BILL NUMBER: AB 1710 CHAPTERED
BILL TEXT
CHAPTER 672
FILED WITH SECRETARY OF STATE SEPTEMBER 27, 2012
APPROVED BY GOVERNOR SEPTEMBER 27, 2012
PASSED THE SENATE AUGUST 20, 2012
PASSED THE ASSEMBLY AUGUST 24, 2012
AMENDED IN SENATE AUGUST 13, 2012
AMENDED IN ASSEMBLY APRIL 26, 2012
AMENDED IN ASSEMBLY APRIL 10, 2012
INTRODUCED BY Assembly Member Yamada
FEBRUARY 15, 2012
An act to amend Sections 1266, 1416.36, 1416.38, and 1416.70 of
the Health and Safety Code, relating to health and care facilities.
LEGISLATIVE COUNSEL'S DIGEST
AB 1710, Yamada. Nursing home administrators: fees and fines.
Existing law, the Nursing Home Administrators' Act, provides for
the licensing of nursing home administrators by the State Department
of Public Health. Existing law prescribes specified licensing fees,
and requires that the fees be adjusted annually, as directed by the
Legislature in the annual Budget Act, by an amount not to exceed the
California Consumer Price Index, as specified. Existing law provides
for the issuance of citations and administrative fines for the
violation of any state or federal statute or regulation governing
licensed nursing home administrators. Existing law requires that
these fees and associated fines be deposited in the Nursing Home
Administrator's State License Examining Fund, a continuously
appropriated fund.
This bill would eliminate the Nursing Home Administrator's State
License Examining Fund and instead require that these fees and fines
be deposited into the State Department of Public Health Licensing and
Certification Program Fund. This bill would authorize the department
to adjust the fees, and would remove the adjustment limitation
relating to the California Consumer Price Index.
This bill would require the department, by February 1 of each
year, to prepare a list of proposed fee adjustments and a specified
report relating to nursing home administrator fees, fee adjustments,
and nursing home administration generally. The bill would require the
department to submit this list and report to the appropriate policy
and fiscal committees of the Legislature and to post this report on
its Internet Web site.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. It is the intent of the Legislature that activities of
the Nursing Home Administrator Program related to licensure of
nursing home administrators be supported by fee revenue that is
sufficient to fund these activities.
SEC. 2. Section 1266 of the Health and Safety Code is amended to
read:
1266. (a) The Licensing and Certification Division shall be
supported entirely by federal funds and special funds by no earlier
than the beginning of the 2009-10 fiscal year unless otherwise
specified in statute, or unless funds are specifically appropriated
from the General Fund in the annual Budget Act or other enacted
legislation. For the 2007-08 fiscal year, General Fund support shall
be provided to offset licensing and certification fees in an amount
of not less than two million seven hundred eighty-two thousand
dollars ($2,782,000).
(b) (1) The Licensing and Certification Program fees for the
2006-07 fiscal year shall be as follows:
Type of Facility Fee
General Acute Care Hospitals $ 134.10 per bed
Acute Psychiatric Hospitals $ 134.10 per bed
Special Hospitals $ 134.10 per bed
Chemical Dependency Recovery
Hospitals $ 123.52 per bed
Skilled Nursing Facilities $ 202.96 per bed
Intermediate Care Facilities $ 202.96 per bed
Intermediate Care Facilities
- Developmentally Disabled $ 592.29 per bed
Intermediate Care Facilities
- Developmentally Disabled - per
Habilitative $1,000.00 facility
Intermediate Care Facilities
- Developmentally Disabled - per
Nursing $1,000.00 facility
Home Health Agencies per
$2,700.00 facility
Referral Agencies per
$5,537.71 facility
Adult Day Health Centers per
$4,650.02 facility
Congregate Living Health
Facilities $ 202.96 per bed
Psychology Clinics per
$ 600.00 facility
Primary Clinics - Community per
and Free $ 600.00 facility
Specialty Clinics - Rehab
Clinics per
(For profit) $2,974.43 facility
(Nonprofit) per
$ 500.00 facility
Specialty Clinics - Surgical per
and Chronic $1,500.00 facility
Dialysis Clinics per
$1,500.00 facility
Pediatric Day Health/Respite
Care $ 142.43 per bed
Alternative Birthing Centers per
$2,437.86 facility
Hospice per
$1,000.00 facility
Correctional Treatment Centers $ 590.39 per bed
(2) In the first year of licensure for intermediate care
facility/developmentally disabled-continuous nursing (ICF/DD-CN)
facilities, the licensure fee for those facilities shall be
equivalent to the licensure fee for intermediate care
facility/developmentally disabled-nursing facilities during the same
year. Thereafter, the licensure fee for ICF/DD-CN facilities shall be
established pursuant to subdivisions (c) and (d).
