Amended in Senate May 31, 2016

Amended in Senate April 26, 2016

Senate Bill No. 980

Introduced by Senator Nielsen

February 10, 2016

An act to amend Sections 1010, 1012, 1012.1, 1012.2, 1012.3, 1023, begin delete 1031, end delete 1034, 1035.3, 1038, and 1044 of, begin insert to add Sections 1011.1, 1011.2, 1011.3, and 1011.4 to, end insert to repeal Sections 1012.4, 1012.6, 1014, 1015, 1024, 1033.2, and 1051 of, begin insert and end insert to repeal and add Section 1011 of, begin delete and to add Sections 1011.1, 1011.2, 1011.3, and 1011.4 to, end delete the Military and Veterans Code, relating to veterans, and making an appropriation therefor.

LEGISLATIVE COUNSEL’S DIGEST

SB 980, as amended, Nielsen. Veterans’ homes.

Existing law provides for the establishment and operation of veterans’ homes at various sites, and provides for an administrator of each home, as specified. Existing law establishes the duties of the Department of Veterans Affairs with regard to the establishment and regulation of veterans’ homes.

This bill would revise and recast those provisions. Among other things, the bill would provide that the administrator is the senior executive appointed to oversee the operations of a veterans’ home. The bill would specify which veterans’ homes are administered by the Department of Veterans Affairs. The bill would require the Secretary of Veterans Affairs to adopt uniform statewide policies and procedures, by regulation, for the operation of those veterans’ homes, as specified. begin delete The bill would require the department to establish a quality of care assessment team, by a specified date, to conduct periodic reviews of each veterans’ home. end delete The bill would require the secretary to implement a statewide electronic medical record system for veterans’ homes by a specified date. The bill would require the secretary to annually report to the begin delete veterans policy committees of the Legislature, end delete begin insert Senate and Assembly Committees on Veterans Affairs, end insert as specified.

Existing law establishes the criteria for admission to a veterans’ home, as specified. Existing law establishes the fees and charges for residency, as established by each administrator of a home, and requires each administrator to adopt rules and regulations for the administration of the homes.

This bill would instead require that the fees and charges be established by the secretary, rather than by each administrator, and that the secretary adopt rules and regulations that apply to the homes and the criteria for admission. The bill would authorize the secretary to establish needs-based criteria for admission to veterans’ homes, as specified.

Existing law authorizes a resident spouse to continue his or her residency after a veteran spouse’s death.

This bill would require a resident spouse who continues residency after a veteran spouse’s death to continue to pay all applicable fees and to comply with all department regulations.

Existing law authorizes the department to investigate a veteran’s financial status for admission purposes.

This bill would further authorize the department to determine the total worth of any member’s property or assets for purposes of admission, including to validate income levels for purposes of establishing fees.

Existing law requires 100% of the moneys received by a veterans’ home from veterans receiving federal aid to be placed to the credit of the home to augment the current appropriation for the support of the home.

This bill would delete that provision, and would instead require moneys received by a veterans’ home from those veterans to be deposited into the Federal Trust Fund, a continuously appropriated fund, to be used for the operating costs of the home. Because the moneys would be continuously appropriated for those purposes, the bill would make an appropriation.

Existing law requires members of a veterans’ home to pay fees and charges as determined by the department, subject to a specified fee schedule.

This bill would prohibit the fees paid by a member from exceeding the average costs of care for the level of care in which the member currently resides.

Existing law, upon the death of a veteran in a home, requires any moneys not in excess of $3,000 held by the home for the veteran to be paid to the home’s Morale, Welfare, and Recreation Fund, if no will or heir or other family member is discovered within a specified number of years after his or her death.

This bill would increase the amount that may be transferred to $15,000.

Existing law, upon the departure of a veteran from a home, requires any moneys not in excess of $3,000 held by the home for the veteran to be paid to the home’s Morale, Welfare, and Recreation Fund, if the money is not requested by the veteran within a specified number of years after his or her departure.

