BILL ANALYSIS �
SB 534
Page 1
SENATE THIRD READING
SB 534 (Ed Hernandez)
As Amended July 3, 2013
Majority vote
SENATE VOTE :34-0
HEALTH 19-0 AGING 6-0
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|Ayes:|Pan, Logue, Ammiano, |Ayes:|Yamada, Wagner, Brown, |
| |Atkins, Bonilla, Bonta, | |Daly, Gray, Levine |
| |Chesbro, Gomez, Roger | | |
| |Hern�ndez, Lowenthal, | | |
| |Maienschein, Mansoor, | | |
| |Mitchell, Nazarian, | | |
| |Nestande, | | |
| |V. Manuel P�rez, Wagner, | | |
| |Wieckowski, Wilk | | |
| | | | |
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APPROPRIATIONS 17-0
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|Ayes:|Gatto, Harkey, Bigelow, |
| |Bocanegra, Bradford, Ian |
| |Calderon, Campos, |
| |Donnelly, Eggman, Gomez, |
| |Hall, Holden, Linder, |
| |Pan, Quirk, Wagner, Weber |
| | |
| | |
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SUMMARY : Requires, until the California Departments of Public
Health (DPH) and Developmental Services (DDS) adopt regulations
for licensure for Intermediate Care Facilities for the
Developmentally Disabled - Nursing (ICF/DD-N), these facilities
comply with applicable federal certification standards.
Requires chronic dialysis clinics, surgical clinics, and
rehabilitation clinics to comply with federal certification
standards until DPH has adopted regulations for those
facilities. Specifically, this bill :
1)Requires, until DPH adopts regulations relating to the
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provision of services by a chronic dialysis clinic, a surgical
clinic, or rehabilitation clinic, the following facilities
licensed or seeking licensure 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 clinic to comply with applicable
federal certification standards for an ambulatory surgical
clinic (ASC); and,
c) Requires a rehabilitation clinic to comply with
applicable federal certification standards for a
comprehensive outpatient rehabilitation facility.
2)Requires until the DPH and DDS adopt regulations pursuant to
existing law, relating to services by ICF/DD-N, licensed
facilities to comply with applicable federal certification
standards in effect immediately preceding January 1, 2013.
3)Deletes a requirement that regulations developed by DPH and
DDS pertaining to ICF/DD-N and ICF/DD-continuous nursing
include licensing fee schedules appropriate to facilities
which will encourage their development.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, 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).
Currently, the California Department of Public Health (CDPH) 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 Facilities Citation Penalty
Account. These are both special fund accounts that are used for
purposes of the CDPH 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
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management costs of facilities whose certification or licensure
is revoked.
COMMENTS : According to the author, 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 are already required to 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.
According to DPH, as of April 2, 2013, there are 173 designated
health care facilities that have been issued a state license.
This includes 98 chronic dialysis clinics, 57 ICF/DD-N's, 16
surgical clinics, and two rehabilitation clinics. Among these
four facility types, 166 facilities (96%) had an active license
while the rest, seven (4%) did not. To date, DPH has not
adopted state regulations for these facilities, but relies on
the federal certification standards to determine licensure. DPH
is currently in the process of drafting regulations for the
ICF/DD facilities, however, the Assembly Health Committee staff
is not aware of any regulations in process for the surgical
clinics, chronic dialysis clinics, and rehabilitation clinics.
The federal regulatory standards for chronic dialysis clinics
(referred to as End Stage Renal Centers in federal regulations),
surgical clinics (referred to as ASC in federal regulations),
and rehabilitation clinics, among other things, set forth the
various standards required at each facility in order to qualify
for Medicare and Medicaid participation by the Centers for
Medicare and Medicaid Services (CMS). Depending on the facility
in question, the regulations set requirements for the facilities
management and governing body, what services may be offered and
safety and cleanliness standards. Standards also include, but
are not limited to, requirements covering patient rights, the
administration of anesthesia, if applicable, medical records,
privacy, and infection control. The federal regulatory
standards for ASCs also include as part of their requirements
for coverage with CMS that the ASC must comply with state
licensure requirements.
DPH is the sponsor of this bill, and states that this bill will
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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. 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 CMS to stop Medicare
and Medicaid program funding if the health care facility is out
of compliance.
Analysis Prepared by : Lara Flynn / HEALTH / (916) 319-2097
FN: 0002148