BILL ANALYSIS Ó
AB 2066
Page 1
Date of Hearing: April 24, 2012
ASSEMBLY COMMITTEE ON AGING AND LONG-TERM CARE
Mariko Yamada, Chair
AB 2066 (Monning) - As Amended: April 17, 2012
SUBJECT : Residential care facilities for the elderly:
revocation of licenses.
SUMMARY : AB 2066 changes required procedures to protect the
well-being of residents when Residential Care Facilities for the
Elderly (RCFE) licensees are the subject of a license
revocation. Specifically, this bill :
1) Requires Department of Social Services (DSS) to notify
appropriate local agencies of the decision to revoke an
RCFE license, just as DSS is required to notify local
agencies when a decision has been made to temporarily
suspend an RCFE license.
2) Requires the director of DSS to make every effort to
minimize trauma to residents in the event of a license
revocation, and to use physicians, surgeons and other
medical personnel to assess residents and to assist in
their transfer, according to an approved, written plan of
relocation.
3) Empowers DSS to pursue any other available remedies, if
necessary, to protect the health and safety of residents,
including amending the date of the revocation order.
4) Requires RCFE licensees to notify each resident, or the
responsible party of each resident, with a written 60 day
notice-of-revocation which may lead to closure, within 24
hours of receipt of the DSS license revocation order, and
provide each resident with contact information for the
local long-term care ombudsman program.
5) Permits a licensee under a revocation order to secure
the services of a qualified, unrelated person or entity to
manage the day-to-day operations of the facility for at
least 60 days, if:
a. The licensee submits to DSS, within 72 hours of the
revocation order, a completed application, and a copy of
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the signed, executed agreement between the licensee and
the applicant;
b. The applicant is in substantial license compliance;
and,
c. The applicant administers a comparable facility.
6) Exempts the licensing fee for the replacement
administrator.
7) Provides for a refund of preadmission fees to the
resident or the resident's responsible party, within 15
days of a revocation order, in the following amounts: 100%
refund of preadmissions fees in excess of $500 if those
fees were paid within six months of the revocation order;
75% if paid 6-12 months before the revocation order; 50% if
paid 12-18 months before the revocation order; and 25% if
paid 18-25 months of the revocation order. Residents are
granted the option to apply the refund amount toward
outstanding monthly charges of the facility.
8) Requires a licensee which is the subject of a revocation
order to provide DSS and the local Long-Term Care Ombudsman
a list of names, and the new locations, of those residents
who moved as a result of the revocation order.
EXISTING LAW :
1) Establishes the Residential Care Facilities for the
Elderly Act which creates a licensing category and
regulations for RCFEs within DSS, Community Care Licensing
Division (CCLD).
2) Provides for enforcement authority of statutes and
regulations governing RCFEs.
3) Provides for procedures to protect residents in the
event of a temporary restraining order placed upon the
licensee by making every effort to minimize trauma for
residents.
4) Provides for procedures to protect RCFE residents in the
event a license is voluntarily surrendered or the use of
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the facility changes by taking all reasonable steps to
transfer affected residents safely and to minimize possible
transfer trauma.
5) Requires DSS to contact local agencies that may have
placement or advocacy responsibilities for RCFE residents
in the event of a temporary restraining order.
6) Requires an RCFE to provide residents, their responsible
party, and the local long-term care ombudsman with a
written notice when DSS commences proceedings to suspend or
revoke its license.
7) Requires the licensee to take all reasonable steps to
transfer affected residents safely as the result of the
revocation of an RCFE license.
FISCAL EFFECT : Unknown
BACKGROUND : RCFEs are licensed, assisted living (non-medical)
facilities for persons 60 years of age and over and other,
younger eligible persons. Varying levels of care and
supervision, protective supervision, and personal care such as
assistance with hygiene, dressing, eating, bathing, and storage
and distribution of medications are provided, based upon
residents' needs. All RCFEs provide meals and housekeeping.
Ongoing medical care is not allowed except in rare cases,
although hospice care is allowed. People with ongoing medical
needs require a higher level of care in a nursing home or an
intermediate care facility.
RCFE care is one of the fastest growing components of the
long-term supports and services industries. There are nearly
7,600 licensed RCFEs in California serving over 170,000 people,
supporting about 70,000 jobs. According to DSS, approximately
80% of RCFEs are licensed for four-six residents; the remaining
20% of RCFEs have an average capacity of about 60 residents.
