BILL ANALYSIS                                                                                                                                                                                                    






                                 SENATE HEALTH
                               COMMITTEE ANALYSIS
                        Senator Elaine K. Alquist, Chair


          BILL NO:       SB 221                                       
          S
          AUTHOR:        Walters                                      
          B
          AMENDED:       As Introduced                               
          HEARING DATE:  April 1, 2009                                
          2
          CONSULTANT:                                                 
          2
          Green/                                                      
          1
                                        
                                         
                                    SUBJECT
                                         
                             Home dialysis agencies

                                     SUMMARY  

          Repeals existing law which provides for the licensure and  
          regulation of home dialysis agencies.

                             CHANGES TO EXISTING LAW  

          Existing law:
          Existing law establishes "home dialysis agencies," which  
          are defined as specified entities that engage in providing  
          home dialysis services and other therapeutic services to  
          patients in their homes.  Existing law defines "home  
          dialysis services" as the treatment and care given to  
          patients of a home dialysis agency which are administered  
          by a physician, qualified registered or licensed nurse, or  
          qualified hemodialysis technician pursuant to a patient's  
          care plan.  

          Existing law requires home dialysis agencies to be licensed  
          by the Department of Public Health (DPH), and sets forth  
          various requirements a home dialysis agency must meet in  
          order to qualify for licensure, having specified policies  
          relating to patient care, personnel training and  
          qualifications, and recordkeeping.  Home dialysis agencies  
                                                         Continued---



          STAFF ANALYSIS OF SENATE BILL  SB 221 (Walters)Page 2


          

          are required to provide specified services, including  
          nursing, nutritional counseling, medical, and social  
          services, perform assessments of a patient's home to ensure  
          a safe physical environment for the performance of  
          dialysis, and meet specified requirements relating to  
          dialysis equipment, supplies, and waste disposal.
          
          This bill:
          This bill would repeal existing statute which provides for  
          the licensing and regulation of home dialysis agencies, and  
          make findings and declarations that the statute has created  
          confusion and misunderstandings with respect to dialysis  
          services provided in skilled nursing facilities (SNFs).



                                  FISCAL IMPACT  

          Unknown.

                            BACKGROUND AND DISCUSSION  

          According to the author, when the home dialysis services  
          statutes were enacted in 1990, there was a company known as  
          Home Intensive Care which was providing products and  
          supplies to home dialysis patients and billing Medicare for  
          their services under a billing approach known as "Method 2  
          billing."  The author states that the statutes establishing  
          home dialysis agencies was enacted so that Home Intensive  
          Care could obtain a license as such an agency, in order to  
          quality for this billing method.  However, the author  
          states that prior to Home Intensive Care's licensure as a  
          home dialysis agency, the billing method was eliminated by  
          Medicare, and subsequently, Home Intensive Care went out of  
          business. Since the change by Medicare, the author states  
          that no other business has sought licensure as a home  
          dialysis agency.

          The author asserts that the existence of home dialysis  
          agency laws has created confusion and misunderstandings  
          with respect to dialysis services provided in skilled  
          nursing facilities, as these laws were intended to apply to  
          home dialysis, where a patient has his or her own dialysis  
          machine and dialyzes at home. The author states that the  
          only company that supported this type of treatment went out  
          of business before this law could be implemented, and thus,  




          STAFF ANALYSIS OF SENATE BILL  SB 221 (Walters)Page 3


          

          the law should be repealed.

          Home dialysis agencies
          The home dialysis agency model set forth by existing law is  
          one where a patient would receive staff-assisted dialysis  
          treatment in his or her own home.  The home dialysis agency  
          law defines a "home" as a house, apartment, skilled nursing  
          facility (SNF), intermediate care facility, congregate  
          living facility, or other setting where dialysis is  
          provided by at least one staff person per patient.

          According to DPH, although existing statute allows for  
          licensure of home dialysis agencies, it has never been  
          implemented, and no provider has been licensed as a home  
          dialysis agency.

          Dialysis services in SNFs
          In June 2007, the then Department of Health Services, now  
          referred to as DPH, issued an All Facilities Letter (AFL)  
          stating that the provision of dialysis services in a  
          long-term care setting, including SNFs, was not authorized.  
           The department interpreted the home dialysis agency  
          statutes as applicable to SNF dialysis providers; since no  
          provider was licensed as a home dialysis agency, the  
          department ordered the delivery of dialysis services in  
          SNFs to cease.

          In August 2007, DPH issued a subsequent All Facilities  
          Letter which superseded and clarified the letter issued two  
          months prior.  In this letter, DPH stated that, upon  
          further review, it had determined that dialysis services  
          may be provided in SNFs under existing regulations, which  
          allow for the provision of dialysis as an optional service.  
           DPH clarified that SNFs must meet specified federal  
          certification standards, and be authorized by DPH to  
          provide the dialysis services, and that the services must  
          be added to the facility's license.  The letter provided  
          that these dialysis services may only be provided to  
          residents of the facility, and not to the general public,  
          and further provided that if the SNF does not employ  
          qualified persons to provide dialysis services, it may  
          contract with an outside service that meets all applicable  
          standards for providing dialysis services.  SNFs are  
          required to have written policies and procedures for the  
          management of dialysis services.





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          Other dialysis provider types
          Patients may also receive dialysis services in an acute  
          care hospital, end-stage renal disease (ESRD) clinic, or  
          chronic dialysis clinic.  There are approximately 400  
          licensed and certified chronic dialysis clinics in  
          California which serve over 50,000 dialysis patients.   
          These clinics are generally licensed as freestanding  
          clinics.  

          Additionally, ESRD and chronic dialysis clinics, with  
          certification from DPH, may provide products, supplies,  
          training, and support to patients who wish to perform  
          dialysis treatments on their own at home.  These services  
          provided to patients who wish to dialyze at home must be at  
          least equivalent to those provided in the clinics, meet  
          most of the same quality and safety standards, as well as  
          standards for home patient training, monitoring, and  
          support services.    

          Arguments in support
          The California Dialysis Council (CDC) states that no entity  
          has ever requested licensure under the home dialysis agency  
          law, and that the existing of the law has created confusion  
          among certain dialysis providers.  The CDC states that this  
          bill will help avoid such confusion by repealing the home  
          dialysis agency law. 
          
          The California Association of Health Facilities states that  
          the home dialysis statute has caused confusion among health  
          care providers as to whether or not the provision of  
          dialysis services in SNFs is permitted.  CAHF explains that  
          in 2007, this confusion resulted in a small group of  
          providers meeting with DPH to ask for clarification on the  
          law.  CAHF states that the meeting prompted DPH's June 2007  
          AFL disallowing dialysis services in SNFs, which as later  
          retracted and replaced by the August 2007 AFL clarifying  
          that dialysis services may be provided in SNFs as an  
          optional service.  CAHF states that this statute is  
          out-dated, and has never been applied, and that by  
          repealing the statute, facilities will have clear authority  
          to provide dialysis services to patients who are often so  
          ill, that they cannot be safely transported between a  
          dialysis clinic and their facility of residence.  

                                    POSITIONS  





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          Support:  California Dialysis Council (sponsor)
                    California Association of Health Facilities

          Oppose:   None received


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