BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 1489|
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THIRD READING
Bill No: AB 1489
Author: Assembly Budget Committee
Amended: 8/31/12 in Senate
Vote: 21
PRIOR VOTES NOT RELEVANT
SUBJECT : Budget Trailer Bill: Medi-Cal
SOURCE : Author
DIGEST : This bill (1) reauthorizes the nursing home
quality assurance fee (QAF); (2) implements nursing home
rate adjustments; and (3) increases oversight of referrals
to community-based services by nursing facilities.
ANALYSIS : This bill contains necessary statutory changes
to implement the Budget Act of 2012 for the Department of
Health Care Services (DHCS). Specifically, this bill:
1. Reauthorizes Nursing Home Quality Assurance Fee .
Reauthorizes the QA) on skilled nursing facilities
(SNFs) (known as the "AB 1629 QAF"). This bill extends
the sunset date by two years to July 31, 2015 for the AB
1629 QAF and the rate-setting methodology. If this fee
were to sunset, it places about $500 million General
Fund support at risk, as use of the QAF has enabled
California to provide reimbursement increases to certain
nursing homes with no added General Fund support.
CONTINUED
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2. Implements Nursing Home Rate Adjustments . This bill:
A. Repeals a 2% rate increase for 2012-13, for $33
million General Fund savings.
B. Defers payment of the Quality and Accountability
Supplemental Payment System (QASP) for one year and
transfers the 1% of the AB 1629 facilities
reimbursement set-aside for QASP to the General Fund.
For General Savings of $37.4 million.
C. Keeps the savings from capping the professional
liability insurance at the 75th percentile in the
General Fund instead of transferring it to the
Skilled Nursing Quality and Accountability Special
Fund. For General Fund savings of $4.25 million
General Fund.
D. Provides for a 3% increase in the weighted average
Medi-Cal reimbursement rate for SNFs in 2013-14 and
2014-15.
E. Authorizes DHCS to identify alternative payment
methodologies for the QASP, such as including the
supplemental payment in the rate. Such alternative
payment methodologies may not be implemented without
subsequent statutory changes.
3. Increases Oversight of Referral to Community-Based
Services by Nursing Home Staff (Section Q of MDS) . This
bill requires the DHCS and the Department of Public
Health (DPH) to provide the Legislature with an analysis
of nursing facility referrals of residents to local
agencies for community-based services. Under Section Q
of MDS 3.0, nursing facilities must ask residents if
they are "interested in learning about the possibility
of returning to the community." If a resident indicates
"yes," a facility is required to make the appropriate
referrals to state designated local contact agency.
4. Requires Stakeholder Participation in Development of
Nursing Facility Quality Improvement Program . This bill
requires the DPH and the DHCS to regularly (and at least
quarterly) meet with stakeholders to plan for and
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implement the skilled nursing facility quality
improvement program.
FISCAL EFFECT : Appropriation: Yes Fiscal Com.: Yes
Local: No
DLW:k 9/10/12 Senate Floor Analyses
SUPPORT/OPPOSITION: NONE RECEIVED
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