BILL NUMBER: AB 1816	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  MAY 23, 2014
	AMENDED IN ASSEMBLY  APRIL 7, 2014

INTRODUCED BY   Assembly Member Yamada

                        FEBRUARY 18, 2014

   An act to amend Section 1420 of the Health and Safety Code,
relating to long-term health care facilities.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 1816, as amended, Yamada. Long-term health care facilities.
   (1) Existing law provides for the licensure and regulation by the
State Department of Public Health of health care facilities,
including long-term health care facilities, as defined. Existing law
establishes procedures to be followed when the department receives a
written or oral complaint about a long-term health care facility. A
complaint is defined to mean any notice to the department, other than
a report from the facility, of an alleged violation of applicable
requirements of state or federal law or any alleged facts that might
constitute a violation.
   This bill  , on or before July 1, 2015,  would require
the department to  complete its investigation of the
complaint within 40 working days of its receipt, except that this
period may be extended up to an additional 30 days if the department
has diligently attempted, but has not been able, to obtain necessary
evidence related to the investigation   set a
performance benchmark for completing its investigations within a
defined number of days after receiving the complaint, not to exceed
60 working days  . The bill would require the department, if it
extends an investigation beyond  40 working days 
 the number of days specified in the benchmark  , to notify
the complainant, in writing, of the basis for the extension. 
The bill would also require, if the investigation exceeds 70 working
days due to circumstances beyond the department's control, that the
department notify the complainant in writing and by telephone or
e-mail of the delay in the investigation and the reason for the
delay.  The bill would require, effective July 1, 2015, 
and upon request of the complainant,  that the 
department's written determination   department
provide specific findings concerning  each   an
 alleged violation, and include a summary of the evidence upon
which the determination is based. The bill would require the
department to comply with those specified time periods established
for investigations and inspections of complaints from a facility of
an alleged violation of applicable requirements of state or federal
law or any alleged facts that may constitute an alleged violation of
these requirements.  The bill would require the department to
analyze its compliance with the benchmark in its annual system and
staffing analysis to make that analysis available to the relevant
fiscal and policy committees of the Legislature, and to post it on
the department's Internet Web site. 
   (2) Existing law provides the complainant with 5 business days
after receipt of the notice of the department's determination in
which to request an informal conference.
   This bill would, instead, provide the complainant with 15 days
after receipt of the notice in which to request an informal
conference.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 1420 of the Health and Safety Code is amended
to read:
   1420.  (a) (1) Upon receipt of a written or oral complaint, the
department shall assign an inspector to make a preliminary review of
the complaint and shall notify the complainant within two working
days of the receipt of the complaint of the name of the inspector.
Unless the department determines that the complaint is willfully
intended to harass a licensee or is without any reasonable basis, it
shall make an onsite inspection or investigation within 10 working
days of the receipt of the complaint. In any case in which the
complaint involves a threat of imminent danger of death or serious
bodily harm, the department shall make an onsite inspection or
investigation as soon as practicable, and in no case more than 24
hours of the receipt of the complaint. In any event, the complainant
shall be promptly informed of the department's proposed course of
action and of the opportunity to accompany the inspector on the
inspection or investigation of the facility. Upon the request of
either the complainant or the department, the complainant or his or
her representative, or both, may be allowed to accompany the
inspector to the site of the alleged violations during his or her
tour of the facility, unless the inspector determines that the
privacy of any patient would be violated thereby.
   (2) When conducting an onsite inspection or investigation pursuant
to this section, the department shall collect and evaluate all
available evidence and may issue a citation based upon, but not
limited to, all of the following:
   (A) Observed conditions.
   (B) Statements of witnesses.
   (C) Facility records.
   (3)  The   On or before July 1, 2015, the
 department shall  complete its   set a
performance benchmark for completing its  investigation 
within 40 working days from receipt of   within a
defined number of days after receiving  the complaint. 
The 40-working-day period may be extended up to an additional 30 days
if the department has diligently attempted, but has not been able to
obtain, necessary evidence related to the investigation. The
department shall analyze its compliance with this requirement in its
annual system and staffing analysis prepared pursuant to subparagraph
(B) of paragraph (2) of subdivision (d) of Section 1266. This
analysis shall include, but not be limited to, a tabulation of open
investigations and completed investigations that summarizes the
number of extensions and their duration.   The
performance benchmark may be less than, but shall not exceed, 60
working days. 
   (4) If the department extends an investigation beyond  40
working days   the number of days specified in the
performance benchmark  , it shall notify the complainant, in
writing, of the basis for the extension, and shall include in the
notice  any outstanding evidence and the sources from which
the evidence has been sought,   the status of the
investigation  and the anticipated completion date.  In
the unusual event that an investigation must be extended beyond 70
