BILL ANALYSIS                                                                                                                                                                                                    Ó






                                  SENATE HUMAN
                               SERVICES COMMITTEE
                            Senator Carol Liu, Chair


          BILL NO:       AB 2066                                     
          A
          AUTHOR:        Monning                                     
          B
          VERSION:       June 14, 2012
          HEARING DATE:  June 26, 2012                               
          2
          FISCAL:        Yes                                         
          0
                                                                     
          6
          CONSULTANT:    Sara Rogers                                 
          6

                                        

                                     SUBJECT
                                         
           Residential care facilities for the elderly: revocation of 
                                    license

                                     SUMMARY  

          Revises procedures used by the Department of Social 
          Services when revoking a license for a Residential Care 
          Facility for the Elderly (RCFE).  Specifies notice that 
          must be provided to residents prior to eviction due to a 
          revocation of license.  Permits a licensee who is subject 
          to a license revocation to arrange for a third part 
          facility manager in order to avoid closure of the facility. 
           Establishes a refund schedule for preadmission fees paid 
          by residents of an RCFE that is subject to closure due to a 
          revocation of license.

                                     ABSTRACT  

           Current law
           
          1.Provides for the inspection and licensure of residential 
            care facilities for the elderly (RCFE) by the Department 
            of Social Services (DSS) pursuant to the California 
                                                         Continued---



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            Residential Facilities for the Elderly Act and provides 
            for the certification of administrators of RCFEs by DSS.


          2.Permits DSS to enforce the Act by levying specified civil 
            penalties, excluding certain individuals from employment 
            in the facility, temporarily suspending a license or 
            revoking a license, as specified.


          3.Requires proceedings for the suspension, revocation, or 
            denial of a license to be conducted (GC 11500).


          4.Requires a licensed residential care facility for the 
            elderly to provide written notice to a resident, a 
            resident's responsible party, and the local long term 
            care ombudsman within 10 days if DSS commences 
            proceedings to suspend or revoke the license of the 
            facility or a criminal action related to the health and 
            safety of residents is brought forward against a facility 
            (HSC 1569.38).


          5.Requires the licensee, in the event of forfeiture or 
            revocation of license, to take all reasonable steps to 
            transfer affected residents safely and to minimize 
            possible transfer trauma including providing a written 
            eviction notice at least 60 days in advance of the 
            eviction date and preparing a relocation evaluation that 
            includes specified information.


          6.Requires DSS, when temporarily suspending a license, to 
            make every effort to minimize trauma for residents, to 
            contact any local agency that may have placement or 
            advocacy responsibility for residents, and to use medical 
            personnel deemed appropriate to provide onsite 
            evaluations of the residents and to assist in the 
            transfer.


           This bill
           
          1.Requires DSS, when revoking a license, to follow the 




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            procedures that are followed when temporarily suspending 
            a license.


          2.Requires the licensee, upon an order to revoke a license, 
            to provide a 60 day written notice to the resident and 
            the resident's responsible person within 24 hours of 
            receipt of the revocation order from DSS.


          3.Requires DSS to permit the licensee to secure the 
            services of a person who is not an immediate family 
            member or of an entity that is not owned by the licensee 
            to manage the day to day operations of the RCFE for at 
            least 60 days, if a proposal is submitted to DSS within 
            72 hours of the licensee's receipt of a revocation order.


          4.Provides that the person or entity assuming 
            responsibility must be currently licensed and in 
            substantial compliance to operate an RCFE that is of 
            comparable size and has comparable programming capacity, 
            as defined, and that the proposal includes all of the 
            following;


                     A completed application for a facility license, 
                 as specified.
                     A copy of the executed agreement between the 
                 licensee and the person or entity assuming 
                 responsibility that delineates the roles and 
                 responsibly of each party and specifies that the 
                 person or entity assuming responsibility shall have 
                 the full authority necessary to operate the facility 
                 without interference from the licensee.


          1.Provides that the person or entity assuming 
            responsibility is not subject to the application fee and 
            that if DSS denies the application, the denial shall not 
            be deemed a denial of licensure application subject to an 
            administrative law hearing or other procedural rights.


          2.Provides that, within 15 days of issuing the notice of 




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            closure, residents who transfer during the 60 day period 
            are entitled to a refund or partial refund of 
            preadmission fees in excess of $500, as in accordance 
            with the following schedule:
                     A 100% refund if fees were paid within six 
                 months of the notice of closure.
                     A 75% refund if fees were paid within 6-12 
                 months of the notice of closure.
                     A 50% refund if fees were paid within 12-18 
                 months of the notice of closure.
                     A 25% refund if fees were paid within 18-25 
                 months of the notice of closure.
                     No refund if fees were paid 25 months or more 
                 prior to the notice of closure.


