BILL ANALYSIS
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|SENATE RULES COMMITTEE | AB 773|
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THIRD READING
Bill No: AB 773
Author: Lieu (D)
Amended: 6/24/09 in Senate
Vote: 21
SENATE HEALTH COMMITTEE : 8-3, 7/8/09
AYES: Alquist, Cedillo, DeSaulnier, Leno, Maldonado,
Negrete McLeod, Pavley, Wolk
NOES: Strickland, Aanestad, Cox
SENATE APPROPRIATIONS COMMITTEE : 7-5, 8/17/09
AYES: Kehoe, Hancock, Leno, Oropeza, Price, Wolk, Yee
NOES: Cox, Denham, Runner, Walters, Wyland
NO VOTE RECORDED: Corbett
ASSEMBLY FLOOR : 56-19, 6/2/09 - See last page for vote
SUBJECT : Health facilities: citations: notifications
SOURCE : Author
DIGEST : This bill requires a long-term care facility to
send a written notification to all current residents and
patients, and to the primary contacts listed n the
admission agreement of each resident and patient, of the
issuance of a citation for a Class "AA" or Class "A"
violation.
ANALYSIS :
CONTINUED
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Existing law:
1. Requires citations issued pursuant to the Long-Term
Care, Health, Safety, and Security Act of 1973 Act (the
Act) to be classified according to the nature of the
violation. The Act is enforced by the Department of
Public Health (DPH). Under existing law, long-term
health care facilities are defined to include skilled
nursing facilities, intermediate care facilities,
congregate living facilities, nursing facilities,
pediatric day health and respite facilities and the
distinct part of the hospital that provides skilled
nursing facility, intermediate care facility, or
pediatric day health and respite care facility services.
2. Defines, under the Act, Class "A" violations as
violations which DPH determines present either (1)
imminent danger that death or serious harm to the
patients or residents of the long-term health care
facility would result; or (2) substantial probability
that death or serious physical harm to patients or
residents of the long-term health care facility would
result. A Class "A" citation is subject to a civil
penalty of at least $2,000 and not more than $20,000 for
each citation.
3. Defines, under the Act, Class "AA" violations as
violations that meet the criteria for a Class "A"
violation and that DPH determines to have been a direct
proximate cause of death of a patient or resident of a
long-term health care facility. A Class "AA" citation
is subject to a civil penalty of at least $25,000 and
not more than $100,000 for each citation.
This bill requires a LTC facility to send written
notification to all current residents and patients and to
the primary contacts listed on the admission agreement of
each resident and patient of the issuance of a citation for
a Class "AA" or Class "A" violation within 30 days of
issuance of the citation. The written notice must disclose
the violation for which the citation was issued, the date
of the citation, and a telephone number or Internet Web
site address for the DPH where more information on the
citation can be accessed. If the facility fails to send
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the notification, DPH is authorized to assess an
administrative penalty of $1,000 for each day following the
end of the 30-day period.
Under this bill, DPH will be required to waive the penalty
if the facility can demonstrate that it has mailed written
notification to all current residents and patients and to
the primary contacts listed in the admission contract of
each resident and patient. DPH will be required to accept
a copy of the written notice and a copy of the list of
individuals and mailing addresses to whom the facility sent
the notification as satisfactory evidence that the facility
provided the required written notification.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
According to the Senate Appropriations Committee:
Fiscal Impact (in thousands)
Major Provisions 2009-10 2010-11
2011-12 Fund
CDPH regulations $70 $120 $0 Special*
*State Department of Public Health Licensing and
Certification Program Fund
SUPPORT : (Verified 8/19/09)
Area Agency on Aging
California Advocates for Nursing Home Reform
California Retired Teachers Association
California Therapeutic Communities
Congress of California
Disability Rights California
Professional Fiduciary Association
SEIU
OPPOSITION : (Verified 8/19/09)
California Hospital Association
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ARGUMENTS IN SUPPORT : The California Retired Teachers
Association writes in support that individuals who are in
the skilled nursing facilities (SNFs), are some of the most
vulnerable populations in California. Because they are
vulnerable, CRTA argues they need to be guaranteed they
will have appropriate care that will not result in
increasing their vulnerability, and this bill will make
SNFs more sensitive to their patients and ensure
appropriate services. The Congress of California Seniors
writes in support that continuing dangerous practices is
less likely because the facility could no longer expect to
keep their actions a secret.
ARGUMENTS IN OPPOSITION : The California Hospital
Association (CHA) writes that there are approximately 125
hospital-based SNFs in its membership, and because of the
nature of care provided in hospital-based distinct part
SNFs (DP-SNFs), the proposed written notification by mail
is impractical and unnecessary. CHA states that, as
compared to free-standing SNFs, which provide a great deal
of long-term residential care, most hospital based DP-SNFs
provide short-term transitional care with a shorter length
of stay. CHA states that given the time frames for
investigating and issuing a citation by the state and
developing communication to the primary contact and mailing
it out, it is more likely that many residents will have
already left the facility. CHA states that notifying them
of the citation serves no purpose and will create
unnecessary confusion. CHA indicates SNFs are already
subject to extensive federal and state regulation, and the
current program of oversight and sanctions provides a
robust and effective program to support the provision of
quality care in SNFs and to identify and punish instances
of non-compliance.
ASSEMBLY FLOOR :
AYES: Adams, Ammiano, Arambula, Beall, Tom Berryhill,
Blumenfield, Brownley, Buchanan, Caballero, Charles
Calderon, Carter, Chesbro, Coto, Davis, De La Torre, De
Leon, Emmerson, Eng, Evans, Feuer, Fletcher, Fong,
Fuentes, Furutani, Gaines, Gilmore, Hall, Hayashi,
Hernandez, Hill, Huffman, Jones, Krekorian, Lieu, Bonnie
Lowenthal, Ma, Mendoza, Monning, Nava, Niello, John A.
Perez, V. Manuel Perez, Portantino, Price, Ruskin, Salas,
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Saldana, Skinner, Solorio, Swanson, Torlakson, Torres,
Torrico, Tran, Yamada, Bass
NOES: Anderson, Blakeslee, Conway, Cook, DeVore, Fuller,
Garrick, Hagman, Harkey, Huber, Jeffries, Knight, Logue,
Nestande, Nielsen, Silva, Smyth, Audra Strickland,
Villines
NO VOTE RECORDED: Bill Berryhill, Block, Duvall, Galgiani,
Miller
CTW:JJA:do 8/19/09 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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