This bill would increase the amount that may be transferred to $5,000.

This bill would make other conforming changes and would delete obsolete provisions and references, as specified.

Vote: majority. Appropriation: yes. Fiscal committee: yes. State-mandated local program: no.

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

SECTION 1.  

Section 1010 of the Military and Veterans Code
is amended to read:

1010.  

As used in this chapter, the following terms have the
following meanings:

(a) “Administrator” means the senior executive appointed to
oversee the operations of a home.

(b) “Department” means the Department of Veterans Affairs.

(c) “Deputy secretary” means the Deputy Secretary of Veterans
Homes.

(d) “Director” or “secretary” means the Secretary of Veterans
Affairs.

(e) “Home” means any facility operated by the department for
the provision of long-term care, assisted living, adult day health,
independent living, or other health care services to eligible
veterans.

(f) “Member” means any veteran or nonveteran spouse who has
been admitted to residency at any home.

(g) “Veteran” means a person who is eligible for benefits under
this chapter.

SEC. 2.  

Section 1011 of the Military and Veterans Code is
repealed.

SEC. 3.  

Section 1011 is added to the Military and Veterans
Code, to read:

1011.  

There is in the department a Veterans’ Home of
California, which the department shall administer. The Veterans’
Home of California is a system comprising the following subsidiary
home locations:

(a) The Veterans’ Home of California, Yountville, in Napa
County.

(b) The Veterans’ Home of California, Barstow, in San
Bernardino County.

(c) The Veterans’ Home of California, Chula Vista, in San Diego
County.

(d) The Veterans’ Home of California, West Los Angeles, in
Los Angeles County.

(e) The Veterans’ Home of California, Lancaster, in Los Angeles
County.

(f) The Veterans’ Home of California, Ventura, in Santa Barbara
County.

(g) The Veterans’ Home of California, Fresno, in Fresno County.

(h) The Veterans’ Home of California, Redding, in Shasta
County.

SEC. 4.  

Section 1011.1 is added to the Military and Veterans
Code, to read:

1011.1.  

(a) The secretary shall adopt uniform statewide policies
and procedures, by regulation, in accordance with the
Administrative Procedure Act (Chapter 3.5 (commencing with
Section 11340) of Part 1 of Division 3 of Title 2 of the Government
Code), for the operation of the homes. The policies and procedures
shall be in conformity, as nearly as possible, to the rules and
regulations of the United States Department of Veterans Affairs
for their facilities and to ensure that adequate care and a homelike
environment is provided in a cost-effective manner for members
of the homes.

(b) These policies and procedures shall implement the
requirements to obtain and maintain required licenses and
accreditations, as well as to ensure members in all homes
throughout the state, to the extent possible, receive equitable
treatment, benefits, and services, and to ensure that high-quality
care is provided.

(c) These policies and procedures shall include, but are not
limited to, all of the following:

(1) The admission of applicants.

(2) The conditions upon which members may enter and remain
in the home.

(3) Resident disciplinary procedures.

(4) Quality of care standards.

(5) An internal quality of care review process.

(6) Delineating which services will be provided to members by
the state.

(7) Setting staffing standards.

(8) Staff training requirements.

(9) Establishment and operation of allied councils.

(10) Any other policies and procedures to ensure the safe and
effective operation of the homes.

begin delete

(d) On or before July 1, 2017, the department shall establish a
quality of care assessment team, from within existing resources,
to conduct periodic reviews of how each home meets the quality
of care standards adopted pursuant to this section.

end delete

SEC. 5.  

Section 1011.2 is added to the Military and Veterans
Code, to read:

1011.2.  

(a) There shall be an administrator for each home,
who shall be recommended by the secretary and appointed by the
Governor, and who shall be located at that home. The salary for
each administrator shall be subject to the approval of the
Department of Human Resources.

