BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  SB 135
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          SENATE THIRD READING
          SB 135 (Ed Hernandez)
          As Amended August 7, 2012
          Majority vote

           SENATE VOTE  :31-2  
           
           HEALTH              16-0        APPROPRIATIONS      16-0        
           
           ----------------------------------------------------------------- 
          |Ayes:|Monning, Logue, Atkins,   |Ayes:|Gatto, Harkey,            |
          |     |Bonilla, Eng, Garrick,    |     |Blumenfield, Bradford,    |
          |     |Gordon, Hayashi, Roger    |     |Charles Calderon, Campos, |
          |     |Hern�ndez, Bonnie         |     |Davis, Fuentes, Hall,     |
          |     |Lowenthal, Mansoor,       |     |Hill, Cedillo, Mitchell,  |
          |     |Mitchell, Nestande, Pan,  |     |Nielsen, Norby, Solorio,  |
          |     |Silva, Williams           |     |Wagner                    |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Establishes a new health facility licensing category 
          of hospice facility, and permits a licensed and certified 
          hospice services provider to provide inpatient hospice services 
          through the operation of a hospice facility, either as a 
          free-standing health facility, or adjacent to, physically 
          connected to, or on the building grounds of another health 
          facility or a residential care facility.  Specifically,  this 
          bill  :

          1)Establishes a new licensure category of a "hospice facility" 
            defined as a facility with no more than 24 beds that is 
            licensed by the Department of Public Health (DPH), and is 
            operated by a licensed and certified provider of hospice 
            services.  Provides that only a hospice licensed and certified 
            in California may apply with DPH for a hospice facility 
            license.

          2)Requires a hospice facility to be separately licensed, 
            irrespective of the location of the facility.  Allows a 
            hospice facility to operate as a freestanding health facility, 
            and also to be located adjacent to, physically connected to, 
            or on the building grounds of another health facility or 
            residential care facility.

          3)Allows a hospice provider, that provides short-term inpatient 








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            respite or inpatient care directly in the hospice provider's 
            facility prior to the effective date of regulations to 
            implement this bill, to continue to be licensed as a specialty 
            hospital, skilled nursing facility (SNF), or congregate living 
            health facility (CLHF).

          4)Requires a hospice facility to meet the fire protection 
            standards set forth in the Medicare Conditions of 
            Participation (COP), and to meet the same building standards 
            as a CLHF, until of the Office of Statewide Health and 
            Planning Development (OSHPD), in consultation with the Office 
            of the State Fire Marshall, develops and adopts building 
            standards for hospice facilities.

          5)Requires a hospice facility to provide evidence of compliance 
            with local building codes or if a hospice facility is located 
            adjacent to, physically connected to, or on the building 
            grounds of another facility to provide evidence of compliance 
            with building standards for the other facility if those are 
            more stringent.

          6)Requires the hospice facility to be responsible for obtaining 
            criminal background checks for employees, volunteers, and 
            contractors in accordance with federal Medicare COP and in 
            accordance with state law.  Further requires the hospice 
            facility licensee to pay the costs of obtaining a criminal 
            background check.

          7)Requires a hospice facility to provide a home-like environment 
            that is comfortable and accommodating to both the patient and 
            the patient's visitors, and to continue to provide services to 
            family and friends after the patient's stay in the hospice 
            facility in accordance with the patient's plan of care. 

          8)Establishes the services and requirements required by a 
            hospice program to be licensed as a hospice facility.  
            Requires DPH to adopt regulations by January 1, 2017, to 
            establish these standards, and requires the regulations to 
            include the following:

             a)   Minimum staffing standards that require at least one 
               licensed nurse to be on duty 24 hours per day and a maximum 
               of six patients at any given time per direct care staff 
               person.  Requires a registered nurse to be available for 








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               consultation and able to come into the facility within 30 
               minutes, if necessary, when no registered nurse is on duty.

             b)   Patient rights provisions, mirroring the patients' 
               rights information provided to skilled nursing facilities, 
               as well as all of the following:

               i)     Full information regarding the patient's health 
                 status and options for end-of-life care;

               ii)                                                         
                 Care that reflects individual preferences regarding 
                 end-of-life care, including the right to refuse any 
                 treatment or procedure;

               iii)                                                        
                 Treatment with consideration, respect, and full 
                 recognition of dignity and individuality, including 
                 privacy in treatment and care of personal needs; and,

               iv)                                                         
                 Entitlement to visitors of the patient's choosing, at any 
                 time the patient                                          
                   chooses, and ensured privacy for those visits.

             c)   A disaster preparedness plan for both internal and 
               external disasters that protect hospice patients, 
               employees, and visitors.

          9)Requires facilities to comply with the federal Centers for 
            Medicare and Medicaid Services (CMS) hospice care regulations. 
             Further allows DPH, until it adopts regulations to implement 
            this bill's provisions, to use CMS hospice care regulations 
            for hospice facility licensure requirements. 

