BILL ANALYSIS Ó
AB 74
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ASSEMBLY THIRD READING
AB
74 (Calderon)
As Amended April 7, 2015
Majority vote
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|Committee |Votes |Ayes |Noes |
| | | | |
| | | | |
|----------------+------+---------------------+---------------------|
|Human Services |7-0 |Chu, Mayes, | |
| | |Calderon, Lopez, | |
| | |Maienschein, Mark | |
| | |Stone, Thurmond | |
| | | | |
|----------------+------+---------------------+---------------------|
|Aging |7-0 |Brown, Hadley, | |
| | |Gipson, Gray, | |
| | |Levine, Lopez, | |
| | |Mathis | |
| | | | |
|----------------+------+---------------------+---------------------|
|Appropriations |17-0 |Gomez, Bigelow, | |
| | |Bonta, Calderon, | |
| | |Chang, Daly, Eggman, | |
| | |Gallagher, | |
| | | | |
| | | | |
| | |Eduardo Garcia, | |
| | |Gordon, Holden, | |
| | |Jones, Quirk, | |
AB 74
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| | |Rendon, Wagner, | |
| | |Weber, Wood | |
| | | | |
| | | | |
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SUMMARY: Phases in annual unannounced inspection visits in
community care facilities, residential care facilities for the
elderly, child day care centers, and family day care homes licensed
by the Department of Social Services. Specifically, this bill:
1)Requires the Department of Social Services (DSS) to increase the
frequency of annual unannounced licensing visits of Community
Care Facilities, Residential Care Facilities for the Elderly,
licensed child day care centers and family day care homes per the
following:
a) By July 1, 2016, requires DSS to conduct annual unannounced
visits to at least a 30% random sample of facilities not
otherwise subject to an annual inspections to address
compliance issues or meet federal funding requirements, and
requires that facilities are visited at least once every three
years;
b) By July 1, 2017, requires DSS to conduct annual unannounced
visits to no less than a 40% random sample of facilities not
otherwise subject to an annual inspection, and requires that
facilities are visited at least once every two years; and
c) Requires DSS to conduct at least one annual unannounced
visit in each licensed facility on and after July 1, 2018.
1)Deletes provisions requiring DSS to conduct an unannounced visit
at least once every five years.
EXISTING LAW:
1)Establishes the California Community Care Facilities Act (CCFA)
to provide a comprehensive statewide service system of quality
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community care for people who have a mental illness, a
developmental or physical disability, and children and adults who
require care or services by a facility or organization. (Health
and Safety Code (H&S Code) Sections 1500 and 1501)
2)Defines a "Community care facility" (CCF) as a facility, place,
or building maintained and operated to provide nonmedical
residential care, day treatment, adult day care, or foster family
agency services for children, adults, or children and adults,
including, but not limited to, individuals with cognitive or
physical disabilities, as specified, and abused or neglected
children. (H&S Code Section 1502)
3)Authorizes DSS to license facilities or organizations that
provide services under the jurisdiction of the CCFA, including,
residential facilities, as defined, adult day programs,
therapeutic day services facilities, foster family agencies and
homes, social rehabilitation facilities, community treatment
facilities, full-service adoption agencies, noncustodial,
adoption agencies, transitional shelter care facilities, and
transitional housing placement providers for foster youth. (H&S
Code Section 1520)
4)Establishes the California Residential Care Facility for the
Elderly (RCFE) Act, which requires facilities that provide
personal care and supervision, protective supervision, or health
related services for persons 60 years of age or older who
voluntarily choose to reside in those facilities to be licensed
by DSS. (H&S Code Section 1569 et seq.)
5)Establishes the California Child Day Care Facilities Act to
provide a comprehensive, quality system for licensing child day
care facilities to ensure that working families have access to
healthy and safe child care providers and that child care
programs contribute positively to a child's emotional, cognitive,
and educational development, and are able to respond to, and
provide for, the unique characteristics and needs of children.
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(H&S Code Section1596.70 et seq.)
6)Subjects all licensed community care facilities to unannounced
inspections by DSS, with certain exceptions in foster family
homes, as specified. (H&S Code Sections 1534, 1569.33, 1597.09
and 1597.55a)
7)Provides that facilities licensed by DSS shall be subject to
unannounced visits by DSS and that the department shall visit
facilities as often as necessary to ensure the quality of care
provided. (H&S Code Sections 1534, 1569.33, 1597.09 and
1597.55a)
8)Requires annual unannounced inspections when a license is on
probation, when required by the terms of a facility compliance
plan, when an accusation is pending, when required for federal
financial participation (CCFs and RCFEs), or to verify that a
person who has been ordered out of the facility is no longer
present. (H&S Code Sections 1534, 1569.33, 1597.09 and 1597.55a)
9)Requires DSS to perform random inspections each year in no fewer
than 20% of facilities not subject to annual inspections.
Provides that this percentage shall increase by 10% if the total
citations issued by the department exceeds the previous year by
10%. Requires DSS to visit every facility no less than every
five years. (H&S Code Sections 1534, 1569.33, 1597.09 and
1597.55a)
FISCAL EFFECT: According to the Assembly Appropriations Committee:
1)Ongoing major future costs in the range of $20 million General
Fund (GF) once the frequency of inspections in all facility types
is completed annually.
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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 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:
Background: The Community Care Licensing Division (CCLD) of the
Department of Social Services is responsible for the regulatory and
licensing activities related to residential and non-residential
programs. CCLD is charged with providing preventative and
protective services to people in "community care facilities"
(24-hour senior, adult, and child residential care homes, as well
as non-residential programs, such as child care centers and adult
day programs). CCLD is responsible for conducting facility
inspections within the facilities it licenses, pursuing
administrative actions when licensing standards are not met and
assisting providers to maintain compliance with licensing
regulations. CCLD also conducts criminal background checks of
licensees, employees and all adults providing direct services to,
or having routine contact with, clients in care.
According to CCLD data, as of June, 2014, there were nearly 1.4
million children and adults served in 76,416 licensed residential
and non-residential programs overseen by CCLD (these include 8,700
foster family homes and family child care homes licensed by
counties through contracts with DSS).
Facility inspection priorities: Prior to 2003, the required
frequency of unannounced licensing visits was annually for most
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facility types (and tri-annually for family child care). However,
the state's ongoing budget deficit and declining revenues resulted
in decreased visit frequency in order to reduce costs. As a
result, CCLD is now required to conduct 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. CCLD also conducts
investigations when a complaint is filed against a facility, and
there are additional inspection requirements for new facilities or
when changes occur to the license. However, in most cases, five
years could pass between CCLD inspection visits at a residential
facility, often jeopardizing resident or client safety. Today,
according to DSS, there are approximately 500 licensing program
analysts responsible for conducting inspections in licensed
community care facilities.
Need for this bill: Unannounced licensing visits are of
fundamental importance in protecting the health and safety of
children and adults receiving care through facility or home-based
care in the community. They ensure that basic health and safety
requirements are being met and provide opportunities for increased
technical assistance to programs, enhanced information sharing, the
development of best practices and, overall, an improvement in the
quality of life for clients of care facilities.
According to the author, "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
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instead of being proactive to prevent issues or fix and stop these
issues before they become deadly. By at least having a licensing
program analyst, or inspector, in these facilities, boots on the
ground, once a year we will be able to be proactive and no longer
be operating under a complaints based system. 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."
Analysis Prepared by:
Myesha Jackson / HUM. S. / (916) 319-2089 FN:
0000569