BILL ANALYSIS Ó SENATE COMMITTEE ON HEALTH Senator Ed Hernandez, O.D., Chair BILL NO: SB 534 AUTHOR: Hernandez AMENDED: April 9, 2013 HEARING DATE: April 17, 2013 CONSULTANT: Marchand SUBJECT : Health and care facilities. SUMMARY : Requires chronic dialysis clinics, surgical clinics, rehabilitation clinics, and intermediate care facilities/developmentally disabled-nursing to meet federal certification standards under the Department of Public Health (DPH) and adopts licensing regulations for these facilities. Existing law: 1.Licenses and regulates various clinics by DPH, including primary care clinics as well as specialty clinics which include: surgical clinics, chronic dialysis clinics, and rehabilitation clinics. 2.Requires DPH to adopt reasonable rules and regulations as may be necessary to enable DPH to carry out the purposes of provisions of law governing the various types of clinics licensed by DPH. 3.Licenses and regulates various types of facilities by DPH, including intermediate care facilities/developmentally disabled-nursing (ICF/DD-N), which is defined as a facility with a capacity of 4 to 15 beds that provides 24-hour personal care, developmental services, and nursing supervision for persons with developmental disabilities who have intermittent recurring needs for skilled nursing care but have been certified by a physician as not requiring continuous skilled nursing care. 4.Requires DPH to propose licensing fees for all of its clinics and facilities at a level that will not require the licensing and certification program to seek General Funds to support its activities unless otherwise specified in statute. This bill: 1.Requires, until DPH adopts regulations relating to the provision of services by a chronic dialysis clinic, surgical Continued--- SB 534 | Page 2 clinic or a rehabilitation clinic, those clinics to comply with the following federal certification standards in effect immediately preceding January 1, 2013: a. Requires a chronic dialysis clinic to comply with applicable federal certification standards for an end stage renal disease clinic; b. Requires a surgical clinics to comply with applicable federal certification standards for an ambulatory surgical clinic; and c. Requires a rehabilitation clinic to comply with applicable federal certification standards for a comprehensive outpatient rehabilitation facility. 2.Requires, until DPH and the Department of Developmental Services (DDS) jointly develop regulations regarding intermediate care facilities/developmentally disabled-nursing (ICF/DD-N), these facilities to comply with applicable federal certification standards for intermediate care facilities for individuals with intellectual disabilities in effect immediately preceding January 1, 2013. 3.Deletes a requirement that regulations developed by DPH and DDS pertaining to ICF/DD-Ns and ICF/DD-continuous nursing include licensing fee schedules appropriate to facilities which will encourage their development. FISCAL EFFECT : This bill has not been analyzed by a fiscal committee. COMMENTS : 1.Author's statement. This bill would require four health facility categories currently regulated by DPH to comply with facility-specific federal certification requirements to meet state licensing requirements until DPH adopts state regulations. These facilities already meet federal requirements in order to receive Medicare and Medicaid funding; this bill simply gives authority to state regulators to enforce these standards until such time that DPH adopts regulations specific to these facilities. 2.Double referral. This bill is double referred. Should it pass out of this committee, it will be referred to the Senate Committee on Human Services. 3.Support. This bill is sponsored by DPH, which states that this bill would enable it to adopt existing federal regulatory SB ___ | Page 3 standards as the state licensing standards for chronic dialysis clinics, rehabilitation clinics, surgical clinics, and ICF/DD-Ns. DPH states that it functions as the regulatory agency for approximately 30 different types of health care facilities and clinics. DPH states that it does not have state licensing standards in place for chronic dialysis clinics, rehabilitation clinics, surgical clinics, and ICF/DD-Ns. Federal standards for these facilities exist, but DPH lacks the statutory authority to enforce the standards. In the absence of such authority, DPH states that it may only recommend action by the federal Centers for Medicare and Medicaid Services to stop Medicare/Medicaid program funding if the health care facility is out of compliance. SUPPORT AND OPPOSITION : Support: California Department of Public Health (sponsor) Oppose: None received -- END --