Amended in Senate April 6, 2015

Senate Bill No. 749

Introduced by Senator Morrell

February 27, 2015

An act to amend begin delete Section 1596.65 of the Health and Safety Code, relating to child care. end delete begin insert Sections 1726, 1747, and 1748 of, and to repeal and add Section 1747.1 of, the Health and Safety Code, relating to home health agencies. end insert

LEGISLATIVE COUNSEL’S DIGEST

SB 749, as amended, Morrell. begin delete Child care: trustline registry. end delete begin insert Home health agencies: hospice care. end insert

begin insert

Existing law provides for the licensure and regulation of home health agencies by the State Department of Public Health. Existing law requires all private or public organizations that provide or arrange for skilled nursing services to patients in the home to obtain a home health agency license.

end insert begin insert

Existing law, the California Hospice Licensure Act of 1990 (the act), provides for the licensure and regulation by the State Department of Public Health of persons or agencies that provide hospice services to persons, and the families of persons, who are experiencing the last phases of life due to a terminal disease. The act prohibits a person, political subdivision of the state, or other governmental agency from establishing or operating a hospice without first obtaining a license. Existing federal law also provides for the certification of hospice care for purposes of Medicare reimbursement. Existing law exempts a hospice program certified in accordance with federal Medicare hospice conditions of participation from the requirement to obtain a license pursuant to the act, but provides that the program is subject to home health agency licensure unless it elects to apply for hospice licensure.

end insert begin insert

This bill instead would exempt a licensed home health agency from the requirement to obtain a license to provide hospice services if the hospice program is certified in accordance with federal Medicare hospice conditions of participation or is in the process of obtaining that certification. The bill would also make conforming changes.

end insert begin delete

Existing law requires the State Department of Social Services to establish a trustline registry for trustline providers who meet prescribed requirements. Existing law defines a trustline provider as a person 18 years of age or older who provides child care, supervision, or in-home educational or counseling services, and who is not required to be licensed as a child day care facility. Existing law prohibits an employment agency from making a referral of a child care provider unless the child care provider is a trustline applicant or registered child care provider.

end delete begin delete

This bill would make a technical, nonsubstantive change to a provision related to the trustline registry.

end delete

Vote: majority. Appropriation: no. Fiscal committee:  begin delete no end delete begin insert yes end insert . State-mandated local program: no.

The people of the State of California do enact as follows:

begin insert

begin insert SECTION 1. end insert   

end insert

begin insert Section 1726 of the end insert begin insert Health and Safety Code end insert begin insert is
amended to read: end insert

1726.  

(a)  begin delete No end delete begin insert A end insert private or public organization, including, but
not limited to, any partnership, corporation, political subdivision
of the state, or other governmental agency within the state, shall
begin insert not end insert provide, or arrange for the provision of, skilled nursing services
in the home in this state without first obtaining a home health
agency license.

(b)  begin delete No end delete begin insert A end insert private or public organization, including, but not
limited to, any partnership, corporation, or political subdivision
of the state, or other governmental agency within the state, shall
begin insert not end insert do any of the following unless it is licensed under this chapter:

(1) Represent itself to be a home health agency by its name or
advertisement, soliciting, or any other presentments to the public,
or in the context of services within the scope of this chapter imply
that it is licensed to provide those services or to make any reference
to employee bonding in relation to those services.

(2) Use the words “home health agency,” “home health,”
“home-health,” “homehealth,” or “in-home health,” or any
combination of those terms, within its name.

(3) Use the words “skilled” or “nursing,” or any combination
of those terms within its name, to imply that it is licensed as a
home health agency to provide those services.

(c) In implementing the system of licensing for home health
agencies, the department shall distinguish between the functions
of a home health agency and the functions of an employment
agency or a licensed nurses’ registry pursuant to Title 2.91
(commencing with Section 1812.500) of Part 4 of Division 3 of
the Civil Code. An employment agency or a licensed nurses’
registry performing its functions as specified in Title 2.91
(commencing with Section 1812.500) of Part 4 of Division 3 of
the Civil Code is not required to secure a home health agency
license under subdivision (a), unless it is performing the functions
of a home health agency, as defined in this chapter. However,
subdivision (b) shall apply to an employment agency or a licensed
nurses’ registry that is not licensed under this chapter.

(d) A begin delete hospice end delete begin insert home health agency end insert is not required to secure a
begin delete home health agency license under subdivision (a). However,
subdivision (b) shall apply to a hospice that is not licensed under
this chapter. end delete begin insert hospice license pursuant to Section 1747 in order to
become certified to provide hospice care. end insert

begin insert

begin insert SEC. 2. end insert   

end insert

begin insert Section 1747 of the end insert begin insert Health and Safety Code end insert begin insert is amended
to read: end insert

1747.  

