BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 535
                                                                  Page  1

          Date of Hearing:   January 21, 2010

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Kevin De Leon, Chair

                  AB 535 (Ammiano) - As Amended:   January 14, 2010

          Policy Committee:                              Health Vote:16-0
                       Aging & LTC                            5-0

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              

           SUMMARY  

          This bill requires 1,100 skilled nursing facilities (SNF)  
          statewide to increase reporting specificity of patient death  
          data to the Office of Statewide Health Planning and Development  
          (OSHPD) and increases the availability of death data to county  
          Elder Death Review Teams (EDRT) statewide. Specifically, this  
          bill: 

          1)Requires SNF to add specified discharge demographic data to  
            current law annual reporting to include at least:

             a)   Date of death
             b)   Time of death
             c)   Age at death
             d)   Gender of patient

          2)Requires OSHPD to compile and make the expanded SNF  
            facility-specific data set established in provision 1), above,  
            upon request to an EDRT. Requires the data to be available by  
            county and by facility. Authorizes OSHPD to include additional  
            census and utilization information including whether a SNF is  
            an Alzheimer's or hospice facility. 

          3)Authorizes the disclosure of electronic death data by local  
            registrars to EDRT.

           FISCAL EFFECT  

          1)One-time fee supported special fund costs to OSHPD in the  
            range of $300,000 to establish more detailed,  
            facility-specific and county-specific reporting to be  








                                                                  AB 535
                                                                  Page  2

            available upon request by EDRT. Unknown on-going fee-supported  
            special fund costs in the range of $50,000 to $100,000 for  
            OSHPD to maintain and release death data pursuant to  
            requirements of this bill. 

          2)The OSHPD workload includes modifying the Automated Licensing  
            Information and Report Tracking System (ALIRTS) and the Annual  
            Utilization Report of Long Term Care Facilities to make death  
            data available on a county-by-county basis as well as for  
            1,100 SNF. Under current law, only aggregate death statistics  
            are reported by SNF as a part of discharge status. Therefore  
            if, under current law, a SNF had 40 deaths in a year, rather  
            than the report displaying "40", this bill will require the  
            time, date, and age at death, as well as patient gender for  
            each of the 40 deaths. 


           COMMENTS  

           1)Rationale  . This bill is increases the availability and  
            specificity of data about deaths in nursing homes. Under  
            current law, SNF deaths are reported in aggregate to OSHPD as  
            a discharge status. Certain deaths are reported to law  
            enforcement or for other investigation. However, the kind of  
            information required in this bill is not currently available  
            to EDRT. The author and supporters of this bill hope that  
            increased data about SNF deaths will help identify patterns of  
            abuse, neglect, or poor health care quality. 

           2)Background  . California has 33 county-based EDRTs to assist  
            local agencies in identifying and reviewing suspicious elder  
            deaths and facilitating communication between agencies  
            investigating and prosecuting elder abuse and neglect cases.  
            Under current law, when a patient dies in a SNF, a physician  
            or physician's assistant completes a death certificate. An  
            unusual occurrence of a death in a SNF, including unusual  
            deaths, must be reported to the California Department of  
            Public Health (DPH) for possible investigation.  Each facility  
            reports its annual utilization data to OSHPD.  The data  
            includes general licensee information, patient census,  
            demographics, and discharge data, including discharges due to  
            death.

           









                                                                 AB 535
                                                                  Page  3

          Analysis Prepared by  :    Mary Ader / APPR. / (916) 319-2081