BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  SB 1228
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          SENATE THIRD READING
          SB 1228 (Alquist)
          As Amended August 27, 2012
          Majority vote

           SENATE VOTE  :36-0  
           
           HEALTH              13-5                                        
           
           -------------------------------- 
          |Ayes:|Pan, Ammiano, Atkins,     |
          |     |Bonilla, Eng, Gordon,     |
          |     |Hayashi, Roger Hern�ndez, |
          |     |Bonnie Lowenthal,         |
          |     |Mitchell, Monning, V.     |
          |     |Manuel P�rez, Williams    |
          |     |                          |
          |-----+--------------------------|
          |Nays:|Logue, Garrick, Mansoor,  |
          |     |Nestande, Silva           |
          |     |                          |
           -------------------------------- 
           SUMMARY  :  Establishes, until January 1, 2020, within the 
          Department of Public Health (DPH) the Small House Skilled 
          Nursing Facilities (SHSNFs) Pilot Program to allow DPH to 
          authorize the development and operation of up to 10 SHSNFs.  
          Specifically,  this bill  :    

          1)Establishes within DPH the SHSNFs Pilot Program to allow DPH 
            to authorize the development and operation of up to 10 SHSNFs.

          2)Defines SHSNFs as a health facility that provides skilled 
            nursing care and supportive care in a small, homelike, 
            residential setting in an apartment, cottage, house, or 
            similar residential unit, to patients whose primary need is 
            for the availability of skilled nursing care on an extended 
            basis.  Permits a SHSNF to consist of a group or cluster of 
            such residential homes, each home having 12 or fewer beds, or 
            a distinct area within an existing skilled nursing facility 
            (SNF) that otherwise meets the definition of a SHSNF, is 
            physically separate and distinguishable from the remainder of 
            the SNF, and has a distinct entry with no traffic of staff, 
            residents, or visitors not affiliated with the SHSNF.  Permits 
            a SHSNF to also be a distinct part of a general acute care 








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            hospital or an acute psychiatric hospital. 

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

          4)Establishes characteristics for facilities that are eligible 
            for the SHSNF pilot program. 

          5)Permits a facility to be licensed by DPH as a SHSNF pilot 
            facility if the facility meets both of the following 
            requirements:

             a)   The facility has been determined by DPH to comply with 
               all provisions necessary to be certified to participate as 
               a provider of care either as a skilled nursing facility 
               (SNF) in the federal Medicare Program or as a nursing 
               facility in the federal Medicaid Program; and,

             b)   The facility has been determined by DPH and the Office 
               of Statewide Health Planning and Development (OSHPD) to 
               fully comply with all pilot program requirements.

          6)Requires each SHSNF pilot facility to be subject to the same 
            licensing enforcement provisions, in existing law, that apply 
            to other SNFs.

          7)Requires each SHSNF pilot facility to be subject to DPH's 
            Licensing and Certification program fee for SNFs.

          8)Requires each SHSNF pilot facility to receive a peer group 
            weighted average Medi-Cal reimbursement rate as calculated by 
            the Department of Health Care Services. 

          9)Requires DPH to permit the formulation of new standards for 
            long-term care that may extend beyond, or vary from, 
            traditional long-term health care facility models, including 
            but not limited to, facility layout and design consistent with 
            newly adopted revisions to the California Building Standards 
            Code, nursing care levels, staffing levels, infection control, 
            sanitation, dietary services, and other personal care and 
            habilitation provisions that may be more flexible than those 
            currently required in California for SNFs and continuous 
            nursing facilities.









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          10)Requires DPH, together with OSHPD and the State Long-Term 
            Care Ombudsman, in developing the standards for the SHSNF 
            pilot program to consult long-term care providers, health 
            advocacy organizations, health care employees organizations, 
            consumer advocates, elder care advocates, and others 
            identified as having a vested interest in long-term health 
            care.

          11)Requires DPH to issue, by July 1, 2013, one or more All 
            Facilities Letters that provide the standards to be used by 
            providers accepted into the pilot program for the development 
            and operation of all pilot facilities. 

          12)Establishes several additional definitions, including 
            defining:  a) "versatile worker" which means a certified 
            nursing assistant who provides personal care, socialization, 
            activity aid services, meal preparation services, and laundry 
            and housekeeping services; b) "supportive care" which includes 
            the provision of socialization, activity aide services, and 
            homemaker services; and, c) "homemaker services" which means 
            food preparation, housekeeping, laundry, and maintenance 
            services.

          13)Requires each pilot facility to provide for consistent staff 
            assignments and self-managed work teams of direct care staff, 
            including staff working as versatile workers.  Requires 
            licensed nursing staff to direct versatile workers in all 
            activities delegated under the licensed nurses' scope of 
            practice.  Permits a versatile worker to be supervised by 
            nonclinical staff when performing nonclinical duties, at the 
            discretion of the facility.

          14)Requires DPH to establish criteria to measure the benefits 
            and successes of SHSNFs, as a whole, and to compare the 
            results achieved by each model variant.  Requires DPH to 
            evaluate and analyze the emerging concepts in long-term SNFs 
            developed pursuant to the pilot program for purposes of 
            considering future regulatory modification.

          15)Requires DPH to prepare and submit a report to the 
            Legislature on the results of the SHSNF pilot program.  
            Requires the report to be submitted to the Legislature at 
            least 24 months prior to the termination of the pilot program, 
            and requires the report to include an evaluation of the pilot 








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            program's cost, safety, and quality of care.

          16)Sunsets the SHSNF pilot program on January 1, 2020. 

          17)Makes conforming changes to avoid chaptering out problems 
            with SB 135 (Ed Hernandez) of 2012 regarding free standing 
            hospice facility licensure.

          18)Makes other technical and clarifying changes.

           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)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.  Require 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  :  This bill, as amended has not yet been heard by 
          a fiscal committee.

           COMMENTS  :  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 SHSNF pilot 
          program to assist the development of SHSNFs in California 
          implementing the core practices that research has shown to 
          reliably deliver improved satisfaction, quality, and cost 
          outcomes.  

          The August 24, 2012, floor amendments changed this bill from 
          establishing a new licensing category for SHSNFs to a pilot 
          program.  The Assembly Health Committee is hearing these 
          substantive changes as well as the August 27, 2012, amendments 
          which do the following:









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          1)Limit the SHSNF pilot facility license to 12 beds;

          2)Establish a definition of "home" for purposes of this bill;

          3)Clarify that a SHSNF pilot facility kitchen may be open, but 
            must allow for separation in accordance with building 
            standards; and,

          4)Make various technical changes.


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


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