Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid Program provisions. Under existing law, certain aged, blind, and disabled Medi-Cal recipients are required to pay a share of cost as a condition of eligibility, with the share of cost determined in accordance with specified requirements. For purposes of determining the share of cost, existing law establishes a formula to calculate the personal and incidental needs deduction for an individual residing in a licensed community care facility. Existing law prohibits that deduction from exceeding the amount by which the Supplemental Security Income recipient retention amount, as defined, exceeds $20.

This bill would revise the formula to determine the personal and incidental needs deduction. By increasing the responsibility of the counties in determining Medi-Cal eligibility, this bill would impose a state-mandated local program. The bill would also require that its provisions be implemented only to the extent that federal financial participation is available and that the department receives any necessary federal approvals.

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, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to these statutory provisions.

SENATE COMMITTEE ON APPROPRIATIONS

Senator Ricardo Lara, Chair

2015 - 2016 Regular Session

AB 1319 (Dababneh) - Medi-Cal benefits: share of cost requirements

This bill meets the criteria for referral to the Suspense File.

Bill Summary:

AB 1319 would increase the personal and incidental needs deduction for Medi-Cal beneficiaries residing in a licensed community care facility from $20 to $50 per month.

Fiscal Impact:

• One-time administrative costs in the hundreds of thousands for the Department of Health Care Services to develop a state plan amendment, develop regulations, and make necessary programming changes (General Fund and federal funds).

• Unknown increased Medi-Cal spending, likely in the millions per year, due to the increase in the personal needs allowance (General Fund and federal funds). For example, for each 3,000 eligible beneficiaries who participate in the program under the bill (about 4% of the estimated number of Medi-Cal beneficiaries in community care facilities), the annual costs would be about $1 million per year.

The bill increases the personal needs allowance over existing law, from $20 per month to $50 per month. The actual cost of the bill will depend on the number of participating beneficiaries. The Department does not have information on how many Share of Cost Medi-Cal beneficiaries reside in community care facilities.

• Unknown impact on Medi-Cal spending due to individuals previously eligible for Share of Cost Medi-Cal newly becoming eligible for full scope Medi-Cal (General Fund and federal funds). It appears that current law requires that the amount of the personal needs allowance must be deducted from an individual’s income when determining Medi-Cal eligibility. By increasing the allowance by $30 per month, the bill is likely to shift some individuals from being eligible for Share of Cost Medi-Cal to full scope Medi-Cal. In doing so, the bill would increase state Medi-Cal spending, by eliminating the requirement that the individual pay any amount of the cost of care.

Background:

Under state and federal law, the Department of Health Care Services operates the Medi-Cal program, which provides health care coverage to low income individuals, families, and children. Medi-Cal provides coverage to childless adults and parents with household incomes up to 138% of the federal poverty level and to children with household incomes up to 266% of the federal poverty level. The federal government provides matching funds that vary from 50% to 90% of expenditures depending on the category of beneficiary.

Under current law, an individual whose income exceeds the Medi-Cal eligibility threshold can become eligible for share of cost Medi-Cal by “spending-down” their income due to significant health care costs (these beneficiaries are referred to as “medically needy”). Under this program, an individual must spend down all his or her monthly income (less certain set asides, for example a fixed amount to maintain their home for non-institutionalized patients or the personal and incidental needs allowance for individuals in community care facilities). Once an individual has spent down his or her income (paying directly to health care providers or long-term care facilities) the state will pay the remaining costs for care through Medi-Cal. Under current law, the personal and incidental needs allowance available to individuals in a licensed community care facility is $20 per month.

Proposed Law:

AB 1319 would increase the personal and incidental needs deduction for Medi-Cal beneficiaries residing in a licensed community care facility from $20 to $50 per month.

The changes made in the bill to current law would only be implemented by the Department of Health Care Services to the extent that federal financial participation is available.

Related Legislation:

AB 1235 (Gipson) would require the home upkeep allowance for Medi-Cal beneficiaries in long term care facilities to be based on the actual cost to maintain the beneficiary’s home. The bill would allow Medi-Cal beneficiaries in long-term care facilities that do not have a home to establish a transitional needs fund to set aside up to $7,500 for the purpose of securing a home. That bill will be heard in this committee.

