BILL ANALYSIS                                                                                                                                                                                                    �




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair

                                          SB 840 (Evans)
          
          Hearing Date: 5/23/2011         Amended: 5/10/2011
          Consultant: Katie Johnson       Policy Vote: Health 5-3
          _________________________________________________________________
          ____
          BILL SUMMARY: SB 840 would require an owner of a health 
          facility, including skilled nursing facilities, all types of 
          intermediate care facilities, and all types of congregate living 
          health facilities, to install carbon monoxide devices in the 
          facility in or around areas that contain a fossil fuel burning 
          appliance within 180 days after the Office of Statewide Health 
          Planning and Development adopts regulations pursuant to this 
          bill.
          _________________________________________________________________
          ____
                            Fiscal Impact (in thousands)

           Major Provisions         2011-12      2012-13       2013-14     Fund
           
          SNF installation       potentially in the hundreds of 
          thousandsGeneral/*
          Medi-Cal mandate       of dollars one-time              Federal

          *Medi-Cal costs shared 50 percent General Fund, 50 percent 
          federal funds
          _________________________________________________________________
          ____

          STAFF COMMENTS: This bill meets the criteria for referral to the 
          Suspense File.
          
          This bill would require an owner of a health facility, including 
          skilled nursing facilities (SNFs), all types of intermediate 
          care facilities (ICFs), and all types of congregate living 
          health facilities (CLHFs), to install carbon monoxide devices in 
          the facility in or around areas that contain a fossil fuel 
          burning appliance. Facilities that do not have a fossil fuel 
          burning appliance within the interior of the facility would be 
          exempt from these provisions. 

          This bill would require the Office of Statewide Health Planning 
          and Development (OSHPD) to 1) prescribe criteria for the number 








          SB 840 (Evans)
          Page 1


          and placement of carbon monoxide devices in a facility with a 
          fossil fuel burning appliance, and 2) adopt regulations 
          prescribing building standards for the adequacy and safety of 
          facility physical plants. Any costs to OSHPD to develop criteria 
          and to promulgate regulations would be absorbable within current 
          resources.

          Facilities would be required to comply with these provisions 
          within 180 days after regulations are approved by OSHPD, likely 
          in FY 2013-2014.

          There could be one-time costs in the hundreds of thousands of 
          dollars to SNFs to install these devices, likely in FY 
          2013-2014. Approximately two-thirds of SNF occupancy are 
          Medi-Cal beneficiaries; Medi-Cal pays SNFs based on their costs, 
          including any costs incurred due to federal or state 
          legislation, such as this bill.

          Additionally, according to the Department of Health Care 
          Services' (DHCS) website, ICFs generally have above a 95 percent 
          Medi-Cal census and annual cost reports are used to determine 
          their annual rates. Additionally, the added cost of any federal 
          or state "mandate," such as this bill, would be added to the 
          costs to determine the final rate. Thus, there would likely be 
          minor costs one-time to DHCS to reimburse ICFs for compliance 
          with this bill. 

          Rates for all long-term care facilities except SNF-Bs were 
          frozen at their FY 2008-2009 levels commencing with FY 
          2009-2010, and, pursuant to the 2011 health trailer bill, were 
          reduced by 10 percent. However, the state continues to pay for 
          any federal or state mandates. Therefore, all facilities subject 
          to this bill would be reimbursed accordingly.

          Medi-Cal costs are shared 50 percent General Fund and 50 percent 
          federal funds.