| 1 | 1 | | CALIFORNIA LEGISLATURE 20192020 REGULAR SESSION Assembly Bill No. 1448Introduced by Assembly Member GrayFebruary 22, 2019 An act to amend Section 1266 of, and to add Section 1228.5 to, the Health and Safety Code, relating to dialysis. LEGISLATIVE COUNSEL'S DIGESTAB 1448, as introduced, Gray. Dialysis Patient Quality of Care Assurance Act of 2019.Existing law requires the State Department of Public Health to license and regulate chronic dialysis clinics, defined as a clinic that provides less than 24-hour care for the treatment of patients with end-stage renal disease, including renal dialysis services. Existing law also requires the department to periodically inspect every clinic for which a license or special permit has been issued, with the frequency to be determined based on the type and complexity of the clinic or special service to be inspected. Existing law makes this provision inapplicable to an end-stage renal disease facility. Existing law makes a person who violates a law or willfully or repeatedly violates a rule or regulation promulgated pursuant to these clinics guilty of a crime.This bill would require the department to inspect each licensed chronic dialysis clinic that receives a one- or 2-star quality rating as determined by the federal Centers for Medicare and Medicaid Services under the Five-Star Quality Rating System at least once per calendar year, until the clinic attains at least a 3-star rating. The bill would also require the department to conduct any additional inspection that the department deems necessary to ensure the continuation of high quality medical care for dialysis patients. The bill would require the department, commencing January 1, 2020, to assess a supplemental license fee on licensed chronic dialysis clinics in an amount not to exceed the reasonable cost to the department to conduct the inspections. The bill would name the act the Dialysis Patient Quality of Care Assurance Act of 2019.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO Bill TextThe people of the State of California do enact as follows:SECTION 1. This act shall be known, and may be cited as, the Dialysis Patient Quality of Care Assurance Act of 2019.SEC. 2. Section 1228.5 is added to the Health and Safety Code, to read:1228.5. (a) (1) The department shall inspect each licensed chronic dialysis clinic that receives a one- or two-star quality rating as determined by the federal Centers for Medicare and Medicaid Services (CMS) under the Five-Star Quality Rating System at least once per calendar year, until the clinic attains at least a three-star rating.(2) The department shall conduct, in addition to the annual inspection required by paragraph (1), any additional inspection of a licensed chronic dialysis clinic that the department deems necessary to ensure the continuation of high quality medical care for dialysis patients.(3) The inspections described in paragraphs (1) and (2) shall review clinic compliance with the CMS Conditions for Coverage.(b) Pursuant to subdivision (l) of Section 1266, the costs for the department to comply with the requirements of this section shall be funded by a supplemental license fee paid by all licensed chronic dialysis clinics and dedicated to fund the reasonable regulatory costs to the department incident to performing these investigations and any resulting administrative enforcement and adjudication.SEC. 3. Section 1266 of the Health and Safety Code is amended to read:1266. (a) The Licensing and Certification Division shall be supported entirely by federal funds and special funds by no earlier than the beginning of the 200910 fiscal year unless otherwise specified in statute, or unless funds are specifically appropriated from the General Fund in the annual Budget Act or other enacted legislation. For the 200708 fiscal year, General Fund support shall be provided to offset licensing and certification fees in an amount of not less than two million seven hundred eighty-two thousand dollars ($2,782,000).(b) (1) The Licensing and Certification Program fees for the 200607 fiscal year shall be as follows:Type of FacilityFeeGeneral Acute Care Hospitals$134.10per bedAcute Psychiatric Hospitals$134.10per bedSpecial Hospitals$134.10per bedChemical Dependency Recovery Hospitals$123.52per bedSkilled Nursing Facilities$202.96per bedIntermediate Care Facilities$202.96per bedIntermediate Care Facilities- Developmentally Disabled$592.29per bedIntermediate Care Facilities- Developmentally Disabled-Habilitative$1,000.00per facilityIntermediate Care Facilities- Developmentally Disabled-Nursing$1,000.00per facilityHome Health Agencies$2,700.00per facilityReferral Agencies$5,537.71per facilityAdult Day Health Centers$4,650.02per facilityCongregate Living Health Facilities$202.96per bedPsychology Clinics$600.00per facilityPrimary Clinics- Community and Free$600.00per facilitySpecialty Clinics- Rehab Clinics(For profit)$2,974.43per facility(Nonprofit)$500.00per facilitySpecialty Clinics- Surgical and Chronic$1,500.00per facilityDialysis Clinics$1,500.00per facilityPediatric Day Health/Respite Care$142.43per bedAlternative Birthing Centers$2,437.86per facilityHospice$1,000.00per providerCorrectional Treatment Centers$590.39per bed(2) (A) In the first year of licensure for intermediate care facility/developmentally disabled-continuous nursing (ICF/DD-CN) facilities, the licensure fee for those facilities shall be equivalent to the licensure fee for intermediate care facility/developmentally disabled-nursing facilities during the same year. Thereafter, the licensure fee for ICF/DD-CN facilities shall be established pursuant to the same procedures described in this section.(B) In the first year of licensure for hospice facilities, the licensure fee shall be equivalent to the licensure fee for congregate living health facilities during the same year. Thereafter, the licensure fee for hospice facilities shall be established pursuant to the same procedures described in this section.(c) Commencing in the 201516 fiscal year, the fees for skilled nursing facilities shall be increased so as to generate four hundred thousand dollars ($400,000) for the California Department of Agings Long-Term Care Ombudsman Program for its work related to investigating complaints made against skilled nursing facilities and increasing visits to those facilities.(d) Commencing February 1, 2007, and every February 1 thereafter, the department shall publish a list of estimated fees pursuant to this section. The calculation of estimated fees and the publication of the report and list of estimated fees shall not be subject to the rulemaking requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.(e) Notwithstanding Section 10231.5 of the Government Code, by February 1 of each year, the department shall prepare the following reports and shall make those reports, and the list of estimated fees required to be published pursuant to subdivision (d), available to the public by submitting them to the Legislature and posting them on the departments Internet Web site: internet website:(1) A report of all costs for activities of the Licensing and Certification Program. At a minimum, this report shall include a narrative of all baseline adjustments and their calculations, a description of how each category of facility was calculated, descriptions of assumptions used in any calculations, and shall recommend Licensing and Certification Program fees in accordance with the following:(A) Projected workload and costs shall be grouped for each fee category, including workload costs for facility categories that have been established by statute and for which licensing regulations and procedures are under development.(B) Cost estimates, and the estimated fees, shall be based on the appropriation amounts in the Governors proposed budget for the next fiscal year, with and without policy adjustments to the fee methodology.(C) The allocation of program, operational, and administrative overhead, and indirect costs to fee categories shall be based on generally accepted cost allocation methods. Significant items of costs shall be directly charged to fee categories if the expenses can be reasonably identified to the fee category that caused them. Indirect and overhead costs shall be allocated to all fee categories using a generally accepted cost allocation method.(D) The amount of federal funds and General Fund moneys to be received in the budget year shall be estimated and allocated to each fee category based upon an appropriate metric.(E) The fee for each category shall be determined by dividing the aggregate state share of all costs for the Licensing and Certification Program by the appropriate metric for the category of licensure. Amounts actually received for new licensure applications, including change of ownership applications, and late payment penalties, pursuant to Section 1266.5, during each fiscal year shall be calculated and 95 percent shall be applied to the appropriate fee categories in determining Licensing and Certification Program fees for the second fiscal year following receipt of those funds. The remaining 5 percent shall be retained in the fund as a reserve until appropriated.(2) (A) A staffing and systems analysis to ensure efficient and effective utilization of fees collected, proper allocation of departmental resources to licensing and certification activities, survey schedules, complaint investigations, enforcement and appeal activities, data collection and dissemination, surveyor training, and policy development.(B) The analysis under this paragraph shall be made available to interested persons and shall include all of the following:(i) The number of surveyors and administrative support personnel devoted to the licensing and certification of health care facilities.(ii) The percentage of time devoted to licensing and certification activities for the various types of health facilities.(iii) The number of facilities receiving full surveys and the frequency and number of followup visits.(iv) The number and timeliness of complaint investigations, including data on the departments compliance with the requirements of paragraphs (3), (4), and (5) of subdivision (a) of Section 1420.(v) Data on deficiencies and citations issued, and numbers of citation review conferences and arbitration hearings.(vi) Other applicable activities of the licensing and certification division.(3) The annual program fee report described in subdivision (d) of Section 1416.36.(f) The reports required pursuant to subdivision (e) shall be submitted in compliance with Section 9795 of the Government Code.(g) Commencing in the 201819 fiscal year, the department may assess a supplemental license fee on facilities located in the County of Los Angeles for all facility types set forth in this section. This supplemental license fee shall be in addition to the license fees set forth in subdivision (d). The department shall calculate the supplemental license fee based upon the difference between the estimated costs of regulating facility types licensed in the County of Los Angeles, including, but not limited to, the costs associated with the departments contract for licensing and certification activities with the County of Los Angeles and the costs of the department conducting the licensing and certification activities for facilities located in the County of Los Angeles. The supplemental license fees shall be used to cover the costs to administer and enforce state licensure standards and other federal compliance activities for facilities located in the County of Los Angeles, as described in the annual report. The supplemental license fee shall be based upon the fee methodology published in the annual report described in subdivision (d).(h) (1) The department shall adjust the list of estimated fees published pursuant to subdivision (d) if the annual Budget Act or other enacted legislation includes an appropriation that differs from those proposed in the Governors proposed budget for that fiscal year.(2) The department shall publish a final fee list, with an explanation of any adjustment, by the issuance of an all facilities letter, by posting the list on the departments Internet Web site, internet website, and by including the final fee list as part of the licensing application package, within 14 days of the enactment of the annual Budget Act. The adjustment of fees and the publication of the final fee list shall not be subject to the rulemaking requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.(i) (1) Fees shall not be assessed or collected pursuant to this section from any state department, authority, bureau, commission, or officer, unless federal financial participation would become available by doing so and an appropriation is included in the annual Budget Act for that state department, authority, bureau, commission, or officer for this purpose. Fees shall not be assessed or collected pursuant to this section from any clinic that is certified only by the federal government and is exempt from licensure under Section 1206, unless federal financial participation would become available by doing so.(2) For the 200607 state fiscal year, a fee shall not be assessed or collected pursuant to this section from any general acute care hospital owned by a health care district with 100 beds or less.(j) The Licensing and Certification Program may change annual license expiration renewal dates to provide for efficiencies in operational processes or to provide for sufficient cashflow to pay for expenditures. If an annual license expiration date is changed, the renewal fee shall be prorated accordingly. Facilities shall be provided with a 60-day notice of any change in their annual license renewal date.(k) Commencing with the 201819 November Program estimate, the Licensing and Certification Program shall evaluate the feasibility of reducing investigation timelines based on experience with implementing paragraphs (3), (4), and (5) of subdivision (a) of Section 1420.(l) Commencing January 1, 2020, the department shall assess a supplemental license fee on licensed chronic dialysis clinics in an amount not to exceed the reasonable cost to the department to conduct the inspections of those clinics that are subject to the fee in accordance with Section 1228.5. This supplemental license fee shall be in addition to the license fees set forth in subdivision (d). |
