BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  SB 534
                                                                  Page  1

          Date of Hearing:   August 14, 2013

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                  Mike Gatto, Chair

                   SB 534 (Hern�ndez) - As Amended:  July 3, 2013 

          Policy Committee:                             HealthVote:19-0
                       Aging                            Vote: 6-0

          Urgency:     No                   State Mandated Local Program:  
          Yes    Reimbursable:              No

           SUMMARY  

          This bill requires certain types of facilities (chronic dialysis  
          clinics, surgical clinics, and rehabilitation clinics,  
          intermediate care facility/developmentally disabled-nursing  
          (ICF/DD-N) facilities, and intermediate care  
          facility/developmentally disabled-continuous nursing (ICF/DD-CN)  
          facilities) to comply with federal certification standards until  
          the Department of Public Health (DPH) adopts regulations  
          relating to the provision of those services.  

          It also requires DPH to conduct at least one public hearing and  
          submit a report to appropriate legislative committees,  
          describing the extent to which the federal certification  
          standards are sufficient, or not, as a basis for state licensing  
          standards, and make recommendations for any California-specific  
          standards which may be necessary, and repeals this bill's  
          provisions as of January 1, 2018.

           FISCAL EFFECT  

          1)One-time costs for analysis of standards, development of  
            recommendations, report to the Legislature, and a public  
            hearing in the range of $200,000 (Licensing and Certification  
            Fund).  

          2)Currently, DPH has the authority to cite facilities under  
            federal law.  If the authority to cite facilities under state  
            law is used instead, revenue may accrue to the State  
            Facilities Citation Penalty Account instead of the Federal  
            State Facilities Citation Penalty Account.  These are both  
            special fund accounts that are used for purposes of the DPH  








                                                                  SB 534
                                                                  Page  2

            Licensing and Certification program and related activities.   
            The State account is available for funding of long-term care  
            ombudsman programs and for quality improvement activities,  
            while the Federal account is used for temporary management  
            costs of facilities whose certification or licensure is  
            revoked.

           COMMENTS  

           Rationale.  This bill is sponsored by DPH.  It would require four  
          health facility categories currently regulated by DPH to comply  
          with facility-specific federal certification standards in order  
          to meet state licensing requirements, until DPH adopts state  
          regulations.  These facilities already meet federal  
          certification standards in order to receive Medicare and  
          Medicaid funding; this bill simply gives authority to state  
          regulators to enforce these standards until DPH adopts  
          regulations specific to these facilities.  In absence of state  
          regulations, the only existing recourse for DPH is to recommend  
          action by the Centers for Medicare and Medicaid Services to stop  
          funding, which carries long-term consequences that could be  
          detrimental to access.  SB 534 allows the state to enforce the  
          federal standards.  Additionally, the 2018 sunset and required  
          review provides accountability that state regulations will be  
          developed.

           Analysis Prepared by  :    Lisa Murawski / APPR. / (916) 319-2081