BILL ANALYSIS Ó
Senate Appropriations Committee Fiscal Summary
Senator Kevin de León, Chair
SB 895 (Corbett) - Residential care facilities for the elderly:
unannounced visits.
Amended: April 23, 2014 Policy Vote: Human Services 5-0
Urgency: No Mandate: No
Hearing Date: April 28, 2014
Consultant: Jolie Onodera
This bill meets the criteria for referral to the Suspense File.
Bill Summary: SB 895 would require the Department of Social
Services (DSS) to conduct unannounced inspections of residential
care facilities for the elderly (RCFEs) at least annually, as
specified. Additionally, this bill requires the DSS to verify
that a deficiency has been corrected no later than 10 days after
notification to a facility.
Fiscal Impact: Major ongoing costs of about $5 million (General
Fund) to increase inspection frequency to at least annually for
all RCFEs.
Background: The Community Care Licensing Division (CCLD) of the
DSS administers the licensure and oversight of over 7,500
assisted living, board and care, and continuing care retirement
homes that are licensed as RCFEs in California. These residences
are designed to provide home-like environment housing options to
elderly residents who need assistance with activities of daily
living but otherwise do not require continuous, 24-hour
assistance or nursing care. The RCFE licensure category includes
facilities with as few as six beds to facilities with hundreds
of residents whose needs may vary widely.
Prior to 2003, the required frequency of CCLD facility visits
was annually for most facility types. Subsequently, in response
to the state's fiscal situation, legislation was enacted to
lengthen the interval between visits in an effort to reduce
program costs. As a result, the CCLD is now required to conduct
unannounced visits annually only in circumstances in which a
facility has a history of compliance issues. For those
residential facilities not subject to annual inspections, the
CCLD is currently required to conduct comprehensive compliance
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inspections on a 30 percent random sample basis each year, with
no facility being visited less than once every five years.
In response to recent health and safety issues discovered at
facilities licensed by the CCLD, the 2014-15 Governor's Budget
proposes a comprehensive plan to reform the CCLD program. This
proposal includes an increase of $7.5 million ($5.8 million
General Fund) and 71.5 positions to improve the timeliness of
investigations, ensure the CCLD inspects all facilities at least
once every five years, increase staff training, and establish
clear fiscal, program, and corporate accountability. The
proposal also increases civil penalties assessed for violations
and increases licensing and application fees by 10 percent.
While the proposal does not include any statutory changes to the
mandated inspection frequency, the number and frequency of
visits is expected to increase due to the addition of resources
dedicated to specialized workloads, thereby permitting licensing
program analysts to conduct more facility inspections.
The proposed budget for CCLD in 2014-15 is $118 million ($36
million General Fund). This represents an 11 percent increase
above estimated 2013-14 total expenditures (37 percent above
2013-14 General Fund expenditures).
Proposed Law: This bill requires the DSS to conduct unannounced
inspections of all RCFEs at least once each year. Specifically,
this bill:
Requires DSS to conduct a comprehensive evaluation of each
facility for compliance with the laws and regulations
governing RCFEs.
Permits DSS to conduct additional unannounced inspections when
a licensee is on probation, when required by the terms of a
facility compliance plan, when an accusation against a
licensee is pending, when required for receipt of federal
financial participation, or to verify that a person who has
been ordered out of a facility is no longer present.
Requires DSS to verify compliance no later than 10 days after
the notification of a deficiency or up to an additional 30
days if the DSS determines the delay will not adversely impact
the health and/or safety of facility residents.
Deletes existing provisions of law requiring annual
unannounced visits of no less than 20 percent of RCFEs, and
the 10 percent trigger. Deletes the existing provision of law
specifying DSS is to visit a RCFE no less than once every five
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years.
Requires all inspection reports, evaluations, or consultations
to be available to the public on the DSS website and in its
district offices.
Related Legislation: AB 1454 (Calderon) 2014 would require all
licensed community care facilities, RCFEs, and child day care
centers to be subject to annual unannounced visits by the DSS.
This bill is currently on the Suspense File of the Assembly
Committee on Appropriations.
Due to long-term reform efforts by the California Advocates for
Nursing Home Reform (CANHR), as well as in response to a growing
number of highly publicized incidents at licensed community care
facilities throughout the state, the following bills regarding
licensing and inspections at community care facilities, and
RCFEs specifically, have been introduced this session:
SB 894 (Corbett) RCFEs: revocation of license.
SB 911 (Block) RCFEs: licensing and training requirements.
SB 1153 (Leno) RCFEs: suspension of new admissions.
SB 1382 (Block) RCFEs: licensure fees.
AB 1436 (Waldron) RCFEs: internet posting of inspection reports.
AB 1523 (Atkins) RCFEs: liability insurance.
AB 1554 (Skinner) RCFEs: complaint procedures.
AB 1570 (Chesbro) RCFEs: training requirements.
AB 1571 (Eggman) RCFEs: disclosure requirements.
AB 1572 (Eggman) RCFEs: single resident council.
AB 1899 (Brown) RCFEs: prohibitions on licensure reinstatement.
AB 2044 (Rodriguez) RCFEs: 24-hour presence of
administrator/staff.
AB 2171 (Wieckowski) RCFEs: residents' rights.
Prior Legislation: AB 364 (Calderon) 2013 would have required
the DSS CCLD inspectors to make unannounced visits to most
licensed facilities (with the exception of licensed child care
facilities) at least once every two years. This bill was held on
the Suspense File of the Assembly Committee on Appropriations.
AB 419 (Mitchell) 2011 would have required the DSS to conduct an
unannounced inspection of a care facility at least once each
year and as often as necessary to ensure the quality of care
provided. This bill was held on the Suspense File of the
Assembly Committee on Appropriations.
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Staff Comments: It is estimated the DSS would require additional
resources in the range of $5 million (General Fund) ongoing to
meet the annual inspection requirements of this bill.