|---|
| 2 | 2 | | |
|---|
| 3 | 3 | | CALIFORNIA LEGISLATURE 20192020 REGULAR SESSION Assembly Bill No. 1448Introduced by Assembly Member GrayFebruary 22, 2019 An act to amend Section 1266 of, and to add Section 1228.5 to, the Health and Safety Code, relating to dialysis. LEGISLATIVE COUNSEL'S DIGESTAB 1448, as introduced, Gray. Dialysis Patient Quality of Care Assurance Act of 2019.Existing law requires the State Department of Public Health to license and regulate chronic dialysis clinics, defined as a clinic that provides less than 24-hour care for the treatment of patients with end-stage renal disease, including renal dialysis services. Existing law also requires the department to periodically inspect every clinic for which a license or special permit has been issued, with the frequency to be determined based on the type and complexity of the clinic or special service to be inspected. Existing law makes this provision inapplicable to an end-stage renal disease facility. Existing law makes a person who violates a law or willfully or repeatedly violates a rule or regulation promulgated pursuant to these clinics guilty of a crime.This bill would require the department to inspect each licensed chronic dialysis clinic that receives a one- or 2-star quality rating as determined by the federal Centers for Medicare and Medicaid Services under the Five-Star Quality Rating System at least once per calendar year, until the clinic attains at least a 3-star rating. The bill would also require the department to conduct any additional inspection that the department deems necessary to ensure the continuation of high quality medical care for dialysis patients. The bill would require the department, commencing January 1, 2020, to assess a supplemental license fee on licensed chronic dialysis clinics in an amount not to exceed the reasonable cost to the department to conduct the inspections. The bill would name the act the Dialysis Patient Quality of Care Assurance Act of 2019.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO |
|---|
| 4 | 4 | | |
|---|
| 5 | 5 | | |
|---|
| 6 | 6 | | |
|---|
| 7 | 7 | | |
|---|
| 8 | 8 | | |
|---|
| 9 | 9 | | CALIFORNIA LEGISLATURE 20192020 REGULAR SESSION |
|---|
| 10 | 10 | | |
|---|
| 11 | 11 | | Assembly Bill No. 1448 |
|---|
| 12 | 12 | | |
|---|
| 13 | 13 | | Introduced by Assembly Member GrayFebruary 22, 2019 |
|---|
| 14 | 14 | | |
|---|
| 15 | 15 | | Introduced by Assembly Member Gray |
|---|
| 16 | 16 | | February 22, 2019 |
|---|
| 17 | 17 | | |
|---|
| 18 | 18 | | An act to amend Section 1266 of, and to add Section 1228.5 to, the Health and Safety Code, relating to dialysis. |
|---|
| 19 | 19 | | |
|---|
| 20 | 20 | | LEGISLATIVE COUNSEL'S DIGEST |
|---|
| 21 | 21 | | |
|---|
| 22 | 22 | | ## LEGISLATIVE COUNSEL'S DIGEST |
|---|
| 23 | 23 | | |
|---|
| 24 | 24 | | AB 1448, as introduced, Gray. Dialysis Patient Quality of Care Assurance Act of 2019. |
|---|
| 25 | 25 | | |
|---|
| 26 | 26 | | Existing law requires the State Department of Public Health to license and regulate chronic dialysis clinics, defined as a clinic that provides less than 24-hour care for the treatment of patients with end-stage renal disease, including renal dialysis services. Existing law also requires the department to periodically inspect every clinic for which a license or special permit has been issued, with the frequency to be determined based on the type and complexity of the clinic or special service to be inspected. Existing law makes this provision inapplicable to an end-stage renal disease facility. Existing law makes a person who violates a law or willfully or repeatedly violates a rule or regulation promulgated pursuant to these clinics guilty of a crime.This bill would require the department to inspect each licensed chronic dialysis clinic that receives a one- or 2-star quality rating as determined by the federal Centers for Medicare and Medicaid Services under the Five-Star Quality Rating System at least once per calendar year, until the clinic attains at least a 3-star rating. The bill would also require the department to conduct any additional inspection that the department deems necessary to ensure the continuation of high quality medical care for dialysis patients. The bill would require the department, commencing January 1, 2020, to assess a supplemental license fee on licensed chronic dialysis clinics in an amount not to exceed the reasonable cost to the department to conduct the inspections. The bill would name the act the Dialysis Patient Quality of Care Assurance Act of 2019. |
|---|
| 27 | 27 | | |
|---|
| 28 | 28 | | Existing law requires the State Department of Public Health to license and regulate chronic dialysis clinics, defined as a clinic that provides less than 24-hour care for the treatment of patients with end-stage renal disease, including renal dialysis services. Existing law also requires the department to periodically inspect every clinic for which a license or special permit has been issued, with the frequency to be determined based on the type and complexity of the clinic or special service to be inspected. Existing law makes this provision inapplicable to an end-stage renal disease facility. Existing law makes a person who violates a law or willfully or repeatedly violates a rule or regulation promulgated pursuant to these clinics guilty of a crime. |
|---|
| 29 | 29 | | |
|---|
| 30 | 30 | | This bill would require the department to inspect each licensed chronic dialysis clinic that receives a one- or 2-star quality rating as determined by the federal Centers for Medicare and Medicaid Services under the Five-Star Quality Rating System at least once per calendar year, until the clinic attains at least a 3-star rating. The bill would also require the department to conduct any additional inspection that the department deems necessary to ensure the continuation of high quality medical care for dialysis patients. The bill would require the department, commencing January 1, 2020, to assess a supplemental license fee on licensed chronic dialysis clinics in an amount not to exceed the reasonable cost to the department to conduct the inspections. The bill would name the act the Dialysis Patient Quality of Care Assurance Act of 2019. |
|---|
| 31 | 31 | | |
|---|
| 32 | 32 | | ## Digest Key |
|---|
| 33 | 33 | | |
|---|
| 34 | 34 | | ## Bill Text |
|---|
| 35 | 35 | | |
|---|
| 36 | 36 | | The people of the State of California do enact as follows:SECTION 1. This act shall be known, and may be cited as, the Dialysis Patient Quality of Care Assurance Act of 2019.SEC. 2. Section 1228.5 is added to the Health and Safety Code, to read:1228.5. (a) (1) The department shall inspect each licensed chronic dialysis clinic that receives a one- or two-star quality rating as determined by the federal Centers for Medicare and Medicaid Services (CMS) under the Five-Star Quality Rating System at least once per calendar year, until the clinic attains at least a three-star rating.(2) The department shall conduct, in addition to the annual inspection required by paragraph (1), any additional inspection of a licensed chronic dialysis clinic that the department deems necessary to ensure the continuation of high quality medical care for dialysis patients.(3) The inspections described in paragraphs (1) and (2) shall review clinic compliance with the CMS Conditions for Coverage.(b) Pursuant to subdivision (l) of Section 1266, the costs for the department to comply with the requirements of this section shall be funded by a supplemental license fee paid by all licensed chronic dialysis clinics and dedicated to fund the reasonable regulatory costs to the department incident to performing these investigations and any resulting administrative enforcement and adjudication.SEC. 3. Section 1266 of the Health and Safety Code is amended to read:1266. (a) The Licensing and Certification Division shall be supported entirely by federal funds and special funds by no earlier than the beginning of the 200910 fiscal year unless otherwise specified in statute, or unless funds are specifically appropriated from the General Fund in the annual Budget Act or other enacted legislation. For the 200708 fiscal year, General Fund support shall be provided to offset licensing and certification fees in an amount of not less than two million seven hundred eighty-two thousand dollars ($2,782,000).(b) (1) The Licensing and Certification Program fees for the 200607 fiscal year shall be as follows:Type of FacilityFeeGeneral Acute Care Hospitals$134.10per bedAcute Psychiatric Hospitals$134.10per bedSpecial Hospitals$134.10per bedChemical Dependency Recovery Hospitals$123.52per bedSkilled Nursing Facilities$202.96per bedIntermediate Care Facilities$202.96per bedIntermediate Care Facilities- Developmentally Disabled$592.29per bedIntermediate Care Facilities- Developmentally Disabled-Habilitative$1,000.00per facilityIntermediate Care Facilities- Developmentally Disabled-Nursing$1,000.00per facilityHome Health Agencies$2,700.00per facilityReferral Agencies$5,537.71per facilityAdult Day Health Centers$4,650.02per facilityCongregate Living Health Facilities$202.96per bedPsychology Clinics$600.00per facilityPrimary Clinics- Community and Free$600.00per facilitySpecialty Clinics- Rehab Clinics(For profit)$2,974.43per facility(Nonprofit)$500.00per facilitySpecialty Clinics- Surgical and Chronic$1,500.00per facilityDialysis Clinics$1,500.00per facilityPediatric Day Health/Respite Care$142.43per bedAlternative Birthing Centers$2,437.86per facilityHospice$1,000.00per providerCorrectional Treatment Centers$590.39per bed(2) (A) In the first year of licensure for intermediate care facility/developmentally disabled-continuous nursing (ICF/DD-CN) facilities, the licensure fee for those facilities shall be equivalent to the licensure fee for intermediate care facility/developmentally disabled-nursing facilities during the same year. Thereafter, the licensure fee for ICF/DD-CN facilities shall be established pursuant to the same procedures described in this section.(B) In the first year of licensure for hospice facilities, the licensure fee shall be equivalent to the licensure fee for congregate living health facilities during the same year. Thereafter, the licensure fee for hospice facilities shall be established pursuant to the same procedures described in this section.(c) Commencing in the 201516 fiscal year, the fees for skilled nursing facilities shall be increased so as to generate four hundred thousand dollars ($400,000) for the California Department of Agings Long-Term Care Ombudsman Program for its work related to investigating complaints made against skilled nursing facilities and increasing visits to those facilities.(d) Commencing February 1, 2007, and every February 1 thereafter, the department shall publish a list of estimated fees pursuant to this section. The calculation of estimated fees and the publication of the report and list of estimated fees shall not be subject to the rulemaking requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.