BILL ANALYSIS Ó
SB 816
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Date of Hearing: June 11, 2013
ASSEMBLY COMMITTEE ON HEALTH
Richard Pan, Chair
SB 816 (Committee on Health) - As Introduced: March 11, 2013
SENATE VOTE : 35-0
SUBJECT : Hospice facilities: developmental disabilities:
intellectual disability.
SUMMARY : Makes the State Fire Marshal, rather than the Office
of Statewide Health Planning and Development (OSHPD),
responsible for the development of building standards for
hospice facilities, and makes other minor and technical
corrections to law related to hospice facilities and
intellectual disabilities. Specifically, this bill :
1)Requires the Office of the State Fire Marshal, in consultation
with OSHPD, to develop and adopt building standards for
hospice facilities.
2)Corrects two references to federal regulations that establish
standards for hospice facilities.
3)Replaces the term "mental retardation" with "intellectual
disability" in the definition of "developmental disability" in
the Lanterman Developmental Disabilities Services Act
(Lanterman Act) and makes other minor, technical corrections
in that definition.
EXISTING LAW :
1)Requires hospices to obtain a license from the Department of
Public Health (DPH) and to provide, or make provision for,
skilled nursing services, social services and/or counseling
services, medical direction, bereavement services, volunteer
services, inpatient care arrangements, and home health aide
services.
2)Allows hospice facilities to operate as freestanding health
facilities with a capacity of no more than 24 beds that
provide routine care, continuous care, inpatient respite care,
and inpatient hospice care.
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3)Requires building standards for hospice facilities to apply
uniformly throughout the state.
4)Until OSHPD, in consultation with the Office of the State Fire
Marshal, develops and adopts building standards for hospice
facilities, requires hospice facilities to meet building
standards and physical environment requirements from federal
Medicare Conditions of Participation for a hospice that
provides inpatient care directly in its own facility.
5)Requires the building standards developed by OSHPD to, at a
minimum, maintain the requirements specified in federal
Medicare Conditions of Participation for a hospice that
provides inpatient care directly in its own facility.
6)Requires congregate living health facilities (CLHFs) serving
individuals who are terminally ill, catastrophically and
severely disabled, mentally alert but physically disabled, or
any combination of these individuals, to obtain and maintain a
valid fire clearance from the appropriate authority having
jurisdiction over the facility, based on compliance with state
regulations concerning fire and life safety, as adopted by the
State Fire Marshal.
7)Requires the State Fire Marshal, with the advice of the State
Board of Fire Services, to adopt regulations establishing
minimum requirements for the protection of life and property
for CLHFs that recognize the residential and non-institutional
setting of CLHFs.
8)Establishes the Lanterman Act, which gives individuals with
disabilities the right to treatment and habilitation services
and supports in the least restrictive environment.
9)For purposes of the Lanterman Act, requires the term
"developmental disability" to include mental retardation,
cerebral palsy, epilepsy, and autism.
FISCAL EFFECT : According to the Senate Appropriations
Committee, pursuant to Senate Rules 28.8, negligible state
costs.
COMMENTS :
1)PURPOSE OF THIS BILL . The author of this bill states that SB
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1381 (Pavley), Chapter 457, Statutes of 2012, made an
important change to statutory terminology by removing
references to the term "mental retardation" from state
statutes. Unfortunately, the Welfare and Institutions Code
Section that defines "developmental disability" was
inadvertently not amended and thus still includes the term
"mental retardation." This bill corrects those references.
In addition, SB 135 (Ed Hernandez), Chapter 673, Statutes of
2012, establishes a new health facility licensing category of
hospice facility, and permits a licensed and certified hospice
services provider to provide inpatient hospice services. The
author writes that SB 135 contains an erroneous
cross-reference of the Federal Code of Regulations (Section
41.100 of Title 42) which imposes incompatible requirements on
the development of hospice facilities. This bill remedies
this incorrect citation with the correct citation of the
Federal Code of Regulations (Section 418.110 of Title 42).
2)BACKGROUND . Among its many provisions, SB 135 makes OSHPD
primarily responsible for the development of building
standards for free-standing hospice facilities. Until OSHPD's
regulations are developed and adopted, SB 135 requires
facilities to meet building standards set out in federal
regulations for hospices that provide inpatient care in their
own facilities. According to the author, the intent of SB 135
was to require a hospice facility to meet the same building
standards as a CLHF, which are not built under OSHPD authority
as they have fewer beds, are more residential in nature, and
have different zoning classifications (unlike OSHPD
facilities, CLHFs are allowed in local neighborhoods). This
bill corrects this incongruity by shifting primary
responsibility for hospice facility building standards to the
State Fire Marshal.
3)SUPPORT . The Arc California and United Cerebral Palsy in
California Collaboration write in support that, originally
intended as a term of respect, the term "mental retardation"
has become a term of hostility, often associated with bullying
and hate crimes. This bill corrects an oversight and replaces
the term with "intellectual disability."
The California Hospice and Palliative Care Association (CHAPCA),
writes in support that this bill contains an erroneous
cross-reference to federal regulations and would impose
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incompatible requirements on the development of hospice
facilities. CHAPCA states that this bill will enable hospice
programs to move forward in developing hospice care facilities
in the state.
4)RELATED LEGISLATION .
a) AB 383 (Wagner), pending in the Senate Judiciary
Committee, makes numerous technical changes in the
California codes that have been recommended by the
Legislative Counsel's Office. Among its many changes, AB
383 replaces the term "mentally retarded" with
"intellectually disabled" in the definition of "gravely
disabled" for purposes of the Lanterman-Petris-Short Act,
which governs involuntary commitment to mental health
institutions.
b) SB 663 (Lara), pending in the Senate Committee on Human
Services, revises the definition of certain sex offenses to
apply if the victim is developmentally disabled. For
purposes of this revision, defines "developmental
disability" to include "mental retardation, cerebral palsy,
epilepsy, and autism" and to include "disabling conditions
found to be closely related to mental retardation or to
require treatment similar to that required for individuals
with mental retardation."
5)PREVIOUS LEGISLATION .
a) SB 135 (Ed Hernandez), Chapter 673, Statutes of 2012,
establishes a new health facility licensing category of
hospice facility, and permits a licensed and certified
hospice services provider to provide inpatient hospice
services through the operation of a hospice facility,
either as a free-standing health facility, or adjacent to,
physically connected to, or on the building grounds of
another health facility or a residential care facility.
b) SB 1381 (Pavley), Chapter 457, Statutes of 2012, deletes
in state law references to "mental retardation" or a
"mentally retarded person" and instead replaces them with
"intellectual disability" or "a person with an intellectual
disability."
c) AB 2370 (Mansoor), Chapter 448, Statutes of 2012, is
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substantially similar to SB 1381.
d) SB 2622 (Maddy), Chapter 1343, Statutes of 1990,
requires hospices to be licensed by the Department of
Health Services (now the DPH).
6)DOUBLE REFERRAL . This bill is double referred. Should it
pass out of this committee, it will be referred to the
Assembly Governmental Organization Committee.
REGISTERED SUPPORT / OPPOSITION :
Support
Arc California and United Cerebral Palsy in California
Collaboration
California Hospice and Palliative Care Association
Opposition
None on file.
Analysis Prepared by: Ben Russell / HEALTH / (916) 319-2097