Amended in Assembly June 22, 2016

Amended in Senate January 26, 2016

Amended in Senate January 5, 2016

Amended in Senate May 5, 2015

Amended in Senate April 20, 2015

Amended in Senate April 7, 2015

Senate Bill No. 648

Introduced by Senator Mendoza

(Coauthor: Assembly Member Levine)

February 27, 2015

An act to amend Sections 1400, 1401, 1404, 1404.5, 1405, 1407, 1408, 1409.3, and 1410 of, and to add Sections 1402, 1409.4, begin insert 1409.5, end insert 1409.6, 1409.7, begin delete and 1409.8 end delete begin insert 1409.8, and 1409.9 end insert to, the Health and Safety Code, begin insert and to amend Section 15630 of the Welfare and Institutions Code, end insert relating to health and care facilities.

LEGISLATIVE COUNSEL’S DIGEST

SB 648, as amended, Mendoza. Health and care facilities: referral agencies.

Existing law requires a referral agency to obtain a license from the State Department of Public Health in order to refer a person to any extended care facility, skilled nursing home, or intermediate care facility. Existing law exempts a local public agency performing referral services without cost from these provisions. Under existing law, a violation of these provisions is subject to a civil penalty and suspension or revocation of the license.

This bill would additionally require a referral agency to obtain a license from the State Department of Social Services in order to refer a person to a residential care facility for the begin delete elderly and end delete begin insert elderly. The bill end insert would prohibit an extended care facility, skilled nursing home, intermediate care facility, or residential care facility for the elderly from paying a commission or fee to a referral agency that is not licensed, as specified. The bill would prohibit a referral agency from holding any power of attorney or any other property of a person receiving referral services, or from disclosing any personal information of a person receiving services, unless authorized to do so. The bill would require a referral agency to begin delete provide a disclosure statement, as specified, end delete begin insert disclose specified information end insert to each person receiving its services, and to retain, for 3 years, begin delete the end delete begin insert an end insert acknowledgment from the person being referred, or his or her conservator, guardian, authorized family member, or agent under a power of attorney, stating that the begin delete disclosure statement was received. The bill would state that failure to provide the disclosure statement or retain the acknowledgment, with the intent to mislead the public on the nature of the services provided, constitutes unfair competition and is subject to a civil penalty of up to $2,500. end delete begin insert disclosures had been made. end insert The bill would also require referral agencies to maintain liability insurance in specified amounts.

begin insert

Existing law makes specified persons mandated reporters of elder or dependent adult abuse, including administrators, supervisors, and licensed staff of a facility that provide care or services for elder or dependent adults. Under existing law, failure to report physical abuse, abandonment, abduction, isolation, financial abuse, or neglect of an elder or dependent adult is a misdemeanor.

end insert begin insert

The bill would include on the list of mandated reporters owners, operators, and employees of a referral agency. By expanding the crime of failure to report elder or dependent adult abuse, this bill would impose a state-mandated local program.

end insert begin insert

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

end insert begin insert

This bill would provide that no reimbursement is required by this act for a specified reason.

end insert

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program:  begin delete no end delete begin insert yes end insert .

The people of the State of California do enact as follows:

SECTION 1.  

Section 1400 of the Health and Safety Code is
amended to read:

1400.  

(a) It is unlawful for any person, association, or
corporation to establish, conduct, or maintain a referral agency or
to refer any person for remuneration to any extended care facility,
skilled nursing home, intermediate care facility, or residential care
facility for the elderly, or a distinct part of a facility providing
extended care, skilled nursing home care, or intermediate care,
without first having obtained a written license as provided in this
chapter from the State Public Health Officer or from an inspection
service approved by the State Public Health Officer pursuant to
Section 1257, from the State Department of Social Services, or
from both, as appropriate.

(b) It is unlawful for any person, association, or corporation to
establish, conduct, or maintain a referral agency or to refer any
person for remuneration to any person or agency outside a
long-term health care facility, as defined in Section 1418, for
professional services for which the long-term health care facility
does not employ a qualified professional person to furnish a
specific service, including, but not limited to, laboratory,
diagnostic, or therapy services, unless the long-term health care
facility complies with current federal and state laws regarding the
provision of these services and all of the following conditions are
met:

(1) The services will be provided in accordance with
professional standards applicable to the provision of these services
in a long-term health care facility.

(2) The long-term health care facility assumes responsibility
for timeliness of the services.

(3) Services are provided or obtained only when ordered by the
attending physician and a notation is made in the resident’s medical
chart reflecting that the service has been provided to the resident.

(c) It is unlawful for any person, association, or corporation to
establish, conduct, or maintain a referral agency or to refer any
person for remuneration to any residential care facility for the
elderly for professional services if that facility does not meet the
licensing standards established in Chapter 3.2 (commencing with
Section 1560). The referral agency may satisfy this requirement
by obtaining and relying on the licensing status information for a
residential care facility for the elderly that is published on the
Internet Web site of the State Department of Social Services.