          1.Requires the licensee to refund a proportional per diem 
            amount of any prepaid monthly fees to residents who 
            transfer during the 60 day period.


          2.Requires the licensee that had his or her license 
            revoked, within 10 days after all residents who are 
            transferring have left the facility, to submit a final 
            list of names and new locations of all residents to DSS 
            and the local ombudsman program.


          3.Allows DSS to amend the effective date of the order of 
            revocation and close the facility prior to the 60 day 
            notice period, or to pursue any other available remedies, 
            if necessary to protect the health and safety of the 
            residents in care. 


          4.Removes "revocation of a license" from statutory notice 
            requirements that currently apply to forfeiture or 
            revocation of a license, such that those notice 
            requirements will only apply to forfeiture of license and 
            the above provisions will apply to revocation of a 
            license.


                                         
                                 FISCAL IMPACT  




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          The Assembly Appropriations Committee finds that costs 
          associated with this legislation would be minor and 
          absorbable within existing resources.


                            BACKGROUND AND DISCUSSION  

          
          Residential Care Facilities for the Elderly (RCFEs) are 
          licensed housing facilities serving residents aged 60 and 
          older, which provide a non-medical, homelike environment 
          for residents who have a broad variety of care needs.

          RCFEs with six or fewer beds are frequently referred to as 
          "board and care homes" or "senior care homes," while RCFEs 
          with more than six beds and in some instances several 
          hundred beds are generally referred to as "assisted living 
          facilities".  Regardless of capacity size, all RCFEs are 
          licensed by DSS in accordance with the California 
          Residential Facilities for the Elderly Act.  DSS reports 
          that, as of June 2012, there were 7,667 licensed RCFEs in 
          the state with a total capacity of 171,939 residents, 
          approximately 80% of which are licensed for six or fewer 
          residents.

          According to the author, AB 2066 addresses an unintended 
          consequence of AB 313 (Monning, Chapter 365, Statutes of 
          2011), which added "revocation of a license" to statute 
          that required licensees to provide a 60-day notice prior to 
          evicting a resident due to voluntary forfeiture of a 
          license.  The author states that, subsequent to passage of 
          AB 313, DSS raised concerns that the law precluded the 
          department from closing a facility prior to the end of the 
          60-day notice period even when necessary to protect the 
          health and safety of the residents in care. This bill 
          deletes the provision that was added under AB 313 and 
          inserts a new notice requirement requiring a licensee to 
          provide a 60-day eviction notice no more than 24 hours 
          after receipt of a revocation order from DSS, but permits 
          DSS to close the facility before the 60-days has elapsed, 
          when necessary to protect the health and safety of the 
          residents in care. 

          Additionally, the author states that a licensee may no 




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          longer be willing or able to meet the needs of the 
          residents for the next 60 days and cites an increased risk 
          that care staff will begin leaving the RCFE for other 
          employment once license revocation is announced.  This bill 
          permits a licensee who is subject to a revocation order to 
          locate a qualified third- party manager to administer the 
          day-to-day operations of the facility during the closure 
          period. 

          AB 313 was introduced in 2011 following the license 
          revocation of Chanticleer Residential Care Facility in the 
          County of Santa Cruz, a 48-bed RCFE, which provided only 
          two weeks' notice to residents prior to closure of the 
          facility even though DSS had begun legal action against the 
          facility several weeks prior to the final 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 with a written 
          notice when the 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, 
          and makes other changes related to these actions.


          AB 419 (Mitchell, 2011) Requires every community care 
          facility licensed by DSS to be inspected unannounced at 
          least once per year using research based, field tested 
          inspection protocols, as specified.  This bill died in the 
          Assembly Appropriations Committee.


          SB 897 (Leno, Chapter 376, Statutes of 2011)  Requires 
          licensed residential care facilities for the elderly 
          (RCFEs) to notify the California Department of Social 
          Services (DSS), the state's Long-Term Care Ombudsman and 
          the facility's residents when the property is subject to 
          foreclosure or certain other events occur due to financial 
          distress.


                                   PRIOR VOTES
           




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          Assembly Floor:          70 - 0
          Assembly Appropriations: 17 - 0
          Assembly Aging and LTC:    6 - 0 
          Assembly Human Services:   6 - 0
          
                                    POSITIONS  

          Support:       Aging Services of California
                         Association of Regional Center Agencies
                         California Assisted Living Association
                         California Commission of Aging
                         Joseph Rodrigues, State Long Term Care 
          Ombudsman

          Oppose:   None received


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