Senate Committee Rejects Care Changes

The Senate Budget Subcommittee on Health and Human Services last week voted to reject a proposal to change some nursing home and hospital regulations.

That happened before this week’s release of Gov. Jerry Brown’s new budget proposal that includes a slew of budget reductions to hospitals and nursing homes.

Hearings on the latest round of cuts — including $2.5 billion in reductions to health care programs in California — are scheduled to start today when the Assembly Budget Subcommittee on Health and Human Services holds its first budget revise hearing. According to chair Holly Mitchell (D-Los Angeles), it will be the 18th hearing of that subcommittee this year alone.

At last Thursday’s Senate subcommittee hearing, government officials proposed several ways to cut back on nursing home regulation. Debbie Rogers, deputy director of the state’s Center for Health Care Quality, said cutbacks were necessary.

“Given the state’s fiscal crisis, [we were] asked to look for ways to streamline workload and to identify efficiencies where reducing the workload would not compromise resident or patient safety,” Rogers said.

The “special fund efficiencies” included elimination of the periodic survey that identifies nursing home deficiencies, and to repeal the 45-day deadline for investigating adverse events at hospitals.

Subcommittee member Elaine Alquist (D-Santa Clara) took exception to the changes — particularly the relaxation of laws to identify nursing home deficiencies.

“Now the word ‘deficiencies’ is really interesting, isn’t it? Let’s talk about what deficiencies really mean,” Alquist said. “We’re talking about your grandmother, your son, your niece, your great-grandfather. People in nursing homes. They are dropped on the floor, they are overmedicated, they are given the wrong medication, they have bedsores from not being turned — and we relegate all of these actions to a simple word: deficiencies. I think that’s horrible.”

The proposed changes are especially egregious, Alquist said, because they don’t actually save any general fund dollars.

“And that’s just a little piece of what the governor wants to do,” Alquist said. “Another piece is repealing nursing home safety laws. And the third piece is to replace the 45-day adverse events investigation timeline with no time frame.”

‘Adverse events’ is a term used to describe unusual accidents that occur in hospitals.

“There are certain things that shouldn’t happen to you in the hospital,” Alquist said. “You shouldn’t get the wrong limb cut off. A sponge should not be left in the body … To me, 45 days was working at the outer limit of what’s reasonable … And what the administration wants to do is to eliminate the 45-day period. I think it’s important to find out in a timely fashion what really happened.”

Subcommittee chair Mark DeSaulnier (D-Concord) agreed. “I’m having a real problem with this,” DeSaulnier said. “There’s no general fund savings. We’re all open to making it work better… but the motion will be to reject it.”

The subcommittee rejected the proposal on a 2-1 vote.

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