(c) Commencing February 1, 2007, and every February 1 thereafter,
the department shall publish a list of estimated fees pursuant to
this section. The calculation of estimated fees and the publication
of the report and list of estimated fees shall not be subject to the
rulemaking requirements of Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code.
(d) Notwithstanding Section 10231.5 of the Government Code, by
February 1 of each year, the department shall prepare the following
reports and shall make those reports, and the list of estimated fees
required to be published pursuant to subdivision (c), available to
the public by submitting them to the Legislature and posting them on
the department's Internet Web site:
(1) A report of all costs for activities of the Licensing and
Certification Program. At a minimum, this report shall include a
narrative of all baseline adjustments and their calculations, a
description of how each category of facility was calculated,
descriptions of assumptions used in any calculations, and shall
recommend Licensing and Certification Program fees in accordance with
the following:
(A) Projected workload and costs shall be grouped for each fee
category, including workload costs for facility categories that have
been established by statute and for which licensing regulations and
procedures are under development.
(B) Cost estimates, and the estimated fees, shall be based on the
appropriation amounts in the Governor's proposed budget for the next
fiscal year, with and without policy adjustments to the fee
methodology.
(C) The allocation of program, operational, and administrative
overhead, and indirect costs to fee categories shall be based on
generally accepted cost allocation methods. Significant items of
costs shall be directly charged to fee categories if the expenses can
be reasonably identified to the fee category that caused them.
Indirect and overhead costs shall be allocated to all fee categories
using a generally accepted cost allocation method.
(D) The amount of federal funds and General Fund moneys to be
received in the budget year shall be estimated and allocated to each
fee category based upon an appropriate metric.
(E) The fee for each category shall be determined by dividing the
aggregate state share of all costs for the Licensing and
Certification Program by the appropriate metric for the category of
licensure. Amounts actually received for new licensure applications,
including change of ownership applications, and late payment
penalties, pursuant to Section 1266.5, during each fiscal year shall
be calculated and 95 percent shall be applied to the appropriate fee
categories in determining Licensing and Certification Program fees
for the second fiscal year following receipt of those funds. The
remaining 5 percent shall be retained in the fund as a reserve until
appropriated.
(2) (A) A staffing and systems analysis to ensure efficient and
effective utilization of fees collected, proper allocation of
departmental resources to licensing and certification activities,
survey schedules, complaint investigations, enforcement and appeal
activities, data collection and dissemination, surveyor training, and
policy development.
(B) The analysis under this paragraph shall be made available to
interested persons and shall include all of the following:
(i) The number of surveyors and administrative support personnel
devoted to the licensing and certification of health care facilities.
(ii) The percentage of time devoted to licensing and certification
activities for the various types of health facilities.
(iii) The number of facilities receiving full surveys and the
frequency and number of follow up visits.
(iv) The number and timeliness of complaint investigations.
(v) Data on deficiencies and citations issued, and numbers of
citation review conferences and arbitration hearings.
(vi) Other applicable activities of the licensing and
certification division.
(3) The annual program fee report described in subdivision (d) of
Section 1416.36.
(e) The reports required pursuant to subdivision (d) shall be
submitted in compliance with Section 9795 of the Government Code.
(f) (1) The department shall adjust the list of estimated fees
published pursuant to subdivision (c) if the annual Budget Act or
other enacted legislation includes an appropriation that differs from
those proposed in the Governor's proposed budget for that fiscal
year.
(2) The department shall publish a final fee list, with an
explanation of any adjustment, by the issuance of an all facilities
letter, by posting the list on the department's Internet Web site,
and by including the final fee list as part of the licensing
application package, within 14 days of the enactment of the annual
Budget Act. The adjustment of fees and the publication of the final
fee list shall not be subject to the rulemaking requirements of
Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3
of Title 2 of the Government Code.
