BILL ANALYSIS Ó
AB 2171
Page 1
Date of Hearing: April 22, 2014
ASSEMBLY COMMITTEE ON AGING AND LONG-TERM CARE
Mariko Yamada, Chair
AB 2171 (Wieckowski) - As Amended: April 21, 2014
SUBJECT : Residential care facilities for the elderly (RCFE);
resident rights.
SUMMARY : Establishes an RCFE resident's "bill of rights" and a
mechanism to enforce them. Specifically, this bill :
1)Expresses legislative intent to:
a. Enhance each RCFE resident's autonomy and strengthen an
RCFE resident's ability to make choices about care,
treatment and daily life;
b. Adopt fundamental rights for people residing in RCFEs,
and to provide residents the ability to enforce them;
c. Encourage facilities to respect and promote those
rights, and treat residents with dignity and kindness;
d. Ensure that every RCFE provide a safe, comfortable and
homelike environment for its residents; and
e. Ensure that RCFEs protect residents from any type of
physical or mental abuse, neglect, restraint, exploitation,
or endangerment.
1)Declares that rights proposed by AB 2171 do not diminish existing
civil and legal rights.
3)Forbids discrimination on the basis of sex, race, color,
religion, national origin, marital status, registered domestic
partner status, ancestry, actual or perceived sexual
orientation or gender identity.
4)Establishes a resident's rights which supplement existing
constitutional and other rights, which may not be waived,
though the exercise of them may be delegated to resident
representatives in case of limited capacity, and shall be
posted prominently in each facility, and presented upon
admission, signed, and entered into the resident's record, to:
a. be treated with dignity and respect;
b. be given privacy;
c. be given control over confidential records;
d. be encouraged and assisted in exercising their rights;
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e. be free of coercion, discrimination, and retaliation in
the exercise of their rights;
f. be given a safe, homelike environment;
g. be given individualized care delivered by adequate,
competent staff;
h. be given good food in adequate amounts;
i. be allowed to make choices about their daily life, and
participate to the extent possible in their care;
j. be allowed to consent to or reject services and
medication;
aa. be free from neglect, exploitation, seclusion, punishment,
humiliation, intimidation, verbal, mental, and sexual
abuse;
bb. be free from physical restraints, as defined, and chemical
restraints, as defined and the inappropriate use of
psychoactive drugs, as defined;
cc. be free to complain, or recommend changes in policies;
dd. be allowed to contact licensing authorities, or the
long-term care ombudsman;
ee. be fully informed of rules;
ff. receive a description of what residents are paying for,
itemized;
gg. be informed of facility resident retention limitations;
hh. be given reasonable accommodation;
ii. be given written notice of room changes;
jj. be allowed to share a room with a spouse or partner;
aaa. be allowed to choose their own physician, or
pharmacist;
bbb. be protected from involuntary transfers;
ccc. be allowed to move;
ddd. be visited;
eee. receive written information about advanced healthcare
directives;
fff. maintain or develop their fullest potential for independent
living, through educational activities, planned activities,
personal interests, worship and other opportunities for
socialization;
i. participate in resident councils;
ii. to have their property protected; and
iii. to manage their affairs.
5)Creates a mechanism to enforce these rights by allowing a
current or former resident to bring an action in a court of
competent jurisdiction for injunctive relief against a
licensee if a violation of one of these rights results in an
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immediate or substantial threat to physical health, mental
health, or safety of residents, and limits financial liability
to $500 for each violation, and for attorney's fees. The
measure stipulates that the right to bring such an action does
not expire upon the death of the resident, and that waiving
such rights is contrary to public policy, and voidable.
EXISTING LAW :
1)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.
2)Defines a "community care facility" (CCF) as a facility,
place, or building 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.
3)Establishes the California 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. In establishing the RCFE Act, the
Legislature finds and declares that a separate licensing
category is necessary for a humane approach in meeting the
housing, social and care needs of older persons within
homelike environments.
4)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 license provided by the Department of Social Services
(DSS).
5)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.
