Bill Text: CA SB315 | 2015-2016 | Regular Session | Amended
Bill Title: Health care access demonstration project grants.
Spectrum: Partisan Bill (Democrat 3-0)
Status: (Failed) 2016-11-30 - From Assembly without further action. [SB315 Detail]
Download: California-2015-SB315-Amended.html
BILL NUMBER: SB 315 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY AUGUST 31, 2015
AMENDED IN ASSEMBLY JUNE 22, 2015
AMENDED IN SENATE MAY 5, 2015
AMENDED IN SENATE APRIL 13, 2015
INTRODUCED BY Senators Monning and Hernandez
(Coauthor: Senator Pan)
FEBRUARY 23, 2015
An act to amend Sections 15432 and 15438.10 of the Government
Code, relating to health care, and making an appropriation therefor.
LEGISLATIVE COUNSEL'S DIGEST
SB 315, as amended, Monning. Health care access demonstration
project grants.
Existing law, the California Health Facilities Financing Authority
Act, establishes a program for the California Health Facilities
Authority to award grants that do not exceed $1,500,000 to one or
more projects designed to demonstrate specified new or enhanced
cost-effective methods of delivering quality health care services to
improve access to quality health care for vulnerable populations or
communities, or both, that are effective at enhancing health outcomes
and improving access to quality health care and preventive services.
Existing law requires a recipient of that grant to adhere to all
applicable laws relating to scope of practice, licensure, staffing,
and building codes. Existing law authorizes the authority, if a
demonstration project receiving a grant is successful at developing
such a new method of delivering high-quality and cost-effective
health care services, to implement a 2nd grant program, as specified,
to replicate in additional California communities the model
developed by that demonstration project. Existing law requires the
authority to prepare and provide a report to the Legislature and the
Governor on the outcomes of the demonstration grant program that
includes, among other information, the total amount of grants issued
and the amount of each grant issued.
This bill would create the California Health Access Model Program
Two Account within the California Health Facilities Financing
Authority Fund for purposes of administering a 2nd competitive grant
selection process, in accordance with existing grant provisions, to
fund one or more projects designed to demonstrate specified new or
enhanced cost-effective methods of delivering quality health care
services to improve access to quality health care for vulnerable
populations or communities, or both. The bill would transfer
up to $6,500,000 authorize the authority to transfer
moneys up to a total of $3,000,000 from the California Health
Facilities Financing Authority Hospital Equipment Loan Program Fund
to the account for the purposes of the bill,
bill if the authority decides to administer the 2nd competitive grant
selection process, and would require that any moneys remaining
in the account as of January 1, 2023, revert to the
California Health Facilities Financing Authority Hospital Equipment
Loan Program Fund. By expanding the purposes for which a continuously
appropriated fund may be used, this bill would make an
appropriation.
The bill would also require the authority to prepare and provide a
report to the Legislature and the Governor every 2 years, commencing
January 1, 2017, on the 2 grant selection programs, that includes,
among other information, the total amount of grants issued and the
amount of each grant issued, as specified.
This bill would also make the existing requirement for adherence
to all applicable laws relating to scope of practice, licensure,
staffing, and building to codes applicable to a recipient of a grant
provided pursuant to the 2nd grant program described above.
Existing law defines health facility, for purposes of the act, to
include a multilevel facility that is an institutional arrangement
where a residential facility for the elderly is operated as a part
of, or in conjunction with, an intermediate care facility, a skilled
nursing facility, or a general acute care hospital. Existing law
defines elderly, for purposes of this provision, to mean a person 62
years of age or older.
This bill would instead define elderly to mean a person 60 years
of age or older.
This bill would become operative only if AB 648 is enacted and
takes effect on or before January 1, 2016.
Vote: majority. Appropriation: yes. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 15432 of the Government Code is amended to
read:
15432. As used in this part, the following words and terms shall
have the following meanings, unless the context clearly indicates or
requires another or different meaning or intent:
(a) "Act" means the California Health Facilities Financing
Authority Act.