working days due to circumstances beyond the department's control,
the department shall notify the complainant in writing and by
telephone or e-mail of the delay in the investigation and the reason
for the delay.  The department shall, thereafter, complete
the investigation as expeditiously as possible.
   (5) Within 10 working days of the completion of the complaint
investigation, the department shall notify the complainant and
licensee, in writing, of the department's determination as a result
of the inspection or investigation.
   (6) Effective July 1, 2015,  up   on request of the
complainant,  the  department's written determination
  department  shall provide specific findings
concerning  each   an  alleged violation,
and shall include a summary of the evidence upon which the
determination is made. The written determination shall not disclose
the names of individual residents.
   (b) Upon being notified of the department's determination as a
result of the inspection or investigation, a complainant who is
dissatisfied with the department's determination, regarding a matter
which would pose a threat to the health, safety, security, welfare,
or rights of a resident, shall be notified by the department of the
right to an informal conference, as set forth in this section. The
complainant may, within 15 days after receipt of the notice, notify
the director in writing of his or her request for an informal
conference. The informal conference shall be held with the designee
of the director for the county in which the long-term health care
facility that is the subject of the complaint is located. The
long-term health care facility may participate as a party in this
informal conference. The director's designee shall notify the
complainant and licensee of his or her determination within 10
working days after the informal conference and shall apprise the
complainant and licensee in writing of the appeal rights provided in
subdivision (c).
   (c) If the complainant is dissatisfied with the determination of
the director's designee in the county in which the facility is
located, the complainant may, within 15 days after receipt of this
determination, notify in writing the Deputy Director of the Licensing
and Certification Division of the department, who shall assign the
request to a representative of the Complainant Appeals Unit for
review of the facts that led to both determinations. As a part of the
Complainant Appeals Unit's independent investigation, and at the
request of the complainant, the representative shall interview the
complainant in the district office where the complaint was initially
referred. Based upon this review, the Deputy Director of the
Licensing and Certification Division of the department shall make his
or her own determination and notify the complainant and the facility
within 30 days.
   (d) Any citation issued as a result of a conference or review
provided for in subdivision (b) or (c) shall be issued and served
upon the facility within three working days of the final
determination, unless the licensee agrees in writing to an extension
of this time. Service shall be effected either personally or by
registered or certified mail. A copy of the citation shall also be
sent to each complainant by registered or certified mail.
   (e) A miniexit conference shall be held with the administrator or
his or her representative upon leaving the facility at the completion
of the investigation to inform him or her of the status of the
investigation. The department shall also state the items of
noncompliance and compliance found as a result of a complaint and
those items found to be in compliance, provided the disclosure
maintains the anonymity of the complainant. In any matter in which
there is a reasonable probability that the identity of the
complainant will not remain anonymous, the department shall also
notify the facility that it is unlawful to discriminate or seek
retaliation against a resident, employee, or complainant.
   (f) For purposes of this section, "complaint" means any oral or
written notice to the department, other than a report from the
facility, of an alleged violation of applicable requirements of state
or federal law or any alleged facts that might constitute a
violation of these requirements.
   (g) The department shall apply the timeframes for investigation or
inspection established in this section to a report from the facility
of an alleged violation of applicable requirements of state or
federal law or any alleged facts that might constitute a violation of
those requirements.
   (h)  (1)    It is the intent of
the Legislature in enacting the amendments that added this
subdivision that the department endeavor to complete investigations
of complaints  made on behalf of a resident of a long-term
health care facility within 40 days   within the
benchmark established pursuant to this section . 
   (2) It is also the intent of the Legislature that only those
complaints that require additional time because the department has
diligently attempted, but has been unable, to obtain necessary
evidence related to the investigation receive an extension of up to
30 days, as necessary to complete the investigation. 

   (3) It is the Legislature's further intent that after 70 working
days, if a complaint investigation has not been completed, the
department shall contact the complainant to share with the
complainant the status of the complaint and the reason for the delay
to the extent that the information can be shared.  
   (i) The department shall analyze its compliance with the benchmark
developed pursuant to paragraph (3) of subdivision (a) in its annual
system and staffing analysis prepared pursuant to paragraph (2) of
subdivision (d) of Section 1266. The analysis required pursuant to
this subdivision shall be made available to the relevant fiscal and
policy committees of the Legislature and shall be posted on the
department's Internet Web site. The analysis shall provide data on
the department's performance and shall include, at a minimum, a
tabulation of all of the following:  
   (1) Open investigations.  
   (2) Completed investigations.  
   (3) Number and percentage of investigations that meet the
benchmark.  
   (4) Average length of time to complete an investigation.