BILL ANALYSIS                                                                                                                                                                                                    Ó




                                                                  AB 1217
                                                                  Page A
          Date of Hearing:   April 30, 2013

                        ASSEMBLY COMMITTEE ON HUMAN SERVICES
                                  Mark Stone, Chair
               AB 1217 (Lowenthal) - As Introduced:  February 22, 2013
           
          SUBJECT  :  Home Care Services Consumer Protection Act of 2013

          SUMMARY  :  Enacts the Home Care Services Consumer Protection  
          (HCSC) Act of 2013.  Specifically,  this bill  :   

          1)States findings and declarations of the Legislature as to the  
            need to regulate the home care provider industry through the  
            establishment of a statewide registration and oversight  
            system.

          2)Establishes the Home Care Services Act of 2011, and requires  
            the Department of Social Services (DSS) to administer and  
            enforce the law.

          3)Defines "home care aide" as an individual who provides home  
            care services to a client in the client's residence, and  
            includes a person who qualifies as a personal attendant as  
            defined by the Industrial Welfare Commission, but does not  
            include the following:

             a)   A family member, as defined; and

             b)   A person employed by a vendor or contractor of a  
               regional center or the Department of Developmental Services  
               (DDS) providing services to people with developmental  
               disabilities pursuant to the Lanterman Developmental  
               Disabilities Services Act (Lanterman Act) or the California  
               Early Intervention Services Act (Early Intervention Act)  
               when funding is provided through DDS and more than 50% of  
               the recipients of the organization are people with  
               developmental disabilities.

          4)Defines "home care organization" (HCO) as an individual,  
            partnership, corporation, limited liability company, joint  
            venture, association, or other entity that arranges for the  
            provision of home care services by a home care aide to a  
            client in the client's residence, but does not include the  
            following:










                                                                  AB 1217
                                                                  Page B
             a)   A home health agency;

             b)   A licensed hospice;

             c)   A health facility;

             d)   A licensed home medical device retail facility;

             e)   A residential care facility for the elderly;

             f)   A vendor or contractor of a regional center or DDS  
               providing services to people with developmental  
               disabilities, as described in 3b above;

             g)   An employment agency as defined in Civil Code Section  
               1812.5095 that is not the employer of home care aides or  
               other workers who provide assistance with activities of  
               daily living; and

             h)   A county providing in-home supportive services pursuant  
               to the In-Home Supportive Services (IHSS) program.

          5)Defines "home care services" as services provided by a home  
            care aid to a client who, because of advanced age or physical  
            or mental infirmity, cannot perform these services for himself  
            or herself, but does not include the services provided by:

             a)   A licensed home health agency;

             b)   A licensed hospice;

             c)   A licensed health facility;

             d)   A licensed residential care facility for the elderly;

             e)   The adherents of and in connection with the practice of  
               the religious tenets of any well recognized church or  
               denomination, so long as they do not otherwise engage in  
               the practice of nursing; or

             f)   Services provided pursuant to the IHSS program.

          6)Defines "Employment Agency" as an agency that procures,  
            offers, refers, provides, or attempts to provide, but is not  
            the employer of, a home care aide who provides home care  









                                                                  AB 1217
                                                                  Page C
            services to clients and consumers in accordance with Civil  
            Code Section 1812.5095, as long as the agency does not employ  
            a home care aide or a person who assists with activities of  
            daily living to the consumer.

          7)Defines a "Priority One Complaint" as a complaint of sexual  
            abuse that involves penetration, a complaint of physical abuse  
            that results in bodily injury, or one that results in the  
            death of a client due to suspicious circumstances.

          8)Defines a "Priority Two Complaint" as a complaint of sexual  
            abuse that involves sexual behavior that does not involve  
            penetration, physical abuse that results in minor injury, and  
            a complaint of felony offenses.

