A certification to be signed by the provider and recipient,
verifying that the information provided in the timesheet is true and
correct.
   (2) A statement that the provider or recipient may be subject to
civil penalties if the information provided is found not to be true
and correct.
   (b) A person who is convicted of fraud, as defined in subdivision
(a) of Section 12305.8, resulting from intentional deception or
misrepresentation in the provision of timesheet information under
this section shall, in addition to any criminal penalties imposed, be
subject to a civil penalty of at least five hundred dollars ($500),
but not to exceed one thousand dollars ($1,000), for each violation.
   (c) Effective July 1, 2011, the standardized provider timesheet
shall also contain designated spaces for the index fingerprint of the
provider and the recipient. The provider and the recipient shall
place their respective index fingerprint in the designated location
on the timesheet in order for the timesheet to be eligible for
payment. An individual who is a minor or who is physically unable to
provide an index fingerprint due to amputation or other physical
limitations shall be exempt from the requirement to provide an index
fingerprint under this section, and documentation of this exemption
shall be maintained in the recipient or provider file, as applicable.



12301.3.  (a) Each county shall appoint an in-home supportive
services advisory committee that shall be comprised of not more than
11 individuals. No less than 50 percent of the membership of the
advisory committee shall be individuals who are current or past users
of personal assistance services paid for through public or private
funds or as recipients of services under this article.
   (1) (A) In counties with fewer than 500 recipients of services
provided pursuant to this article or Section 14132.95, at least one
member of the advisory committee shall be a current or former
provider of in-home supportive services.
   (B) In counties with 500 or more recipients of services provided
pursuant to this article or Section 14132.95, at least two members of
the advisory committee shall be a current or former provider of
in-home supportive services.
   (2) Individuals who represent organizations that advocate for
people with disabilities or seniors may be appointed to committees
under this section.
   (3) Individuals from community-based organizations that advocate
on behalf of home care employees may be appointed to committees under
this section.
   (4) A county board of supervisors shall not appoint more than one
county employee as a member of the advisory committee, but may
designate any county employee to provide ongoing advice and support
to the advisory committee.
   (b) Prior to the appointment of members to a committee required by
subdivision (a), the county board of supervisors shall solicit
recommendations for qualified members through a fair and open process
that includes the provision of reasonable written notice to, and
reasonable response time by, members of the general public and
interested persons and organizations.
   (c) The advisory committee shall submit recommendations to the
county board of supervisors on the preferred mode or modes of service
to be utilized in the county for in-home supportive services.
   (d) Any county that has established a governing body, as provided
in subdivision (b) of Section 12301.6, prior to July 1, 2000, shall
not be required to comply with the composition requirements of
subdivision (a) and shall be deemed to be in compliance with this
section.


12301.4.  (a) Each advisory committee established pursuant to
Section 12301.3 or 12301.6 shall provide ongoing advice and
recommendations regarding in-home supportive services to the county
board of supervisors, any administrative body in the county that is
related to the delivery and administration of in-home supportive
services, and the governing body and administrative agency of the
public authority, nonprofit consortium, contractor, and public
employees.
   (b) Each county shall be eligible to receive state reimbursements
of administrative costs for only one advisory committee and shall
comply with the requirements of subdivision (e) of Section 12302.25.




12301.5.  The department may secure to the extent feasible such
in-home supportive and other health services for persons eligible
under this article to which they are entitled under the Medi-Cal Act
(Chapter 7 (commencing with Section 14000) of this part).




12301.6.  (a) Notwithstanding Sections 12302 and 12302.1, a county
board of supervisors may, at its option, elect to do either of the
following:
   (1) Contract with a nonprofit consortium to provide for the
delivery of in-home supportive services.
   (2) Establish, by ordinance, a public authority to provide for the
delivery of in-home supportive services.
   (b) (1) To the extent that a county elects to establish a public
authority pursuant to paragraph (2) of subdivision (a), the enabling
ordinance shall specify the membership of the governing body of the
public authority, the qualifications for individual members, the
manner of appointment, selection, or removal of members, how long
they shall serve, and other matters as the board of supervisors deems
necessary for the operation of the public authority.
   (2) A public authority established pursuant to paragraph (2) of
subdivision (a) shall be both of the following:
   (A) An entity separate from the county, and shall be required to
file the statement required by Section 53051 of the Government Code.
   (B) A corporate public body, exercising public and essential
governmental functions and that has all powers necessary or
convenient to carry out the delivery of in-home supportive services,
including the power to contract for services pursuant to Sections
12302 and 12302.1 and that makes or provides for direct payment to a
provider chosen by the recipient for the purchase of services
pursuant to Sections 12302 and 12302.2. Employees of the public
authority shall not be employees of the county for any purpose.
   (3) (A) As an alternative, the enabling ordinance may designate
the board of supervisors as the governing body of the public
authority.
   (B) Any enabling ordinance that designates the board of
supervisors as the governing body of the public authority shall also
specify that no fewer than 50 percent of the membership of the
advisory committee shall be individuals who are current or past users
of personal assistance services paid for through public or private
funds or recipients of services under this article.
   (C) If the enabling ordinance designates the board of supervisors
as the governing body of the public authority, it shall also require
the appointment of an advisory committee of not more than 11
individuals who shall be designated in accordance with subparagraph
(B).
   (D) Prior to making designations of committee members pursuant to
subparagraph (C), or governing body members in accordance with
paragraph (4), the board of supervisors shall solicit recommendations
of qualified members of either the governing body of the public
authority or of any advisory committee through a fair and open
process that includes the provision of reasonable written notice to,
and a reasonable response time by, members of the general public and
interested persons and organizations.
   (4) If the enabling ordinance does not designate the board of
supervisors as the governing body of the public authority, the
enabling ordinance shall require the membership of the governing body
to meet the requirements of subparagraph (B) of paragraph (3).
   (c) (1) Any public authority created pursuant to this section
shall be deemed to be the employer of in-home supportive services
personnel referred to recipients under paragraph (3) of subdivision
(e) within the meaning of Chapter 10 (commencing with Section 3500)
of Division 4 of Title 1 of the Government Code. Recipients shall
retain the right to hire, fire, and supervise the work of any in-home
supportive services personnel providing services to them.
   (2) (A) Any nonprofit consortium contracting with a county
pursuant to this section shall be deemed to be the employer of
in-home supportive services personnel referred to recipients pursuant
to paragraph (3) of subdivision (e) for the purposes of collective
bargaining over wages, hours, and other terms and conditions of
employment.
   (B) Recipients shall retain the right to hire, fire, and supervise
the work of any in-home supportive services personnel providing
services for them.
   (d) A public authority established pursuant to this section or a
nonprofit consortium contracting with a county pursuant to this
section, when providing for the delivery of services under this
article by contract in accordance with Sections 12302 and 12302.1 or
by direct payment to a provider chosen by a recipient in accordance
with Sections 12302 and 12302.2, shall comply with and be subject to,
all statutory and regulatory provisions applicable to the respective
delivery mode.
   (e) Any nonprofit consortium contracting with a county pursuant to
this section or any public authority established pursuant to this
section shall provide for all of the following functions under this
article, but shall not be limited to those functions:
   (1) The provision of assistance to recipients in finding in-home
supportive services personnel through the establishment of a
registry.
   (2) (A) (i) The investigation of the qualifications and background
of potential personnel. Upon the effective date of the amendments to
this section made during the 2009-10 Fourth Extraordinary Session of
the Legislature, the investigation with respect to any provider in
the registry or prospective registry applicant shall include criminal
background checks requested by the nonprofit consortium or public
authority and conducted by the Department of Justice pursuant to
Section 15660, for those public authorities or nonprofit consortia
using the agencies on the effective date of the amendments to this
section made during the 2009-10 Fourth Extraordinary Session of the
Legislature. Criminal background checks shall be performed no later
than July 1, 2010, for any provider who is already on the registry on
the effective date of amendments to this section made during the
2009-10 Fourth Extraordinary Session of the Legislature, for whom a
criminal background check pursuant to this section has not previously
been provided, as a condition of the provider's continued enrollment
in the IHSS program. Criminal background checks shall be conducted
at the provider's expense.
   (ii) Upon notice from the Department of Justice notifying the
public authority or nonprofit consortium that the prospective
registry applicant has been convicted of a criminal offense specified
in Section 12305.81, the public authority or nonprofit consortium
shall deny the request to be placed on the registry for providing
supportive services to any recipient of the In-Home Supportive
Services program.
   (iii)  Commencing 90 days after the effective date of the act that
adds Section 12305.87, and upon notice from the Department of
Justice that an applicant who is subject to the provisions of that
section has been convicted of, or incarcerated following conviction
for, an offense described in subdivision (b) of that section, the
public authority or nonprofit consortium shall deny the applicant's
request to become a provider of supportive services to any recipient
of in-home supportive services, subject to the individual waiver and
exception processes described in that section. An applicant who is
denied on the basis of Section 12305.87 shall be informed by the
public authority or nonprofit consortium of the individual waiver and
exception processes described in that section.
   (B) (i) If an applicant or provider is rejected as a result of
information contained in the criminal background report, the
applicant or provider shall receive a copy of his or her own criminal
history record from the Department of Justice, as provided in
Article 5 (commencing with Section 11120) of Chapter 1 of Title 1 of
Part 4 of the Penal Code, to review the information for accuracy and
completeness. The applicant or provider shall be advised that if,
upon review of his or her own criminal history record he or she finds
the information to be inaccurate or incomplete, the applicant or
provider shall have the right to submit a formal challenge to the
Department of Justice to contest the criminal background report.
   (ii) The department shall develop a written appeal process for the
current and prospective providers who are determined ineligible to
receive payment for the provision of services in the In-Home
Supportive Services program.
   (C) An applicant shall be informed of his or her right to a waiver
of the fee for obtaining a copy of a criminal history record, and of
how to submit a claim and proof of indigency, as required by Section
11123 of the Penal Code.
   (D) Nothing in this paragraph shall be construed to prohibit the
Department of Justice from assessing a fee pursuant to Section 11105
or 11123 of the Penal Code to cover the cost of furnishing summary
criminal history information.
   (E) As used in this section, "nonprofit consortium" means a
nonprofit public benefit corporation that has all powers necessary to
carry out the delivery of in-home supportive services under the
delegated authority of a government entity.
   (F) A nonprofit consortium or a public authority authorized to
secure a criminal background check clearance pursuant to this section
shall accept a clearance for an applicant described in clause (i) of
subparagraph (A) who has been deemed eligible by another nonprofit
consortium, public authority, or county with criminal background
check authority pursuant to either Section 12305.86 or this section,
to receive payment for providing services pursuant to this article.
Existence of a clearance shall be determined by verification through
the case management, information, and payrolling system, that another
county, nonprofit consortium, or public authority with criminal
background check authority pursuant to Section 12305.86 or this
section has deemed the current or prospective provider to be eligible
to receive payment for providing services pursuant to this article.
   (3) Establishment of a referral system under which in-home
supportive services personnel shall be referred to recipients.
   (4) Providing for training for providers and recipients.
   (5) (A) Performing any other functions related to the delivery of
in-home supportive services.
   (B) (i) Upon request of a recipient of in-home supportive services
pursuant to this chapter, or a recipient of personal care services
under the Medi-Cal program pursuant to Section 14132.95, a public
authority or nonprofit consortium may provide a criminal background
check on a nonregistry applicant or provider from the Department of
Justice, in accordance with clause (i) of subparagraph (A) of
paragraph (2) of subdivision (e). If the person who is the subject of
the criminal background check is not hired or is terminated because
of the information contained in the criminal background report, the
provisions of subparagraph (B) of paragraph (2) of subdivision (e)
shall apply.
   (ii) A recipient of in-home supportive services pursuant to this
chapter or a recipient of personal care services under the Medi-Cal
program may elect to employ an individual as their service provider
notwithstanding the individual's record of previous criminal
convictions, unless those convictions include any of the offenses
specified in Section 12305.81.
   (6) Ensuring that the requirements of the personal care option
pursuant to Subchapter 19 (commencing with Section 1396) of Chapter 7
of Title 42 of the United States Code are met.
   (f) (1) Any nonprofit consortium contracting with a county
pursuant to this section or any public authority created pursuant to
this section shall be deemed not to be the employer of in-home
supportive services personnel referred to recipients under this
section for purposes of liability due to the negligence or
intentional torts of the in-home supportive services personnel.
   (2) In no case shall a nonprofit consortium contracting with a
county pursuant to this section or any public authority created
pursuant to this section be held liable for action or omission of any
in-home supportive services personnel whom the nonprofit consortium
or public authority did not list on its registry or otherwise refer
to a recipient.
   (3) Counties and the state shall be immune from any liability
resulting from their implementation of this section in the
administration of the In-Home Supportive Services program. Any
obligation of the public authority or consortium pursuant to this
section, whether statutory, contractual, or otherwise, shall be the
obligation solely of the public authority or nonprofit consortium,
and shall not be the obligation of the county or state.
   (g) Any nonprofit consortium contracting with a county pursuant to
this section shall ensure that it has a governing body that complies
with the requirements of subparagraph (B) of paragraph (3) of
subdivision (b) or an advisory committee that complies with
subparagraphs (B) and (C) of paragraph (3) of subdivision (b).
   (h) Recipients of services under this section may elect to receive
services from in-home supportive services personnel who are not
referred to them by the public authority or nonprofit consortium.
Those personnel shall be referred to the public authority or
nonprofit consortium for the purposes of wages, benefits, and other
terms and conditions of employment.
   (i) (1) Nothing in this section shall be construed to affect the
state's responsibility with respect to the state payroll system,
unemployment insurance, or workers' compensation and other provisions
of Section 12302.2 for providers of in-home supportive services.
   (2) The Controller shall make any deductions from the wages of
in-home supportive services personnel, who are employees of a public
authority pursuant to paragraph (1) of subdivision (c), that are
agreed to by that public authority in collective bargaining with the
designated representative of the in-home supportive services
personnel pursuant to Chapter 10 (commencing with Section 3500) of
Division 4 of Title 1 of the Government Code and transfer the
deducted funds as directed in that agreement.
   (3) Any county that elects to provide in-home supportive services
pursuant to this section shall be responsible for any increased costs
to the in-home supportive services case management, information, and
payrolling system attributable to that election. The department
shall collaborate with any county that elects to provide in-home
supportive services pursuant to this section prior to implementing
the amount of financial obligation for which the county shall be
responsible.
   (j) To the extent permitted by federal law, personal care option
funds, obtained pursuant to Subchapter 19 (commencing with Section
1396) of Chapter 7 of Title 42 of the United States Code, along with
matching funds using the state and county sharing ratio established
in subdivision (c) of Section 12306, or any other funds that are
obtained pursuant to Subchapter 19 (commencing with Section 1396) of
Chapter 7 of Title 42 of the United States Code, may be used to
establish and operate an entity authorized by this section.
   (k) Notwithstanding any other provision of law, the county, in
exercising its option to establish a public authority, shall not be
subject to competitive bidding requirements. However, contracts
entered into by either the county, a public authority, or a nonprofit
consortium pursuant to this section shall be subject to competitive
bidding as otherwise required by law.
   (l) (1) The department may adopt regulations implementing this
section as emergency regulations in accordance with Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 3 of Title 2 of
the Government Code. For the purposes of the Administrative
Procedure Act, the adoption of the regulations shall be deemed an
emergency and necessary for the immediate preservation of the public
peace, health and safety, or general welfare. Notwithstanding Chapter
3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title
2 of the Government Code, these emergency regulations shall not be
subject to the review and approval of the Office of Administrative
Law.
   (2) Notwithstanding subdivision (h) of Section 11346.1 and Section
11349.6 of the Government Code, the department shall transmit these
regulations directly to the Secretary of State for filing. The
regulations shall become effective immediately upon filing by the
Secretary of State.
   (3) Except as otherwise provided for by Section 10554, the Office
of Administrative Law shall provide for the printing and publication
of these regulations in the California Code of Regulations. Emergency
regulations adopted pursuant to this subdivision shall remain in
effect for no more than 180 days.
   (m) (1) In the event that a county elects to form a nonprofit
consortium or public authority pursuant to subdivision (a) before the
State Department of Health Care Services has obtained all necessary
federal approvals pursuant to paragraph (3) of subdivision (j) of
Section 14132.95, all of the following shall apply:
   (A) Subdivision (d) shall apply only to those matters that do not
require federal approval.
   (B) The second sentence of subdivision (h) shall not be operative.
   (C) The nonprofit consortium or public authority shall not provide
services other than those specified in paragraphs (1), (2), (3),
(4), and (5) of subdivision (e).
   (2) Paragraph (1) shall become inoperative when the State
Department of Health Care Services has obtained all necessary federal
approvals pursuant to paragraph (3) of subdivision (j) of Section
14132.95.
   (n) (1) One year after the effective date of the first approval by
the department granted to the first public authority, the Bureau of
State Audits shall commission a study to review the performance of
that public authority.
   (2) The study shall be submitted to the Legislature and the
Governor not later than two years after the effective date of the
approval specified in subdivision (a). The study shall give special
attention to the health and welfare of the recipients under the
public authority, including the degree to which all required services
have been delivered, out-of-home placement rates, prompt response to
recipient complaints, and any other issue the director deems
relevant.
   (3) The report shall make recommendations to the Legislature and
the Governor for any changes to this section that will further ensure
the well-being of recipients and the most efficient delivery of
required services.
   (o) Commencing July 1, 1997, the department shall provide annual
reports to the appropriate fiscal and policy committees of the
Legislature on the efficacy of the implementation of this section,
and shall include an assessment of the quality of care provided
pursuant to this section.
   (p) (1) Notwithstanding any other provision of law, and except as
provided in paragraph (2), the department shall, no later than
January 1, 2009, implement subparagraphs (A) and (B) through an
all-county letter from the director:
   (A) Subparagraphs (A) and (B) of paragraph (2) of subdivision (e).
   (B) Subparagraph (B) of paragraph (5) of subdivision (e).
   (2) The department shall, no later than July 1, 2009, adopt
regulations to implement subparagraphs (A) and (B) of paragraph (1).
   (q) The amendments made to paragraphs (2) and (5) of subdivision
(e) made by the act that added this subdivision during the 2007-08
Regular Session of the Legislature shall only be implemented to the
extent that an appropriation is made in the annual Budget Act or
other statute, except for the amendments that added subparagraph (D)
of paragraph (2) of subdivision (e), which shall go into effect
January 1, 2009.



