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HomeMy WebLinkAboutMINUTES - 06092015 - C.44RECOMMENDATION(S): ADOPT a "Support" position on AB 1436 (Burke), as amended: In-Home Support Services: Authorized Representatives, a bill that would authorize an applicant for, or recipient of, in-home supportive services to designate an individual to act as his or her authorized representative for purposes of the In-Home Supportive Services program, as recommended by the Legislation Committee. FISCAL IMPACT: No fiscal impact. BACKGROUND: At its May 7, 2015 meeting, the Legislation Committee considered and accepted the recommendation from the Assistant Director of Policy and Planning for Employment and Human Services Department to recommend a position of "Support" to the Board of Supervisors on AB 1436. Introduced: 02/27/2015 Last Amend: 05/06/2015 Disposition: Pending Location: Assembly Consent Calendar--Second Legislative Day Summary: Authorizes an applicant for, or recipient of, in-home supportive services to designate an individual to act as his or her authorized representative for purposes of the In-Home Supportive Services program. Defines an authorized representative. Provides the representative has a legal responsibility to act in the client's best interest. Excludes certain persons from serving as an authorized representative. Requires the development of a form for this purposes. APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 06/09/2015 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, District I Supervisor Candace Andersen, District II Supervisor Mary N. Piepho, District III Supervisor Karen Mitchoff, District IV Supervisor ABSENT:Federal D. Glover, District V Supervisor Contact: L. DeLaney, 925-335-1097 I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown. ATTESTED: June 9, 2015 David Twa, County Administrator and Clerk of the Board of Supervisors By: June McHuen, Deputy cc: C. 44 To:Board of Supervisors From:LEGISLATION COMMITTEE Date:June 9, 2015 Contra Costa County Subject:AB 1436 (Burke) In-Home Support Services: Authorized Representatives Status: BACKGROUND: (CONT'D) 05/21/2015 In ASSEMBLY. Read second time. To Consent Calendar. Specifically, this bill: 1) Defines "authorized representative" to mean an individual who is appointed by an In-Home Supportive Services (IHSS) applicant or recipient in order to represent that applicant or recipient for purposes related to the IHSS program, as specified. 2) Allows an IHSS applicant or recipient to designate an authorized representative. 3) Specifies that an IHSS applicant or recipient shall determine the duties to be provided by the authorized representative and that these duties may be changed or revoked at any time by the applicant or recipient. 4) Requires the authorized representative to have a legal responsibility to act in the client's best interest. 5) States that legal documentation of authority to act on behalf of the applicant or recipient under state law, including but not limited to a court order establishing legal guardianship or a valid power of attorney to make health care decisions, shall serve in place of an IHSS applicant's or recipient's written appointment of an authorized representative. 6) Permits the authorized representative, if so instructed by the IHSS recipient, to sign timesheets for services rendered on behalf of the recipient, but disallows the authorized representative who is a care provider from signing his or her own timesheet unless the provider has legal custody over a minor recipient, as specified, or the provider is legally authorized to act on the applicant's or recipient's behalf per state law. 7) Specifies that an individual with legal authority to act on behalf of an IHSS applicant or recipient may designate someone other than him or herself to act on behalf of the applicant or recipient. 8) Prohibits anyone prevented from being an IHSS provider due to past criminal convictions, as well as individuals granted certain exemptions to serve as a provider despite past criminal convictions, as specified, from serving as an authorized representative. 9) Prohibits anyone found to have perpetuated a substantiated report of abuse or neglect against a child, elder, or dependent adult from serving as an authorized representative. 10) Directs the Department of Social Services, in consultation with stakeholders, as specified, to develop a standardized statewide form, as specified, and procedures related to the designation of an authorized representative. EXISTING LAW : 1) Establishes the IHSS program to provide supportive services, including domestic, protective supervision, personal care, and paramedical services as specified, to individuals who are aged, blind, or living with disabilities, and who are unable to perform the services themselves or remain safely in their homes without receiving these services. (WIC 12300 et seq.) 2) Specifies requirements regarding IHSS provider timesheets, including that both provider and recipient must sign the timesheet to verify the accuracy of information. (WIC 12301.25) 3) States that counties may choose to contract with a nonprofit consortium or establish a public authority for the provision of IHSS services. Requires nonprofit consortia and public authorities to, among other things, establish a registry to assist recipients in locating IHSS providers, and to investigate the background and qualifications of potential providers, as specified. (WIC 12301.6) 4) Maintains an IHSS recipient's right to hire, fire, and supervise the work of any IHSS provider, regardless of the employer responsibilities of a public authority or nonprofit consortium, as specified. (WIC 12301.6 and 12302.25) 5) Requires counties to perform a background check on individuals applying to become IHSS providers, and stipulates circumstances under which individuals shall be excluded from becoming an IHSS provider, as well as circumstances under which such an exclusion might be waived, as specified. (WIC 12305.86 and 12305.87) COMMENTS: 1) Purpose. According to the author, the authorized representative function is critical in that it provides applicants and recipients with a self-directed pathway to receive needed assistance with complex rules and requirements of these programs. IHSS program applicants and recipients may struggle with increasingly complex and changing program rules; yet, while they may have family members and friends who are able to provide support, there is no formal process to designate these individuals as authorized representatives. This bill, according to the author, provides flexibility for an IHSS applicant or recipient to determine the duties of the authorized representative, and makes it clear that the authorized representative has a legal responsibility to act in the client's best interest. 