BILL ANALYSIS                                                                                                                                                                                                    �






                                  SENATE HUMAN
                               SERVICES COMMITTEE
                          Senator Leland Y. Yee, Chair


          BILL NO:       SB 534                                       
          S
          AUTHOR:        Hernandez                                    
          B
          VERSION:       April 9, 2013
          HEARING DATE:  April 23, 2013                               
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          FISCAL:        Yes                                          
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          CONSULTANT:     Mareva Brown                                 


                                        

                                     SUBJECT
                                         
                           Health and care facilities

                                     SUMMARY  

          This bill requires that until the California departments of  
          Public Health (DPH) and Developmental Services (DDS) adopt  
          regulations for Intermediate Care Facilities for the  
          Developmentally Disabled (ICF/DD), so that these facilities  
          comply with applicable federal certification standards.  
          Also requires chronic dialysis clinics, surgical clinics,  
          and rehabilitation clinics to comply with federal standards  
          until DPH has adopted regulations for those facilities.

                                     ABSTRACT  

           Existing law
           
             1)   Requires DPH to license and regulate various types  
               of facilities, including intermediate care  
               facilities/developmentally disabled-nursing  
               (ICF/DD-N), which are defined as facilities with a  
               capacity of 4 to 15 beds that provide 24-hour personal  

                                                         Continued---




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               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.

             2)   Requires DPH to license and regulate various  
               clinics, including primary care and specialty clinics  
               which include: surgical clinics, chronic dialysis  
               clinics, and rehabilitation clinics. 

             3)   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.

             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.

             5)   Requires DPH and DDS to  jointly develop and  
               implement licensing regulations appropriate for  
               intermediate care facilities for the developmentally  
               disabled-nursing (ICF/DD-N) and intermediate care  
               facility for the developmentally disabled-continuous  
               nursing (ICF/DD-CN). 

           This bill

              1)   Requires that intermediate care facilities for the  
               developmentally disabled-nursing (ICF/DD-N) comply  
               with applicable federal certification standards for  
               intermediate care facilities for individuals with  
               intellectual disabilities in effect immediately  
               preceding January 1, 2013 until DPH and DDS jointly  
               develop licensing regulations. 

             2)   Deletes a requirement that regulations developed by  
               DPH and DDS pertaining to ICF/DD-Ns and ICF/DD-CN  
               include licensing fee schedules appropriate to  
               facilities which will encourage their development.

             3)   Requires DDS to review and approve an applicant's  





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               facility program plan as a prerequisite to the  
               licensing and certification process, rather than as a  
               part of the process.

             4)   Requires, until DPH adopts regulations relating to  
               the provision of services by a chronic dialysis  
               clinic, surgical clinic or a rehabilitation clinic,  
               for 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.

                                  FISCAL IMPACT  

          This bill has not been analyzed by a fiscal committee.

                            BACKGROUND AND DISCUSSION  

           Purpose of the bill
           
          The author states that 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.

           Department of Public Health

           The Licensing and Certification program is housed within  
          DPH's Center for Health Care Quality, which includes about  
          1,200 staff located in 14 District offices. Among its  
          duties is to act as the "state survey agency" for the  





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          federal Centers for Medicare and Medicaid (CMS). In that  
          role, DPH is responsible for certifying to the federal  
          government that the health care facilities are eligible for  
          payments under CMS programs. DPH makes a certification  
          recommendation after surveying the health care facilities  
          and establishing that they are in compliance with all  
          federal Conditions of Participation.

           Intermediate Care Facilities for the Developmentally  
          Disabled

           An ICF/DD provides 24-hour personal care, habilitation,  
          developmental, and supportive health services to  
          developmentally disabled clients whose primary need is for  
          developmental services and who have a recurring but  
          intermittent need for skilled nursing services. There are  
          three specialty types of ICF/DDs operating in California.  
          One of them is the subject of regulations in this bill.

           Intermediate Care Facilities for the Developmentally  
          Disabled / Nursing
           
          The ICF/DD-N is a 4- to 15-bed facility that provides  
          24-hour personal care, developmental services, and nursing  
          supervision for developmentally disabled persons who have  
          intermittent recurring needs for skilled nursing care but  
          have been certified by a physician and surgeon as not  
          requiring continuous skilled nursing care. This type of   
          facility serves medically fragile persons who have  
          developmental disabilities or demonstrate significant  
          developmental delays that may lead to a developmental  
          disability if not treated.<1>

                                    POSITIONS  

           Arguments in support  

          DPH, the bill's sponsor, states that this language is  
          necessary to enable it to adopt existing federal regulatory  
          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. While federal standards  
          -------------------------
          <1> http://www.dds.ca.gov/livingarrang/icf.cfm




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          for these facilities exist, DPH lacks the statutory  
          authority to enforce them.  In the absence of such  
          authority, DPH states that it may only recommend action by  
          the federal CMS to stop Medicare/Medicaid program funding  
          if the health care facility is out of compliance.  
           
                                         

          Support:       California Department of Public Health  
          (sponsor)

          Oppose:   None received






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