BILL ANALYSIS                                                                                                                                                                                                    Ó




           ----------------------------------------------------------------- 
          |SENATE RULES COMMITTEE            |                         AB 74|
          |Office of Senate Floor Analyses   |                              |
          |(916) 651-1520    Fax: (916)      |                              |
          |327-4478                          |                              |
           ----------------------------------------------------------------- 


                                   THIRD READING 


          Bill No:  AB 74
          Author:   Calderon (D), et al.
          Amended:  9/2/15 in Senate
          Vote:     21  

           SENATE HUMAN SERVICES COMMITTEE:  5-0, 6/23/15
           AYES:  McGuire, Berryhill, Hancock, Liu, Nguyen

           SENATE APPROPRIATIONS COMMITTEE:  7-0, 8/27/15
           AYES:  Lara, Bates, Beall, Hill, Leyva, Mendoza, Nielsen

           ASSEMBLY FLOOR:  80-0, 6/1/15 - See last page for vote

           SUBJECT:   Care facilities:  regulatory visits


          SOURCE:    Author
          
          DIGEST:  This bill incrementally increases unannounced  
          inspections of all licensed child day care centers and family  
          child care homes such that on and after January 1, 2019, all  
          licensed facilities shall be inspected annually.

          Senate Floor Amendments of 9/2/15 clarify the timelines for  
          incrementally increasing the frequency of inspections for child  
          day care centers and family day care homes.

          ANALYSIS:   


          Existing Law:


          1)Establishes the California Child Day Care Facilities Act to  
            provide for the licensure and regulation of child day care and  








                                                                      AB 74  
                                                                     Page 2



            family day care facilities as a separate licensing category  
            within the existing licensing structure of CDSS (HSC 1596.72  
            et seq.)


          2)Provides for the CDSS licensure and regulation of small family  
            day care homes serving between six and eight children, as  
            specified, in a residentially zoned and occupied property.  
            (HSC 1597.30 et seq.)


          3)Provides that licensed facilities shall be subject to  
            unannounced visits by CDSS and that the department shall visit  
            facilities as often as necessary to ensure the quality of care  
            provided. (HSC 1534, 1569.33, 1597.09 and 1597.55a)


          4)Requires CDSS to perform random inspections each year on no  
            fewer than 20 percent of facilities not subject to annual  
            inspections. Provides that this percentage shall increase by  
            10 percent if the total citations issued by the department  
            exceeds the previous year by 10 percent. As a result of this  
            trigger, CDSS currently is required to perform random  
            inspections on 30 percent of the facilities not subject to  
            annual inspection. Requires CDSS to visit every facility no  
            less than every 5 years. (HSC 1534, 1569.33, 1597.09, 1597.55  
            (a))


          5)Pursuant to SB 79 (Committee on Budget and Fiscal Review,  
            Chapter 20, Statutes of 2015), incrementally increases the  
            inspection frequency for licensed community care facilities as  
            follows:


             a)   Adult residential facilities and adult day programs:

               i)     Beginning January 1, 2017 facilities shall be  
                 inspected no less than every 3 years;
               ii)    Beginning January 1, 2018, facilities shall be  
                 inspected no less than every 2 years;
               iii)   Beginning January 1, 2019, facilities shall be  








                                                                      AB 74  
                                                                     Page 3



                 inspected annually.

             b)   Children's residential facilities and foster family  
               homes:

               i)     Beginning January 1, 2017 facilities shall be  
                 inspected no less than every 3 years;
               ii)    Beginning January 1, 2018, facilities shall be  
                 inspected no less than every 2 years.

             c)   Child day care centers and family day care homes:

               i)     Beginning January 1, 2017 day care centers shall be  
                 inspected at least every three years.

          This bill:

          1)Provides that, on and after January 1, 2018 and until January  
            1, 2019, CDSS shall do both of the following: 

             a)   Conduct an annual unannounced inspection of no less than  
               20 percent of facilities not otherwise subject to annual  
               inspections.
             b)   Inspect all licensed child day care centers and family  
               day care homes at least once every two years. 