(e) Notwithstanding Section 10231.5 of the Government Code, by February 1 of each year, the department shall prepare the following reports and shall make those reports, and the list of estimated fees required to be published pursuant to subdivision (d), available to the public by submitting them to the Legislature and posting them on the departments Internet Web site: internet website:(1) A report of all costs for activities of the Licensing and Certification Program. At a minimum, this report shall include a narrative of all baseline adjustments and their calculations, a description of how each category of facility was calculated, descriptions of assumptions used in any calculations, and shall recommend Licensing and Certification Program fees in accordance with the following:(A) Projected workload and costs shall be grouped for each fee category, including workload costs for facility categories that have been established by statute and for which licensing regulations and procedures are under development.(B) Cost estimates, and the estimated fees, shall be based on the appropriation amounts in the Governors proposed budget for the next fiscal year, with and without policy adjustments to the fee methodology.(C) The allocation of program, operational, and administrative overhead, and indirect costs to fee categories shall be based on generally accepted cost allocation methods. Significant items of costs shall be directly charged to fee categories if the expenses can be reasonably identified to the fee category that caused them. Indirect and overhead costs shall be allocated to all fee categories using a generally accepted cost allocation method.(D) The amount of federal funds and General Fund moneys to be received in the budget year shall be estimated and allocated to each fee category based upon an appropriate metric.(E) The fee for each category shall be determined by dividing the aggregate state share of all costs for the Licensing and Certification Program by the appropriate metric for the category of licensure. Amounts actually received for new licensure applications, including change of ownership applications, and late payment penalties, pursuant to Section 1266.5, during each fiscal year shall be calculated and 95 percent shall be applied to the appropriate fee categories in determining Licensing and Certification Program fees for the second fiscal year following receipt of those funds. The remaining 5 percent shall be retained in the fund as a reserve until appropriated.(2) (A) A staffing and systems analysis to ensure efficient and effective utilization of fees collected, proper allocation of departmental resources to licensing and certification activities, survey schedules, complaint investigations, enforcement and appeal activities, data collection and dissemination, surveyor training, and policy development.(B) The analysis under this paragraph shall be made available to interested persons and shall include all of the following:(i) The number of surveyors and administrative support personnel devoted to the licensing and certification of health care facilities.(ii) The percentage of time devoted to licensing and certification activities for the various types of health facilities.(iii) The number of facilities receiving full surveys and the frequency and number of followup visits.(iv) The number and timeliness of complaint investigations, including data on the departments compliance with the requirements of paragraphs (3), (4), and (5) of subdivision (a) of Section 1420.(v) Data on deficiencies and citations issued, and numbers of citation review conferences and arbitration hearings.(vi) Other applicable activities of the licensing and certification division.(3) The annual program fee report described in subdivision (d) of Section 1416.36.(f) The reports required pursuant to subdivision (e) shall be submitted in compliance with Section 9795 of the Government Code.(g) Commencing in the 201819 fiscal year, the department may assess a supplemental license fee on facilities located in the County of Los Angeles for all facility types set forth in this section. This supplemental license fee shall be in addition to the license fees set forth in subdivision (d). The department shall calculate the supplemental license fee based upon the difference between the estimated costs of regulating facility types licensed in the County of Los Angeles, including, but not limited to, the costs associated with the departments contract for licensing and certification activities with the County of Los Angeles and the costs of the department conducting the licensing and certification activities for facilities located in the County of Los Angeles. The supplemental license fees shall be used to cover the costs to administer and enforce state licensure standards and other federal compliance activities for facilities located in the County of Los Angeles, as described in the annual report. The supplemental license fee shall be based upon the fee methodology published in the annual report described in subdivision (d).(h) (1) The department shall adjust the list of estimated fees published pursuant to subdivision (d) if the annual Budget Act or other enacted legislation includes an appropriation that differs from those proposed in the Governors proposed budget for that fiscal year.(2) The department shall publish a final fee list, with an explanation of any adjustment, by the issuance of an all facilities letter, by posting the list on the departments Internet Web site, internet website, and by including the final fee list as part of the licensing application package, within 14 days of the enactment of the annual Budget Act. The adjustment of fees and the publication of the final fee list shall not be subject to the rulemaking requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.(i) (1) Fees shall not be assessed or collected pursuant to this section from any state department, authority, bureau, commission, or officer, unless federal financial participation would become available by doing so and an appropriation is included in the annual Budget Act for that state department, authority, bureau, commission, or officer for this purpose. Fees shall not be assessed or collected pursuant to this section from any clinic that is certified only by the federal government and is exempt from licensure under Section 1206, unless federal financial participation would become available by doing so.(2) For the 200607 state fiscal year, a fee shall not be assessed or collected pursuant to this section from any general acute care hospital owned by a health care district with 100 beds or less.(j) The Licensing and Certification Program may change annual license expiration renewal dates to provide for efficiencies in operational processes or to provide for sufficient cashflow to pay for expenditures. If an annual license expiration date is changed, the renewal fee shall be prorated accordingly. Facilities shall be provided with a 60-day notice of any change in their annual license renewal date.(k) Commencing with the 201819 November Program estimate, the Licensing and Certification Program shall evaluate the feasibility of reducing investigation timelines based on experience with implementing paragraphs (3), (4), and (5) of subdivision (a) of Section 1420.(l) Commencing January 1, 2020, the department shall assess a supplemental license fee on licensed chronic dialysis clinics in an amount not to exceed the reasonable cost to the department to conduct the inspections of those clinics that are subject to the fee in accordance with Section 1228.5. This supplemental license fee shall be in addition to the license fees set forth in subdivision (d). |
|---|
| 37 | 37 | | |
|---|
| 38 | 38 | | The people of the State of California do enact as follows: |
|---|
| 39 | 39 | | |
|---|
| 40 | 40 | | ## The people of the State of California do enact as follows: |
|---|
| 41 | 41 | | |
|---|
| 42 | 42 | | SECTION 1. This act shall be known, and may be cited as, the Dialysis Patient Quality of Care Assurance Act of 2019. |
|---|
| 43 | 43 | | |
|---|
| 44 | 44 | | SECTION 1. This act shall be known, and may be cited as, the Dialysis Patient Quality of Care Assurance Act of 2019. |
|---|
| 45 | 45 | | |
|---|
| 46 | 46 | | SECTION 1. This act shall be known, and may be cited as, the Dialysis Patient Quality of Care Assurance Act of 2019. |
|---|
| 47 | 47 | | |
|---|
| 48 | 48 | | ### SECTION 1. |
|---|
| 49 | 49 | | |
|---|
| 50 | 50 | | SEC. 2. Section 1228.5 is added to the Health and Safety Code, to read:1228.5. (a) (1) The department shall inspect each licensed chronic dialysis clinic that receives a one- or two-star quality rating as determined by the federal Centers for Medicare and Medicaid Services (CMS) under the Five-Star Quality Rating System at least once per calendar year, until the clinic attains at least a three-star rating.(2) The department shall conduct, in addition to the annual inspection required by paragraph (1), any additional inspection of a licensed chronic dialysis clinic that the department deems necessary to ensure the continuation of high quality medical care for dialysis patients.(3) The inspections described in paragraphs (1) and (2) shall review clinic compliance with the CMS Conditions for Coverage.(b) Pursuant to subdivision (l) of Section 1266, the costs for the department to comply with the requirements of this section shall be funded by a supplemental license fee paid by all licensed chronic dialysis clinics and dedicated to fund the reasonable regulatory costs to the department incident to performing these investigations and any resulting administrative enforcement and adjudication. |
|---|
| 51 | 51 | | |
|---|
| 52 | 52 | | SEC. 2. Section 1228.5 is added to the Health and Safety Code, to read: |
|---|
| 53 | 53 | | |
|---|
| 54 | 54 | | ### SEC. 2. |
|---|
| 55 | 55 | | |
|---|
| 56 | 56 | | 1228.5. (a) (1) The department shall inspect each licensed chronic dialysis clinic that receives a one- or two-star quality rating as determined by the federal Centers for Medicare and Medicaid Services (CMS) under the Five-Star Quality Rating System at least once per calendar year, until the clinic attains at least a three-star rating.(2) The department shall conduct, in addition to the annual inspection required by paragraph (1), any additional inspection of a licensed chronic dialysis clinic that the department deems necessary to ensure the continuation of high quality medical care for dialysis patients.(3) The inspections described in paragraphs (1) and (2) shall review clinic compliance with the CMS Conditions for Coverage.(b) Pursuant to subdivision (l) of Section 1266, the costs for the department to comply with the requirements of this section shall be funded by a supplemental license fee paid by all licensed chronic dialysis clinics and dedicated to fund the reasonable regulatory costs to the department incident to performing these investigations and any resulting administrative enforcement and adjudication. |
|---|
| 57 | 57 | | |
|---|
| 58 | 58 | | 1228.5. (a) (1) The department shall inspect each licensed chronic dialysis clinic that receives a one- or two-star quality rating as determined by the federal Centers for Medicare and Medicaid Services (CMS) under the Five-Star Quality Rating System at least once per calendar year, until the clinic attains at least a three-star rating.(2) The department shall conduct, in addition to the annual inspection required by paragraph (1), any additional inspection of a licensed chronic dialysis clinic that the department deems necessary to ensure the continuation of high quality medical care for dialysis patients.(3) The inspections described in paragraphs (1) and (2) shall review clinic compliance with the CMS Conditions for Coverage.(b) Pursuant to subdivision (l) of Section 1266, the costs for the department to comply with the requirements of this section shall be funded by a supplemental license fee paid by all licensed chronic dialysis clinics and dedicated to fund the reasonable regulatory costs to the department incident to performing these investigations and any resulting administrative enforcement and adjudication. |
|---|
| 59 | 59 | | |
|---|
