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 --