Existing law, the California Residential Care Facilities for the Elderly Act, regulates residential care facilities for the elderly. A violation of the act is a crime.
Existing law provides for the Medi–Cal program, administered by the State Department of Health Care Services, under which qualified low-income persons are provided with health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid Program provisions. Existing law requires the department to develop a program that requires a waiver of federal law to test the efficacy of providing an assisted living benefit to beneficiaries under the Medi-Cal program. The waiver requires that eligible participants are those who require a nursing facility level of care and wish to live in a residential care setting, such as a residential care facility for the elderly. Under existing law, the State Department of Health Care Services and the State Department of Social Services may waive provisions of the California Residential Care Facilities for the Elderly Act applicable to residential care facilities participating in the program, as necessary and appropriate, including provisions that state that residential care facilities for the elderly are not subject to controls on rent.
Existing law authorizes a Medi-Cal managed care plan to cover those community supports, as defined, approved by the department as cost effective and medically appropriate in a comprehensive risk contract that are in lieu of applicable Medi-Cal state plan services, including, among others, nursing facility transition or diversion to assisted living facilities, such as residential care facilities for the elderly.
Existing law provides for the State Supplementary Program for the Aged, Blind and Disabled (SSP) , which requires the State Department of Social Services to contract with the United States Secretary of Health and Human Services to make payments to SSP recipients to supplement Supplemental Security Income payments made available pursuant to the federal Social Security Act. Under existing regulation, residential facilities for the elderly are prohibited from charging recipients of SSI payments more than a specific set rate for basic services.
This bill would prohibit residential care facilities for the elderly from charging a resident who receives Medi-Cal reimbursed services through the above-described assisted living waiver or nursing facility transition or diversion to assisted living facilities through community supports covered by their Medi-Cal managed care plan a rate exceeding that charged to a resident who is a recipient of SSP.
By creating a new crime, this bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.

Statutes affected:
SB 433: 1569.147 HSC
02/18/25 - Introduced: 1569.147 HSC