AB 468

Under current law, in certain counties, Family Care provides

community-based long-term care services to individuals who meet certain

functional and financial criteria and who are either frail elders or adults with

physical or developmental disabilities. In each geographic area in which the Family

Care benefit is available, the Department of Health Services (DHS) contracts with

an aging and disability resource center to provide information and determine

eligibility for Family Care and a care management organization (CMO) to

administer the Family Care benefit.

This bill requires DHS to notify a county that has financial responsibility for

an individual who is receiving Family Care benefits (enrollee) of an enrollee's

admission to a mental health institute (MHI) within 48 hours of the admission. An

MHI is, as defined in current law, any institution operated by DHS for specialized

psychiatric services, research, education, and which is responsible for consultation

with community programs for education and quality of care. DHS also must

establish criteria to determine, and then must determine, whether an enrollee is at

substantial risk for being admitted to an MHI.

The bill requires every CMO to maintain for each enrollee a record of

individuals who can be contacted in case of an emergency with the enrollee. For

every enrollee whom DHS determines is at substantial risk of being admitted to an

MHI, a CMO and the county in which it operates must create an emergency plan

including an emergency contact and a potential placement for when the enrollee is

discharged from the MHI. If an enrollee is admitted to an MHI, the financially

responsible county; the county that approved the admission, if different; and the

CMO must create a team comprised of certain individuals to coordinate a new

placement for the enrollee.

The bill requires DHS to submit to the Joint Committee on Finance (JCF) a

report identifying issues relating to cost liability for counties with enrollees who are

admitted to an MHI. DHS is required under the bill during the 2013-15 fiscal

biennium to submit one or more requests to JCF for moneys to pay a portion of the

additional costs incurred by a county to support services provided to enrollees by the

MHI. If JCF releases the moneys, DHS may reimburse the county based on the

length of the enrollee's stay at the MHI as described in the bill. The bill allows for

these reimbursements for services provided at an MHI before July 1, 2015.