          2)Provides that, beginning January 1, 2019, child care centers  
            and family day care homes shall be inspected annually. 


          3)Conforms with existing law enacted by SB 79 (Committee on  
            Budget and Fiscal Review, Chapter 20, Statutes of 2015) which  
            provided that on or after January 1, 2017, and until January 1  
            2018, CDSS shall do both of the following:

             a)   Conduct an annual unannounced inspection of no less than  
               30 percent of facilities not otherwise subject to annual  
               inspections.
             b)   Inspect all licensed child day care centers and family  
               day care homes at least once every three years.









                                                                      AB 74  
                                                                     Page 4




          Background


          Regulatory Oversight


          The Community Care Licensing Division (CCLD) of CDSS provides  
          the primary regulatory oversight over the quality and care in  
          nearly 65,000 licensed community care facilities. Counties are  
          contracted with the department to license an additional 6,100  
          facilities. These facilities fall 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 which provide  
          primarily non-medical care and supervision to 1.4 million  
          children and adults in California. 


          Prior to January 2004, CCLD was required to conduct at least  
          annual visits for all licensed community care facilities within  
          its jurisdiction. However, in 2003 under a budget trailer bill  
          enacting substantial budget cuts due to the ongoing deficit,  
          this statute was changed to require that only those facilities  
          which warrant close monitoring because of a poor history of  
          compliance or are federally required to be inspected annually  
          are subject to annual visits (about 10 percent of facilities).  
          The trailer bill required that 10 percent of the remaining  
          facilities not subject to annual inspection would be randomly  
          inspected each year and that no facility shall be visited less  
          than once every five years.


          The bill included a trigger increasing the percentage of random  
          inspections by 10 percent if total citations increased over the  
          prior year by 10 percent or more. Later statute was changed to  
          impose a 20 percent random inspection standard. Today, as a  
          result of the trigger, 30 percent of facilities are randomly  
          selected for inspection each year. 


          Currently, CDSS reports it makes more than 24,000 annual  








                                                                      AB 74  
                                                                     Page 5



          inspections and investigates more than 14,000 complaints  
          involving licensed care. Due to extremely antiquated technology,  
          the department is unable to provide detailed information on the  
          nature of those complaints or how they were resolved. 


          Impact of reduced visit frequency


          A 2008 study published by the California Health Care Foundation  
          investigated the impact on the truncated frequency of visits on  
          RCFEs, and found that "routine visits were replaced with  
          significant increases in the number of complaint and  
          problem-driven visits" and that "the monitoring of quality of  
          care in RCFEs has become a complaint and problem driven  
          process."  CCL has repeatedly sought to restore the cuts made to  
          licensing, arguing that the cuts to staff and resulting changed  
          protocols "have put client health and safety at risk. By not  
          consistently inspecting facilities, or inspecting a facility  
          only as the result of a complaint, CCL (analysts) have lost  
          rapport with licensees, which in turn has not been conducive to  
          helping clients in those facilities."


          Recent Budget Actions


          SB 855 (Committee on Budget and Fiscal Review) Chapter 27,  
          Statutes of 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. This year, SB 79 (Committee on Budget and Fiscal  
          Review) Chapter 20, Statutes of 2015 statutorily increased the  
          frequency of inspections for all facilities as described in the  
          table below.  However, SB 79 does not achieve annual inspections  
          for children's residential care facilities or child care  
          facilities. This bill would expand on the budget action to  
          additionally implement annual inspections for child care  
          facilities, while children's residential facilities would remain  
          subject to inspections every two years. 









