BILL ANALYSIS Ó
SENATE HUMAN
SERVICES COMMITTEE
Senator Carol Liu, Chair
BILL NO: AB 313
A
AUTHOR: Monning
B
VERSION: June 7, 2011
HEARING DATE: June 14, 2011
3
FISCAL: Appropriations
1
3
CONSULTANT:
Park
SUBJECT
Residential care facilities for the elderly
SUMMARY
Requires each residential care facility for the elderly
(RCFE) to provide residents, their responsible party, and
the local long-term care ombudsman (LTC Ombudsman) with a
written notice when the Department of Social Services
commences proceedings to suspend or revoke its license, or
a criminal action relating to health or safety of the
residents is brought against the facility. Makes other
changes related to these actions.
ABSTRACT
Existing law:
1.Under the Residential Care Facilities for the Elderly
Act, provides for the licensure of residential care
facilities for the elderly (RCFEs) by the Department of
Social Services (DSS), Community Care Licensing Division
(CCL).
2.Provides for a state long-term care ombudsman office
(including approved organizations) within the Department
Continued---
STAFF ANALYSIS OF ASSEMBLY BILL 313 (Monning) Page
2
of Aging to investigate and seek to resolve complaints
and concerns communicated by, or on behalf of, patients,
residents, or clients of any long-term care facility.
3.Authorizes DSS to take enforcement action, including, but
not limited to, actions to suspend, temporarily suspend,
or revoke a license and to impose civil penalties for
violations of rules and regulations established under
licensing provisions governing RCFEs.
4.Requires DSS to notify placement agencies and the Office
of the State Long-Term Care Ombudsman when DSS
substantiates that a violation has occurred that poses a
serious threat to the health and safety of any resident
when the violation results in the assessment of a penalty
or filing of an accusation for revocation of the license.
5.Requires that, prior to surrendering its license or
otherwise transferring residents to another facility or
independent living arrangement, the RCFE licensee provide
residents or their responsible person with written notice
no later than 60 days prior to the eviction, and provide
relocation assistance.
6.Requires an RCFE to place, in a conspicuous place, copies
of all DSS licensing reports issued in the preceding 12
months, and all licensing reports resulting from the most
recent annual visit, excluding any reference to a
complaint found by DSS to be unfounded or
unsubstantiated.
7.Requires written notice to a resident's responsible
person at the time of admission that licensing reports
are available for review at the facility, and that copies
of licensing reports and other documents pertaining to
the facility are available from the appropriate DSS
district office.
This bill:
1.Requires a licensed RCFE to provide written notice to
residents, the resident's responsible party, if any, and
the local LTC Ombudsman within 10 days of the occurrence
of either of the following:
STAFF ANALYSIS OF ASSEMBLY BILL 313 (Monning) Page
3
a. DSS commences proceedings to suspend or revoke
the license of the facility; or,
b. A criminal action that relates to the health or
safety of residents is brought against the facility.
2.Requires that the required notice to the resident and
resident's responsible party include contact information
for the local LTC ombudsman and for the DSS Community
Care Licensing Division (CCLD), with a statement
directing the resident or emergency contact person to
contact either the local LTC Ombudsman or CCLD for
information on the license status of the facility.
Requires the notice to also include the reason for the
initiation of suspension or revocation proceedings, or
the criminal action.
3.Requires the RCFE to post a written notice in a
conspicuous location in the facility that includes all of
the following:
a. The date of the notice;
b. The name of the RCFE;
c. A statement that a copy of the most recent
licensing report prepared by DSS, and any additional
reports of facility evaluation visits within the
preceding 12 months may be obtained at the facility;
and,
d. The name and phone number of the contact person
designated by DSS to provide information about the
site visit report.
4.Requires that the notice remain posted until the
deficiencies giving rise to the notice are resolved.
5.Provides that any civil penalty levied by DSS for
violation of the notice provisions of this bill be in
addition to any civil penalty levied for the underlying
violation giving rise to the notice requirement.
6.Defines "responsible party" as an individual, including
the resident's relative, health care surrogate decision
STAFF ANALYSIS OF ASSEMBLY BILL 313 (Monning) Page
4
maker, or a placement agency, who assists the resident in
placement or assumes varying degrees of responsibility
for the well-being of the resident, as designated by the
resident in writing.
FISCAL IMPACT
According to the Assembly Appropriations Committee, the
bill would result in potential minor non-reimbursable local
costs for investigation and prosecution of violations,
which may be potentially offset by fine revenue.
BACKGROUND AND DISCUSSION
Author's statement
The author states that there are more than 170,000
individuals who reside in 7,800 RCFEs, who may have no
advance notice of a potential facility shut-down. The
author states that the possibility of a RCFE losing its
license or facing closure does not happen in a vacuum, but
occurs in a multi-year process. The author highlights
recent events with the Chanticleer Home in Santa Cruz, a
48-bed licensed RCFE, whereby residents, family members,
and their responsible parties were not given adequate
notification prior to a court ordered license revocation,
and, in this case, it was a two-year process prior to the
court action. The author believes that proper written
notification and postings when a license is in serious
jeopardy will reduce the shock, anxiety, and stress
experienced, and give RCFE residents and their loved ones
enough time to make alternative care arrangements and avoid
dangerous last minute evictions.
