BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SB 980|
|Office of Senate Floor Analyses | |
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THIRD READING
Bill No: SB 980
Author: Nielsen (R)
Amended: 5/31/16
Vote: 21
SENATE VETERANS AFFAIRS COMMITTEE: 4-0, 4/12/16
AYES: Nielsen, Hueso, Allen, Roth
NO VOTE RECORDED: Nguyen
SENATE JUDICIARY COMMITTEE: 7-0, 4/19/16
AYES: Jackson, Moorlach, Anderson, Hertzberg, Leno, Monning,
Wieckowski
SENATE APPROPRIATIONS COMMITTEE: 7-0, 5/27/16
AYES: Lara, Bates, Beall, Hill, McGuire, Mendoza, Nielsen
SUBJECT: Veterans homes
SOURCE: AMVETS
California Association of County Veterans Service
Officers
DIGEST: This bill requires the Department of Veterans Affairs
(CalVet) to (1) adopt statewide policies and procedures, by
regulation, for operation of the state veterans home system; (2)
implement a statewide electronic medical records (EMR) system;
and (3) correct and update outdated terminology and references
within the portion of the Military and Veterans Code (MVC) that
governs state veterans' homes.
ANALYSIS:
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Existing law:
1) Authorizes establishment and operation of the Veterans' Home
of California system.
2) Establishes CalVet's authority and responsibilities in
administering the system.
3) Requires each on-site home administrator to adopt rules and
regulations for the administration of each home.
4) Defines criteria for admission to a veterans' home.
5) Requires that home members (residents) pay fees and charges
as determined by CalVet, subject to a specified fee schedule.
6) Authorizes CalVet to investigate a veteran's financial
status for admission purposes.
7) Requires that upon the death of a veteran in a home any
monies not in excess of $3,000 held by the home for the
veteran to be paid to the homes Morale, Welfare, and
Recreation Fund, if no will or heir or other family member is
discovered.
8) Authorizes:
a) Married veteran home members to have their non-veteran
spouses domicile with them.
b) A resident spouse to continue residency after a
veteran spouse's death.
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This bill:
1) Corrects and updates archaic and outdated terminology and
references within the portion of the MVC that governs state
veterans' homes.
2) Clarifies that the on-site home administrator to be the
senior executive appointed to oversee the operations of a
veterans' home.
3) Requires the CalVet Secretary (Secretary) to adopt uniform
statewide policies and procedures, by regulation, for the
operation of the veterans' home system.
4) Requires the Secretary to implement a statewide EMR system.
5) Requires the EMR system and all transactions made in that
system to comply with the privacy and security protections,
which the Legislature has enacted and the federal government
mandated with regard to EMRs, in general.
6) Requires the Secretary to annually report to the veterans
policy committees of the Legislature.
7) Requires that fees and charges be established by the
Secretary.
8) Requires the Secretary to adopt rules and regulations that
apply to the homes and the criteria for admission.
9) Provides that a resident spouse who continues residency
after a veteran spouse's death to continue to pay all
applicable fees and comply with all department regulations.
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10)Requires CalVet to determine the total worth of any member's
property or assets for purposes of admission, including
validating income levels for purposes of establishing fees.
Background
State veterans homes. The State of California provides
veterans' homes to help provide for the state's aged or disabled
veterans to acknowledge the service and tremendous sacrifices
California veterans have made on behalf of our nation.
CalVet's Veterans Homes Division provides rehabilitative,
residential medical care and services in a homelike environment
for aged and disabled veterans (and eligible veteran spouses)
residing in eight veterans homes, which are located in Barstow,
Chula Vista, Fresno, Lancaster. Redding, Ventura, West Los
Angeles, and Yountville. As of April 2016, a total of 2,158
members resided in the homes.
Many of the homes were built in the last 10 years and the
state's laws and regulations governing the homes are not
standardized. Also, some policies and procedures are outdated
and need to be updated to reflect the level of care provided at
the homes.
Levels of care. The eight campuses offer different combinations
of the following levels of care that generate increasing levels
of cost:
1)Independent living/domiciliary care (Barstow, Chula Vista,
Yountville):
This level of care is for residents able to perform activities
of daily living with, at most, minimal assistance. Non-nursing
employees provide limited supervision. Residents have access
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to all of the Home's services, activities, and medical care.
Individuals can transfer to higher levels of care as needed.
Independent living is also referred to as Domiciliary by
CalVet and the United States Department of Veterans Affairs.
2)Residential care/assisted living (All homes except Barstow):
Residential Care Facilities for the Elderly (RCFE) are
available for residents who require minimal assistance and
supervision with some activities of daily living. RCFE
services may include care by licensed nurses. In the future,
memory care programs may be established within the RCFEs.
3)Intermediate care (Barstow, Yountville):
This level is for residents who often require licensed nursing
assistance with medications and treatments, and generally
require unlicensed nursing assistance with several daily
living activities.
4)Skilled nursing (Barstow, Chula Vista, Fresno, Redding, West
LA, Yountville):
This level of care provides 24-hour services of licensed
nurses and certified nursing assistants, and is more
comprehensive than intermediate care. Skilled nursing
residents have greater access to rehabilitation therapies,
nursing care, pharmacy management, structured activities and
clinical dietary services.
5)Memory care:
The Fresno, Redding, West LA and Yountville homes provide
memory care programs within their skilled nursing facilities.
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6)Outpatient clinic:
In addition to the above, each home provides an outpatient
clinic to serve its members. The clinics provide comprehensive
multidisciplinary assessments as well as ongoing primary care.
The clinics address the veteran's routine care needs and also
will arrange visits with outside medical specialists as
necessary.
Electronic medical records. New technologies and financial
incentives have resulted in health care providers increasingly
and actively using EMRs. An EMR is an electronic version of a
patient's medical history, which is maintained by the provider
over time, and may include all of the key administrative
clinical data relevant to that persons care under a particular
provider, including demographics, progress notes, problems,
medications, vital signs, past medical history, immunizations,
laboratory data and radiology reports The EMR automates access
to the information and has the potential to streamline clinician
workflow. The EMR also has the ability to support other
care-related activities directly or indirectly through various
interfaces, including evidence-based decision support, quality
management, and outcomes reporting.
FISCAL EFFECT: Appropriation: Yes Fiscal
Com.:YesLocal: No
According to the Senate Appropriations Committee, though a
precise estimate is unavailable at this time, this bill would
likely result in costs to CalVet in the mid hundreds of
thousands to update existing and develop new regulations.
Additional unknown one-time costs would be incurred for the
implementation of a statewide EMR system. These costs could
range from negligible to significant depending upon the option
used to fulfill this requirement (i.e. purchasing an
off-the-shelf system or modeling the system off of one that
exists in other state departments). Ongoing costs for CalVet to
report to the Legislature on veterans' home-related performance
issues, likely in the tens of thousands. (General Fund)
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SUPPORT: (Verified5/31/16)
AMVETS - Department of California (co-source)
California Association of County Veterans Service Officers
(co-source)
California Long-Term Care Ombudsman Association
California State Commanders Veteran Council
Military Officers Association of America - California Council of
Chapters
Veterans of Foreign Wars - Department of California
Vietnam Veterans of American - California State Council
OPPOSITION: (Verified5/31/16)
None received
Prepared by: Wade Teasdale / V.A. / (916) 651-1503
5/31/16 21:31:46
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