BILL ANALYSIS                                                                                                                                                                                                    Ó






                                  SENATE HUMAN
                               SERVICES COMMITTEE
                          Senator Leland Y. Yee, Chair


          BILL NO:       AB 581                                       
          A
          AUTHOR:        Ammiano                                      
          B
          VERSION:       April 22, 2013
          HEARING DATE:  June 11, 2013                                
          5
          FISCAL:        Yes                                          
          8
                                                                      
          1
          CONSULTANT:    Tepring Piquado
                                        

                                     SUBJECT
                                         
           Community care facilities and residential care facilities  
                          for the elderly: retaliation

                                     SUMMARY
                                         
          This bill prohibits a Community Care Facility (CCF) or  
          Residential Care Facility for the Elderly (RCFE) licensee,  
          or officer or employee of the licensee, from discriminating  
          or retaliating against a person because the person has  
          initiated or participated in the filing of a complaint,  
          grievance or request for inspection, as specified. 

                                     ABSTRACT  

           Existing law:

              1)   Establishes the California Community Care  
               Facilities Act to provide coordinated and  
               comprehensive statewide service system of quality  
               community care for mentally ill, developmentally and  
               physically disabled, and children and adults who  
               require care or services by a facility or organization  
               issued a license or special permit. (HSC § 1500 et  
               seq.)

                                                         Continued---



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             2)   Defines "Community care facility" as any facility,  
               place, or building that is 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. (HSC § 1502)

             3)   Separately, 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, or personal care are provided, based upon  
               their varying needs, as determined in order to be  
               admitted and to remain in the facility. Persons under  
               60 years of age with compatible needs may be allowed  
               to be admitted or retained in a residential care  
               facility for the elderly. (HSC § 1569.2(k))

             4)   Requires the Department of Social Services (DSS) to  
               inspect and license CCFs and RCFEs. (HSC § 100150;   
               HSC § 1569.11)

             5)   Prohibits any person, firm, partnership,  
               association, or corporation within the state as well  
               as any state or local public agency from operating,  
               establishing, managing, conducting or maintaining a  
               CCF, without a current valid California license. (HSC  
               § 1508)

             6)   Establishes that any person may request an  
               inspection of any CCF or RCFE. (HSC § 1538(a);  
               1569.35)

             7)   Prohibits any licensee from discriminating or  
               retaliating in any manner against any person receiving  
               the services of the licensee's CCF, or against any  
               employee of such licensee's facility, on the basis, or  
               for the reason that, such person or employee or any  
               other person has initiated or participated in an  
               inspection. (HSC § 1539)

             8)   Prohibits any licensee from discriminating or  




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               retaliating in any manner against any person receiving  
               the services of the licensee's RCFE, or against any  
               employee of the licensee's facility, because the  
               person or employee or any other person has initiated  
               or participated in an inspection. (HSC § 1569.37)

             9)   Establishes a Long-Term Care Ombudsman Program to  
               encourage community contact and involvement with  
               elderly patients or residents of long-term care  
               facilities or residential facilities through the use  
               of volunteers. (WIC § 9700)  

              10)  Permits the State Ombudsman to investigate and  
               resolve complaints that are made by, or on behalf of,  
               residents of long-term care facilities, as specified.  
               (WIC § 9712.5(a))  
                
           This bill:

              1)   Adds to existing statute that the CCF licensee, or  
               the officer or employee of the licensee shall not  
               discriminate or retaliate against any person, as  
               specified.

             2)   Adds to existing statute that the RCFE licensee, or  
               the officer or employee of the licensee shall not  
               discriminate or retaliate against any person, as  
               specified.

             3)   Specifies in both CCF and RCFE statute that  
               discrimination or retaliation includes eviction or  
               threat of eviction.

             4)   Expands existing statute that establishes  
               protections for individuals who initiated or  
               participated in an inspection to those individuals who  
               file of a complaint, grievance, or a request for  
               inspection.

             5)   Expands existing statute that establishes  
               protections for individuals initiating, participating  
               or filing a complaint with DDS to those individuals  
               initiating, participating or filing a complaint to the  
               appropriate local or state ombudsman.
           




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                                  FISCAL IMPACT  

          An Assembly Appropriations Committee analysis indicates  
          that minor nonreimbursable local law enforcement costs are  
          offset to some extent by fine revenues to the extent anyone  
          is charged with a misdemeanor violation.

                            BACKGROUND AND DISCUSSION
                                         
           Purpose of the bill

           According to the author, AB 581 will extend protections  
          against discriminatory and retaliatory actions by  
          prohibiting staff of a community care facility or  
          residential care facility for the elderly from retaliating  
          against a person for filing a complaint or grievance with  
          the local Ombudsman Program. The author claims that because  
          existing law only protects from retaliation against  
          licensees, individuals are discouraged from filing  
          grievances against staff members for fear of retaliation.

