Amended IN Senate September 06, 2017 CALIFORNIA LEGISLATURE 20172018 REGULAR SESSION Assembly Bill No. 130Introduced by Assembly Member Ting Committee on Budget (Assembly Members Ting (Chair), Arambula, Bloom, Caballero, Chiu, Cooper, Cristina Garcia, Jones-Sawyer, Limn, McCarty, Medina, Mullin, Muratsuchi, ODonnell, Rubio, Mark Stone, Weber, and Wood)January 10, 2017An act relating to the Budget Act of 2017. An act to amend Sections 12301.61, 14126.022, and 17605 of the Welfare and Institutions Code, relating to health and human services, and making an appropriation therefor, to take effect immediately, bill related to the budget.LEGISLATIVE COUNSEL'S DIGESTAB 130, as amended, Committee on Budget. Budget Act of 2017. Health and human services.(1) Existing law establishes the county-administered In-Home Supportive Services (IHSS) program, under which qualified aged, blind, and disabled persons are provided with services in order to permit them to remain in their own homes and avoid institutionalization. Under existing law, a county board of supervisors may elect to contract with a nonprofit consortium to provide for the delivery of in-home supportive services, or establish, by ordinance, a public authority to provide for the delivery of in-home supportive services. Existing law requires, until January 1, 2020, a specified mediation process to be held if a public authority or nonprofit consortium fails to reach agreement on a bargaining contract with its in-home supportive services workers by January 1, 2018.This bill would clarify that the specified mediation process is required if a public authority or nonprofit consortium and the employee organization have not reached an agreement on a bargaining contract with in-home supportive services workers by January 1, 2018.Existing law requires the state and counties to share the annual cost of providing in-home supportive services and requires all counties to have a County IHSS Maintenance of Effort (MOE) commencing July 1, 2017, as prescribed. Existing law requires that a portion of IHSS costs that are the counties responsibility to be offset using a combination of General Fund moneys appropriated in the annual Budget Act and redirected 1991 Realignment Vehicle License Fee growth revenues, as specified.Existing law requires the Controller to deposit into the Caseload Subaccount of the Sales Tax Growth Account of the Local Revenue Fund, from revenues deposited into the Sales Tax Growth Account, an amount determined by the Department of Finance that is sufficient to fund the net cost for the realigned portion of the county or city and county share of growth in social services caseloads and any share of growth from the previous year or years for which sufficient revenues were not available in the Caseload Subaccount, and requires the Controller to allocate funds to counties based on those calculations. Existing law defines growth for these purposes to mean the increase in the actual caseload expenditures for the prior fiscal year over the actual caseload expenditures for the fiscal year preceding the prior fiscal year for costs from specified social services programs, including the County IHSS MOE in effect on June 30, 2017. Commencing with the caseload growth calculation for the 201718 fiscal year and each fiscal year thereafter, growth includes the County IHSS MOE costs to counties commencing on July 1, 2017, for the current fiscal year over the County IHSS MOE costs to counties for the prior fiscal year, less specified amounts.This bill would revise these factors used to calculate the caseload growth, by changing the definition of growth to exclude the County IHSS MOE in effect on June 30, 2017, and by including offsets provided by General Fund moneys and redirected 1991 Realignment Vehicle License Fee growth revenues in the calculation of the County IHSS MOE costs. The bill would also require the State Controller, commencing with the caseload growth calculation for the 201718 fiscal year, to annually post on its Internet Web site the total amount of unfunded caseload growth by county.(2) Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, 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.This bill would appropriate $5,884,000 from the Federal Trust Fund to the State Department of Health Care Services in the 201718 fiscal year for the purpose of providing supplemental reimbursements to specific hospitals that provide trauma care to Medi-Cal beneficiaries.(3) Existing law provides for the licensure and regulation of health facilities, including skilled nursing facilities, by the State Department of Public Health. Among other requirements, these provisions generally require skilled nursing facilities to have a minimum number of nursing hours per patient day of 3.2 hours, and effective July 1, 2018, requires skilled nursing facilities, except as specified, to have a minimum number of direct care service hours, as defined, of 3.5 hours per patient day. Existing law requires the department to adopt regulations to create a waiver of the direct care service hour requirements.Existing law requires the State Department of Health Care Services, in connection with its administration of the Medi-Cal program, to develop the Skilled Nursing Facility Quality and Accountability Supplemental Payment System, and requires the system to be utilized to, among other things, assign quality and accountability payments or penalties relating to direct care staffing levels at a skilled nursing facility, including the nursing hours or direct care service hours per patient per day requirements. Existing law establishes the Skilled Nursing Facility Quality and Accountability Special Fund in the State Treasury, which is a continuously appropriated fund that contains moneys from the assessment of specified administrative penalties and setasides of General Fund moneys, for the purposes of making the quality and accountability payments.Existing law, to a specified extent, provides that a skilled nursing facility shall remain eligible to participate in the supplemental payment program so long as the facility meets applicable nursing hours per patient per day requirements that would have applied in the absence of the direct care service hour requirements described above. Existing law, to a specified extent, prohibits using compliance with the direct care service hour requirements to determine facility qualification for supplemental payments and instead requires the department to apply the nursing hour requirements for purposes of administering the supplemental payments until the performance period beginning in the 201920 fiscal year.This bill, instead, would specify that for performance periods in the 201718 and 201819 fiscal years, a skilled nursing facility shall remain eligible to participate in the supplemental payment program so long as the facility meets applicable nursing hours per patient per day requirements. The bill would, for performance periods beginning in the 201920 fiscal year and each fiscal year thereafter, provide that a skilled nursing facility that is granted a waiver of the direct care service hour requirements shall remain eligible to participate in the supplemental payment program so long as the facility meets the applicable nursing hour requirements that would have applied in the absence of the direct care service hour requirements described above for the duration of time for which the waiver is granted. By expanding the number of facilities that would be eligible to participate in the supplemental payment program and therefore expanding the payments from a continuously appropriated fund, the bill would make an appropriation.(4) The Budget Act of 2017 appropriated a specified sum to the State Department of Social Services for local assistance relating to the CalWORKs program and other assistance payments.This bill would require the department to allocate $5,400,000 from the General Fund moneys in the above-described appropriation to the City of San Jose for purposes of assisting homeless and low-income individuals displaced by the Coyote Creek flooding that occurred in February 2017, and, as a condition of receiving these funds, the bill would require the City of San Jose to provide quarterly reports to the department, as specified.(5) This bill would declare that it is to take effect immediately as a bill providing for appropriations related to the Budget Bill.This bill would express the intent of the Legislature to enact statutory changes relating to the Budget Act of 2017.Digest Key Vote: MAJORITY Appropriation: NOYES Fiscal Committee: NOYES Local Program: NO Bill TextThe people of the State of California do enact as follows:SECTION 1. Section 12301.61 of the Welfare and Institutions Code is amended to read:12301.61. (a) If a public authority or nonprofit consortium established pursuant to Section 12301.6, acting as the employer of record, fails to reach and the employee organization have not reached an agreement on a bargaining contract with its in-home supportive services workers by January 1, 2018, either party may request mediation, pursuant to Section 3505.2 of the Government Code, which shall be mandatory. If the parties fail to agree on a mediator, the Public Employment Relations Board shall appoint one from the pool described in subdivision (c). The mediation shall be held no more than 15 business days from the date requested by either party.(b) If the parties are unable to effect settlement through mediation as described in subdivision (a), the parties shall then submit their differences to factfinding, pursuant to Section 3505 and 3505.4 of the Government Code. Alternatively, if both parties agree, the parties may bypass the mediation process in subdivision (a) and move directly to factfinding.(1) The factfinding panel shall make findings of fact and recommend terms of settlement, which shall be advisory only, within 30 days after the panel is appointed by the Public Employment Relations Board.(2) Within 15 days after the factfinding panel has released its findings of fact and recommended settlement terms, either party may request post-factfinding mediation consistent with Section 3505.2 of the Government Code, which shall be mandatory. If the parties fail to agree on a mediator, the Public Employment Relations Board shall appoint one from the pool described in subdivision (c).(3) If either party elects post-factfinding mediation, the findings of fact and recommended settlement terms, shall not be made public until the mediation has concluded.(4) Mediation shall be held no more than 15 days from the date requested, and may include, at the mediators discretion, the factfinding panel and representatives of both parties. The director, or his or her designee, shall be available to provide information and expertise, as necessary.(c) The Public Employment Relations Board shall designate a pool of no more than five qualified individuals to serve as mediators or on a factfinding panel. The pool shall consist of individuals with relevant subject matter expertise. The board shall select individuals for the pool in consultation with the department and the affected employers and employee organizations. Priority shall be given to individuals with knowledge of the In-Home Supportive Services program. The board may designate the mediator to serve as the neutral member of the factfinding panel.(d) The costs for the services of the factfinding panel and the mediator shall be equally divided between the employer and the employee organization, parties, and shall include per diem fees, if any, and actual and necessary travel and subsistence expenses.(e) By April 1, 2018, the department shall report to the fiscal committees of the Legislature on the status of all in-home supportive services bargaining contracts in each county.(f) If no individual is available to serve as a mediator or factfinder within the timelines specified in this section, the timelines shall be extended until the next mediator or factfinder is available.(g) This section shall remain in effect only until January 1, 2020, and as of that date is repealed.SEC. 2. Section 14126.022 of the Welfare and Institutions Code is amended to read:14126.022. (a) (1) By August 1, 2011, the department shall develop the Skilled Nursing Facility Quality and Accountability Supplemental Payment System, subject to approval by the federal Centers for Medicare and Medicaid Services, and the availability of federal, state, or other funds.(2) (A) The system shall be utilized to provide supplemental payments to skilled nursing facilities that improve the quality and accountability of care rendered to residents in skilled nursing facilities, as defined in subdivision (c) of Section 1250 of the Health and Safety Code, and to penalize those facilities that do not meet measurable standards.(B) A freestanding pediatric subacute care facility, as defined in Section 51215.8 of Title 22 of the California Code of Regulations, shall be exempt from the Skilled Nursing Facility Quality and Accountability Supplemental Payment System.(3) The system shall be phased in, beginning with the 201011 rate year.(4) The department may utilize the system to do all of the following:(A) Assess overall facility quality of care and quality of care improvement, and assign quality and accountability payments to skilled nursing facilities pursuant to performance measures described in subdivision (i).(B) Assign quality and accountability payments or penalties relating to quality of care, or direct care staffing levels, wages, and benefits, or both.(C) Limit the reimbursement of legal fees incurred by skilled nursing facilities engaged in the defense of governmental legal actions filed against the facilities.(D) Publish each facilitys quality assessment and quality and accountability payments in a manner and form determined by the director, or his or her designee.(E) Beginning with the 201112 fiscal year, establish a base year to collect performance measures described in subdivision (i).(F) Beginning with the 201112 fiscal year, in coordination with the State Department of Public Health, publish the direct care staffing level data and the performance measures required pursuant to subdivision (i).(5) The department, in coordination with the State Department of Public Health, shall report to the relevant Assembly and Senate budget subcommittees by May 1, 2016, information regarding the quality and accountability supplemental payments, including, but not limited to, its assessment of whether the payments are adequate to incentivize quality care and to sustain the program.(b) (1) There is hereby created in the State Treasury, the Skilled Nursing Facility Quality and Accountability Special Fund. The fund shall contain moneys deposited pursuant to subdivisions (g) and (j) to (m), inclusive. Notwithstanding Section 16305.7 of the Government Code, the fund shall contain all interest and dividends earned on moneys in the fund.(2) Notwithstanding Section 13340 of the Government Code, the fund shall be continuously appropriated without regard to fiscal year to the department for making quality and accountability payments, in accordance with subdivision (n), to facilities that meet or exceed predefined measures as established by this section.(3) Upon appropriation by the Legislature, moneys in the fund may also be used for any of the following purposes:(A) To cover the administrative costs incurred by the State Department of Public Health for positions and contract funding required to implement this section.(B) To cover the administrative costs incurred by the State Department of Health Care Services for positions and contract funding required to implement this section.(C) To provide funding assistance for the Long-Term Care Ombudsman Program activities pursuant to Chapter 11 (commencing with Section 9700) of Division 8.5.(c) No appropriation associated with Chapter 717 of the Statutes of 2010 is intended to implement the provisions of Section 1276.65 of the Health and Safety Code.(d) (1) There is hereby appropriated for the 201011 fiscal year, one million nine hundred thousand dollars ($1,900,000) from the Skilled Nursing Facility Quality and Accountability Special Fund to the California Department of Aging for the Long-Term Care Ombudsman Program activities pursuant to Chapter 11 (commencing with Section 9700) of Division 8.5. It is the intent of the Legislature for the one million nine hundred thousand dollars ($1,900,000) from the fund to be in addition to the four million one hundred sixty-eight thousand dollars ($4,168,000) proposed in the Governors May Revision for the 201011 Budget. It is further the intent of the Legislature to increase this level of appropriation in subsequent years to provide support sufficient to carry out the mandates and activities pursuant to Chapter 11 (commencing with Section 9700) of Division 8.5.(2) The department, in partnership with the California Department of Aging, shall seek approval from the federal Centers for Medicare and Medicaid Services to obtain federal Medicaid reimbursement for activities conducted by the Long-Term Care Ombudsman Program. The department shall report to the fiscal committees of the Legislature during budget hearings on progress being made and any unresolved issues during the 201112 budget deliberations.(e) There is hereby created in the Special Deposit Fund established pursuant to Section 16370 of the Government Code, the Skilled Nursing Facility Minimum Staffing Penalty Account. The account shall contain all moneys deposited pursuant to subdivision (f).(f) (1) Beginning with the 201011 fiscal year, the State Department of Public Health shall use the direct care staffing level data it collects to determine whether a skilled nursing facility has met the nursing hours or direct care service hours per patient per day requirements pursuant to Section 1276.5 or 1276.65, as applicable, of the Health and Safety Code.(2) (A) Beginning with the 201011 fiscal year, the State Department of Public Health shall assess a skilled nursing facility, licensed pursuant to subdivision (c) of Section 1250 of the Health and Safety Code, an administrative penalty if the State Department of Public Health determines that the skilled nursing facility fails to meet the nursing hours or direct care service hours per patient per day requirements pursuant to Section 1276.5 or 1276.65, as applicable, of the Health and Safety Code, as follows:(i) Fifteen thousand dollars ($15,000) if the facility fails to meet the requirements for 5 percent or more of the audited days up to 49 percent.(ii) Thirty thousand dollars ($30,000) if the facility fails to meet the requirements for over 49 percent or more of the audited days.(B) (i) If the skilled nursing facility does not dispute the determination or assessment, the penalties shall be paid in full by the licensee to the State Department of Public Health within 30 days of the facilitys receipt of the notice of penalty and deposited into the Skilled Nursing Facility Minimum Staffing Penalty Account.(ii) The State Department of Public Health may, upon written notification to the licensee, request that the department offset any moneys owed to the licensee by the Medi-Cal program or any other payment program administered by the department to recoup the penalty provided for in this section.(C) (i) If a facility disputes the determination or assessment made pursuant to this paragraph, the facility shall, within 15 days of the facilitys receipt of the determination and assessment, simultaneously submit a request for appeal to both the department and the State Department of Public Health. The request shall include a detailed statement describing the reason for appeal and include all supporting documents the facility will present at the hearing.(ii) Within 10 days of the State Department of Public Healths receipt of the facilitys request for appeal, the State Department of Public Health shall submit, to both the facility and the department, all supporting documents that will be presented at the hearing.(D) The department shall hear a timely appeal and issue a decision as follows:(i) The hearing shall commence within 60 days from the date of receipt by the department of the facilitys timely request for appeal.(ii) The department shall issue a decision within 120 days from the date of receipt by the department of the facilitys timely request for appeal.(iii) The decision of the departments hearing officer, when issued, shall be the final decision of the State Department of Public Health.(E) The appeals process set forth in this paragraph shall be exempt from Chapter 4.5 (commencing with Section 11400) and Chapter 5 (commencing with Section 11500), of Part 1 of Division 3 of Title 2 of the Government Code. The provisions of Sections 100171 and 131071 of the Health and Safety Code do not apply to appeals under this paragraph.(F) If a hearing decision issued pursuant to subparagraph (D) is in favor of the State Department of Public Health, the skilled nursing facility shall pay the penalties to the State Department of Public Health within 30 days of the facilitys receipt of the decision. The penalties collected shall be deposited into the Skilled Nursing Facility Minimum Staffing Penalty Account.(G) The assessment of a penalty under this subdivision does not supplant the State Department of Public Healths investigation process or issuance of deficiencies or citations under Chapter 2.4 (commencing with Section 1417) of Division 2 of the Health and Safety Code.(g) The State Department of Public Health shall transfer, on a monthly basis, all penalty payments collected pursuant to subdivision (f) into the Skilled Nursing Facility Quality and Accountability Special Fund.(h) This section does not impact the effectiveness or utilization of Section 1278.5 or 1432 of the Health and Safety Code relating to whistleblower protections, or Section 1420 of the Health and Safety Code relating to complaints.(i) (1) Beginning in the 201011 fiscal year, the department, in consultation with representatives from the long-term care industry, organized labor, and consumers, shall establish and publish quality and accountability measures, benchmarks, and data submission deadlines by November 30, 2010.(2) The methodology developed pursuant to this section shall include, but not be limited to, the following requirements and performance measures:(A) Beginning in the 201112 fiscal year:(i) Immunization rates.(ii) Facility acquired pressure ulcer incidence.(iii) The use of physical restraints.(iv) Compliance with the nursing hours or direct care service hours per patient per day requirements pursuant to Section 1276.5 or 1276.65, as applicable, of the Health and Safety Code.(v) Resident and family satisfaction.(vi) Direct care staff retention, if sufficient data is available.(B) If this act is extended beyond the dates on which it becomes inoperative and is repealed, in accordance with Section 14126.033, the department, in consultation with representatives from the long-term care industry, organized labor, and consumers, beginning in the 201314 rate year, shall incorporate additional measures into the system, including, but not limited to, quality and accountability measures required by federal health care reform that are identified by the federal Centers for Medicare and Medicaid Services.(C) The department, in consultation with representatives from the long-term care industry, organized labor, and consumers, may incorporate additional performance measures, including, but not limited to, the following:(i) Compliance with state policy associated with the United States Supreme Court decision in Olmstead v. L.C. ex rel. Zimring (1999) 527 U.S. 581.(ii) Direct care staff retention, if not addressed in the 201213 rate year.(iii) The use of chemical restraints.(D) Beginning with the 201516 fiscal year, the department, in consultation with representatives from the long-term care industry, organized labor, and consumers, shall incorporate direct care staff retention as a performance measure in the methodology developed pursuant to this section.(j) (1) Beginning with the 201011 rate year, and pursuant to subparagraph (B) of paragraph (5) of subdivision (a) of Section 14126.023, the department shall set aside savings achieved from setting the professional liability insurance cost category, including any insurance deductible costs paid by the facility, at the 75th percentile. From this amount, the department shall transfer the General Fund portion into the Skilled Nursing Facility Quality and Accountability Special Fund. A skilled nursing facility shall provide supplemental data on insurance deductible costs to facilitate this adjustment, in the format and by the deadlines determined by the department. If this data is not provided, a facilitys insurance deductible costs will remain in the administrative costs category.(2) Notwithstanding paragraph (1), for the 201213 rate year only, savings from capping the professional liability insurance cost category pursuant to paragraph (1) shall remain in the General Fund and shall not be transferred to the Skilled Nursing Facility Quality and Accountability Special Fund.(k) For the 201314 rate year, if there is a rate increase in the weighted average Medi-Cal reimbursement rate, the department shall set aside the first 1 percent of the weighted average Medi-Cal reimbursement rate increase for the Skilled Nursing Facility Quality and Accountability Special Fund.(l) If this act is extended beyond the dates on which it becomes inoperative and is repealed, for the 201415 rate year, in addition to the amount set aside pursuant to subdivision (k), if there is a rate increase in the weighted average Medi-Cal reimbursement rate, the department shall set aside at least one-third of the weighted average Medi-Cal reimbursement rate increase, up to a maximum of 1 percent, from which the department shall transfer the General Fund portion of this amount into the Skilled Nursing Facility Quality and Accountability Special Fund.(m) Beginning with the 201516 rate year, and each subsequent rate year thereafter for which this article is operative, an amount equal to the amount deposited in the fund pursuant to subdivisions (k) and (l) for the 201415 rate year shall be deposited into the Skilled Nursing Facility Quality and Accountability Special Fund, for the purposes specified in this section.(n) (1) (A) Beginning with the 201314 rate year, the department shall pay a supplemental payment, by April 30, 2014, to skilled nursing facilities based on all of the criteria in subdivision (i), as published by the department, and according to performance measure benchmarks determined by the department in consultation with stakeholders.(B) (i) The department may convene a diverse stakeholder group, including, but not limited to, representatives from consumer groups and organizations, labor, nursing home providers, advocacy organizations involved with the aging community, staff from the Legislature, and other interested parties, to discuss and analyze alternative mechanisms to implement the quality and accountability payments provided to nursing homes for reimbursement.(ii) The department shall articulate in a report to the fiscal and appropriate policy committees of the Legislature the implementation of an alternative mechanism as described in clause (i) at least 90 days prior to any policy or budgetary changes, and seek subsequent legislation in order to enact the proposed changes.(2) Skilled nursing facilities that do not submit required performance data by the departments specified data submission deadlines pursuant to subdivision (i) are not eligible to receive supplemental payments.(3) Notwithstanding paragraph (1), if a facility appeals the performance measure of compliance with the nursing hours or direct care service hours per patient per day requirements, pursuant to Section 1276.5 or 1276.65, as applicable, of the Health and Safety Code, to the State Department of Public Health, and it is unresolved by the departments published due date, the department shall not use that performance measure when determining the facilitys supplemental payment.(4) Notwithstanding paragraph (1), if the department is unable to pay the supplemental payments by April 30, 2014, then on May 1, 2014, the department shall use the funds available in the Skilled Nursing Facility Quality and Accountability Special Fund as a result of savings identified in subdivisions (k) and (l), less the administrative costs required to implement subparagraphs (A) and (B) of paragraph (3) of subdivision (b), in addition to any Medicaid funds that are available as of December 31, 2013, to increase provider rates retroactively to August 1, 2013.(o) The department shall seek necessary approvals from the federal Centers for Medicare and Medicaid Services to implement this section. The department shall implement this section only in a manner that is consistent with federal Medicaid law and regulations, and only to the extent that approval is obtained from the federal Centers for Medicare and Medicaid Services and federal financial participation is available.(p) In implementing this section, the department and the State Department of Public Health may contract as necessary, with Californias Medicare Quality Improvement Organization, or other entities deemed qualified by the department or the State Department of Public Health, not associated with a skilled nursing facility, to assist with development, collection, analysis, and reporting of the performance data pursuant to subdivision (i), and with demonstrated expertise in long-term care quality, data collection or analysis, and accountability performance measurement models pursuant to subdivision (i). This subdivision establishes an accelerated process for issuing any contract pursuant to this section. Any contract entered into pursuant to this subdivision is exempt from the requirements of the Public Contract Code, through December 31, 2020.(q) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the following apply:(1) The director shall implement this section, in whole or in part, by means of provider bulletins, or other similar instructions without taking regulatory action.(2) The State Public Health Officer may implement this section by means of all-facility letters, or other similar instructions without taking regulatory action.(r) Notwithstanding paragraph (1) of subdivision (n), if a final judicial determination is made by any state or federal court that is not appealed, in any action by any party, or a final determination is made by the administrator of the federal Centers for Medicare and Medicaid Services, that any payments pursuant to subdivisions (a) and (n), are invalid, unlawful, or contrary to any provision of federal law or regulations, or of state law, these subdivisions shall become inoperative, and for the 201112 rate year, the rate increase provided under subparagraph (A) of paragraph (4) of subdivision (c) of Section 14126.033 shall be reduced by the amounts described in subdivision (j). For the 201314 and 201415 rate years, any rate increase shall be reduced by the amounts described in subdivisions (j) to (l), inclusive.(s) Notwithstanding any other provision of this section, but only to the extent the department determines federal financial participation is available and not otherwise jeopardized, for performance periods in the 201718 and 201819 fiscal years, a skilled nursing facility shall remain eligible to participate in the supplemental payment program pursuant to this section so long as the facility meets the applicable nursing hours per patient per day requirements pursuant to Section 1276.5 of the Health and Safety Code that would have applied in the absence of the act that added this subdivision. Code.(t) Notwithstanding any provision of this section, but only to the extent the department determines federal financial participation is available and not otherwise jeopardized, compliance with the provisions of subdivision (c) of Section 1276.65 of the Health and Safety Code Code, as amended by Chapter 52 of the act that added this subdivision Statutes of 2017, shall not be used to determine facility qualification for the supplemental payments provided for in this section until the performance period beginning in the 201920 fiscal year. This limitation shall also apply to the issuance of citations pursuant to subdivisions (c) and (d) of Section 1424 of the Health and Safety Code based upon the failure to comply with the provisions of subdivision (c) of Section 1276.65 of the Health and Safety Code as amended by Chapter 52 of the act that added this subdivision. Statutes of 2017. Until the performance period beginning in the 201920 fiscal year, the department shall apply the provisions of Section 1276.5 of the Health and Safety Code for purposes of administering the supplemental payments pursuant to this section. For performance periods beginning in the 201920 fiscal year and each fiscal year thereafter, a skilled nursing facility that is granted a waiver pursuant to subdivision (l) of Section 1276.65 of the Health and Safety Code shall remain eligible to participate in the supplemental payment program pursuant to this section so long as the facility meets the applicable nursing hours per patient per day requirement pursuant to Section 1276.5 of the Health and Safety Code that would have applied in the absence of Chapter 52 of the Statutes of 2017 for the duration of the time for which the waiver is granted.SEC. 3. Section 17605 of the Welfare and Institutions Code is amended to read:17605. (a) For the 199293 fiscal year, the Controller shall deposit into the Caseload Subaccount of the Sales Tax Growth Account of the Local Revenue Fund, from revenues deposited into the Sales Tax Growth Account, an amount to be determined by the Department of Finance, that represents the sum of the shortfalls between the actual realignment revenues received by each county and each city and county from the Social Services Subaccount of the Local Revenue Fund in the 199192 fiscal year and the net costs incurred by each of those counties and cities and counties in the fiscal year for the programs described in Sections 10101, 10101.1, 11322, 11322.2, and 12306, subdivisions (a), (b), (c), and (d) of Section 15200, and Sections 15204.2 and 18906.5. 11322.2, 12306, 15200, 15204.2, and 18906.5, and former Section 11322. The Department of Finance shall provide the Controller with an allocation schedule on or before August 15, 1993, that shall be used by the Controller to allocate funds deposited to the Caseload Subaccount under this subdivision. The Controller shall allocate these funds no later than August 27, 1993.(b) (1) (A) For the 199394 fiscal year and fiscal years thereafter, the Controller shall deposit into the Caseload Subaccount of the Sales Tax Growth Account of the Local Revenue Fund, from revenues deposited into the Sales Tax Growth Account, an amount determined by the Department of Finance, in consultation with the appropriate state departments and the California State Association of Counties, that is sufficient to fund the net cost for the realigned portion of the county or city and county share of growth in social services caseloads, as specified in paragraph (2), and any share of growth from the previous year or years for which sufficient revenues were not available in the Caseload Subaccount. The Department of Finance shall provide the Controller with an allocations schedule on or before March 15 of each year. The schedule shall be used by the Controller to allocate funds deposited into the Caseload Subaccount under this subdivision.(B) It is the intent of the Legislature that counties shall receive allocations from the Caseload Subaccount as soon as possible after funds are received in the Sales Tax Growth Account. The Department of Finance shall recommend to the Legislature, by January 10, 2005, a procedure to expedite the preparation and provision of the allocations schedule described in subparagraph (A) and the allocation of funds by the Controller.(2) (A) For purposes of this subdivision, (i) For the 199293 fiscal year through the caseload growth calculation for the 201718 fiscal year, growth means means, for purposes of this subdivision, the increase in the actual caseload expenditures for the prior fiscal year over the actual caseload expenditures for the fiscal year preceding the prior fiscal year for the programs described in Section 12306, subdivisions (a), (b), (c), and (d) of Section 15200, and Sections 10101, 15204.2 12306, 15200, 15204.2, and 18906.5 of this code, 18906.5, and for which funds are allocated pursuant to subdivision (b) of Section 123940 of the Health and Safety Code.(ii) Commencing with the caseload growth calculation for the 201819 fiscal year and each fiscal year thereafter, for purposes of this subdivision, growth means the increase in the actual caseload expenditures for the prior fiscal year over the actual caseload expenditures for the fiscal year preceding the prior fiscal year for the programs described in Sections 10101, 15200, 15204.2, and 18906.5, and for which funds are allocated pursuant to subdivision (b) of Section 123940 of the Health and Safety Code. (B) Commencing with the caseload growth calculation for the 201718 fiscal year and each fiscal year thereafter, in addition to subparagraph (A), growth shall also include the following:(i) The additional County IHSS MOE costs to counties pursuant to Section Sections 12306.16 and 12306.17 for the current fiscal year over the County IHSS MOE costs to counties for the prior fiscal year, less the amount of sales tax revenues received pursuant to subdivision (g) of Section 17600.15 to fund the amount specified in subparagraph (B) of paragraph (3) of subdivision (f) of Section 17600.15. 17600.15 and the amount of vehicle license fee revenues received pursuant to subdivision (c) of Section 17606.20.(ii) Any additional County IHSS MOE costs to counties pursuant to Section Sections 12306.16 and 12306.17 for the prior fiscal year over the County IHSS MOE costs to counties for the preceding prior fiscal year that were not included in caseload growth calculation pursuant to clause (i). (i) from the prior caseload growth calculation.(3) (A) For the 199394 fiscal year through the 201617 fiscal year, the difference in caseload expenditures between the fiscal years shall be multiplied by the factors that represent the change in county or city and county shares of the realigned programs. These products shall then be added or subtracted, taking into account whether the countys or city and countys share of costs was increased or decreased as a result of realignment, to yield each countys or city and countys allocation for caseload growth. Allocations for counties or cities and counties with allocations of less than zero shall be set at zero.(B) Commencing with the For the caseload growth calculation for the 201718 fiscal year and each fiscal year thereafter, year the difference in caseload expenditures between the fiscal years as determined by clause (i) of subparagraph (A) of paragraph (2) shall be multiplied by the factors that represent the change in county or city and county shares of the realignment programs. These products shall then be added or subtracted, taking into account whether the countys or city and countys share of costs was increased or decreased as a result of realignment, and added to the amounts determined pursuant to subparagraph (B) of paragraph (2) to yield each countys or city and countys allocation for caseload growth. Allocations for counties or cities and counties with allocations of less than zero shall be set at zero.(C) Commencing with the caseload growth calculation for the 201819 fiscal year and each fiscal year thereafter, the difference in caseload expenditures between the fiscal years as determined by clause (ii) of subparagraph (A) of paragraph (2) shall be multiplied by the factors that represent the change in county or city and county shares of the realignment programs. These products shall then be added or subtracted, taking into account whether the countys or city and countys share of costs was increased or decreased as a result of realignment, and added to the amounts determined pursuant to subparagraph (B) of paragraph (2) to yield each countys or city and countys allocation for caseload growth. Allocations for counties or cities and counties with allocations of less than zero shall be set at zero. (c) Annually, the Controller shall allocate, to the local health and welfare trust fund social services account, the amounts deposited and remaining unexpended and unreserved in the Caseload Subaccount, pursuant to the schedules of allocations of caseload growth described in subdivision (b), within 45 days of receiving those schedules from the Department of Finance. If there are insufficient funds to fully satisfy all caseload growth obligations, each countys or city and countys allocation for each program specified in subdivision (d) shall be prorated.(d) Prior to allocating funds pursuant to subdivision (b), to the extent that funds are available from funds deposited in the Caseload Subaccount in the Sales Tax Growth Account in the Local Revenue Fund, the Controller shall allocate moneys to counties or cities and counties to correct any inequity or inequities in the computation of the child welfare services portion of the schedule required by subdivision (a) of Section 17602.(e) (1) For the 200304 fiscal year, no Sales Tax Growth Account funds shall be allocated pursuant to this chapter until the caseload portion of the base of each countys social services account in the countys health and welfare trust fund is funded to the level of the 200102 fiscal year. Funds to meet this requirement shall be allocated from the Sales Tax Account of the Local Revenue Fund. If sufficient funds are not available in the Sales Tax Account of the Local Revenue Fund to achieve that funding level in the 200304 fiscal year, this requirement shall be funded in each succeeding fiscal year in which there are sufficient funds in the Sales Tax Account of the Local Revenue Fund until the caseload base funding level for which each county would have otherwise been eligible in accordance with subdivision (e) of Section 17602 for that year.(2) The caseload portion of each countys social services account base shall be determined by subtracting its noncaseload portion of the base, as determined by the Department of Finance in its annual calculation of General Growth Account allocations, from the total base of each countys social services account for the 200102 fiscal year.(f) Commencing with the caseload growth calculation for the 201718 fiscal year and each fiscal year thereafter, the Controller shall annually post on his or her Internet Web site the total amount of unfunded caseload growth by county.SEC. 4. (a) Notwithstanding any other law, from the General Fund moneys appropriated to the State Department of Social Services in Item 5180-101-0001 of Section 2.00 of the Budget Act of 2017, the department shall allocate five million four hundred thousand dollars ($5,400,000), in a single payment by the Controller, to the City of San Jose for purposes of assisting homeless and low-income individuals displaced by the Coyote Creek flooding that occurred in February 2017.(b) As a condition of receiving these funds, the City of San Jose shall provide quarterly reports to the department regarding the number of families served and the types of services they received, until all funds have been expended.SEC. 5. The sum of five million eight hundred eighty-four thousand dollars ($5,884,000) is hereby appropriated from the Federal Trust Fund to the State Department of Health Care Services in the 201718 fiscal year for the purpose of providing supplemental reimbursements to specific hospitals that provide trauma care to Medi-Cal beneficiaries. These funds shall be available for encumbrance or expenditure until June 30, 2018.SEC. 6. This act is a bill providing for appropriations related to the Budget Bill within the meaning of subdivision (e) of Section 12 of Article IV of the California Constitution, has been identified as related to the budget in the Budget Bill, and shall take effect immediately.SECTION 1.It is the intent of the Legislature to enact statutory changes relating to the Budget Act of 2017.