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SENATE COMMITTEE ON HEALTH

Senator Ed Hernandez, O.D., Chair

BILL NO: AB 1319

SUBJECT: Medi-Cal benefits: share of cost requirements.

SUMMARY:

Increases the personal and incidental needs deduction for Medi-Cal beneficiaries residing in a licensed community care facility from $20 to $50.

Existing law:

1. Establishes the Medi-Cal program, which is administered by the Department of Health Care Services (DHCS), under which qualified low-income individuals receive health care services.
   
   

2. Establishes Medi-Cal eligibility for medically needy persons and medically needy family persons, provided Medi-Cal eligibility criteria are met. (The medically needy Medi-Cal eligibility category are individuals who fit into a federal benefit program category but whose income or resources exceed eligibility levels. Medically needy individuals become Medi-Cal eligible by having a share of cost whereby the individual “spends down” to Medi-Cal eligibility levels.)
   
   

3. Requires certain aged, blind, and disabled Medi-Cal recipients to pay a share of cost as a condition of eligibility, with the share of cost determined in accordance with specified requirements.

4. Requires, in determining the countable income of a medically needy individual residing in a licensed community care facility, the individual to have deducted from his or her income $20 as a personal and incidental needs deduction.

This bill increases the personal and incidental needs deduction for Medi-Cal beneficiary residing in a licensed community care facility from $20 to $50, to the extent that federal financial participation is available and DHCS receives any necessary federal approvals.

FISCAL EFFECT:

According to the Assembly Appropriations Committee:

1. Increased costs, likely in the range of $100,000 or less (General Fund (GF)/federal), to allow certain Share-of-Cost (SOC) Medi-Cal beneficiaries to retain the additional monthly amount.

2. Unknown, likely significant costs for information technology changes in the three local Medi-Cal eligibility and case management systems (GF/federal).

3. According to the Department of Health Care Services (DHCS), by increasing the income deduction for SOC, individuals in the SOC program with incomes slightly above the income threshold for the Aged, Blind, and Disabled federal poverty level (FPL) program, a full-scope program with no SOC, will be eligible to transition to the FPL program. If this dynamic occurs, increasing the monthly income disregard by $30 would essentially make the income threshold 2.5 percentage points higher than it otherwise would be, for individuals residing in community care facilities. Increased enrollment in the FPL program would cost in the range of $1 million annually (GF/federal) for 200 additional beneficiaries. However, staff notes the language appears to apply only to SOC beneficiaries, so whether this shift would actually occur is unclear.

4. This bill is tagged as a reimbursable mandate. Eligibility for Medi-Cal is administered by counties and administrative costs are reimbursed through contract with the state. This change will require notification and minor adjustments in county policies and practices. The total cost pressure associated with this small change is unknown but likely minor, and it will not result in mandate claims due to the reimbursement structure for Medi-Cal county administration.

PRIOR VOTES:

COMMENTS:

1. Author’s statement. According to the author, this bill will increase the personal and incidental needs deduction from $20 a month to $50 a month for an individual who qualifies for the Medically Needy program under Medi-Cal. Medically Needy is a federal Medicaid eligibility category option that provides states with the option to extend Medicaid eligibility to individuals with high medical expenses whose income exceeds the federal poverty line but who would otherwise be eligible for Medi-Cal. This program acts as a safety net for those who are among the most vulnerable in our population -- people whose medical costs overwhelm their income -- including more than 8,000 financially needy older adults. Passing this bill will truly provide seniors with dignity and greater financial stability to cover life’s basic necessitates.
   
   

2. Background. Individuals whose income exceeds the income levels or who do not meet eligibility criteria for no-cost Medi-Cal can quality as medically needy individuals. The medically needy program is a way to extend Medi-Cal eligibility to individuals who do not qualify for no-cost Medi-Cal, such as those with high medical expenses whose income is too high to meet the income eligibility threshold for no-cost Medi-Cal. The program functions as a last resort for those whose incomes are modest and are surpassed by their significant medical expenses.
   
