BILL ANALYSIS �
-----------------------------------------------------------------
|SENATE RULES COMMITTEE | AB 852|
|Office of Senate Floor Analyses | |
|1020 N Street, Suite 524 | |
|(916) 651-1520 Fax: (916) | |
|327-4478 | |
-----------------------------------------------------------------
THIRD READING
Bill No: AB 852
Author: Quirk (D)
Amended: 9/3/13 in Senate
Vote: 21
SENATE HEALTH COMMITTEE : 9-0, 7/3/13
AYES: Hernandez, Anderson, Beall, De Le�n, DeSaulnier, Monning,
Nielsen, Pavley, Wolk
SENATE APPROPRIATIONS COMMITTEE : 7-0, 8/30/13
AYES: De Le�n, Walters, Gaines, Hill, Lara, Padilla, Steinberg
ASSEMBLY FLOOR : 75-2, 5/29/13 - See last page for vote
SUBJECT : Skilled nursing facility construction, alteration,
or addition: review
SOURCE : California Association of Health Facilities
DIGEST : This bill requires the Office of Statewide Health
Planning and Development (OSHPD) to develop and meet reasonable
timeframes for review of health facility construction plans,
permits the OSHPD to charge a reasonable fee for meeting the new
timeframes, and increases the maximum application filing fee
that the OSHPD may charge skilled nursing or intermediate care
facilities to 2% of a project's estimated construction cost.
ANALYSIS :
Existing law:
CONTINUED
AB 852
Page
2
1. Establishes the Alfred E. Alquist Hospital Facilities Seismic
Safety Act of 1983 (Seismic Safety Act), which requires the
OSHPD to propose proper building standards for earthquake
resistance, and provide an independent review of the design
and construction of hospital buildings.
2. Defines "hospital building," for purposes of the Seismic
Safety Act, as any licensed health facility (which include
general acute care hospitals, special hospitals, skilled
nursing facilities, and intermediate care facilities, among
others).
3. Exempts from this definition skilled nursing and intermediate
care facilities if the building is of single-story,
wood-frame or light steel frame construction. However, these
buildings are subject to plan review and inspection by OSHPD.
4. Requires OSHPD to observe the construction, reconstruction,
or alteration of any hospital building it deems necessary to
comply with the Seismic Safety Act.
5. Requires the health facilities, before adopting any plans for
the building, to submit the plans to OSHPD for approval.
6. Requires OSHPD to determine an application filing fee to
cover the costs of reviewing the design and construction of
health facilities under the Seismic Safety Act. Prohibits
this fee from exceeding 2% of a project's estimated
construction cost for general acute care and special
hospitals, and 1.5% of a project's estimated cost for skilled
nursing and intermediate care facilities.
7. Permits OSHPD to exempt from its plan review process
construction or alteration projects for hospital buildings,
as well as the exempted single-story skilled nursing and
intermediate care facilities that have an estimated
construction cost of $50,000 or less.
This bill:
1. Requires the Facilities Development Division (FDD) within
OSHPD, for projects submitted by licensed health facilities
CONTINUED
AB 852
Page
3
that do not qualify for rapid review, as specified, to meet
reasonable timeframes developed by OSHPD, in conjunction with
stakeholders, which include all of the following:
A. Preliminary review of documents submitted to the
office;
B. First review of new projects;
C. Back-checks; and
D. Amended construction documents.
2. Requires documents submitted to OSHPD for new construction
of, alteration of, or addition to skilled nursing facilities
(SNFs), and intermediate care facilities (ICFs) to include
the name and contact information for an individual designated
to be the project coordinator, and to be reviewed and
approved within the timeframes established by this bill.
3. Permits OSHPD, in order to meet the review timeframes
developed pursuant to this bill, to seek outside assistance
through contracts with qualified professional architectural
or engineering firms.
4. Permits OSHPD to publish standard requirements, when feasible
and if resources are available, for design concepts for use
by SNFs and ICFs when submitting plans for new construction,
renovation, or replacement. Permits these design concepts to
include, but not be limited to, the following:
A. Reduction in beds;
B. Installation and use of new technology, such as
electronic medical records;
C. Space conversion dedicated to changes in care delivery
CONTINUED
AB 852
Page
4
models; and
D. Common replacement of major infrastructure equipment,
including roofing, HVAC, generators and emergency power
systems, water heaters and boilers, and kitchen and
laundry room equipment.
5. Requires OSHPD to work with stakeholders to receive input
for, or assistance with, the establishment of education and
outreach programs directed at reducing document submission
error rates and turnaround times. Requires OSHPD, to the
extent resources are available, to publish on its Internet
Web site these requirements, including, but not limited to,
the timeframes established by this bill.
6. Increases, until January 1, 2019, the maximum application
filing fee that OSHPD may charge skilled nursing or
intermediate care facilities, currently 1.5% of a project's
estimated construction cost, to 2% of a project's estimated
construction cost, which is the same maximum filing fee that
can be charged to hospital facilities.
7. Sunsets those provisions on January 1, 2019.
8. Makes various legislative findings and declarations,
including the following:
A. Licensed health care facilities are required to go
through a building application and plan check process
under the jurisdiction of OSHPD, and that this process
is subject to inherent delays impacting timely approvals
of projects;
B. Although OSHPD has developed internal policies that
set timeframes for plan review and approval, these
policies are targets rather than enforceable
requirements; and
C. Improving the efficiency of health care building plan
review and construction efforts will not only reduce the
time to design, review and complete facility
construction, but also lower the cost of the project and
reduce overall cost pressures on the health care system.
