BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 1572|
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THIRD READING
Bill No: AB 1572
Author: Eggman (D), et al.
Amended: 4/8/14 in Assembly
Vote: 21
SENATE HUMAN SERVICES COMMITTEE : 4-0, 6/10/14
AYES: Beall, DeSaulnier, Liu, Wyland
NO VOTE RECORDED: Berryhill
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
ASSEMBLY FLOOR : 72-1, 5/5/14 - See last page for vote
SUBJECT : Residential care facilities for the elderly:
resident and family
council
SOURCE : California Advocates for Nursing Home Reform
DIGEST : This bill requires a Residential Care Facility for
the Elderly (RCFE) to assist residents in establishing and
maintaining a resident council at the request of two or more
residents, instead of at the request of a majority of residents.
Additionally, this bill requires facilities to respond to
resident council concerns in writing and to promote the resident
council as specified. This bill also requires facilities to
respond to concerns raised by family councils and to include
notice of the family council as specified. This bill
additionally requires facilities to perform other specified
actions pertaining to the resident and family councils.
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ANALYSIS :
Existing law:
1. Establishes the Residential Care Facilities for the Elderly
Act, which provides for the California Department of Social
Services (DSS) to license and regulate RCFEs as a separate
category within the existing community care licensing (CCL)
structure of DSS.
2. Requires every licensed RCFE, at the request of a majority of
residents, to assist residents in establishing and
maintaining a resident-oriented facility council composed of
residents and family members.
3. Provides that a willful and repeated violation of the above
shall not constitute a misdemeanor offense but shall be
subject to other civil penalties established pursuant to the
RCFE Act.
4. Provides that an RCFE may not prohibit the formation of a
family council and requires the family council be permitted
to meet in a common room of the RCFE, be provided with
adequate space on a prominent bulletin board.
5. Defines family council as a meeting of two or more family
members, friends, responsible parties or legal agents of
residents.
This bill:
1. Requires RCFEs assist residents in establishing and
maintaining a single resident council at the facility at the
request of two or more residents and renames "resident
oriented facility council" as "resident councils."
2. Provides that various non-resident stakeholders may
participate in resident council meetings and activities at
the invitation of the council.
3. Requires a facility to respond in writing to written concerns
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or recommendations made by a resident council or a family
council within 14 days.
4. Establishes numerous rights of the resident council including
to meet independently with outside persons or facility
personnel and for members to be informed by the facility
about each resident's right to be interviewed as part of the
regulatory inspection process.
5. Requires an RCFE to promote the resident council by informing
residents, providing information regarding the timing and
location of meetings, and the resident representative
contact.
6. Requires an RCFE with 16 or more residents to appoint a
designated staff liaison to assist a resident council or a
family council, as specified.
7. Prohibits an RCFE from willfully interfering with the
formation of a resident or family council or its
participation in the regulatory inspection process, as
defined.
8. Provides that facility personnel may attend a family council
meeting only at the invitation of the council and that upon
request of the family council, a facility shall share the
name and contact information of the designated representative
of the family council with the long-term care ombudsman
program.
9. Requires facilities to provide notice regarding the family
council in routine mailings and to inform family members and
resident representatives identified on a new or current
resident's admissions agreement regarding the family council;
or if no family council exists, requires the facility to
provide written information to the family or resident
representative of their right to form a council.
10.Prohibits an RCFE from willfully interfering with the
formation of a resident council or its participation in the
regulatory inspection process, as defined.
11.Provides that a violation of the facility requirements
pertaining to both resident councils and family councils
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shall constitute a violation of resident's rights and imposes
a $250 daily civil penalty until the violation is corrected.
Background
According to the author's office, RCFEs currently are not
required to inform residents and their families or
representatives of their right to form resident and family
councils. The author's office further states that existing law
requiring a majority of residents to request the formation of a
resident council is prohibitive to the creation of resident
councils. The author's office states that resident and family
councils allow concerns to be addressed through a formal body
that is tasked with representing the interests of the residents
and family members and those councils may be able to resolve
disputes without the involvement of CCL, thus saving the state
money.
