BILL ANALYSIS Ó
AB 581
Page 1
Date of Hearing: April 2, 2013
ASSEMBLY COMMITTEE ON HUMAN SERVICES
Mark Stone, Chair
AB 581 (Ammiano) - As Introduced: February 20, 2013
SUBJECT : Residential Care Facilities for the Elderly:
Retaliation
SUMMARY : This measure would expand protections afforded to
residents and employees of an adult residential facility (ARF)
or a residential care facility for the elderly (RCFE).
Specifically, this bill :
1)Prohibits an ARF or RCFE licensee or their staff from
discriminating or retaliating against a resident, as
specified, if the resident has participated in the filing of a
complaint, grievance, or request for inspection with the
California Department of Social Services (DSS) or with a local
or state ombudsman.
2)Prohibits an ARF or RCFE licensee or their staff from
discriminating or retaliating against a fellow staff person,
as specified, if the staff person has participated in the
filing of a complaint, grievance, or request for inspection
with DSS or with a local or state ombudsman.
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 by a facility or organization.
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
AB 581
Page 2
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 DSS.
4)Prohibits any person, firm, partnership, association,
corporation or public agency from establishing, operating,
managing, conducting or maintaining a CCF or 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)Under the Mello-Granlund Older Californians Act (OCA),
establishes the California Long-Term Care Ombudsman Program
within the California Department of Aging (CDA) run by the
State Long-Term Care Ombudsman (LTC Ombudsman).
7)Provides specified authority for the LTC Ombudsman to identify
and investigate complaints made by, or on behalf of, residents
of long-term care facilities, recommend and advocate for
necessary changes to laws, regulations and policies, and
conduct other necessary activities for and on behalf of
residents of long-term care facilities, as specified.
FISCAL EFFECT : Unknown
COMMENTS :
CCFA Background
Established in 1973, the CCFA was adopted in response to the
need to provide a system of nonmedical community care, to
provide care and supervision services for persons with
developmental and mental health needs, as well as socially
dependent children and adults in California. Over the years,
CCFs have evolved to become more sophisticated in the range of
care they provide, which now includes providing care for persons
with severe behavioral or emotional problems, serious mental or
developmental disorders and significant medical needs.
Community care facilities provide non-medical care and
supervision for children and adults, including persons with
disabilities, seniors in need of residential care, children in
foster care and at-risk children needing shelter services,
AB 581
Page 3
families in need of early childhood education (child care), and
adult care services.
Under the CCFA, adult residential facilities (ARFs) are
generally considered facilities that provide residentially-based
care for adults age 18-59, who are unable to provide for their
own daily needs. ARFs typically provide residential care for
adults with mental health needs or developmental disabilities
that prevent them from living at home safely on their own.
According to DSS, as of February 6, 2013 there were 77,243
licensed CCFs in California with a capacity to serve 1,395,577
residents.
RCFE Background
It was the intent of the Legislature, in creating RCFEs as its
own licensing category under the CCFA to help provide a system
of residential care to allow older persons to live as
independently 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.
Office of the LTC Ombudsman
As established by the Mello-Granlund Older Californians Act, the
LTC Ombudsman serves as an independent entity within the
California Department of Aging. Its primary responsibilities
are two-fold. First, it identifies, investigates and resolves
complaints made by residents of RCFEs, nursing homes and
assisted living facilities. Second, it plays an advocacy role
in the development of policies, regulations and statute to
improve California's system of care for older persons.
Need for the bill
Current law provides the LTC Ombudsman specific authority to
investigate and resolve complaints, and additionally provides
AB 581
Page 4
protections to residents from retaliation from a licensee when
they file a complaint. However, current law only provides
protection of retaliation from the licensee and not their staff.
In many cases, the licensee is a single individual who is
listed on the facility's license as the owner or proprietor, and
who may have limited or no interaction with residents of the
facility. The staff members of the licensee are more likely to
operate the facility and have day-to-day direct care interaction
with a resident by whom or for whom a complaint could be filed.
Although current law could be construed to define "licensee"
broadly, it is not specific as to whether the complainant is
protected from retaliation from a staff person or other
representative of the licensee. This measure seeks to clarify
that the retaliation prohibition protections afforded under the
RCFE Act applies to the staff in addition to the licensee, and
would also establish these same protections under the CCFA for
Adult Residential Facilities.
According to the author:
Residents of both these facilities (RCFEs and Adult
Residential Care Facilities) have many frailties; many have
cognitive deficits, and in the Adult Facilities, residents
have either a mental health diagnosis or a developmental
disability, and both should share the rights to file
grievances regarding their housing conditions without
retaliation, just as other Californians can.
Writing in support of this measure, the California LTC Ombudsman
writes:
This bill will provide stronger and more specific language
in the Health and Safety Code regarding protection for
residents of RCFEs and ARFs from retaliation for exercising
their rights to voice concerns with their care and living
conditions.
RECOMMENDED AMENDMENTS:
AB 581 amends the CCFA to prohibit retaliation from staff to
residents of one category of licensee under the CCFA; ARFs.
However, the CCFA has 15 total licensing categories. AB 581
should be amended to prohibit retaliation of the licensee and
their staff against a resident or staff person of any licensed
AB 581
Page 5
CCF who files a complaint.
Specifically, staff recommends the following amendments:
On page 2, line 3, strike out "adult residential facility"
On page 2, line 7, strike out "adult residential"
DOUBLE REFERRAL . This bill has been double-referred. Should
this bill pass out of this committee, it will be referred to the
Assembly Judiciary Committee.
AB 581
Page 6
REGISTERED SUPPORT / OPPOSITION :
Support
California Advocates for Nursing Home Reform (CANHR)
County Welfare Directors Association of California (CWDA)
Office of State Long-Term Care Ombudsman
Opposition
None on file
Analysis Prepared by : Chris Reefe / HUM. S. / (916) 319-2089