(b) The administrator shall be responsible for ensuring
compliance with all state and federal statutes and regulations
related to the operation of the home and for implementation of all
statewide policies and procedures, as specified in Section 1011.1.

SEC. 6.  

Section 1011.3 is added to the Military and Veterans
Code, to read:

1011.3.  

The secretary shall make an annual report to the
begin delete veterans policy committees of the Legislature end delete begin insert Senate and Assembly
Committees on Veterans Affairs end insert by January 1 of each year,
beginning January 1, 2018, reporting on significant veterans
home-related performance issues, which shall include, but are not
limited to, all of the following:

(a) Current census and census changes since last report.

(b) Any major changes to home policy and the impact of those
changes on the residents.

(c) Changes in provision of care, including licensure changes.

(d) Significant events that impacted the operations of the home.

(e) Results of regulatory agency inspections or reviews and
corrective action taken to address findings.

(f) Significant patient care complaints, results of any
investigations into those complaints, and any corrective action
taken to address validated complaints.

(g) Results of internal quality of care reviews.

(h) A comparison of veterans home quality of care metrics to
industry averages.

(i) Other significant issues that may be of interest to the
committee members.

SEC. 7.  

Section 1011.4 is added to the Military and Veterans
Code, to read:

1011.4.  

(a) On or before January 1, 2018, the secretary shall
implement an electronic medical record system. The usage of the
electronic medical record system shall be standardized in all homes.

(b) The electronic medical record system required by this
section, and all transactions made in that system, shall comply
with the Confidentiality of Medical Information Act (Part 2.6
(commencing with Section 56) of Division 1 of the Civil Code),
Chapter 1 (commencing with Section 123100) of Part 1 of Division
106 of the Health and Safety Code, the Information Practices Act
of 1977 (Chapter 1 (commencing with Section 1798) of Title 1.8
of Part 4 of Division 3 of the Civil Code), the federal Health
Insurance Portability and Accountability Act (HIPAA)(Public Law
104-191), the federal Health Information Technology for Economic
and Clinical Health Act (HITECH) (Public Law 111-005), and all
corresponding regulations relating to privacy and security.

SEC. 8.  

Section 1012 of the Military and Veterans Code is
amended to read:

1012.  

(a) The home is for aged and disabled persons who
served in the Armed Forces of the United begin delete States of America, end delete begin insert States, end insert
who were discharged or released from active duty under honorable
conditions from service, who are eligible for hospitalization or
domiciliary care in a veterans’ facility in accordance with the rules
and regulations of the United States Department of Veterans
Affairs, are unable to pay for necessary domiciliary and licensed
long-term care outside the home, and who are bona fide residents
of this state at the time of application; and for the spouses of these
persons if all of the following conditions, as are applicable, are
satisfied:

(1) Space is available.

(2) Joint residency will be in the best interests of the home
member, as determined by the administrator.

(3) The spouse is a bona fide resident of this state at the time
of application for admission to the home and either is married to,
and has resided with, the home member for at least one year, or is
the widow or widower of a recipient of the Medal of Honor or a
former prisoner of war (POW).

(4) The home member and spouse agree to pay the fees and
charges for joint residency, or for a widow or widower, that the
secretary may establish.

(b) (1) Veterans who qualify for benefits under this chapter due
to service during a time of war shall be given priority over veterans
who qualify due to service during a time of peace.

(2) Veterans who qualify for benefits under this chapter who
are recipients of the Medal of Honor or who were prisoners of war
(POWs) shall be given priority over all other qualified veterans,
regardless of the level of care required.

(3) The secretary may establish needs-based criteria for
admission to the homes, and any veteran meeting those criteria
shall be given priority over veterans who can afford to provide for
their own care elsewhere.

(c) A resident spouse may continue residence after the veteran’s
death, so long as he or she continues to pay all applicable fees and
comply with the department’s policies, procedures, and regulations.

(d) The property of the home shall be used for this purpose.

SEC. 9.  

Section 1012.1 of the Military and Veterans Code is
amended to read:

1012.1.  