(d) It is unlawful for any extended care facility, skilled nursing
home, intermediate care facility, or residential care facility for the
elderly, or a distinct part of a facility providing extended care,
skilled nursing home care, or intermediate care to pay a
commission or fee to a referral agency that does not have a written
license as provided in this chapter from the State Public Health
Officer or from an inspection service approved by the State Public
Health Officer pursuant to Section 1257, from the State Department
of Social Services, or from both, as appropriate.

SEC. 2.  

Section 1401 of the Health and Safety Code is amended
to read:

1401.  

As used in this chapter, “referral agency” means a private,
profit or nonprofit agency that is engaged in the business of
referring persons for remuneration to any extended care facility,
skilled nursing home, intermediate care facility, or residential care
facility for the elderly, or a distinct part of a facility providing
extended care, skilled nursing home care, or intermediate care.
“Referral agency” does not include any of the following:

(a) A licensed residential care facility for the elderly that does
either of the following:

(1) Provides discounts or other remuneration to residents or
their families for referring new or prospective clients.

(2) Provides remuneration to staff for marketing or sales offers.

(b) A resident who refers a new or prospective resident and
receives a discount or other remuneration from a licensed
residential care facility for the elderly.

(c) A licensed residential care facility staff member who receives
remuneration from the facility for sales or marketing efforts.

SEC. 3.  

Section 1402 is added to the Health and Safety Code,
to read:

1402.  

“Residential care facility for the elderly” has the same
meaning as set forth in Section 1569.2.

SEC. 4.  

Section 1404 of the Health and Safety Code is amended
to read:

1404.  

No licensee under this chapter shall have a direct or
indirect financial interest in any facility doing business with the
licensee.

SEC. 5.  

Section 1404.5 of the Health and Safety Code is
amended to read:

1404.5.  

A license application shall be submitted to either or
both licensing departments, as appropriate, whenever any of the
following circumstances occur:

(a) Change of ownership of the referral agency.

(b) Change of name of the referral agency.

(c) Change of location of the referral agency.

SEC. 6.  

Section 1405 of the Health and Safety Code is amended
to read:

1405.  

begin delete (a) end delete begin delete   end delete Any person, partnership, firm, corporation, or
association desiring to obtain a license to refer persons to extended
care facilities, skilled nursing homes, or intermediate care facilities,
or a distinct part of a facility providing extended care, skilled
nursing home care, or intermediate care, shall file with the State
Department of Public Health an application on forms furnished
by the State Department of Public Health. Any person, partnership,
firm, corporation, or association desiring to obtain a license to
refer persons to residential care facilities for the elderly shall file
with the State Department of Social Services an application on
forms furnished by the State Department of Social Services. The
applications shall contain all of the following:

(a) Name of applicant, and if an individual, whether the applicant
has attained the age of 18 years.

(b) Name of referral agency.

(c) The location of the referral agency.

(d) The business or occupation engaged in by each applicant,
and by each partner, begin delete officer end delete begin insert officer, end insert and director, for at least two
years immediately preceding the filing of the application. In
addition, each such person shall submit a statement setting forth
whether he or she has previously engaged in the operation of a
referral agency, whether he or she has been involved in, or the
subject of, a refusal or revocation of a referral agency license, and
whether he or she has been convicted of a crime other than a minor
traffic offense.

(e) If the applicant is a corporation, the name and principal
business address of each officer and director of the corporation;
and for nonpublic corporations, the name and business address of
each stockholder owning 10 percent or more of the stock and the
name and business address of any corporation member who has
responsibility in the operation of the facility.

(f) If the applicant is a partnership, the name and principal
business address of each partner.

(g) Evidence of the right to occupy the premises where the
referral agency is to be located.

(h) A copy of the partnership agreement or the Articles of
Incorporation, if applicable.

(i) A copy of the current organization chart.

(j) A schedule of fees to be charged and collected by the referral
agency, and a statement of the method by which each fee is to be
computed or determined.

(k) A declaration that the licensee will not have any financial
interest in any health facility doing business with the referral
agency.

(l) Evidence satisfactory to the licensing department that the
applicant demonstrates reputable and responsible character and
the capability to comply with this chapter.

SEC. 7.  

Section 1407 of the Health and Safety Code is amended
to read:

1407.  

(a) Any licensee desiring to voluntarily surrender his
or her license for cancellation or temporary suspension shall notify
the licensing department in writing as soon as possible and, in all
cases, at least 30 days prior to the effective date of cancellation or
temporary suspension of the license.

(b) Any license placed in temporary suspension pursuant to this
section may be reinstated by the licensing department within 12
months of the date of the voluntary suspension on receipt of an
application and evidence showing compliance with licensing
requirements.

SEC. 8.  