(b) "Authority" means the California Health Facilities Financing
Authority created by this part or any board, body, commission,
department, or officer succeeding to the principal functions thereof
or to which the powers conferred upon the authority by this part
shall be given by law.
(c) "Cost," as applied to a project or portion of a project
financed under this part, means and includes all or any part of the
cost of construction and acquisition of all lands, structures, real
or personal property, rights, rights-of-way, franchises, easements,
and interests acquired or used for a project, the cost of demolishing
or removing any buildings or structures on land so acquired,
including the cost of acquiring any lands to which those buildings or
structures may be moved, the cost of all machinery and equipment,
financing charges, interest prior to, during, and for a period not to
exceed the later of one year or one year following completion of
construction, as determined by the authority, the cost of insurance
during construction, the cost of funding or financing noncapital
expenses, reserves for principal and interest and for extensions,
enlargements, additions, replacements, renovations and improvements,
the cost of engineering, service contracts, reasonable financial and
legal services, plans, specifications, studies, surveys, estimates,
administrative expenses, and other expenses of funding or financing,
that are necessary or incident to determining the feasibility of
constructing any project, or that are incident to the construction,
acquisition, or financing of any project.
(d) "Health facility" means a facility, place, or building that is
licensed, accredited, or certified and organized, maintained, and
operated for the diagnosis, care, prevention, and treatment of human
illness, or physical, mental, or developmental disability, including
convalescence and rehabilitation and including care during and after
pregnancy, or for any one or more of these purposes, for one or more
persons, and includes, but is not limited to, all of the following
types:
(1) A general acute care hospital that is a health facility having
a duly constituted governing body with overall administrative and
professional responsibility and an organized medical staff that
provides 24-hour inpatient care, including the following basic
services: medical, nursing, surgical, anesthesia, laboratory,
radiology, pharmacy, and dietary services.
(2) An acute psychiatric hospital that is a health facility having
a duly constituted governing body with overall administrative and
professional responsibility and an organized medical staff that
provides 24-hour inpatient care for mentally disordered, incompetent,
or other patients referred to in Division 5 (commencing with Section
5000) or Division 6 (commencing with Section 6000) of the Welfare
and Institutions Code, including the following basic services:
medical, nursing, rehabilitative, pharmacy, and dietary services.
(3) A skilled nursing facility that is a health facility that
provides the following basic services: skilled nursing care and
supportive care to patients whose primary need is for availability or
skilled nursing care on an extended basis.
(4) An intermediate care facility that is a health facility that
provides inpatient care to ambulatory or semiambulatory patients who
have recurring need for skilled nursing supervision and need
supportive care, but who do not require availability or continuous
skilled nursing care.
(5) A special health care facility that is a health facility
having a duly constituted governing body with overall administrative
and professional responsibility and an organized medical or dental
staff that provides inpatient or outpatient, acute or nonacute care,
including, but not limited to, medical, nursing, rehabilitation,
dental, or maternity.
(6) A clinic that is operated by a tax-exempt nonprofit
corporation that is licensed pursuant to Section 1204 or 1204.1 of
the Health and Safety Code or a clinic exempt from licensure pursuant
to subdivision (b) or (c) of Section 1206 of the Health and Safety
Code.
(7) An adult day health center that is a facility, as defined
under subdivision (b) of Section 1570.7 of the Health and Safety
Code, that provides adult day health care, as defined under
subdivision (a) of Section 1570.7 of the Health and Safety Code.
(8) A facility owned or operated by a local jurisdiction for the
provision of county health services.
(9) A multilevel facility that is an institutional arrangement
where a residential facility for the elderly is operated as a part
of, or in conjunction with, an intermediate care facility, a skilled
nursing facility, or a general acute care hospital. "Elderly," for
the purposes of this paragraph, means a person 60 years of age or
older.
(10) A child day care facility operated in conjunction with a
health facility. A child day care facility is a facility, as defined
in Section 1596.750 of the Health and Safety Code. For purposes of
this paragraph, "child" means a minor from birth to 18 years of age.
(11) An intermediate care facility/developmentally disabled
habilitative that is a health facility, as defined under subdivision
(e) of Section 1250 of the Health and Safety Code.
