BILL ANALYSIS Ó ------------------------------------------------------------ |SENATE RULES COMMITTEE | AB 641| |Office of Senate Floor Analyses | | |1020 N Street, Suite 524 | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ------------------------------------------------------------ THIRD READING Bill No: AB 641 Author: Feuer (D), et al. Amended: 7/14/11 in Senate Vote: 21 SENATE HEALTH COMMITTEE : 6-3, 07/06/11 AYES: Hernandez, Alquist, De León, DeSaulnier, Rubio, Wolk NOES: Strickland, Anderson, Blakeslee SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8 ASSEMBLY FLOOR : 52-24, 05/23/11 - See last page for vote SUBJECT : Long-term health care facilities: civil penalties SOURCE : Author DIGEST : This bill eliminates the citation review conference (CRC) process from the citation appeals process for long-term care (LTC) facilities, and allows fines to be levied from both state and federal agencies when an incident violates both state and federal laws. ANALYSIS : Existing law: 1.Provides for the inspection and licensure of LTC facilities by the California Department of Public Health (DPH). CONTINUED AB 641 Page 2 2.Establishes the Long-Term Care, Health, Safety, and Security Act of 1973, which permits DPH to assess penalties against LTC facilities for violation of prescribed state statutes, regulations, and federal standards pertaining to patient care. 3.Prohibits the issuance of both a citation pursuant to state laws and the recommendation that a federal civil monetary penalty be imposed for the same action. 4.Establishes a citation and appeals process that includes a CRC. This bill: 1.Revises state law to enable DPH to recommend that the federal Centers for Medicare and Medicaid Services impose a federal civil monetary penalty when DPH's Licensing and Certification Division determines that a LTC facility is out of compliance with both state and federal requirements. 2.Eliminates the CRC appeals process for all levels of state citations. 3.Repeals existing law requesting DPH to develop recommendations to address the findings published in the June 2010 State Auditor report entitled, "Department of Public Health: It Reported Inaccurate Financial Information and Can Likely Increase Revenues for the State and Federal Health Facilities Citation Penalties Accounts." Background At the request of the Joint Legislative Audit Committee, the California State Auditor produced an audit report in June of 2010, examining DPH. According to the State Auditor report, state law specifies that LTC facilities are not required to pay monetary penalties on contested citations that have not been resolved. LTC facilities may contest a monetary penalty by requesting an appeal through the CRC process in which an independent hearing officer from DPH's Office of Legal Services makes a determination CONTINUED AB 641 Page 3 on whether to uphold, modify, or dismiss the citation. Because of DPH's staffing issues and workload priorities, more than 600 citations, with corresponding monetary penalties amounting to nearly $5 million, were awaiting a CRC as of February 2010. According to DPH, delays in the CRC process may encourage LTC facilities to appeal citations and request CRCs as a way to delay paying their monetary penalties. SB 853 (Budget and Fiscal Review Committee), Chapter 717, Statutes of 2010, required DPH, in consultation with stakeholders, to develop recommendations to address this report, and provide recommendations to the Legislature no later than March 1, 2011. In January 2011, DPH solicited input from stakeholders and issued recommendations in April 2011. AB 641 reflects the revised recommendations of DPH. FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes Local: No SUPPORT : (Verified 8/15/11) Advocacy, Inc. Alzheimer's Association, California Council Bet Tzedek Legal Services California Advocates of Nursing Home Reform California Alliance of Retired Americans California Long-Term Care Ombudsman Association California Senior Legislature Catholic Charities of California United Congress of California Seniors Council on Aging, Orange County Disability Rights California Foundation Aiding the Elderly National Senior Citizens Law Center Ombudsman and HICAP Services of Northern California ARGUMENTS IN SUPPORT : Supporters state that this bill allows for both state and federal penalties to be levied when both state and federal violations occur and gives DPH the necessary discretion when finding serious and blatant violations. Supporters argue the CRC process is inefficient and redundant and by removing the CRC process, nursing home oversight will be streamlined. Supporters CONTINUED AB 641 Page 4 write AB 641 will strengthen the oversight protection for the vulnerable residents in skilled nursing facilities. ASSEMBLY FLOOR : 52-24, 05/23/11 AYES: Alejo, Allen, Ammiano, Atkins, Beall, Block, Blumenfield, Bonilla, Bradford, Brownley, Buchanan, Butler, Charles Calderon, Campos, Carter, Cedillo, Chesbro, Davis, Dickinson, Eng, Feuer, Fong, Fuentes, Furutani, Galgiani, Gatto, Gordon, Hall, Hayashi, Roger Hernández, Hill, Huber, Hueso, Huffman, Lara, Bonnie Lowenthal, Ma, Mendoza, Mitchell, Monning, Pan, Perea, V. Manuel Pérez, Portantino, Skinner, Solorio, Swanson, Torres, Wieckowski, Williams, Yamada, John A. Pérez NOES: Achadjian, Conway, Donnelly, Fletcher, Beth Gaines, Garrick, Grove, Hagman, Halderman, Harkey, Jeffries, Jones, Knight, Logue, Mansoor, Miller, Morrell, Nestande, Nielsen, Olsen, Silva, Smyth, Valadao, Wagner NO VOTE RECORDED: Bill Berryhill, Cook, Gorell, Norby CTW:nl 8/15/11 Senate Floor Analyses SUPPORT/OPPOSITION: SEE ABOVE **** END **** CONTINUED