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F I S C A L I M P A C T R E P O R T



SPONSOR: Sanchez, M. DATE TYPED: 03/02/01 HB
SHORT TITLE: Acuity-Based Staffing Act SB 503/aSPAC
ANALYST: Wilson


APPROPRIATION



Appropriation Contained
Estimated Additional Impact
Recurring

or Non-Rec

Fund

Affected

FY01 FY02 FY01 FY02

$7,000.0 to $20,000.0

See Narrative

Recurring Medicaid



(Parenthesis ( ) Indicate Expenditure Decreases)



Duplicates HB710



SOURCES OF INFORMATION



Agency on Aging (AOA)

Human Services Department (HSD)

Board of Nursing (BN)

Health Policy Commission (HPC)



No Response

Department of Health (DOH)



SUMMARY

Synopsis of SPAC Amendment



SB 503/aSPAC changes the"acuity- based staffing" act to the "optimal based staffing" act. The amendment deletes the definition of" acuity-based," changes the definition of "direct care personnel,"and adds the definition of "optimal staffing". The new definition of "optimal staffing"gives the nursing homes a numerical formula to followed which is easier to interpret and gives the same benefits of care as the original bill. The amendment also moves up the starting date by one year to July 1, 2002. The rest of the bill amendment is technical.



Synopsis of Original Bill



SB 503 provides for minimum staffing requirements in nursing homes and intermediate care facilities. The bill gives DOH the authority to define and regulate staffing based on the resident level of care in nursing homes. SB 503 defines "acuity-based staffing" as assigning the number of direct care personnel per shift to meet the specific needs of the residents for health, functional and behavioral status and capacities. The direct care personnel defined in the bill are the only staff counted in the acuity based method.



Significant Issues



AOA provided the following:



HSD disagrees and reports SB 503 would be redundant. Staffing requirements for nursing facilities were incorporated into the DOH regulations for "Requirements for Long Term Care Facilities," on August 31,2000. These regulations address staffing requirements, define personnel, outline duties and responsibilities, and specify the number of personnel and staff required based on shifts and census data.



FISCAL IMPLICATIONS



The AOA estimates that SB 503 will result in an increase in Medicaid payments to nursing facilities of $7 to $20 million. HSD unofficially estimates the lower number while the industry believes that $20 million will be the actual cost.



ADMINISTRATIVE IMPLICATIONS



DOH did not respond. HSD indicated that if staffing requirements increased, the Medicaid program would recalculate rates for nursing homes based on the number of staff members in each nursing facility.



OTHER SUBSTANTIVE ISSUES





The HPC provided the following:



DW/ar