BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                            



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          |SENATE RULES COMMITTEE            |                        AB 261|
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                                       CONSENT


          Bill No:  AB 261
          Author:   Chesbro (D)
          Amended:  6/18/13 in Senate
          Vote:     21

           
           SENATE HUMAN SERVICES COMMITTEE  :  6-0, 6/25/13
          AYES:  Yee, Berryhill, Emmerson, Evans, Liu, Wright

           SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8

           ASSEMBLY FLOOR  :  76-0, 4/25/13 (Consent) - See last page for  
            vote


           SUBJECT  :    Residential care facilities for the elderly:  fees  
          and charges

           SOURCE  :     California Assisted Living Association


           DIGEST  :    This bill prohibits Residential Care Facilities for  
          the Elderly (RCFE) from requiring advance notice to terminate an  
          admission agreement upon death of a resident, prohibits the  
          accrual of any fees once the personal property of a deceased  
          resident is removed and requires that within three days of a  
          patient's death the RCFE provide a written notice of the  
          facility's polices involving contract termination and refunds,  
          as specified.  This bill requires RCFEs to refund any fees paid  
          in advance that cover the time after the resident's property has  
          been removed. It also makes other conforming changes.

           ANALYSIS  :    
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          Existing law:

           1. Establishes California Residential Care Facilities for the  
             Elderly Act. 

           2. Defines "Residential care facility for the elderly" as a  
             housing arrangement chosen voluntarily by persons 60 years of  
             age or over, or their authorized representative, where  
             varying levels and intensities of care and supervision,  
             protective supervision, personal care, or health-related  
             services are provided, based upon their varying needs, as  
             determined in order to be admitted and to remain in the  
             facility. 

           3. Requires the Department of Social Services (DSS) to inspect  
             and license RCFEs. 

           4. Establishes that an "admission agreement" shall 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. 

           5. Requires the admission agreement include the facility's  
             policy concerning refunds and conditions under which the  
             admission agreement may be terminated, among other things, as  
             detailed. 

           6. Requires RCFEs to implement a theft and loss program which  
             includes an inventory and surrender of personal effects and  
             valuables following the death of a resident to the authorized  
             representative in exchange for a signed receipt and immediate  
             written notice to the public administrator of the county upon  
             the death of a resident whose heirs are unable or unwilling  
             to claim the property. 

           7. Permits RCFEs to charge a fee for the services provided,  
             which shall include, but not be limited to, supervision,  
             room, leisure activities, and meals. 

           8. Provides that any fee charged by a licensee of a residential  
             care facility for the elderly, whether prior to or after  
             admission, shall be clearly specified in the admission  
             agreement. 

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           9. Provides that any person who violates this chapter, or who  
             willfully or repeatedly violates any rule or regulation  
             adopted under this chapter, is guilty of a misdemeanor and  
             upon conviction thereof shall be punished by a fine not to  
             exceed $1,000, by imprisonment in the county jail for a  
             period not to exceed one year, or by both the fine and  
             imprisonment. 

           10.Defines "Equity project" as a continuing care retirement  
             community where residents receive an equity interest in the  
             continuing care retirement community property. 

           11.Defines "Refundable contract" as a continuing care contract  
             that includes a promise, expressed or implied, by the  
             provider to pay an entrance fee refund or to repurchase the  
             transferor's unit, membership, stock, or other interest in  
             the continuing care retirement community when the promise to  
             refund some or all of the initial entrance fee extends beyond  
             the resident's sixth year of residency. 

          Existing state regulation states the admission agreement shall  
          be 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 the  
          court. 

          This bill:

           1. Prohibits an RCFE from requiring advanced notice for  
             terminating an admission agreement upon death of a resident. 

           2. Prohibits an RCFE from accruing fees once all personal  
             property belonging to the deceased resident is removed from  
             the living unit.

           3. Prohibits an RCFE from impeding the removal of the deceased  
             resident's personal property, as specified.

           4. Establishes that an RCFE must refund any fees paid in  
             advance covering the time after the resident's personal  
             property has been removed from the facility within 15 days,  
             as specified. 


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           5. Requires that, if fees are assessed while a resident's  
             property remain in a unit after the resident is deceased, the  
             licensee shall, within three days of becoming aware of the  
             resident's death, provide to the resident's responsible  
             person or other individuals identified in the admissions  
             agreement, with written notice of the facility's policies  
             regarding contract termination upon death and refunds.  

           6. States that this section does not apply to fees charged by a  
             continuing care equity project or amounts deducted from  
             entrance fee refunds or repayments, as specified in statute.