| 60 | 60 | | 1228.5. (a) (1) The department shall inspect each licensed chronic dialysis clinic that receives a one- or two-star quality rating as determined by the federal Centers for Medicare and Medicaid Services (CMS) under the Five-Star Quality Rating System at least once per calendar year, until the clinic attains at least a three-star rating.(2) The department shall conduct, in addition to the annual inspection required by paragraph (1), any additional inspection of a licensed chronic dialysis clinic that the department deems necessary to ensure the continuation of high quality medical care for dialysis patients.(3) The inspections described in paragraphs (1) and (2) shall review clinic compliance with the CMS Conditions for Coverage.(b) Pursuant to subdivision (l) of Section 1266, the costs for the department to comply with the requirements of this section shall be funded by a supplemental license fee paid by all licensed chronic dialysis clinics and dedicated to fund the reasonable regulatory costs to the department incident to performing these investigations and any resulting administrative enforcement and adjudication. |
|---|
| 61 | 61 | | |
|---|
| 62 | 62 | | |
|---|
| 63 | 63 | | |
|---|
| 64 | 64 | | 1228.5. (a) (1) The department shall inspect each licensed chronic dialysis clinic that receives a one- or two-star quality rating as determined by the federal Centers for Medicare and Medicaid Services (CMS) under the Five-Star Quality Rating System at least once per calendar year, until the clinic attains at least a three-star rating. |
|---|
| 65 | 65 | | |
|---|
| 66 | 66 | | (2) The department shall conduct, in addition to the annual inspection required by paragraph (1), any additional inspection of a licensed chronic dialysis clinic that the department deems necessary to ensure the continuation of high quality medical care for dialysis patients. |
|---|
| 67 | 67 | | |
|---|
| 68 | 68 | | (3) The inspections described in paragraphs (1) and (2) shall review clinic compliance with the CMS Conditions for Coverage. |
|---|
| 69 | 69 | | |
|---|
| 70 | 70 | | (b) Pursuant to subdivision (l) of Section 1266, the costs for the department to comply with the requirements of this section shall be funded by a supplemental license fee paid by all licensed chronic dialysis clinics and dedicated to fund the reasonable regulatory costs to the department incident to performing these investigations and any resulting administrative enforcement and adjudication. |
|---|
| 71 | 71 | | |
|---|
| 72 | 72 | | SEC. 3. Section 1266 of the Health and Safety Code is amended to read:1266. (a) The Licensing and Certification Division shall be supported entirely by federal funds and special funds by no earlier than the beginning of the 200910 fiscal year unless otherwise specified in statute, or unless funds are specifically appropriated from the General Fund in the annual Budget Act or other enacted legislation. For the 200708 fiscal year, General Fund support shall be provided to offset licensing and certification fees in an amount of not less than two million seven hundred eighty-two thousand dollars ($2,782,000).(b) (1) The Licensing and Certification Program fees for the 200607 fiscal year shall be as follows:Type of FacilityFeeGeneral Acute Care Hospitals$134.10per bedAcute Psychiatric Hospitals$134.10per bedSpecial Hospitals$134.10per bedChemical Dependency Recovery Hospitals$123.52per bedSkilled Nursing Facilities$202.96per bedIntermediate Care Facilities$202.96per bedIntermediate Care Facilities- Developmentally Disabled$592.29per bedIntermediate Care Facilities- Developmentally Disabled-Habilitative$1,000.00per facilityIntermediate Care Facilities- Developmentally Disabled-Nursing$1,000.00per facilityHome Health Agencies$2,700.00per facilityReferral Agencies$5,537.71per facilityAdult Day Health Centers$4,650.02per facilityCongregate Living Health Facilities$202.96per bedPsychology Clinics$600.00per facilityPrimary Clinics- Community and Free$600.00per facilitySpecialty Clinics- Rehab Clinics(For profit)$2,974.43per facility(Nonprofit)$500.00per facilitySpecialty Clinics- Surgical and Chronic$1,500.00per facilityDialysis Clinics$1,500.00per facilityPediatric Day Health/Respite Care$142.43per bedAlternative Birthing Centers$2,437.86per facilityHospice$1,000.00per providerCorrectional Treatment Centers$590.39per bed(2) (A) In the first year of licensure for intermediate care facility/developmentally disabled-continuous nursing (ICF/DD-CN) facilities, the licensure fee for those facilities shall be equivalent to the licensure fee for intermediate care facility/developmentally disabled-nursing facilities during the same year. Thereafter, the licensure fee for ICF/DD-CN facilities shall be established pursuant to the same procedures described in this section.(B) In the first year of licensure for hospice facilities, the licensure fee shall be equivalent to the licensure fee for congregate living health facilities during the same year. Thereafter, the licensure fee for hospice facilities shall be established pursuant to the same procedures described in this section.(c) Commencing in the 201516 fiscal year, the fees for skilled nursing facilities shall be increased so as to generate four hundred thousand dollars ($400,000) for the California Department of Agings Long-Term Care Ombudsman Program for its work related to investigating complaints made against skilled nursing facilities and increasing visits to those facilities.(d) Commencing February 1, 2007, and every February 1 thereafter, the department shall publish a list of estimated fees pursuant to this section. The calculation of estimated fees and the publication of the report and list of estimated fees shall not be subject to the rulemaking requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.(e) Notwithstanding Section 10231.5 of the Government Code, by February 1 of each year, the department shall prepare the following reports and shall make those reports, and the list of estimated fees required to be published pursuant to subdivision (d), available to the public by submitting them to the Legislature and posting them on the departments Internet Web site: internet website:(1) A report of all costs for activities of the Licensing and Certification Program. At a minimum, this report shall include a narrative of all baseline adjustments and their calculations, a description of how each category of facility was calculated, descriptions of assumptions used in any calculations, and shall recommend Licensing and Certification Program fees in accordance with the following:(A) Projected workload and costs shall be grouped for each fee category, including workload costs for facility categories that have been established by statute and for which licensing regulations and procedures are under development.(B) Cost estimates, and the estimated fees, shall be based on the appropriation amounts in the Governors proposed budget for the next fiscal year, with and without policy adjustments to the fee methodology.(C) The allocation of program, operational, and administrative overhead, and indirect costs to fee categories shall be based on generally accepted cost allocation methods. Significant items of costs shall be directly charged to fee categories if the expenses can be reasonably identified to the fee category that caused them. Indirect and overhead costs shall be allocated to all fee categories using a generally accepted cost allocation method.(D) The amount of federal funds and General Fund moneys to be received in the budget year shall be estimated and allocated to each fee category based upon an appropriate metric.(E) The fee for each category shall be determined by dividing the aggregate state share of all costs for the Licensing and Certification Program by the appropriate metric for the category of licensure. Amounts actually received for new licensure applications, including change of ownership applications, and late payment penalties, pursuant to Section 1266.5, during each fiscal year shall be calculated and 95 percent shall be applied to the appropriate fee categories in determining Licensing and Certification Program fees for the second fiscal year following receipt of those funds. The remaining 5 percent shall be retained in the fund as a reserve until appropriated.(2) (A) A staffing and systems analysis to ensure efficient and effective utilization of fees collected, proper allocation of departmental resources to licensing and certification activities, survey schedules, complaint investigations, enforcement and appeal activities, data collection and dissemination, surveyor training, and policy development.(B) The analysis under this paragraph shall be made available to interested persons and shall include all of the following:(i) The number of surveyors and administrative support personnel devoted to the licensing and certification of health care facilities.(ii) The percentage of time devoted to licensing and certification activities for the various types of health facilities.(iii) The number of facilities receiving full surveys and the frequency and number of followup visits.(iv) The number and timeliness of complaint investigations, including data on the departments compliance with the requirements of paragraphs (3), (4), and (5) of subdivision (a) of Section 1420.(v) Data on deficiencies and citations issued, and numbers of citation review conferences and arbitration hearings.(vi) Other applicable activities of the licensing and certification division.(3) The annual program fee report described in subdivision (d) of Section 1416.36.(f) The reports required pursuant to subdivision (e) shall be submitted in compliance with Section 9795 of the Government Code.(g) Commencing in the 201819 fiscal year, the department may assess a supplemental license fee on facilities located in the County of Los Angeles for all facility types set forth in this section. This supplemental license fee shall be in addition to the license fees set forth in subdivision (d). The department shall calculate the supplemental license fee based upon the difference between the estimated costs of regulating facility types licensed in the County of Los Angeles, including, but not limited to, the costs associated with the departments contract for licensing and certification activities with the County of Los Angeles and the costs of the department conducting the licensing and certification activities for facilities located in the County of Los Angeles. The supplemental license fees shall be used to cover the costs to administer and enforce state licensure standards and other federal compliance activities for facilities located in the County of Los Angeles, as described in the annual report. The supplemental license fee shall be based upon the fee methodology published in the annual report described in subdivision (d).(h) (1) The department shall adjust the list of estimated fees published pursuant to subdivision (d) if the annual Budget Act or other enacted legislation includes an appropriation that differs from those proposed in the Governors proposed budget for that fiscal year.(2) The department shall publish a final fee list, with an explanation of any adjustment, by the issuance of an all facilities letter, by posting the list on the departments Internet Web site, internet website, and by including the final fee list as part of the licensing application package, within 14 days of the enactment of the annual Budget Act. The adjustment of fees and the publication of the final fee list shall not be subject to the rulemaking requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.(i) (1) Fees shall not be assessed or collected pursuant to this section from any state department, authority, bureau, commission, or officer, unless federal financial participation would become available by doing so and an appropriation is included in the annual Budget Act for that state department, authority, bureau, commission, or officer for this purpose. Fees shall not be assessed or collected pursuant to this section from any clinic that is certified only by the federal government and is exempt from licensure under Section 1206, unless federal financial participation would become available by doing so.(2) For the 200607 state fiscal year, a fee shall not be assessed or collected pursuant to this section from any general acute care hospital owned by a health care district with 100 beds or less.(j) The Licensing and Certification Program may change annual license expiration renewal dates to provide for efficiencies in operational processes or to provide for sufficient cashflow to pay for expenditures. If an annual license expiration date is changed, the renewal fee shall be prorated accordingly. Facilities shall be provided with a 60-day notice of any change in their annual license renewal date.(k) Commencing with the 201819 November Program estimate, the Licensing and Certification Program shall evaluate the feasibility of reducing investigation timelines based on experience with implementing paragraphs (3), (4), and (5) of subdivision (a) of Section 1420.(l) Commencing January 1, 2020, the department shall assess a supplemental license fee on licensed chronic dialysis clinics in an amount not to exceed the reasonable cost to the department to conduct the inspections of those clinics that are subject to the fee in accordance with Section 1228.5. This supplemental license fee shall be in addition to the license fees set forth in subdivision (d). |