(12) An intermediate care facility/developmentally
disabled-nursing that is a health facility, as defined under
subdivision (h) of Section 1250 of the Health and Safety Code.
(13) A community care facility that is a facility, as defined
under subdivision (a) of Section 1502 of the Health and Safety Code,
that provides care, habilitation, rehabilitation, or treatment
services to developmentally disabled or mentally impaired persons.
(14) A nonprofit community care facility, as defined in
subdivision (a) of Section 1502 of the Health and Safety Code, other
than a facility that, as defined in that subdivision, is a
residential facility for the elderly, a foster family agency, a
foster family home, a full service adoption agency, or a noncustodial
adoption agency.
(15) A nonprofit accredited community work activity program, as
specified in subdivision (e) of Section 4851 and Section 4856 of the
Welfare and Institutions Code.
(16) A community mental health center, as defined in paragraph (3)
of subdivision (b) of Section 5667 of the Welfare and Institutions
Code.
(17) A nonprofit speech and hearing center, as defined in Section
1201.5 of the Health and Safety Code.
(18) A blood bank, as defined in Section 1600.2 of the Health and
Safety Code, licensed pursuant to Section 1602.5 of the Health and
Safety Code, and exempt from federal income taxation pursuant to
Section 501(c)(3) of the Internal Revenue Code.
(19) A residential facility for persons with developmental
disabilities, as defined in Sections 4688.5 and 4688.6 of the Welfare
and Institutions Code, which includes, but is not limited to, a
community care facility licensed pursuant to Section 1502 of the
Health and Safety Code and a family teaching home as defined in
Section 4689.1 of the Welfare and Institutions Code.
(20) A nonpublic school that provides educational services in
conjunction with a health facility, as defined in paragraphs (1) to
(19), inclusive, that otherwise qualifies for financing pursuant to
this part, if the nonpublic school is certified pursuant to Sections
56366 and 56366.1 of the Education Code as meeting standards relating
to the required special education and specified related services and
facilities for individuals with physical, mental, or developmental
disabilities.
"Health facility" includes a clinic that is described in
subdivision (l) of Section 1206 of the Health and Safety Code.
"Health facility" includes information systems equipment and the
following facilities, if the equipment and facility is operated in
conjunction with or to support the services provided in one or more
of the facilities specified in paragraphs (1) to (20), inclusive, of
this subdivision: a laboratory, laundry, a nurses or interns
residence, housing for staff or employees and their families or
patients or relatives of patients, a physicians' facility, an
administration building, a research facility, a maintenance, storage,
or utility facility, an information systems facility, all structures
or facilities related to any of the foregoing facilities or required
or useful for the operation of a health facility and the necessary
and usual attendant and related facilities and equipment, and parking
and supportive service facilities or structures required or useful
for the orderly conduct of the health facility.
"Health facility" does not include any institution, place, or
building used or to be used primarily for sectarian instruction or
study or as a place for devotional activities or religious worship.
(e) "Participating health institution" means a city, city and
county, or county, a district hospital, or a private nonprofit
corporation or association, or a limited liability company whose sole
member is a nonprofit corporation or association authorized by the
laws of this state to provide or operate a health facility or a
nonprofit corporation that controls or manages, is controlled or
managed by, is under common control or management with, or is
affiliated with any of the foregoing, and that, pursuant to this
part, undertakes the financing or refinancing of the construction or
acquisition of a project or of working capital as provided in this
part. "Participating health institution" also includes, for purposes
of the California Health Facilities Revenue Bonds (UCSF-Stanford
Health Care) 1998 Series A, the Regents of the University of
California.
(f) "Project" means construction, expansion, remodeling,
renovation, furnishing, or equipping, or funding, financing, or
refinancing of a health facility or acquisition of a health facility
to be financed or refinanced with funds provided in whole or in part
pursuant to this part. "Project" may include reimbursement for the
costs of construction, expansion, remodeling, renovation, furnishing,
or equipping, or funding, financing, or refinancing of a health
facility or acquisition of a health facility. "Project" may include
any combination of one or more of the foregoing undertaken jointly by
any participating health institution with one or more other
participating health institutions.