Amended IN Senate September 06, 2017 CALIFORNIA LEGISLATURE 20172018 REGULAR SESSION Assembly Bill No. 130Introduced by Assembly Member Ting Committee on Budget (Assembly Members Ting (Chair), Arambula, Bloom, Caballero, Chiu, Cooper, Cristina Garcia, Jones-Sawyer, Limn, McCarty, Medina, Mullin, Muratsuchi, ODonnell, Rubio, Mark Stone, Weber, and Wood)January 10, 2017An act relating to the Budget Act of 2017. An act to amend Sections 12301.61, 14126.022, and 17605 of the Welfare and Institutions Code, relating to health and human services, and making an appropriation therefor, to take effect immediately, bill related to the budget.LEGISLATIVE COUNSEL'S DIGESTAB 130, as amended, Committee on Budget. Budget Act of 2017. Health and human services.(1) Existing law establishes the county-administered In-Home Supportive Services (IHSS) program, under which qualified aged, blind, and disabled persons are provided with services in order to permit them to remain in their own homes and avoid institutionalization. Under existing law, a county board of supervisors may elect to contract with a nonprofit consortium to provide for the delivery of in-home supportive services, or establish, by ordinance, a public authority to provide for the delivery of in-home supportive services. Existing law requires, until January 1, 2020, a specified mediation process to be held if a public authority or nonprofit consortium fails to reach agreement on a bargaining contract with its in-home supportive services workers by January 1, 2018.This bill would clarify that the specified mediation process is required if a public authority or nonprofit consortium and the employee organization have not reached an agreement on a bargaining contract with in-home supportive services workers by January 1, 2018.Existing law requires the state and counties to share the annual cost of providing in-home supportive services and requires all counties to have a County IHSS Maintenance of Effort (MOE) commencing July 1, 2017, as prescribed. Existing law requires that a portion of IHSS costs that are the counties responsibility to be offset using a combination of General Fund moneys appropriated in the annual Budget Act and redirected 1991 Realignment Vehicle License Fee growth revenues, as specified.Existing law requires the Controller to deposit into the Caseload Subaccount of the Sales Tax Growth Account of the Local Revenue Fund, from revenues deposited into the Sales Tax Growth Account, an amount determined by the Department of Finance that is sufficient to fund the net cost for the realigned portion of the county or city and county share of growth in social services caseloads and any share of growth from the previous year or years for which sufficient revenues were not available in the Caseload Subaccount, and requires the Controller to allocate funds to counties based on those calculations. Existing law defines growth for these purposes to mean the increase in the actual caseload expenditures for the prior fiscal year over the actual caseload expenditures for the fiscal year preceding the prior fiscal year for costs from specified social services programs, including the County IHSS MOE in effect on June 30, 2017. Commencing with the caseload growth calculation for the 201718 fiscal year and each fiscal year thereafter, growth includes the County IHSS MOE costs to counties commencing on July 1, 2017, for the current fiscal year over the County IHSS MOE costs to counties for the prior fiscal year, less specified amounts.This bill would revise these factors used to calculate the caseload growth, by changing the definition of growth to exclude the County IHSS MOE in effect on June 30, 2017, and by including offsets provided by General Fund moneys and redirected 1991 Realignment Vehicle License Fee growth revenues in the calculation of the County IHSS MOE costs. The bill would also require the State Controller, commencing with the caseload growth calculation for the 201718 fiscal year, to annually post on its Internet Web site the total amount of unfunded caseload growth by county.(2) Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, 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.This bill would appropriate $5,884,000 from the Federal Trust Fund to the State Department of Health Care Services in the 201718 fiscal year for the purpose of providing supplemental reimbursements to specific hospitals that provide trauma care to Medi-Cal beneficiaries.(3) Existing law provides for the licensure and regulation of health facilities, including skilled nursing facilities, by the State Department of Public Health. Among other requirements, these provisions generally require skilled nursing facilities to have a minimum number of nursing hours per patient day of 3.2 hours, and effective July 1, 2018, requires skilled nursing facilities, except as specified, to have a minimum number of direct care service hours, as defined, of 3.5 hours per patient day. Existing law requires the department to adopt regulations to create a waiver of the direct care service hour requirements.Existing law requires the State Department of Health Care Services, in connection with its administration of the Medi-Cal program, to develop the Skilled Nursing Facility Quality and Accountability Supplemental Payment System, and requires the system to be utilized to, among other things, assign quality and accountability payments or penalties relating to direct care staffing levels at a skilled nursing facility, including the nursing hours or direct care service hours per patient per day requirements. Existing law establishes the Skilled Nursing Facility Quality and Accountability Special Fund in the State Treasury, which is a continuously appropriated fund that contains moneys from the assessment of specified administrative penalties and setasides of General Fund moneys, for the purposes of making the quality and accountability payments.Existing law, to a specified extent, provides that a skilled nursing facility shall remain eligible to participate in the supplemental payment program so long as the facility meets applicable nursing hours per patient per day requirements that would have applied in the absence of the direct care service hour requirements described above. Existing law, to a specified extent, prohibits using compliance with the direct care service hour requirements to determine facility qualification for supplemental payments and instead requires the department to apply the nursing hour requirements for purposes of administering the supplemental payments until the performance period beginning in the 201920 fiscal year.This bill, instead, would specify that for performance periods in the 201718 and 201819 fiscal years, a skilled nursing facility shall remain eligible to participate in the supplemental payment program so long as the facility meets applicable nursing hours per patient per day requirements. The bill would, for performance periods beginning in the 201920 fiscal year and each fiscal year thereafter, provide that a skilled nursing facility that is granted a waiver of the direct care service hour requirements shall remain eligible to participate in the supplemental payment program so long as the facility meets the applicable nursing hour requirements that would have applied in the absence of the direct care service hour requirements described above for the duration of time for which the waiver is granted. By expanding the number of facilities that would be eligible to participate in the supplemental payment program and therefore expanding the payments from a continuously appropriated fund, the bill would make an appropriation.(4) The Budget Act of 2017 appropriated a specified sum to the State Department of Social Services for local assistance relating to the CalWORKs program and other assistance payments.This bill would require the department to allocate $5,400,000 from the General Fund moneys in the above-described appropriation to the City of San Jose for purposes of assisting homeless and low-income individuals displaced by the Coyote Creek flooding that occurred in February 2017, and, as a condition of receiving these funds, the bill would require the City of San Jose to provide quarterly reports to the department, as specified.(5) This bill would declare that it is to take effect immediately as a bill providing for appropriations related to the Budget Bill.This bill would express the intent of the Legislature to enact statutory changes relating to the Budget Act of 2017.Digest Key Vote: MAJORITY Appropriation: NOYES Fiscal Committee: NOYES Local Program: NO
Amended IN Senate September 06, 2017
Amended IN Senate September 06, 2017
CALIFORNIA LEGISLATURE 20172018 REGULAR SESSION
Assembly Bill No. 130
Introduced by Assembly Member Ting Committee on Budget (Assembly Members Ting (Chair), Arambula, Bloom, Caballero, Chiu, Cooper, Cristina Garcia, Jones-Sawyer, Limn, McCarty, Medina, Mullin, Muratsuchi, ODonnell, Rubio, Mark Stone, Weber, and Wood)January 10, 2017
Introduced by Assembly Member Ting Committee on Budget (Assembly Members Ting (Chair), Arambula, Bloom, Caballero, Chiu, Cooper, Cristina Garcia, Jones-Sawyer, Limn, McCarty, Medina, Mullin, Muratsuchi, ODonnell, Rubio, Mark Stone, Weber, and Wood)
January 10, 2017
An act relating to the Budget Act of 2017. An act to amend Sections 12301.61, 14126.022, and 17605 of the Welfare and Institutions Code, relating to health and human services, and making an appropriation therefor, to take effect immediately, bill related to the budget.
LEGISLATIVE COUNSEL'S DIGEST
## LEGISLATIVE COUNSEL'S DIGEST
AB 130, as amended, Committee on Budget. Budget Act of 2017. Health and human services.
(1) Existing law establishes the county-administered In-Home Supportive Services (IHSS) program, under which qualified aged, blind, and disabled persons are provided with services in order to permit them to remain in their own homes and avoid institutionalization. Under existing law, a county board of supervisors may elect to contract with a nonprofit consortium to provide for the delivery of in-home supportive services, or establish, by ordinance, a public authority to provide for the delivery of in-home supportive services. Existing law requires, until January 1, 2020, a specified mediation process to be held if a public authority or nonprofit consortium fails to reach agreement on a bargaining contract with its in-home supportive services workers by January 1, 2018.This bill would clarify that the specified mediation process is required if a public authority or nonprofit consortium and the employee organization have not reached an agreement on a bargaining contract with in-home supportive services workers by January 1, 2018.Existing law requires the state and counties to share the annual cost of providing in-home supportive services and requires all counties to have a County IHSS Maintenance of Effort (MOE) commencing July 1, 2017, as prescribed. Existing law requires that a portion of IHSS costs that are the counties responsibility to be offset using a combination of General Fund moneys appropriated in the annual Budget Act and redirected 1991 Realignment Vehicle License Fee growth revenues, as specified.Existing law requires the Controller to deposit into the Caseload Subaccount of the Sales Tax Growth Account of the Local Revenue Fund, from revenues deposited into the Sales Tax Growth Account, an amount determined by the Department of Finance that is sufficient to fund the net cost for the realigned portion of the county or city and county share of growth in social services caseloads and any share of growth from the previous year or years for which sufficient revenues were not available in the Caseload Subaccount, and requires the Controller to allocate funds to counties based on those calculations. Existing law defines growth for these purposes to mean the increase in the actual caseload expenditures for the prior fiscal year over the actual caseload expenditures for the fiscal year preceding the prior fiscal year for costs from specified social services programs, including the County IHSS MOE in effect on June 30, 2017. Commencing with the caseload growth calculation for the 201718 fiscal year and each fiscal year thereafter, growth includes the County IHSS MOE costs to counties commencing on July 1, 2017, for the current fiscal year over the County IHSS MOE costs to counties for the prior fiscal year, less specified amounts.This bill would revise these factors used to calculate the caseload growth, by changing the definition of growth to exclude the County IHSS MOE in effect on June 30, 2017, and by including offsets provided by General Fund moneys and redirected 1991 Realignment Vehicle License Fee growth revenues in the calculation of the County IHSS MOE costs. The bill would also require the State Controller, commencing with the caseload growth calculation for the 201718 fiscal year, to annually post on its Internet Web site the total amount of unfunded caseload growth by county.(2) Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, 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.This bill would appropriate $5,884,000 from the Federal Trust Fund to the State Department of Health Care Services in the 201718 fiscal year for the purpose of providing supplemental reimbursements to specific hospitals that provide trauma care to Medi-Cal beneficiaries.(3) Existing law provides for the licensure and regulation of health facilities, including skilled nursing facilities, by the State Department of Public Health. Among other requirements, these provisions generally require skilled nursing facilities to have a minimum number of nursing hours per patient day of 3.2 hours, and effective July 1, 2018, requires skilled nursing facilities, except as specified, to have a minimum number of direct care service hours, as defined, of 3.5 hours per patient day. Existing law requires the department to adopt regulations to create a waiver of the direct care service hour requirements.Existing law requires the State Department of Health Care Services, in connection with its administration of the Medi-Cal program, to develop the Skilled Nursing Facility Quality and Accountability Supplemental Payment System, and requires the system to be utilized to, among other things, assign quality and accountability payments or penalties relating to direct care staffing levels at a skilled nursing facility, including the nursing hours or direct care service hours per patient per day requirements. Existing law establishes the Skilled Nursing Facility Quality and Accountability Special Fund in the State Treasury, which is a continuously appropriated fund that contains moneys from the assessment of specified administrative penalties and setasides of General Fund moneys, for the purposes of making the quality and accountability payments.Existing law, to a specified extent, provides that a skilled nursing facility shall remain eligible to participate in the supplemental payment program so long as the facility meets applicable nursing hours per patient per day requirements that would have applied in the absence of the direct care service hour requirements described above. Existing law, to a specified extent, prohibits using compliance with the direct care service hour requirements to determine facility qualification for supplemental payments and instead requires the department to apply the nursing hour requirements for purposes of administering the supplemental payments until the performance period beginning in the 201920 fiscal year.This bill, instead, would specify that for performance periods in the 201718 and 201819 fiscal years, a skilled nursing facility shall remain eligible to participate in the supplemental payment program so long as the facility meets applicable nursing hours per patient per day requirements. The bill would, for performance periods beginning in the 201920 fiscal year and each fiscal year thereafter, provide that a skilled nursing facility that is granted a waiver of the direct care service hour requirements shall remain eligible to participate in the supplemental payment program so long as the facility meets the applicable nursing hour requirements that would have applied in the absence of the direct care service hour requirements described above for the duration of time for which the waiver is granted. By expanding the number of facilities that would be eligible to participate in the supplemental payment program and therefore expanding the payments from a continuously appropriated fund, the bill would make an appropriation.(4) The Budget Act of 2017 appropriated a specified sum to the State Department of Social Services for local assistance relating to the CalWORKs program and other assistance payments.This bill would require the department to allocate $5,400,000 from the General Fund moneys in the above-described appropriation to the City of San Jose for purposes of assisting homeless and low-income individuals displaced by the Coyote Creek flooding that occurred in February 2017, and, as a condition of receiving these funds, the bill would require the City of San Jose to provide quarterly reports to the department, as specified.(5) This bill would declare that it is to take effect immediately as a bill providing for appropriations related to the Budget Bill.This bill would express the intent of the Legislature to enact statutory changes relating to the Budget Act of 2017.
(1) Existing law establishes the county-administered In-Home Supportive Services (IHSS) program, under which qualified aged, blind, and disabled persons are provided with services in order to permit them to remain in their own homes and avoid institutionalization. Under existing law, a county board of supervisors may elect to contract with a nonprofit consortium to provide for the delivery of in-home supportive services, or establish, by ordinance, a public authority to provide for the delivery of in-home supportive services. Existing law requires, until January 1, 2020, a specified mediation process to be held if a public authority or nonprofit consortium fails to reach agreement on a bargaining contract with its in-home supportive services workers by January 1, 2018.
This bill would clarify that the specified mediation process is required if a public authority or nonprofit consortium and the employee organization have not reached an agreement on a bargaining contract with in-home supportive services workers by January 1, 2018.
Existing law requires the state and counties to share the annual cost of providing in-home supportive services and requires all counties to have a County IHSS Maintenance of Effort (MOE) commencing July 1, 2017, as prescribed. Existing law requires that a portion of IHSS costs that are the counties responsibility to be offset using a combination of General Fund moneys appropriated in the annual Budget Act and redirected 1991 Realignment Vehicle License Fee growth revenues, as specified.
Existing law requires the Controller to deposit into the Caseload Subaccount of the Sales Tax Growth Account of the Local Revenue Fund, from revenues deposited into the Sales Tax Growth Account, an amount determined by the Department of Finance that is sufficient to fund the net cost for the realigned portion of the county or city and county share of growth in social services caseloads and any share of growth from the previous year or years for which sufficient revenues were not available in the Caseload Subaccount, and requires the Controller to allocate funds to counties based on those calculations. Existing law defines growth for these purposes to mean the increase in the actual caseload expenditures for the prior fiscal year over the actual caseload expenditures for the fiscal year preceding the prior fiscal year for costs from specified social services programs, including the County IHSS MOE in effect on June 30, 2017. Commencing with the caseload growth calculation for the 201718 fiscal year and each fiscal year thereafter, growth includes the County IHSS MOE costs to counties commencing on July 1, 2017, for the current fiscal year over the County IHSS MOE costs to counties for the prior fiscal year, less specified amounts.
This bill would revise these factors used to calculate the caseload growth, by changing the definition of growth to exclude the County IHSS MOE in effect on June 30, 2017, and by including offsets provided by General Fund moneys and redirected 1991 Realignment Vehicle License Fee growth revenues in the calculation of the County IHSS MOE costs. The bill would also require the State Controller, commencing with the caseload growth calculation for the 201718 fiscal year, to annually post on its Internet Web site the total amount of unfunded caseload growth by county.
(2) Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, 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.
This bill would appropriate $5,884,000 from the Federal Trust Fund to the State Department of Health Care Services in the 201718 fiscal year for the purpose of providing supplemental reimbursements to specific hospitals that provide trauma care to Medi-Cal beneficiaries.
(3) Existing law provides for the licensure and regulation of health facilities, including skilled nursing facilities, by the State Department of Public Health. Among other requirements, these provisions generally require skilled nursing facilities to have a minimum number of nursing hours per patient day of 3.2 hours, and effective July 1, 2018, requires skilled nursing facilities, except as specified, to have a minimum number of direct care service hours, as defined, of 3.5 hours per patient day. Existing law requires the department to adopt regulations to create a waiver of the direct care service hour requirements.
Existing law requires the State Department of Health Care Services, in connection with its administration of the Medi-Cal program, to develop the Skilled Nursing Facility Quality and Accountability Supplemental Payment System, and requires the system to be utilized to, among other things, assign quality and accountability payments or penalties relating to direct care staffing levels at a skilled nursing facility, including the nursing hours or direct care service hours per patient per day requirements. Existing law establishes the Skilled Nursing Facility Quality and Accountability Special Fund in the State Treasury, which is a continuously appropriated fund that contains moneys from the assessment of specified administrative penalties and setasides of General Fund moneys, for the purposes of making the quality and accountability payments.
Existing law, to a specified extent, provides that a skilled nursing facility shall remain eligible to participate in the supplemental payment program so long as the facility meets applicable nursing hours per patient per day requirements that would have applied in the absence of the direct care service hour requirements described above. Existing law, to a specified extent, prohibits using compliance with the direct care service hour requirements to determine facility qualification for supplemental payments and instead requires the department to apply the nursing hour requirements for purposes of administering the supplemental payments until the performance period beginning in the 201920 fiscal year.
This bill, instead, would specify that for performance periods in the 201718 and 201819 fiscal years, a skilled nursing facility shall remain eligible to participate in the supplemental payment program so long as the facility meets applicable nursing hours per patient per day requirements. The bill would, for performance periods beginning in the 201920 fiscal year and each fiscal year thereafter, provide that a skilled nursing facility that is granted a waiver of the direct care service hour requirements shall remain eligible to participate in the supplemental payment program so long as the facility meets the applicable nursing hour requirements that would have applied in the absence of the direct care service hour requirements described above for the duration of time for which the waiver is granted. By expanding the number of facilities that would be eligible to participate in the supplemental payment program and therefore expanding the payments from a continuously appropriated fund, the bill would make an appropriation.
(4) The Budget Act of 2017 appropriated a specified sum to the State Department of Social Services for local assistance relating to the CalWORKs program and other assistance payments.
This bill would require the department to allocate $5,400,000 from the General Fund moneys in the above-described appropriation to the City of San Jose for purposes of assisting homeless and low-income individuals displaced by the Coyote Creek flooding that occurred in February 2017, and, as a condition of receiving these funds, the bill would require the City of San Jose to provide quarterly reports to the department, as specified.
(5) This bill would declare that it is to take effect immediately as a bill providing for appropriations related to the Budget Bill.
This bill would express the intent of the Legislature to enact statutory changes relating to the Budget Act of 2017.