           7. Requires the RCFE's admission agreement to include the  
             facility's policy concerning refunds, including the  
             conditions under which a refund for advanced monthly fees  
             will be returned in the event of a resident's death.

           Background
           
           Residential Care Facility for the Elderly  .  Residential Care  
          Facilities for the Elderly (RCFEs) provide a housing arrangement  
          chosen voluntarily by the resident, the resident's guardian,  
          conservator or other responsible person.  

          According to DSS, as of May 2013, there were 7,500 licensed  
          RCFEs in the state with a total capacity of 143,459 residents.   
          According to the organization California Registry, the cost of  
          residential care for an elderly person can range from $1,500 to  
          $4,500 a month, depending on the care needs, the quality of the  
          accommodations and the location of the facility. 

           Admission Agreements  .  California Statute provides that an  
          admission agreement contract between an RCFE and a resident  
          shall include all documents that a resident or responsible  
          person must sign at the time of, or as a condition of, admission  
          into an RCFE. 

          Specifically, the admission agreement includes, among other  
          requirements: 

             A comprehensive description of any items and services  
             provided under a single fee, such as a monthly fee for room,  
             board, and other items and services.


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             A comprehensive description of, and the fee schedule for,  
             all items and services not included in a single fee. In  
             addition, the agreement shall indicate that the resident  
             shall receive a monthly statement itemizing all separate  
             charges incurred by the resident.

             A comprehensive description of billing and payment policies  
             and procedures.

             The facility's policy concerning refunds.

             Conditions under which the agreement may be terminated.

          According to the author, there is currently no statutory  
          prohibition on RCFEs requiring a cancellation notice even in  
          cases where a resident has passed away, provided the policy is  
          disclosed and agreed to in writing in the admission agreement. 

           California Regulations  .  California regulation states that "the  
          admission agreement shall be 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 the court." 

          While this legislation would largely codify the state regulation  
          that requires admission agreements to be terminated at the date  
          of death, it would not permit any exceptions, such as orders by  
          the court. 

           Prior Legislation

           AB 1142 (Chesbro, 2011) was substantively similar legislation.  
          It addressed the termination of the admissions agreement and  
          prohibited the assessment of fees after all personal property  
          was removed from the RCFE.  This bill was held without hearing  
          in Senate Human Services.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  Yes

           SUPPORT  :   (Verified  8/9/13)

          California Assisted Living Association (source)
          AARP

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          Alzheimer's Association
          California Advocates for Nursing Home Reform 
          California Association for Health Services at Home
          California Commission on Aging
          California Long-Term Care Ombudsman Association
          California School Employees Association, AFL-CIO
          California Senior Legislature
          Community Residential Care Association of California
          Contra Costa County Advisory Council on Aging 
          County Welfare Directors Association of California 
          National Association of Social Workers


           ARGUMENTS IN SUPPORT  :    According to the author, this bill  
          brings additional clarity and fairness to a certain billing  
          practice with regard to assessing fees upon the death of a  
          resident in Residential Care Facilities for the Elderly (RCFEs).  
          This bill prohibits an RCFE from requiring advanced notice  
          before terminating an admission agreement when the resident has  
          died. It also requires that fees stop once the deceased  
          resident's personal property has been removed from the  
          resident's apartment.


           ASSEMBLY FLOOR  :  76-0, 4/25/13
          AYES:  Achadjian, Alejo, Allen, Ammiano, Atkins, Bigelow, Bloom,  
            Blumenfield, Bocanegra, Bonilla, Bonta, Bradford, Brown,  
            Buchanan, Ian Calderon, Campos, Chau, Chávez, Chesbro, Conway,  
            Dahle, Daly, Dickinson, Donnelly, Eggman, Fong, Fox, Frazier,  
            Beth Gaines, Garcia, Gatto, Gomez, Gordon, Gorell, Gray,  
            Grove, Hagman, Hall, Harkey, Roger Hernández, Holden, Jones,  
            Jones-Sawyer, Levine, Linder, Logue, Maienschein, Mansoor,  
            Medina, Melendez, Mitchell, Morrell, Mullin, Muratsuchi,  
            Nestande, Olsen, Pan, Patterson, Perea, V. Manuel Pérez,  
            Quirk, Quirk-Silva, Rendon, Salas, Skinner, Stone, Ting,  
            Torres, Wagner, Waldron, Weber, Wieckowski, Wilk, Williams,  
            Yamada, John A. Pérez
          NO VOTE RECORDED:  Cooley, Lowenthal, Nazarian, Vacancy


          JL:nl  8/12/13   Senate Floor Analyses 

                           SUPPORT/OPPOSITION:  SEE ABOVE


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