BILL ANALYSIS Ó
SB 177
Page 1
SENATE THIRD READING
SB 177 (Strickland)
As Amended May 25, 2011
Majority vote
SENATE VOTE :33-0
HEALTH 19-0 APPROPRIATIONS 16-0
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|Ayes:|Monning, Logue, Ammiano, |Ayes:|Fuentes, Harkey, |
| |Atkins, Bonilla, Eng, | |Blumenfield, Bradford, |
| |Garrick, Gordon, Hayashi, | |Charles Calderon, Campos, |
| |Roger Hernández, | |Donnelly, Gatto, Hall, |
| |Bonnie Lowenthal, | |Hill, Lara, Mitchell, |
| |Mansoor, Mitchell, | |Nielsen, Norby, Solorio, |
| |Nestande, Pan, | |Wagner |
| |V. Manuel Pérez, Silva, | | |
| |Smyth, Williams | | |
| | | | |
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SUMMARY : Increases the bed limit for congregate living health
facilities (CLHFs) that serve terminally ill patients in the
County of Santa Barbara. Specifically, this bill :
1)Permits a CLHF to have up to 25 beds if the CLHF is located in
the County of Santa Barbara.
2)Finds and declares that a special law is necessary and that a
general law cannot be made applicable within the meaning of
existing law because of the unique business climate
surrounding CLHFs in the County of Santa Barbara.
EXISTING LAW :
1)Provides for the licensure and regulation of health
facilities, including hospitals, skilled nursing facilities,
and CLHFs.
2)Defines a CLHF as a residential home with a capacity of no
more than 12 beds, that provides inpatient care, medical
supervision, 24-hour skilled nursing and supportive care, and
other services to persons who meet one of the following:
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a) Are mentally alert, have physical disabilities and may
be ventilator dependent;
b) Have a diagnosis of terminal illness, or
life-threatening illness, or both, as defined; or,
c) Are catastrophically and severely disabled, as defined.
3)Permits a CLHF that is operated by a city and county to have
59 beds. Permits a CLHF that is not operated by a city and
county that serves persons who have a diagnosis of terminal
illness or life-threatening illness, or both, that is located
in a county of 500,000 or more persons, to have not more than
25 beds.
4)Requires the primary need of CLHF residents to be for skilled
nursing care on a recurring, intermittent, extended, or
continuous basis, and provides that this care is generally
less intense than that provided in general acute care
hospitals but more intense than that provided in skilled
nursing facilities.
5)Requires the Department of Public Health (DPH) to license and
regulate persons or agencies that provide hospice services in
a person's home or other care setting, defined as a
specialized form of interdisciplinary health care that is
designed to provide palliative care, alleviate the physical,
emotional, social, and spiritual discomforts of an individual
diagnosed with a terminal illness, and provide supportive care
to the primary caregiver and the family.
FISCAL EFFECT : According to the Senate Appropriations
Committee, this bill will increase CLHF capacity resulting in
potentially minor to significant costs to Medi-Cal, but could
also result in potentially minor to significant cost avoidance
depending on the costs associated with whether the individuals
receiving hospice Medi-Cal benefits select CLHF services versus
receiving similar services in a skilled nursing facility.
COMMENTS : According to the author, Santa Barbara County has
only one licensed hospice facility, Serenity House, a six-bed
facility operated by Visiting Nurses and Hospice Care of Santa
Barbara (VNHC), the sponsor of this bill. The author maintains
that Serenity House has struggled to meet the patient demand in
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the Santa Barbara community for many years citing that between
2008 and 2009, Serenity Houses experienced a 71% increase in the
number of patients served and also a growing waiting list due to
a lack of available beds for end-of-life patients. The author
argues that in recognition of this critical need, local
community members generously contributed to the campaign to
build a new 18-bed hospice inpatient facility. The author
states that without enactment of this bill the Serenity House,
which recently opened their new 18-bed facility as a 12-bed
facility in accordance with existing law, will have to operate
interminably as a 12-bed facility. According to the author,
this bill will allow the six additional beds to become operative
in January 2012 and thus provide more critical hospice-bed
capacity in the Santa Barbara region of the central coast.
CLHFs are residential-based care facilities that provide
inpatient care, medical supervision, 24-hour skilled nursing and
supportive care, and other services to one of three categories
of persons: 1) persons who are mentally alert who have physical
disabilities, who may be ventilator dependent; 2) persons who
have a diagnosis of terminal illness, or life-threatening
illness, or both; or, 3) persons who are catastrophically and
severely disabled.
According DPH, 53 CLHFs are currently licensed in California to
provide services to these populations. Of these, 12 serve
terminally ill patients. CLHFs that serve terminally ill
patients are sometimes referred to as CLHF-Bs, which denotes the
subparagraph of the statute that refers to them.
Hospice services that are provided to terminally ill patients
and their families generally fall into four categories or levels
of care - routine home care, continuous home care, inpatient
respite care, and general inpatient care. Routine home care and
continuous home care services are generally provided in the
patient's home, which can include a licensed health or
residential care facility that they reside in. CLHF-Bs can
provide this level of care, when it is not feasible for a
patient to be cared for at home. When a hospice patient needs
an inpatient level of care, either to provide respite to family
members or due to a need for 24-hour pain control and symptom
management, hospice service providers generally must arrange to
place the patient in a licensed health facility, such as a
hospital, skilled nursing facility or CLHF-B. Several hospice
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service providers currently operate their own facilities to
accommodate hospice patients with these higher levels of needs.
One currently operates a special hospital in San Diego with 24
beds, which is operating under a pilot project that was
established in 1980. Eleven hospice service providers operate
CLHF-Bs to serve patients who need inpatient care.
Analysis Prepared by : Tanya Robinson-Taylor / HEALTH / (916)
319-2097
FN: 0001602