BILL ANALYSIS Ó
AB 2341
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Date of Hearing: April 13, 2016
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Lorena Gonzalez, Chair
AB
2341 (Lackey) - As Amended April 4, 2016
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Urgency: No State Mandated Local Program: YesReimbursable:
No
SUMMARY:
This bill authorizes the California Department of Public Health
(CDPH) to allow nursing and skilled nursing facilities to
provide dialysis, peritoneal, and infusion services that are not
defined in regulation, if certain quality-of-care and other
criteria are met.
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FISCAL EFFECT:
Costs to CDPH Licensing and Certification are expected to be
minor and absorbable, assuming the availability of this new
option does not lead to a large number of facilities pursuing
the delivery of these services (Licensing and Certification
Fund). Any costs are supported by nursing facility licensure
fees.
COMMENTS:
1)Purpose. According to the author, this bill provides nursing
facilities with flexibility to be innovative in their
provision of care to residents, and increases access to care
to communities. This bill will allow facilities to provide
additional, targeted services to individuals both inside the
facility and on an outpatient basis. The author argues
authorizing these services in a way that explicitly does not
require CDPH to issue regulations will enhance care without
the cost and burden of the regulatory process. This bill is
sponsored by Leading Age California, an advocacy organization
representing nonprofit senior living and care facilities.
2)Background. Nursing facilities are required to provide certain
services to their patients. Existing law also authorizes them
to provide "special services" that are optional, including,
for example, certain therapy, speech pathology, and audiology
services. CDPH regulations specify requirements for the
provision of such services, but have not been recently
updated. Despite the lack of regulations, CDPH has authorized,
through a 2007 memo, the services this bill would authorize
through statute. The authorization pursuant to the CDPH memo
was limited to provision of services to facility residents,
while this bill would allow the facility to serve outpatients
as well. Despite the availability of the option to provide
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these services, only a handful of facilities have sought
authorization.
3)Services authorized by this bill. Hemodialysis is a
life-support treatment that uses a machine to filter harmful
wastes, salt, and excess fluid from the blood. Peritoneal
dialysis is a different means to clean the blood, which can be
done while sleeping or going about daily activities. Infusion
is a process whereby medicine, nutrients or special fluids are
delivered through a needle directly into the body.
4)Prior Legislation. AB 1974 (Quirk), Chapter 288, Statutes of
2014, specifies that a "special service" does not include a
functional division, department, or unit of a nursing facility
that is organized, staffed, and equipped to provide inpatient
physical therapy services, occupational therapy services, or
speech pathology and audiology services to residents of the
facility if these services are provided solely to meet CMS
certification requirements.
5)Support and Opposition. This bill is supported by Leading Age
California. The California Advocates for Nursing Home Reform
(CANHR) opposes this bill, citing a lack of evidence of need
for SNFs to deliver these services, and concern about the
following: 1) that current oversight of dialysis providers is
notoriously weak, whether SNFs would deliver these services
safely to outpatients; and 2) that the bill does not identify
the standard of care for these services.
Analysis Prepared by:Lisa Murawski / APPR. / (916)
319-2081
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