(a)   begin delete No end delete begin insert A end insert person, political subdivision of the state, or
other governmental begin delete agency, that is not operating a hospice as of
January 1, 1991, end delete begin insert agency end insert shall begin insert not end insert establish or operate a hospice
without first obtaining a license under this begin delete chapter. end delete begin insert chapter, unless
it is a licensed home health agency that is exempt pursuant to
Section 1747.1. end insert

(b)  Any person, political subdivision of the state, or other
governmental agency, that is operating a hospice as of January 1,
1991, may continue to operate the hospice only under the following
conditions:

(1)  The person, political subdivision of the state, or other
governmental agency shall apply to the state department for a
license under this chapter within 60 days after forms for the
application of licensure under this chapter are available from the
state department.

(2)  The person, political subdivision of the state, or other
governmental agency shall cease calling or referring to itself as a
hospice upon the final decision of the director upholding the state
department’s denial of an application for licensure under this
chapter.

(c)  Nothing in this chapter shall preclude the ongoing use of
the title “volunteer hospice” by those organizations that satisfy all
of the following:

(1)  They do not provide skilled nursing services.

(2)  They do not charge patients or families for hospice services,
and they do not receive third-party insurance payments for services
rendered.

(3)  They satisfy the disclosure requirements specified in
subdivision (c) of Section 1748.

(d)  A small and rural hospice is exempt from the licensing
provisions of this chapter and the disclosure requirements of
subdivision (c) of Section 1748. A small and rural hospice may
provide skilled nursing services and may use the title “volunteer
hospice.” begin delete For end delete

begin insert (e) end insert begin insert   end insert begin insert For end insert purposes of this chapter, a “small and rural hospice”
means a hospice that provides services to less than 50 patients per
year, does not charge for services, does not receive third-party
payment for services rendered, and is not located in a standard
metropolitan statistical area.

begin insert

begin insert SEC. 3. end insert   

end insert

begin insert Section 1747.1 of the end insert begin insert Health and Safety Code end insert begin insert is
repealed. end insert

begin delete

1747.1.  

A hospice program certified in accordance with federal
Medicare hospice conditions of participation shall be exempt from
subdivision (a) of Section 1747, but shall be subject to Section
1726 unless it elects to apply for hospice licensure. A hospice
program that elects to apply for hospice licensure shall thereafter
be subject to all the hospice licensure requirements set forth in this
chapter.

end delete

begin insert

begin insert SEC. 4. end insert   

end insert

begin insert Section 1747.1 is added to the end insert begin insert Health and Safety Code end insert begin insert ,
to read: end insert

begin insert

begin insert 1747.1. end insert   

A home health agency licensed pursuant to Section
1726 is exempt from the requirement to obtain a license pursuant
to Section 1747 if the hospice program is certified in accordance
with federal Medicare hospice conditions of participation. A home
health agency may provide hospice care if the agency is in the
process of obtaining that certification. The hospice certification
process shall commence no later than the commencement of the
process for recertification as a home health agency, unless the
home health agency is otherwise exempt from the hospice
certification process.

end insert

begin insert

begin insert SEC. 5. end insert   

end insert

begin insert Section 1748 of the end insert begin insert Health and Safety Code end insert begin insert is amended
to read: end insert

1748.  

(a)  Except as otherwise provided in subdivision begin delete (b) end delete begin insert (a),
(b), end insert or (d) of Section 1747, begin delete no end delete begin insert a end insert person, political subdivision of
the state, or other governmental agency shall begin insert not end insert establish, conduct,
maintain, or represent itself as a hospice unless a license has been
issued under this chapter. Multiple locations need not obtain a
separate license. Multiple locations shall be listed on the license
of the parent agency and each shall pay a licensing fee in the
amount prescribed by subdivision (a) of Section 1750.

(b)  Any person, political subdivision of the state, or other
governmental agency desiring a license to establish a hospice shall
file with the state department a verified application on a form
prescribed and furnished by the state department which contains
any information as may be required by the state department for
the proper administration and enforcement of this chapter.

(c)  Any hospice that is not required to obtain a license under
this chapter shall disclose in all advertisements and information
provided to the public all of the following information:

(1)  It is not required to be licensed and is not regulated by the
state department.

(2)  Any complaint against the hospice should be directed to
the local district attorney and the state department.

(3)  Any complaint against personnel licensed by a board or
committee within the Department of Consumer Affairs and
employed by the hospice should be directed to the respective board
or committee. Any complaint against a certified home health aide
or certified nurse assistant shall be directed to the state department.

The address and phone number of any state agency, board, or
committee which is responsible for addressing complaints shall
be provided by the hospice, upon request, to any patient of the
hospice.

begin delete

SECTION 1.  

Section 1596.65 of the Health and Safety Code
is amended to read:

1596.65.  

(a)  An employment agency, as defined in Section
1812.501 of the Civil Code, that refers a child care provider to
parents or guardians who are not required to be a licensed child
day care facility shall not make a placement of a child care provider
who is not a trustline applicant or a registered child care provider.

(b)  A violation of this section is a misdemeanor and shall be
punishable by a fine of one hundred dollars ($100).

end delete