## Digest Key
## Bill Text
The people of the State of California do enact as follows:SECTION 1. Section 12301.61 of the Welfare and Institutions Code is amended to read:12301.61. (a) If a public authority or nonprofit consortium established pursuant to Section 12301.6, acting as the employer of record, fails to reach and the employee organization have not reached an agreement on a bargaining contract with its in-home supportive services workers by January 1, 2018, either party may request mediation, pursuant to Section 3505.2 of the Government Code, which shall be mandatory. If the parties fail to agree on a mediator, the Public Employment Relations Board shall appoint one from the pool described in subdivision (c). The mediation shall be held no more than 15 business days from the date requested by either party.(b) If the parties are unable to effect settlement through mediation as described in subdivision (a), the parties shall then submit their differences to factfinding, pursuant to Section 3505 and 3505.4 of the Government Code. Alternatively, if both parties agree, the parties may bypass the mediation process in subdivision (a) and move directly to factfinding.(1) The factfinding panel shall make findings of fact and recommend terms of settlement, which shall be advisory only, within 30 days after the panel is appointed by the Public Employment Relations Board.(2) Within 15 days after the factfinding panel has released its findings of fact and recommended settlement terms, either party may request post-factfinding mediation consistent with Section 3505.2 of the Government Code, which shall be mandatory. If the parties fail to agree on a mediator, the Public Employment Relations Board shall appoint one from the pool described in subdivision (c).(3) If either party elects post-factfinding mediation, the findings of fact and recommended settlement terms, shall not be made public until the mediation has concluded.(4) Mediation shall be held no more than 15 days from the date requested, and may include, at the mediators discretion, the factfinding panel and representatives of both parties. The director, or his or her designee, shall be available to provide information and expertise, as necessary.(c) The Public Employment Relations Board shall designate a pool of no more than five qualified individuals to serve as mediators or on a factfinding panel. The pool shall consist of individuals with relevant subject matter expertise. The board shall select individuals for the pool in consultation with the department and the affected employers and employee organizations. Priority shall be given to individuals with knowledge of the In-Home Supportive Services program. The board may designate the mediator to serve as the neutral member of the factfinding panel.(d) The costs for the services of the factfinding panel and the mediator shall be equally divided between the employer and the employee organization, parties, and shall include per diem fees, if any, and actual and necessary travel and subsistence expenses.(e) By April 1, 2018, the department shall report to the fiscal committees of the Legislature on the status of all in-home supportive services bargaining contracts in each county.(f) If no individual is available to serve as a mediator or factfinder within the timelines specified in this section, the timelines shall be extended until the next mediator or factfinder is available.(g) This section shall remain in effect only until January 1, 2020, and as of that date is repealed.SEC. 2. Section 14126.022 of the Welfare and Institutions Code is amended to read:14126.022. (a) (1) By August 1, 2011, the department shall develop the Skilled Nursing Facility Quality and Accountability Supplemental Payment System, subject to approval by the federal Centers for Medicare and Medicaid Services, and the availability of federal, state, or other funds.(2) (A) The system shall be utilized to provide supplemental payments to skilled nursing facilities that improve the quality and accountability of care rendered to residents in skilled nursing facilities, as defined in subdivision (c) of Section 1250 of the Health and Safety Code, and to penalize those facilities that do not meet measurable standards.(B) A freestanding pediatric subacute care facility, as defined in Section 51215.8 of Title 22 of the California Code of Regulations, shall be exempt from the Skilled Nursing Facility Quality and Accountability Supplemental Payment System.(3) The system shall be phased in, beginning with the 201011 rate year.(4) The department may utilize the system to do all of the following:(A) Assess overall facility quality of care and quality of care improvement, and assign quality and accountability payments to skilled nursing facilities pursuant to performance measures described in subdivision (i).(B) Assign quality and accountability payments or penalties relating to quality of care, or direct care staffing levels, wages, and benefits, or both.(C) Limit the reimbursement of legal fees incurred by skilled nursing facilities engaged in the defense of governmental legal actions filed against the facilities.(D) Publish each facilitys quality assessment and quality and accountability payments in a manner and form determined by the director, or his or her designee.(E) Beginning with the 201112 fiscal year, establish a base year to collect performance measures described in subdivision (i).(F) Beginning with the 201112 fiscal year, in coordination with the State Department of Public Health, publish the direct care staffing level data and the performance measures required pursuant to subdivision (i).(5) The department, in coordination with the State Department of Public Health, shall report to the relevant Assembly and Senate budget subcommittees by May 1, 2016, information regarding the quality and accountability supplemental payments, including, but not limited to, its assessment of whether the payments are adequate to incentivize quality care and to sustain the program.(b) (1) There is hereby created in the State Treasury, the Skilled Nursing Facility Quality and Accountability Special Fund. The fund shall contain moneys deposited pursuant to subdivisions (g) and (j) to (m), inclusive. Notwithstanding Section 16305.7 of the Government Code, the fund shall contain all interest and dividends earned on moneys in the fund.(2) Notwithstanding Section 13340 of the Government Code, the fund shall be continuously appropriated without regard to fiscal year to the department for making quality and accountability payments, in accordance with subdivision (n), to facilities that meet or exceed predefined measures as established by this section.(3) Upon appropriation by the Legislature, moneys in the fund may also be used for any of the following purposes:(A) To cover the administrative costs incurred by the State Department of Public Health for positions and contract funding required to implement this section.(B) To cover the administrative costs incurred by the State Department of Health Care Services for positions and contract funding required to implement this section.(C) To provide funding assistance for the Long-Term Care Ombudsman Program activities pursuant to Chapter 11 (commencing with Section 9700) of Division 8.5.(c) No appropriation associated with Chapter 717 of the Statutes of 2010 is intended to implement the provisions of Section 1276.65 of the Health and Safety Code.(d) (1) There is hereby appropriated for the 201011 fiscal year, one million nine hundred thousand dollars ($1,900,000) from the Skilled Nursing Facility Quality and Accountability Special Fund to the California Department of Aging for the Long-Term Care Ombudsman Program activities pursuant to Chapter 11 (commencing with Section 9700) of Division 8.5. It is the intent of the Legislature for the one million nine hundred thousand dollars ($1,900,000) from the fund to be in addition to the four million one hundred sixty-eight thousand dollars ($4,168,000) proposed in the Governors May Revision for the 201011 Budget. It is further the intent of the Legislature to increase this level of appropriation in subsequent years to provide support sufficient to carry out the mandates and activities pursuant to Chapter 11 (commencing with Section 9700) of Division 8.5.(2) The department, in partnership with the California Department of Aging, shall seek approval from the federal Centers for Medicare and Medicaid Services to obtain federal Medicaid reimbursement for activities conducted by the Long-Term Care Ombudsman Program. The department shall report to the fiscal committees of the Legislature during budget hearings on progress being made and any unresolved issues during the 201112 budget deliberations.(e) There is hereby created in the Special Deposit Fund established pursuant to Section 16370 of the Government Code, the Skilled Nursing Facility Minimum Staffing Penalty Account. The account shall contain all moneys deposited pursuant to subdivision (f).(f) (1) Beginning with the 201011 fiscal year, the State Department of Public Health shall use the direct care staffing level data it collects to determine whether a skilled nursing facility has met the nursing hours or direct care service hours per patient per day requirements pursuant to Section 1276.5 or 1276.65, as applicable, of the Health and Safety Code.(2) (A) Beginning with the 201011 fiscal year, the State Department of Public Health shall assess a skilled nursing facility, licensed pursuant to subdivision (c) of Section 1250 of the Health and Safety Code, an administrative penalty if the State Department of Public Health determines that the skilled nursing facility fails to meet the nursing hours or direct care service hours per patient per day requirements pursuant to Section 1276.5 or 1276.65, as applicable, of the Health and Safety Code, as follows:(i) Fifteen thousand dollars ($15,000) if the facility fails to meet the requirements for 5 percent or more of the audited days up to 49 percent.(ii) Thirty thousand dollars ($30,000) if the facility fails to meet the requirements for over 49 percent or more of the audited days.(B) (i) If the skilled nursing facility does not dispute the determination or assessment, the penalties shall be paid in full by the licensee to the State Department of Public Health within 30 days of the facilitys receipt of the notice of penalty and deposited into the Skilled Nursing Facility Minimum Staffing Penalty Account.(ii) The State Department of Public Health may, upon written notification to the licensee, request that the department offset any moneys owed to the licensee by the Medi-Cal program or any other payment program administered by the department to recoup the penalty provided for in this section.(C) (i) If a facility disputes the determination or assessment made pursuant to this paragraph, the facility shall, within 15 days of the facilitys receipt of the determination and assessment, simultaneously submit a request for appeal to both the department and the State Department of Public Health. The request shall include a detailed statement describing the reason for appeal and include all supporting documents the facility will present at the hearing.(ii) Within 10 days of the State Department of Public Healths receipt of the facilitys request for appeal, the State Department of Public Health shall submit, to both the facility and the department, all supporting documents that will be presented at the hearing.(D) The department shall hear a timely appeal and issue a decision as follows:(i) The hearing shall commence within 60 days from the date of receipt by the department of the facilitys timely request for appeal.(ii) The department shall issue a decision within 120 days from the date of receipt by the department of the facilitys timely request for appeal.(iii) The decision of the departments hearing officer, when issued, shall be the final decision of the State Department of Public Health.(E) The appeals process set forth in this paragraph shall be exempt from Chapter 4.5 (commencing with Section 11400) and Chapter 5 (commencing with Section 11500), of Part 1 of Division 3 of Title 2 of the Government Code. The provisions of Sections 100171 and 131071 of the Health and Safety Code do not apply to appeals under this paragraph.(F) If a hearing decision issued pursuant to subparagraph (D) is in favor of the State Department of Public Health, the skilled nursing facility shall pay the penalties to the State Department of Public Health within 30 days of the facilitys receipt of the decision. The penalties collected shall be deposited into the Skilled Nursing Facility Minimum Staffing Penalty Account.(G) The assessment of a penalty under this subdivision does not supplant the State Department of Public Healths investigation process or issuance of deficiencies or citations under Chapter 2.4 (commencing with Section 1417) of Division 2 of the Health and Safety Code.(g) The State Department of Public Health shall transfer, on a monthly basis, all penalty payments collected pursuant to subdivision (f) into the Skilled Nursing Facility Quality and Accountability Special Fund.(h) This section does not impact the effectiveness or utilization of Section 1278.5 or 1432 of the Health and Safety Code relating to whistleblower protections, or Section 1420 of the Health and Safety Code relating to complaints.(i) (1) Beginning in the 201011 fiscal year, the department, in consultation with representatives from the long-term care industry, organized labor, and consumers, shall establish and publish quality and accountability measures, benchmarks, and data submission deadlines by November 30, 2010.(2) The methodology developed pursuant to this section shall include, but not be limited to, the following requirements and performance measures:(A) Beginning in the 201112 fiscal year:(i) Immunization rates.(ii) Facility acquired pressure ulcer incidence.(iii) The use of physical restraints.(iv) Compliance with the nursing hours or direct care service hours per patient per day requirements pursuant to Section 1276.5 or 1276.65, as applicable, of the Health and Safety Code.(v) Resident and family satisfaction.(vi) Direct care staff retention, if sufficient data is available.(B) If this act is extended beyond the dates on which it becomes inoperative and is repealed, in accordance with Section 14126.033, the department, in consultation with representatives from the long-term care industry, organized labor, and consumers, beginning in the 201314 rate year, shall incorporate additional measures into the system, including, but not limited to, quality and accountability measures required by federal health care reform that are identified by the federal Centers for Medicare and Medicaid Services.(C) The department, in consultation with representatives from the long-term care industry, organized labor, and consumers, may incorporate additional performance measures, including, but not limited to, the following:(i) Compliance with state policy associated with the United States Supreme Court decision in Olmstead v. L.C. ex rel. Zimring (1999) 527 U.S. 581.(ii) Direct care staff retention, if not addressed in the 201213 rate year.(iii) The use of chemical restraints.(D) Beginning with the 201516 fiscal year, the department, in consultation with representatives from the long-term care industry, organized labor, and consumers, shall incorporate direct care staff retention as a performance measure in the methodology developed pursuant to this section.(j) (1) Beginning with the 201011 rate year, and pursuant to subparagraph (B) of paragraph (5) of subdivision (a) of Section 14126.023, the department shall set aside savings achieved from setting the professional liability insurance cost category, including any insurance deductible costs paid by the facility, at the 75th percentile. From this amount, the department shall transfer the General Fund portion into the Skilled Nursing Facility Quality and Accountability Special Fund. A skilled nursing facility shall provide supplemental data on insurance deductible costs to facilitate this adjustment, in the format and by the deadlines determined by the department. If this data is not provided, a facilitys insurance deductible costs will remain in the administrative costs category.(2) Notwithstanding paragraph (1), for the 201213 rate year only, savings from capping the professional liability insurance cost category pursuant to paragraph (1) shall remain in the General Fund and shall not be transferred to the Skilled Nursing Facility Quality and Accountability Special Fund.(k) For the 201314 rate year, if there is a rate increase in the weighted average Medi-Cal reimbursement rate, the department shall set aside the first 1 percent of the weighted average Medi-Cal reimbursement rate increase for the Skilled Nursing Facility Quality and Accountability Special Fund.(l) If this act is extended beyond the dates on which it becomes inoperative and is repealed, for the 201415 rate year, in addition to the amount set aside pursuant to subdivision (k), if there is a rate increase in the weighted average Medi-Cal reimbursement rate, the department shall set aside at least one-third of the weighted average Medi-Cal reimbursement rate increase, up to a maximum of 1 percent, from which the department shall transfer the General Fund portion of this amount into the Skilled Nursing Facility Quality and Accountability Special Fund.(m) Beginning with the 201516 rate year, and each subsequent rate year thereafter for which this article is operative, an amount equal to the amount deposited in the fund pursuant to subdivisions (k) and (l) for the 201415 rate year shall be deposited into the Skilled Nursing Facility Quality and Accountability Special Fund, for the purposes specified in this section.(n) (1) (A) Beginning with the 201314 rate year, the department shall pay a supplemental payment, by April 30, 2014, to skilled nursing facilities based on all of the criteria in subdivision (i), as published by the department, and according to performance measure benchmarks determined by the department in consultation with stakeholders.(B) (i) The department may convene a diverse stakeholder group, including, but not limited to, representatives from consumer groups and organizations, labor, nursing home providers, advocacy organizations involved with the aging community, staff from the Legislature, and other interested parties, to discuss and analyze alternative mechanisms to implement the quality and accountability payments provided to nursing homes for reimbursement.(ii) The department shall articulate in a report to the fiscal and appropriate policy committees of the Legislature the implementation of an alternative mechanism as described in clause (i) at least 90 days prior to any policy or budgetary changes, and seek subsequent legislation in order to enact the proposed changes.(2) Skilled nursing facilities that do not submit required performance data by the departments specified data submission deadlines pursuant to subdivision (i) are not eligible to receive supplemental payments.(3) Notwithstanding paragraph (1), if a facility appeals the performance measure of compliance with the nursing hours or direct care service hours per patient per day requirements, pursuant to Section 1276.5 or 1276.65, as applicable, of the Health and Safety Code, to the State Department of Public Health, and it is unresolved by the departments published due date, the department shall not use that performance measure when determining the facilitys supplemental payment.(4) Notwithstanding paragraph (1), if the department is unable to pay the supplemental payments by April 30, 2014, then on May 1, 2014, the department shall use the funds available in the Skilled Nursing Facility Quality and Accountability Special Fund as a result of savings identified in subdivisions (k) and (l), less the administrative costs required to implement subparagraphs (A) and (B) of paragraph (3) of subdivision (b), in addition to any Medicaid funds that are available as of December 31, 2013, to increase provider rates retroactively to August 1, 2013.(o) The department shall seek necessary approvals from the federal Centers for Medicare and Medicaid Services to implement this section. The department shall implement this section only in a manner that is consistent with federal Medicaid law and regulations, and only to the extent that approval is obtained from the federal Centers for Medicare and Medicaid Services and federal financial participation is available.(p) In implementing this section, the department and the State Department of Public Health may contract as necessary, with Californias Medicare Quality Improvement Organization, or other entities deemed qualified by the department or the State Department of Public Health, not associated with a skilled nursing facility, to assist with development, collection, analysis, and reporting of the performance data pursuant to subdivision (i), and with demonstrated expertise in long-term care quality, data collection or analysis, and accountability performance measurement models pursuant to subdivision (i). This subdivision establishes an accelerated process for issuing any contract pursuant to this section. Any contract entered into pursuant to this subdivision is exempt from the requirements of the Public Contract Code, through December 31, 2020.(q) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the following apply:(1) The director shall implement this section, in whole or in part, by means of provider bulletins, or other similar instructions without taking regulatory action.(2) The State Public Health Officer may implement this section by means of all-facility letters, or other similar instructions without taking regulatory action.(r) Notwithstanding paragraph (1) of subdivision (n), if a final judicial determination is made by any state or federal court that is not appealed, in any action by any party, or a final determination is made by the administrator of the federal Centers for Medicare and Medicaid Services, that any payments pursuant to subdivisions (a) and (n), are invalid, unlawful, or contrary to any provision of federal law or regulations, or of state law, these subdivisions shall become inoperative, and for the 201112 rate year, the rate increase provided under subparagraph (A) of paragraph (4) of subdivision (c) of Section 14126.033 shall be reduced by the amounts described in subdivision (j). For the 201314 and 201415 rate years, any rate increase shall be reduced by the amounts described in subdivisions (j) to (l), inclusive.(s) Notwithstanding any other provision of this section, but only to the extent the department determines federal financial participation is available and not otherwise jeopardized, for performance periods in the 201718 and 201819 fiscal years, a skilled nursing facility shall remain eligible to participate in the supplemental payment program pursuant to this section so long as the facility meets the applicable nursing hours per patient per day requirements pursuant to Section 1276.5 of the Health and Safety Code that would have applied in the absence of the act that added this subdivision. Code.(t) Notwithstanding any provision of this section, but only to the extent the department determines federal financial participation is available and not otherwise jeopardized, compliance with the provisions of subdivision (c) of Section 1276.65 of the Health and Safety Code Code, as amended by Chapter 52 of the act that added this subdivision Statutes of 2017, shall not be used to determine facility qualification for the supplemental payments provided for in this section until the performance period beginning in the 201920 fiscal year. This limitation shall also apply to the issuance of citations pursuant to subdivisions (c) and (d) of Section 1424 of the Health and Safety Code based upon the failure to comply with the provisions of subdivision (c) of Section 1276.65 of the Health and Safety Code as amended by Chapter 52 of the act that added this subdivision. Statutes of 2017. Until the performance period beginning in the 201920 fiscal year, the department shall apply the provisions of Section 1276.5 of the Health and Safety Code for purposes of administering the supplemental payments pursuant to this section. For performance periods beginning in the 201920 fiscal year and each fiscal year thereafter, a skilled nursing facility that is granted a waiver pursuant to subdivision (l) of Section 1276.65 of the Health and Safety Code shall remain eligible to participate in the supplemental payment program pursuant to this section so long as the facility meets the applicable nursing hours per patient per day requirement pursuant to Section 1276.5 of the Health and Safety Code that would have applied in the absence of Chapter 52 of the Statutes of 2017 for the duration of the time for which the waiver is granted.SEC. 3. Section 17605 of the Welfare and Institutions Code is amended to read:17605. (a) For the 199293 fiscal year, the Controller shall deposit into the Caseload Subaccount of the Sales Tax Growth Account of the Local Revenue Fund, from revenues deposited into the Sales Tax Growth Account, an amount to be determined by the Department of Finance, that represents the sum of the shortfalls between the actual realignment revenues received by each county and each city and county from the Social Services Subaccount of the Local Revenue Fund in the 199192 fiscal year and the net costs incurred by each of those counties and cities and counties in the fiscal year for the programs described in Sections 10101, 10101.1, 11322, 11322.2, and 12306, subdivisions (a), (b), (c), and (d) of Section 15200, and Sections 15204.2 and 18906.5. 11322.2, 12306, 15200, 15204.2, and 18906.5, and former Section 11322. The Department of Finance shall provide the Controller with an allocation schedule on or before August 15, 1993, that shall be used by the Controller to allocate funds deposited to the Caseload Subaccount under this subdivision. The Controller shall allocate these funds no later than August 27, 1993.(b) (1) (A) For the 199394 fiscal year and fiscal years thereafter, the Controller shall deposit into the Caseload Subaccount of the Sales Tax Growth Account of the Local Revenue Fund, from revenues deposited into the Sales Tax Growth Account, an amount determined by the Department of Finance, in consultation with the appropriate state departments and the California State Association of Counties, that is sufficient to fund the net cost for the realigned portion of the county or city and county share of growth in social services caseloads, as specified in paragraph (2), and any share of growth from the previous year or years for which sufficient revenues were not available in the Caseload Subaccount. The Department of Finance shall provide the Controller with an allocations schedule on or before March 15 of each year. The schedule shall be used by the Controller to allocate funds deposited into the Caseload Subaccount under this subdivision.(B) It is the intent of the Legislature that counties shall receive allocations from the Caseload Subaccount as soon as possible after funds are received in the Sales Tax Growth Account. The Department of Finance shall recommend to the Legislature, by January 10, 2005, a procedure to expedite the preparation and provision of the allocations schedule described in subparagraph (A) and the allocation of funds by the Controller.(2) (A) For purposes of this subdivision, (i) For the 199293 fiscal year through the caseload growth calculation for the 201718 fiscal year, growth means means, for purposes of this subdivision, the increase in the actual caseload expenditures for the prior fiscal year over the actual caseload expenditures for the fiscal year preceding the prior fiscal year for the programs described in Section 12306, subdivisions (a), (b), (c), and (d) of Section 15200, and Sections 10101, 15204.2 12306, 15200, 15204.2, and 18906.5 of this code, 18906.5, and for which funds are allocated pursuant to subdivision (b) of Section 123940 of the Health and Safety Code.(ii) Commencing with the caseload growth calculation for the 201819 fiscal year and each fiscal year thereafter, for purposes of this subdivision, growth means the increase in the actual caseload expenditures for the prior fiscal year over the actual caseload expenditures for the fiscal year preceding the prior fiscal year for the programs described in Sections 10101, 15200, 15204.2, and 18906.5, and for which funds are allocated pursuant to subdivision (b) of Section 123940 of the Health and Safety Code. (B) Commencing with the caseload growth calculation for the 201718 fiscal year and each fiscal year thereafter, in addition to subparagraph (A), growth shall also include the following:(i) The additional County IHSS MOE costs to counties pursuant to Section Sections 12306.16 and 12306.17 for the current fiscal year over the County IHSS MOE costs to counties for the prior fiscal year, less the amount of sales tax revenues received pursuant to subdivision (g) of Section 17600.15 to fund the amount specified in subparagraph (B) of paragraph (3) of subdivision (f) of Section 17600.15. 17600.15 and the amount of vehicle license fee revenues received pursuant to subdivision (c) of Section 17606.20.(ii) Any additional County IHSS MOE costs to counties pursuant to Section Sections 12306.16 and 12306.17 for the prior fiscal year over the County IHSS MOE costs to counties for the preceding prior fiscal year that were not included in caseload growth calculation pursuant to clause (i). (i) from the prior caseload growth calculation.(3) (A) For the 199394 fiscal year through the 201617 fiscal year, the difference in caseload expenditures between the fiscal years shall be multiplied by the factors that represent the change in county or city and county shares of the realigned programs. These products shall then be added or subtracted, taking into account whether the countys or city and countys share of costs was increased or decreased as a result of realignment, to yield each countys or city and countys allocation for caseload growth. Allocations for counties or cities and counties with allocations of less than zero shall be set at zero.(B) Commencing with the For the caseload growth calculation for the 201718 fiscal year and each fiscal year thereafter, year the difference in caseload expenditures between the fiscal years as determined by clause (i) of subparagraph (A) of paragraph (2) shall be multiplied by the factors that represent the change in county or city and county shares of the realignment programs. These products shall then be added or subtracted, taking into account whether the countys or city and countys share of costs was increased or decreased as a result of realignment, and added to the amounts determined pursuant to subparagraph (B) of paragraph (2) to yield each countys or city and countys allocation for caseload growth. Allocations for counties or cities and counties with allocations of less than zero shall be set at zero.(C) Commencing with the caseload growth calculation for the 201819 fiscal year and each fiscal year thereafter, the difference in caseload expenditures between the fiscal years as determined by clause (ii) of subparagraph (A) of paragraph (2) shall be multiplied by the factors that represent the change in county or city and county shares of the realignment programs. These products shall then be added or subtracted, taking into account whether the countys or city and countys share of costs was increased or decreased as a result of realignment, and added to the amounts determined pursuant to subparagraph (B) of paragraph (2) to yield each countys or city and countys allocation for caseload growth. Allocations for counties or cities and counties with allocations of less than zero shall be set at zero. (c) Annually, the Controller shall allocate, to the local health and welfare trust fund social services account, the amounts deposited and remaining unexpended and unreserved in the Caseload Subaccount, pursuant to the schedules of allocations of caseload growth described in subdivision (b), within 45 days of receiving those schedules from the Department of Finance. If there are insufficient funds to fully satisfy all caseload growth obligations, each countys or city and countys allocation for each program specified in subdivision (d) shall be prorated.(d) Prior to allocating funds pursuant to subdivision (b), to the extent that funds are available from funds deposited in the Caseload Subaccount in the Sales Tax Growth Account in the Local Revenue Fund, the Controller shall allocate moneys to counties or cities and counties to correct any inequity or inequities in the computation of the child welfare services portion of the schedule required by subdivision (a) of Section 17602.(e) (1) For the 200304 fiscal year, no Sales Tax Growth Account funds shall be allocated pursuant to this chapter until the caseload portion of the base of each countys social services account in the countys health and welfare trust fund is funded to the level of the 200102 fiscal year. Funds to meet this requirement shall be allocated from the Sales Tax Account of the Local Revenue Fund. If sufficient funds are not available in the Sales Tax Account of the Local Revenue Fund to achieve that funding level in the 200304 fiscal year, this requirement shall be funded in each succeeding fiscal year in which there are sufficient funds in the Sales Tax Account of the Local Revenue Fund until the caseload base funding level for which each county would have otherwise been eligible in accordance with subdivision (e) of Section 17602 for that year.(2) The caseload portion of each countys social services account base shall be determined by subtracting its noncaseload portion of the base, as determined by the Department of Finance in its annual calculation of General Growth Account allocations, from the total base of each countys social services account for the 200102 fiscal year.(f) Commencing with the caseload growth calculation for the 201718 fiscal year and each fiscal year thereafter, the Controller shall annually post on his or her Internet Web site the total amount of unfunded caseload growth by county.SEC. 4. (a) Notwithstanding any other law, from the General Fund moneys appropriated to the State Department of Social Services in Item 5180-101-0001 of Section 2.00 of the Budget Act of 2017, the department shall allocate five million four hundred thousand dollars ($5,400,000), in a single payment by the Controller, to the City of San Jose for purposes of assisting homeless and low-income individuals displaced by the Coyote Creek flooding that occurred in February 2017.(b) As a condition of receiving these funds, the City of San Jose shall provide quarterly reports to the department regarding the number of families served and the types of services they received, until all funds have been expended.SEC. 5. The sum of five million eight hundred eighty-four thousand dollars ($5,884,000) is hereby appropriated from the Federal Trust Fund to the State Department of Health Care Services in the 201718 fiscal year for the purpose of providing supplemental reimbursements to specific hospitals that provide trauma care to Medi-Cal beneficiaries. These funds shall be available for encumbrance or expenditure until June 30, 2018.SEC. 6. This act is a bill providing for appropriations related to the Budget Bill within the meaning of subdivision (e) of Section 12 of Article IV of the California Constitution, has been identified as related to the budget in the Budget Bill, and shall take effect immediately.SECTION 1.It is the intent of the Legislature to enact statutory changes relating to the Budget Act of 2017.
