BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



           ------------------------------------------------------------ 
          |SENATE RULES COMMITTEE            |                  AB 1593|
          |Office of Senate Floor Analyses   |                         |
          |1020 N Street, Suite 524          |                         |
          |(916) 651-1520         Fax: (916) |                         |
          |327-4478                          |                         |
           ------------------------------------------------------------ 
           
                                         
                                 THIRD READING


          Bill No:  AB 1593
          Author:   Yamada (D) and Knight (R), et al
          Amended:  8/4/10 in Senate
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  8-0, 6/16/10
          AYES:  Alquist, Strickland, Aanestad, Cedillo, Leno,  
            Negrete McLeod, Pavley, Romero
          NO VOTE RECORDED:  Cox
           
          SENATE VETERANS AFFAIRS COMMITTEE  :  4-0, 6/22/10
          AYES:  Denham, Correa, Negrete McLeod, Cedillo
          NO VOTE RECORDED:  Wyland, Vacancy, Vacancy
           
          SENATE APPROPRIATIONS COMMITTEE  :  11-0, 8/12/10
          AYES:  Kehoe, Ashburn, Alquist, Corbett, Emmerson, Leno,  
            Price, Walters, Wolk, Wyland, Yee
           
          ASSEMBLY FLOOR  :  75-0, 6/2/10 - See last page for vote


           SUBJECT  :    Adult day health care centers

           SOURCE  :     California Association of Adult Day Services


           DIGEST  :    This bill creates an exemption to the exiting  
          Medi-Cal certification moratorium which will allow the  
          opening of two new, publicly-financed, adult day health  
          centers at the William J. "Pete" Knight Veterans Home and  
          the Veterans Home of California, Ventura, contingent on the  
          availability of funds appropriated in the annual Budget  
                                                           CONTINUED





                                                               AB 1593
                                                                Page  
          2

          Act.

           ANALYSIS  :    

          Existing law: 

          1. Establishes the California Adult Day Health Care (ADHC)  
             Act which requires licensure and regulation of ADHCs  
             with administrative responsibility shared between the  
             Department of Public Health (DPH), the Department of  
             Aging (CDA), and the Department of Health Care Services  
             (DHCS) pursuant to an interagency agreement. 

          2. Requires ADHCs to be licensed by DPH as health care  
             facilities and permits certification for Medi-Cal  
             payments by CDA. 

          3. Establishes DHCS as the principal agency to oversee  
             Medi-Cal policy, rates, audits, investigations,  
             eligibility, and utilization. 

          4. Authorizes DPH to implement one year moratoriums on  
             certification and enrollment in the Medi-Cal Program of  
             new adult day health care centers on a statewide or  
             regional basis with certain statutory exceptions.  These  
             exceptions include: 

             A.    Applicants for Programs of All-Inclusive Care for  
                the Elderly.

             B.    Applicants for organizations currently designated  
                as federally qualified health centers.

             C.    Applicants centrally located in counties with no  
                other certified ADHCs.

             D.    Applicants serving discharged nursing home  
                patients in San Francisco.

             E.    Applicants requesting expansion or relocation  
                within a county with a specified ratio of persons  
                over the age of 65 receiving Medi-Cal. 

             F.    Applicants currently licensed and located in a  







                                                               AB 1593
                                                                Page  
          3

                county whose population exceeds 9,000,000 serving a  
                specified population from a regional center. 

          This bill:

          1. Creates an exemption to the exiting Medi-Cal  
             certification moratorium which will allow the opening of  
             two new, publicly-financed, ADHCs at the William J.  
             "Pete" Knight Veterans Home and the Veterans Home of  
             California, Ventura.

          2. Clarifies, for purposes of the bill, that an  
             "underserved area" is a county having two percent or  
             fewer Medi-Cal beneficiaries over 65 years of age using  
             ADHC services, based on 2002 calendar year Medi-Cal  
             utilization data.

          3. States that construction is contingent on the  
             availability of funds appropriated in the annual Budget  
             Act.

           Background
           
          ADHC is an organized day program of therapeutic, social,  
          and health activities and services provided to elderly  
          persons with functional impairments, either physical or  
          mental, at risk of institutional placement.  The sponsor  
          notes that ADHCs employ a multidisciplinary team approach  
          providing multiple services under one roof.  These services  
          include skilled nursing care, physical therapy, social  
          services, meals, speech therapy, and socialization in order  
          to reduce the risk factors which could lead to placement  
          into more expensive care settings.  California offers ADHC  
          as an optional Medi-Cal benefit to reduce utilization of  
          nursing homes, emergency rooms, and hospitals.  According  
          to the bill's sponsor, the California Association of Adult  
          Day Services (CAADS) roughly 37,000 Medi-Cal beneficiaries  
          are now served by 321 ADHCs in this state. 

