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  
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          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  




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            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












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