BILL ANALYSIS �
SB 135
Page 1
Date of Hearing: August 16, 2012
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Mike Gatto, Chair
SB 135 (Hern�ndez) - As Amended: August 7, 2012
Policy Committee: HealthVote:16-0
Urgency: No State Mandated Local Program:
Yes Reimbursable: No
SUMMARY
This bill establishes a new licensing category under the
jurisdiction of the California Department of Public Health (DPH)
Licensing and Certification Division (L&C) for hospice
facilities. Specifically, this bill:
1)Establishes hospice as a CDPH licensing category for
free-standing facilities, defines the services to be provided,
and describes building standards facilities must comply with.
2)Requires facilities to pay an initial-year fee of
approximately $300 per hospice facility bed, and requires the
fee thereafter to be set based on actual workload as specified
in current law for all health facilities.
3)Requires CDPH to promulgate regulations related to minimum
staffing, patient rights, disaster preparedness, compliance
with federal requirements, and any other qualifications and
requirements for licensure.
FISCAL EFFECT
1)One-time fee-supported special fund costs (Licensing and
Certification (L&C) Fund) of $500,000 over three years to DPH
to promulgate regulations and develop standards and protocols
for hospice facilities.
2)$200,000 (L&C Fund) in one-time fee-supported special fund
costs for Information Technology (IT) modifications to
accommodate a new licensure category.
3)Annual workload costs related to facility licensure will
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depend on the number of licenses issued by DPH, but will be
likely be at least $200,000 (L&C Fund).
4)Costs for OSHPD to review and develop hospice-specific
building standards should be minor and absorbable.
COMMENTS
1)Rationale . This bill is sponsored by the California Hospital
and Palliative Care Association, which represents hospice
programs statewide. Under current law, hospice programs are
licensed as service providers, but are not issued a facility
license. Free-standing hospice programs under current law are
licensed as a type of skilled nursing facility (SNF). The
author indicates current law licensure processes can be
cumbersome. This bill creates a new category of license to
streamline.
2)Hospice care focuses on controlling pain and other symptoms of
illness so patients can remain as comfortable as possible near
the end of life. To be eligible for hospice care, patients
typically need a physician to document that a patient is
within six months of passing away. Social and spiritual
support, as well as pain management, is provided to patients
and their families to relieve suffering at the end-of-life.
Hospice care is a covered benefit under Medi-Cal and Medicare.
Many private health insurance policies also cover hospice.
Hospice may be provided in a patient's home, a licensed and/or
certified SNF, an intermediate care facility, a general acute
care hospital, or a licensed residential care facility
licensed by the Department of Social Services. Some agencies
licensed as home health agencies are certified to provide
hospice services.
3)Focus on End-of-Life Care . This bill adds to a continued
effort in California to provide more support for individuals
and families facing end-of-life issues. Recent survey
research shows most Californians would prefer to die at home
than in a health facility, and that most want to die a natural
death rather than receive all possible care to prolong their
life. Less than 40% of dying Californians were served by
hospice in 2010, despite research indicating that hospice
patients have better symptom control and a better quality of
life. Better education about hospice and communication with
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physicians about end-of-life options, as well as greater
availability, may increase use of hospice care.
4)DPH Licensure . The Division of Licensing and Certification
(L&C) within DPH is responsible for ensuring a standard of
care in approximately 7,000 public and private health care
facilities throughout the state. L&C conducts periodic
reviews of facilities that receive payment under Medicare and
Medi-Cal, conducts licensure reviews to ensure compliance with
state laws, investigates complaints related to patient care,
and imposes sanctions on facilities failing to meet certain
requirements.
5)Opposition . The California Nurses Association opposes this
bill based on concerns that the staffing standards and
building safety standards are inadequate to ensure patient
safety.
Analysis Prepared by : Lisa Murawski / APPR. / (916) 319-2081