12301.7.  The annual administrative cost for any public authority or
nonprofit consortium created pursuant to Section 12301.6, exclusive
of any increase in provider wages or benefits or employer taxes when
negotiated or agreed to by the public authority or nonprofit
consortium, shall be shared by the state and the counties as
prescribed in Section 12306.



12301.8.  (a) (1) A public authority or nonprofit consortium
established pursuant to Section 12301.6, upon the request of an aged
or disabled adult or that individual's authorized representative, may
assist an employer, as defined in paragraph (2), in obtaining a
criminal background check conducted by the Department of Justice, as
authorized pursuant to Section 15660, of a provider, as described in
paragraph (3).
   (2) For purposes of this section, an "employer" means an aged or
disabled adult, or that individual's authorized representative, who
is ineligible for benefits under this chapter and who receives care
by a provider as described in paragraph (3).
   (3) For purposes of this section, a "provider" means a person who
is unlicensed and provides nonmedical domestic or personal care to an
aged or disabled adult who is ineligible to receive benefits under
this chapter, in the adult's own home.
   (b) A public authority or nonprofit consortium may recover the
costs of administering this section, including the cost to the
Department of Justice for processing the criminal background check,
from the individual making the request, as described in subdivision
(a).
   (c) No General Fund moneys shall be used to implement this
section.


12302.  Each county is obligated to ensure that services are
provided to all eligible recipients during each month of the year in
accordance with the county plan.
   In order to implement such a plan, an individual county may hire
homemakers and other in-home supportive personnel in accordance with
established county civil service requirements or merit system
requirements for those counties not having civil service, or may
contract with a city, county, or city and county agency, a local
health district, a voluntary nonprofit agency, a proprietary agency,
or an individual or make direct payment to a recipient for the
purchase of services.
   County plans are effective upon submission to the department. In
reviewing county plans the department shall assure that plans are in
compliance with provisions of this article including compliance with
Section 12301. In the event the department finds a county plan is not
in compliance it shall take appropriate action to assure compliance.
   The department shall monitor the actual monthly expenditures where
available for services to assure compliance with the county plans.
If the county's expenditure pattern is not consistent with the plan,
the department shall require the county to amend the plan.



12302.1.  (a) Contracts entered into by a county under Section 12302
shall be for terms not exceeding three years. In the event of a
three-year contract, the county, at the end of the first contract
term, may renew the contract for a second term not exceeding one
year. The rate of reimbursement shall be negotiated consistent with
regulations promulgated by the State Department of Social Services.
For any extended contract, the rate shall reflect, but is not limited
to, the following financial considerations:
   (1) Actual expenditures by the contractor as documented during the
first contract term and approved by the state.
   (2) Changes in federal, state, or county program requirements.
   (3) Federal and state minimum wage and contractual step merit
increases.
   (4) Statutory taxes.
   (5) Insurance costs.
   (6) Reasonable costs which have been approved by the county
department of social services, as long as those costs do not increase
unreimbursed county expenditures or lead to a reduction in client
services, and those costs can be funded within the maximum allowable
rates set by the department for in-home supportive services contracts
and the county's state allocation for in-home supportive services.
   (7) Other reasonable costs over which the contracting parties have
no control.
   (b) (1) Except as provided in paragraph (2), the purchase of
services regulations adopted by the department that govern county
welfare departments shall also govern acceptable in-home supportive
services contracting, including the methods used to advertise,
procure, select, and award the contracts, and the procedures used to
amend, renew, or extend an existing contract with the same
contractor, including, in addition to rate changes, any other change
in other terms of the contract. In no case shall the department's
regulations governing in-home supportive services contracting
procedures differ from the contract procedures specified in the
department's purchase of service regulations for other services
purchased by county welfare departments, except as required by
federal law.
   (2) The department may, through regulation, require until July 1,
2000, the prior review of all bid and contract documents for managed
care contracts under Section 12302.7.



12302.2.  (a) (1) If the state or a county makes or provides for
direct payment to a provider chosen by a recipient or to the
recipient for the purchase of in-home supportive services, the
department shall perform or assure the performance of all rights,
duties and obligations of the recipient relating to those services as
required for purposes of unemployment compensation, unemployment
compensation disability benefits, workers' compensation, federal and
state income tax, and federal old-age survivors and disability
insurance benefits. Those rights, duties, and obligations include,
but are not limited to, registration and obtaining employer account
numbers, providing information, notices, and reports, making
applications and returns, and withholding in trust from the payments
made to or on behalf of a recipient amounts to be withheld from the
wages of the provider by the recipient as an employer, including the
sales tax extended to support services by Article 4 (commencing with
Section 6150) of Chapter 2 of Part 1 of Division 2 of the Revenue and
Taxation Code, and transmitting those amounts along with amounts
required for all contributions, premiums, and taxes payable by the
recipient as the employer to the appropriate person or state or
federal agency. The department may assure the performance of any or
all of these rights, duties, and obligations by contract with any
person, or any public or private agency.
   (2) Contributions, premiums, and taxes shall be paid or
transmitted on the recipient's behalf as the employer for any period
commencing on or after January 1, 1978, except that contributions,
premiums, and taxes for federal and state income taxes and federal
old-age, survivors and disability insurance contributions shall be
paid or transmitted pursuant to this section commencing with the
first full month that begins 90 days after the effective date of this
section.
   (3) Contributions, premiums, and taxes paid or transmitted on the
recipient's behalf for unemployment compensation, workers'
compensation, and the employer's share of federal old-age survivors
and disability insurance benefits shall be payable in addition to the
maximum monthly amount established pursuant to Section 12303.5 or
subdivision (a) of Section 12304 or other amount payable to or on
behalf of a recipient. Contributions, premiums, or taxes resulting
from liability incurred by the recipient as employer for unemployment
compensation, workers' compensation, and federal old-age, survivors
and disability insurance benefits with respect to any period
commencing on or after January 1, 1978, and ending on or before the
effective date of this section shall also be payable in addition to
the maximum monthly amount established pursuant to Section 12303.5 or
subdivision (a) of Section 12304 or other amount payable to or on
behalf of the recipient. Nothing in this section shall be construed
to permit any interference with the recipient's right to select the
provider of services or to authorize a charge for administrative
costs against any amount payable to or on behalf of a recipient.
   (b) If the state makes or provides for direct payment to a
provider chosen by a recipient, the Controller shall make any
deductions from the wages of in-home supportive services personnel
that are authorized by Sections 1152 and 1153 of the Government Code,
as limited by Section 3515.6 of the Government Code, and for the
sales tax extended to support services by Article 4 (commencing with
Section 6150) of Chapter 2 of Part 1 of Division 2 of the Revenue and
Taxation Code.
   (c) Funding for the costs of administering this section and for
contributions, premiums, and taxes paid or transmitted on the
recipient's behalf as an employer pursuant to this section shall
qualify, where possible, for the maximum federal reimbursement. To
the extent that federal funds are inadequate, notwithstanding Section
12306, the state shall provide funding for the purposes of this
section.


12302.21.  (a) For purposes of providing cost-efficient workers'
compensation coverage for in-home supportive services providers under
this article, the department shall assume responsibility for
providing workers' compensation coverage for employees of nonprofit
agencies and proprietary agencies who provide in-home supportive
services pursuant to contracts with counties. The workers'
compensation coverage provided for these employees shall be provided
on the same terms as provided to providers under Section 12302.2 and
12302.5.
   (b) A county that has existing contracts with nonprofit agencies
or proprietary agencies whose employees will be provided workers'
compensation coverage by the department pursuant to subdivision (a),
shall reduce the contract hourly rate by fifty cents ($0.50) per
hour, effective on the date that the department implements this
section.


12302.25.  (a) On or before January 1, 2003, each county shall act
as, or establish, an employer for in-home supportive service
providers under Section 12302.2 for the purposes of Chapter 10
(commencing with Section 3500) of Division 4 of Title 1 of the
Government Code and other applicable state or federal laws. Each
county may utilize a public authority or nonprofit consortium as
authorized under Section 12301.6, the contract mode as authorized
under Sections 12302 and 12302.1, county administration of the
individual provider mode as authorized under Sections 12302 and
12302.2 for purposes of acting as, or providing, an employer under
Chapter 10 (commencing with Section 3500) of Division 4 of Title 1 of
the Government Code, county civil service personnel as authorized
under Section 12302, or mixed modes of service authorized pursuant to
this article and may establish regional agreements in establishing
an employer for purposes of this subdivision for providers of in-home
supportive services. Within 30 days of the effective date of this
section, the department shall develop a timetable for implementation
of this subdivision to ensure orderly compliance by counties.
Recipients of in-home supportive services shall retain the right to
choose the individuals that provide their care and to recruit,
select, train, reject, or change any provider under the contract mode
or to hire, fire, train, and supervise any provider under any other
mode of service. Upon request of a recipient, and in addition to a
county's selected method of establishing an employer for in-home
supportive service providers pursuant to this subdivision, counties
with an IHSS caseload of more than 500 shall be required to offer an
individual provider employer option.
   (b) Nothing in this section shall prohibit any negotiations or
agreement regarding collective bargaining or any wage and benefit
enhancements.
   (c) Nothing in this section shall be construed to affect the state'
s responsibility with respect to the state payroll system,
unemployment insurance, or workers' compensation and other provisions
of Section 12302.2 for providers of in-home supportive services.
   (d) Prior to implementing subdivision (a), a county shall
establish an advisory committee as required by Section 12301.3 and
solicit recommendations from the advisory committee on the preferred
mode or modes of service to be utilized in the county for in-home
supportive services.
   (e) Each county shall take into account the advice and
recommendations of the in-home supportive services advisory
committee, as established pursuant to Section 12301.3, prior to
making policy and funding decisions about the program on an ongoing
basis.
   (f) In implementing and administering this section, no county,
public authority, nonprofit consortium, contractor, or a combination
thereof, that delivers in-home supportive services shall reduce the
hours of service for any recipient below the amount determined to be
necessary under the uniform assessment guidelines established by the
department.
   (g) Any agreement between a county and an entity acting as an
employer under subdivision (a) shall include a provision that
requires that funds appropriated by the state for wage increases for
in-home supportive services providers be used exclusively for that
purpose. Counties or the state may undertake audits of the entities
acting as employers under the terms of subdivision (a) to verify
compliance with this subdivision.
   (h) On or before January 15, 2003, each county shall provide the
department with documentation that demonstrates compliance with the
January 1, 2003, deadline specified in subdivision (a). The
documentation shall include, but is not limited to, any of the
following:
   (1) The public authority ordinance and employee relations
procedures.
   (2) The invitations to bid and requests for proposal for contract
services for the contract mode.
   (3) An invitation to bid and request for proposal for the
operation of a nonprofit consortium.
   (4) A county board of supervisors' resolution resolving that the
county has chosen to act as the employer required by subdivision (a)
either by utilizing county employees, as authorized by Section 12302,
to provide in-home supportive services or through county
administration of individual providers.
   (5) Any combination of the documentation required under paragraphs
(1) to (4), inclusive, that reflects the decision of a county to
provide mixed modes of service as authorized under subdivision (a).
   (i) Any county that is unable to provide the documentation
required by subdivision (h) by January 15, 2003, may provide, on or
before that date, a written notice to the department that does all of
the following:
   (1) Explains the county's failure to provide the required
documentation.
   (2) Describes the county's plan for coming into compliance with
the requirements of this section.
   (3) Includes a timetable for the county to come into compliance
with this section, but in no case shall the timetable extend beyond
March 31, 2003.
   (j) Any county that fails to provide the documentation required by
subdivision (h) and also fails to provide the written notice as
allowed under subdivision (i), shall be deemed by operation of law to
be the employer of IHSS individual providers for purposes of Chapter
10 (commencing with Section 3500) of Division 4 of Title 1 of the
Government Code as of January 15, 2003.
   (k) Any county that provides a written notice as allowed under
subdivision (i), but fails to provide the documentation required
under subdivision (h) by March 31, 2003, shall be deemed by operation
of law to be the employer of IHSS individual providers for purposes
of Chapter 10 (commencing with Section 3500) of Division 4 of Title 1
of the Government Code as of April 1, 2003.
   (l) Any county deemed by operation of law, pursuant to subdivision
(j) or (k), to be the employer of IHSS individual providers for
purposes of Chapter 10 (commencing with Section 3500) of Division 4
of Title 1 of the Government Code shall continue to act in that
capacity until the county notifies the department that it has
established another employer as permitted by this section, and has
provided the department with the documentation required under
subdivision (h) demonstrating the change.
   (m) Section 10605 may be applied in each county that has not
complied with this section by January 1, 2003.