   

For Medi-Cal beneficiaries residing in a community care facility, the share of cost calculation allows for a personal and incidental needs deduction. This amount is set in statute, is currently $20, and has been in effect since January 1, 1977. This amount is deducted from the individual’s income in determining their share of cost. For example, if an individual with a monthly income of $1,300 who is residing in a licensed community care facility would have the $20 personal and incidental needs deduction subtracted from his or her monthly income ($1,300 - $20 = $1,280). The $1,280 would be the individual’s monthly share of cost. Under this bill, $50 would be subtracted, instead of $20.

3. Related legislation. AB 763 (Burke) increases the amount of income that is disregarded in calculating eligibility for purposes of the Medi-Cal aged and disabled (A&D) program which effectively increases the upper limit of financial eligibility to 138 percent of the federal poverty level (FPL). AB 763 was held on the Assembly Appropriations Committee suspense file.

AB 1235 (Gipson) requires the home upkeep allowance (HUA) for Medi-Cal beneficiaries in long-term care facilities to be based on the actual minimum cost of maintaining the resident’s home (the HUA is currently $209 a month). Allows a long-term care facility resident who does not have a home to establish a transitional personal needs fund to be set aside from the income that otherwise would be applied toward the resident’s Medi-Cal share of cost for residing in the long term care facility in an amount of up to $7,500. The personal needs fund would be used to cover the costs of securing a home for the individual. AB 1235 is pending in the Senate Appropriations Committee.

4. Support. The California Advocates for Nursing Home Reform (CAHNR) writes that the $20 deduction is used to offset countable income and could mean the difference between accessing affordable health care to making health care completely unaffordable. CANHR writes that a $30 difference may not seem like a lot, but many seniors are on a fixed income with increasing medical needs and are overwhelmed by the lack of affordable health care options available to them, and this bill would give many seniors and persons with disabilities much needed relief.

SUPPORT AND OPPOSITION:

Support: Los Angeles Jewish Home (sponsor)

American Federation of State, County, and Municipal Employees

California Advocates for Nursing Home Reform

California Assisted Living Association

California Commission on Aging

Leading Age California

Ventura County Board of Supervisors

Oppose: None received

-- END --

ASSEMBLY THIRD READING

ATR Bill Id:AB 1319

Author:(Dababneh)

As Introduced Ver:February 27, 2015

Majority vote

SUMMARY: Raises the current $20 per month incidental needs deduction to $50 for the California Medical Assistance Program (Medi-Cal) beneficiaries who qualify for personal and incidental needs deductions and are residing in a community care facility, provided all necessary federal approvals can be obtained.

FISCAL EFFECT: According to the Assembly Appropriations Committee:

1. Increased costs, likely in the range of $100,000 or less (General Fund (GF)/federal), to allow certain Share-of-Cost (SOC) Medi-Cal beneficiaries to retain the additional monthly amount.

2. Unknown, likely significant costs for information technology changes in the three local Medi-Cal eligibility and case management systems (GF/federal).

3. According to the Department of Health Care Services (DHCS), by increasing the income deduction for SOC, individuals in the SOC program with incomes slightly above the income threshold for the Aged, Blind, and Disabled federal poverty level (FPL) program, a full-scope program with no SOC, will be eligible to transition to the FPL program. If this dynamic occurs, increasing the monthly income disregard by $30 would essentially make the income threshold 2.5 percentage points higher than it otherwise would be, for individuals residing in community care facilities. Increased enrollment in the FPL program would cost in the range of $1 million annually (GF/federal) for 200 additional beneficiaries. However, staff notes the language appears to apply only to SOC beneficiaries, so whether this shift would actually occur is unclear.

4. This bill is tagged as a reimbursable mandate. Eligibility for Medi-Cal is administered by counties and administrative costs are reimbursed through contract with the state. This change will require notification and minor adjustments in county policies and practices. The total cost pressure associated with this small change is unknown but likely minor, and it will not result in mandate claims due to the reimbursement structure for Medi-Cal county administration.

COMMENTS: According to the author, seniors on a fixed income who receive a Medically Needy Only (MNO) benefit need extra help in purchasing everyday items (toothpaste, soap, clothes, etc.) due to their high medical expenses. Currently seniors in the MNO program that live in assisted living facilities only keep the $20 income deduction portion of their income every month. That $20 is expected to cover all items the senior needs from shampoo and toothpaste to clothing and other incidentals, but falls short. This bill seeks to increase the $20 per month incidental needs deduction to $50 for Medi-Cal beneficiaries who qualify for personal and incidental needs deductions. This bill is needed to allow seniors and the disabled to have more money to pay for everyday expenses. This amount has not been raised since 1970 and $20 covers very few expenses. Thus, raising the amount to $50 allows for a modest increase in the quality of life for these seniors.

