BILL ANALYSIS
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|SENATE RULES COMMITTEE | SB 117|
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THIRD READING
Bill No: SB 117
Author: Corbett (D), et al
Amended: 6/1/09
Vote: 21
SENATE HEALTH COMMITTEE : 10-1, 4/1/09
AYES: Alquist, Strickland, Cedillo, Cox, DeSaulnier, Leno,
Maldonado, Negrete McLeod, Pavley, Wolk
NOES: Aanestad
SENATE APPROPRIATIONS COMMITTEE : 10-1, 5/28/09
AYES: Kehoe, Cox, Corbett, Denham, DeSaulnier, Hancock,
Leno, Oropeza, Wyland, Yee
NOES: Walters
NO VOTE RECORDED: Runner, Wolk
SUBJECT : Adult day health care services
SOURCE : California Association for Adult Day Services
DIGEST : This bill extends the deadline by which the
Department of Health Care Services is required to establish
a new Medi-Cal rate reimbursement methodology for adult day
health care services, from August 1, 2010 to August 1,
2011.
ANALYSIS :
Existing law:
CONTINUED
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1. Defines adult day health care services (ADHC) as an
organized day program of therapeutic, social, and health
activities and services provided to elderly persons with
either physical or mental impairments, for the purpose
of restoring an individual's ability to provide
self-care, maintain independence, and avoid
institutionalization in a long-term health care
facility. ADHC is provided at ADHC centers, which are
licensed by the Department of Public Health (DPH), and
certified for the Medi-Cal program by the California
Department of Aging (CDA).
2. Establishes the Medi-Cal program administered by DHCS,
to provide comprehensive health care coverage to certain
categories of low-income eligible individuals and
families, including children, the aged, the blind, the
disabled, nursing home residents, refugees, and pregnant
women. ADHC centers may qualify for Medi-Cal
reimbursement for specified services provided to certain
persons who are eligible for Medi-Cal
3. Requires DHCS, by August 1, 2010, and in consultation
with specified stakeholders, to establish a Medi-Cal
reimbursement methodology for ADHC services that is
based on the cost of services provided to an ADHC
client.
4. Sets forth various timeframes associated with the
establishment and implementation of the new
reimbursement system, including timeframes for DHCS to
establish new ADHC cost reports, train ADHC providers on
the new methodology, and adopt regulations to implement
the new methodology.
This bill extends the timeframe by which DHCS must
establish the new Medi-Cal reimbursement methodology from
August 1, 2010 to August 1, 2011, and makes conforming
changes to other timeframes associated with the
establishment and implementation of the reimbursement
methodology.
Background
ADHC is a licensed community-based day care program
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providing a variety of health, therapeutic, and social
services to those at risk of being placed in a nursing
home. Each ADHC center has a multidisciplinary team of
health professionals who conduct a comprehensive assessment
of each participant in order to determine and plan the ADHC
services needed to meet an individual's specific health and
social needs, pursuant to an individual plan of care.
ADHC centers must provide a set of "core services" to each
participant which includes professional nursing services,
personal care and/or social services, therapeutic
activities, and at least one meal per day. In addition to
core services, ADHC centers often provide other specialty
services such as physical therapy, occupational therapy,
speech and language pathology, dietetics, and mental health
services.
ADHC centers also must provide transportation for
participants to and from the center.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
According to the Senate Appropriations Committee:
Fiscal Impact (in thousands)
Major Provisions 2009-10 2010-11 2011-12
Fund
DHCS staffing costs $0$144 - $393 $287 - $785
General
for development of $144 - $393 $287 - $78
Federal
methodology
Up to 3 Years higherunknown, but in the tens of millions
General
reimbursement due of dollars Federal
to delayed savings
SUPPORT : (Verified 5/29/09)
California Association for Adult Day Services (source)
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Aging Services of California
American Federation of State, County, and Municipal
Employees
California Association of Health Facilities
Commonwealth Adult Day Health Care
Graceful Senescence Adult Day Health Care, Inc.
Hope Adult Day Care Center
SunnyDay Adult Health Care
Yolo Adult Day Health Center
ARGUMENTS IN SUPPORT : The California Association of
Health Facilities (CAHF) states that the development of the
new reimbursement system has been complex and relies on the
collection of valid data. CAHF states that it is critical
that reliable and comparable data be collected from all
ADHCs in order to calculate new reimbursement rates, which
is why the revised implementation dates set forth in this
bill are necessary.
CTW:do 6/1/09 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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