           Licensure

           9)Requires, on or after July 1, 2014, non-exempted entities  
            providing home care services by a home care aide to obtain a  
            license pursuant to the Home Care Services Act of 2013 (HCSA),  
            and establishes civil penalties for violations of this  
            requirement.

          10)Allows DSS to adopt rules and regulations to implement the  
            act; to investigate Priority One and Two Complaints against  
            home care aides not employed by a HCO; establish procedures  
            for the receipt, investigation and resolution of complaints;  
            maintain a registry on its Internet Web site of all certified  
            home care aides, containing limited information that includes  
            their employers, their certification status, and the status of  
            disciplinary actions against them; and, maintain a registry on  
            its Internet Web site of all licensed HCOs containing  
            specified information.

          11)Requires DSS to issue an HCO license to an entity meeting  
            requirements, including, proof of liability insurance; proof  
            of workers' compensation coverage; and, background clearances  
            of the organization's owners.

          12)Requires background clearances of the owners of HCOs, as  
            described, and requires DSS to request subsequent arrest  
            notification service from the Department of Justice (DOJ).   
            Requires DOJ to charge a fee to cover costs related to this  
            bill.










                                                                  AB 1217
                                                                  Page D
          13)Authorizes DSS to deny a license if the background clearance  
            discloses a conviction for a felony or crime that is  
            substantially related to the qualifications, functions, or  
            duties of operating an HCO, and provides that the license  
            shall not be denied if, pursuant to applicable Penal Code  
            provisions, the applicant has obtained a certificate of  
            rehabilitation or the information or accusation against the  
            applicant has been dismissed. 

          14)Requires DSS, in determining whether or not to deny a license  
            based on a prior conviction, to consider specified factors  
            related to the nature and seriousness of the crime, its  
            relationship to the person's employment duties and  
            responsibilities, the person's post-conviction activities, the  
            time elapsed, the individual's compliance with conditions of  
            parole, probation, restitution or other sanctions, other  
            evidence of rehabilitation, employment history and employer  
            recommendations, and the circumstances surrounding the  
            commission of the offense demonstrating the unlikelihood of  
            repetition.

          15)Requires DSS to provide notice, as specified, to the  
            applicant by personal service or registered mail if a license  
            application is denied based on a prior criminal conviction,  
            and specifies procedures for requesting and conducting an  
            administrative hearing.

          16)Prohibits a public or private organization, except a county  
            providing IHSS services or other entity exempted from  
            licensing under the HCSA, from representing itself to be an  
            HCO, implying that it has a license to provide home care  
            services, referring to employee bonding in relation to such  
            services, or using the terms "health care organization," "home  
            care," "in-home care," or any combination of such terms in its  
            name, unless it is licensed pursuant to the HCSA. 

          17)Requires DSS to issue a notice of violation if it determines  
            that a home care aide is in violation of the HCSA and its  
            related regulations, as specified.

          18)Allows DSS to investigate complaints against an employment  
            agency if it fails to comply with the HCSA and levy civil  
            penalties of up to $900 per day per violation.

           Complaints, Inspections, and Investigations









                                                                 AB 1217
                                                                  Page E

           19)Allows DSS to investigate complaints filed against HCOs and  
            home care aides.

          20)Requires DSS to conduct random, unannounced inspections once  
            every five years to ensure compliance with the HCSA.

           HCO Operating Requirements

           21)Requires HCOs to comply with regulations promulgated by DSS  
            and adhere to other specified operating requirements.

          22)Requires HCOs, with respect to home care aides employed by  
            the organization, to consult the DSS registry before hiring  
            the individual, ensure that he or she meets the requirements  
            for home care aides specified in the act, evaluate home care  
            aides, as provided, and ensure that, when providing services,  
            home care aides have access to a supervisor at all times and  
            wear an identification badge.

          23)Requires HCOs to investigate complaints against a home care  
            aide made by a client or the client's family, and if the HCO  
            determines that the home care aide violated the HCSA, it shall  
            immediately notify DSS to take the appropriate action to  
            address the violation.