California is home to the largest number of seniors in the
nation, and the older population is expanding at an
unprecedented historical pace. The California Department of
Finance's Demographic Research Unit estimates that California's
65+ population will grow by 43%, from 4.4 million in 2010 to
6.35 million by 2020; another 39%, to 8.83 million by 2030; and
an additional 21% to 10.5 million by 2040. The expanding
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population of older Californians will impact every facet of
policy, housing being one of the primary areas, and RCFE growth
is reflected in the above describe demographic shift; since
2002, RCFE licenses have increased from 6,000 to nearly 7,600;
nearly a 30% increase.
COMMENTS : AB 2066 resolves an unintentional ramification of AB
313 (Monning), Chapter 365, Statutes of 2011. AB 313 combined
consumer protections in the event of license revocation with
other consumer protections established in the event of voluntary
surrender of a license, or facility-use change. Given that the
process that leads up to license revocation is much different
than the processes leading up to the surrender of a license or
facility use change, Assemblyman Monning introduced AB 2066 to
address revocation orders separate from surrender or use change.
License revocation is the most severe form of disciplinary
action for a licensee, and usually occurs at the end of a
protracted process which DSS undertakes to encourage the
licensee to achieve compliance. Since it may be unrealistic to
expect a licensee under a revocation order to continue to
provide safe accommodations for a vulnerable population,
Assemblymember Monning developed AB 2066 to place the revocation
process in the same code section dealing with temporary
suspension orders.
AB 2066 further establishes procedures specific to license
revocation, including; a 60-day written notification to
residents and their responsible parties; the option for a
licensee to turn day-to-day operations over to a qualified,
temporary administrator, and a preadmission fee refund schedule.
AB 2066 further authorizes DSS latitude to change the effective
date of a revocation order, or to pursue any other remedy to
protect the health and safety of residents. According to the
author, these strategies may be used to maintain administrative
integrity within the facility until residents are safely
relocated, ideally, for the entire 60 day period.
Need for Bill : According to the author, license revocation is
considered the final remedy in a series of on-going, unresolved
deficiencies that place residents' health and safety at risk.
Allowing residents to continue to live in an environment that
does not meet licensing standards may actually be detrimental to
their health. Forcing a licensee to maintain a poorly managed
RCFE may place residents at greater risk than immediate
relocation, though neither option is ideal. The author points
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out that when a revocation order is issued; maintaining staff is
difficult as employees seek stable employment elsewhere. AB
2066 is intended to provide an additional level of options to
provide quality care while residents make arrangements for
alternative accommodations.
DOUBLE REFERRAL : This measure is the subject of a double
referral to both the Assembly Committee on Human Services and
the Assembly Committee on Aging and Long-Term Care. AB 2066 was
heard in Assembly Human Services Committee on April 10, 2012,
and passed as a consent item on a 6-0 vote.
RECENT AMENDMENTS
AB 2066 was amended on April 17th to clarify details of the
60-day notice and to provide for a preadmission fee
reimbursement schedule in the event of a license revocation
order.
RELATED LEGISLATION :
AB 313 (Monning), Chapter 365, Statutes of 2011, requires each
RCFE to provide residents, their responsible party, and the
local long-term care ombudsman (LTC Ombudsman) with a written
notice when DSS 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.
SB 897 (Leno), Chapter 376, Statutes of 2011, requires licensees
of RCFEs, with certain exceptions, to notify DSS, the State
Long-Term Care Ombudsman, and residents, applicants and
potential residents, of specified events, relating to possible
indicators of RCFE closure.
SB 1329 (Leno) of 2010, (Vetoed) would have required licensees
of RCFEs to notify 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.
SB 781 (Leno), Chapter 617, Statutes of 2009, requires a RCFE to
include additional information when providing a notice of
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eviction to a resident, including the reason for the eviction,
the effective date of the eviction, and additional information
informing the resident of his/her rights regarding evictions.
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
changes in the use of the facility, and provides remedies for
noncompliance.
REGISTERED SUPPORT / OPPOSITION :
Support
Aging Services of California
California Assisted Living Association (CALA)
State Long-Term Care Ombudsman
Opposition
None on file.
Analysis Prepared by : Robert MacLaughlin / AGING & L.T.C. /
(916) 319-3990