12302.3.  (a) Notwithstanding any other provision of this article,
and in a manner consistent with the powers available to public
authorities created under this article, the City and County of San
Francisco may do any of the following:
   (1) Increase the wages of all in-home supportive services
providers.
   (2) Subject to the requirements of federal law, use county-only
funds to fund county and state shares to meet federal financial
participation requirements necessary to obtain any available personal
care services reimbursement under Title XIX of the federal Social
Security Act (42 U.S.C. Sec. 1396 et seq.) (Medicaid).
   (3) Provide in-home supportive services workers with any wage
increase the city and county may appropriate, as long as this amount
is in accordance with the provisions of the Medi-Cal State Plan
Amendment 94-006, as approved by the federal Health Care Financing
Administration. The county-only funds shall be used exclusively to
increase workers' wages and to pay any proportionate share of
employer taxes and current benefits, and to pay for the cost of state
and county administration of these activities as provided for in
paragraph (5). Notwithstanding Section 12302.1, any wage increase for
those workers employed under contract shall be passed through by the
contractor to the workers, subject to the limitations specified in
this paragraph. The state shall continue to provide payroll functions
for all workers who are currently individual providers unless and
until the in-home supportive services public authority is
operational.
   (4) Claim the administrative costs of the wage passthrough in
accordance with the department's claiming requirements.
   (5) If that federal financial participation is available for
county-only payroll moneys, the following shall apply:
   (A) If additional payroll costs will be incurred by the state due
to the receipt and payment of federal funds, the department shall
provide the city and county with a detailed estimate of the
additional costs of the provision of payroll functions associated
with the processing of federal funds. If the city and county elects
to pay the additional costs, the department will provide these
payroll functions. If the city and county does not elect to pay the
additional costs, the department and the city and county may seek
another, mutually satisfactory arrangement.
   (B) If that federal financial participation is not available, the
department shall continue to perform the existing payroll functions
provided on July 28, 1995, at no additional cost to the city and
county.
   (b) (1) This section shall not be implemented with respect to any
particular wage increase pursuant to subdivision (a) unless the
department has obtained the approval of the State Department of
Health Services for that wage increase prior to its execution to
determine that it is consistent with federal law and to ensure
federal financial participation for the services under Title XIX of
the federal Social Security Act (42 U.S.C. Sec. 1396 et seq.).
   (2) The Director of Health Services shall seek any federal waivers
or approvals necessary for implementation of this section under
Title XIX of the federal Social Security Act (42 U.S.C. Sec. 1396 et
seq.).


12302.4.  A county, in receiving bids for a contract pursuant to
Sections 12302, 12302.1, and 12303, may evaluate all or any bidders
to determine their responsibility, and their responsiveness to the
requirements of the bidding document. The county may take all of the
following into account:
   (a) Whether the bidder possesses adequate financial resources, or
the ability to obtain those resources as required before the
beginning of the performance of the contract.
   (b) Whether the bidder has the ability to comply with the proposed
delivery and performance schedule, taking into consideration
available expertise and any other existing business commitments.
   (c) Whether the bidder has any record of unsatisfactory
performance. In determining if a bidder has a record of
unsatisfactory performance, the bidder shall submit a list to the
county of all prior in-home supportive services contracts awarded, if
any. A county may review past contracts, if any, to determine if the
bidder's past in-home supportive services contract performance has
been unsatisfactory.
   (d) Whether the bidder has any record of lack of integrity or poor
business ethics.
   (e) Whether the bidder is otherwise qualified and eligible to
receive an award under applicable statutes and regulations.
   (f) Whether the bid substantially and materially complies with all
requirements of the county's bidding document.



12302.5.  (a) Counties may establish entities or agents to act on
behalf of the employers for those recipients who are designated as
the employer of the in-home supportive services worker and who elect
not to, or who are unable to, ensure compliance with all applicable
federal, state, and county wage, hour, and workplace laws.
   (b) Any entity or agent established pursuant to this section shall
not restrict or interfere with the right of a recipient to select,
replace, and terminate the employment of his or her own provider of
in-home supportive services and to set his or her own service
schedule.


12303.  A contract pursuant to Section 12302 shall include the
following provisions:
   (a) The cost of the service shall not exceed by more than 10
percent the allowable cost of the service as determined by the State
Department of Social Services.
   (b) The provider agency shall agree to give preference to the
training and employment of recipients of public assistance or other
low-income persons who would qualify for public assistance in the
absence of such employment.
   (c) The cost of the purchase of such service will qualify, where
possible, for the maximum federal reimbursement.
   (d) A bond may be obtained to secure payment of wages in the event
that bankruptcy, liquidation, embezzlement, fraud, or other factors
prevent payment of wage claims to homemakers, homemaker chore
workers, or other in-home supportive service personnel.
   The provisions of this section shall not restrict the right of a
chartered county from providing a civil service classification for
in-home supportive service personnel.



12303.4.  (a) Any aged, blind, or disabled individual who is
eligible for assistance under this chapter or Chapter 4 (commencing
with Section 12500), and who is not described in Section 12304, shall
receive services under this article which do not exceed the maximum
of 195 hours per month.
   (b) Any aged, blind, or disabled individual who is eligible for
assistance under this chapter or Chapter 4 (commencing with Section
12500), who is in need, as determined by the county welfare
department, of at least 20 hours per week of the services defined in
Section 12304, shall be eligible to receive services under this
article, the total of which shall not exceed a maximum of 283 hours
per month.


12303.6.  (a) No adjustment shall be made under this article for the
1990-91 fiscal year to reflect any change in the cost of living.
   (b) Any cost-of-living adjustment under this article for the
1991-92 fiscal year and any fiscal year thereafter pursuant to
Section 12303.5 shall not include any adjustment to reflect increases
for the cost of living for the 1990-91 fiscal year.



12303.7.  Any aged, or disabled applicant or recipient who is
eligible for assistance under this article, whose disabilities
prevent the use of cooking facilities at home, shall be given the
option to receive an allowance of forty-nine dollars ($49) per month
for an individual and ninety-eight dollars ($98) per month for a
married couple in lieu of the appropriate in-home food preparation
and consumption services. The allowance under this section shall be
in addition to any amount that the applicant or recipient is entitled
to under this chapter. This allowance shall not have the effect of
exceeding the total cost maximum of Sections 12303.5 and 12304.
Nothing in this section shall be construed to limit the applicant's
or recipient's right to receive the allowance under this section and
all other homemaker and chore services.
   The State Department of Social Services shall adjust the amount of
the allowance under this section on July 1, 1984, and each year
thereafter to reflect cost-of-living changes subsequent to January 1,
1983, as provided under Section 12303. 5.



12304.  (a) An individual who is eligible for services subject to
the maximum amount specified in subdivision (b) of Section 12303.4
and who is capable of handling his or her own financial and legal
affairs shall be given the option of hiring and paying his or her own
provider of in-home supportive services. For this purpose the
individual shall be entitled to receive a monthly cash payment in
advance not to exceed an amount to reimburse providers for the
maximum amount of hours specified in subdivision (b) of Section
12303.4, which is in addition to his or her grant, if any. An
individual who is not capable of handling his or her own financial
and legal affairs shall be entitled to receive the cash payment
through his or her guardian, conservator, or protective payee.
   (b) In no event shall the maximum total cost for services and
advance cash payment for one individual recipient under subdivision
(b) of Section 12303.4 and subdivision (a) exceed an amount to
reimburse providers for the maximum hours specified in subdivision
(b) of Section 12303.4.
   (c) The county welfare department shall inform in writing any
individual who is potentially eligible for services under this
section of his or her right to the services.
   (d) For purposes of subdivision (b) of Section 12303.4, a
recipient who is eligible for services subject to the maximum amount
specified in subdivision (b) of Section 12303.4 is one who requires
in-home supportive care of at least 20 hours per week to carry out
any or all of the following:
   (1) Routine bodily functions, such as bowel and bladder care and
respiration assistance.
   (2) Dressing, oral hygiene, and grooming.
   (3) Preparation and consumption of food and meal cleanup for
individuals who require assistance with the preparation and
consumption of food.
   (4) Moving into and out of bed, other assistance in transferring,
turning in bed, and other repositioning.
   (5) Bathing, routine bed baths, and washing.
   (6) Ambulation and care and assistance with prostheses.
   (7) Rubbing of skin to promote circulation.
   (8) Paramedical services.
   (9) Any other function of daily living as determined by the
director.
   This determination of need shall be supported by a medical report
when requested and shall be prepared at the expense of the State
Department of Social Services.



12304.1.  In the selection of providers to perform services pursuant
to this article, preference shall be given to any qualified
individual provider who is chosen by any recipient of personal care
services as defined in subdivision (c) of Section 12300.




12304.2.  (a) A recipient who receives services under this article
through either a contract or managed care provider may, subject to
program requirements, select any qualified person to provide care
under this article.
   (b) For purposes of this section, "qualified person" means any
employee of the contract or managed care provider through which the
recipient may receive services under this article who is available
and eligible to provide the services.



12304.3.  Any recipient of services under this article who has
received benefits under this article for at least one year, and who
hires and pays his or her own service providers, as permitted under
subdivision (b) of Section 12304, may receive his or her grant under
this article through an electronic transfer. The Controller shall
offer electronic transfer services to these recipients as soon as the
option of electronic transfer is available to state employees for
the receipt of wages.



12304.4.  (a) The department shall establish a program of direct
deposit by electronic transfer for payments to in-home supportive
services providers. A provider may choose to receive payments via
direct deposit at his or her option. The department, the Controller,
and the California Health and Human Services Agency shall make all
necessary automation changes to allow for payment by direct deposit.
   (b) On or before March 31, 2008, the department shall complete
those items pertaining to the implementation of direct deposit over
which they have independent control, or those items that do not
depend on ongoing coordination with the office of the Controller in
order to be completed. Examples of these items include, but are not
limited to, rulemaking Case Management Information and Payroll
Systems (CMIPS) modifications, provider notifications, and all-county
letters. The department and the office of the Controller shall
cooperate fully on coordination, implementation, and testing, on a
timeframe that shall not delay implementation of the project.
Notwithstanding any other provision of law, direct deposit for
in-home supportive services providers shall be implemented on or
before June 30, 2008.
   (c) Notwithstanding any other provision of law, a person entitled
to the receipt of direct payment as an individual provider pursuant
to Section 12302.2 for providing in-home supportive services may
authorize payment to be directly deposited by electronic fund
transfer into the person's account at the financial institution of
his or her choice under a program for direct deposit by electronic
transfer established by the department.



12304.5.  Any aged, blind, or disabled individual who would be
eligible for assistance under this chapter or under Chapter 4
(commencing with Section 12500), except for his excess income, is
eligible to receive a payment under this article to purchase in-home
supportive services if his income is insufficient to provide for the
cost of such care, and he is otherwise qualified under this article.



12304.6.  The county welfare department shall provide to each
visually impaired applicant or recipient of benefits under this
article, upon determination or redetermination of eligibility for
benefits under this article, information on, and referral services
to, community public and nonprofit entities that provide reading
services to visually impaired persons.



12304.7.  Between January 1 and April 15 of each year, the
Controller shall include a notice on, and insert an informational
flyer which shall be prepared by the department, with, all payroll
warrants issued to providers of services under this chapter informing
those providers that they may qualify for the federal earned income
tax credit, as provided for in Section 32 of the Internal Revenue
Code.



12305.  Any aged, blind, or disabled individual who would be
eligible for assistance under this chapter or Chapter 4 (commencing
with Section 12500), except for his excess income, and who receives
services under this article, shall be eligible for Medi-Cal benefits
as a categorically needy recipient under Section 14005.1, provided
that his nonexempt income in excess of the sum in the applicable
subdivision of Section 12200 is used toward the purchase of such
services.