6)Provides for Community Care Licensing (CCL) within the
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Department of Social Services to promote the health, safety,
and quality of life of each person in community care through
the administration of an effective collaborative regulatory
enforcement system by promoting strategies to increase
voluntary compliance, providing technical assistance to and
consulting with care providers, working collaboratively with
clients, their families, advocates, care providers, placement
agencies, related programs and regulatory agencies, and others
involved in community care, training staff in all aspects of
the licensing process, educating the public about CCL and
community care options, and promoting continuous improvement
and efficiency throughout the community care licensing system.
7)Establishes the office of Long-Term Care Ombudsman (LTCO)
program as a result of the federal Older Americans Act (OAA)
and places it within the California Department of Aging (CDA)
in order to encourage community contact and involvement with
elderly patients or residents of long-term health care
facilities or residential facilities through the use of
volunteers and volunteer programs.
8)Requires the LTCO, either personally or through
representatives, to identify, investigate, and resolve
complaints that may adversely affect the health, safety,
welfare, or rights of residents of long-term care facilities.
9)Requires RCFE Licensees to disclose to, and inform new
residents, upon admission of personal rights described in
Title 22, California's Code of Regulations which include
rights relative to being accorded dignity in personal
relationships with staff and other persons; safe, healthful
and comfortable accommodations, furnishings and equipment; to
be free from corporal or unusual punishment, infliction of
pain, humiliation, intimidation, ridicule, coercion, threat,
mental abuse, or other actions of a punitive nature; to be
informed of complaints; to be free to attend religious
services or activities of choice and to have visits from the
spiritual advisor of choice; to leave or depart the facility
at any time; not to be locked in any room; receive or reject
medical care, or health-related services; to be informed of
the facility's policy concerning family visits; to have
visitors, including ombudspersons and advocacy representatives
permitted to visit privately; to wear his/her own clothes; to
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keep and use his/her own personal possessions; and to keep and
be allowed to spend his/her own money; to have access to
individual storage space for private use; to have reasonable
access to telephones, to both make and receive confidential
calls; to mail and receive unopened correspondence in a prompt
manner; to receive or reject medical care, or other services;
to receive assistance in exercising the right to vote; and to
move from the facility, among other rights.
FISCAL EFFECT : Unknown
COMMENTS :
Author's Statement : "This bill would establish a statutory Bill
of Rights that ensures the basic dignity and autonomy of today's
RCFE residents. This Bill of Rights includes rights for
residents in several areas including visitation, privacy,
confidentiality, personalized care, autonomy, informed consent,
financial management, freedom from abuse and restraint, adequate
staffing and many more. It would also establish a private right
of action giving residents the opportunity to enforce their
rights when they are being mistreated, and prevent or stop
ongoing violations of their rights."
Background : California is home to the largest number of seniors
in the nation, and the older population is expanding at an
unprecedented historical pace. The California Department of
Finance's Demographic Research Unit estimates that California's
65+ population will grow by 43%, from 4.4 million in 2010 to
6.35 million by 2020; another 39%, to 8.83 million by 2030; and
an additional 21% to 10.5 million by 2040. California's 65+
population will surpass 5 million this year. The expanding
population of older Californians will impact every facet of
policy, housing being one of the primary areas, and RCFE growth
is reflected in the demographic shift; since 2002, RCFE licenses
have increased nearly 30%.
Recent media revealed misconduct, mistreatment, and neglect of
dependent elders living within licensed RCFEs. Additionally,
over the past several years, the elimination of vacant staff
positions, hiring moratoriums, and rolling staff furloughs have
challenged the Department of Social Services in its mission to
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protect vulnerable populations living within facilities that it
licenses. Additional media revealed potential corruption among
DSS field staff who may have accepted expensive gifts from those
whom they regulate. These revelations have led many to believe
that RCFE residents are increasingly exposed to harm.
Background on RCFE's : RCFEs are licensed, assisted living
(non-medical) facilities for persons 60 years of age and over
and other, younger persons with similar needs. Varying levels
of care and supervision, protective supervision, and personal
care such as assistance with hygiene, dressing, eating, bathing,
as well as storage and distribution of medications are provided,
based upon residents' needs. All RCFEs provide meals and
housekeeping. Ongoing medical care is not allowed except in
specific cases, although hospice care is allowed. People with
ongoing medical needs require a higher level of care in a
nursing home or an intermediate care facility.