                                                                      AB 74  
                                                                     Page 6




                Inspection Frequency Summary: SB 79 compared to AB 74



           ----------------------------------------------------------------- 
          |  Facility   |  Current  | January 1, | January 1, | January 1,  |
          |    Type     |    Law    |    2017    |    2018    |    2019     |
           ----------------------------------------------------------------- 
          |-------------+-----------+------------+------------+------+------|
          |             |           |            |   Budget   |Budget|AB 74 |
          |             |           |   Budget   |            |      |      |
          |             |           |            |            |      |      |
          |-------------+-----------+------------+------------+------+------|
          |  Childcare  |  5 years  |  3 years   |  3 years   |3     |Annual|
          | facilities  |           |            |            |  years|  ly  |
          |-------------+-----------+------------+------------+------+------|
          | Children's  |  5 years  |  3 years   |  2 years   |2     | N/A  |
          | residential |           |            |            |  years|      |
          |    care     |           |            |            |      |      |
          | facilities  |           |            |            |      |      |
          |-------------+-----------+------------+------------+------+------|
          |  Adult and  |  5 years  |  3 years   |  2 years   |Annual| N/A  |
          | senior care |           |            |            |      |      |
          | facilities  |           |            |            |      |      |
          |-------------+-----------+------------+------------+------+------|
          | Percentage  |    30%    |    30 %    |    20%     | 30%  | N/A  |
          |     of      |           |            |            | (for |      |
          | facilities  |           |            |            |those |      |
          |  randomly   |           |            |            | not  |      |
          |  inspected  |           |            |            |annual|      |
          |  annually   |           |            |            |  ly  |      |
          |             |           |            |            |inspec|      |
          |             |           |            |            | ted) |      |
           ----------------------------------------------------------------- 
          
          FISCAL EFFECT:   Appropriation:    No          Fiscal  
          Com.:YesLocal:   No

          According to the Senate Appropriations Committee, this bill  
          would incur first-year licensing costs to the Department of  
          Social Services of $13.5 million and $10.5 million (General  








                                                                      AB 74  
                                                                     Page 7



          Fund) annually thereafter.


          SUPPORT:   (Verified8/28/15)


          Advancement Project
          AFSCME
          Alliance 
          California Advocates for Nursing Home Reform
          California Alternative Payment Program Association
          California Assisted Living Association
          California Childcare Resource & Referral Network 
          California Commission on Aging
          California Communities United Institute 
          California Continuing Care Residents Association
          California Long-Term Care Ombudsman Association
          California Retired Teachers Association
          California State PTA
          California State Retirees
          Childcare Alliance of Los Angeles
          Childcare Development Resources of Ventura County
          Children Now
          City of Burbank
          City of Fountain Valley
          Community Action Partnership of Madera County 
          Community Resources for Children 
          Consumer Federation of California
          County of San Bernardino
          County of San Diego
          Del Norte Child Care Council
          Early Edge California
          First 5 California 
          First 5 LA
          LAUP
          Leading Age California
          League of California Cities
          National Association of Social Workers
          Office of the State long-Term Care Ombudsman
          Solano Family and Children Services
          Special Needs Network
          State Council on Developmental Disabilities








                                                                      AB 74  
                                                                     Page 8



          United States Department of Defense State Liaison


          OPPOSITION:   (Verified8/28/15)


          None received

          ASSEMBLY FLOOR:  80-0, 6/1/15
          AYES:  Achadjian, Alejo, Travis Allen, Baker, Bigelow, Bloom,  
            Bonilla, Bonta, Brough, Brown, Burke, Calderon, Campos, Chang,  
            Chau, Chávez, Chiu, Chu, Cooley, Cooper, Dababneh, Dahle,  
            Daly, Dodd, Eggman, Frazier, Beth Gaines, Gallagher, Cristina  
            Garcia, Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez,  
            Gordon, Gray, Grove, Hadley, Harper, Roger Hernández, Holden,  
            Irwin, Jones, Jones-Sawyer, Kim, Lackey, Levine, Linder,  
            Lopez, Low, Maienschein, Mathis, Mayes, McCarty, Medina,  
            Melendez, Mullin, Nazarian, Obernolte, O'Donnell, Olsen,  
            Patterson, Perea, Quirk, Rendon, Ridley-Thomas, Rodriguez,  
            Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting,  
            Wagner, Waldron, Weber, Wilk, Williams, Wood, Atkins

          Prepared by:Sara Rogers / HUMAN S. / (916) 651-1524
          9/3/15 14:10:53


                                    **** END ****