CONTINUED
AB 852
Page
5
9. States the intent of the Legislature to codify the timeframes
and due dates for completion by OSHPD of the review of
facility construction documents and to require OSHPD to
notify applicants of the anticipated date the review will be
completed and returned to them.
Background
OSHPD plan review timelines. According to OSHPD, it has
implemented timeline goals for review of plans. For remodel and
renovation projects of less than $175,000, the goal is an
initial review of 21 days, with back-checks also completed
within 21 days. (According to OSHPD, back-checks occur when
OSHPD returns project plans to the facility's design team for
correction of code deficiencies. The plans are resubmitted to
OSHPD for a back-check to ensure deficiencies are adequately
corrected.) For remodel and renovation projects of greater than
$175,000, the goal is for the initial review to be completed in
60 days, back-checks completed within 30 days, and post-approval
documents (changes made after final approval, during the
construction process) within 30 days. For large, complex
projects with major structural work, the goal is for the initial
review to be completed within 80 days, back-checks within 40
days, and post-approval documents within 30 days. OSHPD notes
that these goals do not apply to Managed Projects or Phased Plan
Reviews, which have schedules that are negotiated on a
case-by-case basis.
OSHPD states that so far in 2013, it is meeting these goals
about 95% of the time for SNFs, and about 94% of the time for
all projects combined.
Prior Legislation
SB 1838 (Perata, Chapter 693, Statute of 2006) authorized OSHPD
to establish a training program for personnel who review
hospital building construction and design plans, exempted
projects that cost less than $50,000 from the plan review
process, and required a pre-submittal meeting with OSHPD review
staff on projects costing more than $20 million.
FISCAL EFFECT : Appropriation: Yes Fiscal Com.: Yes
Local: No
CONTINUED
AB 852
Page
6
According to the Senate Appropriations Committee:
One-time costs up to about $100,000 to update existing
regulations (Hospital Building Fund).
Ongoing costs of about $250,000 per year for additional staff
to develop outreach materials and reduce plan review timelines
(Hospital Building Fund).
SUPPORT : (Verified 9/3/13)
California Association of Health Facilities (source)
Congress of California Seniors
Construction Employers' Association
ARGUMENTS IN SUPPORT : According to the sponsor, part of the
problem that this bill is seeking to address is a lack of
familiarity on both the SNF side, as well as on the side of the
FDD of OSHPD. The sponsor states that the majority of the
freestanding SNFs were built in the late 1960s and early 1970s.
Very few facilities have been built in California in the past 20
years. Because of the age of these facilities, there has been
an increase in the number of renovation projects that have been
submitted to OSHPD, and the lack of familiarity with the process
has led to long delays and increased costs. This bill seeks to
address this issue by requiring OSHPD to designate a staff
member familiar with these types of facilities to conduct a
"peer-review" of projects relating to the construction or
alteration of skilled nursing facilities, and the hope is that
this designated staff member will be able to assist the facility
in navigating the process and helping the facility meet the
requirements in law. Additionally, this bill will establish
timeframes for the various stages of the plan review process,
require OSHPD to meet those timeframes, and increase the
application fee to help pay for the requirements of this bill.
The sponsor further states that current law requires skilled
nursing facilities to receive authorization from OSHPD for any
facility upgrades, changes to address compliance issues, or
routine maintenance of the facility. CAHF states that skilled
nursing facility providers have experienced some delays with
projects that could be avoided if there was staff designated by
OSHPD to coordinate the review of projects, which would also
allow OSHPD to develop staff with some expertise with the
CONTINUED
AB 852
Page
7
skilled nursing facility provider model, which is very different
from the hospital model. This bill is also supported by the
Congress of California Seniors, which states that this bill will
improve the efficiency for skilled nursing facility building
plan review and construction efforts through the development of
standardized timeframes. The Congress of California Seniors
states that the 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. The Construction Employers' Association
states in support that any measure which expedites the
construction process in skilled nursing facilities is in the
best interest of the facility, and the individuals relaying on
the facility, as well as the construction industry.
ASSEMBLY FLOOR : 75-2, 5/29/13
AYES: Achadjian, Alejo, Ammiano, Atkins, Bigelow, Bloom,
Blumenfield, Bocanegra, Bonilla, Bonta, Bradford, Brown,
Buchanan, Ian Calderon, Campos, Chau, Chesbro, Conway, Cooley,
Dahle, Daly, Dickinson, Donnelly, Eggman, Fong, Fox, Frazier,
Beth Gaines, Garcia, Gatto, Gomez, Gonzalez, Gordon, Gorell,
Gray, Grove, Hagman, Hall, Harkey, Roger Hern�ndez, Jones,
Jones-Sawyer, Levine, Linder, Logue, Lowenthal, Maienschein,
Mansoor, Medina, Melendez, Mitchell, Morrell, Mullin,
Muratsuchi, Nazarian, Nestande, Olsen, Pan, Patterson, Perea,
V. Manuel P�rez, Quirk, Quirk-Silva, Rendon, Salas, Skinner,
Stone, Ting, Wagner, Waldron, Weber, Wieckowski, Wilk,
Williams, John A. P�rez
NOES: Allen, Ch�vez
NO VOTE RECORDED: Holden, Yamada, Vacancy
JL:d 9/3/13 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
**** END ****
CONTINUED