(g) "Revenue bond" or "bond" means a bond, warrant, note, lease,
or installment sale obligation that is evidenced by a certificate of
participation or other evidence of indebtedness issued by the
authority.
(h) "Working capital" means moneys to be used by, or on behalf of,
a participating health institution to pay or prepay maintenance or
operation expenses or any other costs that would be treated as an
expense item, under generally accepted accounting principles, in
connection with the ownership or operation of a health facility,
including, but not limited to, reserves for maintenance or operation
expenses, interest for not to exceed one year on any loan for working
capital made pursuant to this part, and reserves for debt service
with respect to, and any costs necessary or incidental to, that
financing.
SEC. 2. Section 15438.10 of the Government Code is amended to
read:
15438.10. (a) The Legislature finds and declares the following:
(1) Many Californians face serious obstacles in obtaining needed
health care services, including, but not limited to, medical, mental
health, dental, and preventive services. The obstacles faced by
vulnerable populations and communities include the existence of
complex medical, physical, or social conditions, disabilities,
economic disadvantage, and living in remote or underserved areas that
make it difficult to access services.
(2) With the recent passage of national health care reform, there
is an increased demand for innovative ways to deliver quality health
care, including preventive services, to individuals in a
cost-effective manner.
(3) There is a need to develop new methods of delivering health
services utilizing innovative models that can be demonstrated to be
effective and then replicated throughout California and that bring
community-based health care preventive services to individuals where
they live or receive education, social, or general health services.
(4) For more than 30 years, the California Health Facilities
Financing Authority has provided financial assistance through
tax-exempt bonds, low-interest loans, and grants to health facilities
in California, assisting in the expansion of the availability of
health services and health care facilities throughout the state.
(b) (1) Following the completion of a competitive selection
process, the authority may award one or more grants that, in the
aggregate, do not exceed one million five hundred thousand dollars
($1,500,000) to one or more projects designed to demonstrate
specified new or enhanced cost-effective methods of delivering
quality health care services to improve access to quality health care
for vulnerable populations or communities, or both, that are
effective at enhancing health outcomes and improving access to
quality health care and preventive services. These health care
services may include, but are not limited to, medical, mental health,
or dental services for the diagnosis, care, prevention, and
treatment of human illness, or individuals with physical, mental, or
developmental disabilities. More than one demonstration project may
receive a grant pursuant to this section. It is the intent of the
Legislature for a demonstration project that receives a grant to
allow patients to receive screenings, diagnosis, or treatment in
community settings, including, but not limited to, school-based
health centers, adult day care centers, and residential care
facilities for the elderly, or for individuals with mental illness or
developmental disabilities.
(2) A grant awarded pursuant to this subdivision may be allocated
in increments to a demonstration project over multiple years to
ensure the demonstration project's ability to complete its work, as
determined by the authority. Prior to the initial allocation of funds
pursuant to this subdivision, the administrators of the
demonstration project shall provide evidence that the demonstration
project has or will have additional funds sufficient to ensure
completion of the demonstration project. If the authority allocates a
grant in increments, each subsequent year's allocation shall be
provided to the demonstration project only upon submission of
research that shows that the project is progressing toward the
identification of a high-quality and cost-effective delivery model
that improves health outcomes and access to quality health care and
preventive services for vulnerable populations or communities, and
can be replicated throughout the state in community settings.
(3) Except for a health facility that qualifies as a "small and
rural hospital" pursuant to Section 124840 of the Health and Safety
Code, a health facility that has received tax-exempt bond financing
from the authority shall not be eligible to receive funds awarded for
a demonstration project. Such a health facility may participate as
an uncompensated partner or member of a collaborative effort that is
awarded a demonstration project grant. A health facility that
participates in a demonstration project that receives funds pursuant
to this section may not claim the funding provided by the authority
toward meeting its community benefit and charity care obligations.
(4) Funds provided to a demonstration project pursuant to this
subdivision may be used to supplement, but not to supplant, existing
financial and resource commitments of the grantee or grantees or any
other member of a collaborative effort that has been awarded a
demonstration project grant.