RCFE's represent a model of care that falls between "independent
living" and "skilled nursing care," on the long-term care
continuum. People who choose the RCFE model require assistance
with non-medical activities of daily living, such as bathing,
preparing meals, dressing, and getting about on one's own.
People who choose skilled nursing care have ongoing and
continuous need for medical supervision.
RCFE care is one of the fastest growing components of the
long-term supports and services industries. There are currently
7,570 licensed RCFEs in California serving 176,026 people.
According to DSS, approximately 80% of RCFEs are licensed for
four-six residents; the remaining 20% of RCFEs have an average
capacity of about 60 residents, though facilities can house over
100 people in some cases.
Growth in the number of RCFE Licensees :
Fiscal Year: # of Licenses
FY 2000-2001 6,187
FY 2001-2002 6,204
FY 2002-2003 6,313
FY 2003-2004 6,491
FY 2004-2005 6,730
FY 2005-2006 6,992
FY 2006-2007 7,334
FY 2007-2008 7,707
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FY 2008-2009 7,847
FY 2009-2010 7,822
FY 2010-2011 7,681
FY 2011-2012 7,695
*As of March 14, 2014 there were 7,570 RCFEs operating in
California serving 176,026 residents. For comparison, the
growth of skilled nursing facilities has remained flat at about
1270, housing about 100,000 people, throughout this period of
rapid growth of the aged population and RCFE licensure.
Governor's Budget : The Community Care Licensing program within
the Department of Social Services serves as the state's
licensing authority for RCFEs. The Governor's budget proposed a
range of initiatives to address enforcement and oversight of
facilities throughout the state, including:
1)Additional positions: 71.5 positions to assist in CCL
enforcement activities include six special investigator
assistants, a nurse practitioner, five licensing program
managers, and others.
2)Staff training and development for new field staff,
supervisors and managers by expanding the Licensing Program
Analyst Academy, implementing ongoing training, and
strengthening the Administrator Certification Section.
3)Recognizing the changing needs of clients in RCFEs, the
Governor's budget proposes that DSS will assist with policy
and practice development for medical and mental health
conditions in community facilities, by establishing medical
expertise resources. Although CCL has no staff with medical
expertise, DSS licenses facilities that do, allow for
incidental medical care.
4)Create a Mental Health Populations Unit which would provide
technical assistance to enforcement staff and licensees, as
well as to individuals who reside in facilities who have
increasing mental health care needs.
5)Establish a Corporate Accountability Unit to perform systemic
noncompliance analysis and ensure corrective actions; create
management reports that identify patterns and trends; make
corrective action recommendations; and, follow-up on
corrective action plans to ensure that licensees with poor
compliance patterns do not support operational expansions.
6)Increased civil penalties, because the current civil penalty
structure is related to a "per violation" event, the current
maximum civil penalty, even in response to serious injury or
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death of a resident, is $150.00.
7)Establish a Temporary Manager and Receivership Process to
appoint a temporary manager or receiver to act as the
provisional licensee, if DSS determines that residents of a
facility are likely to be in danger of serious injury or
death, and the immediate relocation of clients is not
feasible.
8)Specialized complaint hotline and centralized toll-free public
complaint hotline, which can help acquire better initial
information, conduct consistent prioritization, and dispatch
incoming complaints to regional offices.
9)Centralized application processing for Adult and Senior Care
facilities, which is expected to increase inspections of
licensed facilities to at least once every two years.
10)Establish a statewide Quality Assurance Unit to track
information statewide, including complaints, actions, or
performance. It also does not provide aggregate data to
review and identify patterns.
11)Establish an Emergency Client/Resident Contingency Account to
be used at the discretion of the Director of DSS for the care
and relocation of clients and residents, when a facility's
license is revoked or temporarily suspended.
