BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 1489
                                                                  Page  1

          (  Without Reference to File  )

          CONCURRENCE IN SENATE AMENDMENTS
          AB 1489 (Budget Committee)
          As Amended  August 31, 2012
          2/3 vote.  Urgency 
           
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          |ASSEMBLY:  |     |(March 22,      |SENATE: |30-1 |(August 31,    |
          |           |     |2012)           |        |     |2012)          |
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                          (vote not relevant)
           
           Original Committee Reference:    BUDGET  

           SUMMARY :  Contains necessary statutory changes to achieve 
          savings assumed in the 2012 Budget Act related to the Department 
          of Health Care Services and the Department of Public Health.

           The Senate amendments  delete the Assembly version of this bill, 
          and instead:

          1)Extend the sunset on the skilled nursing facilities quality 
            assurance fee for two years, from July 31, 2013, to July 31, 
            2015, and makes various other changes to nursing facilities, 
            to achieve $87.8 million in General Fund (GF) savings in 
            2012-13, including:

             a)   Require that, for the 2012-13 rate year, savings from 
               capping the professional liability insurance cost category 
               shall remain in the GF and shall not be transferred to the 
               Skilled Nursing Facility Quality and Accountability Special 
               Fund.

             b)   Delay by one year the implementation of a 1% set aside 
               of the Medi-Cal reimbursement rate to nursing homes for 
               quality and accountability supplemental payments, and 
               clarify that the 1% set aside shall be implemented if there 
               is a rate increase and that the set aside shall be 1% of 
               the rate increase.  Require for the 2014-15 rate year, if a 
               rate increase is provided, there shall be a set aside of at 
               least one-third of the rate increase, up to a maximum of 
               1%, that shall be transferred into a special fund for 
               quality and accountability payments.









                                                                  AB 1489
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             c)   Eliminate any facility-specific Medi-Cal rate increase 
               for nursing facilities in the 2012-13 rate year.  
               Establishes that in 2013-14 and 2014-15, the annual 
               increase in the weighted average Medi-Cal reimbursement 
               rate, for skilled nursing facilities, shall be 3% for each 
               rate year, plus the projected cost of complying with new 
               state or federal mandates.  Allows for this increase to be 
               adjusted if the federal Centers for Medicare and Medicaid 
               Services does not approve of exemption changes to the 
               facilities or of any proposed modification to the 
               methodology for calculation of the quality assurance fee.

             d)   Authorize the Department of Health Care Services (DHCS) 
               to convene a stakeholder group to discuss and analyze 
               alternative mechanisms to implement the quality and 
               accountability payments provided to nursing homes for 
               reimbursement.  Requires the DHCS to submit a report to the 
               Legislature describing an alternative mechanism at least 90 
               days prior to any to any policy or budgetary changes, and 
               requires subsequent legislation to authorize such changes.

             e)   State findings and declarations of the Legislature 
               related to Section Q of the Minimum Data Set (federal 
               assessment) to ensure that all individuals have the 
               opportunity to learn about home and community-based 
               services and to receive long-term care services in the 
               least restrictive setting possible.  

             f)   Require nursing facilities to either meet the residents' 
               discharge planning and referral needs, or make referrals to 
               a designated local contact agency (LCA).  Requires LCAs to 
               either assist directly with transition services or make 
               referrals to organizations that assist with transition 
               services.  State the Legislature's intent that nursing 
               facilities appropriately refer to LCAs nursing home 
               residents who express interest in the possibility of 
               receiving care and services in the community.

             g)   Require the DHCS, in collaboration with the Department 
               of Public Health, by April 1, 2013, to provide the 
               Legislature with an analysis of the appropriate sections of 
               the Minimum Data Set, nursing facilities' referrals made to 
               LCAs, and LCA responses and outcomes of those referrals.

             h)   Require the DHCS and Public Health to convene a 








                                                                  AB 1489
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               stakeholder group to meet with regularly (at least 
               quarterly), to provide updates and receive input on the 
               planning, implementation, and progress of the nursing 
               facility quality improvement program.

          2)Declare this bill take effect immediately as an urgency 
            statute.

           AS PASSED BY THE ASSEMBLY  , this bill expressed the intent of the 
          Legislature to enact statutory changes relating to the Budget 
          Act of 2012.


           Analysis Prepared by  :   Andrea Margolis / BUDGET / (916) 
          319-2099


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