BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  SB 1228
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          Date of Hearing:  July 3, 2012

                            ASSEMBLY COMMITTEE ON HEALTH
                              William W. Monning, Chair
                    SB 1228 (Alquist) - As Amended:  May 29, 2012

           SENATE VOTE :  36-0
           
          SUBJECT  :  Small house skilled nursing facilities.

           SUMMARY  :  Adds "small house skilled nursing facility" (SHSNF), 
          as defined, to the skilled nursing facility (SNF) category of 
          facilities licensed by the Department of Public Health (DPH), 
          and permits an SHSNF to be licensed by DPH beginning on January 
          1, 2014, if the SHSNF meets specified requirements.  
          Specifically,  this bill  :    

          1)Adds SHSNF, as defined, to the SNF category of facilities 
            licensed by DPH beginning on January 1, 2014, if the SHSNF 
            meets specified requirements.

          2)Defines "home" as an apartment, home, or other similar unit 
            that serves 12 or fewer residents.

          3)Defines "SHSNF" as an SNF that is licensed for the purposes of 
            providing skilled nursing care in a homelike, 
            non-institutional setting and is one of the following:

             a)   A stand-alone home;
             b)   A facility that consists of more than one home; or,
             c)   A distinct area within an existing SNF that otherwise 
               meets the definition of "home" referenced in 2) above and 
               has been dedicated to the small house model, has distinct 
               entry, and has no through traffic of staff, residents, or 
               visitors not affiliated with the household.

          4)Defines "versatile worker," for purposes of SHSNF licensing 
            requirements, as a certified nursing assistant who provides 
            personal care, socialization, activity aide services, meal 
            preparation services, and laundry and housekeeping services.  
            Requires the SHSNF, to the extent permitted under federal law, 
            to utilize versatile workers for purposes of resident care.

          5)Requires the SHSNF to comply with all state laws and 
            regulations that govern SNFs, except to the extent that those 








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            laws and regulations are inconsistent with the provisions of 
            this bill.  Permits DPH or the Office of Statewide Health 
            Planning and Development (OSHPD) to waive one or more 
            regulations that conflict with the provisions of this bill in 
            order to permit SHSNFs to meet licensure requirements, if DPH 
            or OSHPD determines doing so will not jeopardize the health 
            and safety of a facility's residents.  Requires DPH or OSHPD 
            to consider whether the practice contained in the provision 
            has been demonstrated safely in other states and requires them 
            to consider peer-reviewed research.

          6)Requires the SHSNF, to the extent permitted under federal law, 
            to provide meals cooked on the premises of each home, and not 
            prepared in a central kitchen and transported to the home.
          7)Requires the SHSNF to meet all federal and state direct-care 
            staffing requirements for SNFs.  Requires all direct care 
            staff to be onsite, awake, and available within each home at 
            all times.

          8)Requires SHSNFs to provide consistent staff assignments and 
            self-managed work teams of direct care staff.  Requires 
            licensed nursing staff to direct the versatile workers in all 
            activities delegated under the licensed nurses' scope of 
            practice.  A versatile worker may be supervised by nonclinical 
            staff at the discretion of the SHSNF.

          9)Requires SHSNFs to provide training for all staff involved in 
            the operation of the home and be completed prior to initial 
            operation of the home, concerning the philosophy, operations, 
            and skills required to implement and maintain self-directed 
            care, self-managed work teams, a noninstitutional approach to 
            long-term care, safety and emergency skills, food handling and 
            safety, and other elements necessary for the successful 
            operation of the home.  Requires versatile workers and other 
            staff interacting with residents in the homes to demonstrate 
            proficiency in these areas as well as the facility's policies 
            and procedures, conflict resolution, and self-directed care 
            principles. 

          10)Requires replacement staff to undergo the training described 
            in 9) above, within six weeks of commencing employment with 
            the facility.

          11)Exempts any staff members who are employed on a short-term, 
            temporary basis due to permanent staff illness or unexpected 








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            absence from the training requirements set forth in 9) above.