In order to curb the mistreatment of a rapidly growing
vulnerable RCFE population, and to assist with the expanding
enforcement and oversight responsibilities of the DSS the author
is proposing a statutory "Bill of Rights," and an enforcement
mechanism known as a "private right of action," which will
empower RCFE residents, or their representative to sue for
injunctive relief and limited damages, including attorney's
fees. Rights currently exist within Title 22, Section 87468,
regulations that guide facilities and assist the department with
enforcement, though there is very little consequence for not
adhering to them.
Office of the State Long-Term Care Ombudsman : The purpose of the
State Long-Term Care Ombudsman's (OSLTCO) mission is to protect
and advocate for the rights, health and safety of long-term care
facility residents, oftentimes the elderly. California's State
Ombudsman delegates this responsibility to the 35 local
ombudsman programs (local area agencies on aging, or "AAAs")
throughout the state. The local ombudsman program employees are
responsible for making site visits to facilities in an effort to
identify, investigate, and resolve complaints that may adversely
affect the health, safety, welfare, or rights of residents of
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long-term care facilities. In order to achieve this, the
program relies upon the generosity of about 900 volunteers who
are trained, and donate their time and assistance to support the
programs goals. In 2012, the OSLTCO received over 4,000
complaints regarding resident rights in RCFEs, ranging from
access for visitors, neglect, verbal and physical abuse, and
issues related to personal dignity, among others.
Over the past 6 years, the OSLTCO and its 35 field offices
statewide, has experienced a range of budget changes in response
to the state's recent economic difficulties. Though some cuts
were mitigated by one-time allocations from other sources, since
2008, the office has lost 30% of its funding, and the number of
full-time equivalent staff has dropped from 183 to 105.
Correspondingly, the number of complaints has also decreased as
limited staff has made fewer facility visits, providing fewer
opportunities for residents to lodge confidential concerns for
which they seek resolution.
Private Right of Action in Long-Term Healthcare Facilities :
Residents of long-term healthcare facilities (also known as
"nursing homes" or skilled nursing facilities), are availed
injunctive relief to compel compliance by a licensee with state
and other laws related to individual resident rights.
California law establishes a statutory bill of rights for
nursing home residents in Division 2, Chapter 3.9 of the Health
& Safety Code, and supplemented it with a regulatory bill of
rights within Title 22 (CCR §72527). Section 1430(b) gave
residents the ability to obtain an injunction to prevent any
future violations of their rights and attorneys' fees from a
provider. Section 1430(b) was adapted in part because Section
1430(a) did not provide sufficient incentive for attorneys to
take on a case and represent residents. In the absence of
departmental oversight, the injunctive relief and attorneys'
fees provided by Section 1430(b) are powerful tools to ensure
the protection of residents' rights. For instance, under both
federal and California law, nursing home residents have a
"right" to be free from physical and chemical restraints, and
the inappropriate use of psychoactive drugs, and may sue, or
compel and action by the courts, enforce such a right, and the
legal costs of doing so would be borne by the facility.
Text of Health and Safety Code Section 1430(b), granting nursing
home residents the right to seek injunctive relief :
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(b) A current or former resident or patient of a
skilled nursing facility, as defined in subdivision
(c) of Section 1250, or intermediate care facility, as
defined in subdivision (d) of Section 1250, may bring
a civil action against the licensee of a facility who
violates any rights of the resident or patient as set
forth in the Patients Bill of Rights in Section 72527
of Title 22 of the California Code of Regulations, or
any other right provided for by federal or state law
or regulation. The suit shall be brought in a court
of competent jurisdiction. The licensee shall be
liable for the acts of the licensee's employees. The
licensee shall be liable for up to five hundred
dollars ($500), and for costs and attorney fees, and
may be enjoined from permitting the violation to
continue. An agreement by a resident or patient of a
skilled nursing facility or intermediate care facility
to waive his or her rights to sue pursuant to this
subdivision shall be void as contrary to public
policy.
Supporters Argue : According to background provided by the
author, the purpose of AB 2171 is to secure a better, safer,
more dignified future for RCFE residents in California by
strengthening their rights to make choices about their care,
treatment and daily life and to ensure that their choices are
respected. Additionally, AB 2171 is intended to enhance
resident safety and dignity by outlawing dangerous or abusive
practices, such as the use of restraints. In so doing, AB 2171
will bring California in line with the best practices in many
other states.