The MNO program is a way to extend Medi-Cal eligibility to individuals with high medical expenses whose income exceeds the income eligibility threshold for Medi-Cal. The program functions as a last resort for those whose incomes are modest and are surpassed by their significant medical expenses. Medically needy eligibility allows a beneficiary to gain access to Medi-Cal services, but the access is contingent upon a beneficiary sharing the cost.

SOC requires recipients to take full responsibility for health care expenses up to a predetermined amount. Once they meet the full share of cost they are certified and Medi-Cal will cover eligible medical expenses for that month. The share of cost requirement begins anew the following month, so it is a month by month eligibility which is quite different than the remainder of Medi-Cal. In any given month only a small proportion, approximately one in six, of the beneficiaries meet their share of cost obligation and receive Medi-Cal. For those in nursing homes, the proportion is much greater with nearly all meeting their share of cost each month.

A share of cost is the difference between a beneficiary’s countable income and the maintenance need income level (MNIL), or what the state considers to be the base amount of income a person needs to survive on a monthly basis. The MNIL is $600 per month and has not changed since 1989. As a result, anything an individual earns over $600 a month (or a low-income family of four earns over $1,100), becomes that individual’s share of cost. For example a 65 year-old individual with a monthly income of $1,250 would have a $650 share of cost, even though if she was 64, she could be eligible for free Medi-Cal without a share of cost. The beneficiary is now faced with over half of her income paying for Medi-Cal.

For those beneficiaries residing in a community care facility, the share of cost calculation allows for a personal and incidental needs deduction. The amount is set in statute and is currently $20.

The American Federation of State County and Municipal Employees supports this bill because seniors on a fixed income need the extra help in purchasing these everyday items due to their high medical expenses. The Commission on Aging supports this bill because medically needy individuals who must pay a share-of cost for their Medi-Cal community care facilities are left with few resources to cover the cost of personal items they need. The Ventura County Board of Supervisors points out in support, that seniors and others living in licensed community care facilities and receiving benefits from Medi-Cal are already the most vulnerable in society and the current incidental needs deduction is just too small. California Advocates for Nursing Home Reform, also in support, argues the share of cost cliff impoverishes individuals making it almost unaffordable to even pay for small everyday items.

This bill has no known opposition.

Analysis Prepared by: Roger Dunstan / HEALTH / (916) 319-2097 FN: 0000675

Date of Hearing: May 20, 2015

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Jimmy Gomez, Chair

ABPCA Bill Id:AB 1319

Author:(Dababneh) – As Introduced Ver:February 27, 2015

Urgency: No State Mandated Local Program: Yes Reimbursable: No

SUMMARY:

This bill raises the current $20 per month incidental needs deduction to $50 for Medi-Cal beneficiaries who qualify for personal and incidental needs deductions and are residing in a community care facility, provided all necessary federal approvals can be obtained.

FISCAL EFFECT:

1. Increased costs, likely in the range of $100,000 or less (GF/federal), to allow certain Share-of-Cost (SOC) Medi-Cal beneficiaries to retain the additional monthly amount.

2. According to the Department of Health Care Services (DHCS), by increasing the income deduction for SOC, individuals in the SOC program with incomes slightly above the income threshold for the Aged, Blind, and Disabled federal poverty level (FPL) program, a full-scope program with no SOC, will be eligible to transition to the FPL program. If this dynamic occurs, increasing the monthly income disregard by $30 would essentially make the income threshold 2.5 percentage points higher than it otherwise would be, for individuals residing in community care facilities. Increased enrollment in the FPL program would cost in the range of $1 million annually (GF/federal) for 200 additional beneficiaries. However, staff notes the language appears to apply only to SOC beneficiaries, so whether this shift would actually occur is unclear.