|---|
| 73 | 73 | | |
|---|
| 74 | 74 | | SEC. 3. Section 1266 of the Health and Safety Code is amended to read: |
|---|
| 75 | 75 | | |
|---|
| 76 | 76 | | ### SEC. 3. |
|---|
| 77 | 77 | | |
|---|
| 78 | 78 | | 1266. (a) The Licensing and Certification Division shall be supported entirely by federal funds and special funds by no earlier than the beginning of the 200910 fiscal year unless otherwise specified in statute, or unless funds are specifically appropriated from the General Fund in the annual Budget Act or other enacted legislation. For the 200708 fiscal year, General Fund support shall be provided to offset licensing and certification fees in an amount of not less than two million seven hundred eighty-two thousand dollars ($2,782,000).(b) (1) The Licensing and Certification Program fees for the 200607 fiscal year shall be as follows:Type of FacilityFeeGeneral Acute Care Hospitals$134.10per bedAcute Psychiatric Hospitals$134.10per bedSpecial Hospitals$134.10per bedChemical Dependency Recovery Hospitals$123.52per bedSkilled Nursing Facilities$202.96per bedIntermediate Care Facilities$202.96per bedIntermediate Care Facilities- Developmentally Disabled$592.29per bedIntermediate Care Facilities- Developmentally Disabled-Habilitative$1,000.00per facilityIntermediate Care Facilities- Developmentally Disabled-Nursing$1,000.00per facilityHome Health Agencies$2,700.00per facilityReferral Agencies$5,537.71per facilityAdult Day Health Centers$4,650.02per facilityCongregate Living Health Facilities$202.96per bedPsychology Clinics$600.00per facilityPrimary Clinics- Community and Free$600.00per facilitySpecialty Clinics- Rehab Clinics(For profit)$2,974.43per facility(Nonprofit)$500.00per facilitySpecialty Clinics- Surgical and Chronic$1,500.00per facilityDialysis Clinics$1,500.00per facilityPediatric Day Health/Respite Care$142.43per bedAlternative Birthing Centers$2,437.86per facilityHospice$1,000.00per providerCorrectional Treatment Centers$590.39per bed(2) (A) In the first year of licensure for intermediate care facility/developmentally disabled-continuous nursing (ICF/DD-CN) facilities, the licensure fee for those facilities shall be equivalent to the licensure fee for intermediate care facility/developmentally disabled-nursing facilities during the same year. Thereafter, the licensure fee for ICF/DD-CN facilities shall be established pursuant to the same procedures described in this section.(B) In the first year of licensure for hospice facilities, the licensure fee shall be equivalent to the licensure fee for congregate living health facilities during the same year. Thereafter, the licensure fee for hospice facilities shall be established pursuant to the same procedures described in this section.(c) Commencing in the 201516 fiscal year, the fees for skilled nursing facilities shall be increased so as to generate four hundred thousand dollars ($400,000) for the California Department of Agings Long-Term Care Ombudsman Program for its work related to investigating complaints made against skilled nursing facilities and increasing visits to those facilities.(d) Commencing February 1, 2007, and every February 1 thereafter, the department shall publish a list of estimated fees pursuant to this section. The calculation of estimated fees and the publication of the report and list of estimated fees shall not be subject to the rulemaking requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.(e) Notwithstanding Section 10231.5 of the Government Code, by February 1 of each year, the department shall prepare the following reports and shall make those reports, and the list of estimated fees required to be published pursuant to subdivision (d), available to the public by submitting them to the Legislature and posting them on the departments Internet Web site: internet website:(1) A report of all costs for activities of the Licensing and Certification Program. At a minimum, this report shall include a narrative of all baseline adjustments and their calculations, a description of how each category of facility was calculated, descriptions of assumptions used in any calculations, and shall recommend Licensing and Certification Program fees in accordance with the following:(A) Projected workload and costs shall be grouped for each fee category, including workload costs for facility categories that have been established by statute and for which licensing regulations and procedures are under development.(B) Cost estimates, and the estimated fees, shall be based on the appropriation amounts in the Governors proposed budget for the next fiscal year, with and without policy adjustments to the fee methodology.(C) The allocation of program, operational, and administrative overhead, and indirect costs to fee categories shall be based on generally accepted cost allocation methods. Significant items of costs shall be directly charged to fee categories if the expenses can be reasonably identified to the fee category that caused them. Indirect and overhead costs shall be allocated to all fee categories using a generally accepted cost allocation method.(D) The amount of federal funds and General Fund moneys to be received in the budget year shall be estimated and allocated to each fee category based upon an appropriate metric.(E) The fee for each category shall be determined by dividing the aggregate state share of all costs for the Licensing and Certification Program by the appropriate metric for the category of licensure. Amounts actually received for new licensure applications, including change of ownership applications, and late payment penalties, pursuant to Section 1266.5, during each fiscal year shall be calculated and 95 percent shall be applied to the appropriate fee categories in determining Licensing and Certification Program fees for the second fiscal year following receipt of those funds. The remaining 5 percent shall be retained in the fund as a reserve until appropriated.(2) (A) A staffing and systems analysis to ensure efficient and effective utilization of fees collected, proper allocation of departmental resources to licensing and certification activities, survey schedules, complaint investigations, enforcement and appeal activities, data collection and dissemination, surveyor training, and policy development.(B) The analysis under this paragraph shall be made available to interested persons and shall include all of the following:(i) The number of surveyors and administrative support personnel devoted to the licensing and certification of health care facilities.(ii) The percentage of time devoted to licensing and certification activities for the various types of health facilities.(iii) The number of facilities receiving full surveys and the frequency and number of followup visits.(iv) The number and timeliness of complaint investigations, including data on the departments compliance with the requirements of paragraphs (3), (4), and (5) of subdivision (a) of Section 1420.(v) Data on deficiencies and citations issued, and numbers of citation review conferences and arbitration hearings.(vi) Other applicable activities of the licensing and certification division.(3) The annual program fee report described in subdivision (d) of Section 1416.36.(f) The reports required pursuant to subdivision (e) shall be submitted in compliance with Section 9795 of the Government Code.(g) Commencing in the 201819 fiscal year, the department may assess a supplemental license fee on facilities located in the County of Los Angeles for all facility types set forth in this section. This supplemental license fee shall be in addition to the license fees set forth in subdivision (d). The department shall calculate the supplemental license fee based upon the difference between the estimated costs of regulating facility types licensed in the County of Los Angeles, including, but not limited to, the costs associated with the departments contract for licensing and certification activities with the County of Los Angeles and the costs of the department conducting the licensing and certification activities for facilities located in the County of Los Angeles. The supplemental license fees shall be used to cover the costs to administer and enforce state licensure standards and other federal compliance activities for facilities located in the County of Los Angeles, as described in the annual report. The supplemental license fee shall be based upon the fee methodology published in the annual report described in subdivision (d).(h) (1) The department shall adjust the list of estimated fees published pursuant to subdivision (d) if the annual Budget Act or other enacted legislation includes an appropriation that differs from those proposed in the Governors proposed budget for that fiscal year.(2) The department shall publish a final fee list, with an explanation of any adjustment, by the issuance of an all facilities letter, by posting the list on the departments Internet Web site, internet website, and by including the final fee list as part of the licensing application package, within 14 days of the enactment of the annual Budget Act. The adjustment of fees and the publication of the final fee list shall not be subject to the rulemaking requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.(i) (1) Fees shall not be assessed or collected pursuant to this section from any state department, authority, bureau, commission, or officer, unless federal financial participation would become available by doing so and an appropriation is included in the annual Budget Act for that state department, authority, bureau, commission, or officer for this purpose. Fees shall not be assessed or collected pursuant to this section from any clinic that is certified only by the federal government and is exempt from licensure under Section 1206, unless federal financial participation would become available by doing so.(2) For the 200607 state fiscal year, a fee shall not be assessed or collected pursuant to this section from any general acute care hospital owned by a health care district with 100 beds or less.(j) The Licensing and Certification Program may change annual license expiration renewal dates to provide for efficiencies in operational processes or to provide for sufficient cashflow to pay for expenditures. If an annual license expiration date is changed, the renewal fee shall be prorated accordingly. Facilities shall be provided with a 60-day notice of any change in their annual license renewal date.(k) Commencing with the 201819 November Program estimate, the Licensing and Certification Program shall evaluate the feasibility of reducing investigation timelines based on experience with implementing paragraphs (3), (4), and (5) of subdivision (a) of Section 1420.(l) Commencing January 1, 2020, the department shall assess a supplemental license fee on licensed chronic dialysis clinics in an amount not to exceed the reasonable cost to the department to conduct the inspections of those clinics that are subject to the fee in accordance with Section 1228.5. This supplemental license fee shall be in addition to the license fees set forth in subdivision (d). |
|---|
| 79 | 79 | | |
|---|