(c) (1) If a demonstration project that receives a grant pursuant
to subdivision (b) is successful at developing a new method of
delivering high-quality and cost-effective health care services in
community settings that result in increased access to quality health
care and preventive services or improved health care outcomes for
vulnerable populations or communities, or both, then beginning as
early as the second year after the initial allocation of moneys
provided pursuant to subdivision (b), the authority may implement a
second grant program that awards not more than five million dollars
($5,000,000), in the aggregate, to eligible recipients as defined by
the authority, to replicate in additional California communities the
model developed by a demonstration project that received a grant
pursuant to subdivision (b). Prior to the implementation of this
second grant program, the authority shall prepare and provide a
report to the Legislature and the Governor on the outcomes of the
demonstration project. The report shall be made in accordance with
Section 9795.
(2) If the authority implements the second grant program, the
authority shall also report annually, beginning with the first year
of implementation of the second grant program, to the Legislature and
the Governor regarding the program, including, but not limited to,
the total amount of grants issued pursuant to this subdivision, the
amount of each grant issued, and a description of each project
awarded funding for replication of the model.
(3) Grants under this subdivision may be utilized for eligible
costs, as defined in subdivision (c) of Section 15432, including
equipment, information technology, and working capital, as defined in
subdivision (h) of Section 15432.
(4) The authority may adopt regulations relating to the grant
program authorized pursuant to this subdivision, including
regulations that define eligible recipients, eligible costs, and
minimum and maximum grant amounts.
(d) (1) The authority shall prepare and provide a report to the
Legislature and the Governor every two years, commencing on January
1, 2017, on the grants awarded pursuant to subdivisions (b) and (g)
that includes, but is not limited to, the following:
(A) The total amount of grants issued.
(B) The amount of each grant issued.
(C) A description of other sources of funding for each project.
(D) A description of each project awarded funding.
(E) If available, a description of project outcomes that
demonstrate cost-effective delivery of health care services in
community settings, that result in improved access to quality health
care or improved health care outcomes.
(2) A report submitted pursuant to this subdivision shall be
submitted in compliance with Section 9795.
(e) There is hereby created the California Health Access Model
Program Account in the California Health Facilities Financing
Authority Fund. All moneys in the account are hereby continuously
appropriated to the authority for carrying out the purposes of this
section. An amount of up to six million five hundred thousand dollars
($6,500,000) shall be transferred from funds in the California
Health Facilities Financing Authority Fund that are not impressed
with a trust for other purposes into the California Health Access
Model Program Account for the purpose of issuing grants pursuant to
this section. Any moneys remaining in the California Health Access
Model Program Account on January 1, 2020, shall revert as of that
date to the California Health Facilities Financing Authority Fund.
(f) Any recipient of a grant provided pursuant to subdivisions (b)
and (c) shall adhere to all applicable laws relating to scope of
practice, licensure, staffing, and building codes.
(g) There is hereby created the California Health Access Model
Program Two Account within the California Health Facilities Financing
Authority Fund for purposes of administering a second competitive
grant selection process, in accordance with subdivisions (b) and (c),
to fund one or more projects designed to demonstrate specified new
or enhanced cost-effective methods of delivery quality health care
services to improve access to quality health care for vulnerable
populations or communities, or both. An amount of up to six
million five hundred thousand dollars ($6,500,000) shall be
transferred The authority may transfer moneys up to a
total of three million dollars ($3,000,000) from funds in the
California Health Facilities Financing Authority Hospital Equipment
Loan Program Fund that are not impressed with a trust for other
purposes into the California Health Access Model Program Two Account
for the purpose of administering a second competitive grant selection
process pursuant to this subdivision.
subdivision if the authority decides to administer the second
competitive grant selection process. Any moneys remaining in
the California Health Access Model Program Two Account on January 1,
2023, shall revert as of that date to the California Health
Facilities Financing Authority Hospital Equipment Loan Program Fund.
SEC. 3. This act shall become operative only if
Assembly Bill 648 is enacted and takes effect on or before January 1,
2016.
