BILL ANALYSIS Ó
SB 980
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Date of Hearing: June 28, 2016
ASSEMBLY COMMITTEE ON VETERANS AFFAIRS
Jacqui Irwin, Chair
SB
980 (Nielsen) - As Amended June 22, 2016
SENATE VOTE: 39-0
SUBJECT: Veterans' homes
SUMMARY: 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3)Correct and update outdated terminology and references within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.
EXISTING LAW:
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1)Provides for the establishment and operation of veterans'
homes at various sites, and provides for an administrator of
each home, as specified.
2)Establishes the duties of the Department of Veterans Affairs
with regard to the establishment and regulation of veterans'
homes.
3)Establishes the criteria for admission to a veterans' home, as
specified.
4)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.
5)Authorizes a resident spouse to continue his or her residency
after a veteran spouse's death.
6)Authorizes the department to investigate a veteran's financial
status for admission purposes.
7)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.
8)Requires members of a veterans' home to pay fees and charges
as determined by the department, subject to a specified fee
schedule.
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9)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 (MWR)Fund upon the death of a veteran in a home if
no will or heir or other family member is discovered within a
specified number of years after his or her death.
10)Requires any moneys not in excess of $3,000 held by the home
for the veteran to be paid to the home's MWR Fund upon the
departure of a veteran from a home if the money is not
requested by the veteran within a specified number of years
after his or her departure.
This Bill:
1)Requires 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.
2)Authorizes the secretary to establish needs-based criteria for
admission to veterans' homes and to prioritize admission for
veterans with service-related disabilities, as specified.
3)Requires 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, and would
expand those provisions to include domestic partners.
4)Authorizes the department to determine a resident's or
applicant's income or suitability for residence at a veterans'
home and would provide that providing false information or
failure to pay fees is grounds for financial penalties or
discharge from a veterans' home.
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5)Provides that failure to pay fees is cause for the
administrator to refer the resident to collections or dismiss
the resident from the home.
6)Increases the amount that may be transferred to the MWR fund
upon the death of a veteran in a home if no will or heir or
other family member is discovered within a specified number of
years after his or her death to $15,000.
7)Increases the amount that may be transferred to the home's MWR
Fund upon the departure of a veteran from a home if the money
is not requested by the veteran within a specified number of
years after his or her departure to $5,000.
8)Makes other conforming changes and would delete obsolete
provisions and references, as specified.
FISCAL EFFECT: 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
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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)
COMMENTS:
According to the author:
Significant portions of the Military and Veterans Code are
out of date, containing obsolete references and archaic
terminology in dire need of updates. Additionally, over the
past decade the veterans' home system has exploded from
three to eight homes, none of which follow standardized
regulations or procedures.
This bill seeks to update, clarify, and standardize the code
sections governing veterans' homes to increase efficiency
and give veterans the high quality of care they deserve.
The author is correct, the entire Military and Veterans Code
is in need of modernization and cleanup. The department
undertook a project to address the code cleanup but it has
been postponed indefinitely. The code sections for the Homes
are particularly out of date despite the fact that the
operation of the Homes is the department's largest program by
far. Military and Veterans Code section 1010(a) for example
omits reference to six of the eight Veterans Home locations:
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(a) "Home" means the Veterans' Home of California, Yountville,
and the Veterans' Home of California, Barstow.
A bill such as this one is long overdue, in fact, CalVet
undertook a re-write of the Military and Veterans Code in the
recent past, but that effort stalled and its status is unknown.
This bill does not enjoy any official support from the
department; it is the product of input and collaboration to be
sure, but it is the bill's author, not the department who showed
leadership on this issue. CalVet is the state department tasked
with being the expert on veterans issues and which knows the
pros and cons of the existing code better than any other
department. Therefore, if an overhaul and reimagining of the
code is needed, the architecture of the veteran sections of the
Military and Veterans Code reasonably should flow from the
leadership and vision of the department and be the subject of an
officially sponsored proposal. This bill logically focused on
the department's largest program leaving the rest of the code
for a future effort thus it presents an opportunity for CalVet
to occupy the field for future changes.
There are numerous amendments to existing code in the bill,
however, these may generally be summarized and grouped as
follows:
1)Modernization and Cleanup
a) Various amendments correct anachronisms or other
technical issues in the current code.
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2)Operations and Administration- Amendments in the bill create
new or clarify existing operations and administration issues
such as:
a) Statutory/Regulatory compliance planning and action.
b) Development and maintenance of policies and procedures.
3)Regulatory development to support the above and the operations
of the Homes generally.