Section 1408 of the Health and Safety Code is amended
to read:

1408.  

(a)  Upon verification of compliance with this chapter
and with the approval of the licensing department, the licensing
department shall issue the license to the applicant.

(b) When licensing referral agencies that provide referrals to
residential care facilities for the elderly, the State Department of
Social Services is not required to conduct an onsite licensing
inspection as a condition of verifying compliance with this chapter.

(c) As a condition of verifying compliance with this chapter,
the licensing department may require an applicant to submit a copy
or example of the begin delete disclosure statement end delete begin insert disclosures end insert required by
Section 1409.4.

(d) If the applicant is not in compliance with this chapter, the
licensing department shall deny the applicant a license.
Immediately upon the denial of any license, the licensing
department shall notify the applicant in writing. Within 20 days
of receipt of the notice, the applicant may present his or her written
petition for a hearing to the licensing department. Proceedings
conducted by the State Department of Public Health shall be
conducted in accordance with Section 100171.

begin insert

(e) For purposes of compliance with this chapter, an applicant
is not required to have a physical place of business within the
state.

end insert

SEC. 9.  

Section 1409.3 of the Health and Safety Code is
amended to read:

1409.3.  

(a) The licensee shall notify either or both licensing
departments, as appropriate, within 10 days in writing when a
change of stockholder owning 10 percent or more of the nonpublic
corporate stock occurs. The writing shall include the name and
principal mailing addresses of the new stockholder.

(b) When a change of agency manager occurs, either or both
licensing departments, as appropriate, shall be notified in writing
within 10 days by the licensee. The notification shall include the
name of the new agency manager.

(c) Each licensee shall notify either or both licensing
departments, as appropriate, within 10 days in writing of any
change of the mailing address of the licensee. The writing shall
include the new mailing address of the licensee.

(d) When a change begin insert occurs end insert in the principal officer of a corporate
licensee, chairperson, president, or general manager, begin delete occurs end delete either
or both licensing departments, as appropriate, shall be notified
within 10 days in writing by the licensee. The writing shall include
the name and principal business address of the officer.

SEC. 10.  

Section 1409.4 is added to the Health and Safety
Code, to read:

1409.4.  

(a) Before referring a person to any facility, a licensee
shall begin delete provide the person with a disclosure statement containing all
of the following: end delete begin insert disclose all of the following to the person: end insert

(1) Whether the licensee has an agreement or contract with the
facility to which the person is being referred.

(2)  begin delete That end delete begin insert Whether end insert a commission or fee will be received by the
licensee from the facility as a result of the begin delete referral, if applicable. end delete

begin insert referral. end insert

(3) Any gift or exchange of monetary value between the facility
and the licensee that is in addition to, or in lieu of, a commission
or fee.

(4) Any fee charged to the person or persons by the licensee.
The notice shall include a description of the services being rendered
for that fee and the licensee’s refund policy.

(5) The licensee’s contact information, including address and
telephone number, and the licensee’s privacy policy. The privacy
policy may be provided as an Internet Web site link consistent
with provisions set forth in Section 22575 of the Business and
Professions Code.

begin delete

(6) The date of the licensee’s most recent tour or visit to the
facility and, as appropriate, a hyperlink to, or copy of, the most
recent evaluation report for a residential care facility for the elderly
to which the person is being referred, prepared pursuant to Section
1569.33 and published by the State Department of Social Services.

(7) Information regarding the type of facility and the services
offered by the facility.

(8)

end delete

begin insert (6) end insert  The contact information, including address and telephone
number, of the State Department of Social Services or State
Department of Public Health, as appropriate, and the contact
information for filing consumer complaints, including contact
information for the local long-term care ombudsman. If the
disclosure statement is provided electronically, the contact
information for each department and the local long-term care
ombudsman may be provided as a hyperlink.

begin insert

(b) Contemporaneous with a referral, the licensee shall provide
the person with the following information about the facility:

end insert begin insert

(1) The date of the licensee’s most recent tour or visit to the
facility and verification that the facility is licensed and in good
standing, and a hyperlink to, or copy of, the most recent evaluation
report for a residential care facility for the elderly to which the
person is being referred, prepared pursuant to Section 1569.33
and published by the State Department of Social Services, if an
evaluation report has been prepared in the previous 24 months.

end insert begin insert

(2) Information regarding the type of facility and the services
offered by the facility.

end insert begin delete

(b)

end delete

begin insert (c) end insert  (1) The begin delete disclosure statement end delete begin insert disclosures end insert shall be dated and
shall contain, in addition to the requirements of begin delete subdivision (a), end delete
begin insert subdivisions (a) and (b), end insert the name of the person being referred.

(2) If the begin delete disclosure is end delete begin insert disclosures are end insert provided in written form,
begin delete it end delete begin insert they end insert shall be printed in 16-point bold type.

