BILL ANALYSIS Ó AB 74 Page 1 Date of Hearing: May 6, 2015 ASSEMBLY COMMITTEE ON APPROPRIATIONS Jimmy Gomez, Chair AB 74 (Calderon) - As Amended April 7, 2015 ----------------------------------------------------------------- |Policy |Human Services |Vote:|7 - 0 | |Committee: | | | | | | | | | | | | | | |-------------+-------------------------------+-----+-------------| | |Aging and Long Term Care | |7 - 0 | | | | | | | | | | | |-------------+-------------------------------+-----+-------------| | | | | | | | | | | | | | | | ----------------------------------------------------------------- Urgency: No State Mandated Local Program: NoReimbursable: No SUMMARY: This bill revises inspection schedules of facilities licensed by the Department of Social Services, except Foster Care Homes. Specifically, this bill: 1)Requires the Department of Social Services (DSS) to increase the frequency of annual unannounced licensing visits of AB 74 Page 2 community care facilities, residential care facilities for the elderly (RCFEs), licensed child day care centers and family day care homes, from once every 5 years to: a. Once every 3 years beginning July 1, 2016. b. Once every 2 years beginning July 1, 2017. c. Annually beginning July 1, 2018. Unless, (for a and b above), the license for a facility is on probation, the facility is under annual inspection orders based upon a plan of correction, a formal accusation against a facility license is pending, or the terms of federal financial participation already dictate annual unannounced inspections. 2)Provides for a random sampling process to select which facilities will be subject to a once-every-three year unannounced inspection beginning July 1, 2016, and a once-every-two year inspection beginning July 1, 2017. FISCAL EFFECT: 1)Ongoing major future costs in the range of $20 million (GF) once the frequency of inspections in all facility types is completed annually. 2)The Governor's 2015-16 January budget proposal includes $3 million (GF) and 28.5 positions for CCLD to address a backlog of complaint cases and to expand training and technical assistance. In addition, the proposal requires DSS to phase-in increased inspection frequency to once every three AB 74 Page 3 years starting January 2017, for all facilities, once every two years by 2018 for all facility types except child care, and annually by 2019 for adult day care and residential care facilities for the elderly. Ongoing staffing costs are estimated at $14 million (GF). COMMENTS: 1)Purpose. This legislation seeks to significantly increase the number of inspection visits to licensed facilities such as child care centers, residential care facilities for the elderly, and family child care homes. The author notes that increasing the frequency of licensing visits "will demonstrate that California is serious about addressing the deficiency in our inspection process for Community Care Facilities and will put California on par with the inspection procedures of other states. Currently we have a complaint based oversight system that is reactive to issues in our facilities instead of being proactive to prevent issues or fix and stop these issues before they become deadly. Facilities are in need of frequent inspections because of the vulnerability of the clients these facilities serve and it is our job to make sure these individuals are being properly taken care of." 2)Background. The Community Care Licensing Division (CCLD) of DSS is responsible for the regulatory and licensing activities related to residential and non-residential programs licensed by DSS. These include 24-hour senior, adult, and child residential care homes, as well as non-residential programs (e.g., child care centers and adult day programs). CCLD is AB 74 Page 4 responsible for conducting facility inspections, pursuing administrative actions when licensing standards are not met, and assisting providers to maintain compliance with licensing regulations. Prior to 2003, the required frequency of CCLD licensing 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. CCLD now conducts unannounced visits annually only when a facility is experiencing program compliance problems, or when it is required as a condition of federal funding participation. For all other facilities not subject to annual inspections, CCLD is required to conduct comprehensive compliance inspections of a 20% random sample of facilities each year, with no facility being visited less than once every five years. In response to health and safety issues discovered at facilities licensed by the CCLD, the 2014-15 Governor's Budget included a comprehensive plan to reform the CCLD program. The plan included an increase of $7.5 million ($5.8 million GF) 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 plan did not change the mandated inspection frequency, but the number and frequency of visits was expected to increase due to the additional resources dedicated to specialized workloads, thereby permitting licensing program analysts to conduct more facility inspections. In addition, SB 855 (Committee on Budget and Fiscal Review) Chapter 29, Statutes of 2014, included legislative intent language stating "it is the intent of the Legislature to, over a period of time, increase the frequency of facility inspections resulting in annual inspections for some or all facility types." AB 74 Page 5 3)Prior Legislation. a) AB 1454 (Calderon), 2014, was substantially similar to this bill. It would have phased in annual licensing inspection visits by July 1, 2017. It was held on the Senate Appropriations Suspense File. b) AB 364 (Calderon), 2013, required CCL to conduct licensing inspections in most community care facilities at least once every two years. It was held on the Assembly Appropriations Suspense File. c) AB 419 (Mitchell), 2011, would have required DSS to conduct an unannounced inspection of a care facility, using prescribed inspection protocols, at least once each year and as often as necessary to ensure the quality of care provided, except for family day care centers, which the department would have been required to inspect at least once every 2 years. It was held on the Assembly Appropriations Committee Suspense File. Analysis Prepared by:Jennifer Swenson / APPR. / (916) 319-2081 AB 74 Page 6