AB 2171 allows a resident to seek immediate intervention, in the
form of an injunction, to stop a violation of their rights.
Given this option, the resident can obtain timely effective
relief, perhaps even precluding the need for any CCL action. In
other words, a private right of action can overcome the
traditional barriers to enforcement of their rights that
residents have faced. Perhaps most importantly, a private right
of action is meant to empower residents, giving them a resource
to better balance a relationship between providers and residents
that is often asymmetric, with the advantage residing in the
provider.
According to background provide by the author, California is
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very late to respond to the dramatic increase in the use of
RCFEs for late-life care of elders with highly compromised
health conditions such as dementia, diabetes and Chronic
Obstructive Pulmonary Disease (COPD). As the Department of
Social Services has acknowledged, the changing role of the RCFE
"license" necessitates an overhaul of regulatory roles,
structure, and a more sophisticated means to ensure that
residents are safe and secure. By establishing a modern bill of
rights that fits the needs of today's RCFE residents, AB 2171
will take a major step toward that goal while giving residents
and their representatives the abilities to control decisions
affecting their lives.
Co-sponsor of AB 2171, The California Advocates for Nursing Home
Reform, CANHR, cites an "RCFE care crisis" where rapid growth,
inadequate oversight and outdated standards are conspiring to
jeopardize some residents. In a report entitled "Residential
Care in California: Unsafe, Unregulated and Unaccountable," they
describe among other things, a failed inspection system; a
broken complaint system; limited and ineffective penalties for
violations; and "paper tiger" resident rights provisions that
provide no enforcement power to residents, all of which
contribute to a system that is unsafe for RCFE consumers.
According to CANHR, AB 2171 establishes strong statutory
resident rights, and strengthens a resident's ability to make
choices about their care, treatment and daily life.
The Office of the State Long Term Care Ombudsman (OSLTCO), an
office within the California Department of Aging, authorized by
the federal Older Americans Act and the Older Californians Act,
with primary responsibility to investigate and endeavor to
resolve complaints made by, or on behalf of, individual
residents in long-term care facilities, cites troubling
developments in the past year that have focused upon
mistreatment of older, frail and vulnerable Californians living
in RCFEs. Without programmatic resources that are scaled to
respond to the growth in long-term care facilities, and without
the ability to maintain their presence in a rapidly expanding
industry, the OSLTCO believes that the mere existence of
statutory rights compels facilities to remain in compliance with
standards that support safe and adequate care.
The California Commission on Aging, an independent state agency
made up of gubernatorial and legislative appointees, writes that
the lives of RCFE residents are often "limited and bleak," and
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that a resident's bill of rights is a positive step toward
assuring that residents are treated with dignity and respect.
The American Association of Retired Persons (AARP) strongly
believes that the California state legislature should explicitly
provide a private right of action in all legislation intended to
protect individual rights, which is at the heart of AB 2171.
Consumer Attorneys of California describes AB 2171 as the
linchpin of the package of bills introduced this year to protect
seniors and those with disabilities who reside in Residential
Care Facilities for the Elderly (RCFE). AB 2171 reflects a
model of resident rights and enforcement used by residents in
nursing homes for over 30 years. According to this co-sponsor,
this mechanism has been effective for nursing homes and their
residents and there is no reason these protections should not be
as successful in the RCFE system. They argue that unlike
nursing homes which are more heavily regulated, RCFEs, by
comparison, lack even minimal government oversight and
inspections, making this population extremely vulnerable to
abuse and neglect.