RCFEs
RCFEs are licensed assisted living facilities for persons
60 years of age and over and persons under 60 with
compatible needs. Varying levels of care and supervision,
protective supervision, or personal care are provided,
based upon residents' needs. As of February 2011, there
were 7,668 licensed RCFEs in the state with a total
capacity of 170,376 residents. According to DSS,
approximately 80 percent of RCFEs are licensed for six or
fewer residents; the remaining RCFEs have an average
licensed capacity of approximately 60 residents. In the
STAFF ANALYSIS OF ASSEMBLY BILL 313 (Monning) Page
5
last few years, several bills have been enacted and
attempted to provide greater notice and transition for RCFE
residents, when a facility is no longer able to provide
services.
Chanticleer Home
In the case of Chanticleer Home, residents' representatives
received a letter dated April 30, 2010, stating that DSS
began legal action against the facility on April 23, 2009.
The letter explained that DSS "has now received the
Decision and Order that revokes the license" for the RCFE,
and that "Ýt]he closure will be effective on May 14,
2010"-only two weeks following the date of the letter to
the RCFE resident representatives. The representatives
were advised to contact the local LTC Ombudsman for support
and information about other RCFEs, and were also directed
to a facility search website.
Prior legislation
SB 897 (Leno) of 2011 requires licensees of residential
care facilities for the elderly (RCFEs), with certain
exceptions, to notify the Department of Social Services
(DSS), the State Long-Term Care Ombudsman, and residents,
applicants and potential residents, of specified events,
relating to possible indicators of RCFE closure. Pending
referral in the Assembly.
SB 1329 (Leno) of 2010, would have required licensees of
residential care facilities for the elderly (RCFEs), with
certain exceptions, to notify the Department of Social
Services (DSS) and, in some instances, residents,
applicants and potential residents, of specified events,
and would have required DSS to initiate compliance plans,
noncompliance conferences, or other administrative actions
upon receipt of the notification. Vetoed by Governor.
SB 781 (Leno), Chapter 617, Statutes of 2009, requires a
residential care facility for the elderly to include
additional information when providing a notice of eviction
to a resident, including the reason for the eviction, the
effective date of the eviction, and additional information
STAFF ANALYSIS OF ASSEMBLY BILL 313 (Monning) Page
6
informing the resident of his/her rights regarding
evictions.
AB 407 (Beall), Chapter 442, Statutes of 2009 imposes
requirements on continuing care retirement communities in
the event of their permanent closure, including requiring
the continuing care retirement community to provide written
notice to DSS and to the affected residents or designated
representatives 120 days prior to the intended date of
closure of a continuing care retirement community.
AB 949 (Krekorian), Chapter 686, Statutes of 2007,
established procedures to be followed by a residential care
facility for the elderly prior to transferring a resident
to another facility or living arrangement as a result of
forfeiture of a license or change in the use of the
facility, and provides remedies for noncompliance.
Arguments in support
In support of this bill, California Advocates for Nursing
Home Reform (CANHR) writes that despite their special
needs, RCFE residents have few legal protections to ensure
they are notified when their facility is in danger of
losing its license and shutting down. CANHR states that
this bill will substantially reduce the harm that threatens
RCFE residents when they are abruptly forced to move due to
the unanticipated closure of their facility. Advocacy,
Inc., the nonprofit organization operating the LTC
Ombudsman program for Santa Cruz and San Benito Counties,
states that this bill will prevent the anxiety, trauma and
stress Chanticleer residents and families experienced and
offer an opportunity for residents and families to
positively interact with facility administrations to affect
needed changes within vulnerable facilities. AARP writes
that it is important for residents and their families to
know of circumstances that may be relevant to their
continued stay at the facility.
PRIOR VOTES
Assembly Floor: 60 - 0
Assembly Appropriations:16 - 0
Assembly Human Services: 6 - 0
STAFF ANALYSIS OF ASSEMBLY BILL 313 (Monning) Page
7
COMMENTS
1.Immediate closure still possible. According to DSS,
temporary suspension orders, issued for health and safety
and severe cases, result in immediate closures, so there
may be instances where the circumstances still dictate
immediate closure.
2.Notice to residents, responsible party, and long-term
care ombudsman. The author may wish to clarify whether
this notice is to contain identical information to the
posted notice.
3.Licensing status. The bill requires that the required
notice to the resident and resident's responsible party
include contact information for the local LTC ombudsman
and for the DSS Community Care Licensing Division (CCLD),
with a statement directing the resident or emergency
contact person to contact either the local LTC Ombudsman
or CCLD for information on the license status of the
facility. It's unclear whether the local ombudsman would
have the most up-to-date information.
POSITIONS
Support: AARP
Advocacy, Inc.
Aging Services of California
Alzheimer's Association
Bet Tzedek Legal Services
California Advocates for Nursing Home Reform
California Alliance for Retired Americans
California Assisted Living Association
California Commission on Aging
California Communities United Institute
California Long-Term Care Ombudsman Association
City of Santa Cruz
County of Santa Cruz
County Welfare Directors Association of CA
National Association of Social Workers - CA
Ombudsman Services of Northern California
STAFF ANALYSIS OF ASSEMBLY BILL 313 (Monning) Page
8
Professional Fiduciary Association of California
The Arc of California
United Cerebral Palsy in California
1 individual
Oppose:None received
-- END --