           Community Care Facility

           CCFs are licensed by the Community Care Licensing Division  
          of + DSS to provide 24-hour, non-medical, residential care  
          to children and adults with developmental disabilities who  
          are in need of personal services, supervision, or  
          assistance essential for self-protection or with performing  
          activities of daily living. CCFs have various service  
          levels which include providing limited care and supervision  
          for people who can care for themselves to providing  
          professional care and supervision for people with deficits  
          in self-help skills, and/or severe impairment in physical  
          coordination and mobility, and/or severely disruptive or  
          self-injurious behavior. 
           
           According to DSS, as of May 2013, there were 77,059  
          licensed facilities in the state with a total capacity of  
          1.4 million residents.

          CCFs that provide less than 24-hour nonmedical care and  
          supervision include:
                 Child Day Care Facilities: Child Care Centers and  
               Family Child Care Homes
                 Adult Day Programs




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          CCFs that provide 24-hour nonmedical care and supervision  
          include:

                 Children's Residential Facilities including Group  
               Homes, Foster Family Homes, Small Family Homes,  
               Transitional Housing, Crisis Nursery, Adoption  
               Agencies, Foster Family Agencies
                 Adult Residential Facilities including Social  
               Rehabilitation Facilities
                 Residential Care Facilities for the Elderly

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          |      |      |
          |      |      |
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          |      |      |
           ------------- 
           Residential Care Facility for the Elderly

           RCFEs are a specific type of CCF that provide a housing  
          arrangement chosen voluntarily by the resident, the  
          resident's guardian, conservator or other responsible  
          person. RCFEs provide care, supervision and assistance with  
          activities of daily living, such as bathing and grooming.  
          They may also provide incidental medical services under  
          special care plans. RCFEs are licensed by the Community  
          Care Licensing Division of DSS.

          The RCFEs provide services to people 60 years of age and  
          over and people under age 60 with compatible needs. RCFEs  
          may also be known as assisted living facilities, retirement  
          homes and board and care homes. RCFEs can range in size  
          from six beds or less to more than 100 beds. The residents  
          in these facilities require varying levels of personal care  
          and protective supervision. 

           Office of the State Ombudsman

           The state's Long-Term Care Ombudsman program is  
          administered through the California Department of Aging and  
          35 local programs contracted through the network of local  
          area agencies on aging (AAA). The program utilizes  
          approximately 950 volunteers and 155 paid full-time and  
          part-time staff to serve as resident/patient advocates of  




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          residents in more than 9,000 long-term care facilities.  
          Volunteers initially receive a minimum of 36 hours of  
          training to carry out their duties. 


          According to the California Department of Aging website,  
          the primary responsibility of the program is to investigate  
          and endeavor to resolve complaints made by, or on behalf  
          of, individual residents in long-term care facilities. The  
          goal of the program is to advocate for the rights of all  
          residents of long-term care facilities. 


           Expanding Protections Against Retaliation

           Existing law (HSC § 1539, 1569.37) offers protection  
          against retaliation to residents or employees who request  
          an inspection from DSS against retaliation by the RCFE  
          licensee. AB 581 would extend that protection to people  
          requesting an investigation from the Ombudsman as well.  
          Additionally, it extends protections to residents or  
          employees who are retaliated against by an officer or  
          employee of an RCFE. It also extends those protections to  
          individuals who file a complaint or grievance.  


                                     COMMENTS

           Staff notes that the legislation would expand protections  
          against retaliation from officers or employees of CCL or  
          RCFE licensees. Staff recommends extending these  
          protections in the same manner to Residential Care  
          Facilities for Persons With Chronic Life-Threatening  
          Illness in the HSC 1568.07(d).

           1568.07(d) No licensee shall discriminate or retaliate in  
          any manner against any person receiving the services of the  
          facility of the licensee, or against any employee of the  
          facility, on the basis, or for the reason, that a person or  
          employee or any other person has initiated or participated  
          in an inspection pursuant to Section 1568.071
           
          No licensee, or officer or employee of the licensee,  shall  
          discriminate or retaliate in any manner, including, but not  
          limited to, eviction or threat of eviction,  against any  




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          person receiving the services of the  licensee's facility,  
          or against any employee of the  licensee's facility, on the  
          basis, or for the reason that, the  person or employee or  
          any other person has initiated or participated in the  
          filing of a complaint, grievance, or a request for  
          inspection with the department pursuant to this chapter or  
          has initiated or participated in the filing of a complaint,  
          grievance, or request for investigation with the  
          appropriate local or state ombudsman. 
          

                                   PRIOR VOTES

           Assembly Floor:     75 - 0
          Assembly Appropriations:17 - 0
          Assembly Judiciary: 10 - 0
          Assembly Human Services:  7 - 0 
           

                                   POSITIONS  

          Support:       California Assisted Living Association  
          (CALA)
                         California Continuing Care Residents  
          Association (CALCRA)
                         Causa Justa :: Just Cause
                         County Welfare Directors Association (CWDA)
                         7 Individuals 

          Oppose:   None on file


                                        
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