3. This bill is tagged as a reimbursable mandate. Eligibility for Medi-Cal is administered by counties and administrative costs are reimbursed through contract with the state. This change will require notification and minor adjustments in county policies and practices. The total cost pressure associated with this small change is unknown but likely minor, and it will not result in mandate claims due to the reimbursement structure for Medi-Cal county administration. Minor information technology automation changes may be required as well.

COMMENTS:

1. Purpose. This bill updates the personal and incidental needs allowance to better reflect the costs of personal items (toothpaste, soap, clothes, etc.) for individuals residing in assisted living facilities.

2. Background. The medically needy program is a way to extend Medi-Cal eligibility to individuals with high medical expenses whose income exceeds the income eligibility threshold for Medi-Cal. The program functions as a last resort for those whose incomes are modest and are surpassed by their significant medical expenses. Medically needy eligibility allows a beneficiary to gain access to Medi-Cal services, but the access is contingent upon a beneficiary sharing the cost.

Share of cost requires recipients to take full responsibility for health care expenses up to a predetermined amount. Once they meet the full share of cost, they are certified and Medi-Cal will cover eligible medical expenses for that month.

For those beneficiaries residing in a community care facility (generally assisted living facilities, also called residential care facilities for the elderly (RCFEs)), the share of cost calculation allows for a personal and incidental needs deduction. The amount is set in statute and is currently $20.

3. Related Legislation.

1. AB 763 (Burke), pending on the Suspense File of this Committee, increases the amount of income that is disregarded in calculating eligibility for purposes of the Medi-Cal aged and disabled (A&D) program which effectively increases the upper limit of financial eligibility to 138% of the federal poverty level (FPL).

2. AB 1235 (Gipson), pending on the Suspense File of this Committee establishes the home upkeep allowance for certain Medi-Cal eligible long-term care facility residents.

Analysis Prepared by: Lisa Murawski / APPR. / (916) 319-2081

Date of Hearing: April 28, 2015

ASSEMBLY COMMITTEE ON HEALTH

Rob Bonta, Chair

ABPCA Bill Id:AB 1319

Author:(Dababneh) – As Introduced Ver:February 27, 2015

SUBJECT: Medi-Cal benefits: share of cost requirements.

SUMMARY: Raises the current $20 per month incidental needs deduction to $50 for Medi-Cal beneficiaries who qualify for personal and incidental needs deductions and are residing in a community care facility, provided all necessary federal approvals can be obtained.

EXISTING LAW:

1. Establishes California’s Medicaid program, Medi-Cal, through which eligible low-income individuals receive health care services.

2. Requires Medi-Cal coverage of adults under age 65 who are not currently eligible with incomes up to 138% of the federal poverty level (FPL) or below $15,856 in 2013 for an individual.

3. Establishes that medically needy persons and families are entitled to health care services in the Medi-Cal program provided they meet their monthly share of cost requirements.

4. Requires the Department of Health Care Services to establish the income levels for maintenance need at the lowest levels that reasonably permit medically needy persons to meet their basic needs for food, clothing, and shelter, and for which federal financial participation will still be provided.

5. Requires certain aged, blind, and disabled Medi-Cal recipients are required to pay a share of cost as a condition of eligibility, with the share of cost determined in accordance with specified requirements.

6. Establishes, for purposes of determining the share of cost, a formula to calculate the personal and incidental needs deduction for an individual residing in a licensed community care facility. Under this formula these seniors only have $20 a month to cover all expenses not covered by Medi-Cal or provided by their home facility.

FISCAL EFFECT: This bill has not been analyzed by a fiscal committee.

COMMENTS:

1. PURPOSE OF THIS BILL. According to the author, seniors on a fixed income who receive a Medically Needy Only (MNO) benefit need extra help in purchasing everyday items (toothpaste, soap, clothes, etc.) due to their high medical expenses. Currently seniors in the MNO program that live in assisted living facilities only keep the $20 income deduction portion of their income every month. That $20 is expected to cover all items the senior needs from shampoo and toothpaste to clothing and other incidentals, but falls short. This bill seeks to increase the $20 per month incidental needs deduction to $50 for Medi-Cal beneficiaries who qualify for personal and incidental needs deductions. This bill is needed to allow seniors and the disabled to have more money to pay for everyday expenses. This amount has not been raised since 1970 and $20 covers very few expenses. Thus, raising the amount to $50 allows for a modest increase in the quality of life for these seniors.

