BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 667
                                                                  Page  1

          Date of Hearing:   May 4, 2011

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Felipe Fuentes, Chair

                   AB 667 (Mitchell) - As Amended:  April 11, 2011 

          Policy Committee:                              HealthVote:18-0

          Urgency:     No                   State Mandated Local Program: 
          No     Reimbursable:              No

           SUMMARY  

          This bill establishes medical necessity criteria for admission 
          of a child enrolled in Medi-Cal to a pediatric subacute care 
          facility, and provides that the medical necessity definition is 
          intended solely to apply to patients potentially eligible to be 
          transferred from acute level of care to subacute level of care.

           FISCAL EFFECT  

          Potential state cost savings of up to $9 million ($4.5 million 
          General Fund) to the extent additional children are transferred 
          from an acute level of care to a subacute level of care.  

           COMMENTS  

           1)Rationale  . According to the author this bill is needed to 
            update the criteria used to evaluate and authorize admission 
            into Medi-Cal pediatric subacute facilities. The author 
            asserts that current regulations are outdated, and that 
            children whose needs could be adequately provided for in a 
            pediatric subacute facility are often not transferred to this 
            setting because they do not meet the criteria specified in 
            regulations.  The children therefore remain in an acute care 
            hospital at a substantially higher cost to Medi-Cal.  

           2)Pediatric Subacute Care  . California has ten pediatric subacute 
            care hospitals providing health care services to approximately 
            400 children under the age of 21 who require medical 
            technology due to loss of vital bodily function.  Subacute 
            care facilities serve patients with complex medical care 
            needs, often due to a catastrophic illness or injury, 
            providing a level of medical care between that provided at an 








                                                                  AB 667
                                                                 Page  2

            acute care hospital and a skilled nursing facility.  According 
            to the Department of Health Care Services, pediatric subacute 
            care provides a cost savings of $500-$700 per day over an 
            acute care setting.


           Analysis Prepared by  :    Lisa Murawski / APPR. / (916) 319-2081