The people of the State of California do enact as follows:
## The people of the State of California do enact as follows:
SECTION 1. Section 12301.61 of the Welfare and Institutions Code is amended to read:12301.61. (a) If a public authority or nonprofit consortium established pursuant to Section 12301.6, acting as the employer of record, fails to reach and the employee organization have not reached an agreement on a bargaining contract with its in-home supportive services workers by January 1, 2018, either party may request mediation, pursuant to Section 3505.2 of the Government Code, which shall be mandatory. If the parties fail to agree on a mediator, the Public Employment Relations Board shall appoint one from the pool described in subdivision (c). The mediation shall be held no more than 15 business days from the date requested by either party.(b) If the parties are unable to effect settlement through mediation as described in subdivision (a), the parties shall then submit their differences to factfinding, pursuant to Section 3505 and 3505.4 of the Government Code. Alternatively, if both parties agree, the parties may bypass the mediation process in subdivision (a) and move directly to factfinding.(1) The factfinding panel shall make findings of fact and recommend terms of settlement, which shall be advisory only, within 30 days after the panel is appointed by the Public Employment Relations Board.(2) Within 15 days after the factfinding panel has released its findings of fact and recommended settlement terms, either party may request post-factfinding mediation consistent with Section 3505.2 of the Government Code, which shall be mandatory. If the parties fail to agree on a mediator, the Public Employment Relations Board shall appoint one from the pool described in subdivision (c).(3) If either party elects post-factfinding mediation, the findings of fact and recommended settlement terms, shall not be made public until the mediation has concluded.(4) Mediation shall be held no more than 15 days from the date requested, and may include, at the mediators discretion, the factfinding panel and representatives of both parties. The director, or his or her designee, shall be available to provide information and expertise, as necessary.(c) The Public Employment Relations Board shall designate a pool of no more than five qualified individuals to serve as mediators or on a factfinding panel. The pool shall consist of individuals with relevant subject matter expertise. The board shall select individuals for the pool in consultation with the department and the affected employers and employee organizations. Priority shall be given to individuals with knowledge of the In-Home Supportive Services program. The board may designate the mediator to serve as the neutral member of the factfinding panel.(d) The costs for the services of the factfinding panel and the mediator shall be equally divided between the employer and the employee organization, parties, and shall include per diem fees, if any, and actual and necessary travel and subsistence expenses.(e) By April 1, 2018, the department shall report to the fiscal committees of the Legislature on the status of all in-home supportive services bargaining contracts in each county.(f) If no individual is available to serve as a mediator or factfinder within the timelines specified in this section, the timelines shall be extended until the next mediator or factfinder is available.(g) This section shall remain in effect only until January 1, 2020, and as of that date is repealed.
SECTION 1. Section 12301.61 of the Welfare and Institutions Code is amended to read:
### SECTION 1.
12301.61. (a) If a public authority or nonprofit consortium established pursuant to Section 12301.6, acting as the employer of record, fails to reach and the employee organization have not reached an agreement on a bargaining contract with its in-home supportive services workers by January 1, 2018, either party may request mediation, pursuant to Section 3505.2 of the Government Code, which shall be mandatory. If the parties fail to agree on a mediator, the Public Employment Relations Board shall appoint one from the pool described in subdivision (c). The mediation shall be held no more than 15 business days from the date requested by either party.(b) If the parties are unable to effect settlement through mediation as described in subdivision (a), the parties shall then submit their differences to factfinding, pursuant to Section 3505 and 3505.4 of the Government Code. Alternatively, if both parties agree, the parties may bypass the mediation process in subdivision (a) and move directly to factfinding.(1) The factfinding panel shall make findings of fact and recommend terms of settlement, which shall be advisory only, within 30 days after the panel is appointed by the Public Employment Relations Board.(2) Within 15 days after the factfinding panel has released its findings of fact and recommended settlement terms, either party may request post-factfinding mediation consistent with Section 3505.2 of the Government Code, which shall be mandatory. If the parties fail to agree on a mediator, the Public Employment Relations Board shall appoint one from the pool described in subdivision (c).(3) If either party elects post-factfinding mediation, the findings of fact and recommended settlement terms, shall not be made public until the mediation has concluded.(4) Mediation shall be held no more than 15 days from the date requested, and may include, at the mediators discretion, the factfinding panel and representatives of both parties. The director, or his or her designee, shall be available to provide information and expertise, as necessary.(c) The Public Employment Relations Board shall designate a pool of no more than five qualified individuals to serve as mediators or on a factfinding panel. The pool shall consist of individuals with relevant subject matter expertise. The board shall select individuals for the pool in consultation with the department and the affected employers and employee organizations. Priority shall be given to individuals with knowledge of the In-Home Supportive Services program. The board may designate the mediator to serve as the neutral member of the factfinding panel.(d) The costs for the services of the factfinding panel and the mediator shall be equally divided between the employer and the employee organization, parties, and shall include per diem fees, if any, and actual and necessary travel and subsistence expenses.(e) By April 1, 2018, the department shall report to the fiscal committees of the Legislature on the status of all in-home supportive services bargaining contracts in each county.(f) If no individual is available to serve as a mediator or factfinder within the timelines specified in this section, the timelines shall be extended until the next mediator or factfinder is available.(g) This section shall remain in effect only until January 1, 2020, and as of that date is repealed.
12301.61. (a) If a public authority or nonprofit consortium established pursuant to Section 12301.6, acting as the employer of record, fails to reach and the employee organization have not reached an agreement on a bargaining contract with its in-home supportive services workers by January 1, 2018, either party may request mediation, pursuant to Section 3505.2 of the Government Code, which shall be mandatory. If the parties fail to agree on a mediator, the Public Employment Relations Board shall appoint one from the pool described in subdivision (c). The mediation shall be held no more than 15 business days from the date requested by either party.(b) If the parties are unable to effect settlement through mediation as described in subdivision (a), the parties shall then submit their differences to factfinding, pursuant to Section 3505 and 3505.4 of the Government Code. Alternatively, if both parties agree, the parties may bypass the mediation process in subdivision (a) and move directly to factfinding.(1) The factfinding panel shall make findings of fact and recommend terms of settlement, which shall be advisory only, within 30 days after the panel is appointed by the Public Employment Relations Board.(2) Within 15 days after the factfinding panel has released its findings of fact and recommended settlement terms, either party may request post-factfinding mediation consistent with Section 3505.2 of the Government Code, which shall be mandatory. If the parties fail to agree on a mediator, the Public Employment Relations Board shall appoint one from the pool described in subdivision (c).(3) If either party elects post-factfinding mediation, the findings of fact and recommended settlement terms, shall not be made public until the mediation has concluded.(4) Mediation shall be held no more than 15 days from the date requested, and may include, at the mediators discretion, the factfinding panel and representatives of both parties. The director, or his or her designee, shall be available to provide information and expertise, as necessary.(c) The Public Employment Relations Board shall designate a pool of no more than five qualified individuals to serve as mediators or on a factfinding panel. The pool shall consist of individuals with relevant subject matter expertise. The board shall select individuals for the pool in consultation with the department and the affected employers and employee organizations. Priority shall be given to individuals with knowledge of the In-Home Supportive Services program. The board may designate the mediator to serve as the neutral member of the factfinding panel.(d) The costs for the services of the factfinding panel and the mediator shall be equally divided between the employer and the employee organization, parties, and shall include per diem fees, if any, and actual and necessary travel and subsistence expenses.(e) By April 1, 2018, the department shall report to the fiscal committees of the Legislature on the status of all in-home supportive services bargaining contracts in each county.(f) If no individual is available to serve as a mediator or factfinder within the timelines specified in this section, the timelines shall be extended until the next mediator or factfinder is available.(g) This section shall remain in effect only until January 1, 2020, and as of that date is repealed.
12301.61. (a) If a public authority or nonprofit consortium established pursuant to Section 12301.6, acting as the employer of record, fails to reach and the employee organization have not reached an agreement on a bargaining contract with its in-home supportive services workers by January 1, 2018, either party may request mediation, pursuant to Section 3505.2 of the Government Code, which shall be mandatory. If the parties fail to agree on a mediator, the Public Employment Relations Board shall appoint one from the pool described in subdivision (c). The mediation shall be held no more than 15 business days from the date requested by either party.(b) If the parties are unable to effect settlement through mediation as described in subdivision (a), the parties shall then submit their differences to factfinding, pursuant to Section 3505 and 3505.4 of the Government Code. Alternatively, if both parties agree, the parties may bypass the mediation process in subdivision (a) and move directly to factfinding.(1) The factfinding panel shall make findings of fact and recommend terms of settlement, which shall be advisory only, within 30 days after the panel is appointed by the Public Employment Relations Board.(2) Within 15 days after the factfinding panel has released its findings of fact and recommended settlement terms, either party may request post-factfinding mediation consistent with Section 3505.2 of the Government Code, which shall be mandatory. If the parties fail to agree on a mediator, the Public Employment Relations Board shall appoint one from the pool described in subdivision (c).(3) If either party elects post-factfinding mediation, the findings of fact and recommended settlement terms, shall not be made public until the mediation has concluded.(4) Mediation shall be held no more than 15 days from the date requested, and may include, at the mediators discretion, the factfinding panel and representatives of both parties. The director, or his or her designee, shall be available to provide information and expertise, as necessary.(c) The Public Employment Relations Board shall designate a pool of no more than five qualified individuals to serve as mediators or on a factfinding panel. The pool shall consist of individuals with relevant subject matter expertise. The board shall select individuals for the pool in consultation with the department and the affected employers and employee organizations. Priority shall be given to individuals with knowledge of the In-Home Supportive Services program. The board may designate the mediator to serve as the neutral member of the factfinding panel.(d) The costs for the services of the factfinding panel and the mediator shall be equally divided between the employer and the employee organization, parties, and shall include per diem fees, if any, and actual and necessary travel and subsistence expenses.(e) By April 1, 2018, the department shall report to the fiscal committees of the Legislature on the status of all in-home supportive services bargaining contracts in each county.(f) If no individual is available to serve as a mediator or factfinder within the timelines specified in this section, the timelines shall be extended until the next mediator or factfinder is available.(g) This section shall remain in effect only until January 1, 2020, and as of that date is repealed.
12301.61. (a) If a public authority or nonprofit consortium established pursuant to Section 12301.6, acting as the employer of record, fails to reach and the employee organization have not reached an agreement on a bargaining contract with its in-home supportive services workers by January 1, 2018, either party may request mediation, pursuant to Section 3505.2 of the Government Code, which shall be mandatory. If the parties fail to agree on a mediator, the Public Employment Relations Board shall appoint one from the pool described in subdivision (c). The mediation shall be held no more than 15 business days from the date requested by either party.
(b) If the parties are unable to effect settlement through mediation as described in subdivision (a), the parties shall then submit their differences to factfinding, pursuant to Section 3505 and 3505.4 of the Government Code. Alternatively, if both parties agree, the parties may bypass the mediation process in subdivision (a) and move directly to factfinding.
(1) The factfinding panel shall make findings of fact and recommend terms of settlement, which shall be advisory only, within 30 days after the panel is appointed by the Public Employment Relations Board.
(2) Within 15 days after the factfinding panel has released its findings of fact and recommended settlement terms, either party may request post-factfinding mediation consistent with Section 3505.2 of the Government Code, which shall be mandatory. If the parties fail to agree on a mediator, the Public Employment Relations Board shall appoint one from the pool described in subdivision (c).
(3) If either party elects post-factfinding mediation, the findings of fact and recommended settlement terms, shall not be made public until the mediation has concluded.
(4) Mediation shall be held no more than 15 days from the date requested, and may include, at the mediators discretion, the factfinding panel and representatives of both parties. The director, or his or her designee, shall be available to provide information and expertise, as necessary.
(c) The Public Employment Relations Board shall designate a pool of no more than five qualified individuals to serve as mediators or on a factfinding panel. The pool shall consist of individuals with relevant subject matter expertise. The board shall select individuals for the pool in consultation with the department and the affected employers and employee organizations. Priority shall be given to individuals with knowledge of the In-Home Supportive Services program. The board may designate the mediator to serve as the neutral member of the factfinding panel.
(d) The costs for the services of the factfinding panel and the mediator shall be equally divided between the employer and the employee organization, parties, and shall include per diem fees, if any, and actual and necessary travel and subsistence expenses.
(e) By April 1, 2018, the department shall report to the fiscal committees of the Legislature on the status of all in-home supportive services bargaining contracts in each county.
(f) If no individual is available to serve as a mediator or factfinder within the timelines specified in this section, the timelines shall be extended until the next mediator or factfinder is available.
(g) This section shall remain in effect only until January 1, 2020, and as of that date is repealed.
SEC. 2. Section 14126.022 of the Welfare and Institutions Code is amended to read:14126.022. (a) (1) By August 1, 2011, the department shall develop the Skilled Nursing Facility Quality and Accountability Supplemental Payment System, subject to approval by the federal Centers for Medicare and Medicaid Services, and the availability of federal, state, or other funds.(2) (A) The system shall be utilized to provide supplemental payments to skilled nursing facilities that improve the quality and accountability of care rendered to residents in skilled nursing facilities, as defined in subdivision (c) of Section 1250 of the Health and Safety Code, and to penalize those facilities that do not meet measurable standards.(B) A freestanding pediatric subacute care facility, as defined in Section 51215.8 of Title 22 of the California Code of Regulations, shall be exempt from the Skilled Nursing Facility Quality and Accountability Supplemental Payment System.(3) The system shall be phased in, beginning with the 201011 rate year.(4) The department may utilize the system to do all of the following:(A) Assess overall facility quality of care and quality of care improvement, and assign quality and accountability payments to skilled nursing facilities pursuant to performance measures described in subdivision (i).(B) Assign quality and accountability payments or penalties relating to quality of care, or direct care staffing levels, wages, and benefits, or both.(C) Limit the reimbursement of legal fees incurred by skilled nursing facilities engaged in the defense of governmental legal actions filed against the facilities.(D) Publish each facilitys quality assessment and quality and accountability payments in a manner and form determined by the director, or his or her designee.(E) Beginning with the 201112 fiscal year, establish a base year to collect performance measures described in subdivision (i).(F) Beginning with the 201112 fiscal year, in coordination with the State Department of Public Health, publish the direct care staffing level data and the performance measures required pursuant to subdivision (i).(5) The department, in coordination with the State Department of Public Health, shall report to the relevant Assembly and Senate budget subcommittees by May 1, 2016, information regarding the quality and accountability supplemental payments, including, but not limited to, its assessment of whether the payments are adequate to incentivize quality care and to sustain the program.(b) (1) There is hereby created in the State Treasury, the Skilled Nursing Facility Quality and Accountability Special Fund. The fund shall contain moneys deposited pursuant to subdivisions (g) and (j) to (m), inclusive. Notwithstanding Section 16305.7 of the Government Code, the fund shall contain all interest and dividends earned on moneys in the fund.(2) Notwithstanding Section 13340 of the Government Code, the fund shall be continuously appropriated without regard to fiscal year to the department for making quality and accountability payments, in accordance with subdivision (n), to facilities that meet or exceed predefined measures as established by this section.(3) Upon appropriation by the Legislature, moneys in the fund may also be used for any of the following purposes:(A) To cover the administrative costs incurred by the State Department of Public Health for positions and contract funding required to implement this section.(B) To cover the administrative costs incurred by the State Department of Health Care Services for positions and contract funding required to implement this section.(C) To provide funding assistance for the Long-Term Care Ombudsman Program activities pursuant to Chapter 11 (commencing with Section 9700) of Division 8.5.(c) No appropriation associated with Chapter 717 of the Statutes of 2010 is intended to implement the provisions of Section 1276.65 of the Health and Safety Code.(d) (1) There is hereby appropriated for the 201011 fiscal year, one million nine hundred thousand dollars ($1,900,000) from the Skilled Nursing Facility Quality and Accountability Special Fund to the California Department of Aging for the Long-Term Care Ombudsman Program activities pursuant to Chapter 11 (commencing with Section 9700) of Division 8.5. It is the intent of the Legislature for the one million nine hundred thousand dollars ($1,900,000) from the fund to be in addition to the four million one hundred sixty-eight thousand dollars ($4,168,000) proposed in the Governors May Revision for the 201011 Budget. It is further the intent of the Legislature to increase this level of appropriation in subsequent years to provide support sufficient to carry out the mandates and activities pursuant to Chapter 11 (commencing with Section 9700) of Division 8.5.(2) The department, in partnership with the California Department of Aging, shall seek approval from the federal Centers for Medicare and Medicaid Services to obtain federal Medicaid reimbursement for activities conducted by the Long-Term Care Ombudsman Program. The department shall report to the fiscal committees of the Legislature during budget hearings on progress being made and any unresolved issues during the 201112 budget deliberations.(e) There is hereby created in the Special Deposit Fund established pursuant to Section 16370 of the Government Code, the Skilled Nursing Facility Minimum Staffing Penalty Account. The account shall contain all moneys deposited pursuant to subdivision (f).(f) (1) Beginning with the 201011 fiscal year, the State Department of Public Health shall use the direct care staffing level data it collects to determine whether a skilled nursing facility has met the nursing hours or direct care service hours per patient per day requirements pursuant to Section 1276.5 or 1276.65, as applicable, of the Health and Safety Code.(2) (A) Beginning with the 201011 fiscal year, the State Department of Public Health shall assess a skilled nursing facility, licensed pursuant to subdivision (c) of Section 1250 of the Health and Safety Code, an administrative penalty if the State Department of Public Health determines that the skilled nursing facility fails to meet the nursing hours or direct care service hours per patient per day requirements pursuant to Section 1276.5 or 1276.65, as applicable, of the Health and Safety Code, as follows:(i) Fifteen thousand dollars ($15,000) if the facility fails to meet the requirements for 5 percent or more of the audited days up to 49 percent.(ii) Thirty thousand dollars ($30,000) if the facility fails to meet the requirements for over 49 percent or more of the audited days.(B) (i) If the skilled nursing facility does not dispute the determination or assessment, the penalties shall be paid in full by the licensee to the State Department of Public Health within 30 days of the facilitys receipt of the notice of penalty and deposited into the Skilled Nursing Facility Minimum Staffing Penalty Account.(ii) The State Department of Public Health may, upon written notification to the licensee, request that the department offset any moneys owed to the licensee by the Medi-Cal program or any other payment program administered by the department to recoup the penalty provided for in this section.(C) (i) If a facility disputes the determination or assessment made pursuant to this paragraph, the facility shall, within 15 days of the facilitys receipt of the determination and assessment, simultaneously submit a request for appeal to both the department and the State Department of Public Health. The request shall include a detailed statement describing the reason for appeal and include all supporting documents the facility will present at the hearing.(ii) Within 10 days of the State Department of Public Healths receipt of the facilitys request for appeal, the State Department of Public Health shall submit, to both the facility and the department, all supporting documents that will be presented at the hearing.(D) The department shall hear a timely appeal and issue a decision as follows:(i) The hearing shall commence within 60 days from the date of receipt by the department of the facilitys timely request for appeal.(ii) The department shall issue a decision within 120 days from the date of receipt by the department of the facilitys timely request for appeal.(iii) The decision of the departments hearing officer, when issued, shall be the final decision of the State Department of Public Health.(E) The appeals process set forth in this paragraph shall be exempt from Chapter 4.5 (commencing with Section 11400) and Chapter 5 (commencing with Section 11500), of Part 1 of Division 3 of Title 2 of the Government Code. The provisions of Sections 100171 and 131071 of the Health and Safety Code do not apply to appeals under this paragraph.(F) If a hearing decision issued pursuant to subparagraph (D) is in favor of the State Department of Public Health, the skilled nursing facility shall pay the penalties to the State Department of Public Health within 30 days of the facilitys receipt of the decision. The penalties collected shall be deposited into the Skilled Nursing Facility Minimum Staffing Penalty Account.(G) The assessment of a penalty under this subdivision does not supplant the State Department of Public Healths investigation process or issuance of deficiencies or citations under Chapter 2.4 (commencing with Section 1417) of Division 2 of the Health and Safety Code.(g) The State Department of Public Health shall transfer, on a monthly basis, all penalty payments collected pursuant to subdivision (f) into the Skilled Nursing Facility Quality and Accountability Special Fund.(h) This section does not impact the effectiveness or utilization of Section 1278.5 or 1432 of the Health and Safety Code relating to whistleblower protections, or Section 1420 of the Health and Safety Code relating to complaints.(i) (1) Beginning in the 201011 fiscal year, the department, in consultation with representatives from the long-term care industry, organized labor, and consumers, shall establish and publish quality and accountability measures, benchmarks, and data submission deadlines by November 30, 2010.(2) The methodology developed pursuant to this section shall include, but not be limited to, the following requirements and performance measures:(A) Beginning in the 201112 fiscal year:(i) Immunization rates.(ii) Facility acquired pressure ulcer incidence.(iii) The use of physical restraints.(iv) Compliance with the nursing hours or direct care service hours per patient per day requirements pursuant to Section 1276.5 or 1276.65, as applicable, of the Health and Safety Code.(v) Resident and family satisfaction.(vi) Direct care staff retention, if sufficient data is available.(B) If this act is extended beyond the dates on which it becomes inoperative and is repealed, in accordance with Section 14126.033, the department, in consultation with representatives from the long-term care industry, organized labor, and consumers, beginning in the 201314 rate year, shall incorporate additional measures into the system, including, but not limited to, quality and accountability measures required by federal health care reform that are identified by the federal Centers for Medicare and Medicaid Services.(C) The department, in consultation with representatives from the long-term care industry, organized labor, and consumers, may incorporate additional performance measures, including, but not limited to, the following:(i) Compliance with state policy associated with the United States Supreme Court decision in Olmstead v. L.C. ex rel. Zimring (1999) 527 U.S. 581.(ii) Direct care staff retention, if not addressed in the 201213 rate year.(iii) The use of chemical restraints.(D) Beginning with the 201516 fiscal year, the department, in consultation with representatives from the long-term care industry, organized labor, and consumers, shall incorporate direct care staff retention as a performance measure in the methodology developed pursuant to this section.(j) (1) Beginning with the 201011 rate year, and pursuant to subparagraph (B) of paragraph (5) of subdivision (a) of Section 14126.023, the department shall set aside savings achieved from setting the professional liability insurance cost category, including any insurance deductible costs paid by the facility, at the 75th percentile. From this amount, the department shall transfer the General Fund portion into the Skilled Nursing Facility Quality and Accountability Special Fund. A skilled nursing facility shall provide supplemental data on insurance deductible costs to facilitate this adjustment, in the format and by the deadlines determined by the department. If this data is not provided, a facilitys insurance deductible costs will remain in the administrative costs category.(2) Notwithstanding paragraph (1), for the 201213 rate year only, savings from capping the professional liability insurance cost category pursuant to paragraph (1) shall remain in the General Fund and shall not be transferred to the Skilled Nursing Facility Quality and Accountability Special Fund.(k) For the 201314 rate year, if there is a rate increase in the weighted average Medi-Cal reimbursement rate, the department shall set aside the first 1 percent of the weighted average Medi-Cal reimbursement rate increase for the Skilled Nursing Facility Quality and Accountability Special Fund.(l) If this act is extended beyond the dates on which it becomes inoperative and is repealed, for the 201415 rate year, in addition to the amount set aside pursuant to subdivision (k), if there is a rate increase in the weighted average Medi-Cal reimbursement rate, the department shall set aside at least one-third of the weighted average Medi-Cal reimbursement rate increase, up to a maximum of 1 percent, from which the department shall transfer the General Fund portion of this amount into the Skilled Nursing Facility Quality and Accountability Special Fund.(m) Beginning with the 201516 rate year, and each subsequent rate year thereafter for which this article is operative, an amount equal to the amount deposited in the fund pursuant to subdivisions (k) and (l) for the 201415 rate year shall be deposited into the Skilled Nursing Facility Quality and Accountability Special Fund, for the purposes specified in this section.(n) (1) (A) Beginning with the 201314 rate year, the department shall pay a supplemental payment, by April 30, 2014, to skilled nursing facilities based on all of the criteria in subdivision (i), as published by the department, and according to performance measure benchmarks determined by the department in consultation with stakeholders.(B) (i) The department may convene a diverse stakeholder group, including, but not limited to, representatives from consumer groups and organizations, labor, nursing home providers, advocacy organizations involved with the aging community, staff from the Legislature, and other interested parties, to discuss and analyze alternative mechanisms to implement the quality and accountability payments provided to nursing homes for reimbursement.(ii) The department shall articulate in a report to the fiscal and appropriate policy committees of the Legislature the implementation of an alternative mechanism as described in clause (i) at least 90 days prior to any policy or budgetary changes, and seek subsequent legislation in order to enact the proposed changes.(2) Skilled nursing facilities that do not submit required performance data by the departments specified data submission deadlines pursuant to subdivision (i) are not eligible to receive supplemental payments.(3) Notwithstanding paragraph (1), if a facility appeals the performance measure of compliance with the nursing hours or direct care service hours per patient per day requirements, pursuant to Section 1276.5 or 1276.65, as applicable, of the Health and Safety Code, to the State Department of Public Health, and it is unresolved by the departments published due date, the department shall not use that performance measure when determining the facilitys supplemental payment.(4) Notwithstanding paragraph (1), if the department is unable to pay the supplemental payments by April 30, 2014, then on May 1, 2014, the department shall use the funds available in the Skilled Nursing Facility Quality and Accountability Special Fund as a result of savings identified in subdivisions (k) and (l), less the administrative costs required to implement subparagraphs (A) and (B) of paragraph (3) of subdivision (b), in addition to any Medicaid funds that are available as of December 31, 2013, to increase provider rates retroactively to August 1, 2013.(o) The department shall seek necessary approvals from the federal Centers for Medicare and Medicaid Services to implement this section. The department shall implement this section only in a manner that is consistent with federal Medicaid law and regulations, and only to the extent that approval is obtained from the federal Centers for Medicare and Medicaid Services and federal financial participation is available.(p) In implementing this section, the department and the State Department of Public Health may contract as necessary, with Californias Medicare Quality Improvement Organization, or other entities deemed qualified by the department or the State Department of Public Health, not associated with a skilled nursing facility, to assist with development, collection, analysis, and reporting of the performance data pursuant to subdivision (i), and with demonstrated expertise in long-term care quality, data collection or analysis, and accountability performance measurement models pursuant to subdivision (i). This subdivision establishes an accelerated process for issuing any contract pursuant to this section. Any contract entered into pursuant to this subdivision is exempt from the requirements of the Public Contract Code, through December 31, 2020.(q) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the following apply:(1) The director shall implement this section, in whole or in part, by means of provider bulletins, or other similar instructions without taking regulatory action.(2) The State Public Health Officer may implement this section by means of all-facility letters, or other similar instructions without taking regulatory action.(r) Notwithstanding paragraph (1) of subdivision (n), if a final judicial determination is made by any state or federal court that is not appealed, in any action by any party, or a final determination is made by the administrator of the federal Centers for Medicare and Medicaid Services, that any payments pursuant to subdivisions (a) and (n), are invalid, unlawful, or contrary to any provision of federal law or regulations, or of state law, these subdivisions shall become inoperative, and for the 201112 rate year, the rate increase provided under subparagraph (A) of paragraph (4) of subdivision (c) of Section 14126.033 shall be reduced by the amounts described in subdivision (j). For the 201314 and 201415 rate years, any rate increase shall be reduced by the amounts described in subdivisions (j) to (l), inclusive.(s) Notwithstanding any other provision of this section, but only to the extent the department determines federal financial participation is available and not otherwise jeopardized, for performance periods in the 201718 and 201819 fiscal years, a skilled nursing facility shall remain eligible to participate in the supplemental payment program pursuant to this section so long as the facility meets the applicable nursing hours per patient per day requirements pursuant to Section 1276.5 of the Health and Safety Code that would have applied in the absence of the act that added this subdivision. Code.(t) Notwithstanding any provision of this section, but only to the extent the department determines federal financial participation is available and not otherwise jeopardized, compliance with the provisions of subdivision (c) of Section 1276.65 of the Health and Safety Code Code, as amended by Chapter 52 of the act that added this subdivision Statutes of 2017, shall not be used to determine facility qualification for the supplemental payments provided for in this section until the performance period beginning in the 201920 fiscal year. This limitation shall also apply to the issuance of citations pursuant to subdivisions (c) and (d) of Section 1424 of the Health and Safety Code based upon the failure to comply with the provisions of subdivision (c) of Section 1276.65 of the Health and Safety Code as amended by Chapter 52 of the act that added this subdivision. Statutes of 2017. Until the performance period beginning in the 201920 fiscal year, the department shall apply the provisions of Section 1276.5 of the Health and Safety Code for purposes of administering the supplemental payments pursuant to this section. For performance periods beginning in the 201920 fiscal year and each fiscal year thereafter, a skilled nursing facility that is granted a waiver pursuant to subdivision (l) of Section 1276.65 of the Health and Safety Code shall remain eligible to participate in the supplemental payment program pursuant to this section so long as the facility meets the applicable nursing hours per patient per day requirement pursuant to Section 1276.5 of the Health and Safety Code that would have applied in the absence of Chapter 52 of the Statutes of 2017 for the duration of the time for which the waiver is granted.