4)Reporting and enhanced transparency provisions
5)Mandate for implementation of electronic medical record system
by January 1, 2019.
6)Changes to eligibility and admissions priorities
Annual reporting provisions
The expressed intent of the Legislature in the bill is:
?that the department submit the report required pursuant to this
section at a level of detail that will provide the Legislature
and the public with indicators of the quality of both the health
care and the management of facilities of the Veterans' Home of
California without compromising members' privacy while still in
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compliance with applicable law and regulation. ?
The department must include at least the following in the
report:
1)Current census and census changes since last report.
2)Any major changes to home policy and the impact of those
changes on the residents.
3)Changes in provision of care, including licensure changes.
4)Significant events that impacted the operations of the home.
5)Copies of annual licensing survey records.
6)Significant patient care complaints, results of any
investigations into those complaints, and any corrective
action taken to address validated complaints.
7)Copies of available data from licensing agencies comparing
veterans' home quality of care metrics to industry averages.
Changes to eligibility and admissions priorities
This bill:
Removes the requirement in the existing statute that applicants
be unable to pay for care elsewhere.
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1. Permits the department to give admission priority to
service-connected disabled veterans.
2. Allows the department to establish needs-based
admissions criteria.
3. Prioritizes applicants as follows:
a. MOH or POW
If no needs based criteria:
b. Service connected disabled vets (any
disability level) serving in time of war*
c. Service connected disabled vets (any
disability level) serving in time of peace
If needs based criteria are implemented:
d. Service connected disabled vets who
demonstrate the need and who served in a time of war
e. Service connected disabled vets who
demonstrate the need and but who served in a time of
peace
f. Non-service connected disabled veterans who
can pay for care elsewhere.
Enhanced Authority to Investigate Finances of Applicants and
Home Members
1. The bill enhances the authority of the department to
investigate applicants and members finances. At any time
during which a person is a member of a veterans' home, the
department may investigate any applicant's or member's
financial status and personal background to determine the
member's or applicant's income and suitability for
residence at a veterans' home. The department may contract
with any other state or federal agency or private entity to
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conduct such an investigation on its behalf. The bill
authorizes the department to levy financial penalties, to
deny admission to the home, and to discharge a member from
the home if the applicant or member provides the department
with false financial information.
2. Existing section 1012.2 of the Military and Veterans
Code requires home members receiving an aid and attendance
allowance from the United States Department of Veterans
Affairs and who have no dependents or relatives, as
specified, to pay to the home an amount equal to that
allowance in all levels of care excluding domiciliary. The
bill removes the requirement that the veteran have no
specified dependents so that all members receiving an aid
and attendance benefit must pay the department an amount
equal to that benefit. The rationale is that in the case
of home members, regardless of their spousal or immediate
family situation, it is the department that provides aid
and attendance. There is an exception for those members
with a USDVA disability rating greater than 70%
Fee Structure Changes
The bill changes some aspects of the fee structure of the Homes.
This bill:
1. Modernizes the code to include spouses and domestic
partners.
2. Requires fees and charges imposed on members to be based
on the cost of room and board, except as specified in the
existing law. Late fees are permitted above the room and
board cost. The department is authorized to refer member
fees to a collection agency and/or to dismiss a member from
the Home. The department is authorized to subject
retroactive awards from USDVA to fee assessments.
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Authority to Contract
The bill authorizes the department to arrange by contract or any
other form of agreement with the United States Department of
Veterans Affairs to leverage federal contracts for the
procurement of goods and services.
Repealer of Code Sections
The bill repeals Military and Veterans Code Sections:
1. 1012.6- Pertaining to authority to process admission
applications.
2. 1014 - Pertaining to the management authority of the
department and the policymaking authority of the California
Veterans Board.
3. 1024- Pertaining to financial investigations of
applicants.
4. 1033.2- Pertaining to repayment of General Fund Loans.
5. 1051- Pertaining to establishment of the California
Veterans Homes Fund.
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Member Deposits Held by Home, Interest Calculation
The bill conforms the interest calculation method to the Code of
Federal Regulations.
REGISTERED SUPPORT / OPPOSITION:
Support
AMVETS - Department of California
California Association of County Veterans Service Officers
California Long-Term Care Ombudsman Association
California State Commanders Veteran Council
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Military Officers Association of America - California Council of
Chapters
Veterans of Foreign Wars - Department of California
Vietnam Veterans of American - California State Council
Opposition
None on File.
Analysis Prepared by:Jenny Callison / V.A. / (916)
319-3550