BILL ANALYSIS �
AB 1974
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB 1974 (Quirk)
As Amended August 5, 2014
Majority vote
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|ASSEMBLY: |73-0 |(May 23, 2014) |SENATE: |34-0 |(August 7, |
| | | | | |2014) |
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Original Committee Reference: E. & R.
SUMMARY : Specifies that a "special service" does not include a
functional division, department, or unit of a nursing facility
that is Medicare or Medi-Cal certified and that is organized,
staffed, and equipped to provide inpatient physical therapy
services, occupational therapy services, or speech pathology and
audiology services to residents of the facility.
The Senate amendments clarify that this bill does not limit the
Department of Public Health's (DPH) ability to evaluate
compliance with therapy requirements for nursing facilities and
skilled nursing facilities (SNFs) during investigations or
inspections.
AS PASSED BY THE ASSEMBLY , this bill specified that, for
purposes of SNF licensing applications "special service" does
not include a functional division, department, or unit of a
nursing facility that is organized, staffed, and equipped to
provide physical therapy services, occupational therapy
services, or speech pathology and audiology services to
residents of the facility.
FISCAL EFFECT : According to the Senate Appropriations
Committee, pursuant to Senate Rule 28.8, negligible state costs.
COMMENTS : According to the author, state law and regulations
require that SNFs receive approval from DPH to provide "special
services" or "optional services" to their patients and these
services include physical therapy, occupational therapy, and
speech pathology. The author further states that to receive a
license a facility must fill out a detailed application and
state licensing officials must conduct a thorough and
specialized survey of the facility, however, requiring SNFs that
are licensed under Medi-Cal, through the Department of Health
AB 1974
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Care Services and certified under Medicare to also obtain
approval from DPH to provide therapy services is duplicative and
creates an unnecessary burden for both the nursing facility and
the state.
Health care facilities in California are licensed, regulated,
inspected, and/or certified by a number of public and private
agencies at the state and federal levels, including the DPH
Licensing and Certification Program and the United States
Department of Health and Human Services' Centers for Medicare
and Medicaid Services (CMS). These agencies have separate, yet
sometimes overlapping, jurisdictions. DPH is responsible for
ensuring health care facilities comply with state laws and
regulations. In addition, DPH cooperates with CMS to ensure
that facilities accepting Medicare and Medi-Cal (in California,
Medicaid is referred to as Medi-Cal) payments meet federal
requirements.
In 1987 the federal Omnibus Budget Reconciliation Act was
implemented, under which to be federally certified and meet
Medicare and Medicaid requirements, a SNF must offer physical
therapy, occupational therapy, and speech pathology. Medicare
certification surveyors annually review facilities for
compliance with these requirements. California's Title 22
regulations relating to optional services have not been updated
by DPH since the federal changes were made, and specify that
physical therapy, occupational therapy, and speech pathology are
"special services" or "optional services," and as such must be
listed on a facilities licensing application.
The California Association of Health Facilities' (CAHF) is the
sponsor of this bill and states that because of an outdated
technicality licensed and certified nursing facilities must
submit duplicate forms and spend unnecessary time in completing
these requirements along with the state wasting unnecessary
funding and resources in duplicating a survey. CAHF further
states this bill will address the redundant and obsolete
California Title 22 requirements by amending statute to state
that Medicare certified nursing facilities will not be required
to obtain duplicative approval by state licensing to provide
inpatient therapy services already required under their
certification.
The California Hospital Association supports this bill, writing
that outdated Medicaid requirements categorize therapy services
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as optional under the Medi-Cal program, however, if a SNF wants
to participate in the Medicare program (which most facilities
do) they must comply with the mandatory requirement that these
same therapy services be provided to a patient that has a care
plan requiring such services.
This bill has no opposition on file.
Analysis Prepared by : Lara Flynn / HEALTH / (916) 319-2097
FN:
0004396