12305.1.  (a) (1) Any aged, blind, or disabled individual who
received Medi-Cal personal care services pursuant to subdivision (p)
of Section 14132.95 before July 1, 2009, and who continues to receive
those services, and who would otherwise be deemed a categorically
needy recipient pursuant to Section 12305, is eligible to receive a
supplementary payment under this article to be used towards the
purchase of personal care services. Additionally, any aged, blind, or
disabled individual who received services pursuant to Section
14132.951 before July 1, 2009, and who continues to receive those
services, and who would otherwise be deemed a categorically needy
recipient pursuant to Section 12305 is eligible to receive a
supplementary payment under this article to be used towards the
purchase of services under Section 14132.951. Supplementary payments
shall be available only to those individuals who meet the criteria
set forth in this subdivision, and were eligible to receive a
supplementary payment as of June 30, 2009.
   (2) An individual who meets the above criteria for supplementary
payments shall have his or her supplementary payment eliminated as of
October 1, 2009.
   (b) A supplementary payment pursuant to this section shall be the
difference between the following amounts:
   (1) A beneficiary's excess income as determined under Section
12304.5.
   (2) The beneficiary's nonexempt income as determined pursuant to
Section 14005.7, in excess of the income levels for maintenance need
pursuant to Section 14005.12.
   (c) Notwithstanding subdivisions (a) and (b), no supplementary
payment shall be made pursuant to this section unless the amount
specified in paragraph (2) of subdivision (b) is larger than the
amount specified in paragraph (1) of subdivision (b).
   (d) In the event of a final judicial determination by any court of
appellate jurisdiction or a final determination by the Administrator
of the federal Centers for Medicare and Medicaid Services that
supplemental payments to medically needy persons not receiving
services pursuant to subdivision (p) of Section 14132.95 or Section
14132.951 must be made, then this section and subdivision (p) of
Section 14132.95 shall cease to be operative on the first day of the
month that begins after the expiration of a period of 30 days
subsequent to a notification in writing by the Director of Finance to
the chairperson of the committee in each house that considers
appropriations, the chairpersons of the committees and the
appropriate subcommittees in each house that consider the State
Budget, and the Chairperson of the Joint Legislative Budget
Committee.



12305.5.  (a) Notwithstanding any other provision of this chapter,
any person who:
   (1) Was once determined to be disabled in accordance with Section
1614 of Part A of Title XVI of the Social Security Act (Section
1382c, Title 42, United States Code), and
   (2) Became ineligible for benefits under this chapter because the
person engaged in substantial gainful activity, and
   (3) Continues to suffer from the physical or mental impairments
which were the basis of the disability determination required under
paragraph (1), and
   (4) Requires in-home supportive care to carry out any or all of
the following:
   (A) Routine bodily functions, such as bowel or bladder care.
   (B) Dressing.
   (C) Preparation and consumption of food.
   (D) Moving into and out of bed.
   (E) Routine bed bath.
   (F) Ambulation.
   (G) Any other function of daily living as determined by the
director;
shall be considered to be disabled, for the purposes of this article
only, even though such person is engaged in substantial gainful
activity. Regardless of whether such person has excess income, such
person shall be eligible to receive payment under this article to
purchase in-home supportive services if his income is insufficient to
provide for the cost of such care, and he is otherwise qualified
under this article.
   (b) For purposes of this section, "substantial gainful activity"
means work activity considered to be substantial gainful activity
under applicable federal regulations adopted pursuant to Section 1614
of Part A of Title XVI of the Social Security Act.
   (c) The determination of continued impairments and the need for
in-home supportive care shall be supported by medical reports when
requested. Such reports shall be provided at the expense of the
department.
   (d) This section shall not be construed as creating any
entitlement to state supplementation pursuant to Section 12150.



12305.6.  (a) Notwithstanding any other provision of law, any person
specified in subdivision (b) shall be eligible for in-home
supportive services under this chapter.
   (b) Subdivision (a) shall apply to any person who meets all of the
following requirements:
   (1) He or she is not eligible for benefits under this chapter
because of the provisions of federal Public Law 104-193 affecting
eligibility under Title XVI of the Social Security Act.
   (2) He or she would be eligible for benefits under this chapter
but for the provisions of federal Public Law 104-193 affecting
eligibility under Title XVI of the Social Security Act. Eligibility
under this chapter shall include the same deeming provisions pursuant
to Title XVI of the Social Security Act (Subchapter 16 (commencing
with Section 1381) of Chapter 7 of Title 42, United States Code).
   (3) He or she continues to meet all other applicable eligibility
criteria for receiving benefits under this chapter.




12305.7.  The department shall perform all of the following
activities:
   (a) Beginning in the 2004-05 fiscal year, and in each subsequent
fiscal year, the department in consultation with the State Department
of Health Care Services and the county welfare departments shall
design and conduct an error rate study to estimate the extent of
payment and service authorization errors and fraud in the provision
of supportive services. The error rate study findings shall be used
to prioritize and direct state and county fraud detection and quality
improvement efforts. The State Department of Health Care Services
shall provide technical assistance and guidance for the error rate
studies as requested by the department.
   (b) (1) The department and the State Department of Health Care
Services shall conduct automated data matches to compare Medi-Cal
paid claims and third-party liability data with supportive services
paid service hours data to identify potential overpayments, duplicate
payments, alternative payment sources for supportive services, and
other potential supportive services delivery discrepancies, including
but not limited to, receipt of supportive services by a recipient on
the same day that other potentially duplicative Medi-Cal services
are received. Relevant data match findings shall be transmitted to
the counties, or to the appropriate state entity, for action.
   (2) The department, in consultation with the county welfare
departments and the State Department of Health Care Services, shall
determine, define, and issue instructions to the counties describing
the roles and responsibilities of the department, the State
Department of Health Care Services, and counties for resolving data
match discrepancies requiring followup, defining the necessary
actions that will be taken to resolve them, and the process for
exchange of information pertaining to the findings and disposition of
data match discrepancies.
   (c) The department shall develop methods for verifying the receipt
of supportive services by program recipients. In developing the
specified methods the department shall obtain input from program
stakeholders as provided in Section 12305.72. The department shall,
in consultation with the county welfare departments, also determine,
define, and issue instructions describing the roles and
responsibilities of the department and the county welfare departments
for evaluating and responding to identified problems and
discrepancies.
   (d) The department shall make available on its Internet Web site
the regulations, all-county letters, approved forms, and training
curricula developed and officially issued by the department to
implement the items described in Section 12305.72. The department
shall inform supportive services providers, recipients, and the
general public about the availability of these items and of the
Medi-Cal toll free fraud hotline and Web site for reporting suspected
fraud or abuse in the provision or receipt of supportive services.
   (e) (1) The department, in consultation with counties and in
accordance with Section 12305.72, shall develop a standardized
curriculum, training materials, and work aids, and operate an
ongoing, statewide training program on the supportive services
uniformity system for county workers, managers, quality assurance
staff, state hearing officers, and public authority or nonprofit
consortium staff, to the extent a county operates a public authority
or nonprofit consortium. The training shall be expanded to include
variable assessment intervals, statewide hourly task guidelines, and
use of the protective supervision medical certification form as the
development of each of these components is completed. Training shall
be scheduled and provided at sites throughout the state. The
department may obtain a qualified vendor to assist in the development
of the training and to conduct the training program. The design of
the training program shall provide reasonable flexibility to allow
counties to use their preferred training modalities to educate their
supportive services staff in this subject matter.
   (2) On or before July 1, 2010, the department, in consultation
with the State Department of Health Care Services, counties, and
other stakeholders, as appropriate, shall ensure that a standardized
curriculum and training materials for county social workers are
developed for the purpose of preventing fraud within the program.
   (f) The department shall, in conjunction with the counties,
develop protocols and procedures for monitoring county quality
assurance programs. The monitoring may include onsite reviews of
county quality assurance activities. The focus of the established
monitoring protocols and procedures shall include determining the
extent to which counties are fulfilling their quality assurance
responsibilities and county quality assurance staff are correctly
applying the uniformity system in reviewing supportive services cases
for consistent, appropriate, and accurate service need assessments.
The department and the county welfare departments shall also develop
the protocols and procedures under which the department will report
its monitoring findings to a county, disagreements over the findings
are resolved, to the extent possible, and the county, the State
Department of Health Care Services, and the department will follow up
on the findings.
   (g) The department shall conduct a review of program regulations
in effect on the date of enactment of this section and shall revise
the regulations as necessary to conform to the statutory changes that
have occurred since the regulations were initially promulgated and
to conform to federally authorized program changes.
   (h) The department, in consultation with the county welfare
departments and other stakeholders, as appropriate, shall develop
protocols for the implementation of targeted mailings to providers,
to convey program integrity concerns.



12305.71.  Counties shall perform the following quality assurance
activities:
   (a) Establish a dedicated, specialized unit or function to ensure
quality assurance and program integrity, including fraud detection
and prevention, in the provision of supportive services.
   (b) Perform routine, scheduled reviews of supportive services
cases, to ensure that caseworkers appropriately apply the supportive
services uniformity system and other supportive services rules and
policies for assessing recipients' need for services to the end that
there are accurate assessments of needs and hours. Counties may
consult with state quality assurance staff for technical assistance
and shall cooperate with state monitoring of the county's quality
assurance activities and findings.
   (c) The department and the county welfare departments shall
develop policies, procedures, implementation timelines, and
instructions under which county quality assurance programs will
perform the following activities:
   (1) Receiving, resolving, and responding appropriately to claims
data match discrepancies or other state level quality assurance and
program integrity information that indicates potential overpayments
to providers or recipients or third-party liability for supportive
services.
   (2) Implementing procedures to identify potential sources of
third-party liability for supportive services.
   (3) Monitoring the delivery of supportive services in the county
to detect and prevent potential fraud by providers, recipients, and
others and maximize the recovery of overpayments from providers or
recipients.
   (A) As appropriate, in targeted cases, to protect program
integrity, this monitoring may include a visit to the recipient's
home to verify the receipt of services.
   (B) The exact date and time of a home visit shall not be announced
to the supportive services recipient or provider.
   (C) The department, in consultation with the county welfare
departments, shall develop protocols for followup home visits and
other actions, if the provider and recipient are not at the recipient'
s home at the time of the initial home visit. The protocols shall
include, at a minimum, all of the following:
   (i) Information sent to the recipient's home regarding the goals
of the home visit, including the county's objective to maintain
program integrity by verifying the receipt of services, the quality
of services and consumer well-being, and the potential loss of
services if fraud is substantiated.
   (ii) Additional attempted visits to the recipient's home, pursuant
to subparagraph (A).
   (iii) Followup phone calls to both the recipient and the provider,
if necessary.
   (4) Informing supportive services providers and recipients, and
the public that suspected fraud in the provision or receipt of
supportive services can be reported by using the toll-free Medi-Cal
fraud telephone hotline and Internet Web site.
   (5) In accordance with protocols developed pursuant to subdivision
(h) of Section 12305.7, distribute targeted program integrity
mailings to providers. The purpose of the targeted program integrity
mailings is to inform providers of appropriate program rules and
requirements and consequences for failure to adhere to them.
   (d) Develop a schedule, beginning July 1, 2005, under which county
quality assurance staff shall periodically perform targeted quality
assurance studies.
   (e) In accordance with protocols developed by the department and
county welfare departments, conduct joint case review activities with
state quality assurance staff, including random postpayment paid
claim reviews to ensure that payments to providers were valid and
were associated with existing program recipients; identify, refer to,
and work with appropriate agencies in investigation, administrative
action, or prosecution of instances of fraud in the provision of
supportive services. The protocols shall consider the relative
priorities of the activities required pursuant to this section and
available resources.



12305.72.  The department shall convene periodic meetings in which
supportive services recipients, providers, advocates, IHSS provider
representatives, organizations representing recipients, counties,
public authorities, nonprofit consortia, and other interested
stakeholders may receive information and have the opportunity to
provide input to the department regarding the quality assurance,
program integrity, and program consistency efforts required by
Sections 12305.7 and 12305.71. The program development activities
that shall be covered in these meetings shall include, but are not
limited to:
   (a) Implementation of variable assessment intervals as provided in
Section 12301.1.
   (b) Development and implementation of statewide hourly supportive
services task guidelines as provided in Section 12301.2.
   (c) Development and implementation of a standardized medical
certification form for protective supervision, as provided for in
Section 12301.21.
   (d) The development and implementation of statewide training for
county staff, as specified in subdivision (e) of Section 12305.7, on
various subjects relating to the provision of supportive services
including, but not limited to, the uniformity system, variable
assessment intervals, statewide hourly task guidelines, and the
standardized medical certification form for protective supervision
services.
   (e) The development and implementation of approaches to verifying
receipt of program services by program recipients.
   (f) Alternatives to requiring that a full reassessment be
completed in order to authorize a temporary increase in supportive
services hours following the discharge of a recipient from a medical
facility.



12305.73.  (a) The department, in consultation with the county
welfare departments, shall develop protocols and procedures for
obtaining fingerprint images of all individuals who are being
assessed or reassessed to receive supportive services under this
chapter.
   (b) (1) For any recipient whose initial client assessment occurs
on or after April 1, 2010, he or she shall be fingerprinted at the
same time of initial assessment by a social worker, in the recipient'
s home, as specified in the protocols and procedures developed by
this section.
   (2) For any recipient already receiving in-home supportive
services on April 1, 2010, during the recipient's next reassessment,
a social worker shall obtain fingerprint images for that recipient,
in the recipient's home, pursuant to this section.
   (c) Fingerprint imaging information obtained from a recipient
pursuant to this section shall remain confidential, and shall only be
used for identification purposes directly connected with the
provision of supportive services to that recipient and program
integrity.
   (d) An individual who is a minor or who is physically unable to
provide fingerprints due to amputation or other physical limitations
shall be exempt from any requirement to provide fingerprints under
this section.
   (e) Upon completion of the development of protocols and procedures
pursuant to subdivision (a), the department shall be authorized to
take the necessary steps to implement this section by April 1, 2010.



12305.8.  The following definitions apply for purposes of this
article:
   (a) "Fraud" means the intentional deception or misrepresentation
made by a person with the knowledge that the deception could result
in some unauthorized benefit to himself or herself or some other
person. Fraud also includes any act that constitutes fraud under
applicable federal or state law.
   (b) "Overpayment" means the amount paid by the department or the
State Department of Health Services to a provider or recipient, which
is in excess of the amount for services authorized or furnished
pursuant to this article.
   (c) Notwithstanding any other provision of law, "health care
benefits" includes supportive services, for purposes of subdivision
(a) of Section 550 of the Penal Code.



