BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  SB 177
                                                                  Page  1

          SENATE THIRD READING  
           SB 177 (Strickland)
          As Amended August 18, 2011
          Majority vote

           SENATE VOTE  :33-0  
           
           HEALTH              19-0        APPROPRIATIONS      16-0        
           
           ----------------------------------------------------------------- 
          |Ayes:|Monning, Logue, Ammiano,  |Ayes:|Fuentes, Harkey,          |
          |     |Atkins, Bonilla, Eng,     |     |Blumenfield, Bradford,    |
          |     |Garrick, Gordon, Hayashi, |     |Charles Calderon, Campos, |
          |     |Roger Hern�ndez,          |     |Donnelly, Gatto, Hall,    |
          |     |Bonnie Lowenthal,         |     |Hill, Lara, Mitchell,     |
          |     |Mansoor, Mitchell,        |     |Nielsen, Norby, Solorio,  |
          |     |Nestande, Pan,            |     |Wagner                    |
          |     |V. Manuel P�rez, Silva,   |     |                          |
          |     |Smyth, Williams           |     |                          |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Expands the provision of dietary services provided in 
          general acute care hospitals.  Increases the bed limit for 
          congregate living health facilities (CLHFs) that serve 
          terminally ill patients in the County of Santa Barbara.  
          Specifically,  this bill  :

          1)Permits a CLHF to have up to 25 beds if the CLHF is located in 
            the County of Santa Barbara.

          2)Finds and declares that a special law is necessary and that a 
            general law cannot be made applicable within the meaning of 
            existing law because of the unique business climate 
            surrounding CLHFs in the County of Santa Barbara.

          3)Allows, for the purposes of hospital licensing requirements, 
            dietary services to be provided either at the hospital, or in 
            another hospital immediately adjacent to the hospital, as long 
            as dedicated facilities are in place to accommodate the 
            delivery of these services, and the Department of Public 
            Health determines that all applicable statutory and regulatory 
            standards pertaining to dietary services have been met.

          4)Double joints this bill to SB 844 (Price), to avoid 
            chaptering-out problems, as the two bills amend the same 








                                                                  SB 177
                                                                  Page  2

            Health and Safety Code section. 

           FISCAL EFFECT  :  According to the Senate Appropriations 
          Committee, this bill will increase CLHF capacity resulting in 
          potentially minor to significant costs to Medi-Cal, but could 
          also result in potentially minor to significant cost avoidance 
          depending on the costs associated with whether the individuals 
          receiving hospice Medi-Cal benefits select CLHF services versus 
          receiving similar services in a skilled nursing facility.

           COMMENTS  :  According to the author, Hollywood Presbyterian 
          Medical Center (HPMC) must temporarily shut down their dietary 
          services department in order to accommodate seismic upgrades to 
          the emergency room and other portions of the hospital.  HPMC is 
          seeking the ability to use the dietary services of Children's 
          Hospital Los Angeles that is immediately adjacent to HPMC during 
          construction and until construction is completed.  The author 
          explains that HPMC is landlocked by a street on one side and 
          Children's Hospital Los Angeles on the other side prohibiting 
          planned construction activities except inside the hospital 
          itself.  Areas of HPMC scheduled for retrofitting, according to 
          the author, are the emergency room, the dietary services 
          department, and a number of floors that provide hospital beds.  
          The only area that is large enough to accommodate the staging of 
          construction is the emergency room or the dietary services 
          department, however, Children's Hospital Los Angeles has the 
          capacity to absorb the dietary services functions on behalf of 
          HPMC.  The author describes that HPMC and Children's Hospital 
          Los Angeles are connected by a dedicated walkway that joins the 
          two hospitals.  The author argues that the only other option 
          available to HPMC is to shut down the emergency room, which 
          would result in laying-off hospital workers at a time when 
          unemployment in the county exceeds 13%.  Additionally, the 
          author maintains, without the exemption granted by this bill, 
          there would be a re-routing of approximately 35,000 emergency 
          room visits annually, negatively impacting other emergency rooms 
          in the greater Los Angeles area.

          According to the author, Santa Barbara County has only one 
          licensed hospice facility, Serenity House, a six-bed facility 
          operated by Visiting Nurses and Hospice Care of Santa Barbara 
          (VNHC), the sponsor of this bill.  The author maintains that 
          Serenity House has struggled to meet the patient demand in the 
          Santa Barbara community for many years citing that between 2008 
          and 2009, Serenity Houses experienced a 71% increase in the 








                                                                  SB 177
                                                                  Page  3

          number of patients served and also a growing waiting list due to 
          a lack of available beds for end-of-life patients.  The author 
          argues that in recognition of this critical need, local 
          community members generously contributed to the campaign to 
          build a new 18-bed hospice inpatient facility.  The author 
          states that without enactment of this bill the Serenity House, 
          which recently opened their new 18-bed facility as a 12-bed 
          facility in accordance with existing law, will have to operate 
          interminably as a 12-bed facility.  According to the author, 
          this bill will allow the six additional beds to become operative 
          in January 2012 and thus provide more critical hospice-bed 
          capacity in the Santa Barbara region of the central coast.


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


                                                               FN:  0001847