BILL ANALYSIS
AB 2645
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Date of Hearing: April 28, 2010
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
AB 2645 (Chesbro) - As Introduced: February 19, 2010
Policy Committee: Health Vote:18-0
Urgency: No State Mandated Local Program:
No Reimbursable:
SUMMARY
This bill applies a skilled nursing facilities (SNF, nursing
homes) rate freeze established by ABX4 5 Chapter 5, Statutes of
2009 to county-supported institutes of mental disease (IMD, a
type of psychiatric SNF). Under current law, IMD receive a
statutory 4.7% increase to their annual rates, per requirements
of AB 360, Chapter 508, Statutes of 2005.
FISCAL EFFECT
Annual county savings in the range of $3 million to $5 million
for the first year a rate freeze for IMD is in effect. The
accumulation of future county savings would depend on changes in
the SNF rate freeze statute. According to the California
Department of Public Health, which licenses IMD, there are 15
facilities statewide that would be subject to the rate adjust
proposed in this bill.
COMMENTS
1)Rationale . This bill is sponsored by the California Mental
Health Directors Association (CMHDA) to conform a rate freeze
established in last year's budget act for nursing homes and
applies the freeze to local psychiatric nursing facilities.
Action taken last year to freeze rates to SNF, for a savings
of $75 million GF, was not adopted for IMD, which are
county-funded. This bill provides some budgetary relief to
counties operating IMD.
2)Background . An institute of mental disease is a term used to
describe a type of skilled nursing facility that provides
24-hour care to residents with psychiatric issues. Federal law
AB 2645
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prohibits federal Medi-Cal funds from being used for the
treatment of individuals in these facilities. Due to this
federal funding prohibition and California county realignment
statutes, counties pay 100% of the cost of services provided
to patients in IMD. Current law requires counties to provide
a 4.7% increase to these rates each year. This bill prevents
the application of this automatic rate increase.
Analysis Prepared by : Mary Ader / APPR. / (916) 319-2081