BILL ANALYSIS Ó
AB 1211
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB
1211 (Maienschein)
As Amended August 19, 2015
2/3 vote. Urgency
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|ASSEMBLY: | 78-0 | (May 14, |SENATE: |40-0 | (August 31, |
| | |2015) | | |2015) |
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Original Committee Reference: HEALTH
SUMMARY: Increases the maximum number of beds allowed in
congregate living health facilities (CLHFs) to provide basic
services for inpatient care, as specified. Contains an urgency
clause to ensure that the provisions of this bill go into
immediate effect upon enactment.
The Senate amendments are technical and nonsubstantive.
FISCAL EFFECT: According to the Senate Appropriations
Committee, pursuant to Senate Rule 28.8, negligible state costs.
COMMENTS: The author states the demand for CLHF services to
provide alternative, non-institutional settings for patients is
increasing beyond current capacity. The author asserts the only
current alternative to expanding the number of beds from 12 to
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18 is for operators to construct new CLHFs within the same
community, which lengthens the time it takes to place in-need
patients in a CLHF and increases the number of facilities that
DPH must oversee. The author maintains that by increasing the
number of licensed beds from 12 to 18, providers may reduce the
fixed costs related to operating a CLHF, rather than increasing
costs due to new construction, to meet the increasing demand.
The author also explains a cap of 18 would allow the program to
stay residential in nature but provide additional economies of
scale to help keep average fixed cost per bed of the program
down. The author states this bill will increase parity between
the restrictions placed upon private and public sector
CLHF-licensed programs.
1)CLHFs in California. CLHFs are one type of long-term care
facility licensed by DPH in California. DPH requires that the
primary need of CLHF residents be for skilled nursing care on
a recurring, intermittent, extended, or continuous basis.
CLHFs are designed to provide care that is generally less
intense than that provided in general acute care hospitals but
more intense than that provided in skilled nursing facilities.
There are currently 84 licensed CLHFs operating throughout
the state, with a total bed capacity of 661. The sponsor
states occupancy rates at its facilities have consistently run
over 92% within the last few years.
There are currently three classifications of licensure for
CLHFs:
a) CLHF "A" facilities provide services for individuals who
are mentally alert, physically disabled individuals who may
be ventilator dependent;
b) CHLF "B" facilities allow for services for individuals
who have a diagnosis of terminal illness, a diagnosis of a
life-threatening illness, or both; and,
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c) CLHF "C" facilities provide services for individuals who
are catastrophically and severely disabled. Services
offered to catastrophically disabled persons include, but
are not limited to, speech, physical, and occupational
therapy.
2)Expansion of CHLFs. The sponsors of this bill point to
referral records demonstrating the necessity to turn patients
away due to the lack of availability of beds with the current
CLHF bed capacity limits. Anecdotal evidence from supporters
of this bill suggests there is a great demand for increased
access to CLHF facilities. Current statute mandates CHLFs to
maintain a residential, home-like setting for its patients in
order to maintain valid CLHF licensure; thus, unless
legislation is enacted to change these requirements, a simple
expansion on the maximum allowable beds in CLHFs in statute
must adhere to these provisions. However, existing law also
allows for exemptions on maximum bed capacity for CHLFs in
specified locations in California, with some capacities of 25
beds or 59 beds. The expansion allowed in this bill still
remains significantly under the current allowable maximum
capacity of those counties exempt from the current 12 bed
limit for CLHFs.
CareMeridian, the sponsor of this bill, states as healthcare
inflation continues to increase, providers must look for ways to
lower the cost of patient care. The sponsor states by
increasing the number of licensed beds from 12 to 18, providers
may reduce the fixed costs related to operating a CLHF, rather
than increasing costs due to other factors, such as new
construction, to meet patient demand. The sponsor asserts that
CLHFs with greater than 12 beds can still maintain the same high
quality, home-like appearance and feel as programs operating at
the lower bed threshold.
Supporters contend with the rising demand from non-institutional
settings, increasing the number of beds in current CLHFs
provides more options for patients needing more intense medical
care and rehabilitation than what can be provided in a standard
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skilled nursing facility. Supporters state this bill will allow
for improved access to community-based, highly-skilled care for
patients and comfort to their families.
There is no known opposition to this bill.
Analysis Prepared by:
An-Chi Tsou / HEALTH / (916) 319-2097 FN:
0001462