BILL ANALYSIS Ó
SB 1153
Page A
SENATE THIRD READING
SB 1153 (Leno)
As Amended April 10, 2014
Majority vote
SENATE VOTE :36-0
HUMAN SERVICES 6-0 AGING 6-0
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|Ayes:|Stone, Maienschein, |Ayes:|Yamada, Wagner, Brown, |
| |Ammiano, | |Daly, Gray, Levine |
| |Ian Calderon, Garcia, | | |
| |Lowenthal | | |
|-----+--------------------------+-----+--------------------------|
| | | | |
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APPROPRIATIONS 17-0
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|Ayes:|Gatto, Bigelow, | | |
| |Bocanegra, Bradford, Ian | | |
| |Calderon, Campos, | | |
| |Donnelly, Eggman, Gomez, | | |
| |Holden, Jones, Linder, | | |
| |Pan, Quirk, | | |
| |Ridley-Thomas, Wagner, | | |
| |Weber | | |
|-----+--------------------------+-----+--------------------------|
| | | | |
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SUMMARY : Permits the California Department of Social Services
(DSS) to suspend admissions to a RCFE if the facility has
violated the law, been cited for repeated violations, or has
failed to pay a civil penalty, as specified. Specifically, this
bill :
1)Authorizes DSS to order a suspension of new admissions for a
facility in either of the following circumstances:
a) The RCFE has violated statute or any applicable
regulations, the violation presents a direct and immediate
risk to the health, safety, or personal rights of a
resident or residents of the facility, and the violation is
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not corrected immediately; or
b) The RCFE has failed to pay a fine assessed by the
department after the facility's appeal rights have been
exhausted.
2)Provides that any suspension of new admissions for a failure
to pay a fine, as specified, shall remain in effect until the
facility pays the assessed find.
3)Requires a suspension of new admissions to remain in effect
until DSS determines that the facility has corrected the
violation.
4)Requires DSS to conduct a follow-up visit to determine
compliance within 10 working days following the latest date of
correction specified in the notice of deficiency, unless the
licensee has demonstrated that the deficiency was corrected as
required in the notice.
5)Authorizes DSS to make unannounced visits after the suspension
of new admissions is lifted to ensure that the facility
continues to maintain correction of the violation and permits
DSS to order another suspension of new admissions or take
other appropriate enforcement action if the facility does not
maintain correction of the violation.
6)Provides appeal rights for RCFEs who have received an
admissions suspension.
7)Requires DSS to adopt regulations that specify the appeal
procedure.
8)Provides that a suspension of new admissions ordered may not
be stayed pending the facility's appeal or request for review.
FISCAL EFFECT : According to the Assembly Appropriations
Committee:
1)One-time costs to DSS of approximately $118,000 (General Fund)
to develop an implementation plan, write regulations, and
update the Evaluator Manual.
2)On-going costs to DSS, likely in the range of $30,000 to
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$60,000 annually, for compliance and case management visits
following admissions bans, assuming between 50% and 100% of
possible admissions bans are imposed.
3)Unknown on-going costs to DSS, likely in the range of $250,000
to $500,000 annually, to process appeals. DSS reports that in
2012-13 there were 509 citations or penalty delinquencies that
could qualify for admissions suspension under this bill.
Assuming between 25% and 50% of RCFEs appeal a suspension and
that each appeal takes approximately 12.75 hours of staff
time, costs to handle the appeals would range from $250,000 to
$500,000. If suspensions were not imposed in all cases, the
costs would be less.
COMMENTS :
Background: RCFEs, commonly referred to as assisted living
facilities, are licensed retirement residential homes and board
and care homes that accommodate and provide services to meet the
varying, and at times, fluctuating health care needs of
individuals who are 60 years of age and over, and persons under
the age of 60 with compatible needs. Licensed by DSS Community
Care Licensing Division (CCLD), they can range in size from
residential homes with six or less beds to more formal
residential facilities with 100 beds or more.
Growing demand: Over the past thirty years, the demand for
RCFEs has grown substantially. Although RCFEs have been
generally available, they experienced explosive growth in the
1990s, more than doubling the number of beds between 1990 and
2002,<1> and continued to grow 16% between 2001 and 2010.<2>
Nationwide, states reported 1.2 million beds in licensed RCFEs
in 2010.<3> That same year, the national Centers for Disease
Control reported that 40% of RCFE residents needed help with
three or more activities of daily living and three-fourths of
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<1> Flores and Newcomer, "Monitoring Quality of Care in
Residential Care for the Elderly: The Information Challenge".
Journal of Aging and Social Policy, 21:225-242, 2009.
<2> SCAN Foundation. "Long Term Care Fundamentals: Residential
Care Facilities for the Elderly." March 2011.
http://thescanfoundation.org/sites/thescanfoundation.org/files/LT
C_Fundamental_7_0.pdf
<3> "Assisted Living and Residential Care in the States in
2010," Mollica, Robert, AARP Public Policy Institute
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residents had at least two of the 10 most common chronic
conditions.<4>
Recent events: A series of recent events has drawn attention to
questions about the adequacy of RCFEs and the CCLD's ability to
comply with existing oversight and enforcement requirements to
help ensure for the health and safety of individuals who receive
services within CCLD-licensed facilities. Over the last several
years, numerous media outlets have documented chronic
understaffing and a lack of required assessments and substandard
care. Reports in September 2013, prompted by a consumer
watchdog group that had hand-culled through stacks of documents
in San Diego, revealed that more than two dozen seniors had died
in recent years in RCFEs under questionable circumstances that
went ignored or unpunished by CCLD.<5>
Need for the bill: Stating the need for the bill, the author
states:
It is unacceptable to allow elderly Californians,
especially those who are most vulnerable, to become
residents of care homes that we already know are
unsafe. Under no circumstances should new patients
enter a facility that has documented and unaddressed
health and safety violations.
SB 1153 provides serious consequences for a center's
failure to provide a safe living environment for its
elderly residents, which should be the top concern and
priority. It improves the state's ability to protect
vulnerable seniors who live in assisted living
facilities.
Analysis Prepared by : Chris Reefe / HUM. S. / (916) 319-2089
FN: 0004956
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<4> "Residents Living in Residential Care Facilities: United
States, 2010, Caffrey, Christine, et al., US Centers for
Disease Control, April 2012
<5> "Care Home Deaths Show System Failures," San Diego Union
Tribune, Sept.7, 2013
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