Prior to the admission of a veteran as a member of the
home, and at any time during which a veteran is a member of the
home, the department may investigate any member’s financial
status to determine the total value of the property and assets of any
veteran applying for admission to the home, or to ensure that the
member is unable to pay for necessary care outside of the home,
or to validate income levels for the purposes of establishing fees.
The department may contract with any other state agency to
conduct such an investigation in its behalf.

SEC. 10.  

Section 1012.2 of the Military and Veterans Code is
amended to read:

1012.2.  

(a) (1) Notwithstanding any other law, any member
of the home who is receiving an aid and attendance allowance
from the United States Department of Veterans Affairs and who
has no dependent spouse, child, grandchild, father, or mother shall
pay to the home an amount equal to that allowance in all levels of
care excluding domiciliary.

(2) Paragraph (1) shall not apply to a member of the home who
is in intermediate care or skilled nursing care and has a disability
that has been rated by the United States Department of Veterans
Affairs as being 70 percent or more service-connected, as
determined under Part 4 of Title 38 of the Code of Federal
Regulations.

(b) Moneys received by a home under this section shall be
deposited into the Federal Trust Fund and shall be used for the
operating costs of the home.

SEC. 11.  

Section 1012.3 of the Military and Veterans Code is
amended to read:

1012.3.  

(a) Members of the home, including members who
are nonveteran spouses, shall pay fees and charges as determined
by the department, except that the total of the individual member’s
fees and charges for any fiscal year shall not be greater than as set
forth in the following schedule:

(1) Forty-seven and one-half percent of the member’s annual
income for domiciliary care.

(2) Fifty-five percent of the member’s annual income for
residential care for the elderly or assisted living.

(3) Sixty-five percent of the member’s annual income for
intermediate care.

(4) Seventy percent of the member’s annual income for skilled
nursing care.

(b) Subdivision (a) shall not apply to a member of the home
who is in intermediate care or skilled nursing care and has a
disability that has been rated by the United States Department of
Veterans Affairs as being 70 percent or more service-connected,
as determined under Part 4 of Title 38 of the Code of Federal
Regulations and whose related payments made under Section 51.41
of Title 38 of the Code of Federal Regulations are considered by
the United States Department of Veterans Affairs as payment in
full for the member’s care.

(c) Fees paid by a member shall not exceed the average cost of
care for the level of care in which the member currently resides.

SEC. 12.  

Section 1012.4 of the Military and Veterans Code is
repealed.

SEC. 13.  

Section 1012.6 of the Military and Veterans Code is
repealed.

SEC. 14.  

Section 1014 of the Military and Veterans Code is
repealed.

SEC. 15.  

Section 1015 of the Military and Veterans Code is
repealed.

SEC. 16.  

Section 1023 of the Military and Veterans Code is
amended to read:

1023.  

(a) The department may sue and be sued in any of the
courts of this state. All property held by the department for the
home shall be held in trust for the state and for the use and benefit
of the home. The secretary shall adopt rules and regulations for
the administration of the homes conforming as nearly as possible
to the rules and regulations of the United States Department of
Veterans Affairs and those of other states with veterans’ homes.

(b) The Director of General Services may lease or let any real
property held by the department for the home, and not needed for
any direct or immediate purpose of the home, to any entity or
person upon terms and conditions determined to be in the best
interests of the home. All moneys received in connection therewith
shall be deposited in the General Fund as a reimbursement for
operating costs of the home.

SEC. 17.  

Section 1024 of the Military and Veterans Code is
repealed.

begin delete

SEC. 18.  

Section 1031 of the Military and Veterans Code is
amended to read:

1031.  

All moneys received by the state from the United States
for the use of the home shall be deposited into the General Fund
as a reimbursement for operating costs of the home.

end delete

begin delete SEC. 19. end delete

begin insert SEC. 18. end insert   

Section 1033.2 of the Military and Veterans Code is
repealed.

begin delete SEC. 20. end delete

begin insert SEC. 19. end insert   

Section 1034 of the Military and Veterans Code is
amended to read:

1034.  

