BILL ANALYSIS �
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|SENATE RULES COMMITTEE | SB 177|
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UNFINISHED BUSINESS
Bill No: SB 177
Author: Strickland (R), et al.
Amended: 8/18/11
Vote: 21
SENATE HEALTH COMMITTEE : 7-0, 04/13/11
AYES: Hernandez, Strickland, Alquist, Anderson, De Le�n,
DeSaulnier, Rubio
NO VOTE RECORDED: Blakeslee, Wolk
SENATE APPROPRIATIONS COMMITTEE : 9-0, 05/23/11
AYES: Kehoe, Walters, Alquist, Emmerson, Lieu, Pavley,
Price, Runner, Steinberg
SENATE FLOOR : 33-0, 05/31/11
AYES: Alquist, Anderson, Blakeslee, Calderon, Cannella,
Correa, De Le�n, DeSaulnier, Dutton, Evans, Fuller,
Gaines, Hancock, Harman, Hernandez, Huff, Kehoe, Leno,
Lieu, Lowenthal, Negrete McLeod, Padilla, Pavley, Rubio,
Runner, Simitian, Steinberg, Strickland, Walters, Wolk,
Wright, Wyland, Yee
NO VOTE RECORDED: Berryhill, Corbett, Emmerson, La Malfa,
Liu, Price, Vargas
ASSEMBLY FLOOR : 76-0, 08/22/11 - See last page for vote
SUBJECT : Congregate living health facilities
SOURCE : Visiting Nurse & Hospice Care
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DIGEST : This bill raises the bed limit from 12 to 25 for
congregate living health facilities that serve terminally
ill patients in Santa Barbara County.
Assembly Amendments provide chaptering amendments with SB
844 (Price).
ANALYSIS : Existing law:
1.Provides for the licensure and regulation of health
facilities, including hospitals, skilled nursing
facilities, and congregate living health facilities
(CLHFs).
2.Defines a CLHF as 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, and other services to persons who meet
one of the following:
A. Persons who are mentally alert who have physical
disabilities, who may be ventilator dependent;
B. Persons who have a diagnosis of terminal illness,
or life-threatening illness, or both, as defined; or
C. Persons who are catastrophically and severely
disabled, as defined.
1.Provides, notwithstanding the 12-bed limit, that a CLHF
that is operated by a city and county may have 59 beds,
and provides that a CLHF that is not operated by a city
and county that serves persons who have a diagnosis of
terminal illness or life-threatening illness, or both,
that is located in a county of 500,000 or more persons,
may have not more than 25 beds.
2.Provides that the primary need of CLHF residents shall be
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 skilled nursing facilities.
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3.Provides for the licensure and regulation by the
Department of Public Health of persons or agencies that
provide hospice services in a person's home or other care
setting, defined 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 provide supportive
care to the primary caregiver and the family.
4.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.
5.Provides chaptering amendments with SB 844 (Price).
This bill raises the bed limit from 12 to 25 for congregate
living health facilities that serve terminally ill patients
in Santa Barbara County.
Background
In order to provide options for providing care to
chronically ill patients outside of hospitals, CLHFs were
established as a category of licensed health facilities in
1986. CLHFs were initially limited to having no more than
six beds and were limited to serving mentally alert,
physically disabled residents, who can be
ventilator-dependent. In 1988, a second category of CLHFs
was authorized to provide 24-hour inpatient care to
terminally ill patients. These facilities were allowed to
have 25 beds in counties which have a population of 500,000
or more persons. In 1989, a third category of CLHFs was
established, to serve persons who are catastrophically and
severely disabled, which were allowed to have 12 beds in
counties with more than 500,000 persons. In 2005,
legislation was enacted which raised the bed-size limit for
CLHFs in all counties to 12 beds, while retaining the
higher 25-bed limit for CLHFs serving terminally ill
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patients in counties with more than 500,000 persons.
