SB 433: Residential care facilities for the elderly: assisted living waiver rental rate protection.

Official summary

Legislative Counsel’s Digest (official, as of the latest version). Written by nonpartisan legislative staff; reproduced verbatim.

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 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 (SSI) 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. Existing law requires an individual under these provisions to satisfy certain financial eligibility requirements to be eligible for Medi-Cal, including, among other things, that the individual’s countable income does not exceed an income standard equal to a specified amount, plus an income disregard of specified amounts, subject to certain exceptions.

This bill would prohibit a residential care facility for the elderly that is contracted to receive Medi-Cal reimbursement for services provided to a resident enrolled in Medi-Cal from charging that resident a room and board rate exceeding the difference between their income, as defined, and the personal and incidental needs allowance set by the department for recipients of SSI/SSP in nonmedical out-of-home care. By creating a new crime, this bill would impose a state-mandated local program.

This bill would, for the purposes of determining Medi-Cal eligibility, exclude the difference between the resident’s income and the rate charged by a residential care facility for the elderly and retained by the resident from countable income. The bill would state that the exclusion does not apply to the portion of the difference retained by the resident that exceeds the personal and incidental needs allowance set by the department for recipients of SSI/SSP in nonmedical out-of-home care. Because counties are required to make Medi-Cal eligibility determinations, and this bill would alter Medi-Cal eligibility by changing the income disregard amounts and would increase the responsibility of counties in determining Medi-Cal eligibility, the 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.

Sponsors

Sponsors by party (alphabetical): Democratic 6

“Support” is shown only as formal sponsorship recorded by the legislature. Roll-call votes are available on the official bill page.

Recent official actions

1. August 29, 2025August 29 hearing: Held in committee and under submission.
2. August 20, 2025August 20 set for first hearing. Placed on APPR. suspense file.
3. July 17, 2025Read second time and amended. Re-referred to Com. on APPR.
4. July 16, 2025From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 5. Noes 0.) (July 15).
5. June 25, 2025From committee: Do pass and re-refer to Com. on HUM. S. (Ayes 5. Noes 1.) (June 24). Re-referred to Com. on HUM. S.
6. June 17, 2025From committee with author's amendments. Read second time and amended. Re-referred to Com. on AGING & L.T.C.
7. June 16, 2025Referred to Coms. on AGING & L.T.C and HUM. S.
8. June 5, 2025In Assembly. Read first time. Held at Desk.
9. June 4, 2025Read third time. Passed. (Ayes 32. Noes 5. Page 1493.) Ordered to the Assembly.
10. May 23, 2025Read second time. Ordered to third reading.
11. May 23, 2025From committee: Do pass. (Ayes 5. Noes 1. Page 1200.) (May 23).
12. May 16, 2025Set for hearing May 23.