(g) (1) No fees shall be assessed or collected pursuant to this
section from any state department, authority, bureau, commission, or
officer, unless federal financial participation would become
available by doing so and an appropriation is included in the annual
Budget Act for that state department, authority, bureau, commission,
or officer for this purpose. No fees shall be assessed or collected
pursuant to this section from any clinic that is certified only by
the federal government and is exempt from licensure under Section
1206, unless federal financial participation would become available
by doing so.
(2) For the 2006-07 state fiscal year, no fee shall be assessed or
collected pursuant to this section from any general acute care
hospital owned by a health care district with 100 beds or less.
(h) The Licensing and Certification Program may change annual
license expiration renewal dates to provide for efficiencies in
operational processes or to provide for sufficient cash flow to pay
for expenditures. If an annual license expiration date is changed,
the renewal fee shall be prorated accordingly. Facilities shall be
provided with a 60-day notice of any change in their annual license
renewal date.
SEC. 3. Section 1416.36 of the Health and Safety Code is amended
to read:
1416.36. (a) The fees prescribed by this chapter are as follows:
(1) The application fee for reviewing an applicant's eligibility
to take the examination shall be twenty-five dollars ($25).
(2) The application fee for persons applying for reciprocity
consideration licensure under Section 1416.40 shall be fifty dollars
($50).
(3) The application fee for persons applying for the AIT Program
shall be one hundred dollars ($100).
(4) The examination fees shall be:
(A) Two hundred seventy-five dollars ($275) for an automated
national examination.
(B) Two hundred ten dollars ($210) for an automated state
examination or one hundred forty dollars ($140) for a written state
examination.
(5) The fee for an initial license shall be one hundred ninety
dollars ($190).
(6) The renewal fee for an active or inactive license shall be one
hundred ninety dollars ($190).
(7) The delinquency fee shall be fifty dollars ($50).
(8) The duplicate license fee shall be twenty-five dollars ($25).
(9) The fee for a provisional license shall be two hundred fifty
dollars ($250).
(10) The fee for endorsement of credentials to the licensing
authority of another state shall be twenty-five dollars ($25).
(11) The preceptor certification fee shall be fifty dollars ($50)
for each three-year period.
(12) The biennial fee for approval of a continuing education
provider shall be one hundred fifty dollars ($150).
(13) The biennial fee for approval of a continuing education
course shall be not more than fifteen dollars ($15).
(b) (1) If the revenue projected to be collected is less than the
projected costs for the budget year, the department may propose that
fees be adjusted to an amount sufficient to cover the reasonable
regulatory costs to the department. Notwithstanding Section 10231.5
of the Government Code, commencing February 1, 2013, and every
February 1 thereafter, the department shall publish a list of
proposed adjustments to fees pursuant to this section. The department
shall make this list available to the public by submitting it to the
appropriate policy and fiscal committees of the Legislature and by
posting it on the department's Internet Web site.
(2) The list described in paragraph (1) shall be submitted in
compliance with Section 9795 of the Government Code.
(c) (1) The department shall, within 30 days of the enactment of
the annual Budget Act each year, publish a list of actual numerical
fee charges as adjusted pursuant to this section. The final fee list,
with an explanation of any adjustment, shall be published by both of
the following means:
(A) On the department's Internet Web site.
(B) In the initial licensing application package, by including a
reference to the link to the department's Internet Web site address
as described in subparagraph (A).
(2) (A) This adjustment of fees and the publication of the fee
list shall not be subject to the requirements of Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 3 of Title 2 of
the Government Code.
(d) (1) Notwithstanding Section 10231.5 of the Government Code, by
February 1 of each year, the department shall prepare a report
containing the following information, and shall make this report
available to the public by submitting it to the appropriate policy
and fiscal committees of the Legislature and by posting it on the
department's Internet Web site, as required by Section 1266:
(A) Estimates of costs to implement activities required by this
chapter and estimated fee revenue.
(B) Recommended adjustments to fees based on projected workload
and costs.
(C) An analysis containing the following information for the
current fiscal year and each of the previous four fiscal years:
(i) The number of persons applying for a nursing home
administrator's license, the number of nursing home administrator
licenses approved or denied, and the number of nursing home
administrator licenses renewed.