The impetus for the 1988 legislation establishing the new
CLHF category for terminally ill patients, with a bed limit
of 25 in counties with over 500,000 persons, was to enable
a proposed 25-bed hospice facility serving persons with
AIDS, which was proposed to be operated by Barlow Hospital
in Los Angeles, to be licensed as a CLHF.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
According to the Senate Appropriations Committee:
Major Provisions 2011-12 2012-13
2013-14 Fund
Increased CLHF-B
potentially minor to significant costs General/*
capacity Federal
Cost avoidance
potentially minor to significant
General/*
cost avoidance Federal
*Medi-Cal costs shared 50 percent General Fund, 50 percent
federal funds.
SUPPORT : (Verified 8/22/11)
Visiting Nurse & Hospice Care (source)
Alliance for Living and Dying Well
Alzheimer's Association
American Dream Concepts Business Development Group
Brown & Brown Insurance
California Hospice & Palliative Care Association
California Hospital Association
CenCal Health
City of Goleta
Community Home Health
Cottage Health System
Donate Life
Dream Foundation
Easy Lift
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Frank Schipper Construction Co.
Grace House
Hutton Parker Foundation
Orfalea Foundations
PMSM Architects
Santa Barbara County Board of Supervisors
Santa Barbara County Medical Society
Santa Barbara Foundation
Santa Barbara Neighborhood Clinics
Sharon Kennedy Estate Management
St. Francis Foundation
The Council on Alcoholism and Drug Abuse
United Way of Santa Barbara County
Vista Del Monte Retirement Community
OPPOSITION : (Verified 8/22/11)
State Council on Developmental Disabilities
ARGUMENTS IN SUPPORT : Visiting Nurse &Hospice Care
(VNHC) states that as the only licensed hospice inpatient
facility in Santa Barbara County, Serenity House has
struggled to meet demands for end-of-life beds. Between
2008 and 2009, Serenity House saw a 71 percent increase in
the number of patients served and has a growing waiting
list due to the lack of available beds for end of life
patients. VNHC states that based on current population
projections, the number of people over the age of 65 in
Santa Barbara County will increase by 24 percent by 2050.
While VNHC acknowledges that it made an error in assuming
it would be able to build an 18-bed facility, because it
believed that a waiver or exception process existed to
allow it to operate at the higher bed-size, VNHC states
that the need for additional end-of-life beds continues to
be critical in Santa Barbara County and this bill will
enable it to meet these needs and continue providing
compassionate care to persons at the end of life.
ARGUMENTS IN OPPOSITION : The State Council on
Developmental Disabilities (SCDD) opposes this bill and
writes, "This bill would allow an increase in the number of
beds allowed in congregate living health facilities in the
county of Santa Barbara.
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"The SCDD is aware that this bill seems to be directed to
one specific instance; however, it creates the unintended
consequence of increasing the size of facilities for
persons with disabilities now and in the future.
Therefore, the SCDD opposes this bill as being inconsistent
with the direction of individuals being supported in their
own homes and inclusive communities."
ASSEMBLY FLOOR : 76-0, 08/22/11
AYES: Achadjian, Alejo, Allen, Ammiano, Atkins, Beall,
Bill Berryhill, Block, Blumenfield, Bonilla, Bradford,
Brownley, Buchanan, Butler, Charles Calderon, Campos,
Carter, Cedillo, Chesbro, Conway, Cook, Davis, Donnelly,
Eng, Feuer, Fletcher, Fong, Beth Gaines, Galgiani,
Garrick, Gatto, Gordon, Grove, Hagman, Halderman, Hall,
Harkey, Hayashi, Roger Hern�ndez, Hill, Huber, Hueso,
Huffman, Jeffries, Jones, Knight, Lara, Logue, Bonnie
Lowenthal, Ma, Mansoor, Mendoza, Miller, Mitchell,
Monning, Morrell, Nestande, Nielsen, Norby, Olsen, Pan,
Perea, V. Manuel P�rez, Portantino, Silva, Skinner,
Smyth, Solorio, Swanson, Torres, Valadao, Wagner,
Wieckowski, Williams, Yamada, John A. P�rez
NO VOTE RECORDED: Dickinson, Fuentes, Furutani, Gorell
CTW:nl 8/24/11 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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