BILL ANALYSIS                                                                                                                                                                                                    �



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          SENATE THIRD READING
          SB 135 (Ed Hernandez)
          As Amended  August 24, 2012
          Majority vote

           SENATE VOTE  :31-2  
           
           HEALTH              16-0        APPROPRIATIONS      16-0        
           
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          |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 licensing category of "hospice facility" 
            defined as a health facility with a capacity of no more than 
            24 beds that is licensed by the Department of Public Health 
            (DPH), and provides hospice services including, but not 
            limited to:  a) routine care; b) continuous care; c) inpatient 
            respite care and inpatient hospice care as defined in existing 
            law; and, d) is operated by a provider of hospice services 
            that is licensed pursuant to existing law and certified 
            pursuant to federal Medicare Conditions of Participation 
            (MCP).

          2)Requires a hospice facility to be separately licensed, 
            irrespective of the location of the facility.  Permits 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 








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            residential care facility.  Permits DPH to issue a provisional 
            license to a hospice facility for a period of up to one year.

          3)Requires DPH to establish a licensure fee for hospice 
            facilities.  Requires in the first year of licensure for 
            hospice providers, the licensure fee to be equivalent to the 
            licensure fee for congregate living health facilities (CLHFs) 
            during the same year.  Requires, thereafter, the licensure fee 
            for hospice providers to be established pursuant to the 
            provisions of this bill.

          4)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.

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

          6)Defines "inpatient hospice care" to mean hospice care that is 
            provided to patients in a hospice facility, including routine, 
            continuous and inpatient care directly as specified by MCP.  
            Permits short-term inpatient respite care, as specified by 
            existing law, to be included in this definition.

          7)Prohibits a person, governmental agency, or political 
            subdivision of the state from being licensed as a hospice 
            facility unless the person or entity is a provider of hospice 
            services licensed under existing law and is certified by MCP.

          8)Establishes DPH application requirements and other 
            administrative procedures for hospice facility licensure. 

             9)   Permits a hospice facility that participates in the 
               Medicare and Medicaid programs to obtain initial 
               certification from a CMS-approved accreditation 
               organization.

             10)  Clarifies building and physical environment requirements 
               for hospice facilities, both freestanding, and those that 
               operate within, adjacent to, physically connected to, or on 
               the grounds of another facility.  









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             11)  Requires a freestanding hospice facility to meet the 
               fire protection standards set forth in MCP, until OSHPD, in 
               consultation with the Office of the State Fire Marshall, 
               develops and adopts building standards for hospice 
               facilities.  Requires a hospice facility located within the 
               physical plant of another licensed health facility to meet 
               building standards for that category of health facility 
               within which the hospice facility is located.

             12)  Prohibits a private or public organization, including, 
               but not limited to, a partnership, corporation, or 
               political subdivision of the state, or other governmental 
               agency within the state, to do any of the following without 
               a license issued pursuant to the provisions of this bill:

             a)   Represent itself to be a hospice facility by its name or 
               advertisement, soliciting, or any other presentments to the 
               public, or in the context of services within the scope of 
               the provisions of this bill imply that it is licensed to 
               provide those services or to make any reference to employee 
               bonding in relation to those services;

             b)   Use the words "hospice facility," "hospice home," 
               "hospice-facility," or any combination of those terms, 
               within its name; or,

             c)   Use words to imply that it is licensed as a hospice 
               facility to provide those services.

             13)  Requires the hospice facility to be responsible for 
               obtaining criminal background checks for employees, 
               volunteers, and contractors in accordance with MCP and in 
               accordance with state law.  Requires the hospice facility 
               licensee to pay the costs of obtaining a criminal 
               background check.

             14)  Requires a hospice facility to provide a home-like 
               environment that is comfortable and accommodating to both 
               the patient and 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.

             15)  Establishes the services and requirements required by a 
               hospice program to be licensed as a hospice facility.








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             16)  Defines "inpatient hospice care" to mean hospice care 
               that is provided to patients in a hospice facility, 
               including routine, continuous and inpatient care directly 
               as specified by the MCP.  Permits short-term inpatient 
               respite care, as specified by existing law, to be included 
               in this definition.

             17)  Establishes minimum staffing standards that require at 
               least one registered nurse to be on duty 24 hours a day and 
               a maximum of six patients assigned at any given time per 
               direct caregiver.

             18)  Defines "direct caregiver" other than a registered nurse 
               to mean a licensed vocational nurse and a certified nurse 
               assistant.

             19)  Adopts for hospice facilities patient rights provisions, 
               mirroring the patients' rights information provided to 
               skilled nursing facilities (SNFs) and intermediate care 
               facilities to ensure that patients are advised of their 
               fundamental rights and the obligations of the facility.

          20)Excludes from the definition in existing law for "hospital 
            building" any freestanding building used, or designed to be 
            used, as a CLHF or hospice facility.

          21)Makes conforming changes to avoid chaptering out problems 
            with SB 1228 (Alquist) of 2012 regarding licensure for small 
            house SNFs.

          22)Makes other technical and clarifying changes.

           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 
            terminal illness, and to provide supportive care to the 








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            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.

           COMMENTS  :  According to the author, this bill would allow a 








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          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: 0005649












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