| 80 | 80 | | 1266. (a) The Licensing and Certification Division shall be supported entirely by federal funds and special funds by no earlier than the beginning of the 200910 fiscal year unless otherwise specified in statute, or unless funds are specifically appropriated from the General Fund in the annual Budget Act or other enacted legislation. For the 200708 fiscal year, General Fund support shall be provided to offset licensing and certification fees in an amount of not less than two million seven hundred eighty-two thousand dollars ($2,782,000).(b) (1) The Licensing and Certification Program fees for the 200607 fiscal year shall be as follows:Type of FacilityFeeGeneral Acute Care Hospitals$134.10per bedAcute Psychiatric Hospitals$134.10per bedSpecial Hospitals$134.10per bedChemical Dependency Recovery Hospitals$123.52per bedSkilled Nursing Facilities$202.96per bedIntermediate Care Facilities$202.96per bedIntermediate Care Facilities- Developmentally Disabled$592.29per bedIntermediate Care Facilities- Developmentally Disabled-Habilitative$1,000.00per facilityIntermediate Care Facilities- Developmentally Disabled-Nursing$1,000.00per facilityHome Health Agencies$2,700.00per facilityReferral Agencies$5,537.71per facilityAdult Day Health Centers$4,650.02per facilityCongregate Living Health Facilities$202.96per bedPsychology Clinics$600.00per facilityPrimary Clinics- Community and Free$600.00per facilitySpecialty Clinics- Rehab Clinics(For profit)$2,974.43per facility(Nonprofit)$500.00per facilitySpecialty Clinics- Surgical and Chronic$1,500.00per facilityDialysis Clinics$1,500.00per facilityPediatric Day Health/Respite Care$142.43per bedAlternative Birthing Centers$2,437.86per facilityHospice$1,000.00per providerCorrectional Treatment Centers$590.39per bed(2) (A) In the first year of licensure for intermediate care facility/developmentally disabled-continuous nursing (ICF/DD-CN) facilities, the licensure fee for those facilities shall be equivalent to the licensure fee for intermediate care facility/developmentally disabled-nursing facilities during the same year. Thereafter, the licensure fee for ICF/DD-CN facilities shall be established pursuant to the same procedures described in this section.(B) In the first year of licensure for hospice facilities, the licensure fee shall be equivalent to the licensure fee for congregate living health facilities during the same year. Thereafter, the licensure fee for hospice facilities shall be established pursuant to the same procedures described in this section.(c) Commencing in the 201516 fiscal year, the fees for skilled nursing facilities shall be increased so as to generate four hundred thousand dollars ($400,000) for the California Department of Agings Long-Term Care Ombudsman Program for its work related to investigating complaints made against skilled nursing facilities and increasing visits to those facilities.(d) Commencing February 1, 2007, and every February 1 thereafter, the department shall publish a list of estimated fees pursuant to this section. The calculation of estimated fees and the publication of the report and list of estimated fees shall not be subject to the rulemaking requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.(e) Notwithstanding Section 10231.5 of the Government Code, by February 1 of each year, the department shall prepare the following reports and shall make those reports, and the list of estimated fees required to be published pursuant to subdivision (d), available to the public by submitting them to the Legislature and posting them on the departments Internet Web site: internet website:(1) A report of all costs for activities of the Licensing and Certification Program. At a minimum, this report shall include a narrative of all baseline adjustments and their calculations, a description of how each category of facility was calculated, descriptions of assumptions used in any calculations, and shall recommend Licensing and Certification Program fees in accordance with the following:(A) Projected workload and costs shall be grouped for each fee category, including workload costs for facility categories that have been established by statute and for which licensing regulations and procedures are under development.(B) Cost estimates, and the estimated fees, shall be based on the appropriation amounts in the Governors proposed budget for the next fiscal year, with and without policy adjustments to the fee methodology.(C) The allocation of program, operational, and administrative overhead, and indirect costs to fee categories shall be based on generally accepted cost allocation methods. Significant items of costs shall be directly charged to fee categories if the expenses can be reasonably identified to the fee category that caused them. Indirect and overhead costs shall be allocated to all fee categories using a generally accepted cost allocation method.(D) The amount of federal funds and General Fund moneys to be received in the budget year shall be estimated and allocated to each fee category based upon an appropriate metric.(E) The fee for each category shall be determined by dividing the aggregate state share of all costs for the Licensing and Certification Program by the appropriate metric for the category of licensure. Amounts actually received for new licensure applications, including change of ownership applications, and late payment penalties, pursuant to Section 1266.5, during each fiscal year shall be calculated and 95 percent shall be applied to the appropriate fee categories in determining Licensing and Certification Program fees for the second fiscal year following receipt of those funds. The remaining 5 percent shall be retained in the fund as a reserve until appropriated.(2) (A) A staffing and systems analysis to ensure efficient and effective utilization of fees collected, proper allocation of departmental resources to licensing and certification activities, survey schedules, complaint investigations, enforcement and appeal activities, data collection and dissemination, surveyor training, and policy development.(B) The analysis under this paragraph shall be made available to interested persons and shall include all of the following:(i) The number of surveyors and administrative support personnel devoted to the licensing and certification of health care facilities.(ii) The percentage of time devoted to licensing and certification activities for the various types of health facilities.(iii) The number of facilities receiving full surveys and the frequency and number of followup visits.(iv) The number and timeliness of complaint investigations, including data on the departments compliance with the requirements of paragraphs (3), (4), and (5) of subdivision (a) of Section 1420.(v) Data on deficiencies and citations issued, and numbers of citation review conferences and arbitration hearings.(vi) Other applicable activities of the licensing and certification division.(3) The annual program fee report described in subdivision (d) of Section 1416.36.(f) The reports required pursuant to subdivision (e) shall be submitted in compliance with Section 9795 of the Government Code.(g) Commencing in the 201819 fiscal year, the department may assess a supplemental license fee on facilities located in the County of Los Angeles for all facility types set forth in this section. This supplemental license fee shall be in addition to the license fees set forth in subdivision (d). The department shall calculate the supplemental license fee based upon the difference between the estimated costs of regulating facility types licensed in the County of Los Angeles, including, but not limited to, the costs associated with the departments contract for licensing and certification activities with the County of Los Angeles and the costs of the department conducting the licensing and certification activities for facilities located in the County of Los Angeles. The supplemental license fees shall be used to cover the costs to administer and enforce state licensure standards and other federal compliance activities for facilities located in the County of Los Angeles, as described in the annual report. The supplemental license fee shall be based upon the fee methodology published in the annual report described in subdivision (d).(h) (1) The department shall adjust the list of estimated fees published pursuant to subdivision (d) if the annual Budget Act or other enacted legislation includes an appropriation that differs from those proposed in the Governors proposed budget for that fiscal year.(2) The department shall publish a final fee list, with an explanation of any adjustment, by the issuance of an all facilities letter, by posting the list on the departments Internet Web site, internet website, and by including the final fee list as part of the licensing application package, within 14 days of the enactment of the annual Budget Act. The adjustment of fees and the publication of the final fee list shall not be subject to the rulemaking requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.(i) (1) Fees shall not be assessed or collected pursuant to this section from any state department, authority, bureau, commission, or officer, unless federal financial participation would become available by doing so and an appropriation is included in the annual Budget Act for that state department, authority, bureau, commission, or officer for this purpose. Fees shall not be assessed or collected pursuant to this section from any clinic that is certified only by the federal government and is exempt from licensure under Section 1206, unless federal financial participation would become available by doing so.(2) For the 200607 state fiscal year, a fee shall not be assessed or collected pursuant to this section from any general acute care hospital owned by a health care district with 100 beds or less.(j) The Licensing and Certification Program may change annual license expiration renewal dates to provide for efficiencies in operational processes or to provide for sufficient cashflow to pay for expenditures. If an annual license expiration date is changed, the renewal fee shall be prorated accordingly. Facilities shall be provided with a 60-day notice of any change in their annual license renewal date.(k) Commencing with the 201819 November Program estimate, the Licensing and Certification Program shall evaluate the feasibility of reducing investigation timelines based on experience with implementing paragraphs (3), (4), and (5) of subdivision (a) of Section 1420.(l) Commencing January 1, 2020, the department shall assess a supplemental license fee on licensed chronic dialysis clinics in an amount not to exceed the reasonable cost to the department to conduct the inspections of those clinics that are subject to the fee in accordance with Section 1228.5. This supplemental license fee shall be in addition to the license fees set forth in subdivision (d). |
|---|
| 81 | 81 | | |
|---|
| 82 | 82 | | 1266. (a) The Licensing and Certification Division shall be supported entirely by federal funds and special funds by no earlier than the beginning of the 200910 fiscal year unless otherwise specified in statute, or unless funds are specifically appropriated from the General Fund in the annual Budget Act or other enacted legislation. For the 200708 fiscal year, General Fund support shall be provided to offset licensing and certification fees in an amount of not less than two million seven hundred eighty-two thousand dollars ($2,782,000).(b) (1) The Licensing and Certification Program fees for the 200607 fiscal year shall be as follows:Type of FacilityFeeGeneral Acute Care Hospitals$134.10per bedAcute Psychiatric Hospitals$134.10per bedSpecial Hospitals$134.10per bedChemical Dependency Recovery Hospitals$123.52per bedSkilled Nursing Facilities$202.96per bedIntermediate Care Facilities$202.96per bedIntermediate Care Facilities- Developmentally Disabled$592.29per bedIntermediate Care Facilities- Developmentally Disabled-Habilitative$1,000.00per facilityIntermediate Care Facilities- Developmentally Disabled-Nursing$1,000.00per facilityHome Health Agencies$2,700.00per facilityReferral Agencies$5,537.71per facilityAdult Day Health Centers$4,650.02per facilityCongregate Living Health Facilities$202.96per bedPsychology Clinics$600.00per facilityPrimary Clinics- Community and Free$600.00per facilitySpecialty Clinics- Rehab Clinics(For profit)$2,974.43per facility(Nonprofit)$500.00per facilitySpecialty Clinics- Surgical and Chronic$1,500.00per facilityDialysis Clinics$1,500.00per facilityPediatric Day Health/Respite Care$142.43per bedAlternative Birthing Centers$2,437.86per facilityHospice$1,000.00per providerCorrectional Treatment Centers$590.39per bed(2) (A) In the first year of licensure for intermediate care facility/developmentally disabled-continuous nursing (ICF/DD-CN) facilities, the licensure fee for those facilities shall be equivalent to the licensure fee for intermediate care facility/developmentally disabled-nursing facilities during the same year. Thereafter, the licensure fee for ICF/DD-CN facilities shall be established pursuant to the same procedures described in this section.(B) In the first year of licensure for hospice facilities, the licensure fee shall be equivalent to the licensure fee for congregate living health facilities during the same year. Thereafter, the licensure fee for hospice facilities shall be established pursuant to the same procedures described in this section.(c) Commencing in the 201516 fiscal year, the fees for skilled nursing facilities shall be increased so as to generate four hundred thousand dollars ($400,000) for the California Department of Agings Long-Term Care Ombudsman Program for its work related to investigating complaints made against skilled nursing facilities and increasing visits to those facilities.(d) Commencing February 1, 2007, and every February 1 thereafter, the department shall publish a list of estimated fees pursuant to this section. The calculation of estimated fees and the publication of the report and list of estimated fees shall not be subject to the rulemaking requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.