           ADHC Moratorium  .  The 2004-05 Health Budget Trailer Bill,  
          SB 1103 (Senate Budget and Fiscal Review Committee),  
          Chapter 228, Statutes of 2004, authorizes DHCS to impose a  
          12-month moratorium on the certification of new ADHCs after  
          August 2004.  DHCS has interpreted this authority to be  







                                                               AB 1593
                                                                Page  
          4

          renewable annually at the discretion of the Director.  This  
          authority has been exercised every year and has been  
          extended through fiscal year 2010-11.  The Health Budget  
          Trailer Bill of 2005 (AB 131 [Assembly Budget Committee],  
          Chapter 80, Statutes of 2005) added additional exceptions. 

          ADHCs were initially required to be nonprofit, charitable  
          facilities until 1994 when legislation (SB 1492 [Mello],  
          Chapter 1121, Statutes of 1994) authorized for-profit  
          companies to develop ADHCs.  Since 1994, the number of  
          centers has grown from 90 to approximately 322 stand-alone  
          operations and an estimated 37,000 monthly users. 

          According to DHCS, the moratorium was implemented to  
          capture the enrollment of ADHCs at that time and to limit  
          any increases in licensed capacity until ADHC reform was  
          accomplished.  The moratorium was established to be  
          moderate in nature, and allow for increases in capacity,  
          change of ownership and relocation.  It has exceptions for  
          new ADHCs in unserved areas and for increases in  
          underserved areas.  It was in response to the very rapid  
          growth in ADHCs.  For example, the growth rate jumped from  
          seven percent in 1997-98 to 25 percent in 1998-99, and  
          continued in the double digits until the moratorium. 

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No

          According to the Senate Appropriations Committee:

                         Fiscal Impact (in thousands)

           Major Provisions      2010-11     2011-12     2012-13      Fund  

          ADHC services       Annual costs of approximately  
          $200-$800           Federal
          reimbursed by Medi-Cal        commencing in the fiscal  
          year that the 
                              ADHC centers open; likely FY 2014-15

                              * Same amount in General Fund offsets

           * Medi-Cal costs would be shared 50 percent General Fund,  
            50 percent federal funds







                                                               AB 1593
                                                                Page  
          5


           SUPPORT  :   (Verified  8/16/10)

          California Association of Adult Day Services (source) 
          Aging Services of California 
          California Association of County Veterans Service Officers 
          National Association of Social Workers, California Chapter 

          OPPOSITION  :    (Verified  8/16/10)

          Department of Finance

           ARGUMENTS IN SUPPORT  :    This bill is sponsored by the  
          California Association for Adult Day Services (CAADS) to  
          create an exemption to the current ADHC moratorium on  
          Medi-Cal certification to permit two ADHCs operated by the  
          CDVA to become eligible for Medi-Cal reimbursement.  CAADS  
          argues the inability to certify the Department of Veterans  
          Affairs (DVA) ADHCs is an unintended consequence of the  
          ADHC moratorium.  The California Chapter of the National  
          Association of Social Workers writes that the ADHC  
          moratorium will force DVA to pay for ADHC services out of  
          its operating budget, which is a GF allocation.  If the  
          ADHC were able to receive Medi-Cal certification, federal  
          matching funds could be used to fund the ADHCs, which would  
          offset state costs.

           ARGUMENTS IN OPPOSITION  :    The Department of Finance (DOF)  
          writes in opposition that this bill is similar to AB 369  
          (Yamada), which was vetoed by the Governor.  DOF states the  
          concerns in the Governor's veto message were timing (the  
          facilities were not operational), competing demands for  
          available General Fund, and process (the budget process is  
          a more appropriate venue for this proposal to be considered  
          rather than legislation).  DOF states these concerns  
          remain, and states this bill expands ADHC, which is  
          contrary to the Governor's budget proposal to eliminate  
          ADHC as an optional Medi-Cal benefit in 2010-11.  
           

           ASSEMBLY FLOOR  : 
          AYES:  Adams, Ammiano, Anderson, Arambula, Bass, Beall,  
            Bill Berryhill, Blakeslee, Block, Blumenfield, Bradford,  
            Brownley, Buchanan, Caballero, Charles Calderon, Carter,  







                                                              AB 1593
                                                                Page  
          6

            Chesbro, Conway, Cook, Coto, Davis, De La Torre, De Leon,  
            DeVore, Emmerson, Eng, Evans, Feuer, Fletcher, Fong,  
            Fuentes, Fuller, Furutani, Gaines, Galgiani, Garrick,  
            Gilmore, Hagman, Hall, Harkey, Hayashi, Hernandez, Hill,  
            Huber, Huffman, Jeffries, Jones, Knight, Logue, Bonnie  
            Lowenthal, Ma, Mendoza, Miller, Monning, Nava, Nestande,  
            Niello, Nielsen, V. Manuel Perez, Portantino, Ruskin,  
            Salas, Saldana, Silva, Skinner, Smyth, Solorio, Swanson,  
            Torlakson, Torres, Torrico, Tran, Villines, Yamada, John  
            A. Perez
          NO VOTE RECORDED:  Tom Berryhill, Lieu, Norby, Audra  
            Strickland, Vacancy


          CTW:mw  8/17/10   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

                                ****  END  ****