Opponents Argue : The California Assisted Living Association
(CALA), an organization representing licensed RCFEs throughout
the state, which is committed to the well-being of residents and
the RCFE model of care attributes recent lapses in oversight as
a cause for concern for all stakeholders. CALA has sponsored
legislation recently calling for increased inspections of
facilities, including advocating for increased licensing fees to
support the additional workload. CALA cites existing state
regulation which already provides for the vast majority of the
rights described in AB 2171. CALA asserts that the primary
impact of AB 2171 would be more lawsuits, as the rights that
currently exist in regulation would be codified as law, and
could be enforced via a private individual's right to seek
relief through the courts, a prospect that carries significant
financial implications in terms of fines, liability insurance,
reputation and particularly attorney's fees. CALA remains
concerned about language which may inappropriately place
facilities in the position of judging and becoming liable for,
actions of a resident's physician. CALA also stresses that the
private right of action is broader than the one provided to
residents of nursing homes, and that the effect is to invite
more law suits and drive-up liability insurance costs, with no
relationship to improved safety.
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The Civil Justice Association of California (CJAC) argues that
merging current statutory and regulatory standards with those
included in AB 2171 will lead to increased, unjustified
litigation against facilities offering care to seniors by
creating legal "traps" enforceable through civil lawsuits with
severe penalties, attorney's fees, and a three year statute of
limitations. Though sympathetic to the importance of protecting
vulnerable adults, they assert that the framework in AB 2171
will needlessly increase litigation and will ultimately result
in reduced services for the growing elderly population. As an
example, CJAC cites that a person could seek injunctive relief
and damages for failure to distribute a document describing
resident's rights upon admission. They argue that AB 2171's
three-year statute of limitations, coupled with a $500 per day
fine, could cause financially devastating consequences for what
could be perceived as a technical oversight. Additional areas
for potentially conflicting resident rights are also raised with
regard to a right to a safe and home like environment; the right
to be encouraged to maintain and develop to their fullest
potential for independent living through activities that are
designed and implemented for this purpose; and the right to have
relatives and other individuals of the resident's choosing visit
at any time. What may be characterized as one individual
resident's right could be characterized as an encroachment upon
another's.
LeadingAge California which represents more than 400 providers
of not-for-profit senior care and living opportunities, such as
affordable housing, continuing care retirement communities,
assisted living (RCFE), skilled nursing, and community-based
care, is concerned that AB 2171 invites litigation and does
little to improve oversight. They cite Title 22's resident
rights, and is concerned that AB 2171 would add current
regulatory requirements as new "rights," which would allow for
private enforcement outside of the state's regulatory agency.
LeadingAge is also concerned that AB 2171 inserts RCFE
caregiving staff into the physician's treatment plan regarding
the use of medications. RCFEs do not prescribe medications and
under existing law and practice, all medications must be
self-administered. Requiring RCFEs to verify "informed consent"
is beyond the scope of the social model of care RCFEs provide.
The California Hospice and Palliative Care Association (CHAPCA)
cites similar concerns with AB 2171. CHAPCA states that they
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recognize the intent of AB 2171 to help RCFE residents, but
hospice provider's core mission is to lessen the suffering and
improve the quality of life during the dying process, and
frequently require flexibility to meet their clients' needs.
CHAPCA asserts that requiring informed consent could create
barriers to reducing suffering. If "informed consent" is
enforced, meeting needs for medication to relieve mental
anguish, or physical pain from the dying process could be
prohibited.
Other critics of a nursing home resident's private right of
action cite an undermining of the original intent and policy
behind Section 1430 by "stacking" awards (alleging multiple
violations of the same right, or by defining violations on
separate days or shifts). Critics argue that through this
process, nursing homes are faced to make choices between
diverting resources to defend cases, and risking unfavorable
verdicts, or settling cases with large awards to cover
attorney's fees.
Recent Amendments : The author amended AB 2171 to reduce the
monetary award available to complainants to $500, and to address
concerns of opponents related to definitions. Although concerns
still reside with opponents, the author has expressed his
commitment to continue working with opposition to determine the
most appropriate balance.
Previous and Related Legislation :
AB 2791 (Simitian) Chapter 270, Statutes of 2004, provided for a
similar right of action for residents in skilled nursing or
intermediate care facilities.
AB 185 (Mello) Chapter 1127, Statutes of 1985, separated
licensure of RCFEs from community care facilities.
