BILL ANALYSIS                                                                                                                                                                                                    




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair

                                           2645 (Chesbro)
          
          Hearing Date:  08/02/2010           Amended: 06/21/2010
          Consultant:  Dan Troy           Policy Vote: Health 7-0
          _________________________________________________________________ 
          ____
          BILL SUMMARY:   AB 2645, an urgency measure, would require  
          reimbursement rates for services at institutions for mental  
          disorders that are certified as skilled nursing facilities to be  
          the same as they were on July 1, 2009, from July 1, 2010 through  
          June 30, 2012.   
          _________________________________________________________________ 
          ____
                            Fiscal Impact (in thousands)

           Major Provisions         2010-11      2011-12       2012-13     Fund
                                                                  
          IMD-SNFs                          ($3,000 to $6,000), annually,  
          for two years    Local
          _________________________________________________________________ 
          ____

          STAFF COMMENTS: 
          
          Institutions for mental disorders (IMDs) are defined as  
          hospitals, nursing facilities, or other institutions of more  
          than 16 beds that are primarily engaged in providing diagnosis,  
          treatment, or care of persons with mental diseases.  IMDs fall  
          into a variety of categories, including skilled nursing  
          facilities (SNFs), as licensed by the Department of Public  
          Health.  According to the bill's sponsor, the County Mental  
          Health Directors Association (CMHDA), there are 24 IMD-SNF's  
          licensed in the state to which this bill would apply.  

          Current reimbursement rates for IMD-SNFs range from $136.22 to  
          $190.23 per day depending on region, the number of beds, and  
          other factors, and funding is the responsibility of county  
          governments (pursuant to realignment).  Current law establishes  
          an annual 4.7 percent increase to these reimbursement rates.   
          This bill would effectively eliminate this statutory rate  
          increase for the 2010-11 and 2011-12 fiscal years.  While there  
          is no comprehensive statewide cost data available to precisely  
          forecast this bill's  cost savings for counties, information  










          provided from some impacted counties suggests that annual  
          savings would range from $3 million to $6 million.  

          Chapter 5 of the Statutes of 2009 (ABx4 5), froze the  
          reimbursement rates of a variety of licensed facilities,  
          including certain skilled nursing facilities, at 2008-09 levels.  
           This measure did not include IMD-SNFs.