(e) Notwithstanding Section 10231.5 of the Government Code, by February 1 of each year, the department shall prepare the following reports and shall make those reports, and the list of estimated fees required to be published pursuant to subdivision (d), available to the public by submitting them to the Legislature and posting them on the departments Internet Web site: internet website:(1) A report of all costs for activities of the Licensing and Certification Program. At a minimum, this report shall include a narrative of all baseline adjustments and their calculations, a description of how each category of facility was calculated, descriptions of assumptions used in any calculations, and shall recommend Licensing and Certification Program fees in accordance with the following:(A) Projected workload and costs shall be grouped for each fee category, including workload costs for facility categories that have been established by statute and for which licensing regulations and procedures are under development.(B) Cost estimates, and the estimated fees, shall be based on the appropriation amounts in the Governors proposed budget for the next fiscal year, with and without policy adjustments to the fee methodology.(C) The allocation of program, operational, and administrative overhead, and indirect costs to fee categories shall be based on generally accepted cost allocation methods. Significant items of costs shall be directly charged to fee categories if the expenses can be reasonably identified to the fee category that caused them. Indirect and overhead costs shall be allocated to all fee categories using a generally accepted cost allocation method.(D) The amount of federal funds and General Fund moneys to be received in the budget year shall be estimated and allocated to each fee category based upon an appropriate metric.(E) The fee for each category shall be determined by dividing the aggregate state share of all costs for the Licensing and Certification Program by the appropriate metric for the category of licensure. Amounts actually received for new licensure applications, including change of ownership applications, and late payment penalties, pursuant to Section 1266.5, during each fiscal year shall be calculated and 95 percent shall be applied to the appropriate fee categories in determining Licensing and Certification Program fees for the second fiscal year following receipt of those funds. The remaining 5 percent shall be retained in the fund as a reserve until appropriated.(2) (A) A staffing and systems analysis to ensure efficient and effective utilization of fees collected, proper allocation of departmental resources to licensing and certification activities, survey schedules, complaint investigations, enforcement and appeal activities, data collection and dissemination, surveyor training, and policy development.(B) The analysis under this paragraph shall be made available to interested persons and shall include all of the following:(i) The number of surveyors and administrative support personnel devoted to the licensing and certification of health care facilities.(ii) The percentage of time devoted to licensing and certification activities for the various types of health facilities.(iii) The number of facilities receiving full surveys and the frequency and number of followup visits.(iv) The number and timeliness of complaint investigations, including data on the departments compliance with the requirements of paragraphs (3), (4), and (5) of subdivision (a) of Section 1420.(v) Data on deficiencies and citations issued, and numbers of citation review conferences and arbitration hearings.(vi) Other applicable activities of the licensing and certification division.(3) The annual program fee report described in subdivision (d) of Section 1416.36.(f) The reports required pursuant to subdivision (e) shall be submitted in compliance with Section 9795 of the Government Code.(g) Commencing in the 201819 fiscal year, the department may assess a supplemental license fee on facilities located in the County of Los Angeles for all facility types set forth in this section. This supplemental license fee shall be in addition to the license fees set forth in subdivision (d). The department shall calculate the supplemental license fee based upon the difference between the estimated costs of regulating facility types licensed in the County of Los Angeles, including, but not limited to, the costs associated with the departments contract for licensing and certification activities with the County of Los Angeles and the costs of the department conducting the licensing and certification activities for facilities located in the County of Los Angeles. The supplemental license fees shall be used to cover the costs to administer and enforce state licensure standards and other federal compliance activities for facilities located in the County of Los Angeles, as described in the annual report. The supplemental license fee shall be based upon the fee methodology published in the annual report described in subdivision (d).(h) (1) The department shall adjust the list of estimated fees published pursuant to subdivision (d) if the annual Budget Act or other enacted legislation includes an appropriation that differs from those proposed in the Governors proposed budget for that fiscal year.(2) The department shall publish a final fee list, with an explanation of any adjustment, by the issuance of an all facilities letter, by posting the list on the departments Internet Web site, internet website, and by including the final fee list as part of the licensing application package, within 14 days of the enactment of the annual Budget Act. The adjustment of fees and the publication of the final fee list shall not be subject to the rulemaking requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.(i) (1) Fees shall not be assessed or collected pursuant to this section from any state department, authority, bureau, commission, or officer, unless federal financial participation would become available by doing so and an appropriation is included in the annual Budget Act for that state department, authority, bureau, commission, or officer for this purpose. Fees shall not be assessed or collected pursuant to this section from any clinic that is certified only by the federal government and is exempt from licensure under Section 1206, unless federal financial participation would become available by doing so.(2) For the 200607 state fiscal year, a fee shall not be assessed or collected pursuant to this section from any general acute care hospital owned by a health care district with 100 beds or less.(j) The Licensing and Certification Program may change annual license expiration renewal dates to provide for efficiencies in operational processes or to provide for sufficient cashflow to pay for expenditures. If an annual license expiration date is changed, the renewal fee shall be prorated accordingly. Facilities shall be provided with a 60-day notice of any change in their annual license renewal date.(k) Commencing with the 201819 November Program estimate, the Licensing and Certification Program shall evaluate the feasibility of reducing investigation timelines based on experience with implementing paragraphs (3), (4), and (5) of subdivision (a) of Section 1420.(l) Commencing January 1, 2020, the department shall assess a supplemental license fee on licensed chronic dialysis clinics in an amount not to exceed the reasonable cost to the department to conduct the inspections of those clinics that are subject to the fee in accordance with Section 1228.5. This supplemental license fee shall be in addition to the license fees set forth in subdivision (d). |
|---|
| 83 | 83 | | |
|---|
| 84 | 84 | | |
|---|
| 85 | 85 | | |
|---|
| 86 | 86 | | 1266. (a) The Licensing and Certification Division shall be supported entirely by federal funds and special funds by no earlier than the beginning of the 200910 fiscal year unless otherwise specified in statute, or unless funds are specifically appropriated from the General Fund in the annual Budget Act or other enacted legislation. For the 200708 fiscal year, General Fund support shall be provided to offset licensing and certification fees in an amount of not less than two million seven hundred eighty-two thousand dollars ($2,782,000). |
|---|
| 87 | 87 | | |
|---|
| 88 | 88 | | (b) (1) The Licensing and Certification Program fees for the 200607 fiscal year shall be as follows: |
|---|
| 89 | 89 | | |
|---|
| 90 | 90 | | Type of Facility Fee |
|---|
| 91 | 91 | | General Acute Care Hospitals $134.10 per bed |
|---|
| 92 | 92 | | Acute Psychiatric Hospitals $134.10 per bed |
|---|
| 93 | 93 | | Special Hospitals $134.10 per bed |
|---|
| 94 | 94 | | Chemical Dependency Recovery Hospitals $123.52 per bed |
|---|
| 95 | 95 | | Skilled Nursing Facilities $202.96 per bed |
|---|
| 96 | 96 | | Intermediate Care Facilities $202.96 per bed |
|---|
| 97 | 97 | | Intermediate Care Facilities- Developmentally Disabled $592.29 per bed |
|---|
| 98 | 98 | | Intermediate Care Facilities- Developmentally Disabled-Habilitative $1,000.00 per facility |
|---|
| 99 | 99 | | Intermediate Care Facilities- Developmentally Disabled-Nursing $1,000.00 per facility |
|---|
| 100 | 100 | | Home Health Agencies $2,700.00 per facility |
|---|
| 101 | 101 | | Referral Agencies $5,537.71 per facility |
|---|
| 102 | 102 | | Adult Day Health Centers $4,650.02 per facility |
|---|
| 103 | 103 | | Congregate Living Health Facilities $202.96 per bed |
|---|
| 104 | 104 | | Psychology Clinics $600.00 per facility |
|---|
| 105 | 105 | | Primary Clinics- Community and Free $600.00 per facility |
|---|
| 106 | 106 | | Specialty Clinics- Rehab Clinics(For profit) $2,974.43 per facility |
|---|
| 107 | 107 | | (Nonprofit) $500.00 per facility |
|---|
| 108 | 108 | | Specialty Clinics- Surgical and Chronic $1,500.00 per facility |
|---|
| 109 | 109 | | Dialysis Clinics $1,500.00 per facility |
|---|
| 110 | 110 | | Pediatric Day Health/Respite Care $142.43 per bed |
|---|
| 111 | 111 | | Alternative Birthing Centers $2,437.86 per facility |
|---|
| 112 | 112 | | Hospice $1,000.00 per provider |
|---|
| 113 | 113 | | Correctional Treatment Centers $590.39 per bed |
|---|
| 114 | 114 | | |
|---|
| 115 | 115 | | Type of Facility |
|---|
| 116 | 116 | | |
|---|
| 117 | 117 | | General Acute Care Hospitals |
|---|
| 118 | 118 | | |
|---|
| 119 | 119 | | $134.10 |
|---|
| 120 | 120 | | |
|---|
| 121 | 121 | | per bed |
|---|
| 122 | 122 | | |
|---|
| 123 | 123 | | Acute Psychiatric Hospitals |
|---|
| 124 | 124 | | |
|---|
| 125 | 125 | | $134.10 |
|---|
| 126 | 126 | | |
|---|
| 127 | 127 | | per bed |
|---|
| 128 | 128 | | |
|---|
| 129 | 129 | | Special Hospitals |
|---|
| 130 | 130 | | |
|---|
| 131 | 131 | | $134.10 |
|---|
| 132 | 132 | | |
|---|
| 133 | 133 | | per bed |
|---|
| 134 | 134 | | |
|---|
| 135 | 135 | | Chemical Dependency Recovery Hospitals |
|---|
| 136 | 136 | | |
|---|
| 137 | 137 | | $123.52 |
|---|
| 138 | 138 | | |
|---|
| 139 | 139 | | per bed |
|---|
| 140 | 140 | | |
|---|
| 141 | 141 | | Skilled Nursing Facilities |
|---|
| 142 | 142 | | |
|---|
| 143 | 143 | | $202.96 |
|---|
| 144 | 144 | | |
|---|
| 145 | 145 | | per bed |
|---|
| 146 | 146 | | |
|---|
| 147 | 147 | | Intermediate Care Facilities |
|---|
| 148 | 148 | | |
|---|
| 149 | 149 | | $202.96 |
|---|
| 150 | 150 | | |
|---|
| 151 | 151 | | per bed |
|---|
| 152 | 152 | | |
|---|
| 153 | 153 | | Intermediate Care Facilities- Developmentally Disabled |
|---|
| 154 | 154 | | |
|---|
| 155 | 155 | | $592.29 |
|---|
| 156 | 156 | | |
|---|
| 157 | 157 | | per bed |
|---|
| 158 | 158 | | |
|---|
| 159 | 159 | | Intermediate Care Facilities- Developmentally Disabled-Habilitative |
|---|
| 160 | 160 | | |
|---|
| 161 | 161 | | $1,000.00 |
|---|
| 162 | 162 | | |
|---|
| 163 | 163 | | per facility |
|---|
| 164 | 164 | | |
|---|
| 165 | 165 | | Intermediate Care Facilities- Developmentally Disabled-Nursing |
|---|
| 166 | 166 | | |
|---|
| 167 | 167 | | $1,000.00 |
|---|
| 168 | 168 | | |
|---|
| 169 | 169 | | per facility |
|---|
| 170 | 170 | | |
|---|
| 171 | 171 | | Home Health Agencies |
|---|
| 172 | 172 | | |
|---|
| 173 | 173 | | $2,700.00 |
|---|
| 174 | 174 | | |
|---|
| 175 | 175 | | per facility |
|---|
| 176 | 176 | | |
|---|
| 177 | 177 | | Referral Agencies |
|---|
| 178 | 178 | | |
|---|
| 179 | 179 | | $5,537.71 |
|---|
| 180 | 180 | | |
|---|
| 181 | 181 | | per facility |
|---|
| 182 | 182 | | |
|---|
| 183 | 183 | | Adult Day Health Centers |
|---|
| 184 | 184 | | |
|---|
| 185 | 185 | | $4,650.02 |
|---|
| 186 | 186 | | |
|---|
| 187 | 187 | | per facility |
