BILL ANALYSIS Ó
SENATE COMMITTEE ON APPROPRIATIONS
Senator Ricardo Lara, Chair
2015 - 2016 Regular Session
AB 1387 (Chu) - Care facilities: civil penalties, deficiencies,
and appeal procedures
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|Version: July 16, 2015 |Policy Vote: HUMAN S. 3 - 0 |
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|Urgency: No |Mandate: No |
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|Hearing Date: August 17, 2015 |Consultant: Jolie Onodera |
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This bill meets the criteria for referral to the Suspense File.
Bill
Summary: AB 1387 would revise the civil penalty review and
appeals process for violations resulting in death or serious
bodily injury of a child or resident in a community are
facility, residential care facility for the elderly (RCFE), or
child day care facility. This bill would also establish a civil
penalty review and appeals process for all other violations, as
specified. Additionally, this bill would establish an appeals
process for complainants against an RCFE who are dissatisfied
with the investigation, findings, enforcement actions, or
decision regarding a complaint, as specified.
Fiscal
Impact:
Appeals process for death/serious violations : Potential
future cost savings due to simplification of the civil penalty
review and appeals process from a four-tiered to two-tiered
level of review.
AB 1387 (Chu) Page 1 of
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Appeals process for all other violations : Potentially
significant ongoing costs in excess of $150,000 (General Fund)
annually.
Appeals process for RCFE complaints : Potentially significant
ongoing costs in excess of $1 million (General Fund) annually
for DSS to review complaints, confer with complainants,
conduct complaint investigations, provide notifications, and
conduct the two-tiered appeals process within the prescribed
timeframes.
Background: The Community Care Licensing Division (CCLD) of the Department
of Social Services (DSS) administers the licensure and oversight
of over 7,500 assisted living, board and care, and continuing
care retirement homes that are licensed as RCFEs in California.
These residences are designed to provide home-like environment
housing options to elderly residents who need assistance with
activities of daily living but otherwise do not require
continuous, 24-hour assistance or nursing care. The RCFE
licensure category includes facilities with as few as six beds
to facilities with hundreds of residents whose needs may vary
widely.
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 revise the civil penalty review and appeals
process for violations in licensed community care facilities,
AB 1387 (Chu) Page 2 of
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RCFEs, and child day care facilities, as follows:
Requires civil penalties assessed by the CCLD due to death or
serious bodily injury to be approved by the program
administrator prior to issuance, instead of by the Director of
DSS.
Requires notification of a deficiency by the CCLD to include a
factual description of the nature of the deficiency fully
stating the manner in which the licensee failed to comply with
the specified statute or regulation, and if applicable, the
particular place or area in the facility in which the
deficiency occurred.
Subsequent to approval of the civil penalty by the program
administrator, establishes two levels of formal appeal and
review (instead of four) that a licensee may request,
initially by the deputy director of the CCLD and subsequently
by an administrative law judge.
Permits a licensee to request a two-tier review of any other
civil penalty or deficiency within 10 days of receiving notice
of a civil penalty, as specified. Provides that review of
these civil penalties shall be conducted by a regional manager
of the CCLD, as specified, and requires that the licensee
shall be notified of the decision within 60 days. Subsequent
to the decision, permits a licensee to request a second review
to be conducted by a program administrator of CCLD within 10
days of receipt of the regional manager's decision, and the
licensee be notified of the final decision within 60 days.
Provides that a complaint filed by a local long-term care
ombudsman or the state Long-Term Care Ombudsman alleging
denial of a statutory right of access to an RCFE shall be
given priority by DSS which shall notify the officer of the
State Long-Term Care Ombudsman that an investigation has been
initiated.
Prior to conducting an onsite complaint investigation,
requires DSS to document in writing a good-faith effort to
contact and interview the complainant and to inform the
complainant of the department's proposed course of action, as
specified. Within 10 days of a decision, requires DSS to
notify the complainant in writing of the department's
determination.
Provides a complainant who is dissatisfied with the
department's investigation, findings, enforcement actions, or
decision with regard to the complaint to file an appeal by
notifying a program manager in writing within 15 business days
of receiving notice.
AB 1387 (Chu) Page 3 of
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Requires the program manager to schedule a meeting or
teleconference with the complainant within 30 business days of
receiving an appeal, as specified, and to notify the
complainant of the decision within 10 business days of a
decision.
Permits the complainant to further appeal the decision to the
Quality Assurance Unit of CCLD, which must interview the
complainant, consider any information presented, review the
complaint record, and no later than 10 days after completing
the review to notify the complainant in writing of the
decision.
Deletes the requirement that revenues from civil penalties
levied by DSS against licensed day care providers and family
day care home providers be used to assist families with the
identification, transportation, and enrollment of children to
another center when a center's license is revoked or
temporarily suspended.
Related
Legislation: AB 1554 (Skinner) 2014 was similar to this
measure. This bill was held on the Suspense File of this
Committee.
AB 2236 (Maienschein) Chapter 813/2014 established civil penalty
assessments for violations that lead to death or serious bodily
injury of a resident or child in a community care facility, an
RCFE, or a child day care facility. This bill also established
the four-tier appeals process for violations resulting in death
or serious bodily injury to a resident or child, as specified.
Staff
Comments: In order to comply with the revised complaint
investigation processes and timelines established in this bill,
the DSS would incur additional costs above what was provided in
the 2014 and 2015 Budget Acts for investigations. While the
additional resource needs would be dependent on the volume of
complaints to be addressed pursuant to the new process, it is
estimated costs could potentially be in excess of $1 million
annually to review complaints, confer with complainants, conduct
complaint investigations, provide notifications, and conduct the
two-tiered appeals process within the prescribed timeframes of
AB 1387 (Chu) Page 4 of
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the bill.
As noted in the Background Section above, the 2014 Budget Act
included funding for a comprehensive plan to reform the CCLD
program. The Budget includes 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. While the Budget includes positions to improve
the timeliness of investigations, it did not contemplate an
expedited process for complaint investigations as mandated under
the provisions of this bill, nor did it provide for the two
levels of appeals for complainants dissatisfied with DSS
investigations, findings, or enforcement actions resulting from
the investigations.
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