          24)Requires HCOs to ensure that each of its home care aides  
            employed prior to January 1, 2015, are certified pursuant to  
            the HCSA by July 1, 2015.

          25)Requires HCOs to immediately notify DSS when they no longer  
            employ a home health care aide to allow DSS to update its  
            Internet Web site.

          26)Requires home care aides to demonstrate that they are free of  
            active tuberculosis, as specified, and to annually complete  
            not less than five hours of DSS-approved job-related training,  
            and prohibits home care aides from accepting money or property  
            from a client without written permission of the HCO.

           Employment Agency Insurance  

          27)Requires employment agencies that are exempt from licensure  
            as an HCO to maintain general and professional liability  
            insurance of $1,000,000 per occurrence and $3,000,000 in the  









                                                                  AB 1217
                                                                  Page F
            aggregate.

           Client Rights

           28)Establishes requirements on HCOs to protect clients' rights,  
            including the following:

             a)   Advising clients of changes in the client's plan for  
               home care services; and,

             b)   Prior to arranging for the provision of home care  
               services to a client:

               i)     Distributing to the client its advance directive  
                 policy and a summary of applicable state law;

               ii)    Advising the client of its policy on disclosure of  
                 client records;

               iii)   Informing the client of the types and hours of  
                 available home care services;

               iv)    Advising and updating the client, orally and in  
                 writing, concerning applicable payment sources, including  
                 Medi-Cal or Medicare; and

               v)     Having a written agreement with the client that  
                 includes the cost of and hours during which home care  
                 services will be provided, and reference to personal  
                 attendant requirements, if applicable.

          29)Delineates home care client rights, including the rights to  
            have the client's property treated with respect, voice  
            grievances free of reprisal, be informed and participate in  
            the planning of home care services, and confidentiality of the  
            client's personal information.

           Home Care Aides

           30)Requires DSS to certify any person hired after January 1,  
            2014 as a home care aide to be within 90 days of the date of  
            hire and that any person referred by an employment agency who  
            provides assistance with activities of daily living be  
            certified prior to any referral.










                                                                  AB 1217
                                                                  Page G
          31)Establishes training requirements for home care aide  
            certification, including requiring home care aides to complete  
            five paid hours of DSS approved training on job-related  
            topics, training curricula that are developed with input from  
            consumer and worker representatives, require instruction by  
            qualified instructors, and are approved by DSS.

          32)Requires that DSS set a fee for a two-year certification to  
            be paid for by the home care aide.

          33)Requires applicants for certification to submit to an  
            examination to determine if he or she is free of active  
            tuberculosis.

          34)Prohibits, beginning January 1, 2015, an HCO from hiring an  
            individual as a home care aide unless the individual completes  
            an interview and meets specified job requirements, and  
            requires the individual to provide proof of certification.

          35)Authorizes DSS to issue a temporary home care aide  
            certificate if it determines that required training is not  
            available in an applicant's county, and provides that required  
            entry-level and annual training may be completed through an  
            on-line training program.

          36)Requires an applicant for employment as a home care aide to  
            consent to a background clearance, and prohibits a home care  
            aide employed on or after January 1, 2015, from providing home  
            care services until he or she passes the required background  
            clearance.

          37)Requires a background clearance through DOJ, as described, on  
            individuals hired as home care aides, unless the individual  
            holds a valid, unexpired license or registration in a  
            health-related field that requires background checks; requires  
            DSS to request subsequent arrest notification service from  
            DOJ; and, requires DOJ to charge a fee to cover the actual  
            costs related to these activities.

          38)Requires that DSS deny certification to an individual  
            convicted or incarcerated for conviction, within 10 years, for  
            child abuse, senior or dependent adult abuse, a violent or  
            serious felony as defined in the Penal Code, or a felony  
            offense for which the person is required to register as a sex  
            offender, unless the individual has obtained a certificate of  









                                                                  AB 1217
                                                                  Page H
            rehabilitation, or the information or accusation has been  
            dismissed, pursuant to specified provisions of the Penal Code.