          10)Requires a hospice facility to demonstrate the ability to 
            meet licensing requirements and to be fully responsible for 
            meeting all licensing requirements, regardless of whether 
            those requirements are met through direct provision of 
            services by the facility or under contract with another 
            entity.  

          11)Requires DPH to establish a licensure fee for hospice 
            facilities.  Allows the licensure fee to be equivalent to the 








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            licensure fee of a CLHF during the first year of licensure for 
            hospice facilities.  
          12)Requires DPH to conduct a licensing inspection on each 
            hospice facility at least once every two years and establishes 
            penalties for licensing violations that are equivalent to 
            existing CLHF licensing violation penalties.  Further 
            establishes penalties for medical privacy breeches that are 
            currently applicable to CLHFs.

          13)Requires hospice facilities to report data elements such as 
            assets, liabilities, a statement of income, revenue by payer, 
            and other data elements defined in current statute.

          14)Establishes several definitions, including defining an 
            "interdisciplinary team" that is to be coordinated by a 
            registered nurse and under medical direction.  Defines 
            "multiple location" to mean a location or site from which a 
            hospice makes available basic hospice services within the 
            service area of the parent agency.  Further defines "parent 
            agency" to be the part of the hospice that is licensed 
            pursuant to this chapter and that develops and maintains 
            administrative control of multiple locations.  Also defines 
            "palliative care" as services that have the primary purpose of 
            preventing or relieving suffering and enhancing the quality of 
            life, rather than curing the disease.  

          15)Makes several legislative declarations related to hospice 
            care, including that permitting the establishment of licensed 
            hospice facilities is consistent with federal legal 
            affirmations of the right of an individual to refuse 
            life-sustaining treatment and that each person's preferences 
            about his or her end-of-life care should be considered.

           EXISTING LAW  :
          
          1)Provides for the licensure and regulation of health 
            facilities, including hospitals, skilled nursing facilities, 
            and CLHFs by DPH.

          2)Requires persons or agencies providing hospice services to be 
            licensed by DPH and defines hospice as a specialized form of 
            interdisciplinary health care that is designed to provide 
            palliative care, alleviate the physical, emotional, social, 
            and spiritual discomforts of an individual diagnosed with a 








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            terminal illness, and to provide supportive care to the 
            primary caregiver and the family.

          3)Requires, to the extent appropriate, that hospice services be 
            provided in the patient's home or primary place of residence, 
            based on the medical needs of the patient.  Also requires 
            hospices to make arrangements for inpatient care as needed by 
            the patient.

          4)Establishes DPH Licensing and Certification (L&C) program fees 
            for health facilities, including hospice.

          5)Includes hospice care as a covered benefit under Medicare and 
            Medi-Cal, under specified conditions, including that an 
            individual is certified as terminally ill and his or her life 
            expectancy is six months or less.

          6)Defines a CLHF to be a residential home with a capacity of no 
            more than 12 beds that provides inpatient care, medical 
            supervision, 24-hour skilled nursing, and supportive care.

          7)Provides that the primary needs of CLHF residents is for 
            skilled nursing care on a recurring, intermittent, extended, 
            or continuous basis, and provides that this care is generally 
            less intense than that provided in general acute care 
            hospitals but more intense than that provided in SNFs.

           FISCAL EFFECT  :  According to the Assembly Appropriations 
          Committee, this bill will result in the following costs:

          1)One-time fee-supported special fund costs (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 
            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.








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           COMMENTS  :  According to the author, this bill would allow a 
          licensed and certified hospice program to operate an inpatient 
          facility within its hospice license.  The author states that 
          California currently does not allow hospice providers to operate 
          an independent, stand-alone inpatient hospice facility.  The 
          author maintains that approximately 95% of all hospice care is 
          provided to patients residing in their own home because that is 
          where most people wish to be.  In those instances, however, 
          where a patient cannot remain in their own home due to safety 
          concerns or lack of caregivers, hospices need the flexibility to 
          provide their services in facilities that are as homelike and 
          residential as possible.

          The author states that currently, hospice providers who wish to 
          provide inpatient hospice directly must be licensed as a CLHF, a 
          SNF, or a specialty hospice, none of which are consistent with 
          the provision of hospice care.  If the hospice is providing care 
          in another health or residential care facility, the hospice 
          program can only provide hospice services, and may not provide 
          any other services to the patient.  This makes the hospice 
          dependent on the health or residential facility for much of the 
          patient's care.  The author believes that this can lead to 
          discontinuity of care in some cases.

          The author states that this bill does not change the available 
          options, but simply adds another option.  By establishing a new 
          category of hospice facility, hospice programs will be able to 
          operate their own facility with standards that are tailored to 
          hospice care. This will result in continuity of care that is 
          consistent with the patient's wishes and appropriate for 
          end-of-life care in a home-like environment that permits 
          visitors at any time of day, a safe environment for those who 
          may not have family or friends to provide care, and the 
          opportunity for patients to stay in their residential community, 
          if they live in a residential care setting.


           Analysis Prepared by  :    Tanya Robinson-Taylor / HEALTH / (916) 
          319-2097 


                                                                FN: 0004970









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