12305.81.  (a) Notwithstanding any other law, a person shall not be
eligible to provide or receive payment for providing supportive
services for 10 years following a conviction for, or incarceration
following a conviction for, fraud against a government health care or
supportive services program, including Medicare, Medicaid, or
services provided under Title V, Title XX, or Title XXI of the
federal Social Security Act or a violation of subdivision (a) of
Section 273a of the Penal Code, or Section 368 of the Penal Code, or
similar violations in another jurisdiction. The department and the
State Department of Health Care Services shall develop a provider
enrollment form that each person seeking to provide supportive
services shall complete, sign under penalty of perjury, and submit to
the county. Submission of the form shall include the photocopying by
the county of original documentation verifying the provider's
identity, and shall be considered as an application to render
services under the Medi-Cal program consistent with subdivision (c)
of Section 14043.1. A provider shall submit the form to the county in
person, and the county shall retain the form and a copy of the
identification documentation in the file of the provider. The form
shall contain statements to the following effect:
   (1) A person who, in the last 10 years, has been convicted for, or
incarcerated following conviction for, fraud against a government
health care or supportive services program is not eligible to be
enrolled as a provider or to receive payment for providing supportive
services.
   (2) An individual who, in the last 10 years, has been convicted
for, or incarcerated following conviction for, a violation of
subdivision (a) of Section 273a of the Penal Code or Section 368 of
the Penal Code, or similar violations in another jurisdiction, is not
eligible to be enrolled as a provider or to receive payment for
providing supportive services.
   (3) A statement declaring that the person has not, in the last 10
years, been convicted or incarcerated following conviction for a
crime involving fraud against a government health care or supportive
services program.
   (4) A statement declaring that he or she has not, in the last 10
years, been convicted for, or incarcerated following conviction for,
a violation of subdivision (a) of Section 273a of the Penal Code or
Section 368 of the Penal Code, or similar violations in another
jurisdiction.
   (5) The person agrees to reimburse the state for any overpayment
paid to the person as determined in accordance with Section 12305.83,
and that the amount of any overpayment, individually or in the
aggregate, may be deducted from any future warrant to that person for
services provided to any recipient of supportive services, as
authorized in Section 12305.83.
   (b) The department shall include the text of subdivision (a) of
Section 273a of the Penal Code and Section 368 of the Penal Code on
the provider enrollment form.
   (c) A public authority or nonprofit consortium that is notified by
the department or the State Department of Health Care Services that
a supportive services provider is ineligible to receive payments
under this chapter or under Medi-Cal law shall exclude that provider
from its registry.
   (d) A public authority or nonprofit consortium that determines
that a registry provider is not eligible to provide supportive
services based on the requirements of subdivision (a) shall report
that finding to the department.



12305.82.  (a) In addition to its existing authority under the
Medi-Cal program, the State Department of Health Care Services shall
have the authority to investigate fraud in the provision or receipt
of in-home supportive services. Counties shall also have the
authority to investigate fraud in the provision or receipt of in-home
supportive services pursuant to the protocols developed in
subdivision (b). The department, the State Department of Health Care
Services, and counties, including county quality assurance staff,
shall work together as appropriate to coordinate activities to detect
and prevent fraud by in-home supportive services providers and
recipients in accordance with federal and state laws and regulations,
including applicable due process requirements, to take appropriate
administrative action relating to suspected fraud in the provision or
receipt of in-home supportive services, and to refer suspected
criminal offenses to appropriate law enforcement agencies for
prosecution.
   (b) (1) The department, in consultation with county welfare
directors and other stakeholders, as appropriate, shall develop
uniform statewide protocols for acceptable activities to be performed
and acceptable measures to be taken by the department, the State
Department of Health Care Services, and the counties for purposes of
fraud prevention.
   (2) The State Department of Health Care Services, the department,
and the county may share data with each other as necessary to prevent
fraud and investigate suspected fraud pursuant to this section. The
information shall only be used for purposes of preventing and
investigating suspected fraud in the In-Home Supportive Services
program, and shall otherwise remain confidential.
   (c) If the State Department of Health Care Services concludes that
there is reliable evidence that a provider or recipient of
supportive services has engaged in fraud in connection with the
provision or receipt of in-home supportive services, the State
Department of Health Care Services shall notify the department, the
county, and the county's public authority or nonprofit consortium, if
any, of that conclusion.
   (d) If a county concludes that there is reliable evidence that a
supportive services provider or recipient has engaged in fraud in
connection with the provision or receipt of in-home supportive
services, the county shall notify the department and the State
Department of Health Care Services of that conclusion.
   (e) Notwithstanding any other provision of law, a county may
investigate suspected fraud in connection with the provision or
receipt of supportive services, with respect to an overpayment of
five hundred dollars ($500) or less.
   (f) The failure of a provider or a recipient to comply with
program requirements may result in termination of his or her
participation in the In-Home Supportive Services program, subject to
all applicable federal and state due process requirements.



12305.83.  (a) When it has been determined that a provider of
supportive services participating under this chapter has received an
overpayment that is a debt due and owing, as defined in subdivision
(g) of Section 14043.1, the director or the county may, to the extent
permissible under existing labor laws, recover the overpayment by
offset against any amount currently due to a provider under the
provisions of this chapter, Chapter 7 (commencing with Section 14000)
or Chapter 8 (commencing with Section 14200) or by means of a
repayment agreement executed between the provider and the director or
the county, or by filing a civil action.
   (b) The department, in consultation with the entities listed in
Section 12305.72, shall identify, define, and develop policies,
procedures, and applicable due process requirements under which
overpayments to supportive services providers will be identified and
recovered.
   (c) If it is determined that an overpayment to a supportive
services provider has occurred the county shall:
   (1) Take all appropriate actions to recover the full amount of the
overpayment by any combination of the following actions:
   (A) Offsetting the overpayment from any future warrants to that
provider for services provided to any recipient of services pursuant
to subdivision (d).
   (B) Entering into a negotiated repayment agreement.
   (C) Filing a civil court action.
   (2) If the overpayment was determined to have occurred as a result
of fraud on the part of the supportive services provider, take all
appropriate actions to suspend or exclude the provider as an enrolled
provider and to prevent in the future any further payment of state
or federal funds to the provider for up to 10 years following the
conviction or the term of incarceration following the conviction for
fraud.
   (d) If the overpayment described in this section was determined to
be the result of fraud, the full amount of the overpayment may be
offset, in total, from any future warrants, as described in paragraph
(1) of subdivision (c). If the overpayment is not determined to be
the result of fraud the offset shall be limited to either of the
following:
   (1) The amounts provided for in a repayment agreement negotiated
with the provider.
   (2) No more than 5 percent of each warrant, for errors caused by
the government and no more than 10 percent of each warrant, for
errors resulting for any other reason, until the full or negotiated
amount is recovered.


12305.84.  (a) Upon enactment of this section, the department shall
convene a stakeholder group and begin a process with this group to
develop and issue a report evaluating the implementation of the
quality assurance and fraud prevention and detection activities
enacted from 2004 to the present. The department shall include and
collaborate with the State Department of Health Care Services, the
California State Association of Counties, the County Welfare
Directors Association, and stakeholders representing consumers and
providers.
   (b) The department shall provide this report to the Legislature on
or before December 31, 2010.
   (c) The stakeholder group shall:
   (1) Review the annual error reports issued and state-level quality
assurance activities to date required by Section 12305.7 and review
and evaluate the implementation of county quality assurance
activities required by Section 12305.71, including a review of the
number of instances, amounts, and causes of overpayments and
underpayments identified by quality assurance activity at the state
and county level from enactment to date.
   (2) Review information available regarding prevention and early
detection of fraud, the latter as defined by Section 12305.81.
   (3) Collect and review information regarding referrals of
suspected fraud to the State Department of Health Care Services
pursuant to Section 12305.82, and subsequent investigative efforts,
including cost-benefit information regarding these efforts, as well
as the number of fraud cases handled locally.
   (4) Collect and review information regarding final convictions for
fraud, including all of the following:
   (A) The amount of funds involved in the conviction.
   (B) The basis of the fraud conviction, including whether it
involved services not provided or falsified consumers or providers,
or both.
   (C) Aggregate information regarding the number and source of
individuals responsible, including, but not limited to, state
employees, IHSS providers, consumers, county workers, or others.
   (5) Provide recommendations on options for preventing errors and
fraud for both the state and county levels, and recommendations for
early detection strategies to combat fraud in the program.



12305.85.  (a) A provider enrollment form shall be completed using
the provider's physical residential address, and shall not be
completed using a post office box address.
   (b) A paycheck for a provider shall not be mailed to a post office
box unless the county approves a written or oral request from the
provider, which shall include an explanation of the circumstances
that make the use of a post office box appropriate or necessary. The
county shall document an oral request received pursuant to this
subdivision the provider's request and the county's approval or
disapproval shall be retained in the provider's file.



12305.86.  (a) Effective October 1, 2009, a county shall investigate
the background of a person who seeks to become a supportive services
provider and who is not listed on the registry of a public authority
or nonprofit consortium pursuant to Section 12301.6. This
investigation shall include criminal background checks conducted by
the Department of Justice pursuant to Section 15660.
   (b) No later than July 1, 2010, the county shall complete a
criminal background check pursuant to subdivision (a) for a provider
who is providing in-home supportive services prior to October 1,
2009, and who is not listed on a public authority or nonprofit
consortium registry, as a condition of the provider's continued
enrollment in the IHSS program. Criminal background checks shall be
conducted at the provider's expense.
   (c) (1) Upon notice from the Department of Justice that a
prospective or current provider has been convicted of a criminal
offense specified in Section 12305.81, the county shall deny or
terminate the applicant's request to become a provider of supportive
services to any recipient of the In-Home Supportive Services program.
   (2) Commencing 90 days after the effective date of the act that
adds Section 12305.87, and upon notice from the Department of Justice
that an applicant who is subject to the provisions of that section
has been convicted of, or incarcerated following conviction for, an
offense described in subdivision (b) of that section, the county
shall deny the applicant's request to become a provider of supportive
services to any recipient of in-home supportive services, subject to
the individual waiver and exception processes described in that
section. An applicant who is denied on the basis of Section 12305.87
shall be informed by the county of the individual waiver and
exception processes described in that section.
   (3) If an applicant or provider is rejected as a result of
information contained in the criminal background report, the
applicant or provider shall receive a copy of his or her own criminal
history record from the Department of Justice, as provided in
Article 5 (commencing with Section 11120) of Chapter 1 of Title 1 of
Part 4 of the Penal Code, to review the information for accuracy and
completeness. The applicant or provider shall be advised that if,
upon review of his or her own criminal history record, he or she
finds the information to be inaccurate or incomplete, the applicant
or provider shall have the right to submit a formal challenge to the
Department of Justice to contest the criminal background report.
   (4) The department shall develop a written appeal process for the
current and prospective providers who are determined ineligible to
receive payment for the provision of services under the In-Home
Supportive Services program.
   (5) An applicant shall be informed of his or her right to a waiver
of the fee for obtaining a copy of a criminal history record, and of
how to submit a claim and proof of indigency, as required by Section
11123 of the Penal Code.
   (d) Nothing in this section shall be construed to prohibit the
Department of Justice from assessing a fee pursuant to Section 11105
or 11123 of the Penal Code to cover the cost of furnishing summary
criminal history information.
   (e) A county authorized to secure a criminal background check
clearance pursuant to this section shall accept a clearance for an
individual described in subdivision (a) or (b) who has been deemed
eligible by another nonprofit consortium, public authority, or county
with criminal background check authority pursuant to either Section
12301.6 or this section, to receive payment for providing services
pursuant to this article. Existence of a clearance shall be
determined by verification through the case management, information,
and payrolling system, that another county, nonprofit consortium, or
public authority with criminal background check authority pursuant to
Section 12301.6 or this section has deemed the current or
prospective provider to be eligible to receive payment for providing
services pursuant to this article.
   (f) The department shall seek federal financial participation, to
the extent possible, to cover any costs associated with this section.