          39)Requires DSS to provide notice, as specified, to the  
            applicant for certification by personal service or registered  
            mail if a license application is denied based on a prior  
            criminal conviction, and specifies procedures for requesting  
            and conducting an administrative hearing.

          40)Provides that an applicant for certification convicted of a  
            disqualifying offense may seek from DSS a general exception to  
            the exclusion, and that DSS shall consider the same factors  
            applicable to the determination of whether to deny a license  
            to a prospective licensee based on a prior conviction.   
            Specifies notice requirements and administrative hearing  
            procedures in the event a request for a general exception is  
            denied.

          41)Requires an employment agency to ensure that any person it  
            refers to provide home care services or assistance with  
            activities of daily living has been certified prior to  
            referral.

           Revenues

           42)Requires DSS to assess licensure and certification fees in  
            amounts sufficient to cover the costs of administering the  
            HCSA.

          43)Prohibits the use of General Fund (GF) moneys for purposes of  
            funding activities under the HCSA unless specifically  
            transferred or appropriated by the Legislature.

          44)Establishes the Home Care Organization and Home Care Aide  
            Fund within the State Treasury and requires that licensure and  
            certification funds, as well as fines and penalties, be  
            deposited into the Fund, from which funds shall, upon  
            appropriation by the Legislature, be made available to DSS to  
            administer the HCSA.

          45)Requires DSS to report on all costs for home care licensure  
            and home care aide certification activities, as specified, and  
            to submit the report to the Legislature and make it available  
            to the public on its Internet Web site.










                                                                  AB 1217
                                                                  Page I
           Enforcement and Penalties

           46)Establishes requirements for notifying HCOs and employment  
            agencies of violations of the HCSA or rules promulgated under  
            the act, and authorizes DSS to impose a fine of up to $900 per  
            violation per day based on consideration of specified factors.

          47)Requires DSS, in consultation with a working group of  
            affected stakeholders, to adopt regulations establishing  
            procedures for notices, correction plans, appeals, and  
            hearings related to enforcement of HCSA requirements.

          48)Requires DSS to issue a notice of violation to a home care  
            aide found to be in violation of the HCSA, which shall specify  
            the nature of the violation, any action DSS may take as a  
            result of the violation, and include information about their  
            right to a hearing.

          49)Requires collected penalties to be deposited into the Home  
            Care Organization and Home Care Aide Penalties Subaccount,  
            which is created within the existing State Health Facilities  
            Citation Penalties Account, and provides that, upon  
            appropriation by the Legislature, funds in the subaccount  
            shall be made available to DSS for purposes of enforcing the  
            HCSA.

           EXISTING LAW   

          1)Provides for the licensing and regulation of various  
            nonmedical residential and nonresidential community care  
            facilities by DSS and provides for the licensing and  
            regulation of healthcare facilities by the Department of  
            Public Health (DPH).

          2)Establishes the IHSS program, administered at the state level  
            by DSS, to provide personal services and home care for  
            eligible poor aged, blind and disabled individuals.

          3)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.

          4)Establishes the California Residential Care Facilities for the  









                                                                  AB 1217
                                                                  Page J
            Elderly (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 DSS.

          5)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 licensed provided by DSS.

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

           FISCAL EFFECT  :  Unknown

           COMMENTS  :    

           Medical and nonmedical home care services
           California law currently provides for two types of in-home care  
          for the elderly, disabled, and people in need of home-based  
          care; through In-Home Supportive Services (IHSS) and Home Health  
          Agencies (HHA).