2) Background. A number of programs administered by the state allow for, and set forth definitions and designation procedures regarding, authorized representatives in order to facilitate recipients' full participation in programs. These authorized representatives are permitted, within specified limits, to act on behalf of program applicants and participants typically for purposes of applying for services and other required program activities. REGISTERED SUPPORT / OPPOSITION: Support County Welfare Directors Association of CA (CWDA) -sponsor California Association of Public Authorities (CAPA) - co-sponsor American Federation of State, County and Municipal Employees (AFSCME) California State Association of Counties (CSAC) Ventura County Board of Supervisors UDW/AFSCME Local 3930 Opposition None on file. CONSEQUENCE OF NEGATIVE ACTION: Contra Costa County would not have a position on the bill. ATTACHMENTS Attachment A - Bill Text Attachment B - Fact Sheet AMENDED IN ASSEMBLY MAY 6, 2015 california legislature—2015–16 regular session ASSEMBLY BILL No. 1436 Introduced by Assembly Member Burke February 27, 2015 An act to add Section 12300.3 to the Welfare and Institutions Code, relating to public social services. legislative counsel’s digest AB 1436, as amended, Burke. In-home supportive services: authorized representative. Existing law provides for the In-Home Supportive Services program, under which qualified aged, blind, or disabled persons are provided with supportive services in order to permit them to remain in their own homes and avoid institutionalization. Existing law specifies that supportive services include, among other things, domestic services, personal care services, and paramedical services that make it possible for the recipient to establish and maintain an independent living arrangement. This bill would authorize an applicant for, or recipient of, in-home supportive services to designate an individual to act as his or her authorized representative for purposes of the In-Home Supportive Services program. The bill would define an authorized representative to mean an individual who is appointed in writing, on a form designated by the State Department of Social Services, by a competent person who is an applicant for or recipient of in-home supportive services, to act in place or on behalf of the applicant or recipient for purposes related to the program, including, but not limited to, accompanying, assisting, or representing the applicant in the application process, or the recipient in 98 Attachment A directing the services received, as specified. The bill would require the duties to be provided by the authorized representative to be specified by the applicant or recipient and would provide that those duties may be changed or revoked at any time by the applicant or recipient. The bill would also provide that the authorized representative has a legal responsibility to act in the client’s best interest. The bill would exclude certain persons from serving as an authorized representative, including a person who is found to have perpetrated a substantiated report of abuse or neglect against a child or an elder or dependent adult. The bill would require the department, in consultation with specified parties, including representatives of applicants for, and recipients of, services, to develop a form for this purpose, as specified. Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no. The people of the State of California do enact as follows: line 1 SECTION 1. Section 12300.3 is added to the Welfare and line 2 Institutions Code, to read: line 3 12300.3. (a)  For purposes of this section, an “authorized line 4 representative” means an individual who is appointed in writing, line 5 on a form designated by the department, by a competent person line 6 who is an applicant for or recipient of in-home supportive services line 7 pursuant to this article, to act in place or on behalf of the applicant line 8 or recipient for purposes related to the program, including, but not line 9 limited to, accompanying, assisting, or representing the applicant line 10 in the application process, or the recipient in directing the services line 11 received, and in the redetermination of eligibility process. line 12 (b)  (1)  An applicant for, or recipient of, services pursuant to line 13 this article may designate an individual to act as his or her line 14 authorized representative for purposes of the in-home supportive line 15 services program. line 16 (1) line 17 (2)  (A)  The duties to be provided by the authorized line 18 representative shall be specified by the applicant or recipient and line 19 may be changed or revoked at any time by the applicant or line 20 recipient. The authorized representative shall have a legal line 21 responsibility to act in the client’s best interest. line 22 (B)  Legal documentation of authority to act on behalf of the line 23 applicant or recipient under state law, including, but not limited 98 — 2 —AB 1436 Attachment A line 1 to, a court order establishing legal guardianship or a valid power line 2 of attorney to make health care decisions, shall serve in place of line 3 a written appointment by the applicant or recipient. line 4 (C)  The authorized