12305.87.  (a) (1) Commencing 90 days following the effective date
of the act that adds this section, a person specified in paragraph
(2) shall be subject to the criminal conviction exclusions provided
for in this section, in addition to the exclusions required under
Section 12305.81.
   (2) This section shall apply to a person who satisfies either of
the following conditions:
   (A) He or she is a new applicant to provide services under this
article.
   (B) He or she is an applicant to provide services under this
article whose application has been denied on the basis of a
conviction and for whom an appeal of that denial is pending.
   (b) Subject to subdivisions (c), (d), and (e), an applicant
subject to this section shall not be eligible to provide or receive
payment for providing supportive services for 10 years following a
conviction for, or incarceration following a conviction for, any of
the following:
   (1) A violent or serious felony, as specified in subdivision (c)
of Section 667.5 of the Penal Code and subdivision (c) of Section
1192.7 of the Penal Code.
   (2) A felony offense for which a person is required to register
under subdivision (c) of Section 290 of the Penal Code. For purposes
of this subparagraph, the 10-year time period specified in this
section shall commence with the date of conviction for, or
incarceration following a conviction for, the underlying offense, and
not the date of registration.
   (3) A felony offense described in paragraph (2) of subdivision (c)
or paragraph (2) of subdivision (g) of Section 10980.
   (c) Notwithstanding subdivision (b), an application shall not be
denied under this section if the applicant has obtained a certificate
of rehabilitation under Chapter 3.5 (commencing with Section
4852.01) of Title 6 of Part 3 of the Penal Code or the information or
accusation against him or her has been dismissed pursuant to Section
1203.4 of the Penal Code.
   (d) (1) Notwithstanding subdivision (b), a recipient of services
under this article who wishes to employ a provider applicant who has
been convicted of an offense specified in subdivision (b) may submit
to the county an individual waiver of the exclusion provided for in
this section. This paragraph shall not be construed to allow a
recipient to submit an individual waiver with respect to a conviction
or convictions for offenses specified in Section 12305.81.
   (2) The county shall notify a recipient who wishes to hire a
person who is applying to be a provider and who has been convicted of
an offense subject to exclusion under this section of that applicant'
s relevant criminal offense convictions that are covered by
subdivision (b). The notice shall include both of the following:
   (A) A summary explanation of the exclusions created by subdivision
(b), as well as the applicable waiver process described in this
subdivision and the process for an applicant to seek a general
exception, as described in subdivision (e). This summary explanation
shall be developed by the department for use by all counties.
   (B) An individual waiver form, which shall also be developed by
the department and used by all counties. The waiver form shall
include both of the following:
   (i) A space for the county to include a reference to any Penal
Code sections and corresponding offense names or descriptions that
describe the relevant conviction or convictions that are covered by
subdivision (b) and that the provider applicant has in his or her
background.
   (ii) A statement that the service recipient, or his or her
authorized representative, if applicable, is aware of the applicant's
conviction or convictions and agrees to waive application of this
section and employ the applicant as a provider of services under this
article.
   (3) To ensure that the initial summary explanation referenced in
this subdivision is comprehensible for recipients and provider
applicants, the department shall consult with representatives of
county welfare departments and advocates for, or representatives of,
recipients and providers in developing the summary explanation and
offense descriptions.
   (4) The individual waiver form shall be signed by the recipient,
or by the recipient's authorized representative, if applicable, and
returned to the county welfare department by mail or in person. The
county shall retain the waiver form and a copy of the provider
applicant's criminal offense record information search response until
the date that the convictions that are the subject of the waiver
request are no longer within the 10-year period specified in
subdivision (b).
   (5) An individual waiver submitted pursuant to this subdivision
shall entitle a recipient to hire a provider applicant who otherwise
meets all applicable enrollment requirements for the In-Home
Supportive Services program. A provider hired pursuant to an
individual waiver may be employed only by the recipient who requested
that waiver, and the waiver shall only be valid with respect to
convictions that are specified in that waiver. A new waiver shall be
required if the provider is subsequently convicted of an offense to
which this section otherwise would apply. A provider who wishes to be
listed on a provider registry or to provide supportive services to a
recipient who has not requested an individual waiver shall be
required to apply for a general exception, as provided for in
subdivision (e).
   (6) Nothing in this section shall preclude a provider who is
eligible to receive payment for services provided pursuant to an
individual waiver under this subdivision from being eligible to
receive payment for services provided to one or more additional
recipients who obtain waivers pursuant to this same subdivision.
   (7) The state and a county shall be immune from any liability
resulting from granting an individual waiver under this subdivision.
   (e) (1) Notwithstanding subdivision (b), an applicant who has been
convicted of an offense identified in subdivision (b) may seek from
the department a general exception to the exclusion provided for in
this section.
   (2) Upon receipt of a general exception request, the department
shall request a copy of the applicant's criminal offender record
information search response from the applicable county welfare
department. Notwithstanding any other provision of law, the county
shall provide a copy of the criminal offender record information
search response, as provided to the county by the Department of
Justice, to the department. The county shall provide this information
in a manner that protects the confidentiality and privacy of the
criminal offender record information search response. The state or
federal criminal history record information search response shall not
be modified or altered from its form or content as provided by the
Department of Justice.
   (3) The department shall consider the following factors when
determining whether to grant a general exception under this
subdivision:
   (A) The nature and seriousness of the conduct or crime under
consideration and its relationship to employment duties and
responsibilities.
   (B) The person's activities since conviction, including, but not
limited to, employment or participation in therapy education, or
community service, that would indicate changed behavior.
   (C) The number of convictions and the time that has elapsed since
the conviction or convictions.
   (D) The extent to which the person has complied with any terms of
parole, probation, restitution, or any other sanction lawfully
imposed against the person.
   (E) Any evidence of rehabilitation, including character
references, submitted by the person, or by others on the person's
behalf.
   (F) Employment history and current or former employer
recommendations. Additional consideration shall be given to employer
recommendations provided by a person who has received or has
indicated a desire to receive supportive or personal care services
from the applicant, including, but not limited to, those services,
specified in Section 12300.
   (G) Circumstances surrounding the commission of the offense that
would demonstrate the unlikelihood of repetition.
   (H) The granting by the Governor of a full and unconditional
pardon.
   (f) If the department makes a determination to deny an application
to provide services pursuant to a request for a general exception,
the department shall notify the applicant of this determination by
either personal service or registered mail. The notice shall include
the following information:
   (1) A statement of the department's reasons for the denial that
evaluates evidence of rehabilitation submitted by the applicant, if
any, and that specifically addresses any evidence submitted relating
to the factors in paragraph (3) of subdivision (e).
   (2) A copy of the applicant's criminal offender record information
search response, even if the applicant already has received a copy
pursuant to Section 12301.6 or 12305.86. The department shall provide
this information in a manner that protects the confidentiality and
privacy of the criminal offender record information search response.
   (A) The state or federal criminal history record shall not be
modified or altered from its form or content as provided by the
Department of Justice.
   (B) The department shall retain a copy of each individual's
criminal offender record information search response until the date
that the convictions that are the subject of the exception are no
longer within the 10-year period specified in subdivision (b), and
shall record the date the copy of the response was provided to the
individual and the department.
   (C) The criminal offender record information search response shall
not be made available by the department to any individual other than
the provider applicant.
   (g) (1) Upon written notification that the department has
determined that a request for exception shall be denied, the
applicant may request an administrative hearing by submitting a
written request to the department within 15 business days of receipt
of the written notification. Upon receipt of a written request, the
department shall hold an administrative hearing consistent with the
procedures specified in Section 100171 of the Health and Safety Code,
except where those procedures are inconsistent with this section.
   (2) A hearing under this subdivision shall be conducted by a
hearing officer or administrative law judge designated by the
director. A written decision shall be sent by certified mail to the
applicant.
   (h) The department shall revise the provider enrollment form
developed pursuant to Section 12305.81 to include both of the
following:
   (1) The text of subdivision (c) of Section 290 of the Penal Code,
subdivision (c) of Section 667.5 of the Penal Code, subdivision (c)
of Section 1192.7 of the Penal Code, and paragraph (2) of
subdivisions (c) and (g) of Section 10980.
   (2) A statement that the provider understands that if he or she
has been convicted, or incarcerated following conviction for, any of
the crimes specified in the provisions identified in paragraph (b) in
the last 10 years, and has not received a certificate of
rehabilitation or had the information or accusation dismissed, as
provided in subdivision (c), he or she shall only be authorized to
receive payment for providing in-home supportive services under an
individual waiver or general exception as described in this section,
and upon meeting all other applicable criteria for enrollment as a
provider in the program.
   (i) (1) Notwithstanding the rulemaking provisions of the
Administrative Procedure Act (Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code),
the department may implement and administer this section through
all-county letters or similar instructions from the department until
regulations are adopted. The department shall adopt emergency
regulations implementing these provisions no later than July 1, 2011.
The department may readopt any emergency regulation authorized by
this section that is the same as or substantially equivalent to an
emergency regulation previously adopted under this section.
   (2) The initial adoption of emergency regulations pursuant to this
section and one readoption of emergency regulations shall be deemed
an emergency and necessary for the immediate preservation of the
public peace, health, safety, or general welfare. Initial emergency
regulations and the one readoption of emergency regulations
authorized by this section shall be exempt from review by the Office
of Administrative Law. The initial emergency regulations and the one
readoption of emergency regulations authorized by this section shall
be submitted to the Office of Administrative Law for filing with the
Secretary of State and each shall remain in effect for no more than
180 days, by which time final regulations may be adopted.
   (j) In developing the individual waiver form and all-county
letters or information notices or similar instructions, the
department shall consult with stakeholders, including, but not
limited to, representatives of the county welfare departments, and
representatives of consumers and providers. The consultation shall
include at least one in-person meeting prior to the finalization of
the individual waiver form and all-county letters or information
notices or similar instructions.



12306.  (a) The state and counties shall share the annual cost of
providing services under this article as specified in this section.
   (b) Except as provided in subdivisions (c) and (d), the state
shall pay to each county, from the General Fund and any federal funds
received under Title XX of the federal Social Security Act available
for that purpose, 65 percent of the cost of providing services under
this article, and each county shall pay 35 percent of the cost of
providing those services.
   (c) For services eligible for federal funding pursuant to Title
XIX of the federal Social Security Act under the Medi-Cal program
and, except as provided in subdivisions (b) and (d) the state shall
pay to each county, from the General Fund and any funds available for
that purpose 65 percent of the nonfederal cost of providing services
under this article, and each county shall pay 35 percent of the
nonfederal cost of providing those services.
   (d) (1) For the period of July 1, 1992, to June 30, 1994,
inclusive, the state's share of the cost of providing services under
this article shall be limited to the amount appropriated for that
purpose in the annual Budget Act.
   (2) The department shall restore the funding reductions required
by subdivision (c) of Section 12301, fully or in part, as soon as
administratively practicable, if the amount appropriated from the
General Fund for the 1992-93 fiscal year under this article is
projected to exceed the sum of the General Fund expenditures under
Section 14132.95 and the actual General Fund expenditures under this
article for the 1992-93 fiscal year. The entire amount of the excess
shall be applied to the restoration. Services shall not be restored
under this paragraph until the Department of Finance has determined
that the restoration of services would result in no additional costs
to the state or to the counties relative to the combined state
appropriation and county matching funds for in-home supportive
services under this article in the 1992-93 fiscal year.



12306.1.  (a) When any increase in provider wages or benefits is
negotiated or agreed to by a public authority or nonprofit consortium
under Section 12301.6, then the county shall use county-only funds
to fund both the county share and the state share, including
employment taxes, of any increase in the cost of the program, unless
otherwise provided for in the annual Budget Act or appropriated by
statute. No increase in wages or benefits negotiated or agreed to
pursuant to this section shall take effect unless and until, prior to
its implementation, the department has obtained the approval of the
State Department of Health Care Services for the increase pursuant to
a determination that it is consistent with federal law and to ensure
federal financial participation for the services under Title XIX of
the federal Social Security Act, and unless and until all of the
following conditions have been met:
   (1) Each county has provided the department with documentation of
the approval of the county board of supervisors of the proposed
public authority or nonprofit consortium rate, including wages and
related expenditures. The documentation shall be received by the
department before the department and the State Department of Health
Care Services may approve the increase.
   (2) Each county has met department guidelines and regulatory
requirements as a condition of receiving state participation in the
rate.
   (b) Any rate approved pursuant to subdivision (a) shall take
effect commencing on the first day of the month subsequent to the
month in which final approval is received from the department. The
department may grant approval on a conditional basis, subject to the
availability of funding.
   (c) The state shall pay 65 percent, and each county shall pay 35
percent, of the nonfederal share of wage and benefit increases
negotiated by a public authority or nonprofit consortium pursuant to
Section 12301.6 and associated employment taxes, only in accordance
with subdivisions (d) to (f), inclusive.
   (d) (1) The state shall participate as provided in subdivision (c)
in wages up to seven dollars and fifty cents ($7.50) per hour and
individual health benefits up to sixty cents ($0.60) per hour for all
public authority or nonprofit consortium providers. This paragraph
shall be operative for the 2000-01 fiscal year and each year
thereafter unless otherwise provided in paragraphs (2), (3), (4), and
(5), and without regard to when the wage and benefit increase
becomes effective.
   (2) The state shall participate as provided in subdivision (c) in
a total of wages and individual health benefits up to nine dollars
and ten cents ($9.10) per hour, if wages have reached at least seven
dollars and fifty cents ($7.50) per hour. Counties shall determine,
pursuant to the collective bargaining process provided for in
subdivision (c) of Section 12301.6, what portion of the nine dollars
and ten cents ($9.10) per hour shall be used to fund wage increases
above seven dollars and fifty cents ($7.50) per hour or individual
health benefit increases, or both. This paragraph shall be operative
for the 2001-02 fiscal year and each fiscal year thereafter, unless
otherwise provided in paragraphs (3), (4), and (5).
   (3) The state shall participate as provided in subdivision (c) in
a total of wages and individual health benefits up to ten dollars and
ten cents ($10.10) per hour, if wages have reached at least seven
dollars and fifty cents ($7.50) per hour. Counties shall determine,
pursuant to the collective bargaining process provided for in
subdivision (c) of Section 12301.6, what portion of the ten dollars
and ten cents ($10.10) per hour shall be used to fund wage increases
above seven dollars and fifty cents ($7.50) per hour or individual
health benefit increases, or both. This paragraph shall be operative
commencing with the next state fiscal year for which the May Revision
forecast of General Fund revenue, excluding transfers, exceeds by at
least 5 percent, the most current estimate of revenue, excluding
transfers, for the year in which paragraph (2) became operative.
   (4) The state shall participate as provided in subdivision (c) in
a total of wages and individual health benefits up to eleven dollars
and ten cents ($11.10) per hour, if wages have reached at least seven
dollars and fifty cents ($7.50) per hour. Counties shall determine,
pursuant to the collective bargaining process provided for in
subdivision (c) of Section 12301.6, what portion of the eleven
dollars and ten cents ($11.10) per hour shall be used to fund wage
increases or individual health benefits, or both. This paragraph
shall be operative commencing with the next state fiscal year for
which the May Revision forecast of General Fund revenue, excluding
transfers, exceeds by at least 5 percent, the most current estimate
of revenues, excluding transfers, for the year in which paragraph (3)
became operative.
   (5) The state shall participate as provided in subdivision (c) in
a total cost of wages and individual health benefits up to twelve
dollars and ten cents ($12.10) per hour, if wages have reached at
least seven dollars and fifty cents ($7.50) per hour. Counties shall
determine, pursuant to the collective bargaining process provided for
in subdivision (c) of Section 12301.6, what portion of the twelve
dollars and ten cents ($12.10) per hour shall be used to fund wage
increases above seven dollars and fifty cents ($7.50) per hour or
individual health benefit increases, or both. This paragraph shall be
operative commencing with the next state fiscal year for which the
May Revision forecast of General Fund revenue, excluding transfers,
exceeds by at least 5 percent, the most current estimate of revenues,
excluding transfers, for the year in which paragraph (4) became
operative.
   (6) Notwithstanding paragraphs (2) to (5), inclusive, the state
shall participate as provided in subdivision (c) in a total cost of
wages up to nine dollars and fifty cents ($9.50) per hour and in
individual health benefits up to sixty cents ($0.60) per hour. This
paragraph shall become operative on July 1, 2009.
   (7) (A) The Legislature finds and declares that injunctions issued
by the courts have prevented the state from implementing the changes
described in paragraph (6) during the pendency of litigation. To
avoid confusion for providers, recipients, and other stakeholders, it
is therefore the intent of the Legislature to temporarily suspend
the reductions described in that paragraph until July 1, 2012, to
allow the litigation to reach a final result.
   (B) Paragraph (6) shall not be implemented until July 1, 2012, and
as of that date shall only be implemented if a court of competent
jurisdiction has issued an order, that is not subject to appeal or
for which the time to appeal has expired, upholding its validity.
   (e) (1) On or before May 14 immediately prior to the fiscal year
for which state participation is provided under paragraphs (2) to
(5), inclusive, of subdivision (d), the Director of Finance shall
certify to the Governor, the appropriate committees of the
Legislature, and the department that the condition for each
subdivision to become operative has been met.
   (2) For purposes of certifications under paragraph (1), the
General Fund revenue forecast, excluding transfers, that is used for
the relevant fiscal year shall be calculated in a manner that is
consistent with the definition of General Fund revenues, excluding
transfers, that was used by the Department of Finance in the 2000-01
Governor's Budget revenue forecast as reflected on Schedule 8 of the
Governor's Budget.
   (f) Any increase in overall state participation in wage and
benefit increases under paragraphs (2) to (5), inclusive, of
subdivision (d), shall be limited to a wage and benefit increase of
one dollar ($1) per hour with respect to any fiscal year. With
respect to actual changes in specific wages and health benefits
negotiated through the collective bargaining process, the state shall
participate in the costs, as approved in subdivision (c), up to the
maximum levels as provided under paragraphs (2) to (6), inclusive, of
subdivision (d).



