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