BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  AB 261
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          Date of Hearing:    April 2, 2013

                        ASSEMBLY COMMITTEE ON HUMAN SERVICES
                                  Mark Stone, Chair
                    AB 261 (Chesbro) - As Amended:  April 1, 2013
           
            SUBJECT  :  Residential care facilities for the elderly: fees and  
          charges

           SUMMARY  :  Provides clarification on the termination of an  
          admission agreement and the charging of fees when a residential  
          care facility for the elderly (RCFE) resident passes away.    
          Specifically,  this bill  :  

          1)Prohibits a RCFE from requiring advance notice for the  
            termination of an admission agreement upon the death of a  
            resident.

          2)Requires a RCFE to cease charging fees when all personal  
            property of a deceased resident is removed from the living  
            unit.

          3)Prohibits a RCFE from impeding the removal of a deceased  
            resident's belongings by the resident's authorized  
            representative(s).

          4)Requires a RCFE to issue a refund of any fees paid in advance  
            that cover time after the deceased resident's belongings have  
            been removed from the facility to the resident's authorized  
            representative(s) within 15 days of removal of the belongings.

          5)Requires a RCFE licensee to provide a deceased resident's  
            representative written notice regarding contract termination  
            upon death and refunds within three days of becoming aware of  
            the resident's death if fees are assessed while a deceased  
            resident's belongings remain in the facility.

           EXISTING LAW  

          1)Establishes the California Community Care Facilities Act  
            (CCFA) to provide a comprehensive statewide service system of  
            quality community care for people who have a mental illness, a  
            developmental or physical disability, and children and adults  
            who require care or services from a facility or organization.









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          2)Defines a "Community care facility" (CCF) as a facility,  
            place, or building maintained and operated to provide  
            nonmedical residential care, day treatment, adult day care, or  
            foster family agency services for children, adults, or  
            children and adults, including, but not limited to, the  
            physically handicapped, mentally impaired, incompetent  
            persons, and abused or neglected children.

          3)Establishes the California RCFE Act, which requires facilities  
            that provide personal care and supervision, protective  
            supervision or health related services for persons 60 years of  
            age or older who voluntarily choose to reside in that facility  
            to be licensed by the California Department of Social Services  
            (DSS).

          4)Prohibits any person, firm, partnership, association,  
            corporation or public agency from establishing, operating,  
            managing, conducting or maintaining a CCF or a RCFE without a  
            valid license provided by DSS.

          5)Provides that any person who violates the CCFA or the RCFE Act  
            shall be guilty of a misdemeanor and upon conviction be fined  
            no more than $1,000, imprisoned in county jail for up to one  
            year, or both.

          6)Requires RCFE administrators and staff to meet specified  
            professional development and training requirements in order to  
            be certified to operate or work in a RCFE.

          7)Requires an "admission agreement" to include all documents  
            that a resident or his or her representative must sign at the  
            time of, or as a condition of admission to a RCFE.

          8)Requires an admission agreement to include a breakdown of  
            items and services provided, a comprehensive description of  
            the RCFE's fee schedule, its refund policy, the conditions  
            under which the admission agreement may be terminated, and  
            other requirements, as specified.

           FISCAL EFFECT  :  Unknown

           COMMENTS  :

           Background  
          It is the intent of the Legislature, in creating RCFEs as its  








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          own separate licensing category under the RCFE Act, to help  
          provide a system of residential care to allow older persons to  
          remain as independent as possible while not forcing them to move  
          between medical and nonmedical services.  Commonly referred to  
          as assisted living facilities, retirement homes and board and  
          care homes, RCFEs are licensed facilities under the CCFA that  
          provide services to individuals who are 60 years of age and over  
          and persons under the age of 60 with compatible needs.  RCFEs  
          provide a wide array of care, which can include varying levels  
          of personal care and protective supervision, based upon the  
          needs of the resident. 

          According to DSS, as of February 6, 2013 there are currently  
          7,613 licensed RCFEs in California with a capacity to serve  
          173,333 residents. 

          Under the CCFA, RCFEs are required to provide each resident with  
          an "admission agreement."  An admission agreement generally  
          refers to all documents that resident or his or her authorized  
          representative must sign at the time of, or as a condition of,  
          admission to the RCFE.  Admission agreements are required to  
          meet explicit and specific requirements as to what may and may  
          not be included.  In regards to termination of the admission  
          agreement, current law provides for two methods of termination.   
          The first is through the resident moving out of the facility  
          voluntarily or involuntarily, i.e. eviction, and the other is  
          through the death of the resident. 

           Past Legislation  
          Similar legislation, AB 1142 (Chesbro), was pursued during the  
          2011-12 Legislative Session to address a conflict between  
          existing statute and regulations regarding how an admission  
          agreement may be canceled when a resident passes away. 

          As noted in this committee's analysis of AB 1142:

               The author points out that administrative regulations  
               pertaining to RCFEs allow for admission agreements to  
               include a 30-day cancellation notice.  The RCFE regulations  
               also provide that the agreement is "automatically  
               terminated by the death of the resident, whose relatives  
               shall not be liable for any payment beyond that due at the  
               date of death, unless agreed to in writing or ordered by  
               court."  22 CCR Section 87507(h).  Although, the author  
               notes, it appears to be an uncommon practice, some RCFEs  








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               apparently apply these regulations together to include  
               provisions in admission agreements holding relatives  
               responsible for payment of fees for 30 days, even after the  
               death of the resident.  According to the author, "the  
               policy needs to be clarified to eliminate confusion or  
               distress for residents and their families."

           Need for the bill
           
          AB 261 is a reintroduction of AB 1142 with similar intent but a  
          simpler approach.  Whereas AB 1142 introduced new terminology to  
          the CCFA, AB 261 uses existing terminology and builds upon  
          current law to address the conflict in the interpretation of how  
          and when facility-related fees may be charged to a deceased  
          resident's authorized representative(s). 

          Writing in support of AB 261, the California Commission on Aging  
          writes:

               By prohibiting the imposition of a 30-day termination  
               notice when a resident dies, AB 261 protects families  
               already traumatized by the death [of a family member] from  
               unnecessary expenses.  By requiring that fees stop once the  
               personal property of the deceased resident has been removed  
               from the resident's apartment, RCFE operators have some  
               degree of leverage to have the residence vacated promptly,  
               while assuring that families do not face ongoing fees once  
               the room has been cleared.  

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          Alzheimer's Association
          California Assisted Living Association (CALA)
          California Association for Health Services at Home (CAHSAH)
          California Commission on Aging
          California School Employees Association, AFL-CIO
          Community Residential Care Association of CA
          County Welfare Directors Association of California (CWDA)
          LeadingAge California

           Opposition 
           
          None on file








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          Analysis Prepared by  :    Chris Reefe / HUM. S. / (916) 319-2089