Medi-Cal: pediatric subacute care units: respiratory therapy hours

Existing law provides for the licensure and regulation of health facilities, including skilled nursing facilities, by the State Department of Public Health. Existing law also provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, pursuant to which medical benefits are provided to public assistance recipients and certain other low-income persons. Existing law requires the State Department of Health Care Services to establish a subacute care program in health facilities in order to more effectively use available Medi-Cal funding while simultaneously ensuring needed services for subacute care patients. Existing regulatory law defines a pediatric subacute care unit as an identifiable unit of a certified nursing facility licensed as a skilled nursing facility and meeting the standards for participation as a provider under the Medi-Cal program. Existing regulatory law requires pediatric subacute care units to utilize a licensed respiratory care practitioner to provide a minimum of 3.0 hours per patient day to each ventilator dependent patient and a minimum of 2.0 hours per patient day to each nonventilator dependent patient of medically necessary respiratory care services. This bill would require the State Department of Health Care Services to waive the above-described regulatory requirements and allow a pediatric subacute care unit to reduce its respiratory therapy hours by one hour per patient day, thereby reducing the required minimum numbers of hours to 2.0 hours per patient day to each ventilator dependent patient and 1.0 hour per patient day to each nonventilator dependent patient, if certain conditions are satisfied.