          Licensed by to the California Department of Public Health (DPH),  
          HHAs provide an array of medical and non-medical care and  
          services, including skilled nursing services, based upon a plan  
          of treatment prescribed by the patient's physician or surgeon.   
          These services can range in types of care from regular  
          day-to-day home care services to significant medical care,  
          including the administration of intravenous medications and  
          other services that would otherwise be provided in a skilled  
          nursing facility (SNF).  In order to provide "home health aide  
          services," home health aides must undergo specified training and  
          be certified by DPH.  HHAs help to provide patients with the  
          opportunity to live as comfortably as possible at home while  
          receiving necessary medical care as prescribed by their  
          physician rather than in a medical facility. 

          IHSS is a county operated service, in coordination with DSS,  
          which provides in-home care to low-income elderly or disabled  
          persons.  Although similar in the provision of non-medical care,  
          IHSS differs from HHAs in that it provides support services and  









                                                                  AB 1217
                                                                  Page K
          some "paramedical services" but often not substantial, SNF-level  
          medical services in the home.  The focus of IHSS is to provide  
          services that make it possible for a patient (or recipient) to  
          live independently at home while receiving basic personal care  
          assistance and domestic services from an IHSS provider, in  
          addition to help with administering medications, assistance with  
          prosthetic devices, and bowel, bladder and menstrual care.

           Current licensing standards for community care providers
           DSS Community Care Licensing Division (CCLD) is responsible for  
          carrying out the duties established by the California Community  
          Care Facilities Act and other related licensing acts in the  
          Health and Safety Code.  It is their responsibility to:

                 Process license applications;

                 Provide monitoring, oversight and technical assistance;

                 Conduct facility and organizational visits;

                 Pursue investigations of complaints; and

                 Enforce penalties, fines and administrative legal action

          Prior to 2003, CCLD was required to visit most licensed  
          organizations once per year and family child care homes once  
          every three years.  However, due to the state's ongoing budget  
          deficit, the state eliminated these requirements in the 2003-04  
          budget and limited visits to 10% of facilities based upon their  
          poor performance history. 

          For those residential facilities not subject to annual  
          inspections, CCLD is currently required to conduct comprehensive  
          compliance inspections of a 30% random sample of facilities each  
          year, with each facility required to be visited as least once  
                                            every 5 years.  There are additional inspection requirements for  
          new facilities or when changes occur to the license, which  
          includes pre-licensing and post-licensing inspections that help  
          to ensure that a new licensee starts off correctly. 
           
          Importance of unannounced licensing visits  
          Unannounced licensing visits are of fundamental importance in  
          protecting the health and safety of children and adults  
          receiving care through facility or home-based care.  They ensure  
          that basic health and safety requirements are being met and also  









                                                                  AB 1217
                                                                  Page L
          provide opportunities for increased technical assistance to  
          programs, enhanced information sharing, the development of best  
          practices, and ultimately lead to an improvement in the quality  
          of life for clients under care. 

          Numerous studies have also been conducted, which document a  
          connection between increased licensing visits with a decrease in  
          accidents requiring medical attention<1> and greater provider  
          compliance with health and safety standards.<2>  

          Additionally, regular and frequent unannounced inspection visits  
          allow for state and local agencies to provide relevant and  
          up-to-date information to the public on the quality of care  
          being provided to consumers.  Further, DSS also stated, in a  
          2010-11 Spring Finance Letter, that "regular and frequent  
          inspections of facilities improve client health and safety as  
          evidenced by reductions in the percentage of the more serious  
          imminent risk to total citations."  Specifically, "more annual  
          inspections equates to better quality of care" and "more annual  
          inspections equates to a smaller risk to the health and safety  
          of clients."