(3) If the begin delete disclosure statement is end delete begin insert disclosures are end insert provided
electronically, begin delete it end delete begin insert they end insert shall be begin insert provided in a manner that is end insert
consistent with provisions set forth in Title 2.5 (commencing with
Section 1633.1) of Part 2 of Division 3 of the Civil Code, and shall
be displayed on a secured Web page in a larger type than the
surrounding text.

begin delete

(c)

end delete

begin insert (d) end insert  The licensee shall begin delete provide the disclosure statement end delete begin insert make
the disclosures end insert pursuant to begin delete subdivision (a) end delete begin insert subdivisions (a) and
(b) end insert in the same language in which the licensee negotiates any
referral services with the person receiving services.

begin delete

(d)

end delete

begin insert (e) end insert  The begin delete disclosure statement end delete begin insert disclosures end insert shall be signed or
otherwise acknowledged by the person being referred, or his or
her conservator, guardian, authorized family member, or agent
under a power of attorney, stating that the begin delete disclosure statement end delete
begin insert disclosures end insert required by this section begin delete was end delete begin insert were end insert received. The
acknowledgment shall be begin delete executed with one of the following: end delete

begin insert evidenced in one of the following ways: end insert

(1) The signature of the person being referred, or his or her
conservator, guardian, authorized family member, or agent under
a power of attorney on begin delete the exact disclosure statement. end delete begin insert the document
containing the required disclosures. end insert

(2) An electronic signature that is consistent with standards set
forth in Title 2.5 (commencing with Section 1633.1) of Part 2 of
Division 3 of the Civil Code and includes the date, time, and
Internet provider address and displays the begin delete exact disclosure
statement document. end delete begin insert required disclosures. end insert

(3) A faxed confirmation that includes the date, time, and fax
number and displays the begin delete exact disclosure statement document. end delete

begin insert required disclosures. end insert

(4) A telephonic, oral acknowledgment of the person being
referred, or his or her conservator, guardian, authorized family
member, or agent under power of attorney, which shall be recorded,
with that person’s consent, consistent with Sections 632 and 632.7
of the Penal Code. This paragraph does not authorize an inperson,
oral acknowledgment.

begin delete

(e) The acknowledgment required by this section

end delete

begin insert (f) end insert begin insert   end insert begin insert Evidence of the dated disclosure acknowledgment end insert shall be
retained for a period of no less than three years.

begin delete

(f)

end delete

begin insert (g) end insert  (1) If the begin delete disclosure statement, end delete begin insert disclosures, end insert or any other
referral-related document, begin delete is end delete begin insert are end insert provided electronically, the
licensee shall provide a written copy, in 16-point bold type, to the
person being referred, or his or her conservator, guardian,
authorized family member, or agent under power of attorney
following any referral. This written copy may be provided by fax,
email, or other means of electronic communication, if appropriate.

(2) Recorded telephonic acknowledgments shall, upon request,
be provided in an easily accessible format to the person being
referred or the licensing department within five days of the request.

begin delete

(g) Any violation of this section with the intent to directly or
indirectly mislead the public on the nature of services provided by
the referral agency will constitute unfair competition which
includes unlawful, unfair, or fraudulent business acts or practices
and unfair, deceptive, untrue, or misleading advertising. Any person
or entity that engages in unfair competition shall be liable for a
civil penalty not to exceed two thousand five hundred dollars
($2,500) for each violation.

end delete

begin insert

begin insert SEC. 11. end insert   

end insert

begin insert Section 1409.5 is added to the end insert begin insert Health and Safety
Code end insert begin insert , to read: end insert

begin insert

begin insert 1409.5. end insert   

Owners, operators, and employees of a licensee are
mandated reporters of elder or dependent adult abuse pursuant
to Section 15630 of the Welfare and Institutions Code.

end insert

begin delete SEC. 11. end delete

begin insert SEC. 12. end insert   

Section 1409.6 is added to the Health and Safety
Code, to read:

1409.6.  

(a) It is unlawful for a licensee to share any personal
information, including, but not limited to, the name, address, age,
gender, or medical information of the person receiving services
from the licensee, with any unauthorized person or third-party
affiliate of the licensee, unless authorized pursuant to subdivision
(b).

