BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 1217|
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THIRD READING
Bill No: AB 1217
Author: Lowenthal (D)
Amended: 9/11/13 in Senate
Vote: 21
SENATE HUMAN SERVICES COMMITTEE : 4-2, 6/25/13
AYES: Yee, Evans, Liu, Wright
NOES: Berryhill, Emmerson
SENATE APPROPRIATIONS COMMITTEE : 5-2, 8/30/13
AYES: De León, Hill, Lara, Padilla, Steinberg
NOES: Walters, Gaines
SENATE HUMAN SERV. COMM. : 4-2, 9/11/13 (pursuant to Senate Rule
29.10)
AYES: Yee, Evans, Liu, Wright
NOES: Berryhill, Emmerson
ASSEMBLY FLOOR : 52-26, 5/30/13 - See last page for vote
SUBJECT : Home Care Services Consumer Protection Act of 2013
SOURCE : Congress of California Seniors
DIGEST : This bill enacts the Home Care Services Consumer
Protection Act, which provides, on and after January 1, 2015,
for the licensure and regulation of home care organizations, as
defined, by Department of Social Services (DSS), and the
registration of home care aides. This bill excludes specified
entities from the definition of a home care organization and
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excludes certain types of individuals as home care aides.
Requires DSS to establish and continuously update a home care
aid registry and requires background clearances for home care
aides, as prescribed. This bill requires DSS to impose various
fees to be deposited in the Home Care Aide Fund created by this
bill.
Senate Floor Amendments of 9/11/13 remove inclusion of Child
Abuse Client Index information on the home care aide registry,
remove an inadvertent re-insertion of previously deleted
language, and make one technical amendment.
Senate Floor Amendments of 9/6/13 gut existing language and
restructure the bill, significantly revising its language and
making several key policy changes; limit the scope of a
DSS-administered public registry for home care aides and their
organizations; remove client rights protections; modify
certification requirements for aides who work for home care
organization; remove requirement for independent aides to become
certified or to be placed on the registry; and establish a
misdemeanor crime for impersonating a home health care aide,
makes other substantive changes.
Senate Floor Amendments of 9/5/13 clarify that information
shared by the Department of Social Services (DSS) pursuant to
this bill is subject to existing law (Penal Code Section 11142),
which states that the sharing of criminal records or information
from criminal records with persons not authorized by law to
receive such information is a misdemeanor.
ANALYSIS :
Existing law:
1.Establishes the California Community Care Facilities Act,
which provides for the licensing and regulation of community
care facilities providing non-medical residential care, day
treatment, and adult day care under the Department of Social
Services (DSS).
2.Provides for the licensing and regulation of health care
facilities providing diagnosis, care, prevention, and
treatment of human illness, physical or mental, to which more
than one person is admitted for a 24-hour stay or longer.
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3.Provides for the licensing and regulation of home health
agencies and home health aides providing skilled nursing
services to patients in their home residence.
4.Establishes the In-Home Supportive Services (IHSS) program to
provide in-home domestic and personal care services for aged,
blind or disabled individuals living at or below the poverty
level for the purpose of enabling IHSS consumers to avoid
institutionalization and remain safely in their homes with
supportive services.
5.Requires prospective IHSS providers to undergo a criminal
background check and establishes two tiers of exclusionary
crimes.
6.Permits an IHSS consumer or any employer of an unlicensed
in-home care provider to an aged or disabled consumer, to
request a criminal background check for the provider and
requires county welfare agencies to regularly inform the
consumer of this right.
This bill:
1.Separates the definition of "affiliated home care aides" -
those aides who are employed by a homecare organization to
provide home care services to a client - from "independent
home care aides" - those aides who are not employed by a home
care organization.
2.Removes reference to home care aide "certification" and
replaces it with "registration." Additionally, the amendments
remove DSS' oversight responsibility over registered aides,
aside from maintaining the home care registry. While
affiliated home care aides will still be required to be
registered, pass a tuberculosis test, and complete basic
training, the amendments remove these requirements for
independent home care aides.
3.Requires affiliated home care aides to be listed on the public
home care aide registry, administered by DSS, and removes the
requirement independent home care aides' registry is
voluntary. Establishes that, when determining whether to
approve an application for registration, DSS shall consider,
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among other things, whether a home care aide is "reputable and
responsible" by reviewing information including criminal
offender records.
4.Requires DSS to maintain on its website a registry of both
registered home care aides and applicants, and facilitate
public search of these individuals using the following search
criteria:
A. name
B. registration number
C. registration status
D. registration expiration date
1.Deletes language that required DSS to maintain a registry on
its Internet Web site of home care organizations and their
licensure status.
2.Removes the section on Clients' Rights.
3.Newly establishes as a misdemeanor the following: falsely
representing or presenting oneself as a home care aide
applicant or registered home care aide, and violating the
chapter in question or willfully or repeatedly violating a
rule or regulation under that chapter.
4.Adds specified child care providers in the definition of home
care aides, but excludes providers of care to children from
multiple families, foster parents, relatives and other
categories of providers, as specified.
5.Removes the section requiring employment agencies that refer,
but do not act as the employer of, home care aides to maintain
general and professional liability insurance.
6.Moves the bill's operative date to January 1, 2015.
Background
Licensing standards . Existing law generally provides for the
DPH to license or certify facilities, organizations and
individuals that provide clinical medical services, whether in a
facility or in a patient's residence. Such services range from
minor medical care to intensive skilled nursing services. Home
health providers are required to complete a minimum of 75 hours
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of training and complete a background check.