           Regulating the home care market
           This measure seeks to regulate what is considered to currently  
          be the home care industry, which has existed for many years, but  
          has begun to increase as the nation's elderly population expands  
          and the demand for in-home care increases to allow individuals  
          to live comfortably at home with the assistance of a day-to-day  
          home care provider.  Home care providers provide basic daily  
          non-medical living assistance, such as cooking, cleaning,  
          dressing, feeding, and other regular daily needs.  However,  
          unlike their IHSS and HHA counterparts, there are no  
          requirements in current law that require home care aides to have  
          minimum levels of training, undergo a criminal background check,  
          or comply with basic standards of service.
          ---------------------------
          <1> Fiene, R. (2002). 13 indicators of quality child care:  
          Research update. U.S. Department of Health and Human Services,  
          Office of Assistant Secretary for Planning and Evaluation, at  
           http://aspe.hhs.gov/hsp/ccquality-ind02/  
          <2> Koch Consulting. (2005). Report on effective legal  
          proceedings to ensure provider compliance: Prepared for the  
          State of Washington Department of Social and Health Services.  
           http://www.naralicensing.drivehq.com/publications/archives/nara/E 
          ffective_Legal_Proceedings.pdf  









                                                                  AB 1217
                                                                  Page M

          Due to the lack of a regulatory structure and related  
          enforcement, there is no framework or definition for what is  
          considered a home care aide.  Although the title "home care  
          aide" implies a level of expertise and integrity associated with  
          a minimum level of care, any person may represent him or herself  
          as a home care aide.  In some instances, individuals may solicit  
          their services through notifications posted online on websites  
          such as Craigslist or in newspaper classified ads.  This can  
          place consumers who are in need of day-to-day living assistance  
          services in the home in potentially vulnerable situations, as  
          there are little to no existing legal requirements and  
          protections established.  In some respects, it is not  
          unreasonable to associate home care aides unaffiliated with  
          reputable or established organizations or who operate as  
          independent contractors as part of an underground home care  
          industry whereby the public rests their faith in the hope that  
          the elderly and disabled are receiving adequate and beneficial  
          care in the home. 

          Regarding established agencies and associations that currently  
          employ home care aides, there is an expectation and desire to  
          develop a regulatory framework in anticipation of public demand  
          for greater standards and accountability.  AB 1217, as proposed,  
          seeks to regulate the entirety of the home care industry,  
          addressing home care organizations and the home care aides they  
          employ, agencies that provide referrals for contract based home  
          care aides and independent home care aides. 

           Certification and registry
           This measure seeks to require home care aides to have their  
          names, certification information and geographic location, as  
          well as any information relating to disciplinary action taken  
          against them, posted on the DSS website.  Although it also  
          prohibits any home care aide's personal information from being  
          identifiable from the information required to be posted on the  
          internet, it is not specific as to what geographic location  
          means.  The intent of the public posting of a home care aide's  
          information appears intended to provide potential clients the  
          opportunity to search and review potential home care aides  
          online.  This can help to provide an effective consumer based  
          tool to identify certified home care aides.  However, it can  
          also have the impact of placing the home care aide's personal  
          safety at risk, including potential identity theft.










                                                                  AB 1217
                                                                  Page N
          Should this committee pass this measure, it should consider  
          whether the bill should be amended to:

             a)   Limit the time period a home care aide employed prior to  
               enactment of the legislation should have to comply with the  
               background check clearance requirements from one year to  
               six months; and

             b)   Limit the type of information that is required to be  
               posted publicly on the DSS' website in order to balance the  
               privacy of the home care aide with the need to provide the  
               client with sufficient information to identify potential  
               home care aides.  

             c)   Require minimum but more specific training requirements  
               for home care aides, such as client rights and safety,  
               universal health precautions, emergency procedures, living  
               skills, abuse and neglect, personal hygiene and safe  
               transport of a client.

           Need for the bill
           
          Writing regarding the need for the bill, the author states:

               AB 1217 is about consumer protection.  It requires all home  
               care agencies to be licensed by the Department of Social  
               Services and requires all home care aides, whether they  
               work for an agency or operate as an independent contractor,  
               to be certified - complete with a background check, minimum  
               training standards, and regular tuberculosis screenings.   
               Twenty-three other states, including Florida, Illinois, New  
               York, Oregon, Pennsylvania, Texas, and Washington already  
               have similar laws in place.  AB 1217 simply ensures that  
               all consumers of home care services in California have  
               access to quality care from properly screened and trained  
               caregivers, whether they receive services through a public  
               or private entity.

