Health and human services.

(1) Existing law establishes the county-administered In-Home Supportive Services (IHSS) program, under which qualified aged, blind, and disabled persons are provided with services in order to permit them to remain in their own homes and avoid institutionalization. Under existing law, a county board of supervisors may elect to contract with a nonprofit consortium to provide for the delivery of in-home supportive services, or establish, by ordinance, a public authority to provide for the delivery of in-home supportive services. Existing law requires, until January 1, 2020, a specified mediation process to be held if a public authority or nonprofit consortium fails to reach agreement on a bargaining contract with its in-home supportive services workers by January 1, 2018. This bill would clarify that the specified mediation process is required if a public authority or nonprofit consortium and the employee organization have not reached an agreement on a bargaining contract with in-home supportive services workers by January 1, 2018. Existing law requires the state and counties to share the annual cost of providing in-home supportive services and requires all counties to have a County IHSS Maintenance of Effort (MOE) commencing July 1, 2017, as prescribed. Existing law requires that a portion of IHSS costs that are the counties' responsibility to be offset using a combination of General Fund moneys appropriated in the annual Budget Act and redirected 1991 Realignment Vehicle License Fee growth revenues, as specified. Existing law requires the Controller to deposit into the Caseload Subaccount of the Sales Tax Growth Account of the Local Revenue Fund, from revenues deposited into the Sales Tax Growth Account, an amount determined by the Department of Finance that is sufficient to fund the net cost for the realigned portion of the county or city and county share of growth in social services caseloads and any share of growth from the previous year or years for which sufficient revenues were not available in the Caseload Subaccount, and requires the Controller to allocate funds to counties based on those calculations. Existing law requires the Controller, for the 2015– 16 fiscal year and fiscal years thereafter and after satisfying the above-mentioned obligation to deposit revenues into the Caseload Subaccount from the Sales Tax Growth Account, to deposit into the County Medical Services Program Growth Subaccount 4.027% of the amounts remaining and unexpended in the Sales Tax Growth Account, as specified. This bill, for the 2016–17 fiscal year, would instead require the Controller to allocate to the social services account of each county and city and county the amount that would otherwise have been deposited into the County Medical Services Program Growth Subaccount, as specified. Existing law requires the Controller, for the 2013–14 fiscal year and every fiscal year thereafter, to allocate a specified amount to the Mental Health Account and health account of each county, city, or city and county from the General Growth Subaccount of the Sales Tax Growth Account based on a schedule provided by the Department of Finance. This bill, for the 2016–17 fiscal year, would instead require the Controller to allocate to the social services account of each county and city and county the amount that would otherwise have been deposited into the Mental Health Account and health account of each county, or city and county, as specified. Existing law defines "growth" for purposes of the above-mentioned obligation to deposit revenues into the Caseload Subaccount from the Sales Tax Growth Account to mean the increase in the actual caseload expenditures for the prior fiscal year over the actual caseload expenditures for the fiscal year preceding the prior fiscal year for costs from specified social services programs, including the County IHSS MOE in effect on June 30, 2017. Commencing with the caseload growth calculation for the 2017–18 fiscal year and each fiscal year thereafter, "growth" includes the County IHSS MOE costs to counties commencing on July 1, 2017, for the current fiscal year over the County IHSS MOE costs to counties for the prior fiscal year, less specified amounts. This bill would revise these factors used to calculate the caseload growth, by changing the definition of "growth" to exclude the County IHSS MOE in effect on June 30, 2017, and by including offsets provided by General Fund moneys and redirected 1991 Realignment Vehicle License Fee growth revenues, and, for the 2016–17 fiscal year, the redirected sales tax growth revenues, as specified above, in the calculation of the County IHSS MOE costs. The bill would also require the State Controller, commencing with the caseload growth calculation for the 2017–18 fiscal year, to annually post on its Internet Web site the total amount of unfunded caseload growth by county. (2) Existing law requires the State Department of Social Services to provide grants to qualifying nonprofit organizations for purposes of providing services that include, among other things, services relating to the application process for initial or renewal requests of deferred action under the Deferred Action for Childhood Arrivals policy with the United States Citizenship and Immigration Services. This bill would appropriate $20,000,000 to the department for immigration services funding to be available for payment to existing entities under contract pursuant to those provisions for work on behalf of clients involved in, applying for, or subject to, federal Deferred Action for Childhood Arrivals status. (3) Existing law provides for the licensure and regulation of health facilities, including skilled nursing facilities, by the State Department of Public Health. Among other requirements, these provisions generally require skilled nursing facilities to have a minimum number of nursing hours per patient day of 3.2 hours, and effective July 1, 2018, requires skilled nursing facilities, except as specified, to have a minimum number of direct care service hours, as defined, of 3.5 hours per patient day. Existing law requires the department to adopt regulations to create a waiver of the direct care service hour requirements. Existing law requires the State Department of Health Care Services, in connection with its administration of the Medi-Cal program, to develop the Skilled Nursing Facility Quality and Accountability Supplemental Payment System, and requires the system to be utilized to, among other things, assign quality and accountability payments or penalties relating to direct care staffing levels at a skilled nursing facility, including the nursing hours or direct care service hours per patient per day requirements. Existing law establishes the Skilled Nursing Facility Quality and Accountability Special Fund in the State Treasury, which is a continuously appropriated fund that contains moneys from the assessment of specified administrative penalties and setasides of General Fund moneys, for the purposes of making the quality and accountability payments. Existing law, to a specified extent, provides that a skilled nursing facility shall remain eligible to participate in the supplemental payment program so long as the facility meets applicable nursing hours per patient per day requirements that would have applied in the absence of the direct care service hour requirements described above. Existing law, to a specified extent, prohibits using compliance with the direct care service hour requirements to determine facility qualification for supplemental payments and instead requires the department to apply the nursing hour requirements for purposes of administering the supplemental payments until the performance period beginning in the 2019–20 fiscal year. This bill, instead, would specify that for performance periods in the 2017–18 and 2018–19 fiscal years, a skilled nursing facility shall remain eligible to participate in the supplemental payment program so long as the facility meets applicable nursing hours per patient per day requirements. The bill would, for performance periods beginning in the 2019–20 fiscal year and each fiscal year thereafter, provide that a skilled nursing facility that is granted a waiver of the direct care service hour requirements shall remain eligible to participate in the supplemental payment program so long as the facility meets the applicable nursing hour requirements that would have applied in the absence of the direct care service hour requirements described above for the duration of time for which the waiver is granted. By expanding the number of facilities that would be eligible to participate in the supplemental payment program and therefore expanding the payments from a continuously appropriated fund, the bill would make an appropriation. (4) The Budget Act of 2017 appropriated a specified sum to the State Department of Social Services for local assistance relating to the CalWORKs program and other assistance payments. This bill would require the department to allocate $5,400,000 from the General Fund moneys in the above-described appropriation to the City of San Jose for purposes of assisting homeless and low-income individuals displaced by the Coyote Creek flooding that occurred in February 2017, and, as a condition of receiving these funds, the bill would require the City of San Jose to provide quarterly reports to the department, as specified. (5) This bill would declare that it is to take effect immediately as a bill providing for appropriations related to the Budget Bill.