12306.2.  (a) Notwithstanding any other provision of law, for the
2000-01 fiscal year, the state shall pay 65 percent and each county
shall pay 35 percent of the nonfederal share of any increase to
individual provider wages a county chooses to grant, up to 3 percent
above the statewide minimum wage.
   (b) This section shall not apply to providers who are employees of
a public authority or nonprofit consortium pursuant to Section
12301.6.
   (c) This section shall be operative on January 1, 2001.



12306.21.  (a) Notwithstanding any other provision of law, for the
2001-02 fiscal year, the state shall pay 65 percent and each county
shall pay 35 percent of the nonfederal share of any increase to
individual provider wages a county chooses to grant, up to 5.31
percent above the statewide minimum wage.
   (b) This section shall not apply to providers who are employees of
a public authority or nonprofit consortium pursuant to Section
12301.6.
   (c) This section shall become operative on July 1, 2001.



12306.3.  In consultation with stakeholder organizations, including,
but not limited to, the California State Association of Counties and
employee organizations representing in-home supportive service
workers, the department shall develop and evaluate various options
for providing health care benefits for uninsured individual in-home
supportive services providers who are not employees of a public
authority or nonprofit consortium under Section 12301.6. The
department shall report its findings and recommendations to the
Legislature by January 15, 2001.


12306.5.  (a) Any public or private agency, including a contractor
under Section 12302.1, who maintains a list or registry of
prospective in-home supportive services providers shall require proof
of identification from a prospective provider. This identification
shall be provided prior to placing the prospective provider on a list
or registry or supplying a name from the list or registry to an
applicant for, or recipient of, in-home supportive services.
   (b) For purposes of this section, proof of identification
includes, but is not limited to, a positive photograph identification
from a government source.



12306.6.  (a) (1) Notwithstanding any other provision of law,
beginning on the date for which the federal Centers for Medicare and
Medicaid Services authorizes commencement of the implementation of
this section, but no earlier than July 1, 2010, and concurrent with
the collection of the sales tax extended to support services pursuant
to Article 4 (commencing with Section 6150) of Chapter 2 of Part 1
of Division 2 of the Revenue and Taxation Code, a provider of in-home
supportive services shall receive a supplementary payment under this
article equal to a percentage, as set forth in paragraph (2), of the
gross receipts, as defined in subdivision (b) of Section 6150 of the
Revenue and Taxation Code, of the provider for the sale of in-home
supportive services, plus an amount described in paragraph (3) if
applicable. If the underlying payment for in-home supportive services
that is being supplemented is a Medi-Cal payment, then the
supplementary payment shall also be a Medi-Cal payment. Supplementary
payments shall be made only to those providers from whom the tax
imposed pursuant to Section 6151 of the Revenue and Taxation Code has
been collected.
   (2) The percentage applicable to the supplementary payment
required by paragraph (1) shall equal the rate described in
subdivision (b) of Section 6151 of the Revenue and Taxation Code and
shall only be applied to services provided under this article,
including personal care option services reimbursable under the
Medi-Cal program.
   (3) The supplementary payment of an individual provider whose
payroll withholding required for federal income tax purposes and for
purposes of taxation for the Social Security and Medicare programs is
increased due to the supplementary payment, in comparison to the
amounts for those purposes that would be withheld without the
supplementary payment, shall be increased by an additional amount
that is equal to the amount of this additional federal withholding.
   (b) (1) All revenues deposited in the Personal Care IHSS Quality
Assurance Revenue Fund established pursuant to Section 6168 of the
Revenue and Taxation Code shall be used solely for purposes of the
In-Home Supportive Services program, including, but not limited to,
those services provided under the Medi-Cal program. All supplementary
payments required by this section shall be paid from the Personal
Care IHSS Quality Assurance Revenue Fund.
   (2) The Director of Finance shall determine the sum required to be
deposited in the Personal Care IHSS Quality Assurance Revenue Fund
to fund the initial supplementary payments from the fund. As soon
thereafter as reasonably possible, this sum shall be transferred, in
the form of a loan, from the General Fund to the Personal Care IHSS
Quality Assurance Revenue Fund. At the time sufficient revenues have
been deposited in the Personal Care IHSS Quality Assurance Revenue
Fund pursuant to Section 6168 of the Revenue and Taxation Code to
sustain the continued operation of the fund for that portion of the
supplementary payment described in paragraph (2) of subdivision (a)
plus an additional amount equal to the General Fund loan made
pursuant to this paragraph, plus interest, the sum transferred from
the General Fund, including interest, shall be repaid to the General
Fund. Subsequent supplementary payments pursuant to this section
shall be made from revenue deposited in the Personal Care IHSS
Quality Assurance Revenue Fund pursuant to Section 6168 of the
Revenue and Taxation Code.
   (3) The Department of Finance, on an ongoing basis, shall
determine the amount necessary to implement paragraph (3) of
subdivision (a), and subdivision (c) of Section 12302.2, and
immediately transfer this amount from the General Fund to the
Personal Care IHSS Quality Assurance Revenue Fund.
   (c) (1) The Director of Health Care Services shall seek all
federal Medicaid approvals necessary to implement this section,
including using the revenues obtained pursuant to Article 4
(commencing with Section 6150) of Chapter 2 of Part 1 of Division 2
of the Revenue and Taxation Code as the nonfederal share for
supplementary payments. As part of that request for approval, the
director shall seek to make the supplementary payments effective as
of July 1, 2010.
   (2) This section shall become operative only if the federal
Centers for Medicare and Medicaid Services grants Medicaid approvals
sought pursuant to paragraph (1).
   (3) If Medicaid approval is granted pursuant to paragraph (2),
within 10 days of that approval the Director of Health Care Services
shall notify the State Board of Equalization and the appropriate
fiscal and policy committees of the Legislature of the approval.
   (d) If Article 4 (commencing with Section 6150) of Chapter 2 of
Part 1 of Division 2 of the Revenue and Taxation Code becomes
inoperative pursuant to subdivision (b) of Section 6170 of the
Revenue and Taxation Code, supplementary payments shall cease to be
made pursuant to subdivision (a) when all moneys in the fund have
been expended.
   (e) (1) Notwithstanding the rulemaking provisions of the
Administrative Procedure Act, Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code, the
department and the State Department of Health Care Services may
implement and administer this section through all-county letters or
similar instruction from the department and the State Department of
Health Care Services until regulations are adopted. The department
and the State Department of Health Care Services shall adopt
emergency regulations implementing this section no later than 12
months following the initial effective date of the supplementary
payments. The department and the State Department of Health Care
Services may readopt any emergency regulation authorized by this
section that is the same as or substantially equivalent to an
emergency regulation previously adopted under this section.
   (2) The initial adoption of emergency regulations implementing
this section and the one readoption of emergency regulations
authorized by this subdivision shall be deemed an emergency and
necessary for the immediate preservation of the public peace, health,
safety, or general welfare. Initial emergency regulations and the
one readoption of emergency regulations authorized by this section
shall be exempt from review and approval by the Office of
Administrative Law. The initial emergency regulations and the one
readoption of emergency regulations authorized by this section shall
be submitted to the Office of Administrative Law for filing with the
Secretary of State and each shall remain in effect for no more than
180 days, by which time final regulations may be adopted.
   (f) This section shall remain in effect only until the January 1
following the date supplementary payments cease to be made pursuant
to subdivision (d), and as of that date is repealed.



12307.  The amendments to Sections 12302, 12303 and 12304 of, and
the addition of Sections 12303.5 and 12304.5 to, the Welfare and
Institutions Code made by Chapter 75 of the Statutes of 1974 do not
constitute a change in, but are declaratory of, the preexisting law.




12308.  Funding of this article is subject to the provisions of Part
1.5 (commencing with Section 10100) of this division.



12309.  (a) In order to assure that in-home supportive services are
delivered in all counties in a uniform manner, the department shall
develop a uniform needs assessment tool.
   (b) (1) Each county shall, in administering this article, use the
uniform needs assessment tool developed pursuant to subdivision (a)
in collecting and evaluating information.
   (2) For purposes of paragraph (1), "information" includes, but is
not limited to, all of the following:
   (A) The recipient's living environment.
   (B) Alternative resources.
   (C) The recipient's functional abilities.
   (c) (1) The uniform needs assessment tool developed pursuant to
subdivision (a) shall evaluate the recipient's functioning in
activities of daily living and instrumental activities of daily
living.
   (2) The recipient's functioning shall be quantified, using the
general hierarchical five-point scale for ranking each function, as
specified in subdivision (d).
   (d) The recipient's functioning ranks shall be as follows:
   (1) Rank one. A recipient's functioning shall be classified as
rank one if his or her functioning is independent, and he or she is
able to perform the function without human assistance, although the
recipient may have difficulty in performing the function, but the
completion of the function, with or without a device or mobility aid,
poses no substantial risk to his or her safety.
   (2) Rank two. A recipient's functioning shall be classified as
rank two if he or she is able to perform a function, but needs verbal
assistance, such as reminding, guidance, or encouragement.
   (3) Rank three. A recipient's functioning shall be classified as
rank three if he or she can perform the function with some human
assistance, including, but not limited to, direct physical assistance
from a provider.
   (4) Rank four. A recipient's functioning shall be classified as
rank four if he or she can perform a function, but only with
substantial human assistance.
   (5) Rank five. A recipient's functioning shall be classified as
rank five if he or she cannot perform the function, with or without
human assistance.
   (e) (1) Notwithstanding any other law, and effective September 1,
2009, individuals shall be eligible for each domestic or related
service only if assessed at a rank four or five, as defined in
subdivision (d), in the activity of daily living relating to that
service. The activities of daily living that relate to domestic and
related services are defined in regulations and include housework,
laundry, shopping and errands, meal preparation, and meal cleanup.
The rank for each domestic and related service shall be determined
based on an assessment of need for supportive services by the county,
in accordance with this section and the hourly task guidelines as
defined by Section 12301.2. This paragraph does not apply to
individuals meeting one of the conditions specified in paragraph (2).
   (2) Paragraph (1) shall not apply to individuals authorized to
receive either protective supervision pursuant to subdivision (b) of
Section 12300 and Section 12301.21 or paramedical services pursuant
to Section 12300.1, or to individuals authorized to receive over 120
hours of services per month.
   (3) To the extent necessary to maintain federal financial
participation, the director may waive any or all of the provisions of
paragraph (2), after consultation with the State Department of
Health Care Services.
   (f) A recipient shall be assigned a functional index score. The
functional index score for a recipient shall be a weighted average
based on the individual functional index rankings, as described in
subdivision (d), to provide a single measure of a recipient's
relative dependence on human assistance for performance of activities
of daily living that are used in the assessment of services provided
pursuant to this article.
   (g) (1) Notwithstanding the rulemaking provisions of the
Administrative Procedure Act (Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code) the
department may implement and administer this section through
all-county letters or similar instruction from the department until
regulations are adopted. The department shall adopt emergency
regulations implementing this section no later than July 1, 2010. The
department may readopt any emergency regulation authorized by this
section that is the same as or substantially equivalent to an
emergency regulation previously adopted under this section.
   (2) The initial adoption of emergency regulations implementing
this section and one readoption of emergency regulations shall be
deemed an emergency and necessary for the immediate preservation of
the public peace, health, safety, or general welfare. Initial
emergency regulations and the one readoption of emergency regulations
authorized by this subdivision shall be exempt from review and
approval by the Office of Administrative Law. The initial emergency
regulations and the one readoption of emergency regulations
authorized by this subdivision shall be submitted to the Office of
Administrative Law for filing with the Secretary of State and each
shall remain in effect for no more than 180 days, by which time final
regulations may be adopted.
   (h) Subdivisions (e), (f), and (g) shall become operative on
September 1, 2009.
   (i)  (1) The Legislature finds and declares that injunctions
issued by the courts have prevented the state from implementing the
changes described in subdivisions (e), (f), and (g) during the
pendency of litigation. To avoid confusion for providers, recipients,
and other stakeholders, it is therefore the intent of the
Legislature to temporarily suspend the reductions described in those
subdivisions until July 1, 2012, to allow the litigation to reach a
final result.
   (2) Notwithstanding subdivision (h) or any other provision of law,
subdivisions (e), (f), and (g) shall not be implemented until July
1, 2012, and as by that date shall only be implemented if a court of
competent jurisdiction has issued an order, that is not subject to
appeal or for which the time to appeal has expired, upholding their
validity.



12309.2.  (a) Notwithstanding any other law, except as provided in
subdivision (b), and pursuant to subdivision (e) of Section 12309,
and effective September 1, 2009, eligibility for in-home supportive
services provided pursuant to Article 7 (commencing with Section
12300) of Chapter 3 shall also include functional index scores
calculated pursuant to subdivision (f) of Section 12309, as follows:
   (1) Individuals with a functional index score of 2.0 and above
shall be eligible to receive all appropriate in-home supportive
services provided pursuant to this article.
   (2) Individuals with a functional index score below 2.0 shall not
be eligible for any in-home supportive services provided pursuant to
this article.
   (3) Paragraph (2) shall not apply to individuals authorized to
receive protective supervision pursuant to subdivision (b) of Section
12300 and Section 12301.21 or paramedical services pursuant to
Section 12300.1, or to individuals authorized to receive over 120
hours of services per month pursuant to Section 12301.2.
   (4) To the extent necessary to maintain federal financial
participation, the director may waive any or all of the provisions of
paragraph (3), after consultation with the State Department of
Health Care Services.
   (b) The department shall modify the notice of action forms to
inform individuals whose hours are reduced or for whom eligibility is
eliminated by the changes made to Section 12309 or this section by
the act adding this section of their functional rank and functional
index score. The form shall be modified no later than September 1,
2009.
   (c) (1) Notwithstanding the rulemaking provisions of the
Administrative Procedure Act, Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code, the
department may implement and administer this section through
all-county letters or similar instruction from the department until
regulations are adopted. The department shall adopt emergency
regulations implementing this section no later than July 1, 2010. The
department may readopt any emergency regulation authorized by this
section that is the same as or substantially equivalent to an
emergency regulation previously adopted under this section.
   (2) The initial adoption of emergency regulations implementing
this section and the one readoption of emergency regulations
authorized by this subdivision shall be deemed an emergency and
necessary for the immediate preservation of the public peace, health,
safety, or general welfare. Initial emergency regulations and the
one readoption of emergency regulations authorized by this section
shall be exempt from review and approval by the Office of
Administrative Law. The initial emergency regulations and the one
readoption of emergency regulations authorized by this section shall
be submitted to the Office of Administrative Law for filing with the
Secretary of State and each shall remain in effect for no more than
180 days, by which time final regulations may be adopted.
   (d) This section shall become operative on September 1, 2009.
   (e) (1) The Legislature finds and declares that injunctions issued
by the courts have prevented the state from implementing the changes
described in this section during the pendency of litigation. To
avoid confusion for providers, recipients, and other stakeholders, it
is therefore the intent of the Legislature to temporarily suspend
the reductions described in this section until July 1, 2012, to allow
the litigation to reach a final result.
   (2) Notwithstanding subdivision (d) or any other provision of law,
this section shall not be implemented until July 1, 2012, and as of
that date shall only be implemented if a court of competent
jurisdiction has issued an order, that is not subject to appeal or
for which the time to appeal has expired, upholding its validity.