SEC. 2. Section 14126.022 of the Welfare and Institutions Code is amended to read:
### SEC. 2.
14126.022. (a) (1) By August 1, 2011, the department shall develop the Skilled Nursing Facility Quality and Accountability Supplemental Payment System, subject to approval by the federal Centers for Medicare and Medicaid Services, and the availability of federal, state, or other funds.(2) (A) The system shall be utilized to provide supplemental payments to skilled nursing facilities that improve the quality and accountability of care rendered to residents in skilled nursing facilities, as defined in subdivision (c) of Section 1250 of the Health and Safety Code, and to penalize those facilities that do not meet measurable standards.(B) A freestanding pediatric subacute care facility, as defined in Section 51215.8 of Title 22 of the California Code of Regulations, shall be exempt from the Skilled Nursing Facility Quality and Accountability Supplemental Payment System.(3) The system shall be phased in, beginning with the 201011 rate year.(4) The department may utilize the system to do all of the following:(A) Assess overall facility quality of care and quality of care improvement, and assign quality and accountability payments to skilled nursing facilities pursuant to performance measures described in subdivision (i).(B) Assign quality and accountability payments or penalties relating to quality of care, or direct care staffing levels, wages, and benefits, or both.(C) Limit the reimbursement of legal fees incurred by skilled nursing facilities engaged in the defense of governmental legal actions filed against the facilities.(D) Publish each facilitys quality assessment and quality and accountability payments in a manner and form determined by the director, or his or her designee.(E) Beginning with the 201112 fiscal year, establish a base year to collect performance measures described in subdivision (i).(F) Beginning with the 201112 fiscal year, in coordination with the State Department of Public Health, publish the direct care staffing level data and the performance measures required pursuant to subdivision (i).(5) The department, in coordination with the State Department of Public Health, shall report to the relevant Assembly and Senate budget subcommittees by May 1, 2016, information regarding the quality and accountability supplemental payments, including, but not limited to, its assessment of whether the payments are adequate to incentivize quality care and to sustain the program.(b) (1) There is hereby created in the State Treasury, the Skilled Nursing Facility Quality and Accountability Special Fund. The fund shall contain moneys deposited pursuant to subdivisions (g) and (j) to (m), inclusive. Notwithstanding Section 16305.7 of the Government Code, the fund shall contain all interest and dividends earned on moneys in the fund.(2) Notwithstanding Section 13340 of the Government Code, the fund shall be continuously appropriated without regard to fiscal year to the department for making quality and accountability payments, in accordance with subdivision (n), to facilities that meet or exceed predefined measures as established by this section.(3) Upon appropriation by the Legislature, moneys in the fund may also be used for any of the following purposes:(A) To cover the administrative costs incurred by the State Department of Public Health for positions and contract funding required to implement this section.(B) To cover the administrative costs incurred by the State Department of Health Care Services for positions and contract funding required to implement this section.(C) To provide funding assistance for the Long-Term Care Ombudsman Program activities pursuant to Chapter 11 (commencing with Section 9700) of Division 8.5.(c) No appropriation associated with Chapter 717 of the Statutes of 2010 is intended to implement the provisions of Section 1276.65 of the Health and Safety Code.(d) (1) There is hereby appropriated for the 201011 fiscal year, one million nine hundred thousand dollars ($1,900,000) from the Skilled Nursing Facility Quality and Accountability Special Fund to the California Department of Aging for the Long-Term Care Ombudsman Program activities pursuant to Chapter 11 (commencing with Section 9700) of Division 8.5. It is the intent of the Legislature for the one million nine hundred thousand dollars ($1,900,000) from the fund to be in addition to the four million one hundred sixty-eight thousand dollars ($4,168,000) proposed in the Governors May Revision for the 201011 Budget. It is further the intent of the Legislature to increase this level of appropriation in subsequent years to provide support sufficient to carry out the mandates and activities pursuant to Chapter 11 (commencing with Section 9700) of Division 8.5.(2) The department, in partnership with the California Department of Aging, shall seek approval from the federal Centers for Medicare and Medicaid Services to obtain federal Medicaid reimbursement for activities conducted by the Long-Term Care Ombudsman Program. The department shall report to the fiscal committees of the Legislature during budget hearings on progress being made and any unresolved issues during the 201112 budget deliberations.(e) There is hereby created in the Special Deposit Fund established pursuant to Section 16370 of the Government Code, the Skilled Nursing Facility Minimum Staffing Penalty Account. The account shall contain all moneys deposited pursuant to subdivision (f).(f) (1) Beginning with the 201011 fiscal year, the State Department of Public Health shall use the direct care staffing level data it collects to determine whether a skilled nursing facility has met the nursing hours or direct care service hours per patient per day requirements pursuant to Section 1276.5 or 1276.65, as applicable, of the Health and Safety Code.(2) (A) Beginning with the 201011 fiscal year, the State Department of Public Health shall assess a skilled nursing facility, licensed pursuant to subdivision (c) of Section 1250 of the Health and Safety Code, an administrative penalty if the State Department of Public Health determines that the skilled nursing facility fails to meet the nursing hours or direct care service hours per patient per day requirements pursuant to Section 1276.5 or 1276.65, as applicable, of the Health and Safety Code, as follows:(i) Fifteen thousand dollars ($15,000) if the facility fails to meet the requirements for 5 percent or more of the audited days up to 49 percent.(ii) Thirty thousand dollars ($30,000) if the facility fails to meet the requirements for over 49 percent or more of the audited days.(B) (i) If the skilled nursing facility does not dispute the determination or assessment, the penalties shall be paid in full by the licensee to the State Department of Public Health within 30 days of the facilitys receipt of the notice of penalty and deposited into the Skilled Nursing Facility Minimum Staffing Penalty Account.(ii) The State Department of Public Health may, upon written notification to the licensee, request that the department offset any moneys owed to the licensee by the Medi-Cal program or any other payment program administered by the department to recoup the penalty provided for in this section.(C) (i) If a facility disputes the determination or assessment made pursuant to this paragraph, the facility shall, within 15 days of the facilitys receipt of the determination and assessment, simultaneously submit a request for appeal to both the department and the State Department of Public Health. The request shall include a detailed statement describing the reason for appeal and include all supporting documents the facility will present at the hearing.(ii) Within 10 days of the State Department of Public Healths receipt of the facilitys request for appeal, the State Department of Public Health shall submit, to both the facility and the department, all supporting documents that will be presented at the hearing.(D) The department shall hear a timely appeal and issue a decision as follows:(i) The hearing shall commence within 60 days from the date of receipt by the department of the facilitys timely request for appeal.(ii) The department shall issue a decision within 120 days from the date of receipt by the department of the facilitys timely request for appeal.(iii) The decision of the departments hearing officer, when issued, shall be the final decision of the State Department of Public Health.(E) The appeals process set forth in this paragraph shall be exempt from Chapter 4.5 (commencing with Section 11400) and Chapter 5 (commencing with Section 11500), of Part 1 of Division 3 of Title 2 of the Government Code. The provisions of Sections 100171 and 131071 of the Health and Safety Code do not apply to appeals under this paragraph.(F) If a hearing decision issued pursuant to subparagraph (D) is in favor of the State Department of Public Health, the skilled nursing facility shall pay the penalties to the State Department of Public Health within 30 days of the facilitys receipt of the decision. The penalties collected shall be deposited into the Skilled Nursing Facility Minimum Staffing Penalty Account.(G) The assessment of a penalty under this subdivision does not supplant the State Department of Public Healths investigation process or issuance of deficiencies or citations under Chapter 2.4 (commencing with Section 1417) of Division 2 of the Health and Safety Code.(g) The State Department of Public Health shall transfer, on a monthly basis, all penalty payments collected pursuant to subdivision (f) into the Skilled Nursing Facility Quality and Accountability Special Fund.(h) This section does not impact the effectiveness or utilization of Section 1278.5 or 1432 of the Health and Safety Code relating to whistleblower protections, or Section 1420 of the Health and Safety Code relating to complaints.(i) (1) Beginning in the 201011 fiscal year, the department, in consultation with representatives from the long-term care industry, organized labor, and consumers, shall establish and publish quality and accountability measures, benchmarks, and data submission deadlines by November 30, 2010.(2) The methodology developed pursuant to this section shall include, but not be limited to, the following requirements and performance measures:(A) Beginning in the 201112 fiscal year:(i) Immunization rates.(ii) Facility acquired pressure ulcer incidence.(iii) The use of physical restraints.(iv) Compliance with the nursing hours or direct care service hours per patient per day requirements pursuant to Section 1276.5 or 1276.65, as applicable, of the Health and Safety Code.(v) Resident and family satisfaction.(vi) Direct care staff retention, if sufficient data is available.(B) If this act is extended beyond the dates on which it becomes inoperative and is repealed, in accordance with Section 14126.033, the department, in consultation with representatives from the long-term care industry, organized labor, and consumers, beginning in the 201314 rate year, shall incorporate additional measures into the system, including, but not limited to, quality and accountability measures required by federal health care reform that are identified by the federal Centers for Medicare and Medicaid Services.(C) The department, in consultation with representatives from the long-term care industry, organized labor, and consumers, may incorporate additional performance measures, including, but not limited to, the following:(i) Compliance with state policy associated with the United States Supreme Court decision in Olmstead v. L.C. ex rel. Zimring (1999) 527 U.S. 581.(ii) Direct care staff retention, if not addressed in the 201213 rate year.(iii) The use of chemical restraints.(D) Beginning with the 201516 fiscal year, the department, in consultation with representatives from the long-term care industry, organized labor, and consumers, shall incorporate direct care staff retention as a performance measure in the methodology developed pursuant to this section.(j) (1) Beginning with the 201011 rate year, and pursuant to subparagraph (B) of paragraph (5) of subdivision (a) of Section 14126.023, the department shall set aside savings achieved from setting the professional liability insurance cost category, including any insurance deductible costs paid by the facility, at the 75th percentile. From this amount, the department shall transfer the General Fund portion into the Skilled Nursing Facility Quality and Accountability Special Fund. A skilled nursing facility shall provide supplemental data on insurance deductible costs to facilitate this adjustment, in the format and by the deadlines determined by the department. If this data is not provided, a facilitys insurance deductible costs will remain in the administrative costs category.(2) Notwithstanding paragraph (1), for the 201213 rate year only, savings from capping the professional liability insurance cost category pursuant to paragraph (1) shall remain in the General Fund and shall not be transferred to the Skilled Nursing Facility Quality and Accountability Special Fund.(k) For the 201314 rate year, if there is a rate increase in the weighted average Medi-Cal reimbursement rate, the department shall set aside the first 1 percent of the weighted average Medi-Cal reimbursement rate increase for the Skilled Nursing Facility Quality and Accountability Special Fund.(l) If this act is extended beyond the dates on which it becomes inoperative and is repealed, for the 201415 rate year, in addition to the amount set aside pursuant to subdivision (k), if there is a rate increase in the weighted average Medi-Cal reimbursement rate, the department shall set aside at least one-third of the weighted average Medi-Cal reimbursement rate increase, up to a maximum of 1 percent, from which the department shall transfer the General Fund portion of this amount into the Skilled Nursing Facility Quality and Accountability Special Fund.(m) Beginning with the 201516 rate year, and each subsequent rate year thereafter for which this article is operative, an amount equal to the amount deposited in the fund pursuant to subdivisions (k) and (l) for the 201415 rate year shall be deposited into the Skilled Nursing Facility Quality and Accountability Special Fund, for the purposes specified in this section.(n) (1) (A) Beginning with the 201314 rate year, the department shall pay a supplemental payment, by April 30, 2014, to skilled nursing facilities based on all of the criteria in subdivision (i), as published by the department, and according to performance measure benchmarks determined by the department in consultation with stakeholders.(B) (i) The department may convene a diverse stakeholder group, including, but not limited to, representatives from consumer groups and organizations, labor, nursing home providers, advocacy organizations involved with the aging community, staff from the Legislature, and other interested parties, to discuss and analyze alternative mechanisms to implement the quality and accountability payments provided to nursing homes for reimbursement.(ii) The department shall articulate in a report to the fiscal and appropriate policy committees of the Legislature the implementation of an alternative mechanism as described in clause (i) at least 90 days prior to any policy or budgetary changes, and seek subsequent legislation in order to enact the proposed changes.(2) Skilled nursing facilities that do not submit required performance data by the departments specified data submission deadlines pursuant to subdivision (i) are not eligible to receive supplemental payments.(3) Notwithstanding paragraph (1), if a facility appeals the performance measure of compliance with the nursing hours or direct care service hours per patient per day requirements, pursuant to Section 1276.5 or 1276.65, as applicable, of the Health and Safety Code, to the State Department of Public Health, and it is unresolved by the departments published due date, the department shall not use that performance measure when determining the facilitys supplemental payment.(4) Notwithstanding paragraph (1), if the department is unable to pay the supplemental payments by April 30, 2014, then on May 1, 2014, the department shall use the funds available in the Skilled Nursing Facility Quality and Accountability Special Fund as a result of savings identified in subdivisions (k) and (l), less the administrative costs required to implement subparagraphs (A) and (B) of paragraph (3) of subdivision (b), in addition to any Medicaid funds that are available as of December 31, 2013, to increase provider rates retroactively to August 1, 2013.(o) The department shall seek necessary approvals from the federal Centers for Medicare and Medicaid Services to implement this section. The department shall implement this section only in a manner that is consistent with federal Medicaid law and regulations, and only to the extent that approval is obtained from the federal Centers for Medicare and Medicaid Services and federal financial participation is available.(p) In implementing this section, the department and the State Department of Public Health may contract as necessary, with Californias Medicare Quality Improvement Organization, or other entities deemed qualified by the department or the State Department of Public Health, not associated with a skilled nursing facility, to assist with development, collection, analysis, and reporting of the performance data pursuant to subdivision (i), and with demonstrated expertise in long-term care quality, data collection or analysis, and accountability performance measurement models pursuant to subdivision (i). This subdivision establishes an accelerated process for issuing any contract pursuant to this section. Any contract entered into pursuant to this subdivision is exempt from the requirements of the Public Contract Code, through December 31, 2020.(q) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the following apply:(1) The director shall implement this section, in whole or in part, by means of provider bulletins, or other similar instructions without taking regulatory action.(2) The State Public Health Officer may implement this section by means of all-facility letters, or other similar instructions without taking regulatory action.(r) Notwithstanding paragraph (1) of subdivision (n), if a final judicial determination is made by any state or federal court that is not appealed, in any action by any party, or a final determination is made by the administrator of the federal Centers for Medicare and Medicaid Services, that any payments pursuant to subdivisions (a) and (n), are invalid, unlawful, or contrary to any provision of federal law or regulations, or of state law, these subdivisions shall become inoperative, and for the 201112 rate year, the rate increase provided under subparagraph (A) of paragraph (4) of subdivision (c) of Section 14126.033 shall be reduced by the amounts described in subdivision (j). For the 201314 and 201415 rate years, any rate increase shall be reduced by the amounts described in subdivisions (j) to (l), inclusive.(s) Notwithstanding any other provision of this section, but only to the extent the department determines federal financial participation is available and not otherwise jeopardized, for performance periods in the 201718 and 201819 fiscal years, a skilled nursing facility shall remain eligible to participate in the supplemental payment program pursuant to this section so long as the facility meets the applicable nursing hours per patient per day requirements pursuant to Section 1276.5 of the Health and Safety Code that would have applied in the absence of the act that added this subdivision. Code.(t) Notwithstanding any provision of this section, but only to the extent the department determines federal financial participation is available and not otherwise jeopardized, compliance with the provisions of subdivision (c) of Section 1276.65 of the Health and Safety Code Code, as amended by Chapter 52 of the act that added this subdivision Statutes of 2017, shall not be used to determine facility qualification for the supplemental payments provided for in this section until the performance period beginning in the 201920 fiscal year. This limitation shall also apply to the issuance of citations pursuant to subdivisions (c) and (d) of Section 1424 of the Health and Safety Code based upon the failure to comply with the provisions of subdivision (c) of Section 1276.65 of the Health and Safety Code as amended by Chapter 52 of the act that added this subdivision. Statutes of 2017. Until the performance period beginning in the 201920 fiscal year, the department shall apply the provisions of Section 1276.5 of the Health and Safety Code for purposes of administering the supplemental payments pursuant to this section. For performance periods beginning in the 201920 fiscal year and each fiscal year thereafter, a skilled nursing facility that is granted a waiver pursuant to subdivision (l) of Section 1276.65 of the Health and Safety Code shall remain eligible to participate in the supplemental payment program pursuant to this section so long as the facility meets the applicable nursing hours per patient per day requirement pursuant to Section 1276.5 of the Health and Safety Code that would have applied in the absence of Chapter 52 of the Statutes of 2017 for the duration of the time for which the waiver is granted.
14126.022. (a) (1) By August 1, 2011, the department shall develop the Skilled Nursing Facility Quality and Accountability Supplemental Payment System, subject to approval by the federal Centers for Medicare and Medicaid Services, and the availability of federal, state, or other funds.(2) (A) The system shall be utilized to provide supplemental payments to skilled nursing facilities that improve the quality and accountability of care rendered to residents in skilled nursing facilities, as defined in subdivision (c) of Section 1250 of the Health and Safety Code, and to penalize those facilities that do not meet measurable standards.(B) A freestanding pediatric subacute care facility, as defined in Section 51215.8 of Title 22 of the California Code of Regulations, shall be exempt from the Skilled Nursing Facility Quality and Accountability Supplemental Payment System.(3) The system shall be phased in, beginning with the 201011 rate year.(4) The department may utilize the system to do all of the following:(A) Assess overall facility quality of care and quality of care improvement, and assign quality and accountability payments to skilled nursing facilities pursuant to performance measures described in subdivision (i).(B) Assign quality and accountability payments or penalties relating to quality of care, or direct care staffing levels, wages, and benefits, or both.(C) Limit the reimbursement of legal fees incurred by skilled nursing facilities engaged in the defense of governmental legal actions filed against the facilities.(D) Publish each facilitys quality assessment and quality and accountability payments in a manner and form determined by the director, or his or her designee.(E) Beginning with the 201112 fiscal year, establish a base year to collect performance measures described in subdivision (i).(F) Beginning with the 201112 fiscal year, in coordination with the State Department of Public Health, publish the direct care staffing level data and the performance measures required pursuant to subdivision (i).(5) The department, in coordination with the State Department of Public Health, shall report to the relevant Assembly and Senate budget subcommittees by May 1, 2016, information regarding the quality and accountability supplemental payments, including, but not limited to, its assessment of whether the payments are adequate to incentivize quality care and to sustain the program.(b) (1) There is hereby created in the State Treasury, the Skilled Nursing Facility Quality and Accountability Special Fund. The fund shall contain moneys deposited pursuant to subdivisions (g) and (j) to (m), inclusive. Notwithstanding Section 16305.7 of the Government Code, the fund shall contain all interest and dividends earned on moneys in the fund.(2) Notwithstanding Section 13340 of the Government Code, the fund shall be continuously appropriated without regard to fiscal year to the department for making quality and accountability payments, in accordance with subdivision (n), to facilities that meet or exceed predefined measures as established by this section.(3) Upon appropriation by the Legislature, moneys in the fund may also be used for any of the following purposes:(A) To cover the administrative costs incurred by the State Department of Public Health for positions and contract funding required to implement this section.(B) To cover the administrative costs incurred by the State Department of Health Care Services for positions and contract funding required to implement this section.(C) To provide funding assistance for the Long-Term Care Ombudsman Program activities pursuant to Chapter 11 (commencing with Section 9700) of Division 8.5.(c) No appropriation associated with Chapter 717 of the Statutes of 2010 is intended to implement the provisions of Section 1276.65 of the Health and Safety Code.(d) (1) There is hereby appropriated for the 201011 fiscal year, one million nine hundred thousand dollars ($1,900,000) from the Skilled Nursing Facility Quality and Accountability Special Fund to the California Department of Aging for the Long-Term Care Ombudsman Program activities pursuant to Chapter 11 (commencing with Section 9700) of Division 8.5. It is the intent of the Legislature for the one million nine hundred thousand dollars ($1,900,000) from the fund to be in addition to the four million one hundred sixty-eight thousand dollars ($4,168,000) proposed in the Governors May Revision for the 201011 Budget. It is further the intent of the Legislature to increase this level of appropriation in subsequent years to provide support sufficient to carry out the mandates and activities pursuant to Chapter 11 (commencing with Section 9700) of Division 8.5.(2) The department, in partnership with the California Department of Aging, shall seek approval from the federal Centers for Medicare and Medicaid Services to obtain federal Medicaid reimbursement for activities conducted by the Long-Term Care Ombudsman Program. The department shall report to the fiscal committees of the Legislature during budget hearings on progress being made and any unresolved issues during the 201112 budget deliberations.(e) There is hereby created in the Special Deposit Fund established pursuant to Section 16370 of the Government Code, the Skilled Nursing Facility Minimum Staffing Penalty Account. The account shall contain all moneys deposited pursuant to subdivision (f).(f) (1) Beginning with the 201011 fiscal year, the State Department of Public Health shall use the direct care staffing level data it collects to determine whether a skilled nursing facility has met the nursing hours or direct care service hours per patient per day requirements pursuant to Section 1276.5 or 1276.65, as applicable, of the Health and Safety Code.(2) (A) Beginning with the 201011 fiscal year, the State Department of Public Health shall assess a skilled nursing facility, licensed pursuant to subdivision (c) of Section 1250 of the Health and Safety Code, an administrative penalty if the State Department of Public Health determines that the skilled nursing facility fails to meet the nursing hours or direct care service hours per patient per day requirements pursuant to Section 1276.5 or 1276.65, as applicable, of the Health and Safety Code, as follows:(i) Fifteen thousand dollars ($15,000) if the facility fails to meet the requirements for 5 percent or more of the audited days up to 49 percent.(ii) Thirty thousand dollars ($30,000) if the facility fails to meet the requirements for over 49 percent or more of the audited days.(B) (i) If the skilled nursing facility does not dispute the determination or assessment, the penalties shall be paid in full by the licensee to the State Department of Public Health within 30 days of the facilitys receipt of the notice of penalty and deposited into the Skilled Nursing Facility Minimum Staffing Penalty Account.(ii) The State Department of Public Health may, upon written notification to the licensee, request that the department offset any moneys owed to the licensee by the Medi-Cal program or any other payment program administered by the department to recoup the penalty provided for in this section.(C) (i) If a facility disputes the determination or assessment made pursuant to this paragraph, the facility shall, within 15 days of the facilitys receipt of the determination and assessment, simultaneously submit a request for appeal to both the department and the State Department of Public Health. The request shall include a detailed statement describing the reason for appeal and include all supporting documents the facility will present at the hearing.(ii) Within 10 days of the State Department of Public Healths receipt of the facilitys request for appeal, the State Department of Public Health shall submit, to both the facility and the department, all supporting documents that will be presented at the hearing.(D) The department shall hear a timely appeal and issue a decision as follows:(i) The hearing shall commence within 60 days from the date of receipt by the department of the facilitys timely request for appeal.(ii) The department shall issue a decision within 120 days from the date of receipt by the department of the facilitys timely request for appeal.(iii) The decision of the departments hearing officer, when issued, shall be the final decision of the State Department of Public Health.(E) The appeals process set forth in this paragraph shall be exempt from Chapter 4.5 (commencing with Section 11400) and Chapter 5 (commencing with Section 11500), of Part 1 of Division 3 of Title 2 of the Government Code. The provisions of Sections 100171 and 131071 of the Health and Safety Code do not apply to appeals under this paragraph.(F) If a hearing decision issued pursuant to subparagraph (D) is in favor of the State Department of Public Health, the skilled nursing facility shall pay the penalties to the State Department of Public Health within 30 days of the facilitys receipt of the decision. The penalties collected shall be deposited into the Skilled Nursing Facility Minimum Staffing Penalty Account.(G) The assessment of a penalty under this subdivision does not supplant the State Department of Public Healths investigation process or issuance of deficiencies or citations under Chapter 2.4 (commencing with Section 1417) of Division 2 of the Health and Safety Code.(g) The State Department of Public Health shall transfer, on a monthly basis, all penalty payments collected pursuant to subdivision (f) into the Skilled Nursing Facility Quality and Accountability Special Fund.(h) This section does not impact the effectiveness or utilization of Section 1278.5 or 1432 of the Health and Safety Code relating to whistleblower protections, or Section 1420 of the Health and Safety Code relating to complaints.(i) (1) Beginning in the 201011 fiscal year, the department, in consultation with representatives from the long-term care industry, organized labor, and consumers, shall establish and publish quality and accountability measures, benchmarks, and data submission deadlines by November 30, 2010.(2) The methodology developed pursuant to this section shall include, but not be limited to, the following requirements and performance measures:(A) Beginning in the 201112 fiscal year:(i) Immunization rates.(ii) Facility acquired pressure ulcer incidence.(iii) The use of physical restraints.(iv) Compliance with the nursing hours or direct care service hours per patient per day requirements pursuant to Section 1276.5 or 1276.65, as applicable, of the Health and Safety Code.(v) Resident and family satisfaction.(vi) Direct care staff retention, if sufficient data is available.(B) If this act is extended beyond the dates on which it becomes inoperative and is repealed, in accordance with Section 14126.033, the department, in consultation with representatives from the long-term care industry, organized labor, and consumers, beginning in the 201314 rate year, shall incorporate additional measures into the system, including, but not limited to, quality and accountability measures required by federal health care reform that are identified by the federal Centers for Medicare and Medicaid Services.(C) The department, in consultation with representatives from the long-term care industry, organized labor, and consumers, may incorporate additional performance measures, including, but not limited to, the following:(i) Compliance with state policy associated with the United States Supreme Court decision in Olmstead v. L.C. ex rel. Zimring (1999) 527 U.S. 581.(ii) Direct care staff retention, if not addressed in the 201213 rate year.(iii) The use of chemical restraints.(D) Beginning with the 201516 fiscal year, the department, in consultation with representatives from the long-term care industry, organized labor, and consumers, shall incorporate direct care staff retention as a performance measure in the methodology developed pursuant to this section.(j) (1) Beginning with the 201011 rate year, and pursuant to subparagraph (B) of paragraph (5) of subdivision (a) of Section 14126.023, the department shall set aside savings achieved from setting the professional liability insurance cost category, including any insurance deductible costs paid by the facility, at the 75th percentile. From this amount, the department shall transfer the General Fund portion into the Skilled Nursing Facility Quality and Accountability Special Fund. A skilled nursing facility shall provide supplemental data on insurance deductible costs to facilitate this adjustment, in the format and by the deadlines determined by the department. If this data is not provided, a facilitys insurance deductible costs will remain in the administrative costs category.(2) Notwithstanding paragraph (1), for the 201213 rate year only, savings from capping the professional liability insurance cost category pursuant to paragraph (1) shall remain in the General Fund and shall not be transferred to the Skilled Nursing Facility Quality and Accountability Special Fund.(k) For the 201314 rate year, if there is a rate increase in the weighted average Medi-Cal reimbursement rate, the department shall set aside the first 1 percent of the weighted average Medi-Cal reimbursement rate increase for the Skilled Nursing Facility Quality and Accountability Special Fund.(l) If this act is extended beyond the dates on which it becomes inoperative and is repealed, for the 201415 rate year, in addition to the amount set aside pursuant to subdivision (k), if there is a rate increase in the weighted average Medi-Cal reimbursement rate, the department shall set aside at least one-third of the weighted average Medi-Cal reimbursement rate increase, up to a maximum of 1 percent, from which the department shall transfer the General Fund portion of this amount into the Skilled Nursing Facility Quality and Accountability Special Fund.(m) Beginning with the 201516 rate year, and each subsequent rate year thereafter for which this article is operative, an amount equal to the amount deposited in the fund pursuant to subdivisions (k) and (l) for the 201415 rate year shall be deposited into the Skilled Nursing Facility Quality and Accountability Special Fund, for the purposes specified in this section.(n) (1) (A) Beginning with the 201314 rate year, the department shall pay a supplemental payment, by April 30, 2014, to skilled nursing facilities based on all of the criteria in subdivision (i), as published by the department, and according to performance measure benchmarks determined by the department in consultation with stakeholders.(B) (i) The department may convene a diverse stakeholder group, including, but not limited to, representatives from consumer groups and organizations, labor, nursing home providers, advocacy organizations involved with the aging community, staff from the Legislature, and other interested parties, to discuss and analyze alternative mechanisms to implement the quality and accountability payments provided to nursing homes for reimbursement.(ii) The department shall articulate in a report to the fiscal and appropriate policy committees of the Legislature the implementation of an alternative mechanism as described in clause (i) at least 90 days prior to any policy or budgetary changes, and seek subsequent legislation in order to enact the proposed changes.(2) Skilled nursing facilities that do not submit required performance data by the departments specified data submission deadlines pursuant to subdivision (i) are not eligible to receive supplemental payments.(3) Notwithstanding paragraph (1), if a facility appeals the performance measure of compliance with the nursing hours or direct care service hours per patient per day requirements, pursuant to Section 1276.5 or 1276.65, as applicable, of the Health and Safety Code, to the State Department of Public Health, and it is unresolved by the departments published due date, the department shall not use that performance measure when determining the facilitys supplemental payment.(4) Notwithstanding paragraph (1), if the department is unable to pay the supplemental payments by April 30, 2014, then on May 1, 2014, the department shall use the funds available in the Skilled Nursing Facility Quality and Accountability Special Fund as a result of savings identified in subdivisions (k) and (l), less the administrative costs required to implement subparagraphs (A) and (B) of paragraph (3) of subdivision (b), in addition to any Medicaid funds that are available as of December 31, 2013, to increase provider rates retroactively to August 1, 2013.(o) The department shall seek necessary approvals from the federal Centers for Medicare and Medicaid Services to implement this section. The department shall implement this section only in a manner that is consistent with federal Medicaid law and regulations, and only to the extent that approval is obtained from the federal Centers for Medicare and Medicaid Services and federal financial participation is available.(p) In implementing this section, the department and the State Department of Public Health may contract as necessary, with Californias Medicare Quality Improvement Organization, or other entities deemed qualified by the department or the State Department of Public Health, not associated with a skilled nursing facility, to assist with development, collection, analysis, and reporting of the performance data pursuant to subdivision (i), and with demonstrated expertise in long-term care quality, data collection or analysis, and accountability performance measurement models pursuant to subdivision (i). This subdivision establishes an accelerated process for issuing any contract pursuant to this section. Any contract entered into pursuant to this subdivision is exempt from the requirements of the Public Contract Code, through December 31, 2020.(q) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the following apply:(1) The director shall implement this section, in whole or in part, by means of provider bulletins, or other similar instructions without taking regulatory action.(2) The State Public Health Officer may implement this section by means of all-facility letters, or other similar instructions without taking regulatory action.(r) Notwithstanding paragraph (1) of subdivision (n), if a final judicial determination is made by any state or federal court that is not appealed, in any action by any party, or a final determination is made by the administrator of the federal Centers for Medicare and Medicaid Services, that any payments pursuant to subdivisions (a) and (n), are invalid, unlawful, or contrary to any provision of federal law or regulations, or of state law, these subdivisions shall become inoperative, and for the 201112 rate year, the rate increase provided under subparagraph (A) of paragraph (4) of subdivision (c) of Section 14126.033 shall be reduced by the amounts described in subdivision (j). For the 201314 and 201415 rate years, any rate increase shall be reduced by the amounts described in subdivisions (j) to (l), inclusive.(s) Notwithstanding any other provision of this section, but only to the extent the department determines federal financial participation is available and not otherwise jeopardized, for performance periods in the 201718 and 201819 fiscal years, a skilled nursing facility shall remain eligible to participate in the supplemental payment program pursuant to this section so long as the facility meets the applicable nursing hours per patient per day requirements pursuant to Section 1276.5 of the Health and Safety Code that would have applied in the absence of the act that added this subdivision. Code.(t) Notwithstanding any provision of this section, but only to the extent the department determines federal financial participation is available and not otherwise jeopardized, compliance with the provisions of subdivision (c) of Section 1276.65 of the Health and Safety Code Code, as amended by Chapter 52 of the act that added this subdivision Statutes of 2017, shall not be used to determine facility qualification for the supplemental payments provided for in this section until the performance period beginning in the 201920 fiscal year. This limitation shall also apply to the issuance of citations pursuant to subdivisions (c) and (d) of Section 1424 of the Health and Safety Code based upon the failure to comply with the provisions of subdivision (c) of Section 1276.65 of the Health and Safety Code as amended by Chapter 52 of the act that added this subdivision. Statutes of 2017. Until the performance period beginning in the 201920 fiscal year, the department shall apply the provisions of Section 1276.5 of the Health and Safety Code for purposes of administering the supplemental payments pursuant to this section. For performance periods beginning in the 201920 fiscal year and each fiscal year thereafter, a skilled nursing facility that is granted a waiver pursuant to subdivision (l) of Section 1276.65 of the Health and Safety Code shall remain eligible to participate in the supplemental payment program pursuant to this section so long as the facility meets the applicable nursing hours per patient per day requirement pursuant to Section 1276.5 of the Health and Safety Code that would have applied in the absence of Chapter 52 of the Statutes of 2017 for the duration of the time for which the waiver is granted.