          12)Requires the SHSNF, to the extent permitted under federal 
            law, to consist of a home-like, rather than institutional, 
            environment having the following characteristics:

             a)   The home is accessible to disabled persons, and is 
               designed as a house, an apartment, or a distinct area 
               within an existing SNF that is similar to housing available 
               in the surrounding community, and that includes shared 
               areas that would only be commonly shared in a private home 
               or apartment;
             b)   The home does not, to the extent practicable, contain 
               institutional features, such as nursing stations, 
               medication carts, room numbers, and wall-mounted licenses 
               or certificates;
             c)   The home includes resident rooms that accommodate not 
               more than two residents per room.  Homes are encouraged to 
               include private, single-occupancy bedrooms that are shared 
               only at the request of a resident to accommodate a spouse, 
               partner, family member, or friend, and that contain a full 
               private and accessible bathroom.  Double occupancy rooms 
               contain a full private and accessible bathroom, and each 
               resident's bedroom area be visually separated from the 
               other by a full height wall or a permanently installed 
               sliding door, folding door, or partition that provide 
               visual and acoustic separation.  Residents have direct use 
               of, and access to, an exterior window at all times.
             d)   The home contains a living area where residents and 
               staff socialize, dine, and prepare food together that 
               provides, at a minimum, a living room seating area, a 
               dining area large enough to accommodate all residents and 
               at least two staff members, and a full kitchen that may be 
               utilized by residents;
             e)   The home contains ample natural light;
             f)   The home has built-in safety features to allow areas of 
               the facility to be accessible to residents during the 
               majority of the day and night; 
             g)   The home provides access to secured outdoor space; and,
             h)   The home endeavors to create an aging in place 
               environment where long-stay residents may form permanent 
               homes with each other.

          13)Requires the SHSNF to be certified to participate as a 
            provider of care either as a SNF under the federal Medicare 








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            Program or as a nursing facility under the federal Medicaid 
            Program.

          14)Requires DPH and OSHPD to consult with providers, employee 
            organizations, consumer advocates, and other interested 
            stakeholders including groups with demonstrated experience in 
            SHSNF operations, on the physical, operational, and other 
            aspects of SHSNFs.

          15)Requires DPH to adopt regulations to implement this bill.

           EXISTING LAW  :
          
          1)Provides for the licensure of health facilities, including 
            SNFs, by DPH.

          2)Defines "SNF" as a health facility that provides skilled 
            nursing care and supportive care to patients whose primary 
            need is for availability of skilled nursing care on an 
            extended basis.

          3)Requires OSHPD, under the Alfred E. Alquist Hospital 
            Facilities Seismic Safety Act, to assume responsibility for 
            the enforcement of all building standards related to hospital 
            buildings, including SNFs.

           EXISTING REGULATIONS  :
          
          1)Further define "SNF" as a facility providing 24-hour inpatient 
            care and, at a minimum, includes physician, skilled nursing, 
            dietary, and pharmaceutical services and an activity program.

          2)Require each SNF licensed for 59 or fewer beds to have at 
            least one registered nurse or a licensed vocational nurse, 
            awake and on duty, in the facility at all times, day and 
            night.

          3)Require each SNF to employ sufficient nursing staff to provide 
            a minimum of 3.2 nursing hours per patient day.  Requires this 
            staffing ratio to only include direct caregivers, which is 
            defined to include registered nurses, licensed vocational 
            nurses, psychiatric technicians, or certified nurse 
            assistants, who are performing nursing services.

          4)Specify that while all SNFs are required to maintain 








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            compliance with licensing requirements, these requirements are 
            not to prohibit the use of alternate concepts, methods, 
            procedures, techniques, equipment, personnel qualifications, 
            or the conducting of pilot projects, as long as such 
            exceptions have prior written approval of DPH.
          
           
          FISCAL EFFECT  :  According to the Senate Appropriations 
          Committee, this bill will result in the following:

          1)Startup costs of about $120,000 per year for three years to 
            develop regulations (Licensing and Certification Program 
            Fund); and,
          2)Minor ongoing costs to license and inspect facilities 
            (Licensing and Certification Program Fund).

           COMMENTS  :    

           1)PURPOSE OF THIS BILL  .  According to the author, SHSNFs 
            implementing the core practices outlined in this bill are an 
            important development in long-term care options that many 
            consumers, family, and staff prefer to traditional settings.  
            The author states that they also deliver better clinical 
            outcomes, more direct-care time, and greater resident 
            engagement at the same operating cost as traditional nursing 
            homes.  The author asserts that this deep culture change model 
            of small house nursing homes is proliferating in many states 
            and meets all federal nursing home certification requirements. 
             Unfortunately, these homes are difficult to develop in 
            California under current state requirements, and California's 
            current statutory and regulatory framework did not anticipate 
            this significant innovation.

          According to the author, SHSNFs following the practices outlined 
            in this bill currently require multiple agency interpretations 
            and waivers to move forward in California.  These 
            interpretations and waivers add a great deal of time and 
            expense to implementation - both for the provider 
            organizations and the state agencies involved.  This 
            additional time and expense discourages their development and 
            deprives California residents of this important option.