12310.  It is the intent of the Legislature that the department
conduct special pilot projects to test appropriate methods for
assuring equity and efficiency in reducing program costs necessary to
remain within budget appropriations pursuant to Sections 12301 and
12306, and which use the experience gained and the techniques
developed by the in-home supportive services demonstration projects
conducted by the University of California in Alameda, Contra Costa,
and Marin Counties. The department may establish pilot projects in
Alameda and Marin Counties for the purpose of assessing methods which
allow for all of the following:
   (a) Greater equity in decisions regarding eligibility and level of
service as a means of reducing program costs.
   (b) Administrative reforms that promote greater economy in program
administration.
   (c) Less costly processes for periodic redetermination of
eligibility and service awards.



12311.  The director is authorized to grant such waivers from the
provisions of this article as are necessary to carry out the purposes
and intent of this section, however, the county must provide
services within its allocation. The department shall evaluate the
results of these pilot studies which shall include a comparison of
results obtained by nonpilot counties in their efforts to maintain a
budget-managed in-home supportive services program.



12314.  It is the intent of the Legislature that the department
conduct a pilot program, of not less than three years' duration, to
comprehensively assess the comparative cost effectiveness and quality
of care of both contract and individual provider modes of service.
   The pilot project will test alternative methods to maximize
delivery of services under this article within budget appropriations.
The project may also investigate the feasibility of the "capitation"
method of payment in any or all of the counties participating in the
project. County participation shall be on a voluntary basis.
   The department shall have the authority, if necessary, to
reallocate available funds as necessary to ensure the success of the
project within the overall state budget.
   The director may issue waivers, as necessary, pursuant to Section
18204.


12315.  (a) (1) Commencing January 1, 2009, a pilot project shall be
established in five consenting counties that provides severely
impaired recipients who receive in-home supportive services under
this article through the public authority, as described in Section
12301.6, with a choice of receiving services through the public
authority or receiving services through a voluntary nonprofit or
proprietary agency pursuant to Section 12302. The pilot project shall
be developed to provide services to severely impaired recipients, as
described in Section 12303.4.
   (2) To accomplish this end, the five consenting counties shall
administer the In-Home Supportive Services (IHSS) program through a
public authority pursuant to Section 12301.6.
   (3) (A) Following the submission of input and recommendations of
the IHSS advisory committee for the county, each participating
county, with the consent of the public authority in that county, or
the public authority, with the consent of the participating county,
shall contract with a voluntary nonprofit or proprietary agency,
pursuant to Section 12302.
   (B) Severely impaired recipients in each participating county may
continue to receive supportive services through the county's public
authority, or may choose to receive services through the voluntary
nonprofit or proprietary agency, pursuant to paragraph (1).
Recipients who choose to receive services through the voluntary
nonprofit or proprietary agency shall be compensated only for those
services described in the recipients' then-existing care plan, as
approved by the county social worker.
   (4) Administrative costs of the pilot project, including the cost
of developing guidelines other than the guidelines in this section
and the cost of administering the project and providing oversight,
shall not be paid by the state. Instead, an estimate of
administrative costs shall be included in the county request for
proposal for each contract with the voluntary nonprofit or
proprietary agency and administrative costs shall then be paid by the
agency up to the amount estimated unless the county and agency reach
an alternative cost-sharing agreement in the contract that does not
involve state participation.
   (b) (1) (A) For purposes of this section, to the extent possible,
all providers employed by the voluntary nonprofit or proprietary
agency shall be persons previously listed on the public authority's
registry. The agency shall, pursuant to the contract, continually
recruit and provide the public authority with names of new workers
for the registry.
   (B) The voluntary nonprofit or proprietary agency in each
participating county shall provide for training for all providers
recruited pursuant to this paragraph. A public authority may retain
the voluntary nonprofit or proprietary agency to provide these
services for and under the direction of the public authority. A
public authority shall not be eligible to receive reimbursement for
any costs associated with administering the pilot project. This shall
not prohibit any public authority from using the funding it receives
pursuant to paragraph (4) of subdivision (a) for newsletters and
other means of communication about training opportunities available
through the voluntary nonprofit or proprietary agency.
   (C) All providers employed by the voluntary nonprofit or
proprietary agency shall be paid no less than the wages and benefits
provided for in the public authority's collective bargaining
agreement, provided that this provision shall not obligate the state
to participate in a contract rate higher than the maximum allowable
contract rate. However, providers employed by the voluntary nonprofit
or proprietary agency are not covered by any existing collective
bargaining agreements with the public authority.
   (2) A voluntary nonprofit or proprietary agency that contracts
with a participating county pursuant to subdivision (a) shall perform
all of the following duties:
   (A) Maintain a live, on-call emergency service response system
that is available 24 hours a day, seven days a week.
   (B) Replace or supplement providers for a recipient who needs
immediate service for the sake of preserving his or her health or
safety within two hours of notification.
   (C) To the extent possible, employ the recipient's preferred
provider or providers.
   (D) If required by the county, provide emergency backup services
to severely impaired IHSS recipients when there is an unexpected
interruption in services.
   (E) Maintain a list of its providers with the public authority.
   (F) Establish and maintain an upskilling program, based on
practices in existing agency contracts, wherein employees may have
the opportunity to use work experience and training toward upward
movement on a long-term care career ladder. Any costs associated with
the development and maintenance of the upskilling program shall be
paid solely by the voluntary nonprofit or proprietary agency.
   (G) Be liable for any fraud, waste, or abuse for which it is
responsible.
   (3) For the duration of the pilot project, supportive services not
provided in any month due to hospitalization, illness, refusal, or
other cause not within the control of the provider shall not be made
up in a subsequent period without caseworker approval.
   (c) (1) In each participating county, the IHSS advisory committee,
as described in Section 12301.3, shall monitor the pilot program.
   (2) Each participating county shall not be eligible to receive
state reimbursement of administrative costs associated with
monitoring the pilot program. Any administrative costs incurred by a
public authority for monitoring the pilot project shall be paid to
the public authority pursuant to paragraph (4) of subdivision (a).
Any advisory committee expenses incurred as a result of this pilot
project, if determined to be reimbursable to the county, shall be
reimbursed with the current advisory committee allocation.
   (3) Each county pilot project shall continue for four years,
provided that if a county takes action to terminate a contract for
cause, as defined in the contract, it may then terminate its
participation in the pilot project. By the end of the third year,
each participating county shall provide for an independent evaluation
to assess the success of the pilot program, based on all of the
following criteria:
   (A) Consumer satisfaction.
   (B) Cost-effectiveness.
   (C) Average turnover of providers.
   (D) The effect of the pilot project on non-IHSS vendors, workers,
and referral agencies.
   (E) Worker satisfaction.
   (F) The extent to which counties identify, refer to, and work with
appropriate agencies in investigation, administrative action, or
prosecution of instances of fraud, as defined in subdivision (a) of
Section 12305.8, in the provision of supportive services.
   (d) All costs associated with the independent evaluation shall be
paid solely by the voluntary nonprofit or proprietary agency.
   (e) The independent evaluation shall be sent directly to the
appropriate policy and fiscal committees of the Legislature.
   (f) County social workers shall continue to establish eligibility,
needs, and frequency of service and serve as recipient advocates, as
appropriate.


12316.  (a) The City and County of San Francisco may implement a
pilot project of not less than three years' duration to implement the
provision of pooled services under this article through a modified
delivery system in no more than five HUD-subsidized senior housing
facilities owned by nonprofit organizations. If the department deems
that a waiver of statutes or regulations is necessary, the pilot
project shall be operated in accordance with that waiver. The purpose
of the pilot project shall be to improve consumer satisfaction with
in-home supportive services.
   (b) (1) A pool of providers shall be selected by consumers, site
staff, and the county to provide in-home supportive services under
the pilot project consistent with the county's uniform assessment of
needs as specified in Section 12309.
   (2) Authorized nonmedical personal services shall be provided
under the pilot project by providers in the pool at the times and
frequency appropriate to meet each consumer's need intermittently
throughout the course of the day.
   (3) A memorandum of understanding between the county and the
specific sites shall be signed before the project begins.
   (c) (1) Consumers shall sign a disclosure form that explains the
consumer's rights and responsibilities as an indication of their
election to participate in the pilot project.
   (2) Consumers who live in designated senior housing projects shall
be offered the option of being serviced by the pilot project. These
consumers shall have the option to change that decision at any time.
   (d) As a separate consumer option under the pilot project,
designated related services shall be provided for several consumers
simultaneously.
   (e) The county shall monitor the provision of services under the
pilot project to ensure that the level and quality of services
provided through the pilot project is at least at the same level that
would have been provided under the nonpilot project individual
provider service delivery as provided in Section 12302.
   (f) (1) The department shall, in conjunction with the county,
develop a provider timesheet and daily log to track the work
performed by providers under the pilot project to ensure appropriate
provider payment and to track the work provided for each consumer
back to the consumer's authorization.
   (2) It is the intent of the Legislature that provider payment be
issued by the state's Case Management Information and Payroll System
(CMIPS) to each provider who provides services pursuant to the pilot
project.
   (g) At the end of three years, the county shall evaluate the
success of the pilot project implemented under this section. If the
pilot project is successful, the department shall, at the county's
request, extend the pilot project for an additional two years. The
success of the pilot project shall be evaluated based on the
following factors:
   (1) Consumer satisfaction.
   (2) Cost effectiveness.
   (3) Average turnover of providers.
   (h) In evaluating the project, the county shall ensure all of the
following:
   (1) An independent, impartial, outside evaluator or a county
employee independent of the project shall be used.
   (2) If the county decides to employ an outside evaluator, the
county shall be responsible for all costs associated with the
evaluation.
   (3) The department shall approve the evaluation design and plan.
   (4) Quarterly progress reports shall be completed.
   (5) If a federal waiver is required, the county shall follow
federal waiver evaluation criteria requirements.
   (i) The department may waive the enforcement of specific statutory
requirements, regulations, and standards in the county by formal
order of the director pursuant to Section 18204.
   (j) The department, in coordination with the Director of Health
Services, shall seek any federal waivers or approvals necessary for
continued funding of the Personal Care Services Program (PCSP)
pursuant to Section 14132.95 of the Welfare and Institutions Code.
The State Department of Health Services shall have 30 days from the
date of request by the county to make a determination of the need to
seek federal approval and, if the department deems the approval to be
necessary, to formally request the approval. The implementation of
the pilot project shall occur after any necessary federal waivers or
approvals are obtained.
   (k) The pilot project shall be cost-neutral to the state.




12317.  (a) The State Department of Social Services shall be
responsible for procuring and implementing a new Case Management
Information and Payroll System (CMIPS) for the In-Home Supportive
Services Program and Personal Care Services Program (IHSS/PCSP). This
section shall not be interpreted to transfer any of the IHSS/PCSP
policy responsibilities from the State Department of Social Services
or the State Department of Health Care Services.
   (b) At a minimum, the new system shall provide case management,
payroll, and management information in order to support the
IHSS/PCSP, and shall do all of the following:
   (1) Provide current and accurate information in order to manage
the IHSS/PCSP caseload.
   (2) Calculate accurate wage and benefit deductions.
   (3) Provide management information to monitor and evaluate the
IHSS/PCSP.
   (4) Coordinate benefits information and processing with the
California Medicaid Management Information System.
   (c) The new system shall be consistent with current state and
federal laws, shall incorporate technology that can be readily
enhanced and modernized for the expected life of the system, and, to
the extent possible, shall employ open architectures and standards.
   (d) By August 31, 2004, the State Department of Social Services
shall begin a fair and open competitive procurement for the new
CMIPS. All state agencies shall cooperate with the State Department
of Social Services and the California Health and Human Services
Agency Data Center to expedite the procurement, design, development,
implementation, and operation of the new CMIPS.
   (e) The State Department of Social Services, with any necessary
assistance from the State Department of Health Care Services, shall
seek all federal approvals and waivers necessary to secure federal
financial participation and system design approval of the new system.
   (f) The new CMIPS shall include features to strengthen fraud
prevention and detection, as well as to reduce overpayments. Program
requirements shall include, but shall not be limited to, the ability
to readily identify out-of-state providers, recipient hospital stays
that are five days or longer, and excessive hours paid to a single
provider, and to match recipient information with death reports. This
functionality shall be available by April 1, 2010, and implemented
statewide by July 1, 2011.



12317.1.  The department may enter into interagency agreements with
the State Department of Health Services to administer approved
federal waivers authorized pursuant to Section 14132.951 or services
provided under Section 14132.95, and to deliver waiver services in
the same manner as services delivered pursuant to this article, and
as authorized by Section 1396a(a)(11)(A) of Title 42 of the United
States Code, which provides that California's state plan for medical
assistance under the Medicaid program allows the State Department of
Health Services, as the single state Medicaid agency, to "enter into
cooperative arrangements with the State agencies responsible for
administering or supervising the administration of health services
and vocational rehabilitation services in the State looking toward
maximum utilization of such services in the provision of medical
assistance under the plan." If an interagency agreement is entered
into pursuant to this section, it shall come within the provisions of
Section 14000.03.


12317.2.  (a) Except as set forth in subdivision (b), in the event
of a conflict between the terms of the waiver approved pursuant to
Section 14132.951 and any provision of this part or any regulation
adopted for the purpose of implementing this part, the terms of the
waiver shall control to the extent that the services are covered
under the waiver. If the department determines that a conflict
exists, the department shall issue updated instructions to counties
for purposes of implementing necessary program changes. The
department shall post a copy of, or a link to, the instructions on
its Web site.
   (b) The authority to waive or modify provisions of this part
pursuant to this section does not include the authority to waive or
modify the provisions of Section 12301.2, 12301.6, 12302.25, 12306.1,
or 12309.