representative may sign timesheets for line 5 services rendered on the recipient’s behalf, if specified to do so line 6 by the recipient. However, an authorized representative who is the line 7 provider of services for the recipient may not sign his or her own line 8 timesheet unless one of the following applies: line 9 (i)  The provider is a parent, guardian, or other person having line 10 legal custody of a minor recipient. line 11 (ii)  The provider is legally authorized to act on behalf of the line 12 applicant or recipient under state law. line 13 (2) line 14 (3)  For purposes of this section, an individual having legal line 15 authority to act on behalf of an applicant or recipient may also line 16 designate the authorized representative to specify an individual line 17 other than himself or herself to act on behalf of the applicant or line 18 recipient if that individual elects to do so. line 19 (3) line 20 (4)  An individual who is prevented from being a provider of line 21 services in the program pursuant to Section 12305.86 shall not line 22 serve as an authorized representative for an applicant or recipient. line 23 (4) line 24 (5)  An individual who has been granted an exemption to serve line 25 as a provider of services pursuant to Section 12305.87 and who is line 26 not described in clause (i) or (ii) of subparagraph (C) of paragraph line 27 (1), (2), shall not serve as an authorized representative for an line 28 applicant or recipient. line 29 (5) line 30 (6)  An individual shall not serve as an authorized representative line 31 if he or she is found to have perpetrated a substantiated report of line 32 abuse or neglect against a child or an elder or dependent adult. line 33 (c)  (1)  The department, in consultation with the State line 34 Department of Health Care Services, the County Welfare Directors line 35 Association of California, representatives of applicants for and line 36 recipients of services under this article, and representatives of line 37 providers of services under this article, shall develop a standardized line 38 statewide form and procedures for effectuating the designation of line 39 an authorized representative pursuant to this section. 98 AB 1436— 3 — Attachment A line 1 (2)  The standard agreement form shall include a notification line 2 regarding the requirements of this subdivision and a statement that line 3 by signing the agreement, the individual named as an authorized line 4 representative agrees to abide by those requirements. O 98 — 4 —AB 1436 Attachment A AB 1436 (Burke) In-Home Supportive Services – Authorized Representative SUMMARY AB 1436 allows an applicant for, or recipient of, In- Home Supportive Services (IHSS) to designate an authorized representative to act on their behalf for various program requirements. BACKGROUND A number of programs overseen by the Department of Health Care Services (DHCS) and the California Department of Social Services (CDSS) have processes in place allowing their applicants and recipients to identify an “authorized representative” who can act on their behalf for purposes of applying for services and other required program activities with which the applicant/recipient may require assistance. These programs include Medi-Cal, CalFresh, and CalWORKS, as well as the administrative appeal process. The authorized representative function is critical as it provides applicants and recipients with a self-directed pathway to receive needed assistance with the complex rules and requirements of these programs. In contrast, IHSS has not had the benefit of this function as a formal part of the statute or regulations governing the program, except for conservators or parents of a minor child. As a result, some IHSS program applicants/recipients, who are elderly, blind or disabled, have struggled without this assistance. IHSS applicant/recipient family members and friends often provide support, but there is no formal process to designate them as the authorized representative. Without the statutory authority, they cannot legally be included directly in any program communications. This creates an irregular and sometimes dangerous situation for IHSS applicants/recipients. As IHSS program rules and requirements have become more complex, the lack of this function has presented greater challenges. Additionally, the state has at times issued IHSS forms and All-County Letters referencing “authorized representatives,” but CDSS has never defined who an authorized representative is, or established a process for an IHSS applicant or recipient to designate one. Forms that have space for an authorized representative to sign have required counties to develop internal processes for designating a representative, which may vary by county. This legislation would provide the statutory authority for a standardized framework, reducing inconsistencies from the current process and providing guidance and protection for applicants and recipients of IHSS services. AB 1436 AB 1436 specifically allows an applicant for, or recipient of, IHSS services to appoint an authorized representative to act on their behalf. The bill provides flexibility for the applicant/recipient to specify the duties of the authorized representative, and makes it clear that the individual has a legal responsibility to act in the client’s best interest. IHSS program recipients are the employer of their care provider for purposes of hiring/firing, training, supervising, scheduling and signing their timesheet. Similarly, whether to designate an authorized representative and who to designate would be their decision. For those aged, blind or disabled clients who struggle with programmatic rules and complex paperwork, and could benefit from the formal designation of an authorized representative, it is critical that this function be established in law. SUPPORT County Welfare Directors Association of California (Sponsor) STAFF CONTACT Allison Ruff, Capitol Director Assemblywoman Autumn R. Burke (916) 319-2062 allison.ruff@asm.ca.gov Attachment B