BILL ANALYSIS Ó AB 348 Page 1 ASSEMBLY THIRD READING AB 348 (Brown) As Amended May 28, 2015 Majority vote ------------------------------------------------------------------- |Committee |Votes |Ayes |Noes | | | | | | | | | | | |----------------+------+--------------------+----------------------| |Health |18-0 |Bonta, Maienschein, | | | | |Bonilla, Burke, | | | | |Chávez, Chiu, | | | | |Gomez, Gonzalez, | | | | | | | | | | | | | | |Roger Hernández, | | | | |Lackey, Nazarian, | | | | |Patterson, | | | | | | | | | | | | | | |Ridley-Thomas, | | | | |Rodriguez, | | | | |Santiago, Thurmond, | | | | |Waldron, Wood | | | | | | | |----------------+------+--------------------+----------------------| |Aging |7-0 |Brown, Hadley, | | | | |Gipson, Gray, | | | | |Levine, Lopez, | | | | |Mathis | | AB 348 Page 2 | | | | | |----------------+------+--------------------+----------------------| |Appropriations |17-0 |Gomez, Bigelow, | | | | |Bonta, Calderon, | | | | |Chang, Daly, | | | | |Eggman, Gallagher, | | | | | | | | | | | | | | |Eduardo Garcia, | | | | |Gordon, Holden, | | | | |Jones, Quirk, | | | | |Rendon, Wagner, | | | | |Weber, Wood | | | | | | | | | | | | ------------------------------------------------------------------- SUMMARY: Establishes a 45-working-day timeframe by which the Department of Public Health (DPH) would be required to complete investigations of long-term health care facility complaints or reports. Specifically, this bill: 1)Requires DPH to complete its investigation of a long-term health care facility complaint or report within 45 working days of its receipt, and authorizes DPH to extend the 45-working-day timeframe by an additional 30 days if DPH has diligently attempted, but has not been able to obtain necessary evidence related to the investigation. 2)Requires DPH, in the case that it extends an investigation beyond 45 working days, to notify the complainant, in writing, of the basis for the extension, any outstanding evidence sought to complete the investigation, the source of the outstanding evidence, and the anticipated completion date. 3)Effective January 1, 2018, applies the 45-working-day, and 30-day extension timeframes to investigations of entity-reported incidents (ERIs), which are incidents such as epidemics, outbreaks, disasters, fires, disruptions of services, major AB 348 Page 3 accidents, or other unusual occurrences that long-term health care facilities are required to self-report to DPH. 4)Effective January 1, 2018, requires long-term health care facilities that self-report to DPH pursuant to existing law, in the case that they extend an investigation beyond 45 working days, to notify the complainant, in writing, of the basis for the extension, any outstanding evidence sought to complete the investigation, the source of the outstanding evidence, and the anticipated completion date. 5)Requires DPH, effective July 1, 2016, to include in its written notice of investigation determinations, specific findings concerning each alleged violation, and a summary of the evidence upon which its determination is made. Prohibits the written determination from disclosing the names of individual residents. 6)Grants complainants 15 days, rather than five days, to request an informal conference with DPH if the complainant does not agree with the findings of the investigation. 7)Requires DPH to analyze its compliance with the complaint and ERI investigation timeframes in its annual system and staffing analysis. 8)Provides that none of the provisions proposed in this bill are to be interpreted to diminish the DPH's authority and obligation to investigate any alleged violation of state or federal law, or to enforce applicable state and federal requirements. FISCAL EFFECT: According to the Assembly Appropriations Committee: AB 348 Page 4 1)Assuming the significant backlog of complaints is cleared by 2018, ongoing costs may be in the range of $1 million to $2 million beginning in 2018. 2)Unknown one-time costs to develop policies and procedures for, and for training on, the requirement to include a summary of the evidence upon which the determination is made. This provision would also result in significant ongoing costs, potentially in the range of $1 million overall (Licensing and Certification Program special fund). 3)Additional minor costs to DPH to expand notification pursuant to the bill's requirements and report specified data. COMMENTS: According to the author, DPH is charged with protecting nursing home residents from harmful events and with investigating complaints filed by the public and facilities. However, the author contends that, by any measure, DPH's system of investigation is not functioning as expected. The author states that in 2009, DPH eliminated its policy calling for complaint investigations to be completed within 40 days, and now has no specific time frames for completing investigations of nursing home complaints. Despite the elimination of this policy, the author cites numerous reports issued by federal and state agencies, private organizations, and the media documenting DPH's failures to investigate nursing home complaints in a timely manner. The author also states that DPH has been the subject of two recent lawsuits for failing to investigate nursing home complaints with timeliness. The author concludes by stating that legislation to improve timeliness of complaint investigations is critically needed. Supporters of this bill state this bill is critical to establish AB 348 Page 5 meaningful complaint investigation deadlines, that the timely investigation of nursing home complaints is a matter of life and death for nursing home residents, and that by improving complaint investigation standards, this bill will help restore public confidence in California's nursing home oversight system. Other supporters state that this bill will provide certainty about DPH's responsiveness and dedication to completing investigations, thereby strengthening and improving the state's nursing home oversight and enforcement process. Other supporters state that, due to chronic understaffing within the Licensing and Certification Program, health facility evaluator nurses have not had the ability to consistently complete and close investigations, resulting in a serious backlog of complaints. There is no known opposition to this bill. Analysis Prepared by: An-Chi Tsou / HEALTH / (916) 319-2097 FN: 0000851