Medi-Cal Pay on Hold for Nursing Homes, Long-Term Care Centers

Nursing homes and other long-term care facilities in California have fallen victim to a budget stalemate in the Legislature that has forced state officials to withhold about $1.1 billion in payments until a consensus is reached. The overdue budget has left health care providers without $227 million in Medi-Cal reimbursements that the state was scheduled to make this week.

The delay could force some adult day health care centers to close, particularly small and independent facilities. Senate Republicans have raised the possibility of an emergency funding measure for health care and other vital services while negotiations continue, but with the Assembly in recess until Aug. 20, the prospects for such a move are slim.

A contingency account put in place for just this situation also proved unequal to the task. In 1998, the state created a reserve fund -- $1 billion in state money, and $1 billion in federal matching funds -- to cover Medi-Cal payments in the event of a budget gridlock.

To Sacramento's chagrin, that money already has run out. Originally intended to cover Medi-Cal provider payments for two months, the nine-year-old fund never was adjusted for inflation. As a result, the reserve held the state over for only one month.

Prior to adjourning, the Legislature took action on a number of other health care measures. Here's a summary of where things stand:

AB 398 by Assembly member Mike Feuer (D-West Hollywood) would require the Department of Health Care Services to create a consumer information service system about long-term care facilities and require all facilities to post a profile for the system (Bill Text, 7/3). The bill is before the Senate Appropriations Committee (Bill Status, 7/17).

Sen. Sheila Kuehl (D-Los Angeles) carried companion legislation (SB 535) in the Senate (Bill Text, 4/19). Kuehl's bill is before the Assembly Appropriations Committee (Bill Status, 7/11).

Feuer also introduced a measure (AB 399) that would require DHCS to complete an investigation of a complaint against a long-term care facility within 40 days (Bill Text, 6/1). The bill is before the Senate Appropriations Committee (Bill Status, 7/2).

Assembly member Mary Salas (D-Chula Vista) introduced a measure (AB 1142) that would require the Department of Public Health to identify innovative resident care models for end-of-life and palliative care and to provide information on each model to skilled nursing facilities (Bill Text, 7/17). The bill is before the Senate Appropriations Committee (Bill Status, 7/17).

SB 633 by Sen. Elaine Alquist (D-San Jose) would require hospitals to provide contact information of an agency that provides options on community-based long-term care options to discharged patients in need of such services (Bill Text, 7/10). The measure is before the Assembly Appropriations Committee (Bill Status, 7/10).