BILL ANALYSIS                                                                                                                                                                                                    �



                                                                AB 641
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        CONCURRENCE IN SENATE AMENDMENTS
        AB 641 (Feuer)
        As Amended August 23, 2011
        Majority vote
         
         
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        |ASSEMBLY: |52-24|(May 23, 2011)  |SENATE: |24-14|(September 7, 2011)  |
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        |COMMITTEE VOTE:  |11-4 |(September 8, 2011) |RECOMMENDATION: |Concur    |
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        Original Committee Reference:    HEALTH  

         SUMMARY  :  Eliminates the citation review conference (CRC) process 
        from the citation appeals process for long-term care (LTC) 
        facilities, and allows fines to be levied from both state and 
        federal agencies when an incident violates both state and federal 
        laws.  Requires the Department of Health Care Services (DHCS) to 
        consider, at the initial application or upon redetermination for 
        the Medi-Cal LTC benefit, whether an undue hardship exists for 
        eligibility for home and facility care under specified 
        circumstances relating to the transfer of assets. 

         The Senate amendments  :

        1)Require, in addition to existing undue hardship provisions, DHCS 
          to consider, at initial application or upon redetermination for 
          the Medi-Cal LTC benefit, whether an undue hardship exists prior 
          to finding a person ineligible for Medi-Cal.

        2)Provide that an undue hardship shall be found under the following 
          conditions:

           a)   The applicant has transferred ownership interest in the 
             shared principal residence to his or her same-sex spouse or 
             registered domestic partner;

           b)   The applicant has transferred ownership interest in assets 








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             other than the principal residence to his or her same-sex 
             spouse or registered domestic partner in an amount that does 
             not exceed the community spouse resource allowance that would 
             be available if the person was an opposite-sex spouse; or,

           c)   The applicant has transferred income or right to receive 
             income to his or her same-sex spouse or registered domestic 
             partner and the amount does not exceed the amount that would 
             be allowed if the person was an opposite-sex spouse. 

        3)Require DHCS to seek federal approval, including by state plan 
          amendment as needed, retroactive to January 1, 2012, and provide 
          that the provisions of 1) and 2) above are to be implemented only 
          to the extent federal approval and federal financial 
          participation is available and authorizes implementation by 
          all-county letter without the requirement of adopting 
          regulations.

        4)Delete the provisions that increase increases the maximum penalty 
          amount for class "B" citations for LTC facilities from $1,000 to 
          $2,000.

        5)Make other technical and clarifying changes. 

         AS PASSED BY THE ASSEMBLY  , this bill streamlined the citation 
        appeals process for LTC by facilities by eliminating the CRC, 
        increased the maximum fine for class "B" citations for LTC 
        facilities and allowed fines to be levied from both state and 
        federal agencies when an incident violates both state and federal 
        laws.  

         FISCAL EFFECT  :  According to the Senate Appropriations Committee:

                            Fiscal Impact (in thousands)
         Major Provisions         2011-12      2012-13       2013-14     Fund
         Reduction in CDPH      redirect $470 annually to other assignments 
        Special*
        workload

        Increase in penalty    potentially significant          Special**
        revenue

        Lost Medi-Cal          potentially significant, likely in 
        theGeneral/***
        share-of-cost revenue  high hundreds of thousands to    Federal








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                               millions of dollars

        * State Department of Public Health Licensing and Certification 
        Program Fund
        **State and Federal Health Facilities Citation Penalty Account
        ***50% federal, 50% General Fund 

         COMMENTS  :  According to the author, LTC facilities are unable to 
        resolve citations they feel are unwarranted and LTC facility 
        residents, who may have been violated, do not receive justice in a 
        timely manner due to the prolonged citation review conference (CRC) 
        appeals process which at times can take years.  The author 
        maintains that it makes sense to remove the CRC appeals process as 
        an available option to LTC facilities in favor of the more trusted 
        appeals processes in existing law, such as an administrative law 
        judge or a California Superior Court.

        AB 19 X1 (Blumenfield), Chapter 4, Statutes of 2011-12 First 
        Extraordinary Session, increased the upper limit of the penalty 
        range for Class B citations from $1,000 to $2,000 in conjunction 
        with the extension of the Medi-Cal Quality Assessment Fee on LTC 
        facilities.  This provision was therefore removed from this bill. 

        The author also argues that California is one of a few states that 
        bar a monetary penalty from both a state and federal agency when a 
        LTC facility action involves noncompliance with both a state and 
        federal law.  The author asserts that it makes sense to allow both 
        entities to act if the laws of either were violated.  By removing 
        this prohibition, this bill allows DPH to make a recommendation to 
        the federal Centers for Medicare and Medicaid Services (CMS) to 
        levy a monetary penalty.  According to the author, there are no 
        requirements in this bill that such levies should be done for each 
        and every citation and this bill provides DPH with the discretion 
        to cite a higher penalty for the most egregious violations.

        In June 10, 2011, CMS issued a State Medicaid Directors letter 
        regarding same sex partners and Medicaid liens, transfers of 
        assets, and estate recovery.  Specifically, the letter restated the 
        federal policy that states have considerable flexibility in 
        determining whether undue hardship exists and the circumstances 
        under which they will impose transfer of assets penalties.  The 
        letter further states that because of this flexibility, states may 
        adopt criteria that recognize that imposing transfer of assets 
        penalties on the basis of the transfer of ownership interest in a 
        shared home to a same-sex spouse or domestic partner would 








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        constitute an undue hardship.  This bill exercises this state 
        flexibility with regard to ownership in a shared home.  The author 
        has also included the transfer of assets other than interest in a 
        shared home and transfer of income in the definition of undue 
        hardship.  

        DHCS has advised the author that under current estate recovery 
        procedures, estate recovery is deferred for the lifetime of a 
        surviving registered domestic partner or same-sex spouse.  
        Therefore, the DHCS Estate Recovery program would not place a lien 
        on the home or take other actions to recover from the estate for 
        the lifetime of the registered domestic partner or same-sex spouse 
        similar to the exemption in state and federal law for opposite-sex 
        spouses.


         Analysis Prepared by  :    Marjorie Swartz / HEALTH / (916) 319-2097 

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