Bill Text: CA SB1354 | 2023-2024 | Regular Session | Amended

California Senate Bill 1354

Bill Title: Long-term health care facilities: payment source and resident census.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced) 2024-04-25 - From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 9. Noes 2.) (April 24). [SB1354 Detail]

Download: California-2023-SB1354-Amended.html

Amended IN Senate April 15, 2024

CALIFORNIA LEGISLATURE— 2023–2024 REGULAR SESSION

Senate Bill

No. 1354

Introduced by Senator Wahab

February 16, 2024

An act to amend Section 1599.78 of, and to add Section 1439.9 to, the Health and Safety Code, and to amend Sections 14005.19 and 14124.7 of the Welfare and Institutions Code, relating to health facilities.

LEGISLATIVE COUNSEL'S DIGEST

SB 1354, as amended, Wahab. ~~Health facilities: payment source.~~ Long-term health care facilities: payment source and resident census.

Existing law provides for the licensing and regulation of long-term health care facilities, including, among others, skilled nursing facilities and intermediate care facilities, by the State Department of Public Health. A violation of those provisions is generally a crime. Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.
Existing law prohibits a long-term health care facility that participates as a provider under the Medi-Cal program from discriminating against a Medi-Cal patient on the basis of the source of payment for the facility’s services that are required to be provided to individuals entitled to services under the Medi-Cal program. Existing law prohibits that facility from seeking to evict out of the facility, or transfer within the facility, any resident as a result of the resident changing their manner of purchasing the services from private payment or Medicare to Medi-Cal, except as specified.
This bill would require the facility to provide aid, care, service, or other benefits available under Medi-Cal to Medi-Cal beneficiaries in the same manner, by the same methods, and at the same scope, level, and quality as provided to the general public, regardless of payment source.
Existing federal regulations require certain nursing facilities to post their resident census on a daily basis.
This bill would require a long-term health care facility that participates as a provider under the Medi-Cal program to make publicly available its daily resident census, excluding any personally identifiable information. The bill would require the facility to make the information available by posting it on the facility’s internet website, if one exists, and by providing the information to a requester within 24 hours of a request, as specified. The bill would exempt these requirements from the above-described and other related criminal penalties.
Existing law requires that a contract of admission to a long-term health care facility state that, except in an emergency, a resident may not be involuntarily transferred or discharged from the facility unless the resident and, if applicable, the resident’s representative, are given reasonable notice in writing and transfer or discharge planning as required by law. Existing law requires that the written notice state the reason for the transfer or discharge.
This bill would require that the notice also include a specified statement relating to, among other things, restrictions on transfer or discharge from the facility because of a change from private payment or Medicare to Medi-Cal payment, and certain resource information about facilities participating in Medi-Cal.
Existing law prohibits a long-term health care facility that participates as a provider under the Medi-Cal program from transferring or seeking to evict out of the facility any resident as a result of the resident changing his or her manner of purchasing the services from private payment or Medicare to Medi-Cal benefits and for whom an eligibility determination has not yet been made, except as specified.
This bill would require a long-term health care that participates as a provider under the Medi-Cal program to provide aid, care, service, or other benefits available under Medi-Cal to Medi-Cal beneficiaries in the same manner, by the same methods, and at the same scope, level, and quality as provided to the general public, regardless of payment source.

Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO

The people of the State of California do enact as follows:

SECTION 1.

Section 1439.9 is added to the Health and Safety Code, to read:

1439.9.
(a) A long-term health care facility participating as a provider under the Medi-Cal program shall make publicly available its daily resident census by meeting both of the following conditions:
(1) The facility shall post on its internet website, if one exists, the facility’s daily resident census dating back to at least 18 months.
(2) Upon request, and within 24 hours of that request, the facility shall provide the requester with the facility’s daily resident census dating back to a time as specified by the requester. The facility may charge the requester a reasonable fee to cover any necessary administrative costs incurred by the facility in preparing and providing the requested information.
(b) The data made available pursuant to subdivision (a) shall exclude any personally identifiable information.
(c) A violation of this section is exempt from Sections 1290 and 1431.

SEC. 2.

Section 1599.78 of the Health and Safety Code is amended to read:

1599.78.

(a) A contract of admission shall state ~~that~~ that, except in an emergency, a resident may not be involuntarily transferred or discharged from a long-term health care facility unless the resident and, if applicable, the resident’s representative, is are given reasonable notice in writing and transfer or discharge planning as required by law. The written notice shall ~~state~~ meet both of the following conditions:

(1) The notice shall state the reason for the transfer or discharge.

(2) The notice shall include the following statement:

“Our facility is required to provide continuous skilled nursing care and supportive care to residents whose primary need is for availability of skilled nursing care on an extended basis.
We have been approved to receive payment from the following government health care programs: ____ Medi-Cal ____ Medicare.
If we participate in Medi-Cal, we will not transfer you from the facility or discharge you solely because you change from private payment or Medicare to Medi-Cal payment or to open a bed for residents with health care coverage that provides a higher rate of reimbursement.
If we participate in Medi-Cal, you may be eligible for the Long-Term Care Medi-Cal program to help pay for your stay in the facility. For more information, refer to the attached notice DHCS 7077, Notice Regarding Standards for Medi-Cal Eligibility, from the State Department of Health Care Services. Medi-Cal, Medicare, or a private payor may require that the resident pay a copayment, coinsurance, or a deductible, all of which the facility considers to be the resident’s share of cost.”

(b) The facility shall promptly notify the Office of the State Long-Term Care Ombudsman in every case of involuntary discharge as specified in Section 1439.7.

SEC. 3.

Section 14005.19 of the Welfare and Institutions Code is amended to read:

14005.19.

The receipt of respite care, as defined in Section 1418.1 of the Health and Safety Code, shall not affect the eligibility of any individual with respect to benefits under this chapter, except as subject to the limitations of subdivision ~~(b)~~ (c) of Section 14124.7.

SECTION 1.SEC. 4.

Section 14124.7 of the Welfare and Institutions Code is amended to read:

14124.7.

(a) A long-term health care facility participating as a provider under the Medi-Cal program shall provide aid, care, service, or other benefits available under Medi-Cal to Medi-Cal beneficiaries in the same manner, by the same methods, and at the same scope, level, and quality as provided to the general public, regardless of payment source. This subdivision applies to, but is not limited to, admission practices, room selection and placements, meal provision, and wait times for surgical procedures.

(b) No long-term health care facility participating as a provider under the Medi-Cal program shall seek to evict out of the facility or, effective January 1, 2002, transfer within the facility, any resident as a result of the resident changing ~~his or her~~ their manner of purchasing the services from private payment or Medicare to Medi-Cal, except that a facility may transfer a resident from a private room to a semiprivate room if the resident changes to Medi-Cal payment status. This section also applies to residents who have made a timely and good faith application for Medi-Cal benefits and for whom an eligibility determination has not yet been made.

(c) This section does not apply to any resident of a skilled nursing facility or intermediate care facility, receiving respite care services, as defined in Section 1418.1 of the Health and Safety Code, unless it is already being provided through a Medicaid waiver program pursuant to Section 1396n of Title 42 of the United States Code, or is already allowed as a covered service by the Medi-Cal program.

(d) Nothing in this section shall limit a facility’s ability to transfer a resident within a facility, as provided by law, because of a change in a resident’s health care needs or if the bed retention would result in there being no available Medicare-designated beds within a facility.

(e) This section shall be implemented only to the extent that it does not conflict with federal law.