BILL ANALYSIS Ó SENATE COMMITTEE ON APPROPRIATIONS Senator Ricardo Lara, Chair 2015 - 2016 Regular Session AB 74 (Calderon) - Care facilities: regulatory visits ----------------------------------------------------------------- | | | | | | ----------------------------------------------------------------- |--------------------------------+--------------------------------| | | | |Version: June 25, 2015 |Policy Vote: HUMAN S. 5 - 0 | | | | |--------------------------------+--------------------------------| | | | |Urgency: No |Mandate: No | | | | |--------------------------------+--------------------------------| | | | |Hearing Date: July 13, 2015 |Consultant: Jolie Onodera | | | | ----------------------------------------------------------------- This bill meets the criteria for referral to the Suspense File. Bill Summary: AB 74 would require the Department of Social Services (DSS) to increase the frequency of random unannounced licensing visits of community care facilities, residential care facilities for the elderly (RCFEs), and child day care centers, except foster care homes, as specified, achieving annual unannounced visits for all facilities by July 1, 2018. Fiscal Impact: Increased annual General Fund costs in the low millions of dollars in 2016-17 and 2017-18, approximately $20 million in 2018-19, and about $15 million annually thereafter to increase the visitation frequency to annually for all facilities. Staff notes this bill would chapter out several provisions of SB 79 (Committee on Budget and Fiscal Review) Chapter 20/2015, the Human Services budget trailer bill. AB 74 (Calderon) Page 1 of ? Background: The Community Care Licensing Division (CCLD) of the DSS administers the licensure and oversight of over 66,000 licensed community care facilities in California. These facilities are classified under 23 separate licensure categories including adoption agencies, foster family homes, RCFEs, group homes, adult residential facilities, adult day care, child day care facilities and others that provide primarily non-medical care and supervision to 1.4 million children and adults in California. Prior to 2003, the required frequency of CCLD facility 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. As a result, the CCLD is now required to conduct unannounced visits annually only in circumstances in which a facility has a history of compliance issues. For those residential facilities not subject to annual inspections, the CCLD is currently required to conduct comprehensive compliance inspections on a 30 percent random sample basis each year, with no facility being visited less than once every five years. In response to numerous health and safety issues discovered at facilities licensed by the CCLD, the 2014 and 2015 Budget Acts include funding for a comprehensive plan to reform the CCLD program. The 2014 Budget Act included an increase of $7.5 million ($5.8 million General Fund) 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 2014 Budget also increased licensing and application fees by 10 percent. The recently enacted 2015 Budget Act additionally includes $3 million General Fund and 28.5 positions to address a backlog of complaint cases and expand training and technical assistance. Beginning in January 2017, the DSS will begin increasing inspection frequency to every three years for all facilities, every two years by 2018 for all facility types except child care, and annually by 2019 for adult day care and RCFEs. Proposed Law: This bill would require the DSS to increase the frequency of AB 74 (Calderon) Page 2 of ? unannounced licensing visits of community care facilities, RCFEs, child day care centers, and family day care homes, as follows: On or before July 1, 2016, requires DSS to conduct annual unannounced visits to no less than 30 percent of facilities, as specified, and visit all facilities at least once every three years. On or before July 1, 2017, requires DSS to conduct annual unannounced visits to no less than 40 percent of facilities, as specified, and visit all facilities at least once every two years. On and after July 1, 2018, requires DSS to conduct at least one annual unannounced visit to each licensed community care facility. Prior Legislation: AB 1454 (Calderon) 2014 was substantially similar to this measure and would have phased in annual licensing inspections by July 1, 2017. This bill was held on the Suspense File of this Committee. SB 855 (Committee on Budget and Fiscal Review) Chapter 27/2014, among other provisions, 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. The bill would require the DSS to update the Legislature on the status of the structural and quality enhancement improvements during the 2015-16 legislative budget subcommittee hearings." No statutory increase to the frequency of licensed facility visits was included in SB 855. AB 364 (Calderon) 2013 would have required the DSS CCLD inspectors to make unannounced visits to most licensed facilities (with the exception of licensed child care facilities) at least once every two years. This bill was held on the Suspense File of the Assembly Committee on Appropriations. 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 AB 74 (Calderon) Page 3 of ? provided. This bill was held on the Suspense File of the Assembly Committee on Appropriations. Staff Comments: By increasing the frequency of facility visits beyond what the 2015 Budget Act requires, the provisions of this bill will result in additional General Fund costs. The marginal increase over the 2015 Budget Act requirements for unannounced facility visits are estimated in the low millions of dollars in each of 2016-17 and 2017-18, approximately $20 million in 2018-19, and about $15 million annually thereafter to conduct annual visits above and beyond what is required under existing law as recently enacted under SB 79, the Human Services budget trailer bill. -- END --