          Writing in support of this measure, the California Commission on  
          Aging, which also supports AB 322 (Yamada), writes:

               California is long overdue in establishing home care  
               regulation.  AB 1217 will better align the state's  
               oversight of home care providers with that of 23 other  
               states that have already taken these critical steps.  The  









                                                                  AB 1217
                                                                  Page O
               comprehensive procedures established by the bill will  
               assure that home care agencies and home care aides have  
               completed steps toward licensure or certification and that  
               their ongoing compliance can be monitored.


















































                                                                  AB 1217
                                                                  Page P

           Concerns and Opposition  
          Several home care organizations have registered their opposition  
          to AB 1217 while referencing their support for AB 322 (Yamada).   
          This committee passed out AB 322 on a 5 - 1 vote at its April  
          16, 2013 hearing.  The opposition writes that the establishment  
          of registries for home care organizations and home care aides  
          would "dramatically increase the workload" for DSS and their  
          agencies, and that "as written, the legislation would make it  
          very difficult for home care agencies to provide consumers with  
          affordable care."


           RECOMMENDED AMENDMENTS  

          1.On page 5, line 8 delete ""organization," or"  and insert  
            "and"

          2.On the following pages and lines, before "organization" insert  
            "home care"

                  i.        Page 9, line 8
                  ii.       Page 10, line 6
                  iii.      Page 13, line 16
                  iv.       Page 13, line 18
                  v.        Page 13, line 38
                  vi.       Page 14, line 19
                  vii.      Page 14, line 22
                  viii.     Page 14, line 31
                  ix.       Page 15, line 10
                  x.        Page 19, line 5
                  xi.       Page 19, line 8
                  xii.      Page 22, line 7
                  xiii.     Page 22, line 14
                  xiv.      Page 22, line 18

          1.On page 18, lines 14 after "regulation" insert the following  
            language: 

             , which shall include but not be limited to the following  
            areas:
               (1) Client rights and safety.
               (2) How to provide for and respond to a client's daily  
               living needs.
               (3) How to report, prevent, and detect abuse and neglect.









                                                                 AB 1217
                                                                  Page Q
               (4) How to assist a client with personal hygiene and other  
               home care services.
               (5) If transportation services are provided, how to safely  
               transport a client.

           2.On page 21, line 27 delete "January 1, 2015" and insert "July  
            1, 2014"

           RELATED LEGISLATION

           AB 322 (Yamada) - Establishes the Home Care Services Act of 2013  
          (HCSA) to license and regulate only home care organizations  
          providing services for the elderly, frail and persons with  
          disabilities.  This measure is currently in the Assembly  
          Appropriations Committee.

          AB 987 (Maienschein) - Requires the Secretary of the State and  
          Consumer Services Agency to apply for the United States  
          Department of Health and Human Services' Personal and Home Care  
          Aide Training Program Grant under the Affordable Care Act.  This  
          measure is currently in the Assembly Human Services Committee.

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          California Senior Legislature (CSL)
          DonningtoN Home Care
          Congress of California Seniors
          SEIU
          California Commission on Aging (CCoA)

           Opposition 
           
          Absolute Health Care
          ACCREDITED (The Accredited Family of Home Care Services)
          Care to stay Home
          Comfort Keepers
          Home Care Association of America
          Home Instead Senior Care
          La Jolla Nurses Homecare
          Pacific Coast Home Care
          Right at Home
          California Association for Health Services at Home
           









                                                                 AB 1217
                                                                  Page R
          Analysis Prepared by  :    Chris Reefe / HUM. S. / (916) 319-2089