(ii) The number of applicants taking the nursing home
administrator exam and the number of applicants who pass or fail the
exam.
(iii) The number of persons applying for, accepted into, and
completing the AIT Program.
(iv) The number, source, and disposition of complaints made
against persons in the AIT Program and licensed nursing home
administrators, including the length of time between receipt of the
complaint and completion of the investigation.
(v) The number and type of final administrative, remedial, or
disciplinary actions taken against licensed nursing home
administrators.
(vi) A listing of the names and nature of violations for
individual licensed nursing home administrators, including final
administrative, remedial, or disciplinary actions taken.
(vii) The number of appeals, informal conferences, or hearings
filed by nursing home administrators or held, the length of time
between the request being filed and the final determination of the
appeal, and the number of administrative, remedial, or disciplinary
actions taken.
(2) The report required to be submitted pursuant to paragraph (1)
shall be submitted in compliance with Section 9795 of the Government
Code.
SEC. 4. Section 1416.38 of the Health and Safety Code is amended
to read:
1416.38. Within 10 days after the beginning of every month, all
fees collected by the program for the month preceding, under this
chapter, shall be paid into the State Department of Public Health
Licensing and Certification Program Fund established by Section
1266.9, to defray the expenses of the program and in carrying out and
enforcing the provisions of this chapter.
SEC. 5. Section 1416.70 of the Health and Safety Code is amended
to read:
1416.70. (a) The program shall establish a system for the
issuance of citations to licensees, examinees, or participants of any
program activity offered or approved by the program. The citations
may contain an order of abatement, an order to pay an administrative
fine assessed by the program chief, or both, where the licensee,
examinee, or participant is in violation of any state or federal
statute or regulation governing licensed nursing home administrators.
(b) The system shall contain all of the following provisions:
(1) Citations shall be in writing and shall describe with
particularity the nature of the violation, including specific
reference to the provision of law determined to have been violated.
(2) Where appropriate, the citation shall contain an order of
abatement fixing reasonable time for abatement of the violation.
(3) (A) Administrative fines assessed by the program shall be
separate from and shall not preclude the levying of any other fines
or any civil or criminal penalty.
(B) In no event shall the administrative fine assessed by the
program be less than fifty dollars ($50) or exceed two thousand five
hundred dollars ($2,500) for each violation. The total assessment
shall not exceed ten thousand dollars ($10,000) for each
investigation or for counts involving fraudulent billings submitted
to insurance companies, Medi-Cal, or Medicare programs.
(4) In assessing a fine, the program shall give due consideration
to the appropriateness of the amount of the fine with respect to
factors such as the gravity of the violation, the good faith effort
of the licensee, examinee, or participant, the unprofessional
conduct, including, but not limited to, incompetence and negligence
in the performance of the duties and responsibilities of an
administrator, the extent to which the cited person has mitigated or
attempted to mitigate any damage or injury caused by his or her
violation, whether the violation was related to patient care, the
history of any previous violations, and other matters as may be
appropriate.
(5) A citation or fine assessment issued pursuant to a citation
shall inform the licensee, examinee, or participant that if he or she
desires a hearing to contest the finding of a violation, the hearing
shall be requested by written notice to the program within 30 days
after the date of issuance of the citation or assessment. A licensee
may, in lieu of contesting a citation pursuant to this section,
transmit to the state department 75 percent of the amount specified
in the citation for each violation within 15 business days after the
issuance of the citation.
(6) Failure of a licensee, examinee, or participant to pay a fine
within 30 days of the date of the assessment, unless the citation is
being appealed, may result in further disciplinary action being taken
by the program. Where a citation is not contested and a fine is not
paid, the full amount of the assessed fine, along with any accrued
penalty interest, shall be added to the fee for renewal of the
license. A license shall not be renewed without payment of the
renewal fee, fine, and accrued interest penalty. A citation may be
issued without the assessment of an administrative fine.
(c) Assessment of administrative fines may be limited to only
particular violations of the applicable licensing act.
Notwithstanding any other provisions of law, where a fine is paid to
satisfy an assessment based on the finding of a violation, payment of
the fine shall be represented as satisfactory resolution of the
matter for purposes of public disclosures. Administrative fines
collected pursuant to this section shall be deposited in the State
Department of Public Health Licensing and Certification Program Fund
established by Section 1266.9.