14126.022. (a) (1) By August 1, 2011, the department shall develop the Skilled Nursing Facility Quality and Accountability Supplemental Payment System, subject to approval by the federal Centers for Medicare and Medicaid Services, and the availability of federal, state, or other funds.(2) (A) The system shall be utilized to provide supplemental payments to skilled nursing facilities that improve the quality and accountability of care rendered to residents in skilled nursing facilities, as defined in subdivision (c) of Section 1250 of the Health and Safety Code, and to penalize those facilities that do not meet measurable standards.(B) A freestanding pediatric subacute care facility, as defined in Section 51215.8 of Title 22 of the California Code of Regulations, shall be exempt from the Skilled Nursing Facility Quality and Accountability Supplemental Payment System.(3) The system shall be phased in, beginning with the 201011 rate year.(4) The department may utilize the system to do all of the following:(A) Assess overall facility quality of care and quality of care improvement, and assign quality and accountability payments to skilled nursing facilities pursuant to performance measures described in subdivision (i).(B) Assign quality and accountability payments or penalties relating to quality of care, or direct care staffing levels, wages, and benefits, or both.(C) Limit the reimbursement of legal fees incurred by skilled nursing facilities engaged in the defense of governmental legal actions filed against the facilities.(D) Publish each facilitys quality assessment and quality and accountability payments in a manner and form determined by the director, or his or her designee.(E) Beginning with the 201112 fiscal year, establish a base year to collect performance measures described in subdivision (i).(F) Beginning with the 201112 fiscal year, in coordination with the State Department of Public Health, publish the direct care staffing level data and the performance measures required pursuant to subdivision (i).(5) The department, in coordination with the State Department of Public Health, shall report to the relevant Assembly and Senate budget subcommittees by May 1, 2016, information regarding the quality and accountability supplemental payments, including, but not limited to, its assessment of whether the payments are adequate to incentivize quality care and to sustain the program.(b) (1) There is hereby created in the State Treasury, the Skilled Nursing Facility Quality and Accountability Special Fund. The fund shall contain moneys deposited pursuant to subdivisions (g) and (j) to (m), inclusive. Notwithstanding Section 16305.7 of the Government Code, the fund shall contain all interest and dividends earned on moneys in the fund.(2) Notwithstanding Section 13340 of the Government Code, the fund shall be continuously appropriated without regard to fiscal year to the department for making quality and accountability payments, in accordance with subdivision (n), to facilities that meet or exceed predefined measures as established by this section.(3) Upon appropriation by the Legislature, moneys in the fund may also be used for any of the following purposes:(A) To cover the administrative costs incurred by the State Department of Public Health for positions and contract funding required to implement this section.(B) To cover the administrative costs incurred by the State Department of Health Care Services for positions and contract funding required to implement this section.(C) To provide funding assistance for the Long-Term Care Ombudsman Program activities pursuant to Chapter 11 (commencing with Section 9700) of Division 8.5.(c) No appropriation associated with Chapter 717 of the Statutes of 2010 is intended to implement the provisions of Section 1276.65 of the Health and Safety Code.(d) (1) There is hereby appropriated for the 201011 fiscal year, one million nine hundred thousand dollars ($1,900,000) from the Skilled Nursing Facility Quality and Accountability Special Fund to the California Department of Aging for the Long-Term Care Ombudsman Program activities pursuant to Chapter 11 (commencing with Section 9700) of Division 8.5. It is the intent of the Legislature for the one million nine hundred thousand dollars ($1,900,000) from the fund to be in addition to the four million one hundred sixty-eight thousand dollars ($4,168,000) proposed in the Governors May Revision for the 201011 Budget. It is further the intent of the Legislature to increase this level of appropriation in subsequent years to provide support sufficient to carry out the mandates and activities pursuant to Chapter 11 (commencing with Section 9700) of Division 8.5.(2) The department, in partnership with the California Department of Aging, shall seek approval from the federal Centers for Medicare and Medicaid Services to obtain federal Medicaid reimbursement for activities conducted by the Long-Term Care Ombudsman Program. The department shall report to the fiscal committees of the Legislature during budget hearings on progress being made and any unresolved issues during the 201112 budget deliberations.(e) There is hereby created in the Special Deposit Fund established pursuant to Section 16370 of the Government Code, the Skilled Nursing Facility Minimum Staffing Penalty Account. The account shall contain all moneys deposited pursuant to subdivision (f).(f) (1) Beginning with the 201011 fiscal year, the State Department of Public Health shall use the direct care staffing level data it collects to determine whether a skilled nursing facility has met the nursing hours or direct care service hours per patient per day requirements pursuant to Section 1276.5 or 1276.65, as applicable, of the Health and Safety Code.(2) (A) Beginning with the 201011 fiscal year, the State Department of Public Health shall assess a skilled nursing facility, licensed pursuant to subdivision (c) of Section 1250 of the Health and Safety Code, an administrative penalty if the State Department of Public Health determines that the skilled nursing facility fails to meet the nursing hours or direct care service hours per patient per day requirements pursuant to Section 1276.5 or 1276.65, as applicable, of the Health and Safety Code, as follows:(i) Fifteen thousand dollars ($15,000) if the facility fails to meet the requirements for 5 percent or more of the audited days up to 49 percent.(ii) Thirty thousand dollars ($30,000) if the facility fails to meet the requirements for over 49 percent or more of the audited days.(B) (i) If the skilled nursing facility does not dispute the determination or assessment, the penalties shall be paid in full by the licensee to the State Department of Public Health within 30 days of the facilitys receipt of the notice of penalty and deposited into the Skilled Nursing Facility Minimum Staffing Penalty Account.(ii) The State Department of Public Health may, upon written notification to the licensee, request that the department offset any moneys owed to the licensee by the Medi-Cal program or any other payment program administered by the department to recoup the penalty provided for in this section.(C) (i) If a facility disputes the determination or assessment made pursuant to this paragraph, the facility shall, within 15 days of the facilitys receipt of the determination and assessment, simultaneously submit a request for appeal to both the department and the State Department of Public Health. The request shall include a detailed statement describing the reason for appeal and include all supporting documents the facility will present at the hearing.(ii) Within 10 days of the State Department of Public Healths receipt of the facilitys request for appeal, the State Department of Public Health shall submit, to both the facility and the department, all supporting documents that will be presented at the hearing.(D) The department shall hear a timely appeal and issue a decision as follows:(i) The hearing shall commence within 60 days from the date of receipt by the department of the facilitys timely request for appeal.(ii) The department shall issue a decision within 120 days from the date of receipt by the department of the facilitys timely request for appeal.(iii) The decision of the departments hearing officer, when issued, shall be the final decision of the State Department of Public Health.(E) The appeals process set forth in this paragraph shall be exempt from Chapter 4.5 (commencing with Section 11400) and Chapter 5 (commencing with Section 11500), of Part 1 of Division 3 of Title 2 of the Government Code. The provisions of Sections 100171 and 131071 of the Health and Safety Code do not apply to appeals under this paragraph.(F) If a hearing decision issued pursuant to subparagraph (D) is in favor of the State Department of Public Health, the skilled nursing facility shall pay the penalties to the State Department of Public Health within 30 days of the facilitys receipt of the decision. The penalties collected shall be deposited into the Skilled Nursing Facility Minimum Staffing Penalty Account.(G) The assessment of a penalty under this subdivision does not supplant the State Department of Public Healths investigation process or issuance of deficiencies or citations under Chapter 2.4 (commencing with Section 1417) of Division 2 of the Health and Safety Code.(g) The State Department of Public Health shall transfer, on a monthly basis, all penalty payments collected pursuant to subdivision (f) into the Skilled Nursing Facility Quality and Accountability Special Fund.(h) This section does not impact the effectiveness or utilization of Section 1278.5 or 1432 of the Health and Safety Code relating to whistleblower protections, or Section 1420 of the Health and Safety Code relating to complaints.(i) (1) Beginning in the 201011 fiscal year, the department, in consultation with representatives from the long-term care industry, organized labor, and consumers, shall establish and publish quality and accountability measures, benchmarks, and data submission deadlines by November 30, 2010.(2) The methodology developed pursuant to this section shall include, but not be limited to, the following requirements and performance measures:(A) Beginning in the 201112 fiscal year:(i) Immunization rates.(ii) Facility acquired pressure ulcer incidence.(iii) The use of physical restraints.(iv) Compliance with the nursing hours or direct care service hours per patient per day requirements pursuant to Section 1276.5 or 1276.65, as applicable, of the Health and Safety Code.(v) Resident and family satisfaction.(vi) Direct care staff retention, if sufficient data is available.(B) If this act is extended beyond the dates on which it becomes inoperative and is repealed, in accordance with Section 14126.033, the department, in consultation with representatives from the long-term care industry, organized labor, and consumers, beginning in the 201314 rate year, shall incorporate additional measures into the system, including, but not limited to, quality and accountability measures required by federal health care reform that are identified by the federal Centers for Medicare and Medicaid Services.(C) The department, in consultation with representatives from the long-term care industry, organized labor, and consumers, may incorporate additional performance measures, including, but not limited to, the following:(i) Compliance with state policy associated with the United States Supreme Court decision in Olmstead v. L.C. ex rel. Zimring (1999) 527 U.S. 581.(ii) Direct care staff retention, if not addressed in the 201213 rate year.(iii) The use of chemical restraints.(D) Beginning with the 201516 fiscal year, the department, in consultation with representatives from the long-term care industry, organized labor, and consumers, shall incorporate direct care staff retention as a performance measure in the methodology developed pursuant to this section.(j) (1) Beginning with the 201011 rate year, and pursuant to subparagraph (B) of paragraph (5) of subdivision (a) of Section 14126.023, the department shall set aside savings achieved from setting the professional liability insurance cost category, including any insurance deductible costs paid by the facility, at the 75th percentile. From this amount, the department shall transfer the General Fund portion into the Skilled Nursing Facility Quality and Accountability Special Fund. A skilled nursing facility shall provide supplemental data on insurance deductible costs to facilitate this adjustment, in the format and by the deadlines determined by the department. If this data is not provided, a facilitys insurance deductible costs will remain in the administrative costs category.(2) Notwithstanding paragraph (1), for the 201213 rate year only, savings from capping the professional liability insurance cost category pursuant to paragraph (1) shall remain in the General Fund and shall not be transferred to the Skilled Nursing Facility Quality and Accountability Special Fund.(k) For the 201314 rate year, if there is a rate increase in the weighted average Medi-Cal reimbursement rate, the department shall set aside the first 1 percent of the weighted average Medi-Cal reimbursement rate increase for the Skilled Nursing Facility Quality and Accountability Special Fund.(l) If this act is extended beyond the dates on which it becomes inoperative and is repealed, for the 201415 rate year, in addition to the amount set aside pursuant to subdivision (k), if there is a rate increase in the weighted average Medi-Cal reimbursement rate, the department shall set aside at least one-third of the weighted average Medi-Cal reimbursement rate increase, up to a maximum of 1 percent, from which the department shall transfer the General Fund portion of this amount into the Skilled Nursing Facility Quality and Accountability Special Fund.(m) Beginning with the 201516 rate year, and each subsequent rate year thereafter for which this article is operative, an amount equal to the amount deposited in the fund pursuant to subdivisions (k) and (l) for the 201415 rate year shall be deposited into the Skilled Nursing Facility Quality and Accountability Special Fund, for the purposes specified in this section.(n) (1) (A) Beginning with the 201314 rate year, the department shall pay a supplemental payment, by April 30, 2014, to skilled nursing facilities based on all of the criteria in subdivision (i), as published by the department, and according to performance measure benchmarks determined by the department in consultation with stakeholders.(B) (i) The department may convene a diverse stakeholder group, including, but not limited to, representatives from consumer groups and organizations, labor, nursing home providers, advocacy organizations involved with the aging community, staff from the Legislature, and other interested parties, to discuss and analyze alternative mechanisms to implement the quality and accountability payments provided to nursing homes for reimbursement.(ii) The department shall articulate in a report to the fiscal and appropriate policy committees of the Legislature the implementation of an alternative mechanism as described in clause (i) at least 90 days prior to any policy or budgetary changes, and seek subsequent legislation in order to enact the proposed changes.(2) Skilled nursing facilities that do not submit required performance data by the departments specified data submission deadlines pursuant to subdivision (i) are not eligible to receive supplemental payments.(3) Notwithstanding paragraph (1), if a facility appeals the performance measure of compliance with the nursing hours or direct care service hours per patient per day requirements, pursuant to Section 1276.5 or 1276.65, as applicable, of the Health and Safety Code, to the State Department of Public Health, and it is unresolved by the departments published due date, the department shall not use that performance measure when determining the facilitys supplemental payment.(4) Notwithstanding paragraph (1), if the department is unable to pay the supplemental payments by April 30, 2014, then on May 1, 2014, the department shall use the funds available in the Skilled Nursing Facility Quality and Accountability Special Fund as a result of savings identified in subdivisions (k) and (l), less the administrative costs required to implement subparagraphs (A) and (B) of paragraph (3) of subdivision (b), in addition to any Medicaid funds that are available as of December 31, 2013, to increase provider rates retroactively to August 1, 2013.(o) The department shall seek necessary approvals from the federal Centers for Medicare and Medicaid Services to implement this section. The department shall implement this section only in a manner that is consistent with federal Medicaid law and regulations, and only to the extent that approval is obtained from the federal Centers for Medicare and Medicaid Services and federal financial participation is available.(p) In implementing this section, the department and the State Department of Public Health may contract as necessary, with Californias Medicare Quality Improvement Organization, or other entities deemed qualified by the department or the State Department of Public Health, not associated with a skilled nursing facility, to assist with development, collection, analysis, and reporting of the performance data pursuant to subdivision (i), and with demonstrated expertise in long-term care quality, data collection or analysis, and accountability performance measurement models pursuant to subdivision (i). This subdivision establishes an accelerated process for issuing any contract pursuant to this section. Any contract entered into pursuant to this subdivision is exempt from the requirements of the Public Contract Code, through December 31, 2020.(q) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the following apply:(1) The director shall implement this section, in whole or in part, by means of provider bulletins, or other similar instructions without taking regulatory action.(2) The State Public Health Officer may implement this section by means of all-facility letters, or other similar instructions without taking regulatory action.(r) Notwithstanding paragraph (1) of subdivision (n), if a final judicial determination is made by any state or federal court that is not appealed, in any action by any party, or a final determination is made by the administrator of the federal Centers for Medicare and Medicaid Services, that any payments pursuant to subdivisions (a) and (n), are invalid, unlawful, or contrary to any provision of federal law or regulations, or of state law, these subdivisions shall become inoperative, and for the 201112 rate year, the rate increase provided under subparagraph (A) of paragraph (4) of subdivision (c) of Section 14126.033 shall be reduced by the amounts described in subdivision (j). For the 201314 and 201415 rate years, any rate increase shall be reduced by the amounts described in subdivisions (j) to (l), inclusive.(s) Notwithstanding any other provision of this section, but only to the extent the department determines federal financial participation is available and not otherwise jeopardized, for performance periods in the 201718 and 201819 fiscal years, a skilled nursing facility shall remain eligible to participate in the supplemental payment program pursuant to this section so long as the facility meets the applicable nursing hours per patient per day requirements pursuant to Section 1276.5 of the Health and Safety Code that would have applied in the absence of the act that added this subdivision. Code.(t) Notwithstanding any provision of this section, but only to the extent the department determines federal financial participation is available and not otherwise jeopardized, compliance with the provisions of subdivision (c) of Section 1276.65 of the Health and Safety Code Code, as amended by Chapter 52 of the act that added this subdivision Statutes of 2017, shall not be used to determine facility qualification for the supplemental payments provided for in this section until the performance period beginning in the 201920 fiscal year. This limitation shall also apply to the issuance of citations pursuant to subdivisions (c) and (d) of Section 1424 of the Health and Safety Code based upon the failure to comply with the provisions of subdivision (c) of Section 1276.65 of the Health and Safety Code as amended by Chapter 52 of the act that added this subdivision. Statutes of 2017. Until the performance period beginning in the 201920 fiscal year, the department shall apply the provisions of Section 1276.5 of the Health and Safety Code for purposes of administering the supplemental payments pursuant to this section. For performance periods beginning in the 201920 fiscal year and each fiscal year thereafter, a skilled nursing facility that is granted a waiver pursuant to subdivision (l) of Section 1276.65 of the Health and Safety Code shall remain eligible to participate in the supplemental payment program pursuant to this section so long as the facility meets the applicable nursing hours per patient per day requirement pursuant to Section 1276.5 of the Health and Safety Code that would have applied in the absence of Chapter 52 of the Statutes of 2017 for the duration of the time for which the waiver is granted.
14126.022. (a) (1) By August 1, 2011, the department shall develop the Skilled Nursing Facility Quality and Accountability Supplemental Payment System, subject to approval by the federal Centers for Medicare and Medicaid Services, and the availability of federal, state, or other funds.
(2) (A) The system shall be utilized to provide supplemental payments to skilled nursing facilities that improve the quality and accountability of care rendered to residents in skilled nursing facilities, as defined in subdivision (c) of Section 1250 of the Health and Safety Code, and to penalize those facilities that do not meet measurable standards.
(B) A freestanding pediatric subacute care facility, as defined in Section 51215.8 of Title 22 of the California Code of Regulations, shall be exempt from the Skilled Nursing Facility Quality and Accountability Supplemental Payment System.
(3) The system shall be phased in, beginning with the 201011 rate year.
(4) The department may utilize the system to do all of the following:
(A) Assess overall facility quality of care and quality of care improvement, and assign quality and accountability payments to skilled nursing facilities pursuant to performance measures described in subdivision (i).
(B) Assign quality and accountability payments or penalties relating to quality of care, or direct care staffing levels, wages, and benefits, or both.
(C) Limit the reimbursement of legal fees incurred by skilled nursing facilities engaged in the defense of governmental legal actions filed against the facilities.
(D) Publish each facilitys quality assessment and quality and accountability payments in a manner and form determined by the director, or his or her designee.
(E) Beginning with the 201112 fiscal year, establish a base year to collect performance measures described in subdivision (i).
(F) Beginning with the 201112 fiscal year, in coordination with the State Department of Public Health, publish the direct care staffing level data and the performance measures required pursuant to subdivision (i).
(5) The department, in coordination with the State Department of Public Health, shall report to the relevant Assembly and Senate budget subcommittees by May 1, 2016, information regarding the quality and accountability supplemental payments, including, but not limited to, its assessment of whether the payments are adequate to incentivize quality care and to sustain the program.
(b) (1) There is hereby created in the State Treasury, the Skilled Nursing Facility Quality and Accountability Special Fund. The fund shall contain moneys deposited pursuant to subdivisions (g) and (j) to (m), inclusive. Notwithstanding Section 16305.7 of the Government Code, the fund shall contain all interest and dividends earned on moneys in the fund.
(2) Notwithstanding Section 13340 of the Government Code, the fund shall be continuously appropriated without regard to fiscal year to the department for making quality and accountability payments, in accordance with subdivision (n), to facilities that meet or exceed predefined measures as established by this section.
(3) Upon appropriation by the Legislature, moneys in the fund may also be used for any of the following purposes:
(A) To cover the administrative costs incurred by the State Department of Public Health for positions and contract funding required to implement this section.
(B) To cover the administrative costs incurred by the State Department of Health Care Services for positions and contract funding required to implement this section.
(C) To provide funding assistance for the Long-Term Care Ombudsman Program activities pursuant to Chapter 11 (commencing with Section 9700) of Division 8.5.
(c) No appropriation associated with Chapter 717 of the Statutes of 2010 is intended to implement the provisions of Section 1276.65 of the Health and Safety Code.