(b)  begin delete Before making a referral end delete begin insert A referral agency shall not refer
a person end insert to any facility or begin delete facilities, end delete begin insert facilities unless end insert the person
being referred, or his or her conservator, guardian, family member,
or agent under power of attorney, begin delete may authorize end delete begin insert authorizes end insert the
licensee to share begin delete his or her end delete begin insert the referred person’s end insert personal
information, as well as the name and a description of the care or
services needed by the individual being referred, with a facility or
facilities for purposes of the referral. The personal information, or
other information shared, shall be limited to only that information
which is necessary to complete the referral process. The
authorization shall be obtained in either of the following ways:

(1) As a separate authorization form that clearly discloses begin delete that,
by executing an acknowledgment in the manner described in
subdivision (d) of Section 1409.4, end delete begin insert that end insert the individual is consenting
to the disclosure of his or her personal information to a facility or
facilities for which they are being referred. This begin delete acknowledgment end delete
begin insert authorization form end insert shall include the name and location of the
facility or facilities that will receive the personal begin delete information and
the format in which the personal information will be shared. end delete

begin insert information, and shall be executed end insert begin insert in the manner described in
subdivision (e) of Section 1409.4. end insert

(2) As part of the begin delete disclosure statement required by Section
1409.4 if it clearly indicates that the individual end delete begin insert disclosures required
by Section 1409.4, if the acknowledgment required by subdivision
(e) of Section 1409.4 clearly indicates that the individual being
referred, or his or her conservator, guardian, authorized family
member, or agent under power of attorney, end insert is consenting to the
referral agency’s disclosure of his or her personal information to
a facility or facilities for which begin delete her end delete begin insert he end insert or she is being referred. The
begin delete authorization shall include end delete begin insert licensee shall provide to the individual
being referred end insert the name and location begin delete information end delete of the facility
or facilities that will receive the personal begin delete information and the
format in which the personal information will be shared. end delete

begin insert information, as applicable. end insert

(c) The licensee shall not share the contact information of an
individual who has not provided his or her authorization pursuant
to subdivision (b).

begin delete SEC. 12. end delete

begin insert SEC. 13. end insert   

Section 1409.7 is added to the Health and Safety
Code, to read:

1409.7.  

It is unlawful for a licensee to hold any power of
attorney for a person receiving placement referral services from
that licensee, or to receive or hold a client’s property in any
capacity.

begin delete SEC. 13. end delete

begin insert SEC. 14. end insert   

Section 1409.8 is added to the Health and Safety
Code, to read:

1409.8.  

On and after July 1, begin delete 2016, end delete begin insert 2017, end insert all persons,
associations, or corporations licensed pursuant to this chapter shall
maintain liability insurance coverage in an amount of at least one
million dollars ($1,000,000) per person occurrence and three
million dollars ($3,000,000) in the total annual aggregate, for
negligent acts or omissions by the licensee.

begin insert

begin insert SEC. 15. end insert   

end insert

begin insert Section 1409.9 is added to the end insert begin insert Health and Safety
Code end insert begin insert , to read: end insert

begin insert

begin insert 1409.9. end insert   

A licensee shall display the licensee’s name and license
number on all advertising, promotional or marketing material,
and Internet Web sites paid for or operated by the licensee.

end insert

begin delete SEC. 14. end delete

begin insert SEC. 16. end insert   

Section 1410 of the Health and Safety Code is
amended to read:

1410.  

The licensing department may suspend or revoke a
license issued under this chapter for violation of any provisions
of this chapter or rules and regulations promulgated hereunder. In
addition, the licensing department shall assess a civil penalty in
the amount of fees received by a licensee as a result of a violation
of any provisions of this chapter or rules and regulations
promulgated hereunder. Proceedings to suspend or revoke a license
conducted by the State Department of Public Health shall be
conducted pursuant to Section 100171.

begin insert

begin insert SEC. 17. end insert   

end insert

begin insert Section 15630 of the end insert begin insert Welfare and Institutions Code end insert

begin insert is amended to read: end insert

begin delete

15630.  

(a) Any person who has assumed full or intermittent
responsibility for the care or custody of an elder or dependent
adult, whether or not he or she receives compensation, including
administrators, supervisors, and any licensed staff of a public or
private facility that provides care or services for elder or dependent
adults, or any elder or dependent adult care custodian, health
practitioner, clergy member, or employee of a county adult
protective services agency or a local law enforcement agency, is
a mandated reporter.

end delete

begin insert

begin insert 15630. end insert   

end insert begin insert

(a) All of the following persons are mandated
reporters:

end insert begin insert

(1) A person who has assumed full or intermittent responsibility
for the care or custody of an elder or dependent adult, whether or
not he or she receives compensation, including administrators,
supervisors, and any licensed staff of a public or private facility
that provides care or services for elder or dependent adults.

end insert begin insert

(2) An elder or dependent adult care custodian.

end insert begin insert

(3) A health practitioner.

end insert begin insert

(4) A clergy member.

end insert begin insert

(5) An employee of a county adult protective services agency.

end insert begin insert

(6) An employee of a local law enforcement agency.

end insert begin insert

(7) An owner, operator, or employee of a referral agency
licensed under Article 1 (commencing with Section 1400) of
Chapter 2.3 of Division 2 of the Health and Safety Code.

end insert

(b) (1) Any mandated reporter who, in his or her professional
capacity, or within the scope of his or her employment, has
observed or has knowledge of an incident that reasonably appears
to be physical abuse, as defined in Section 15610.63, abandonment,
abduction, isolation, financial abuse, or neglect, or is told by an
elder or dependent adult that he or she has experienced behavior,
including an act or omission, constituting physical abuse, as defined
in Section 15610.63, abandonment, abduction, isolation, financial
abuse, or neglect, or reasonably suspects that abuse, shall report
the known or suspected instance of abuse by telephone or through
a confidential Internet reporting tool, as authorized by Section
15658, immediately or as soon as practicably possible. If reported
by telephone, a written report shall be sent, or an Internet report
shall be made through the confidential Internet reporting tool
established in Section 15658, within two working days.