2. BACKGROUND. The MNO program is a way to extend Medi-Cal eligibility to individuals with high medical expenses whose income exceeds the income eligibility threshold for Medi-Cal. The program functions as a last resort for those whose incomes are modest and are surpassed by their significant medical expenses. Medically needy eligibility allows a beneficiary to gain access to Medi-Cal services, but the access is contingent upon a beneficiary sharing the cost.

Beneficiaries typically use the program in one of three ways:

1. Catastrophic coverage. It covers medical expenses for a major health events such as an injury or accident;

2. Long term care coverage. Support for nursing home care, community care facilities, or in-home supportive services; or,

3. Coverage for costly chronic conditions. Health care services for an illness that is costly and/or chronic enough to generate high monthly expenses.

This “share of cost” arrangement is different than cost sharing or co-pay requirements that are familiar to so many. Share of cost requires recipients to take full responsibility for health care expenses up to a predetermined amount. Once they meet the full share of cost they are certified and Medi-Cal will cover eligible medical expenses for that month. The share of cost requirement begins anew the following month, so it is a month by month eligibility which is quite different than the remainder of Medi-Cal. In any given month only a small proportion, approximately one in six, of the beneficiaries meet their share of cost obligation and receive Medi-Cal. For those in nursing homes, the proportion is much greater with nearly all meeting their share of cost each month.

A share of cost is the difference between a beneficiary’s countable income and the maintenance need income level (MNIL), or what the state considers to be the base amount of income a person needs to survive on a monthly basis. The MNIL is $600 per month and has not changed since 1989. As a result, anything an individual earns over $600 a month (or a low-income family of four earns over $1,100), becomes that individual’s share of cost. For example a 65 year-old individual with a monthly income of $1,250 would have a $650 share of cost, even though if she was 64 she could be eligible for free Medi-Cal without a share of cost. The beneficiary is now faced with over half of her income paying for Medi-Cal.

Determining eligibility for the medically needy program is somewhat rigid. If a beneficiary’s income is $1.00 over the allowable amount for say, the aged and disabled program income level, he or she ends up with a very high share of cost – commonly referred to as the share of cost cliff. A share of cost is the difference between a beneficiary’s countable income and the MNIL, or what the state considers to be the base amount of income a person needs to survive on a monthly basis. The MNIL is $600 per month and has not changed since 1989. As a result, anything an individual earns over $600 a month (or a low-income family of four earns over $1,100), becomes that individual’s share of cost.

For those beneficiaries residing in a community care facility, the share of cost calculation allows for a personal and incidental needs deduction. The amount is set in statute and is currently $20.

3. SUPPORT. The American Federation of State County and Municipal Employees supports this bill because seniors on a fixed income need the extra help in purchasing these everyday items due to their high medical expenses. The Commission on Aging supports this bill because medically needy individuals who must pay a share-of cost for their Medi-Cal community care facilities are left with few resources to cover the cost of personal items they need. The Ventura County Board of Supervisors points out that seniors and others living in licensed community care facilities and receiving benefits from Medi-Cal are already the most vulnerable in society and the current incidental needs deduction is just too small. California Advocates for Nursing Home Reform argue the share of cost cliff impoverishes individuals making it almost unaffordable to even pay for small everyday items.

4. RELATED LEGISLATION.

   1. AB 763 (Burke) increases the amount of income that is disregarded in calculating eligibility for purposes of the Medi-Cal aged and disabled (A&D) program which effectively increases the upper limit of financial eligibility to 138% of the federal poverty level (FPL). This bill is on the suspense file of the Assembly Appropriations Committee.

   2. AB 1235 (Gipson) establishes the home upkeep allowance for certain Medi-Cal eligible long-term care facility residents. This bill is set for hearing in Assembly Health on April 28, 2015.

REGISTERED SUPPORT / OPPOSITION:

Support

American Federation of State, County, and Municipal Employees, AFL-CIO

California Advocates for Nursing Home Reform

California Commission on Aging

Ventura County Board of Supervisors

Opposition

None on file.

Analysis Prepared by: Roger Dunstan / HEALTH / (916) 319-2097