(d) (1) There is hereby appropriated for the 201011 fiscal year, one million nine hundred thousand dollars ($1,900,000) from the Skilled Nursing Facility Quality and Accountability Special Fund to the California Department of Aging for the Long-Term Care Ombudsman Program activities pursuant to Chapter 11 (commencing with Section 9700) of Division 8.5. It is the intent of the Legislature for the one million nine hundred thousand dollars ($1,900,000) from the fund to be in addition to the four million one hundred sixty-eight thousand dollars ($4,168,000) proposed in the Governors May Revision for the 201011 Budget. It is further the intent of the Legislature to increase this level of appropriation in subsequent years to provide support sufficient to carry out the mandates and activities pursuant to Chapter 11 (commencing with Section 9700) of Division 8.5.
(2) The department, in partnership with the California Department of Aging, shall seek approval from the federal Centers for Medicare and Medicaid Services to obtain federal Medicaid reimbursement for activities conducted by the Long-Term Care Ombudsman Program. The department shall report to the fiscal committees of the Legislature during budget hearings on progress being made and any unresolved issues during the 201112 budget deliberations.
(e) There is hereby created in the Special Deposit Fund established pursuant to Section 16370 of the Government Code, the Skilled Nursing Facility Minimum Staffing Penalty Account. The account shall contain all moneys deposited pursuant to subdivision (f).
(f) (1) Beginning with the 201011 fiscal year, the State Department of Public Health shall use the direct care staffing level data it collects to determine whether a skilled nursing facility has met the nursing hours or direct care service hours per patient per day requirements pursuant to Section 1276.5 or 1276.65, as applicable, of the Health and Safety Code.
(2) (A) Beginning with the 201011 fiscal year, the State Department of Public Health shall assess a skilled nursing facility, licensed pursuant to subdivision (c) of Section 1250 of the Health and Safety Code, an administrative penalty if the State Department of Public Health determines that the skilled nursing facility fails to meet the nursing hours or direct care service hours per patient per day requirements pursuant to Section 1276.5 or 1276.65, as applicable, of the Health and Safety Code, as follows:
(i) Fifteen thousand dollars ($15,000) if the facility fails to meet the requirements for 5 percent or more of the audited days up to 49 percent.
(ii) Thirty thousand dollars ($30,000) if the facility fails to meet the requirements for over 49 percent or more of the audited days.
(B) (i) If the skilled nursing facility does not dispute the determination or assessment, the penalties shall be paid in full by the licensee to the State Department of Public Health within 30 days of the facilitys receipt of the notice of penalty and deposited into the Skilled Nursing Facility Minimum Staffing Penalty Account.
(ii) The State Department of Public Health may, upon written notification to the licensee, request that the department offset any moneys owed to the licensee by the Medi-Cal program or any other payment program administered by the department to recoup the penalty provided for in this section.
(C) (i) If a facility disputes the determination or assessment made pursuant to this paragraph, the facility shall, within 15 days of the facilitys receipt of the determination and assessment, simultaneously submit a request for appeal to both the department and the State Department of Public Health. The request shall include a detailed statement describing the reason for appeal and include all supporting documents the facility will present at the hearing.
(ii) Within 10 days of the State Department of Public Healths receipt of the facilitys request for appeal, the State Department of Public Health shall submit, to both the facility and the department, all supporting documents that will be presented at the hearing.
(D) The department shall hear a timely appeal and issue a decision as follows:
(i) The hearing shall commence within 60 days from the date of receipt by the department of the facilitys timely request for appeal.
(ii) The department shall issue a decision within 120 days from the date of receipt by the department of the facilitys timely request for appeal.
(iii) The decision of the departments hearing officer, when issued, shall be the final decision of the State Department of Public Health.
(E) The appeals process set forth in this paragraph shall be exempt from Chapter 4.5 (commencing with Section 11400) and Chapter 5 (commencing with Section 11500), of Part 1 of Division 3 of Title 2 of the Government Code. The provisions of Sections 100171 and 131071 of the Health and Safety Code do not apply to appeals under this paragraph.
(F) If a hearing decision issued pursuant to subparagraph (D) is in favor of the State Department of Public Health, the skilled nursing facility shall pay the penalties to the State Department of Public Health within 30 days of the facilitys receipt of the decision. The penalties collected shall be deposited into the Skilled Nursing Facility Minimum Staffing Penalty Account.
(G) The assessment of a penalty under this subdivision does not supplant the State Department of Public Healths investigation process or issuance of deficiencies or citations under Chapter 2.4 (commencing with Section 1417) of Division 2 of the Health and Safety Code.
(g) The State Department of Public Health shall transfer, on a monthly basis, all penalty payments collected pursuant to subdivision (f) into the Skilled Nursing Facility Quality and Accountability Special Fund.
(h) This section does not impact the effectiveness or utilization of Section 1278.5 or 1432 of the Health and Safety Code relating to whistleblower protections, or Section 1420 of the Health and Safety Code relating to complaints.
(i) (1) Beginning in the 201011 fiscal year, the department, in consultation with representatives from the long-term care industry, organized labor, and consumers, shall establish and publish quality and accountability measures, benchmarks, and data submission deadlines by November 30, 2010.
(2) The methodology developed pursuant to this section shall include, but not be limited to, the following requirements and performance measures:
(A) Beginning in the 201112 fiscal year:
(i) Immunization rates.
(ii) Facility acquired pressure ulcer incidence.
(iii) The use of physical restraints.
(iv) Compliance with the nursing hours or direct care service hours per patient per day requirements pursuant to Section 1276.5 or 1276.65, as applicable, of the Health and Safety Code.
(v) Resident and family satisfaction.
(vi) Direct care staff retention, if sufficient data is available.
(B) If this act is extended beyond the dates on which it becomes inoperative and is repealed, in accordance with Section 14126.033, the department, in consultation with representatives from the long-term care industry, organized labor, and consumers, beginning in the 201314 rate year, shall incorporate additional measures into the system, including, but not limited to, quality and accountability measures required by federal health care reform that are identified by the federal Centers for Medicare and Medicaid Services.
(C) The department, in consultation with representatives from the long-term care industry, organized labor, and consumers, may incorporate additional performance measures, including, but not limited to, the following:
(i) Compliance with state policy associated with the United States Supreme Court decision in Olmstead v. L.C. ex rel. Zimring (1999) 527 U.S. 581.
(ii) Direct care staff retention, if not addressed in the 201213 rate year.
(iii) The use of chemical restraints.
(D) Beginning with the 201516 fiscal year, the department, in consultation with representatives from the long-term care industry, organized labor, and consumers, shall incorporate direct care staff retention as a performance measure in the methodology developed pursuant to this section.
(j) (1) Beginning with the 201011 rate year, and pursuant to subparagraph (B) of paragraph (5) of subdivision (a) of Section 14126.023, the department shall set aside savings achieved from setting the professional liability insurance cost category, including any insurance deductible costs paid by the facility, at the 75th percentile. From this amount, the department shall transfer the General Fund portion into the Skilled Nursing Facility Quality and Accountability Special Fund. A skilled nursing facility shall provide supplemental data on insurance deductible costs to facilitate this adjustment, in the format and by the deadlines determined by the department. If this data is not provided, a facilitys insurance deductible costs will remain in the administrative costs category.
(2) Notwithstanding paragraph (1), for the 201213 rate year only, savings from capping the professional liability insurance cost category pursuant to paragraph (1) shall remain in the General Fund and shall not be transferred to the Skilled Nursing Facility Quality and Accountability Special Fund.
(k) For the 201314 rate year, if there is a rate increase in the weighted average Medi-Cal reimbursement rate, the department shall set aside the first 1 percent of the weighted average Medi-Cal reimbursement rate increase for the Skilled Nursing Facility Quality and Accountability Special Fund.
(l) If this act is extended beyond the dates on which it becomes inoperative and is repealed, for the 201415 rate year, in addition to the amount set aside pursuant to subdivision (k), if there is a rate increase in the weighted average Medi-Cal reimbursement rate, the department shall set aside at least one-third of the weighted average Medi-Cal reimbursement rate increase, up to a maximum of 1 percent, from which the department shall transfer the General Fund portion of this amount into the Skilled Nursing Facility Quality and Accountability Special Fund.
(m) Beginning with the 201516 rate year, and each subsequent rate year thereafter for which this article is operative, an amount equal to the amount deposited in the fund pursuant to subdivisions (k) and (l) for the 201415 rate year shall be deposited into the Skilled Nursing Facility Quality and Accountability Special Fund, for the purposes specified in this section.
(n) (1) (A) Beginning with the 201314 rate year, the department shall pay a supplemental payment, by April 30, 2014, to skilled nursing facilities based on all of the criteria in subdivision (i), as published by the department, and according to performance measure benchmarks determined by the department in consultation with stakeholders.
(B) (i) The department may convene a diverse stakeholder group, including, but not limited to, representatives from consumer groups and organizations, labor, nursing home providers, advocacy organizations involved with the aging community, staff from the Legislature, and other interested parties, to discuss and analyze alternative mechanisms to implement the quality and accountability payments provided to nursing homes for reimbursement.
(ii) The department shall articulate in a report to the fiscal and appropriate policy committees of the Legislature the implementation of an alternative mechanism as described in clause (i) at least 90 days prior to any policy or budgetary changes, and seek subsequent legislation in order to enact the proposed changes.
(2) Skilled nursing facilities that do not submit required performance data by the departments specified data submission deadlines pursuant to subdivision (i) are not eligible to receive supplemental payments.
(3) Notwithstanding paragraph (1), if a facility appeals the performance measure of compliance with the nursing hours or direct care service hours per patient per day requirements, pursuant to Section 1276.5 or 1276.65, as applicable, of the Health and Safety Code, to the State Department of Public Health, and it is unresolved by the departments published due date, the department shall not use that performance measure when determining the facilitys supplemental payment.
(4) Notwithstanding paragraph (1), if the department is unable to pay the supplemental payments by April 30, 2014, then on May 1, 2014, the department shall use the funds available in the Skilled Nursing Facility Quality and Accountability Special Fund as a result of savings identified in subdivisions (k) and (l), less the administrative costs required to implement subparagraphs (A) and (B) of paragraph (3) of subdivision (b), in addition to any Medicaid funds that are available as of December 31, 2013, to increase provider rates retroactively to August 1, 2013.
(o) The department shall seek necessary approvals from the federal Centers for Medicare and Medicaid Services to implement this section. The department shall implement this section only in a manner that is consistent with federal Medicaid law and regulations, and only to the extent that approval is obtained from the federal Centers for Medicare and Medicaid Services and federal financial participation is available.
(p) In implementing this section, the department and the State Department of Public Health may contract as necessary, with Californias Medicare Quality Improvement Organization, or other entities deemed qualified by the department or the State Department of Public Health, not associated with a skilled nursing facility, to assist with development, collection, analysis, and reporting of the performance data pursuant to subdivision (i), and with demonstrated expertise in long-term care quality, data collection or analysis, and accountability performance measurement models pursuant to subdivision (i). This subdivision establishes an accelerated process for issuing any contract pursuant to this section. Any contract entered into pursuant to this subdivision is exempt from the requirements of the Public Contract Code, through December 31, 2020.
(q) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the following apply:
(1) The director shall implement this section, in whole or in part, by means of provider bulletins, or other similar instructions without taking regulatory action.
(2) The State Public Health Officer may implement this section by means of all-facility letters, or other similar instructions without taking regulatory action.
(r) Notwithstanding paragraph (1) of subdivision (n), if a final judicial determination is made by any state or federal court that is not appealed, in any action by any party, or a final determination is made by the administrator of the federal Centers for Medicare and Medicaid Services, that any payments pursuant to subdivisions (a) and (n), are invalid, unlawful, or contrary to any provision of federal law or regulations, or of state law, these subdivisions shall become inoperative, and for the 201112 rate year, the rate increase provided under subparagraph (A) of paragraph (4) of subdivision (c) of Section 14126.033 shall be reduced by the amounts described in subdivision (j). For the 201314 and 201415 rate years, any rate increase shall be reduced by the amounts described in subdivisions (j) to (l), inclusive.
(s) Notwithstanding any other provision of this section, but only to the extent the department determines federal financial participation is available and not otherwise jeopardized, for performance periods in the 201718 and 201819 fiscal years, a skilled nursing facility shall remain eligible to participate in the supplemental payment program pursuant to this section so long as the facility meets the applicable nursing hours per patient per day requirements pursuant to Section 1276.5 of the Health and Safety Code that would have applied in the absence of the act that added this subdivision. Code.
(t) Notwithstanding any provision of this section, but only to the extent the department determines federal financial participation is available and not otherwise jeopardized, compliance with the provisions of subdivision (c) of Section 1276.65 of the Health and Safety Code Code, as amended by Chapter 52 of the act that added this subdivision Statutes of 2017, shall not be used to determine facility qualification for the supplemental payments provided for in this section until the performance period beginning in the 201920 fiscal year. This limitation shall also apply to the issuance of citations pursuant to subdivisions (c) and (d) of Section 1424 of the Health and Safety Code based upon the failure to comply with the provisions of subdivision (c) of Section 1276.65 of the Health and Safety Code as amended by Chapter 52 of the act that added this subdivision. Statutes of 2017. Until the performance period beginning in the 201920 fiscal year, the department shall apply the provisions of Section 1276.5 of the Health and Safety Code for purposes of administering the supplemental payments pursuant to this section. For performance periods beginning in the 201920 fiscal year and each fiscal year thereafter, a skilled nursing facility that is granted a waiver pursuant to subdivision (l) of Section 1276.65 of the Health and Safety Code shall remain eligible to participate in the supplemental payment program pursuant to this section so long as the facility meets the applicable nursing hours per patient per day requirement pursuant to Section 1276.5 of the Health and Safety Code that would have applied in the absence of Chapter 52 of the Statutes of 2017 for the duration of the time for which the waiver is granted.
SEC. 3. Section 17605 of the Welfare and Institutions Code is amended to read:17605. (a) For the 199293 fiscal year, the Controller shall deposit into the Caseload Subaccount of the Sales Tax Growth Account of the Local Revenue Fund, from revenues deposited into the Sales Tax Growth Account, an amount to be determined by the Department of Finance, that represents the sum of the shortfalls between the actual realignment revenues received by each county and each city and county from the Social Services Subaccount of the Local Revenue Fund in the 199192 fiscal year and the net costs incurred by each of those counties and cities and counties in the fiscal year for the programs described in Sections 10101, 10101.1, 11322, 11322.2, and 12306, subdivisions (a), (b), (c), and (d) of Section 15200, and Sections 15204.2 and 18906.5. 11322.2, 12306, 15200, 15204.2, and 18906.5, and former Section 11322. The Department of Finance shall provide the Controller with an allocation schedule on or before August 15, 1993, that shall be used by the Controller to allocate funds deposited to the Caseload Subaccount under this subdivision. The Controller shall allocate these funds no later than August 27, 1993.(b) (1) (A) For the 199394 fiscal year and fiscal years thereafter, the Controller shall deposit into the Caseload Subaccount of the Sales Tax Growth Account of the Local Revenue Fund, from revenues deposited into the Sales Tax Growth Account, an amount determined by the Department of Finance, in consultation with the appropriate state departments and the California State Association of Counties, that is sufficient to fund the net cost for the realigned portion of the county or city and county share of growth in social services caseloads, as specified in paragraph (2), and any share of growth from the previous year or years for which sufficient revenues were not available in the Caseload Subaccount. The Department of Finance shall provide the Controller with an allocations schedule on or before March 15 of each year. The schedule shall be used by the Controller to allocate funds deposited into the Caseload Subaccount under this subdivision.(B) It is the intent of the Legislature that counties shall receive allocations from the Caseload Subaccount as soon as possible after funds are received in the Sales Tax Growth Account. The Department of Finance shall recommend to the Legislature, by January 10, 2005, a procedure to expedite the preparation and provision of the allocations schedule described in subparagraph (A) and the allocation of funds by the Controller.(2) (A) For purposes of this subdivision, (i) For the 199293 fiscal year through the caseload growth calculation for the 201718 fiscal year, growth means means, for purposes of this subdivision, the increase in the actual caseload expenditures for the prior fiscal year over the actual caseload expenditures for the fiscal year preceding the prior fiscal year for the programs described in Section 12306, subdivisions (a), (b), (c), and (d) of Section 15200, and Sections 10101, 15204.2 12306, 15200, 15204.2, and 18906.5 of this code, 18906.5, and for which funds are allocated pursuant to subdivision (b) of Section 123940 of the Health and Safety Code.(ii) Commencing with the caseload growth calculation for the 201819 fiscal year and each fiscal year thereafter, for purposes of this subdivision, growth means the increase in the actual caseload expenditures for the prior fiscal year over the actual caseload expenditures for the fiscal year preceding the prior fiscal year for the programs described in Sections 10101, 15200, 15204.2, and 18906.5, and for which funds are allocated pursuant to subdivision (b) of Section 123940 of the Health and Safety Code. (B) Commencing with the caseload growth calculation for the 201718 fiscal year and each fiscal year thereafter, in addition to subparagraph (A), growth shall also include the following:(i) The additional County IHSS MOE costs to counties pursuant to Section Sections 12306.16 and 12306.17 for the current fiscal year over the County IHSS MOE costs to counties for the prior fiscal year, less the amount of sales tax revenues received pursuant to subdivision (g) of Section 17600.15 to fund the amount specified in subparagraph (B) of paragraph (3) of subdivision (f) of Section 17600.15. 17600.15 and the amount of vehicle license fee revenues received pursuant to subdivision (c) of Section 17606.20.(ii) Any additional County IHSS MOE costs to counties pursuant to Section Sections 12306.16 and 12306.17 for the prior fiscal year over the County IHSS MOE costs to counties for the preceding prior fiscal year that were not included in caseload growth calculation pursuant to clause (i). (i) from the prior caseload growth calculation.(3) (A) For the 199394 fiscal year through the 201617 fiscal year, the difference in caseload expenditures between the fiscal years shall be multiplied by the factors that represent the change in county or city and county shares of the realigned programs. These products shall then be added or subtracted, taking into account whether the countys or city and countys share of costs was increased or decreased as a result of realignment, to yield each countys or city and countys allocation for caseload growth. Allocations for counties or cities and counties with allocations of less than zero shall be set at zero.(B) Commencing with the For the caseload growth calculation for the 201718 fiscal year and each fiscal year thereafter, year the difference in caseload expenditures between the fiscal years as determined by clause (i) of subparagraph (A) of paragraph (2) shall be multiplied by the factors that represent the change in county or city and county shares of the realignment programs. These products shall then be added or subtracted, taking into account whether the countys or city and countys share of costs was increased or decreased as a result of realignment, and added to the amounts determined pursuant to subparagraph (B) of paragraph (2) to yield each countys or city and countys allocation for caseload growth. Allocations for counties or cities and counties with allocations of less than zero shall be set at zero.(C) Commencing with the caseload growth calculation for the 201819 fiscal year and each fiscal year thereafter, the difference in caseload expenditures between the fiscal years as determined by clause (ii) of subparagraph (A) of paragraph (2) shall be multiplied by the factors that represent the change in county or city and county shares of the realignment programs. These products shall then be added or subtracted, taking into account whether the countys or city and countys share of costs was increased or decreased as a result of realignment, and added to the amounts determined pursuant to subparagraph (B) of paragraph (2) to yield each countys or city and countys allocation for caseload growth. Allocations for counties or cities and counties with allocations of less than zero shall be set at zero. (c) Annually, the Controller shall allocate, to the local health and welfare trust fund social services account, the amounts deposited and remaining unexpended and unreserved in the Caseload Subaccount, pursuant to the schedules of allocations of caseload growth described in subdivision (b), within 45 days of receiving those schedules from the Department of Finance. If there are insufficient funds to fully satisfy all caseload growth obligations, each countys or city and countys allocation for each program specified in subdivision (d) shall be prorated.(d) Prior to allocating funds pursuant to subdivision (b), to the extent that funds are available from funds deposited in the Caseload Subaccount in the Sales Tax Growth Account in the Local Revenue Fund, the Controller shall allocate moneys to counties or cities and counties to correct any inequity or inequities in the computation of the child welfare services portion of the schedule required by subdivision (a) of Section 17602.(e) (1) For the 200304 fiscal year, no Sales Tax Growth Account funds shall be allocated pursuant to this chapter until the caseload portion of the base of each countys social services account in the countys health and welfare trust fund is funded to the level of the 200102 fiscal year. Funds to meet this requirement shall be allocated from the Sales Tax Account of the Local Revenue Fund. If sufficient funds are not available in the Sales Tax Account of the Local Revenue Fund to achieve that funding level in the 200304 fiscal year, this requirement shall be funded in each succeeding fiscal year in which there are sufficient funds in the Sales Tax Account of the Local Revenue Fund until the caseload base funding level for which each county would have otherwise been eligible in accordance with subdivision (e) of Section 17602 for that year.(2) The caseload portion of each countys social services account base shall be determined by subtracting its noncaseload portion of the base, as determined by the Department of Finance in its annual calculation of General Growth Account allocations, from the total base of each countys social services account for the 200102 fiscal year.(f) Commencing with the caseload growth calculation for the 201718 fiscal year and each fiscal year thereafter, the Controller shall annually post on his or her Internet Web site the total amount of unfunded caseload growth by county.
SEC. 3. Section 17605 of the Welfare and Institutions Code is amended to read:
### SEC. 3.
17605. (a) For the 199293 fiscal year, the Controller shall deposit into the Caseload Subaccount of the Sales Tax Growth Account of the Local Revenue Fund, from revenues deposited into the Sales Tax Growth Account, an amount to be determined by the Department of Finance, that represents the sum of the shortfalls between the actual realignment revenues received by each county and each city and county from the Social Services Subaccount of the Local Revenue Fund in the 199192 fiscal year and the net costs incurred by each of those counties and cities and counties in the fiscal year for the programs described in Sections 10101, 10101.1, 11322, 11322.2, and 12306, subdivisions (a), (b), (c), and (d) of Section 15200, and Sections 15204.2 and 18906.5. 11322.2, 12306, 15200, 15204.2, and 18906.5, and former Section 11322. The Department of Finance shall provide the Controller with an allocation schedule on or before August 15, 1993, that shall be used by the Controller to allocate funds deposited to the Caseload Subaccount under this subdivision. The Controller shall allocate these funds no later than August 27, 1993.(b) (1) (A) For the 199394 fiscal year and fiscal years thereafter, the Controller shall deposit into the Caseload Subaccount of the Sales Tax Growth Account of the Local Revenue Fund, from revenues deposited into the Sales Tax Growth Account, an amount determined by the Department of Finance, in consultation with the appropriate state departments and the California State Association of Counties, that is sufficient to fund the net cost for the realigned portion of the county or city and county share of growth in social services caseloads, as specified in paragraph (2), and any share of growth from the previous year or years for which sufficient revenues were not available in the Caseload Subaccount. The Department of Finance shall provide the Controller with an allocations schedule on or before March 15 of each year. The schedule shall be used by the Controller to allocate funds deposited into the Caseload Subaccount under this subdivision.(B) It is the intent of the Legislature that counties shall receive allocations from the Caseload Subaccount as soon as possible after funds are received in the Sales Tax Growth Account. The Department of Finance shall recommend to the Legislature, by January 10, 2005, a procedure to expedite the preparation and provision of the allocations schedule described in subparagraph (A) and the allocation of funds by the Controller.(2) (A) For purposes of this subdivision, (i) For the 199293 fiscal year through the caseload growth calculation for the 201718 fiscal year, growth means means, for purposes of this subdivision, the increase in the actual caseload expenditures for the prior fiscal year over the actual caseload expenditures for the fiscal year preceding the prior fiscal year for the programs described in Section 12306, subdivisions (a), (b), (c), and (d) of Section 15200, and Sections 10101, 15204.2 12306, 15200, 15204.2, and 18906.5 of this code, 18906.5, and for which funds are allocated pursuant to subdivision (b) of Section 123940 of the Health and Safety Code.(ii) Commencing with the caseload growth calculation for the 201819 fiscal year and each fiscal year thereafter, for purposes of this subdivision, growth means the increase in the actual caseload expenditures for the prior fiscal year over the actual caseload expenditures for the fiscal year preceding the prior fiscal year for the programs described in Sections 10101, 15200, 15204.2, and 18906.5, and for which funds are allocated pursuant to subdivision (b) of Section 123940 of the Health and Safety Code. (B) Commencing with the caseload growth calculation for the 201718 fiscal year and each fiscal year thereafter, in addition to subparagraph (A), growth shall also include the following:(i) The additional County IHSS MOE costs to counties pursuant to Section Sections 12306.16 and 12306.17 for the current fiscal year over the County IHSS MOE costs to counties for the prior fiscal year, less the amount of sales tax revenues received pursuant to subdivision (g) of Section 17600.15 to fund the amount specified in subparagraph (B) of paragraph (3) of subdivision (f) of Section 17600.15. 17600.15 and the amount of vehicle license fee revenues received pursuant to subdivision (c) of Section 17606.20.(ii) Any additional County IHSS MOE costs to counties pursuant to Section Sections 12306.16 and 12306.17 for the prior fiscal year over the County IHSS MOE costs to counties for the preceding prior fiscal year that were not included in caseload growth calculation pursuant to clause (i). (i) from the prior caseload growth calculation.(3) (A) For the 199394 fiscal year through the 201617 fiscal year, the difference in caseload expenditures between the fiscal years shall be multiplied by the factors that represent the change in county or city and county shares of the realigned programs. These products shall then be added or subtracted, taking into account whether the countys or city and countys share of costs was increased or decreased as a result of realignment, to yield each countys or city and countys allocation for caseload growth. Allocations for counties or cities and counties with allocations of less than zero shall be set at zero.(B) Commencing with the For the caseload growth calculation for the 201718 fiscal year and each fiscal year thereafter, year the difference in caseload expenditures between the fiscal years as determined by clause (i) of subparagraph (A) of paragraph (2) shall be multiplied by the factors that represent the change in county or city and county shares of the realignment programs. These products shall then be added or subtracted, taking into account whether the countys or city and countys share of costs was increased or decreased as a result of realignment, and added to the amounts determined pursuant to subparagraph (B) of paragraph (2) to yield each countys or city and countys allocation for caseload growth. Allocations for counties or cities and counties with allocations of less than zero shall be set at zero.(C) Commencing with the caseload growth calculation for the 201819 fiscal year and each fiscal year thereafter, the difference in caseload expenditures between the fiscal years as determined by clause (ii) of subparagraph (A) of paragraph (2) shall be multiplied by the factors that represent the change in county or city and county shares of the realignment programs. These products shall then be added or subtracted, taking into account whether the countys or city and countys share of costs was increased or decreased as a result of realignment, and added to the amounts determined pursuant to subparagraph (B) of paragraph (2) to yield each countys or city and countys allocation for caseload growth. Allocations for counties or cities and counties with allocations of less than zero shall be set at zero. (c) Annually, the Controller shall allocate, to the local health and welfare trust fund social services account, the amounts deposited and remaining unexpended and unreserved in the Caseload Subaccount, pursuant to the schedules of allocations of caseload growth described in subdivision (b), within 45 days of receiving those schedules from the Department of Finance. If there are insufficient funds to fully satisfy all caseload growth obligations, each countys or city and countys allocation for each program specified in subdivision (d) shall be prorated.(d) Prior to allocating funds pursuant to subdivision (b), to the extent that funds are available from funds deposited in the Caseload Subaccount in the Sales Tax Growth Account in the Local Revenue Fund, the Controller shall allocate moneys to counties or cities and counties to correct any inequity or inequities in the computation of the child welfare services portion of the schedule required by subdivision (a) of Section 17602.(e) (1) For the 200304 fiscal year, no Sales Tax Growth Account funds shall be allocated pursuant to this chapter until the caseload portion of the base of each countys social services account in the countys health and welfare trust fund is funded to the level of the 200102 fiscal year. Funds to meet this requirement shall be allocated from the Sales Tax Account of the Local Revenue Fund. If sufficient funds are not available in the Sales Tax Account of the Local Revenue Fund to achieve that funding level in the 200304 fiscal year, this requirement shall be funded in each succeeding fiscal year in which there are sufficient funds in the Sales Tax Account of the Local Revenue Fund until the caseload base funding level for which each county would have otherwise been eligible in accordance with subdivision (e) of Section 17602 for that year.(2) The caseload portion of each countys social services account base shall be determined by subtracting its noncaseload portion of the base, as determined by the Department of Finance in its annual calculation of General Growth Account allocations, from the total base of each countys social services account for the 200102 fiscal year.(f) Commencing with the caseload growth calculation for the 201718 fiscal year and each fiscal year thereafter, the Controller shall annually post on his or her Internet Web site the total amount of unfunded caseload growth by county.