(A) If the suspected or alleged abuse is physical abuse, as
defined in Section 15610.63, and the abuse occurred in a long-term
care facility, except a state mental health hospital or a state
developmental center, the following shall occur:

(i) If the suspected abuse results in serious bodily injury, a
telephone report shall be made to the local law enforcement agency
immediately, but also no later than within two hours of the
mandated reporter observing, obtaining knowledge of, or
suspecting the physical abuse, and a written report shall be made
to the local ombudsman, the corresponding licensing agency, and
the local law enforcement agency within two hours of the mandated
reporter observing, obtaining knowledge of, or suspecting the
physical abuse.

(ii) If the suspected abuse does not result in serious bodily injury,
a telephone report shall be made to the local law enforcement
agency within 24 hours of the mandated reporter observing,
obtaining knowledge of, or suspecting the physical abuse, and a
written report shall be made to the local ombudsman, the
corresponding licensing agency, and the local law enforcement
agency within 24 hours of the mandated reporter observing,
obtaining knowledge of, or suspecting the physical abuse.

(iii) When the suspected abuse is allegedly caused by a resident
with a physician’s diagnosis of dementia, and there is no serious
bodily injury, as reasonably determined by the mandated reporter,
drawing upon his or her training or experience, the reporter shall
report to the local ombudsman or law enforcement agency by
telephone, immediately or as soon as practicably possible, and by
written report, within 24 hours.

(iv) When applicable, reports made pursuant to clauses (i) and
(ii) shall be deemed to satisfy the reporting requirements of the
federal Elder Justice Act of 2009, as set out in Subtitle H of the
federal Patient Protection and Affordable Care Act (Public Law
111-148), Section 1418.91 of the Health and Safety Code, and
Section 72541 of Title 22 of California Code of Regulations. When
a local law enforcement agency receives an initial report of
suspected abuse in a long-term care facility pursuant to this
subparagraph, the local law enforcement agency may coordinate
efforts with the local ombudsman to provide the most immediate
and appropriate response warranted to investigate the mandated
report. The local ombudsman and local law enforcement agencies
may collaborate to develop protocols to implement this
subparagraph.

(B) Notwithstanding the rulemaking provisions of Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 3 of Title
2 of the Government Code, or any other law, the department may
implement subparagraph (A), in whole or in part, by means of
all-county letters, provider bulletins, or other similar instructions
without taking regulatory action.

(C) If the suspected or alleged abuse is abuse other than physical
abuse, and the abuse occurred in a long-term care facility, except
a state mental health hospital or a state developmental center, a
telephone report and a written report shall be made to the local
ombudsman or the local law enforcement agency.

(D) With regard to abuse reported pursuant to subparagraph
(C), the local ombudsman and the local law enforcement agency
shall, as soon as practicable, except in the case of an emergency
or pursuant to a report required to be made pursuant to clause (v),
in which case these actions shall be taken immediately, do all of
the following:

(i) Report to the State Department of Public Health any case of
known or suspected abuse occurring in a long-term health care
facility, as defined in subdivision (a) of Section 1418 of the Health
and Safety Code.

(ii) Report to the State Department of Social Services any case
of known or suspected abuse occurring in a residential care facility
for the elderly, as defined in Section 1569.2 of the Health and
Safety Code, or in an adult day program, as defined in paragraph
(2) of subdivision (a) of Section 1502 of the Health and Safety
Code.

(iii) Report to the State Department of Public Health and the
California Department of Aging any case of known or suspected
abuse occurring in an adult day health care center, as defined in
subdivision (b) of Section 1570.7 of the Health and Safety Code.

(iv) Report to the Bureau of Medi-Cal Fraud and Elder Abuse
any case of known or suspected criminal activity.

(v) Report all cases of known or suspected physical abuse and
financial abuse to the local district attorney’s office in the county
where the abuse occurred.

(E) (i) If the suspected or alleged abuse or neglect occurred in
a state mental hospital or a state developmental center, and the
suspected or alleged abuse or neglect resulted in any of the
following incidents, a report shall be made immediately, but no
later than within two hours of the mandated reporter observing,
obtaining knowledge of, or suspecting abuse, to designated
investigators of the State Department of State Hospitals or the
State Department of Developmental Services, and also to the local
law enforcement agency:

(I) A death.

