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SB-1269 Safety net hospitals.(2023-2024)

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Date Published: 02/15/2024 09:00 PM
SB1269:v99#DOCUMENT


CALIFORNIA LEGISLATURE— 2023–2024 REGULAR SESSION

Senate Bill
No. 1269

Introduced by Senator Padilla
(Coauthors: Assembly Members Ramos and Blanca Rubio)

February 15, 2024

An act to add Chapter 23 (commencing with Section 26280) to Division 20 of the Health and Safety Code, relating to hospitals.


LEGISLATIVE COUNSEL'S DIGEST


SB 1269, as introduced, Padilla. Safety net hospitals.
Existing law provides for the licensure and regulation of various types of health facilities, including hospitals, by the State Department of Public Health. Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.
Existing law sets forth various provisions relating to disproportionate share hospitals (DSH), which are hospitals providing acute inpatient services to Medi-Cal beneficiaries that meet the criteria for disproportionate share status, as specified; small and rural hospitals; and critical access hospitals, as certified by the Secretary of the United States Department of Health and Human Services under the federal Medicare rural hospital flexibility program.
Existing law sets forth other provisions relating to safety net hospitals in different contexts, including among others, special health authorities and Medi-Cal reimbursement.
This bill would establish a definition for “safety net hospital” and would state the intent of the Legislature that this definition serve as a recommended definition for policymakers to elect to utilize when crafting policy aimed at focusing on or supporting those hospitals. Under the bill, the definition would not be construed as affecting existing or new references to safety net hospitals, unless future legislation or other action expressly makes reference to this definition, as specified.
Under the bill, “safety net hospital” would mean a Medicaid DSH-eligible hospital; a rural hospital, including a small and rural hospital and a critical access hospital, as specified; or a sole community hospital, as classified by the federal Centers for Medicare and Medicaid Services and in accordance with certain federal provisions.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: NO   Local Program: NO  

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


SECTION 1.

 Chapter 23 (commencing with Section 26280) is added to Division 20 of the Health and Safety Code, to read:
CHAPTER  23. Safety Net Hospitals

26280.
 (a) (1) It is the intent of the Legislature that the definition of “safety net hospital,” as set forth in subdivision (b), serve as a recommended definition for policymakers to elect to utilize when crafting policy aimed at focusing on or supporting those hospitals.
(2) The definition of “safety net hospital,” as set forth in subdivision (b), shall not be construed as amending or otherwise affecting existing or new references to, or definitions of, safety net hospitals, or variations of that term, in other laws, including statutory or regulatory provisions, or in departmental policies, programs, services, or elsewhere, unless future legislation or other action expressly makes reference to this section for purposes of those laws, policies, programs, services, or elsewhere, as applicable.
(b) For purposes of this section, “safety net hospital” means any of the following:
(1) A Medicaid Disproportionate Share Hospital (DSH)-eligible hospital, as set forth in the federal definition of DSH under Section 1886 of the federal Social Security Act (42 U.S.C. Sec. 1395ww) or its successor. “Medicaid DSH-eligible hospital” includes a designated public, nonpublic, district, children’s, or psychiatric hospital providing acute inpatient services to Medi-Cal beneficiaries that meets the criteria for disproportionate share status relating to acute inpatient services, as described in Section 14105.98 of the Welfare and Institutions Code.
(2) A rural hospital. “Rural hospital” includes the designation of “small and rural hospital” as defined in Section 124840. “Rural hospital” also includes a critical access hospital (CAH), as certified by the Secretary of the United States Department of Health and Human Services under the federal Medicare Rural Hospital Flexibility Program, and as described in Section 1250.7. For purposes of this section, a CAH shall meet any applicable federal criteria under Sections 485.610 and 485.620 of Title 42 of the Code of Federal Regulations or their successors, including, but not limited to, both of the following:
(A) Unless otherwise modified by federal law, the hospital does not exceed 25 inpatient beds for inpatient or swing-bed services.
(B) Unless otherwise modified by federal law, the hospital is located more than a 35-mile drive on primary roads from another CAH or other hospital, or, in the case of mountainous terrain or in areas with only secondary roads available, is located more than a 15-mile drive from another CAH or other hospital, or before January 1, 2006, the hospital was certified by the state as being a necessary provider of health care services to residents in the area.
(3) A sole community hospital, as classified by the federal Centers for Medicare and Medicaid Services and as set forth in the federal definition of a sole community hospital under Section 1886 of the federal Social Security Act (42 U.S.C. Sec. 1395ww) or its successor. For purposes of this section, a sole community hospital shall meet any applicable federal criteria under Section 412.92 of Title 42 of the Code of Federal Regulations or its successor, including, but not limited to, being located more than 35 miles from other like hospitals, or being located in a rural area and designated as an essential community hospital, unless otherwise modified by federal law.