Legislative Update: Hospice and CDPH Gearing Up for SB 294 Implementation

Originally posted on December 20, 2017

 “When can a hospice begin providing skilled services to non-hospice patients under SB 294?… How and where should a hospice submit the required paperwork?…  Is CDPH planning any education on the implementation of SB 294?…”

These are just a few of the questions that the Coalition for Compassionate Care of California (CCCC) posed to California Department of Public Health (CDPH) officials at a Dec. 18 meeting along with the California Hospice and Palliative Care Association (CHAPCA) and the California Association for Health Services at Home (CAHSAH).

Senate Bill 294 updates the hospice agency licensing statute to make clear hospice agencies can provide palliative care services to patients who are not on hospice. (Read our earlier blog posts on this bill here.)

CCCC co-sponsored SB 294 with the California Hospice and Palliative Care Association (CHAPCA).

The bill was needed because California Hospice Licensure Act permitted “preliminary” palliative care services to be provided concurrently with curative treatment to non-hospice patients, but the statute was unclear with regard to whether hospices could to provide palliative care services beyond initial consultations.

CCCC and CHAPCA worked together to successfully shepherd SB 294 through the legislature, and celebrated when the bill was signed into law in October.

In response to some concerns expressed by CDPH during the legislative process, the bill essentially creates a “pilot” to observe and measure the effects of hospice providers offering palliative care services.

The law goes into effect on January 1, 2018, and CDPH has been working hard to develop the policies, procedures, instructions and forms that hospice providers will need to take part.

All details regarding implementation of SB 294 will be spelled out in an upcoming All-Facility Letter (AFL) that CDPH will issue prior to December 31, 2017, according to Chelsea Driscoll, Chief of CDPH’s Policy and Enforcement Branch, Licensing and Certification Program.  A webinar with CDPH is also planned for broadcast in mid to late January 2018.

In the meantime, we know the following:
  • The legislation requires hospices wanting to provide palliative care services to non-hospice patients to notify CDPH of the date they intend to start providing the services and provide all necessary paperwork at least 45 days before they start offering services. According to CDPH, hospices must wait until after 1, 2018, to begin the notification process.
  • Hospice licensees will be required to submit “completed relevant portions” of form HS 200 and federal form CMS 417 related to the change of service. The AFL will identify the “relevant portions” of each form.
  • The notification and all paperwork must be submitted via U.S. mail to:
    • CDPH Licensing and Certification Program
      Centralized Applications Unit,
      P.O. Box 997377, MS 3207
      Sacramento, CA 95899-7377
  • Providers can begin the new service 45 days after submission of the necessary paperwork, even if they have received official notification of approval from CDPH.
  • The Department will not charge an application fee related to this service.
  • Participating licensees will be required to submit annual data to DPH and OSHPD on the palliative care services provided. (Details on the data and how it will be submitted will be included in the AFL.)
The new law sunsets January 1, 2022. Before that, CDPH will convene a stakeholders meeting to share data collected throughout the pilot. A decision can then be made whether to seek an extension of the law beyond 2022.