BILL ANALYSIS Ó AB 667 Page 1 Date of Hearing: May 4, 2011 ASSEMBLY COMMITTEE ON APPROPRIATIONS Felipe Fuentes, Chair AB 667 (Mitchell) - As Amended: April 11, 2011 Policy Committee: HealthVote:18-0 Urgency: No State Mandated Local Program: No Reimbursable: No SUMMARY This bill establishes medical necessity criteria for admission of a child enrolled in Medi-Cal to a pediatric subacute care facility, and provides that the medical necessity definition is intended solely to apply to patients potentially eligible to be transferred from acute level of care to subacute level of care. FISCAL EFFECT Potential state cost savings of up to $9 million ($4.5 million General Fund) to the extent additional children are transferred from an acute level of care to a subacute level of care. COMMENTS 1)Rationale . According to the author this bill is needed to update the criteria used to evaluate and authorize admission into Medi-Cal pediatric subacute facilities. The author asserts that current regulations are outdated, and that children whose needs could be adequately provided for in a pediatric subacute facility are often not transferred to this setting because they do not meet the criteria specified in regulations. The children therefore remain in an acute care hospital at a substantially higher cost to Medi-Cal. 2)Pediatric Subacute Care . California has ten pediatric subacute care hospitals providing health care services to approximately 400 children under the age of 21 who require medical technology due to loss of vital bodily function. Subacute care facilities serve patients with complex medical care needs, often due to a catastrophic illness or injury, providing a level of medical care between that provided at an AB 667 Page 2 acute care hospital and a skilled nursing facility. According to the Department of Health Care Services, pediatric subacute care provides a cost savings of $500-$700 per day over an acute care setting. Analysis Prepared by : Lisa Murawski / APPR. / (916) 319-2081