This bill is part of a broad package of legislation sponsored by
California Advocates for Nursing Home Reform (CANHR) in response
to recent instances of inadequate regulatory oversight of RCFEs.
A series of events has drawn attention to questions about the
adequacy of DSS oversight and the state's ability to protect
people who reside in RCFEs.
In July 2013, ProPublica and Frontline reporters wrote and
produced a series of stories on Emeritus, the nation's
largest RCFE provider. Featured in the article was a woman
who died after receiving poor care at in a facility in
Auburn, California. The series documented chronic
understaffing, a lack of required assessments and substandard
care.
Reports in September 2013, prompted by a consumer watchdog
group that had hand-culled through stacks of documents in San
Diego, revealed that more than two dozen seniors had died in
recent years in RCFEs under questionable circumstances that
went ignored or unpunished by CCL.
In late October 2013, 19 frail seniors were abandoned at
Valley Springs Manor in Castro Valley by the licensee and all
but two staff after the state began license revocation
proceedings. DSS inspectors, noting the facility had been
abandoned, left the two unpaid service staff to care for the
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abandoned residents with insufficient food and medication,
handing them a $3,800 citation before leaving for the
weekend. The next day sheriff's deputies and paramedics sent
the patients to local hospitals.
Regulatory Oversight . The CCL division of DSS provides the
primary public oversight over the quality and care provided in
RCFE facilities. Prior to January 2004, CCL conducted annual
visits of all RCFEs and other licensed facilities within its
jurisdiction. However, as a result of a series of budget cuts
beginning in 2003, CCL began inspecting facilities based on a
random sample protocol. Under this scenario, those facilities
that warrant close monitoring because of a poor history of
compliance are monitored annually, as well as facilities that
are federally required to be inspected annually. Typically,
this comprises about 10% of all facilities. Of the remaining
90%, approximately 30% are randomly selected for inspection each
year. A five-year inspection mandate was imposed with the
intent to catch facilities that are not randomly selected at
least that often for inspection.
A 2008 study published by the California Health Care Foundation
investigating the impact on the truncated frequency of visits
found that "routine visits were replaced with significant
increases in the number of complaint and problem-driven visits"
and that "the monitoring of quality of care in RCFEs has become
a complaint and problem driven process."
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
SUPPORT : (Verified 6/20/14)
California Advocates for Nursing Home Reform (source)
California Long-Term Care Ombudsman Association
County of San Diego
ARGUMENTS IN SUPPORT : The bill's sponsor, CANHR, states that
resident councils and family councils can positively influence
the quality of care in RCFEs by offering a forum to enhance
communications with facility staff and assist with identifying
and addressing facility problems. The author's office and
sponsor additionally state that while existing law permits the
formation of resident and family councils, it does not encourage
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their development, as there is no affirmative obligation for
facilities to inform potential participants or their right to
form, or the existence of a resident or family council, nor any
obligation to respond to concerns raised.
ASSEMBLY FLOOR : 72-1, 5/5/14
AYES: Achadjian, Alejo, Allen, Ammiano, Atkins, Bigelow, Bloom,
Bocanegra, Bonilla, Bonta, Bradford, Brown, Buchanan, Ian
Calderon, Campos, Chau, Chávez, Chesbro, Conway, Cooley,
Dababneh, Dahle, Daly, Dickinson, Eggman, Fong, Fox, Frazier,
Beth Gaines, Garcia, Gatto, Gomez, Gonzalez, Gordon, Gorell,
Gray, Grove, Hagman, Hall, Harkey, Holden, Jones,
Jones-Sawyer, Levine, Linder, Lowenthal, Maienschein, Medina,
Mullin, Muratsuchi, Nazarian, Nestande, Olsen, Pan, Perea, V.
Manuel Pérez, Quirk, Quirk-Silva, Rendon, Ridley-Thomas,
Rodriguez, Salas, Skinner, Stone, Ting, Wagner, Weber,
Wieckowski, Wilk, Williams, Yamada, John A. Pérez
NOES: Donnelly
NO VOTE RECORDED: Roger Hernández, Logue, Mansoor, Melendez,
Patterson, Waldron, Vacancy
JL:d 6/23/14 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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