BILL ANALYSIS �
AB 852
Page 1
ASSEMBLY THIRD READING
AB 852 (Quirk)
As Amended April 16, 2013
Majority vote
HEALTH 18-1 APPROPRIATIONS 17-0
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|Ayes:|Pan, Logue, Ammiano, |Ayes:|Gatto, Harkey, Bigelow, |
| |Atkins, Bonilla, Bonta, | |Bocanegra, Bradford, Ian |
| |Chesbro, Gomez, Roger | |Calderon, Campos, |
| |Hern�ndez, Rendon, | |Donnelly, Eggman, Gomez, |
| |Maienschein, Mansoor, | |Hall, Ammiano, Linder, |
| |Mitchell, Nazarian, | |Pan, Quirk, Wagner, Weber |
| |Nestande, | | |
| |V. Manuel P�rez, | | |
| |Wieckowski, Wilk | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Wagner | | |
| | | | |
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SUMMARY : Requires the Office of Statewide Health Planning and
Development (OSHPD) to develop with stakeholders reasonable
timeframes for review and approval of skilled nursing facility
(SNF) construction, alteration, or addition projects and
increases the maximum filing fee OSHPD may assess SNFs for
construction projects, from 1.5% of total project cost, to 2%.
Specifically, this bill :
1)Requires OSHPD to charge a reasonable fee for the review and
approval of plans. Requires the fee to be based on the
estimated cost, including costs associated with the designated
qualified professional staff, but not exceed the reasonable
cost of the entire phased review and approval process for
those plans.
2) Increases the maximum filing fee OSHPD may assess SNFs for
construction projects, from 1.5% of total project cost, to 2%.
3)Requires, for projects not qualifying for rapid review, as
specified, the Facilities Development Division (FDD) to meet
reasonable timeframes developed by OSHPD, in conjunction with
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stakeholders, that include all of the following:
a) Preliminary review of documents submitted to OSHPD;
b) First review of new projects;
c) Backchecks; and,
d) Amended construction documents.
4)Requires that documents submitted to OSHPD for new
construction of, alteration of, or additions to SNFs to
include the name and contact information for an individual
designated to be the project coordinator, and requires these
documents to be reviewed and approved within the timeframes
established by this bill.
5)Requires OSHPD to designate professional staff familiar with
health facilities providing skilled nursing care to review
projects relating to SNF construction or alteration.
6)Increases, for the purposes of a SNF only, from $50,000 to
$100,000, the existing project cost threshold of construction
or alteration projects that may be exempt from existing plan
review process.
7)Authorizes OSHPD to seek outside assistance through contracts
with qualified professional architectural or engineering firms
to meet the review timeframes developed pursuant to this bill.
8)Requires OSHPD to monitor document submissions related to new
or comparative design concepts meeting approval and, when
feasible, publish standard requirements for use by
stakeholders. Allows design concepts to include new
construction, renovation, or replacement. Indicates that
design concepts to be considered, may include, but are not
limited to, reduction in beds; installation and use of new
technology, such as electronic medical records; space
conversion dedicated to changes in care delivery models; and
common replacement of major infrastructure equipment,
including roofing, heating, ventilation, and air conditioning,
generators and emergency power systems, water heaters and
boilers, and kitchen and laundry room equipment.
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9)Requires OSHPD to work with stakeholders to establish
education and outreach programs directed at reducing document
submission error rates and turnaround times.
10)Requires OSHPD to publish on its Internet Web site these
requirements including, but not limited to, the timeframes
developed.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, initial and ongoing fee-supported costs to OSHPD in
the range of $200,000 to $300,000 for increased staff to work
with stakeholders and design professionals on the OSHPD review
process, monitor submissions, and publish design standards.
COMMENTS : The California Association of Health Facilities
(CAHF) is the sponsor of this bill. According to the author,
OSHPD's review of renovation and compliance projects is a source
of significant frustration for the skilled nursing provider
community. Repetitive reviews at the local and state levels
lengthen the review process. The FDD, a subdivision of OSHPD,
is responsible for monitoring construction plans to ensure
conformance to federal and state requirements. The aspects of
the FDD's responsibility that have the greatest negative impact
on long term care providers are: 1) cumbersome and confusing
plan review; 2) duplicative field review and inspections; and,
3) the difficulty in altering projects to meet compliance. In
addition, project cost thresholds for an exemption, currently
set at $50,000, are too low to cover small projects such as the
replacement of a generator or a kitchen oven, which can cost
more than $70,000. Removing some of the barriers for
facilities to make changes to physical plants efficiently will
allow for improvements in care delivery.
Current law requires that the governing board of each hospital
or other hospital governing authority, before adopting any plans
for the hospital building, to submit the plans to OSHPD for
approval. The application for approval of the plans must
include architectural, mechanical and electrical specifications
and structural design computations. OSHPD then reviews the
plans, and issues the necessary permits for the construction.
During construction or alteration, inspections are conducted by
OSHPD. Hospitals that apply for construction or alteration
permits must pay specified fees, depending on the cost of the
construction. According to OSHPD, it has implemented a 60-30-30
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policy where the review of a project is undertaken within 60
days. If a project design does not meet all the requirements,
it is sent back to the owner of the facility and is deemed
non-compliant. After corrections are re-submitted, OSHPD takes
30 days to do the re-review (commonly referred to as the first
backcheck). After the owner resubmits the corrected design,
OSHPD conducts a re-review (second backcheck) usually within 30
days. OSHPD indicates that it is meeting these timeframes 91%
of the time. It should be noted that these timeframes depend on
the quality of the designs that are submitted and resubmitted to
OSHPD. Additionally, OSHPD points out that if there are changes
that need to be done during project construction, it usually
conducts a post-approval of the changes within 30 days.
OSHPD's Rapid Review Unit was established to provide expedient
review times for qualified projects not involving unusual
proximity. According to OSHPD, projects that qualify for rapid
review are approved within 15 days. To be eligible for rapid
review, new projects must cost between $100,000 - $175,000.
Construction or alteration projects with estimated construction
costs of $50,000 or less may be exempt from the plan review
process. This bill increases this threshold to $100,000.
CAHF indicates in support, that this bill will improve the
efficiency for SNF building plan review and construction efforts
through OSHPD's development of standardized time frames for plan
review/approval and will authorize OSHPD to participate in joint
training and educational efforts to assist in reducing document
submission error rates. These changes will not only reduce the
time to design, review, and complete facility construction, but
will also lower the cost of the project and reduce overall cost
pressures on the health care system, allowing more resources to
be directed to direct patient services. The Associated General
Contractors indicate that OSHPD's process includes a cumbersome
plan check and review process to meet compliance requirements.
Existing project cost thresholds for a streamlined review are
also too low even for small projects. The Construction
Employers' Association, also in support, states that any measure
which expedites the construction process in SNFs is in the best
interest of the facility, and the individuals relying on the
facility.
Analysis Prepared by : Lara Flynn / HEALTH / (916) 319-2097
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FN: 0000872