BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1409
                                                                  Page  1

          Date of Hearing:   May 30, 2001

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                              Carole Migden, Chairwoman

                     AB 1409 (Chan) - As Amended:  May 24, 2001 

          Policy Committee:                              HealthVote:13-0

          Urgency:     No                   State Mandated Local Program:  
          Yes    Reimbursable:              No

           SUMMARY  

          This bill transfers the authority to license and regulate  
          nursing home administrators (NHAs) from the Department of  
          Consumer Affairs (DCA) to the Department of Health Services  
          (DHS) and makes other related changes.  Specifically, this bill:  


          1)Establishes the Nursing Home Administrator Program (NHAP)  
            within DHS and repeals a statute relating to licensure by DCA.  
             Codifies existing regulations on NHA licensure.

          2)Requires applicants for NHA licensure to submit fingerprints  
            for a criminal clearance by the Department of Justice.  Based  
            on the results, requires the program to:

             a)   Deny any application for a license, and to suspend or  
               revoke an existing license, if the applicant or licensee  
               has been convicted of any specified crimes (known as  
               mandatory exclusions).  These crimes are generally crimes  
               against persons, but include such property crimes as first  
               degree burglary, petty theft, and receiving stolen  
               property.  No appeal is permitted, unless the person has  
               obtained a certificate of rehabilitation, has had the  
               conviction dismissed, and meets other specified conditions.

             b)   Approve or deny the application, at the discretion of  
               the department, if the person has been convicted of any  
               crime other than a minor traffic violation or a crime that  
               is not a mandatory exclusion.  Specifies factors for DHS to  
               consider as evidence of good character and rehabilitation.

          1)Authorizes various licensing and examination fees to be  








                                                                  AB 1409
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            charged applicants, and permits DHS to increase the fee to  
            reflect increases in the California Consumer Price Index.

          2)Requires fees collected to be deposited in the renamed Nursing  
            Home Administrator's State License Examining Fund, the  
            proceeds of which are continuously appropriated to operate the  
            NHA licensing program.

           FISCAL EFFECT  

          Negligible fiscal impact on the state.  The current licensing  
          program is budgeted at $479,000 (Nursing Home Administrator's  
          State License Examining Board Fund) for five positions.  This  
          bill continues the program at its current level, but transfers  
          position and expenditure authority from DCA to DHS.

           COMMENTS  

           1)Purpose  .  DHS has been licensing NHAs pursuant to an   
            interagency agreement with DCA that is due to expire on June  
            30, 2001.  In June 1998, when the Board of Nursing Home  
            Administrators within DCA sunset, the Board was renamed the  
            Nursing Home Administrator Program.  In effect, DHS has been  
            licensing NHAs in the absence of a regulatory board to provide  
            oversight.  In order to have clear state administrative  
            accountability for the program, this bill designates DHS as  
            the agency responsible for licensing nursing home  
            administrators.

          The bill also gives DHS authority to charge a fee for the  
            national Nursing Home Administrator Licensing Examination,  
            which every NHA must pass as a condition of licensure.  Since  
            current law restricts the state's ability to charge a fee,  
            California residents must take the examination in other  
            states.  By permitting DHS to charge a fee, this bill will  
            allow Californians to take the licensing exam in-state.

           2)Mandatory Exclusions from Licensure  .  This bill is based on  
            requirements currently used to license administrators of  
            intermediate care facilities.  It broadens the types of  
            convictions that would bar a person from NHA licensure and  
            requires automatic denials for certain types of criminal  
            convictions.  The list of crimes includes misdemeanors and  
            wobblers (e.g., receiving stolen property, illegal use of an  
            ATM card).  If a person has been convicted of any of these  








                                                                  AB 1409
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            mandatory exclusion crimes, NHA licensure would be denied  
            except in very narrow circumstances.  If the applicant has a  
            certificate of rehabilitation and has had the conviction  
            dismissed by a court, a license may be granted.  Otherwise, it  
            must be denied.

          Current law, in contrast, gives discretion in deciding whether  
            or not to deny a license.  A license may be denied "only if  
            the crime or act is substantially related to the  
            qualifications, functions or duties of the business or  
            profession for which application is made."  This language is  
            consistent with the Fourteenth Amendment, which requires that  
            employment requirements be directly related to the  
            individual's capacity and fitness to perform the duties.

          3)  Opposition  .  The American Civil Liberties Union (ACLU) is  
            opposed because:  (a) the bill violates the Fourteenth  
            Amendment regarding employment requirements being directly  
            related to a person's fitness to perform the duties; (b)  
            people denied a license should be given an opportunity to  
            appeal the denial by presenting evidence in opposition to the  
            denial; and (c) the bill requires applicants to present proof  
            of U.S. citizenship or evidence of legal residence status,  
            both of which exceed federal immigration requirements.

          ACLU recommends making this a two-year bill to allow time to  
            develop consistent standards among this bill and three  
            others-AB 829 (Cohn), also set for hearing May 30, and AB 1454  
            (Thomson) and SB 1095 (Escutia), both of which are two-year  
            bills.  As an alternative, ACLU suggests amendments to:  (a)  
            give DHS more flexibility in deciding whether or not to grant  
            a license; (b) limit the mandatory exclusions to felonies; (c)  
            allow an opportunity to rebut a proposed denial; and (d)  
            delete the documentation requirements for citizenship.

           Given that there are three other related bills, some of which  
            are two-year measures, should a one-year sunset be placed on  
            the mandatory exclusion provisions to allow time during the  
            interim to develop a uniform approach to the issue?
           
           Analysis Prepared by :    Joyce Iseri / APPR. / (916) 319-2081