(II) A sexual assault, as defined in Section 15610.63.

(III) An assault with a deadly weapon, as described in Section
245 of the Penal Code, by a nonresident of the state mental hospital
or state developmental center.

(IV) An assault with force likely to produce great bodily injury,
as described in Section 245 of the Penal Code.

(V) An injury to the genitals when the cause of the injury is
undetermined.

(VI) A broken bone when the cause of the break is
undetermined.

(ii) All other reports of suspected or alleged abuse or neglect
that occurred in a state mental hospital or a state developmental
center shall be made immediately, but no later than within two
hours of the mandated reporter observing, obtaining knowledge
of, or suspecting abuse, to designated investigators of the State
Department of State Hospitals or the State Department of
Developmental Services, or to the local law enforcement agency.

(iii) When a local law enforcement agency receives an initial
report of suspected or alleged abuse or neglect in a state mental
hospital or a state developmental center pursuant to clause (i), the
local law enforcement agency shall coordinate efforts with the
designated investigators of the State Department of State Hospitals
or the State Department of Developmental Services to provide the
most immediate and appropriate response warranted to investigate
the mandated report. The designated investigators of the State
Department of State Hospitals or the State Department of
Developmental Services and local law enforcement agencies may
collaborate to develop protocols to implement this clause.

(iv) Except in an emergency, the local law enforcement agency
shall, as soon as practicable, report any case of known or suspected
criminal activity to the Bureau of Medi-Cal Fraud and Elder Abuse.

(v) Notwithstanding any other law, a mandated reporter who is
required to report pursuant to Section 4427.5 shall not be required
to report under clause (i).

(F) If the abuse has occurred in any place other than a long-term
care facility, a state mental hospital, or a state developmental
center, the report shall be made to the adult protective services
agency or the local law enforcement agency.

(2) (A) A mandated reporter who is a clergy member who
acquires knowledge or reasonable suspicion of elder or dependent
adult abuse during a penitential communication is not subject to
paragraph (1). For purposes of this subdivision, “penitential
communication” means a communication that is intended to be in
confidence, including, but not limited to, a sacramental confession
made to a clergy member who, in the course of the discipline or
practice of his or her church, denomination, or organization is
authorized or accustomed to hear those communications and under
the discipline tenets, customs, or practices of his or her church,
denomination, or organization, has a duty to keep those
communications secret.

(B) This subdivision shall not be construed to modify or limit
a clergy member’s duty to report known or suspected elder and
dependent adult abuse if he or she is acting in the capacity of a
care custodian, health practitioner, or employee of an adult
protective services agency.

(C) Notwithstanding any other provision in this section, a clergy
member who is not regularly employed on either a full-time or
part-time basis in a long-term care facility or does not have care
or custody of an elder or dependent adult shall not be responsible
for reporting abuse or neglect that is not reasonably observable or
discernible to a reasonably prudent person having no specialized
training or experience in elder or dependent care.

(3) (A) A mandated reporter who is a physician and surgeon,
a registered nurse, or a psychotherapist, as defined in Section 1010
of the Evidence Code, shall not be required to report, pursuant to
paragraph (1), an incident if all of the following conditions exist:

(i) The mandated reporter has been told by an elder or dependent
adult that he or she has experienced behavior constituting physical
abuse, as defined in Section 15610.63, abandonment, abduction,
isolation, financial abuse, or neglect.

(ii) The mandated reporter is not aware of any independent
evidence that corroborates the statement that the abuse has
occurred.

(iii) The elder or dependent adult has been diagnosed with a
mental illness or dementia, or is the subject of a court-ordered
conservatorship because of a mental illness or dementia.

(iv) In the exercise of clinical judgment, the physician and
surgeon, the registered nurse, or the psychotherapist, as defined
in Section 1010 of the Evidence Code, reasonably believes that
the abuse did not occur.

(B) This paragraph shall not be construed to impose upon
mandated reporters a duty to investigate a known or suspected
incident of abuse and shall not be construed to lessen or restrict
any existing duty of mandated reporters.

(4) (A) In a long-term care facility, a mandated reporter shall
not be required to report as a suspected incident of abuse, as defined
in Section 15610.07, an incident if all of the following conditions
exist:

(i) The mandated reporter is aware that there is a proper plan
of care.

(ii) The mandated reporter is aware that the plan of care was
properly provided or executed.

(iii) A physical, mental, or medical injury occurred as a result
of care provided pursuant to clause (i) or (ii).

(iv) The mandated reporter reasonably believes that the injury
was not the result of abuse.

(B) This paragraph shall not be construed to require a mandated
reporter to seek, nor to preclude a mandated reporter from seeking,
information regarding a known or suspected incident of abuse prior
to reporting. This paragraph shall apply only to those categories
of mandated reporters that the State Department of Public Health
determines, upon approval by the Bureau of Medi-Cal Fraud and
Elder Abuse and the state long-term care ombudsman, have access
to plans of care and have the training and experience necessary to
determine whether the conditions specified in this section have
been met.