Except money received from this state for disbursement,
all moneys received by the home, or by any officer of the home,
including pension and other moneys belonging to veterans and
other trust moneys, shall be immediately paid to the administrator
of the home. On or before the 10th day of each month, the
administrator of the home shall forward to the Treasurer all moneys
in his or her possession, except pension and other moneys
belonging to veterans, trust moneys, the post funds, the emergency
fund, and donations made to each home, hereinafter mentioned,
together with a statement of the sources from which the moneys
have been received. The moneys shall be deposited by the Treasurer
to the credit of the General Fund; provided, however, that
abatements of support expenditures shall be credited to the support
appropriation current at the time of collection.

begin delete SEC. 21. end delete

begin insert SEC. 20. end insert   

Section 1035.3 of the Military and Veterans Code is
amended to read:

1035.3.  

(a) If no will or heir is discovered within two years
after the death of the veteran, any moneys not exceeding fifteen
thousand dollars ($15,000) held by the home pursuant to Section
1035 and not paid or otherwise delivered to the heir or heirs or
pursuant to the will of the deceased veteran, or otherwise disbursed
by the administrator pursuant to Section 1035, shall be paid to the
Morale, Welfare, and Recreation Fund.

If no will or heir is discovered within five years after the death
of the veteran, any moneys exceeding fifteen thousand dollars
($15,000) held by the home pursuant to Section 1035 and not paid
or otherwise delivered to the heir or heirs or pursuant to the will
of the deceased veteran, or otherwise disbursed by the administrator
pursuant to Section 1035, shall be paid to the Morale, Welfare,
and Recreation Fund.

This subdivision applies only to veterans becoming members of
the home on or after January 1, 1984.

(b) If no spouse, child, grandchild, or father or mother is
discovered within two years after the death of the veteran, any
moneys not exceeding fifteen thousand dollars ($15,000) held by
the home pursuant to Section 1035 and not paid or otherwise
delivered to the spouse, children, grandchildren, or father or
mother, or otherwise disbursed by the administrator pursuant to
Section 1035, shall be paid to the Morale, Welfare, and Recreation
Fund.

If no spouse, child, grandchild, or father or mother is discovered
within five years after the death of the veteran, any moneys
exceeding fifteen thousand dollars ($15,000) held by the home
pursuant to Section 1035 and not paid or otherwise delivered to
the spouse, children, grandchildren, or father or mother, or
otherwise disbursed by the administrator pursuant to Section 1035,
shall be paid to the Morale, Welfare, and Recreation Fund.

This subdivision applies only to veterans who have become
members of the home prior to January 1, 1984.

begin delete SEC. 22. end delete

begin insert SEC. 21. end insert   

Section 1038 of the Military and Veterans Code is
amended to read:

1038.  

All money deposited with the home for a veteran shall
be paid to him or her on demand, upon his or her discharge or
voluntary departure from the home. If the money is not so
demanded at the time of his or her discharge or departure or within
a period of two years thereafter, if the amount does not exceed
five thousand dollars ($5,000), or within a period of five years
thereafter, if the amount exceeds five thousand dollars ($5,000)
either by the veteran, or, in the event of the veteran’s death after
his or her discharge or departure, by the veteran’s heirs, devisees,
legatees, or qualified executor or administrator of his or her estate,
the money shall be paid to the Morale, Welfare, and Recreation
Fund.

begin delete SEC. 23. end delete

begin insert SEC. 22. end insert   

Section 1044 of the Military and Veterans Code is
amended to read:

1044.  

The secretary may adopt rules and regulations governing
the admission of applicants and may prescribe the conditions upon
which they may enter and remain with the home.

begin delete SEC. 24. end delete

begin insert SEC. 23. end insert   

Section 1051 of the Military and Veterans Code is
repealed.