IHSS program . California's IHSS program is the state's primary
community-based long-term service, providing in-home domestic
and personal care services for 448,000 aged, blind or disabled
individuals living at or below the poverty level. The purpose
of IHSS is to enable seniors and persons with disabilities to
remain safely in their homes and avoid institutional care
through the provision of a specified number of assistance hours
provided by a home care worker under the direction of the
consumer. The program is administered locally by counties and
county public authorities under the direction and regulation of
DSS. There are approximately 386,000 providers.
Prior Legislation
AB 322 (Yamada, 2013) would have established the Home Care
Services Act of 2013 to license and regulate home care
organizations providing services for the elderly, frail and
persons with disabilities. The bill was held in Assembly
Appropriations Committee.
SB 411 (Price, 2011) would have established the Home Care
Services Act of 2011, which required DPH to license and regulate
home care organizations. The bill was vetoed by Governor Brown.
AB 899 (Yamada, 2011) would have established the Home Care
Services Act of 2013 to license and regulate home care
organizations providing services for the elderly, frail and
persons with disabilities. The bill was held in Assembly
Appropriations Committee.
AB 853 (Jones, 2007) would have established the Home Care
Services Act to license and regulate home care services for the
elderly, frail and persons with disabilities. The bill was held
in Assembly Appropriations Committee.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
According to the Senate Appropriations Committee:
One-time costs of approximately $22.5 million (General Fund)
to promulgate regulations, forms, automation changes to create
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the new licensing system and development of registries,
inspections and licensing for 2,000 agencies, and
certification of over 101,000 home care aides. Ongoing costs
to be covered by licensure and certification fees from the
newly created Home Care Organization and Home Care Aide
(HCOHCA) Fund.
Estimated ongoing costs of approximately $20 million (HCOHCA
Fund) to administer the licensure and certification programs,
to be fully offset by licensure and certification fees.
Assuming 60% of ongoing costs would be attributable to
licensure would result in a licensure fee of $6,000 per agency
and $80 certification fee per home care aide.
Fingerprint Fees Account costs to the Department of Justice of
$280,000 in FY 2013-14, $400,000 in FY 2014-15, and $130,000
in FY 2015-16 and annually thereafter for workload associated
with additional background checks required of all home care
aides and home care organization licensees.
Minor ongoing administrative costs to the Secretary of State
to the extent additional organizations register to conduct
business in California.
SUPPORT : (Verified 9/9/13)
Congress of California Seniors (source)
AARP
AFSCME
California Commission on Aging
California Council of the Blind
California Senior Legislature
Contra Costa Advisory Council on Aging
Los Angeles County District Attorney's Office
Richmond Commission on Aging
SEIU California
UDW/AFSCME Local 3930
OPPOSITION : (Verified 9/9/13)
California Association for Health Services at Home
Cambrian Homecare
Care to Stay Home
Caring Solutions
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Comfort Care Senior Services
Home Care Association of California
Home Instead Senior Care
Matched CareGivers Continuous Care
Maxim Healthcare Services, Inc.
People's Care
ARGUMENTS IN SUPPORT : According to the author's office, the
number of California residents aged 85 and older will double to
more than 1.3 million by 2030. The author's office states that
many older adults, facing chronic conditions and functional
limitations, will require the provision of medical and
non-medical services in their homes. The author's office notes
that individuals and organizations providing skilled nursing
services at a person's residence are required to be licensed,
however for non-medical in-home personal care services, only the
publicly funded service programs require providers to pass a
background check or meet basic training standards.
The author's office states that approximately 1,200
privately-funded homecare agencies operate in California with a
business license and that an unknown number of independent home
care aides provide services without any oversight or regulation.
The author's office states that this bill requires all home
care aides to be certified and that this bill ensures that all
consumers of home care services have access to quality care from
properly screened and trained caregivers, whether they receive
services through a public or private entity.
ARGUMENTS IN OPPOSITION : The Home Care Association of
California and Maxim Healthcare Services, Inc. write, expressing
their support for licensure in concept, but opposition to this
bill as drafted. Specifically, both state concerns with the
DSS-maintained registry mandated in the bill due to privacy
concerns, the availability of personal information on a website
and potential costs.
ASSEMBLY FLOOR : 52-26, 5/30/13
AYES: Alejo, Ammiano, Atkins, Bloom, Blumenfield, Bocanegra,
Bonilla, Bonta, Bradford, Brown, Buchanan, Ian Calderon,
Campos, Chau, Chesbro, Cooley, Daly, Dickinson, Eggman, Fong,
Fox, Frazier, Garcia, Gatto, Gomez, Gonzalez, Gordon, Gray,
Hall, Roger Hernández, Jones-Sawyer, Levine, Lowenthal,
Medina, Mitchell, Mullin, Muratsuchi, Nazarian, Pan, Perea, V.
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Manuel Pérez, Quirk, Quirk-Silva, Rendon, Salas, Skinner,
Stone, Ting, Weber, Wieckowski, Williams, John A. Pérez
NOES: Achadjian, Allen, Bigelow, Chávez, Conway, Dahle,
Donnelly, Beth Gaines, Gorell, Grove, Hagman, Harkey, Jones,
Linder, Logue, Maienschein, Mansoor, Melendez, Morrell,
Nestande, Olsen, Patterson, Wagner, Waldron, Wilk, Yamada
NO VOTE RECORDED: Holden, Vacancy
JL:ej 9/11/13 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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