          The author states that this bill would create a new health 
            facility licensing category to assist the development of 
            SHSNFs implementing the core practices that research has shown 








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            to reliably deliver improved satisfaction, quality, and cost 
            outcomes.  

           2)PERSON-CENTERED CARE IN NURSING HOMES AND THE CULTURE-CHANGE 
            MOVEMENT  .  According to the Commonwealth Fund, in the 1980's 
            consumer groups exposed substandard care in some nursing 
            homes, as well as instances of even more dire problems like 
            abuse and neglect.  These revelations led to the Institute of 
            Medicine to issue a report recommending major regulatory 
            changes and, in 1987, Congress passed a sweeping set of 
            nursing home reforms that required facilities to provide 
            individualized, or "person-centered," care.  As a result, some 
            providers began to move away from the institutional model of 
            nursing home care and toward a more home-like environment in 
            which residents could have a say in their day-to-day lives.  
            According to the Commonwealth Fund, proponents of culture 
            change do not recommend a specific model or set of practices.  
            Instead, they support principles governing resident care 
            practices; organizational and human resource practices; and 
            the design of the physical facility.  According to these 
            principles, an ideal culture change facility would feature:
                
               a)   Resident direction.   Residents should be offered choices 
               and encouraged to make their own decision about personal 
               issues like what to wear or when to go to bed;
              b)   Homelike atmosphere  .  Practices and structures should be 
               more homelike and less institutional.  For instance, larger 
               nursing units with 40 or more residents would be replaced 
               with smaller "households" of 10 to 15 residents, residents 
               would have access to refrigerators for snacks, and overhead 
               public address systems would be eliminated;
              c)   Close relationships  .  To foster strong bonds, the same 
               nurse should always provide care to a resident;
              d)   Staff empowerment  .  Staff should have the authority, and 
               the necessary training, to respond on their own to 
               residents' needs.  The use of care teams should also be 
               encouraged;
              e)   Collaborative decision  -making.  The traditional 
               management hierarchy should be flattened, with frontline 
               staff given the authority to make decisions regarding 
               residents' care; and,
              f)   Quality improvement processes  .  Culture change should be 
               treated as an ongoing process of overall performing 
               improvement, not just as a superficial change or provision 
               of amenities.








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             According to the California HealthCare Foundation (CHCF), 
            recent literature shows that nursing homes embracing culture 
            change have improved quality outcomes and offer preliminary 
            evidence of positive business impacts.  However, CHCF 
            indicates that California has lagged behind other states in 
            culture change.  

           3)THE GREEN HOUSE CONCEPT  .  This bill is sponsored by NCB 
            Capital Impact (NCB), which has established The Green House 
            Project, funded by the Robert Wood Johnson Foundation, to help 
            spur replication of The Green House concept.  NCB describes 
            The Green House concept as an innovative model for residential 
            long-term care that involves a total rethinking of the 
            philosophy of care, architecture, and organizational structure 
            normally associated with long-term care.

          According to NCB, a Green House home is an independent, 
            self-contained home for six to 12 people, designed to look 
            like a private home or apartment in the surrounding community. 
            NCB states that Green House homes are typically licensed as 
            SNFs and meet all applicable federal and state regulatory 
            requirements.  Each home is staffed by a team of universal 
            workers, who have core training as Certified Nurse Assistants 
            (CNA), plus extensive training in the Green House philosophy, 
            the self-managed work team structure of the Green House home, 
            culinary skills, and household management.  These CNAs provide 
            personal care, meal preparation, and light housekeeping and 
            laundry, among other duties. 

          According to the author, Green House homes are currently 
            operating in 21 states.  The author states that one California 
            nursing home provider has been working for three years to 
            implement the Green House model, but the provider has 
            experienced significant delays and added costs because the 
            Green House model does not fit well with California's current 
            law.  

           4)SUPPORT  .  Aging Services (AS) writes in support of this bill 
            that they commend the leadership in bringing SHSNF concept to 
            the attention of the California Legislature.  According to AS, 
            advocates for resident centered care and culture change in 
            nursing homes have successfully championed the SHSNF concept 
            in most Eastern states for many years.  The California 
            Association of Health facilities (CAHF) also writes in support 








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            that CAHF has ben dedicated to advancing the concepts of 
            resident-centered care in SNFs.  CAHF recognizes that SHSNFs 
            are an important development in realizing resident-centered 
            care and that this bill will provide an opportunity to design 
            a model that meets the needs of residents.

           REGISTERED SUPPORT / OPPOSITION  :

           Support 
           
          Aging Services of California
          Association of Regional Center Agencies
          California Association of Health Facilities

           Opposition 
           
          None on file.

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