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:

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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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