BILL ANALYSIS �
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|SENATE RULES COMMITTEE | AB 272|
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THIRD READING
Bill No: AB 272
Author: Monning (D)
Amended: 1/25/12 in Senate
Vote: 27 - Urgency
SENATE HEALTH COMMITTEE : 5-0, 1/11/12
AYES: Hernandez, Alquist, De Le�n, DeSaulnier, Wolk
NO VOTE RECORDED: Strickland, Anderson, Blakeslee, Rubio
SENATE APPROPRIATIONS COMMITTEE : 6-2, 1/19/12
AYES: Kehoe, Alquist, Lieu, Pavley, Price, Steinberg
NOES: Walters, Emmerson
NO VOTE RECORDED: Runner
ASSEMBLY FLOOR : Not relevant
SUBJECT : Health care facilities: financing
SOURCE : California State Treasurer Bill Lockyer
DIGEST : This bill permits the California Health
Facilities Financing Authority to award one or more grants,
as specified, to one or more projects designed to
demonstrate specified new or cost-effective methods of
delivering health care services to improve access to
quality health care for vulnerable populations or
communities that are effective at enhancing health
outcomes, and improving access to quality health care.
ANALYSIS :
CONTINUED
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Existing law :
1.Establishes California Health Facilities Financing
Authority (CHFFA), consisting of nine members, including
the State Treasurer who serves as chairman, through the
CHFFA Act.
2.Permits CHFFA to make loans from the continuously
appropriated CHFFA Fund to public or nonprofit health
institutions for financing or refinancing the
acquisition, construction, or remodeling of health
facilities.
3.Requires, for the purposes of CHFFA's loans, a nonprofit
health institution to include, but not be limited to: a
general acute care hospital; an acute psychiatric
hospital; a skilled nursing facility (SNF); an
intermediate care facility; a special health care
facility that provides medical, nursing, rehabilitation,
dental, or maternity services; a clinic; an adult day
health center; a county-operated health facility; a
residential facility for the elderly that is operated as
a part of, or in conjunction with, an intermediate care
facility, a SNF, or a general acute care hospital; a
child day care facility operated in conjunction with a
health facility; an intermediate care
facility/developmentally disabled habilitative, that is a
health facility; a community care facility; an accredited
community work-activity program; a community mental
health center; a speech and hearing center; or a blood
bank.
This bill:
1. Permits CHFFA, after a competitive selection process,
to award one or more grants that, in the aggregate, do
not exceed $1.5 million to one or more projects designed
to demonstrate new or cost-effective methods of
delivering health care services to improve access to
quality health care for vulnerable populations or
communities that are effective at enhancing health
outcomes, and improving access to quality health care.
Exempts the competitive selection process from
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competitive bidding requirements under existing law, as
specified.
2. Permits the services to include, but not be limited to,
medical, mental health, or dental services for the
diagnosis, care, prevention, and treatment of human
illness, or individuals with physical, mental, or
developmental disabilities.
3. Permits more than one demonstration project to receive
a grant. States legislative intent that grantees allow
patients to receive screenings, diagnoses, or treatments
in community settings, including, but not limited to,
school-based health centers, adult day health centers,
and residential care facilities for the elderly, or for
individuals with mental illness or developmental
disabilities.
4. Permits grants to a demonstration project to be
allocated in increments over multiple years to ensure
the demonstration project's ability to complete its
work, as determined by CHFFA.
5. Requires the demonstration project administrators,
prior to the initial allocation of funds, to provide
evidence that the project has or will have additional
funds sufficient to ensure completion of the project.
6. Requires, if CHFFA allocates a grant in increments,
that each subsequent year's allocation be provided to
the project only upon submission of research that shows
that the project is progressing towards the
identification of a cost-effective delivery model that
improves health outcomes and access to quality care for
vulnerable populations or communities, and can be
replicated throughout the state in community settings.
7. Prohibits a health facility, except for one that
qualifies as a "small and rural hospital", that has
received tax-exempt bond financing from CHFFA from being
eligible to receive funds for a demonstration project,
but permits it to participate as an uncompensated
partner or member of a collaborative effort that is
awarded a demonstration project grant.
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8. States that funds provided to a demonstration project
pursuant to this subdivision may be used to supplement,
but not to supplant, existing financial and resource
commitments of the grantee or grantees or any other
member of a collaborative effort that has been awarded a
demonstration project grant.
9. Requires CHFFA, to provide a report to the Legislature
and the Governor, by January 1, 2014, the outcomes of
the demonstration project, as specified.
10.Creates the California Health Access Model Program
Account (Account) in the CHFFA Fund and continuously
appropriates the moneys in the Account to CHFFA for
carrying out the purposes of this bill. Transfers an
amount of up $1.5 million from funds in the CHFFA Fund
that are not impressed with a trust for other purposes
into the Account for the purpose of issuing grants
pursuant to this bill. Reverts any monies remaining in
the Account on January 1, 2015, to the CHFFA Fund.
11.States that any recipient of a grant provide pursuant
to subdivision (b) shall adhere to all applicable laws
relating to scope of practice, licensure, staffing and
building codes.
FISCAL EFFECT : Appropriation: Yes Fiscal Com.: Yes
Local: No
Fiscal Impact (in thousands)
Major Provisions 2011-12 2012-13
2013-14 Fund
Fund transfer $1,500 Special*
CHFFA grant admin. absorbable
costs for demonstration Special*
Program.
* CHFFA Fund
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SUPPORT : (Verified 1/25/12)
California State Treasurer Bill Lockyer (source)
American Federation of State, County and Municipal
Employees
Association of California Healthcare Districts
California Hospital Association
OPPOSITION : (Verified 1/25/12)
California Nurses Association
ARGUMENTS IN SUPPORT : California State Treasurer Bill
Lockyer, the sponsor of this bill, writes that this bill
will authorize CHFFA to use money from its fund balance to
fast-track and spur innovative new grant programs which
target the state's burgeoning health care needs. The
Treasurer writes that California's health care and medical
services systems have undergone devastating reductions,
leaving its most vulnerable and underserved populations
without the proper access to health care needed to survive
and thrive. In light of this, the Treasurer contends that
it is important, and within CHFFA's mission, to utilize
available funds to immediately spur innovative and
cost-effective health care services approaches, even when
the available funds are relatively modest. The Treasurer
states that this bill would do just that by allowing
existing monies in the CHFFA fund balance to support the
creation of new models for health care delivery to
California's most vulnerable populations and communities.
The California Hospital Association writes that using these
monies to spark innovative and cost-effective models for
delivering health care for underserved and vulnerable
populations presents the opportunity to greatly impact
millions of people who have been hit the hardest by
decreases in health care services.
ARGUMENTS IN OPPOSITION : The California Nurses
Association opposes this bill and writes, "The bill
eliminates from the competitive process health facilities
that have receive tax-exempt bond financing from CHFFA but
allows them to participate as uncompensated partners or as
members of a collaborative effort that is awarded a
demonstration projects. Allowing health facilities that
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have received tax-exempt bonds to participate in any way
potentially undermines community health projects. Their
participation may be used by the non-profit healthcare
industry to pad their already overinflated community
benefit numbers and any supplant existing community
undertakings. We believe that health facilities that have
received tax-exempt bond financing should be entirely
excluded from these demonstration projects."
CTW:do 1/25/12 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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