BILL ANALYSIS Ó
SENATE COMMITTEE ON APPROPRIATIONS
Senator Ricardo Lara, Chair
2015 - 2016 Regular Session
SB 980 (Nielsen) - Veterans' homes
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|Version: April 26, 2016 |Policy Vote: V.A. 4 - 0, JUD. 7 |
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|Urgency: No |Mandate: No |
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|Hearing Date: May 9, 2016 |Consultant: Jillian Kissee |
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This bill meets the criteria for referral to the Suspense File.
Bill
Summary: This bill updates code sections governing state
veterans' homes and among other things, requires the Department
of Veterans Affairs (CalVet) to: (1) adopt statewide policies
and procedures, by regulation, for the operation of the state
veterans home system; (2) establish a quality of care assessment
team; and (3) implement a statewide electronic health records
system.
Fiscal
Impact:
Though a precise estimate is unavailable at this time, this
bill would likely result in costs to CalVet in the low
millions and would require several additional positions. Some
of these costs are one-time. See staff comments. (General
Fund)
Potential cash flow and deficiency issues for homes related to
SB 980 (Nielsen) Page 1 of
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requiring federal funds to be deposited into the General Fund
as a reimbursement for operating costs instead of being
treated as revenue.
Background: The state provides veterans' homes to help provide for the
state's aged or disabled veterans. CalVet provides
rehabilitative, residential medical care and services in a
homelike environment for veterans and eligible veteran spouses
residing in the homes. Eight homes in California currently
serve over 2,000 veterans. The homes are located in Barstow,
Chula Vista, Fresno, Lancaster, Redding, Ventura, West Los
Angeles, and Yountville.
Many of the homes were built within the last 10 years and the
state's laws and regulations governing the homes are not
standardized. The eight campuses offer different combinations
of levels of care that result in varied levels of cost.
Proposed Law:
This bill updates code sections governing state veterans'
homes. In addition, this bill:
Requires the Secretary of Veterans Affairs to adopt
uniform statewide policies and procedures, by regulation,
for the operation of the veterans' home system. Authorizes
the Secretary to adopt rules and regulation governing the
admission of applicants and may prescribe the conditions
upon which they may enter and remain with the home.
Requires the administrator to 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.
Requires, by July 1, 2017, CalVet to 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, as specified.
SB 980 (Nielsen) Page 2 of
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Requires, by January 1, 2018, CalVet to implement an
electronic medical record system in which the usage of the
system is standardized in all homes.
Requires the Secretary to annually report to the
Legislature on significant veterans' home-related
performance issues, as specified.
Expands CalVet's authority to investigate a member's,
not just a veteran's, financial status to determine the
total value of the property and assets of any veteran
applying for admission to the home; to ensure the member is
able to pay for necessary care outside of the home; or to
validate income levels for the purposes of establishing
fees. A member is defined as any veteran or nonveteran
spouse who has been admitted to residency at any home.
Requires moneys received by a home from veterans who
receive federal aid to be deposited into the Federal Trust
Fund, a continuously appropriated fund, to be used for the
operating costs of the home. Requires all moneys received
by the state from the United States for the use of the home
to be deposited into the General Fund as a reimbursement
for operating costs of the home.
Prohibits fees paid by a member from exceeding the
average cost of care for the level of care in which the
member currently resides. Authorizes the Secretary to
establish fees for residency, instead of the administrator
of a home. Authorizes a spouse to continue residence after
the veteran's death as long as he or she continues to pay
all applicable fees and comply with CalVet's rules.
Changes the amounts that are able to be paid to the
Morale, Welfare, and Recreation Fund after the death of a
veteran or upon a veteran's departure from the home.
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Specifies that veterans' homes are for those aged and
disabled veterans who are unable to pay for necessary
domiciliary and licensed long-term care outside the home.
Related
Legislation: SB 543 (Wolk, 2016) with regard to the Veterans
Home of California system, creates a single system-wide Morale,
Welfare, and Recreation Fund that consolidates existing and
future moneys generated by individual veterans home campuses,
and establishes procedures and restrictions on the budgeting and
spending of moneys in the Fund. SB 543 is pending in the
Assembly Veterans Affairs Committee.
SB 1410 (Wolk, Chapter 659, Statutes of 2014) requires
nonveteran spouses to pay the same fees and charges as paid by
veteran members of a veterans' home, as determined by CalVet,
and subjects them to the same prohibitions.
Staff
Comments: Though this bill requires CalVet to establish a
quality of care assessment team from within existing resources,
it will likely be one of the major cost drivers of this bill.
The bill specifies that the team would be required to conduct
periodic reviews of how each home meets the quality of care
standards adopted by the Secretary. Assuming a team of six,
funding for the quality care assessment team would be over
$700,000 for salaries and benefits only. There would also
likely be additional travel costs.
This bill also requires the implementation of an electronic
medical record system that is standardized in all homes. It is
unclear as to whether CalVet could update its existing system or
would have to develop and transition to a new system. However,
it is likely that either option would result in significant
limited-term administrative costs at least in the hundreds of
thousands.
This bill requires the Secretary to develop policies and
procedures through regulations for the operations of the homes
SB 980 (Nielsen) Page 4 of
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and, to the extent possible, are required to be in conformity to
federal regulations. The policies and procedures are required
to include specified topics including: admission of applicants,
resident disciplinary procedures, and quality of care standards.
This requirement could drive additional limited-term costs to
CalVet in the hundreds of thousands but could be more depending
upon the complexity of developing these policies and procedures.
The annual reporting requirements of the Secretary to the
Legislature regarding significant veterans home-related
performance issues, as specified, is likely to drive ongoing
costs in the tens of thousands.
Finally, this bill makes several amendments impacting fees and
other revenue streams. The increase to the caps on the amounts
that may be transferred to the Morale, Welfare, and Recreation
Fund upon a veteran's death or departure if he or she has
unclaimed assets by an heir or relative after a specified period
of time, is not anticipated to have a state fiscal impact.
These revenues remain at the local level. In addition, the bill
prohibits fees paid by a member from exceeding the average cost
of care for the level of care in which the member currently
resides is not expected to have a state fiscal impact as the
fees currently do not cover the full cost of care that members
receive. The bill's authorization for the Secretary to
establish fees for residency, instead of the administrator of a
home, will have an unknown impact on revenue from those fees.
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