Bill Establishing CNA Staff-to-Patient Ratios Being Heard in Asm. Health Committee

A bill introduced earlier this year that would require the California Department of Public Health to develop regulations creating Certified Nursing Assistant (CNA) staff-to-patient ratios in skilled nursing facilities will be heard in the Assembly Health Committee on Tuesday, March 29th. This bill is nearly identical to last year’s SB 779 (Hall), which LeadingAge California adamantly opposed. SB 779 died in the Senate Appropriations Committee.

AB 2079, authored by Assemblymember Ian Calderon, would require that, by July 1, 2017, the California Department of Public Heath develop regulations that establish staff-to-patient ratios for CNAs in skilled nursing facilities. Furthermore, the bill would have increased the minimum number of required nursing hours per patient day from 3.2 hours to 4.1 hours, with staff-to patient ratios that reflected 2.8 hours for CNAs and 1.3 hours for licensed nurses.

Under the provisions of this bill, skilled nursing facilities would need to ensure that, at any time, CNA staff-to-patient ratios would have been no less than the following:

• During the “day shift” – a minimum of one CNA for every six patients • During the “evening shift” – a minimum of one CNA for every eight patients 
• During the “night shift” – a minimum of one CNA for every 17 patients Under the provisions of this bill, eligible skilled nursing facilities would also be disqualified from receiving their Quality and Accountability Supplemental Payment (QASP) should the facility be out of compliance with the staffing requirements in this bill for even one day. The QASP program provides additional reimbursements for eligible facilities to implement quality improvements.

During last year’s debate around SB 779, the Senate Appropriations Committee projected that the implementation of SB 779 would have annual costs of $110 million per year to $250 million per year to the General Fund – which is likely why the bill died in the fiscal committee. We expect that AB 2079 will likely generate similar costs, thus adding a significant financial burden to the General Fund.

LeadingAge California opposes AB 2079 due to the numerous concerns surrounding implementation issues, adequate workforce concerns and tying the new staffing requirements to QASP eligibility.