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:  9/3/09 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 long-term care facilities to  
          post specified citations for 120 days, as specified.

           Senate Floor Amendments  of 9/3/09 delete the current  
          contents of the bill which requires notification to  
          residents and their primary contacts of a Class "A" or  
          Class "AA" citation, and instead require long-term care  
          facilities to past Class "AA" and "A" citations for 120  
          days.
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           ANALYSIS  :    Existing law defines Class "A" violations  
          which the Department of Public Health (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.

          Existing law defines Class "AA" violations as violations  
          that meet the criteria for 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.

          Existing law requires each Class "AA" and Class "A"  
          citation that has become final to be prominently posted at  
          the facility, as prescribed in DPH regulations, until the  
          violation is corrected to the satisfaction of DPH, up to a  
          maximum of 120 days.  The citation or a copy of the  
          citation must be posted in a place or paces in plain view  
          of the patients or residents in the long-term care  
          facility, persons visiting those patients or residents, and  
          persons who inquire about placement in the facility.

          This bill requires long-term care facilities to post Class  
          "AA" and "A" citations for 120 days.  This bill deletes the  
          requirement in existing law that the posting be prescribed  
          in regulations issued by DPH, and that the violations be  
          posted until the violation is corrected to the satisfaction  
          of DPH, up to a maximum of 120 days.  This bill deletes the  
          requirement in existing law that the citation become final  
          before it is required to be posted.  Additionally, the bill  
          specifies the minimum locations where the citation must be  
          posted, the paper and font size of the posting (which must  
          include the name and address of the facility) and require  
          the posting to include whether the citation is a Class AA  
          or Class A citation.


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          The bill allows the facility to post the plan of  
          correction, a statement disputing the citation, or a  
          statement showing the appeal status (or both).   
          Additionally, the facility can remove and discontinue the  
          posting if the citation is withdrawn or dismissed by DPH,  
          or is dismissed as a result of the citation review  
          conference.

          This bill requires a violation of the posting requirements  
          to constitute a Class "B" violation that is subject to a  
          civil penalty in the amount of $1,000.  Such a violation  
          will not constitute a crime.  Fines imposed under this  
          provision will be deposited in the State Health Facilities  
          Citation Penalties Account in existing law.

           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  9/4/09)

          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

           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  

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          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.

           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,  
            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  9/4/09   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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