SB 894 (Corbett) RCFE Suspension/Revocation of Licenses would
strengthen and clarify the obligations of the department and the
licensee when a license is suspended or revoked and would create
timelines for the safe relocation of residents when a facility's
license has been suspended or revoked.
SB 895 (Corbett) would require Community Care Licensing to
conduct unannounced, comprehensive inspections of all
residential care facilities for the elderly at least annually
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and as often as necessary to ensure the quality of care
provided. The inspection must evaluate each facility for
compliance with all laws and regulations governing residential
care facilities for the elderly.
SB 911 (Block) would increase the qualifications and training
requirements for RCFE administrators and staff and require
facilities who accept and retain residents with restricted or
prohibited health conditions to employ trained medical personnel
on a full or part-time basis as appropriate.
SB 1153 (Leno) creates new penalties for non-compliance,
including authorizing the Department of Social Services to
suspend the admission of new residents in facilities where there
is a substantial probability of harm.
SB 1218 (Yee) would increase civil penalties against RCFEs for
violations of laws and regulations from the current maximum of
$150.00. The fines would vary the minimum and maximum
penalties, depending on the seriousness of the violation. SB
1218 would also establish the Emergency Resident Relocation
Fund, and require 50% of the revenue from the civil penalties to
be deposited into the Fund for relocation and care of residents
when a facility's license is revoked or suspended.
AB 364 (Calderon) would increase DSS inspections of community
care facilities, passed Assembly Human Services Committee on
March 25, 2014 on a 7-0 vote.
AB 1554 (Skinner) would require the DSS to start and complete
complaint investigations in a timely manner, give complainants
written notice of findings and provide complainants an
opportunity to appeal.
AB 1571 (Eggman) would require that the Department of Social
Services/Community Care Licensing establish an on-line RCFE
Consumer Information system to include specified updated and
accurate license, ownership, survey, complaint and enforcement
information on every licensed RCFE in California with components
to be phased in over a five (5) year period ending June 30,
2019. This bill also would require complete disclosure of
ownership and prior ownership of any type of facility, including
nursing facilities, and any similar entity in other states,
including history of compliance or non-compliance and require
cross checks with the Department of Public Health (DPH).
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AB 1572 (Eggman) will amend current laws to enhance the rights
of resident councils and family councils in RCFEs.
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Support
Bet Tzedek Legal Services
California Advocates for Nursing Home Reform (CANHR) -
Co-Sponsor
Consumer Attorneys of California - Co-Sponsor
Alliance on Aging
American Association of Retired Persons (AARP)
Assisted Living Consumer Alliance (ALCA)
California Alliance for Retired Americans (CARA)
California Commission on Aging
California Conference Board of the Amalgamated Transit Union
California Conference of Machinists
California Continuing Care Residents Association
California Senior Legislature
California Teamsters Public Affairs Council
Congress of California Seniors
Consumer Advocates for RCFE Reform (CARR)
Consumer Attorneys of California - Co-Sponsor
Consumer Federation of California
Elder Abuse Task Force of Santa Clara County
Elder Law & Advocacy
Engineers and Scientists of CA, IFPTE Local 20, AFL-CIO
International Longshore and Warehouse Union
Johnson Moore Trial Lawyers
Long Term Care Services of Ventura County, Inc.
Moran Law
National Association of Social Workers (NASW) California Chapter
National Consumer Voice for Quality Long-Term Care
National Senior Citizens Law Center
Office of the State Long-Term Care Ombudsman
Older Women's League (OWL)
Ombudsman Services of Contra Costa
Professional & Technical Engineers, IFPTE Local 21, AFL-CIO
Stebner and Associates
Utility Workers Union of America, Local 132
UNITE-HERE, AFL-CIO
Valentine Law Group
WISE & Healthy Aging
AB 2171
Page 17
Numerous individuals.
Opposition
Barney & Barney
California Assisted Living Association (CALA)
California Hospice and Palliative Care Association
Channing House
Community Residential Care Association of California
Civil Justice Association of California (CJAC)
LeadingAge California
One individual.
Analysis Prepared by : Robert MacLaughlin / AGING & L.T.C. /
(916) 319-3990