17605. (a) For the 199293 fiscal year, the Controller shall deposit into the Caseload Subaccount of the Sales Tax Growth Account of the Local Revenue Fund, from revenues deposited into the Sales Tax Growth Account, an amount to be determined by the Department of Finance, that represents the sum of the shortfalls between the actual realignment revenues received by each county and each city and county from the Social Services Subaccount of the Local Revenue Fund in the 199192 fiscal year and the net costs incurred by each of those counties and cities and counties in the fiscal year for the programs described in Sections 10101, 10101.1, 11322, 11322.2, and 12306, subdivisions (a), (b), (c), and (d) of Section 15200, and Sections 15204.2 and 18906.5. 11322.2, 12306, 15200, 15204.2, and 18906.5, and former Section 11322. The Department of Finance shall provide the Controller with an allocation schedule on or before August 15, 1993, that shall be used by the Controller to allocate funds deposited to the Caseload Subaccount under this subdivision. The Controller shall allocate these funds no later than August 27, 1993.(b) (1) (A) For the 199394 fiscal year and fiscal years thereafter, the Controller shall deposit into the Caseload Subaccount of the Sales Tax Growth Account of the Local Revenue Fund, from revenues deposited into the Sales Tax Growth Account, an amount determined by the Department of Finance, in consultation with the appropriate state departments and the California State Association of Counties, that is sufficient to fund the net cost for the realigned portion of the county or city and county share of growth in social services caseloads, as specified in paragraph (2), and any share of growth from the previous year or years for which sufficient revenues were not available in the Caseload Subaccount. The Department of Finance shall provide the Controller with an allocations schedule on or before March 15 of each year. The schedule shall be used by the Controller to allocate funds deposited into the Caseload Subaccount under this subdivision.(B) It is the intent of the Legislature that counties shall receive allocations from the Caseload Subaccount as soon as possible after funds are received in the Sales Tax Growth Account. The Department of Finance shall recommend to the Legislature, by January 10, 2005, a procedure to expedite the preparation and provision of the allocations schedule described in subparagraph (A) and the allocation of funds by the Controller.(2) (A) For purposes of this subdivision, (i) For the 199293 fiscal year through the caseload growth calculation for the 201718 fiscal year, growth means means, for purposes of this subdivision, the increase in the actual caseload expenditures for the prior fiscal year over the actual caseload expenditures for the fiscal year preceding the prior fiscal year for the programs described in Section 12306, subdivisions (a), (b), (c), and (d) of Section 15200, and Sections 10101, 15204.2 12306, 15200, 15204.2, and 18906.5 of this code, 18906.5, and for which funds are allocated pursuant to subdivision (b) of Section 123940 of the Health and Safety Code.(ii) Commencing with the caseload growth calculation for the 201819 fiscal year and each fiscal year thereafter, for purposes of this subdivision, growth means the increase in the actual caseload expenditures for the prior fiscal year over the actual caseload expenditures for the fiscal year preceding the prior fiscal year for the programs described in Sections 10101, 15200, 15204.2, and 18906.5, and for which funds are allocated pursuant to subdivision (b) of Section 123940 of the Health and Safety Code. (B) Commencing with the caseload growth calculation for the 201718 fiscal year and each fiscal year thereafter, in addition to subparagraph (A), growth shall also include the following:(i) The additional County IHSS MOE costs to counties pursuant to Section Sections 12306.16 and 12306.17 for the current fiscal year over the County IHSS MOE costs to counties for the prior fiscal year, less the amount of sales tax revenues received pursuant to subdivision (g) of Section 17600.15 to fund the amount specified in subparagraph (B) of paragraph (3) of subdivision (f) of Section 17600.15. 17600.15 and the amount of vehicle license fee revenues received pursuant to subdivision (c) of Section 17606.20.(ii) Any additional County IHSS MOE costs to counties pursuant to Section Sections 12306.16 and 12306.17 for the prior fiscal year over the County IHSS MOE costs to counties for the preceding prior fiscal year that were not included in caseload growth calculation pursuant to clause (i). (i) from the prior caseload growth calculation.(3) (A) For the 199394 fiscal year through the 201617 fiscal year, the difference in caseload expenditures between the fiscal years shall be multiplied by the factors that represent the change in county or city and county shares of the realigned programs. These products shall then be added or subtracted, taking into account whether the countys or city and countys share of costs was increased or decreased as a result of realignment, to yield each countys or city and countys allocation for caseload growth. Allocations for counties or cities and counties with allocations of less than zero shall be set at zero.(B) Commencing with the For the caseload growth calculation for the 201718 fiscal year and each fiscal year thereafter, year the difference in caseload expenditures between the fiscal years as determined by clause (i) of subparagraph (A) of paragraph (2) shall be multiplied by the factors that represent the change in county or city and county shares of the realignment programs. These products shall then be added or subtracted, taking into account whether the countys or city and countys share of costs was increased or decreased as a result of realignment, and added to the amounts determined pursuant to subparagraph (B) of paragraph (2) to yield each countys or city and countys allocation for caseload growth. Allocations for counties or cities and counties with allocations of less than zero shall be set at zero.(C) Commencing with the caseload growth calculation for the 201819 fiscal year and each fiscal year thereafter, the difference in caseload expenditures between the fiscal years as determined by clause (ii) of subparagraph (A) of paragraph (2) shall be multiplied by the factors that represent the change in county or city and county shares of the realignment programs. These products shall then be added or subtracted, taking into account whether the countys or city and countys share of costs was increased or decreased as a result of realignment, and added to the amounts determined pursuant to subparagraph (B) of paragraph (2) to yield each countys or city and countys allocation for caseload growth. Allocations for counties or cities and counties with allocations of less than zero shall be set at zero. (c) Annually, the Controller shall allocate, to the local health and welfare trust fund social services account, the amounts deposited and remaining unexpended and unreserved in the Caseload Subaccount, pursuant to the schedules of allocations of caseload growth described in subdivision (b), within 45 days of receiving those schedules from the Department of Finance. If there are insufficient funds to fully satisfy all caseload growth obligations, each countys or city and countys allocation for each program specified in subdivision (d) shall be prorated.(d) Prior to allocating funds pursuant to subdivision (b), to the extent that funds are available from funds deposited in the Caseload Subaccount in the Sales Tax Growth Account in the Local Revenue Fund, the Controller shall allocate moneys to counties or cities and counties to correct any inequity or inequities in the computation of the child welfare services portion of the schedule required by subdivision (a) of Section 17602.(e) (1) For the 200304 fiscal year, no Sales Tax Growth Account funds shall be allocated pursuant to this chapter until the caseload portion of the base of each countys social services account in the countys health and welfare trust fund is funded to the level of the 200102 fiscal year. Funds to meet this requirement shall be allocated from the Sales Tax Account of the Local Revenue Fund. If sufficient funds are not available in the Sales Tax Account of the Local Revenue Fund to achieve that funding level in the 200304 fiscal year, this requirement shall be funded in each succeeding fiscal year in which there are sufficient funds in the Sales Tax Account of the Local Revenue Fund until the caseload base funding level for which each county would have otherwise been eligible in accordance with subdivision (e) of Section 17602 for that year.(2) The caseload portion of each countys social services account base shall be determined by subtracting its noncaseload portion of the base, as determined by the Department of Finance in its annual calculation of General Growth Account allocations, from the total base of each countys social services account for the 200102 fiscal year.(f) Commencing with the caseload growth calculation for the 201718 fiscal year and each fiscal year thereafter, the Controller shall annually post on his or her Internet Web site the total amount of unfunded caseload growth by county.
17605. (a) For the 199293 fiscal year, the Controller shall deposit into the Caseload Subaccount of the Sales Tax Growth Account of the Local Revenue Fund, from revenues deposited into the Sales Tax Growth Account, an amount to be determined by the Department of Finance, that represents the sum of the shortfalls between the actual realignment revenues received by each county and each city and county from the Social Services Subaccount of the Local Revenue Fund in the 199192 fiscal year and the net costs incurred by each of those counties and cities and counties in the fiscal year for the programs described in Sections 10101, 10101.1, 11322, 11322.2, and 12306, subdivisions (a), (b), (c), and (d) of Section 15200, and Sections 15204.2 and 18906.5. 11322.2, 12306, 15200, 15204.2, and 18906.5, and former Section 11322. The Department of Finance shall provide the Controller with an allocation schedule on or before August 15, 1993, that shall be used by the Controller to allocate funds deposited to the Caseload Subaccount under this subdivision. The Controller shall allocate these funds no later than August 27, 1993.(b) (1) (A) For the 199394 fiscal year and fiscal years thereafter, the Controller shall deposit into the Caseload Subaccount of the Sales Tax Growth Account of the Local Revenue Fund, from revenues deposited into the Sales Tax Growth Account, an amount determined by the Department of Finance, in consultation with the appropriate state departments and the California State Association of Counties, that is sufficient to fund the net cost for the realigned portion of the county or city and county share of growth in social services caseloads, as specified in paragraph (2), and any share of growth from the previous year or years for which sufficient revenues were not available in the Caseload Subaccount. The Department of Finance shall provide the Controller with an allocations schedule on or before March 15 of each year. The schedule shall be used by the Controller to allocate funds deposited into the Caseload Subaccount under this subdivision.(B) It is the intent of the Legislature that counties shall receive allocations from the Caseload Subaccount as soon as possible after funds are received in the Sales Tax Growth Account. The Department of Finance shall recommend to the Legislature, by January 10, 2005, a procedure to expedite the preparation and provision of the allocations schedule described in subparagraph (A) and the allocation of funds by the Controller.(2) (A) For purposes of this subdivision, (i) For the 199293 fiscal year through the caseload growth calculation for the 201718 fiscal year, growth means means, for purposes of this subdivision, the increase in the actual caseload expenditures for the prior fiscal year over the actual caseload expenditures for the fiscal year preceding the prior fiscal year for the programs described in Section 12306, subdivisions (a), (b), (c), and (d) of Section 15200, and Sections 10101, 15204.2 12306, 15200, 15204.2, and 18906.5 of this code, 18906.5, and for which funds are allocated pursuant to subdivision (b) of Section 123940 of the Health and Safety Code.(ii) Commencing with the caseload growth calculation for the 201819 fiscal year and each fiscal year thereafter, for purposes of this subdivision, growth means the increase in the actual caseload expenditures for the prior fiscal year over the actual caseload expenditures for the fiscal year preceding the prior fiscal year for the programs described in Sections 10101, 15200, 15204.2, and 18906.5, and for which funds are allocated pursuant to subdivision (b) of Section 123940 of the Health and Safety Code. (B) Commencing with the caseload growth calculation for the 201718 fiscal year and each fiscal year thereafter, in addition to subparagraph (A), growth shall also include the following:(i) The additional County IHSS MOE costs to counties pursuant to Section Sections 12306.16 and 12306.17 for the current fiscal year over the County IHSS MOE costs to counties for the prior fiscal year, less the amount of sales tax revenues received pursuant to subdivision (g) of Section 17600.15 to fund the amount specified in subparagraph (B) of paragraph (3) of subdivision (f) of Section 17600.15. 17600.15 and the amount of vehicle license fee revenues received pursuant to subdivision (c) of Section 17606.20.(ii) Any additional County IHSS MOE costs to counties pursuant to Section Sections 12306.16 and 12306.17 for the prior fiscal year over the County IHSS MOE costs to counties for the preceding prior fiscal year that were not included in caseload growth calculation pursuant to clause (i). (i) from the prior caseload growth calculation.(3) (A) For the 199394 fiscal year through the 201617 fiscal year, the difference in caseload expenditures between the fiscal years shall be multiplied by the factors that represent the change in county or city and county shares of the realigned programs. These products shall then be added or subtracted, taking into account whether the countys or city and countys share of costs was increased or decreased as a result of realignment, to yield each countys or city and countys allocation for caseload growth. Allocations for counties or cities and counties with allocations of less than zero shall be set at zero.(B) Commencing with the For the caseload growth calculation for the 201718 fiscal year and each fiscal year thereafter, year the difference in caseload expenditures between the fiscal years as determined by clause (i) of subparagraph (A) of paragraph (2) shall be multiplied by the factors that represent the change in county or city and county shares of the realignment programs. These products shall then be added or subtracted, taking into account whether the countys or city and countys share of costs was increased or decreased as a result of realignment, and added to the amounts determined pursuant to subparagraph (B) of paragraph (2) to yield each countys or city and countys allocation for caseload growth. Allocations for counties or cities and counties with allocations of less than zero shall be set at zero.(C) Commencing with the caseload growth calculation for the 201819 fiscal year and each fiscal year thereafter, the difference in caseload expenditures between the fiscal years as determined by clause (ii) of subparagraph (A) of paragraph (2) shall be multiplied by the factors that represent the change in county or city and county shares of the realignment programs. These products shall then be added or subtracted, taking into account whether the countys or city and countys share of costs was increased or decreased as a result of realignment, and added to the amounts determined pursuant to subparagraph (B) of paragraph (2) to yield each countys or city and countys allocation for caseload growth. Allocations for counties or cities and counties with allocations of less than zero shall be set at zero. (c) Annually, the Controller shall allocate, to the local health and welfare trust fund social services account, the amounts deposited and remaining unexpended and unreserved in the Caseload Subaccount, pursuant to the schedules of allocations of caseload growth described in subdivision (b), within 45 days of receiving those schedules from the Department of Finance. If there are insufficient funds to fully satisfy all caseload growth obligations, each countys or city and countys allocation for each program specified in subdivision (d) shall be prorated.(d) Prior to allocating funds pursuant to subdivision (b), to the extent that funds are available from funds deposited in the Caseload Subaccount in the Sales Tax Growth Account in the Local Revenue Fund, the Controller shall allocate moneys to counties or cities and counties to correct any inequity or inequities in the computation of the child welfare services portion of the schedule required by subdivision (a) of Section 17602.(e) (1) For the 200304 fiscal year, no Sales Tax Growth Account funds shall be allocated pursuant to this chapter until the caseload portion of the base of each countys social services account in the countys health and welfare trust fund is funded to the level of the 200102 fiscal year. Funds to meet this requirement shall be allocated from the Sales Tax Account of the Local Revenue Fund. If sufficient funds are not available in the Sales Tax Account of the Local Revenue Fund to achieve that funding level in the 200304 fiscal year, this requirement shall be funded in each succeeding fiscal year in which there are sufficient funds in the Sales Tax Account of the Local Revenue Fund until the caseload base funding level for which each county would have otherwise been eligible in accordance with subdivision (e) of Section 17602 for that year.(2) The caseload portion of each countys social services account base shall be determined by subtracting its noncaseload portion of the base, as determined by the Department of Finance in its annual calculation of General Growth Account allocations, from the total base of each countys social services account for the 200102 fiscal year.(f) Commencing with the caseload growth calculation for the 201718 fiscal year and each fiscal year thereafter, the Controller shall annually post on his or her Internet Web site the total amount of unfunded caseload growth by county.
17605. (a) For the 199293 fiscal year, the Controller shall deposit into the Caseload Subaccount of the Sales Tax Growth Account of the Local Revenue Fund, from revenues deposited into the Sales Tax Growth Account, an amount to be determined by the Department of Finance, that represents the sum of the shortfalls between the actual realignment revenues received by each county and each city and county from the Social Services Subaccount of the Local Revenue Fund in the 199192 fiscal year and the net costs incurred by each of those counties and cities and counties in the fiscal year for the programs described in Sections 10101, 10101.1, 11322, 11322.2, and 12306, subdivisions (a), (b), (c), and (d) of Section 15200, and Sections 15204.2 and 18906.5. 11322.2, 12306, 15200, 15204.2, and 18906.5, and former Section 11322. The Department of Finance shall provide the Controller with an allocation schedule on or before August 15, 1993, that shall be used by the Controller to allocate funds deposited to the Caseload Subaccount under this subdivision. The Controller shall allocate these funds no later than August 27, 1993.
(b) (1) (A) For the 199394 fiscal year and fiscal years thereafter, the Controller shall deposit into the Caseload Subaccount of the Sales Tax Growth Account of the Local Revenue Fund, from revenues deposited into the Sales Tax Growth Account, an amount determined by the Department of Finance, in consultation with the appropriate state departments and the California State Association of Counties, that is sufficient to fund the net cost for the realigned portion of the county or city and county share of growth in social services caseloads, as specified in paragraph (2), and any share of growth from the previous year or years for which sufficient revenues were not available in the Caseload Subaccount. The Department of Finance shall provide the Controller with an allocations schedule on or before March 15 of each year. The schedule shall be used by the Controller to allocate funds deposited into the Caseload Subaccount under this subdivision.
(B) It is the intent of the Legislature that counties shall receive allocations from the Caseload Subaccount as soon as possible after funds are received in the Sales Tax Growth Account. The Department of Finance shall recommend to the Legislature, by January 10, 2005, a procedure to expedite the preparation and provision of the allocations schedule described in subparagraph (A) and the allocation of funds by the Controller.
(2) (A) For purposes of this subdivision, (i) For the 199293 fiscal year through the caseload growth calculation for the 201718 fiscal year, growth means means, for purposes of this subdivision, the increase in the actual caseload expenditures for the prior fiscal year over the actual caseload expenditures for the fiscal year preceding the prior fiscal year for the programs described in Section 12306, subdivisions (a), (b), (c), and (d) of Section 15200, and Sections 10101, 15204.2 12306, 15200, 15204.2, and 18906.5 of this code, 18906.5, and for which funds are allocated pursuant to subdivision (b) of Section 123940 of the Health and Safety Code.
(ii) Commencing with the caseload growth calculation for the 201819 fiscal year and each fiscal year thereafter, for purposes of this subdivision, growth means the increase in the actual caseload expenditures for the prior fiscal year over the actual caseload expenditures for the fiscal year preceding the prior fiscal year for the programs described in Sections 10101, 15200, 15204.2, and 18906.5, and for which funds are allocated pursuant to subdivision (b) of Section 123940 of the Health and Safety Code.
(B) Commencing with the caseload growth calculation for the 201718 fiscal year and each fiscal year thereafter, in addition to subparagraph (A), growth shall also include the following:
(i) The additional County IHSS MOE costs to counties pursuant to Section Sections 12306.16 and 12306.17 for the current fiscal year over the County IHSS MOE costs to counties for the prior fiscal year, less the amount of sales tax revenues received pursuant to subdivision (g) of Section 17600.15 to fund the amount specified in subparagraph (B) of paragraph (3) of subdivision (f) of Section 17600.15. 17600.15 and the amount of vehicle license fee revenues received pursuant to subdivision (c) of Section 17606.20.
(ii) Any additional County IHSS MOE costs to counties pursuant to Section Sections 12306.16 and 12306.17 for the prior fiscal year over the County IHSS MOE costs to counties for the preceding prior fiscal year that were not included in caseload growth calculation pursuant to clause (i). (i) from the prior caseload growth calculation.
(3) (A) For the 199394 fiscal year through the 201617 fiscal year, the difference in caseload expenditures between the fiscal years shall be multiplied by the factors that represent the change in county or city and county shares of the realigned programs. These products shall then be added or subtracted, taking into account whether the countys or city and countys share of costs was increased or decreased as a result of realignment, to yield each countys or city and countys allocation for caseload growth. Allocations for counties or cities and counties with allocations of less than zero shall be set at zero.
(B) Commencing with the For the caseload growth calculation for the 201718 fiscal year and each fiscal year thereafter, year the difference in caseload expenditures between the fiscal years as determined by clause (i) of subparagraph (A) of paragraph (2) shall be multiplied by the factors that represent the change in county or city and county shares of the realignment programs. These products shall then be added or subtracted, taking into account whether the countys or city and countys share of costs was increased or decreased as a result of realignment, and added to the amounts determined pursuant to subparagraph (B) of paragraph (2) to yield each countys or city and countys allocation for caseload growth. Allocations for counties or cities and counties with allocations of less than zero shall be set at zero.
(C) Commencing with the caseload growth calculation for the 201819 fiscal year and each fiscal year thereafter, the difference in caseload expenditures between the fiscal years as determined by clause (ii) of subparagraph (A) of paragraph (2) shall be multiplied by the factors that represent the change in county or city and county shares of the realignment programs. These products shall then be added or subtracted, taking into account whether the countys or city and countys share of costs was increased or decreased as a result of realignment, and added to the amounts determined pursuant to subparagraph (B) of paragraph (2) to yield each countys or city and countys allocation for caseload growth. Allocations for counties or cities and counties with allocations of less than zero shall be set at zero.
(c) Annually, the Controller shall allocate, to the local health and welfare trust fund social services account, the amounts deposited and remaining unexpended and unreserved in the Caseload Subaccount, pursuant to the schedules of allocations of caseload growth described in subdivision (b), within 45 days of receiving those schedules from the Department of Finance. If there are insufficient funds to fully satisfy all caseload growth obligations, each countys or city and countys allocation for each program specified in subdivision (d) shall be prorated.
(d) Prior to allocating funds pursuant to subdivision (b), to the extent that funds are available from funds deposited in the Caseload Subaccount in the Sales Tax Growth Account in the Local Revenue Fund, the Controller shall allocate moneys to counties or cities and counties to correct any inequity or inequities in the computation of the child welfare services portion of the schedule required by subdivision (a) of Section 17602.
(e) (1) For the 200304 fiscal year, no Sales Tax Growth Account funds shall be allocated pursuant to this chapter until the caseload portion of the base of each countys social services account in the countys health and welfare trust fund is funded to the level of the 200102 fiscal year. Funds to meet this requirement shall be allocated from the Sales Tax Account of the Local Revenue Fund. If sufficient funds are not available in the Sales Tax Account of the Local Revenue Fund to achieve that funding level in the 200304 fiscal year, this requirement shall be funded in each succeeding fiscal year in which there are sufficient funds in the Sales Tax Account of the Local Revenue Fund until the caseload base funding level for which each county would have otherwise been eligible in accordance with subdivision (e) of Section 17602 for that year.
(2) The caseload portion of each countys social services account base shall be determined by subtracting its noncaseload portion of the base, as determined by the Department of Finance in its annual calculation of General Growth Account allocations, from the total base of each countys social services account for the 200102 fiscal year.
(f) Commencing with the caseload growth calculation for the 201718 fiscal year and each fiscal year thereafter, the Controller shall annually post on his or her Internet Web site the total amount of unfunded caseload growth by county.
SEC. 4. (a) Notwithstanding any other law, from the General Fund moneys appropriated to the State Department of Social Services in Item 5180-101-0001 of Section 2.00 of the Budget Act of 2017, the department shall allocate five million four hundred thousand dollars ($5,400,000), in a single payment by the Controller, to the City of San Jose for purposes of assisting homeless and low-income individuals displaced by the Coyote Creek flooding that occurred in February 2017.(b) As a condition of receiving these funds, the City of San Jose shall provide quarterly reports to the department regarding the number of families served and the types of services they received, until all funds have been expended.
SEC. 4. (a) Notwithstanding any other law, from the General Fund moneys appropriated to the State Department of Social Services in Item 5180-101-0001 of Section 2.00 of the Budget Act of 2017, the department shall allocate five million four hundred thousand dollars ($5,400,000), in a single payment by the Controller, to the City of San Jose for purposes of assisting homeless and low-income individuals displaced by the Coyote Creek flooding that occurred in February 2017.(b) As a condition of receiving these funds, the City of San Jose shall provide quarterly reports to the department regarding the number of families served and the types of services they received, until all funds have been expended.
SEC. 4. (a) Notwithstanding any other law, from the General Fund moneys appropriated to the State Department of Social Services in Item 5180-101-0001 of Section 2.00 of the Budget Act of 2017, the department shall allocate five million four hundred thousand dollars ($5,400,000), in a single payment by the Controller, to the City of San Jose for purposes of assisting homeless and low-income individuals displaced by the Coyote Creek flooding that occurred in February 2017.
### SEC. 4.
(b) As a condition of receiving these funds, the City of San Jose shall provide quarterly reports to the department regarding the number of families served and the types of services they received, until all funds have been expended.
SEC. 5. The sum of five million eight hundred eighty-four thousand dollars ($5,884,000) is hereby appropriated from the Federal Trust Fund to the State Department of Health Care Services in the 201718 fiscal year for the purpose of providing supplemental reimbursements to specific hospitals that provide trauma care to Medi-Cal beneficiaries. These funds shall be available for encumbrance or expenditure until June 30, 2018.
SEC. 5. The sum of five million eight hundred eighty-four thousand dollars ($5,884,000) is hereby appropriated from the Federal Trust Fund to the State Department of Health Care Services in the 201718 fiscal year for the purpose of providing supplemental reimbursements to specific hospitals that provide trauma care to Medi-Cal beneficiaries. These funds shall be available for encumbrance or expenditure until June 30, 2018.
SEC. 5. The sum of five million eight hundred eighty-four thousand dollars ($5,884,000) is hereby appropriated from the Federal Trust Fund to the State Department of Health Care Services in the 201718 fiscal year for the purpose of providing supplemental reimbursements to specific hospitals that provide trauma care to Medi-Cal beneficiaries. These funds shall be available for encumbrance or expenditure until June 30, 2018.
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SEC. 6. This act is a bill providing for appropriations related to the Budget Bill within the meaning of subdivision (e) of Section 12 of Article IV of the California Constitution, has been identified as related to the budget in the Budget Bill, and shall take effect immediately.
SEC. 6. This act is a bill providing for appropriations related to the Budget Bill within the meaning of subdivision (e) of Section 12 of Article IV of the California Constitution, has been identified as related to the budget in the Budget Bill, and shall take effect immediately.
SEC. 6. This act is a bill providing for appropriations related to the Budget Bill within the meaning of subdivision (e) of Section 12 of Article IV of the California Constitution, has been identified as related to the budget in the Budget Bill, and shall take effect immediately.
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It is the intent of the Legislature to enact statutory changes relating to the Budget Act of 2017.