BILL ANALYSIS Ó SB 895 Page 1 Date of Hearing: August 6, 2014 ASSEMBLY COMMITTEE ON APPROPRIATIONS Mike Gatto, Chair SB 895 (Corbett) - As Amended: June 24, 2014 Policy Committee: Human ServicesVote:6 - 0 Urgency: No State Mandated Local Program: No Reimbursable: SUMMARY This bill phases in the requirement that the Department of Social Services (DSS) conduct unannounced inspections of residential care facilities for the elderly (RCFEs) at least annually by July 1, 2018. The bill also requires DSS to verify that a deficiency has been corrected no later than 10 days after notification to the facility and allows DSS to extend the compliance period in some circumstances. In addition, the bill requires DSS to make inspection reports, consultation reports, lists of deficiencies, and plans of correction available to the public on its website and in its district offices. FISCAL EFFECT 1)Ongoing costs to DSS of approximately $5 million (GF) once the inspection frequency has increased to at least annually for all RCFEs. 2)Initial costs to DSS in the low millions of dollars (GF) annually for approximately three years during the inspection frequency phase-in period. 3)Ongoing costs to DSS in the hundreds of thousands of dollars for project development, testing and maintenance and other related IT contract work necessary to make inspection result details available on its website. 4)Ongoing costs to DSS of approximately $50,000 (GF) to verify that deficiencies have been corrected within 10 days of SB 895 Page 2 notification to the facility. COMMENTS 1)Purpose . Recent media focused upon the abandonment of Valley Springs Manor, a RCFE with 19 residents in the city of Castro Valley. In May 2013 DSS, taking action in response to the facility's poor care history, revoked Valley Springs Manor's license. The revocation was immediately appealed by the licensee, which allowed the facility to remain operational. The licensee abandoned the facility during the fall of 2013, ultimately leaving its frail clientele under the care of the facility cook. It was not until the cook called "911" that emergency protocol to protect the residents was activated. According to the author, it is clear that what happened at Valley Springs Manor in Castro Valley was both tragic and disgraceful. The author believes this bill will help detect and correct problems at assisted living facilities well before a facility closure becomes necessary. 2)Background . RCFEs, commonly referred to as assisted living facilities, are licensed retirement residential homes and board and care homes that provide personal care and supervision or health related services to persons who are 60 years of age and over, who voluntarily choose to reside in the facility. RCFEs enable older persons to live independently in a home-like environment rather than in a nursing home or other institutionalized facility. Services include personal care and protective supervision, including incidental medical services, based on the needs of the resident. There are 7,589 licensed RCFEs in California with a capacity to serve over 176,000 residents. Licensed by DSS' Community Care Licensing Division, RCFEs range in size from residential homes with six or fewer beds to more formal residential facilities with more than 100 beds. DSS is required to conduct unannounced licensing inspections of the more than 75,000 licensed community care facilities, including RCFEs, at least once every five years, more often in some circumstances. 3)2014-15 Budget Language . SB 855 (Committee on Budget and Fiscal Review) Chapter 29, Statutes of 2014, stated "it is the intent of the Legislature to, over a period of time, increase SB 895 Page 3 the frequency of facility inspections resulting in annual inspections for some or all facility types." The bill would require DSS to "update the Legislature on the status of the structural and quality enhancement improvements during the 2015-16 legislative budget subcommittee hearings." While SB 855 does not include any statutory changes to the mandated inspection frequency, the number and frequency of visits is expected to increase due to the additional resources in the budget. 4)DSS Website . DSS is required to operate an automated RCFE license information system to provide information on current and former licensees of RCFEs. DSS recently added to its Website searchable historical information on the name of each facility, its licensee's name and contact information, the number of substantiated, unsubstantiated, and inconclusive complaints filed against the facility, including complaint severity and any resulting citations, and the number of inspections, complaint investigations, and general visits the facility has received. DSS indicates it does not currently have the technological capacity to add additional information to their electronic database, particularly the information required by this bill, because the document formatting is inconsistent with their system capabilities. 5)RCFE Reform Package . Due to long-term reform efforts by the California Advocates for Nursing Home Reform (CANHR), as well as in response to a number of highly publicized events at facilities that have raised questions about the adequacy of RCFEs and the state's ability to comply with existing oversight and enforcement requirements, a number of legislative measures are being pursued to strengthen, address shortcomings, resolve legal liabilities and gaps in the provision of services, and ultimately reform the RCFE industry. 6)Related Legislation . a) AB 1454 (Calderon, 2014) would require DSS to increase the frequency of unannounced visits of community care facilities, RCFEs, child day care centers, and family day care homes over three years, so by July 1, 2017, every facility would be visited annually. This bill is pending on the Senate Appropriations Committee's Suspense File. SB 895 Page 4 b) AB 2621 (Garcia, 2014) requires DSS to post similar information on their website regarding child day care facilities. This bill is pending in the Senate Appropriations Committee. 1)Prior Legislation . a) AB 364 (Calderon) 2013 would have required DSS to make unannounced visits to most licensed facilities (except licensed child care facilities) at least once every two years. This bill was held on this committee's Suspense File. b) 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 this committee's Suspense File. Analysis Prepared by : Jennifer Swenson / APPR. / (916) 319-2081