Bill Text: CA SB1033 | 2023-2024 | Regular Session | Amended

California Senate Bill 1033

NOTE: There are more recent revisions of this legislation. Read Latest Draft

Bill Title: Medi-Cal cost reporting: private duty nursing and congregate living health facilities.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Engrossed) 2024-06-25 - June 25 set for first hearing canceled at the request of author. [SB1033 Detail]

Download: California-2023-SB1033-Amended.html

Amended IN Senate April 15, 2024

Amended IN Senate March 11, 2024

CALIFORNIA LEGISLATURE— 2023–2024 REGULAR SESSION

Senate Bill

No. 1033

Introduced by Senator Menjivar

February 06, 2024

An act to add Article 3.87 (commencing with Section 14127) to Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions Code, relating to health facilities.

LEGISLATIVE COUNSEL'S DIGEST

SB 1033, as amended, Menjivar. Health facilities: congregate living health facilities.

Existing law provides for the licensure and regulation by the State Department of Public Health of health facilities, including, congregate living health facilities. Existing law defines “congregate living health facility” as a residential home with a capacity of 18 beds that provides inpatient and skilled nursing care, as specified. Existing law provides for 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 Long-Term Care Reimbursement Act requires the department to implement a facility-specific ratesetting system using a cost-based reimbursement rate methodology and to update these rates annually.

This bill would require, beginning January 10, 2026, and every 3 years thereafter, the State Department of Health Care Services to prepare and submit a cost study to the appropriate fiscal and policy committees of the Legislature. The bill would require the cost study to evaluate all financial and operational costs associated with licensed congregate living health facilities, as specified. The bill would require the department to consult with congregate living health facility providers, patients or families, caregivers, and other relevant parties in preparing the study. The bill would require the department to increase rates for licensed congregate living facilities if a cost study shows an increase above the Consumer Price index for the years between the submitted studies. The bill would authorize the department to adjust rates to maintain patient access if licensed congregate living health facilities can demonstrate that costs have increased in a single year. The bill would require the department to adjust rates in a manner consistent with the study. The bill would require, after January 10, 2026, and each year thereafter, rate changes to be included in the Medi-Cal estimate, consistent with the annual Budget Act released on or before January 10 of each year, and are to be indexed to the previous fiscal year.

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

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

SECTION 1.

Article 3.87 (commencing with Section 14127) is added to Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions Code, to read:

Article 3.87. Congregate Living Health Facilities Cost Study

14127.

(a) On or before January 10, 2026, and every three years thereafter, the State Department of Health Care Services shall submit a cost study to the appropriate fiscal and policy committees of the Legislature. This cost study shall evaluate all financial and operational costs associated with licensed congregate living health facilities in California. In developing the cost study, the department shall consult with congregate living health facility providers, patients or families, caregivers, and other relevant parties.

(b) The study shall include, but not be limited to, an assessment of the operational costs of direct and indirect labor, licensing fees, medical equipment, food, utilities, liability insurance, property tax, and staff training.

(c)If a cost study prepared pursuant to this section shows increases in operational costs above the Consumer Price Index for the years between each study, the department shall increase rates for licensed congregate living facilities to an amount that accounts for and reimburses the excess costs.
(d)To the extent that licensed congregate living health facilities can demonstrate that costs have increased in a single year, the department may adjust rates in a non-study year to maintain patient access.
(c) Notwithstanding any other law, the department shall adjust rates in a manner consistent with the triennial rate study required by subdivision (a). After January 10, 2026, and each year thereafter, rate changes shall be included in the Medi-Cal estimate, consistent with the annual Budget Act released on or before January 10 of each year, and shall be indexed to the previous fiscal year.