|---|
| 188 | 188 | | |
|---|
| 189 | 189 | | Congregate Living Health Facilities |
|---|
| 190 | 190 | | |
|---|
| 191 | 191 | | $202.96 |
|---|
| 192 | 192 | | |
|---|
| 193 | 193 | | per bed |
|---|
| 194 | 194 | | |
|---|
| 195 | 195 | | Psychology Clinics |
|---|
| 196 | 196 | | |
|---|
| 197 | 197 | | $600.00 |
|---|
| 198 | 198 | | |
|---|
| 199 | 199 | | per facility |
|---|
| 200 | 200 | | |
|---|
| 201 | 201 | | Primary Clinics- Community and Free |
|---|
| 202 | 202 | | |
|---|
| 203 | 203 | | $600.00 |
|---|
| 204 | 204 | | |
|---|
| 205 | 205 | | per facility |
|---|
| 206 | 206 | | |
|---|
| 207 | 207 | | Specialty Clinics- Rehab Clinics |
|---|
| 208 | 208 | | |
|---|
| 209 | 209 | | (For profit) |
|---|
| 210 | 210 | | |
|---|
| 211 | 211 | | $2,974.43 |
|---|
| 212 | 212 | | |
|---|
| 213 | 213 | | per facility |
|---|
| 214 | 214 | | |
|---|
| 215 | 215 | | (Nonprofit) |
|---|
| 216 | 216 | | |
|---|
| 217 | 217 | | $500.00 |
|---|
| 218 | 218 | | |
|---|
| 219 | 219 | | per facility |
|---|
| 220 | 220 | | |
|---|
| 221 | 221 | | Specialty Clinics- Surgical and Chronic |
|---|
| 222 | 222 | | |
|---|
| 223 | 223 | | $1,500.00 |
|---|
| 224 | 224 | | |
|---|
| 225 | 225 | | per facility |
|---|
| 226 | 226 | | |
|---|
| 227 | 227 | | Dialysis Clinics |
|---|
| 228 | 228 | | |
|---|
| 229 | 229 | | $1,500.00 |
|---|
| 230 | 230 | | |
|---|
| 231 | 231 | | per facility |
|---|
| 232 | 232 | | |
|---|
| 233 | 233 | | Pediatric Day Health/Respite Care |
|---|
| 234 | 234 | | |
|---|
| 235 | 235 | | $142.43 |
|---|
| 236 | 236 | | |
|---|
| 237 | 237 | | per bed |
|---|
| 238 | 238 | | |
|---|
| 239 | 239 | | Alternative Birthing Centers |
|---|
| 240 | 240 | | |
|---|
| 241 | 241 | | $2,437.86 |
|---|
| 242 | 242 | | |
|---|
| 243 | 243 | | per facility |
|---|
| 244 | 244 | | |
|---|
| 245 | 245 | | Hospice |
|---|
| 246 | 246 | | |
|---|
| 247 | 247 | | $1,000.00 |
|---|
| 248 | 248 | | |
|---|
| 249 | 249 | | per provider |
|---|
| 250 | 250 | | |
|---|
| 251 | 251 | | Correctional Treatment Centers |
|---|
| 252 | 252 | | |
|---|
| 253 | 253 | | $590.39 |
|---|
| 254 | 254 | | |
|---|
| 255 | 255 | | per bed |
|---|
| 256 | 256 | | |
|---|
| 257 | 257 | | (2) (A) In the first year of licensure for intermediate care facility/developmentally disabled-continuous nursing (ICF/DD-CN) facilities, the licensure fee for those facilities shall be equivalent to the licensure fee for intermediate care facility/developmentally disabled-nursing facilities during the same year. Thereafter, the licensure fee for ICF/DD-CN facilities shall be established pursuant to the same procedures described in this section. |
|---|
| 258 | 258 | | |
|---|
| 259 | 259 | | (B) In the first year of licensure for hospice facilities, the licensure fee shall be equivalent to the licensure fee for congregate living health facilities during the same year. Thereafter, the licensure fee for hospice facilities shall be established pursuant to the same procedures described in this section. |
|---|
| 260 | 260 | | |
|---|
| 261 | 261 | | (c) Commencing in the 201516 fiscal year, the fees for skilled nursing facilities shall be increased so as to generate four hundred thousand dollars ($400,000) for the California Department of Agings Long-Term Care Ombudsman Program for its work related to investigating complaints made against skilled nursing facilities and increasing visits to those facilities. |
|---|
| 262 | 262 | | |
|---|
| 263 | 263 | | (d) Commencing February 1, 2007, and every February 1 thereafter, the department shall publish a list of estimated fees pursuant to this section. The calculation of estimated fees and the publication of the report and list of estimated fees shall not be subject to the rulemaking requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code. |
|---|
| 264 | 264 | | |
|---|
| 265 | 265 | | (e) Notwithstanding Section 10231.5 of the Government Code, by February 1 of each year, the department shall prepare the following reports and shall make those reports, and the list of estimated fees required to be published pursuant to subdivision (d), available to the public by submitting them to the Legislature and posting them on the departments Internet Web site: internet website: |
|---|
| 266 | 266 | | |
|---|
| 267 | 267 | | (1) A report of all costs for activities of the Licensing and Certification Program. At a minimum, this report shall include a narrative of all baseline adjustments and their calculations, a description of how each category of facility was calculated, descriptions of assumptions used in any calculations, and shall recommend Licensing and Certification Program fees in accordance with the following: |
|---|
| 268 | 268 | | |
|---|
| 269 | 269 | | (A) Projected workload and costs shall be grouped for each fee category, including workload costs for facility categories that have been established by statute and for which licensing regulations and procedures are under development. |
|---|
| 270 | 270 | | |
|---|
| 271 | 271 | | (B) Cost estimates, and the estimated fees, shall be based on the appropriation amounts in the Governors proposed budget for the next fiscal year, with and without policy adjustments to the fee methodology. |
|---|
| 272 | 272 | | |
|---|
| 273 | 273 | | (C) The allocation of program, operational, and administrative overhead, and indirect costs to fee categories shall be based on generally accepted cost allocation methods. Significant items of costs shall be directly charged to fee categories if the expenses can be reasonably identified to the fee category that caused them. Indirect and overhead costs shall be allocated to all fee categories using a generally accepted cost allocation method. |
|---|
| 274 | 274 | | |
|---|
| 275 | 275 | | (D) The amount of federal funds and General Fund moneys to be received in the budget year shall be estimated and allocated to each fee category based upon an appropriate metric. |
|---|
| 276 | 276 | | |
|---|
| 277 | 277 | | (E) The fee for each category shall be determined by dividing the aggregate state share of all costs for the Licensing and Certification Program by the appropriate metric for the category of licensure. Amounts actually received for new licensure applications, including change of ownership applications, and late payment penalties, pursuant to Section 1266.5, during each fiscal year shall be calculated and 95 percent shall be applied to the appropriate fee categories in determining Licensing and Certification Program fees for the second fiscal year following receipt of those funds. The remaining 5 percent shall be retained in the fund as a reserve until appropriated. |
|---|
| 278 | 278 | | |
|---|
| 279 | 279 | | (2) (A) A staffing and systems analysis to ensure efficient and effective utilization of fees collected, proper allocation of departmental resources to licensing and certification activities, survey schedules, complaint investigations, enforcement and appeal activities, data collection and dissemination, surveyor training, and policy development. |
|---|
| 280 | 280 | | |
|---|
| 281 | 281 | | (B) The analysis under this paragraph shall be made available to interested persons and shall include all of the following: |
|---|
| 282 | 282 | | |
|---|
| 283 | 283 | | (i) The number of surveyors and administrative support personnel devoted to the licensing and certification of health care facilities. |
|---|
| 284 | 284 | | |
|---|
| 285 | 285 | | (ii) The percentage of time devoted to licensing and certification activities for the various types of health facilities. |
|---|
| 286 | 286 | | |
|---|
| 287 | 287 | | (iii) The number of facilities receiving full surveys and the frequency and number of followup visits. |
|---|
| 288 | 288 | | |
|---|
| 289 | 289 | | (iv) The number and timeliness of complaint investigations, including data on the departments compliance with the requirements of paragraphs (3), (4), and (5) of subdivision (a) of Section 1420. |
|---|
| 290 | 290 | | |
|---|
| 291 | 291 | | (v) Data on deficiencies and citations issued, and numbers of citation review conferences and arbitration hearings. |
|---|
| 292 | 292 | | |
|---|
| 293 | 293 | | (vi) Other applicable activities of the licensing and certification division. |
|---|
| 294 | 294 | | |
|---|
| 295 | 295 | | (3) The annual program fee report described in subdivision (d) of Section 1416.36. |
|---|
| 296 | 296 | | |
|---|
| 297 | 297 | | (f) The reports required pursuant to subdivision (e) shall be submitted in compliance with Section 9795 of the Government Code. |
|---|
| 298 | 298 | | |
|---|
| 299 | 299 | | (g) Commencing in the 201819 fiscal year, the department may assess a supplemental license fee on facilities located in the County of Los Angeles for all facility types set forth in this section. This supplemental license fee shall be in addition to the license fees set forth in subdivision (d). The department shall calculate the supplemental license fee based upon the difference between the estimated costs of regulating facility types licensed in the County of Los Angeles, including, but not limited to, the costs associated with the departments contract for licensing and certification activities with the County of Los Angeles and the costs of the department conducting the licensing and certification activities for facilities located in the County of Los Angeles. The supplemental license fees shall be used to cover the costs to administer and enforce state licensure standards and other federal compliance activities for facilities located in the County of Los Angeles, as described in the annual report. The supplemental license fee shall be based upon the fee methodology published in the annual report described in subdivision (d). |
|---|
| 300 | 300 | | |
|---|
| 301 | 301 | | (h) (1) The department shall adjust the list of estimated fees published pursuant to subdivision (d) if the annual Budget Act or other enacted legislation includes an appropriation that differs from those proposed in the Governors proposed budget for that fiscal year. |
|---|
| 302 | 302 | | |
|---|
| 303 | 303 | | (2) The department shall publish a final fee list, with an explanation of any adjustment, by the issuance of an all facilities letter, by posting the list on the departments Internet Web site, internet website, and by including the final fee list as part of the licensing application package, within 14 days of the enactment of the annual Budget Act. The adjustment of fees and the publication of the final fee list shall not be subject to the rulemaking requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code. |
|---|
| 304 | 304 | | |
|---|
| 305 | 305 | | (i) (1) Fees shall not be assessed or collected pursuant to this section from any state department, authority, bureau, commission, or officer, unless federal financial participation would become available by doing so and an appropriation is included in the annual Budget Act for that state department, authority, bureau, commission, or officer for this purpose. Fees shall not be assessed or collected pursuant to this section from any clinic that is certified only by the federal government and is exempt from licensure under Section 1206, unless federal financial participation would become available by doing so. |
|---|
| 306 | 306 | | |
|---|
| 307 | 307 | | (2) For the 200607 state fiscal year, a fee shall not be assessed or collected pursuant to this section from any general acute care hospital owned by a health care district with 100 beds or less. |
|---|
| 308 | 308 | | |
|---|
| 309 | 309 | | (j) The Licensing and Certification Program may change annual license expiration renewal dates to provide for efficiencies in operational processes or to provide for sufficient cashflow to pay for expenditures. If an annual license expiration date is changed, the renewal fee shall be prorated accordingly. Facilities shall be provided with a 60-day notice of any change in their annual license renewal date. |
|---|
| 310 | 310 | | |
|---|
| 311 | 311 | | (k) Commencing with the 201819 November Program estimate, the Licensing and Certification Program shall evaluate the feasibility of reducing investigation timelines based on experience with implementing paragraphs (3), (4), and (5) of subdivision (a) of Section 1420. |
|---|
| 312 | 312 | | |
|---|
| 313 | 313 | | (l) Commencing January 1, 2020, the department shall assess a supplemental license fee on licensed chronic dialysis clinics in an amount not to exceed the reasonable cost to the department to conduct the inspections of those clinics that are subject to the fee in accordance with Section 1228.5. This supplemental license fee shall be in addition to the license fees set forth in subdivision (d). |
|---|