(c) (1) Any mandated reporter who has knowledge, or
reasonably suspects, that types of elder or dependent adult abuse
for which reports are not mandated have been inflicted upon an
elder or dependent adult, or that his or her emotional well-being
is endangered in any other way, may report the known or suspected
instance of abuse.

(2) If the suspected or alleged abuse occurred in a long-term
care facility other than a state mental health hospital or a state
developmental center, the report may be made to the long-term
care ombudsman program. Except in an emergency, the local
ombudsman shall report any case of known or suspected abuse to
the State Department of Public Health and any case of known or
suspected criminal activity to the Bureau of Medi-Cal Fraud and
Elder Abuse, as soon as is practicable.

(3) If the suspected or alleged abuse occurred in a state mental
health hospital or a state developmental center, the report may be
made to the designated investigator of the State Department of
State Hospitals or the State Department of Developmental Services
or to a local law enforcement agency. Except in an emergency,
the local law enforcement agency shall report any case of known
or suspected criminal activity to the Bureau of Medi-Cal Fraud
and Elder Abuse, as soon as is practicable.

(4) If the suspected or alleged abuse occurred in a place other
than a place described in paragraph (2) or (3), the report may be
made to the county adult protective services agency.

(5) If the conduct involves criminal activity not covered in
subdivision (b), it may be immediately reported to the appropriate
law enforcement agency.

(d) If two or more mandated reporters are present and jointly
have knowledge or reasonably suspect that types of abuse of an
elder or a dependent adult for which a report is or is not mandated
have occurred, and there is agreement among them, the telephone
report or Internet report, as authorized by Section 15658, may be
made by a member of the team selected by mutual agreement, and
a single report may be made and signed by the selected member
of the reporting team. Any member who has knowledge that the
member designated to report has failed to do so shall thereafter
make the report.

(e) A telephone report or Internet report, as authorized by
Section 15658, of a known or suspected instance of elder or
dependent adult abuse shall include, if known, the name of the
person making the report, the name and age of the elder or
dependent adult, the present location of the elder or dependent
adult, the names and addresses of family members or any other
adult responsible for the elder’s or dependent adult’s care, the
nature and extent of the elder’s or dependent adult’s condition, the
date of the incident, and any other information, including
information that led that person to suspect elder or dependent adult
abuse, as requested by the agency receiving the report.

(f) The reporting duties under this section are individual, and
no supervisor or administrator shall impede or inhibit the reporting
duties, and no person making the report shall be subject to any
sanction for making the report. However, internal procedures to
facilitate reporting, ensure confidentiality, and apprise supervisors
and administrators of reports may be established, provided they
are not inconsistent with this chapter.

(g) (1) Whenever this section requires a county adult protective
services agency to report to a law enforcement agency, the law
enforcement agency shall, immediately upon request, provide a
copy of its investigative report concerning the reported matter to
that county adult protective services agency.

(2) Whenever this section requires a law enforcement agency
to report to a county adult protective services agency, the county
adult protective services agency shall, immediately upon request,
provide to that law enforcement agency a copy of its investigative
report concerning the reported matter.

(3) The requirement to disclose investigative reports pursuant
to this subdivision shall not include the disclosure of social services
records or case files that are confidential, nor shall this subdivision
be construed to allow disclosure of any reports or records if the
disclosure would be prohibited by any other provision of state or
federal law.

(h) Failure to report, or impeding or inhibiting a report of,
physical abuse, as defined in Section 15610.63, abandonment,
abduction, isolation, financial abuse, or neglect of an elder or
dependent adult, in violation of this section, is a misdemeanor,
punishable by not more than six months in the county jail, by a
fine of not more than one thousand dollars ($1,000), or by both
that fine and imprisonment. Any mandated reporter who willfully
fails to report, or impedes or inhibits a report of, physical abuse,
as defined in Section 15610.63, abandonment, abduction, isolation,
financial abuse, or neglect of an elder or dependent adult, in
violation of this section, if that abuse results in death or great bodily
injury, shall be punished by not more than one year in a county
jail, by a fine of not more than five thousand dollars ($5,000), or
by both that fine and imprisonment. If a mandated reporter
intentionally conceals his or her failure to report an incident known
by the mandated reporter to be abuse or severe neglect under this
section, the failure to report is a continuing offense until a law
enforcement agency specified in paragraph (1) of subdivision (b)
of Section 15630 discovers the offense.

(i) For purposes of this section, “dependent adult” shall have
the same meaning as in Section 15610.23.

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begin insert SEC. 18. end insert   

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No reimbursement is required by this act pursuant
to Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of
the Government Code, or changes the definition of a crime within
the meaning of Section 6 of Article XIII B of the California
Constitution.

end insert