BILL ANALYSIS
AB 1409
Page 1
ASSEMBLY THIRD READING
AB 1409 (Chan)
As Amended June 4, 2001
2/3 vote. Appropriation
HEALTH 13-0 APPROPRIATIONS 20-0
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|Ayes:|Thomson, Aanestad, Bates, |Ayes:|Migden, Bates, Alquist, |
| |Chan, Koretz, Negrete | |Aroner, Cedillo, Corbett, |
| |McLeod, | |Correa, Daucher, |
| |Robert Pacheco, Richman, | |Goldberg, Maldonado, |
| |Salinas, Steinberg, | |Robert Pacheco, Papan, |
| |Wayne, Wesson, Zettel | |Pavley, Runner, Simitian, |
| | | |Thomson, Wesson, Wiggins, |
| | | |Wright, Zettel |
| | | | |
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SUMMARY : Transfers the authority to regulate the licensure and
regulation of nursing home administrators from the Department of
Consumer Affairs (DCA) to the Department of Health Services
(DHS) and makes various technical and conforming amendments
including establishing a procedure for a provisional one-year
license. Specifically, this bill :
1)Establishes within DHS, a Nursing Home Administrator Program
(NHAP) to license and regulate nursing home administrators and
repeals existing statutes which provide for the licensure and
regulation of nursing home administrators by the Board of
Nursing Home Administrators (BNHA) of DCA.
2)Applies existing statutes applicable to BNHA's licensure and
regulation of nursing home administrators to NHAP. Codifies
existing regulations regarding the licensing of nursing home
administrators.
3)Requires the state examination to be held at least four times
a year, at a time and place determined by NHAP. Requires the
applicant to schedule the computer-based national examination
after the applicant is notified by NHAP of his or her
eligibility to take the examination.
4)Establishes requirements relating to the application and
examination for nursing home administrators.
5)Prohibits the suspension, expiration, or forfeiture by
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operation of law of a license issued by DHS, the suspension,
forfeiture, or cancellation by order of DHS or a court of law
of a license, or the surrender without the written consent of
DHS of a license, from depriving DHS of its authority to
institute or continue a disciplinary proceeding against the
licensee upon any ground provided by law or to enter an order
suspending or revoking the license or otherwise taking
disciplinary action against the licensee on any grounds.
6)Requires NHAP to provide the Franchise Tax Board (FTB) with
specified information relating to licensees upon request by
the FTB.
7)Requires NHAP to require compliance with any judgment or order
for support prior to issuance or renewal of a license to a
nursing home administrator.
8)Permits NHAP to deny, suspend, revoke, or otherwise restrict
the license of an applicant or licensee for specified acts.
9)Establishes a fee schedule for fees relating to the licensure
of nursing home administrators.
10)Permits provisional one-year licenses to be granted to
reciprocity applicants, as defined by this bill, who hold a
valid out of state license and who comply with criteria
established by this bill.
11)Establishes criteria for renewing licenses that have or have
not expired.
12)Requires an Administrator-in-Training Program (AIT) to be
developed by NHAP, in consultation with representatives from
the long-term care industry and advocacy groups. Requires AIT
to include specified areas of instruction including
orientation, administration and business office, residents'
rights and abuse prevention, and staffing requirements and
work force retention.
13)Requires NHAP, in reviewing citation logs, to base the
determination of whether disciplinary action is warranted
against a nursing home administrator on the administrator's
involvement or culpability in the citations.
14)Prohibits a licensee from being cited for a violation caused
by any person licensed pursuant to the Medical Practice Act if
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the person is independent of, and not connected with, the
facility and the licensee shows that he or she has exercised
reasonable care and diligence in notifying these persons of
their duties to the patients in the nursing facility.
15)Revises the factors NHAP is required to give due
consideration to in assessing a fine to licensee. Specifies
what may happen if a licensee, examinee or participant fails
to pay a fine.
16)Requires DHS to assess the licensee a civil penalty in the
amount of $50 for each day that the violation continues beyond
the date specified by the citation. Requires there to be a 7%
interest penalty on the unpaid balance of an administrative
fine.
17)Permits NHAP to deny, suspend, or revoke, a nursing home
administrator license or participation in specific training
program areas under this bill upon specified grounds including
misappropriation of funds or property of the facility, the
patients, or of others.
18)Permits NHAP to place a nursing home administrator license on
probation in lieu of formal action. Establishes criteria for
the probationary license.
19)Permits NHAP to temporarily suspend any license prior to any
hearing if the action is necessary to protect the public
welfare.
20)Permits certain superior courts to issue injunctions or other
appropriate orders, on application of NHAP, the Attorney
General, or the district attorney whenever a person has
engaged, or is about to engage, in any acts or practices that
constitute, or will constitute, a violation of this bill.
21)Makes various other technical and conforming changes relating
to the licensure of nursing home administrators.
EXISTING LAW :
1)Provides for the licensure and regulation of nursing home
administrators through DCA.
2)Requires the examination for nursing home administrators to be
held at least once a year.
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3)Establishes an administrator-in-training program for nursing
home administrators.
FISCAL EFFECT : According to the Assembly Appropriations
Committee analysis, 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)According to the author, this bill is sponsored by DHS and
DCA. The author states that the Nursing Home Administrator
Program (Program) currently operates under an Interagency
Agreement between DHS and DCA that is due to expire June 30,
2001. Federal law imposed the state licensure requirements
for nursing home administrators in 1970. At that time BNHA
had the responsibility for licensing and regulating nursing
home administrators. BNHA was statutorily sunset on June 30,
1998, and DCA renamed BNHA the NHAP. However, the sunset
eliminated the BNHA members, not the licensing and regulatory
responsibility, and federal law still requires states to
license nursing home administrators. The author argues that
in order to strengthen the oversight provisions of NHAP and to
ensure clear state administrative accountability for its
operation, the designation of DHS as the authority with
responsibility for the program is necessary.
The author states that there has been a 17% reduction in
licensed nursing home administrators in California since the
1993/94 fiscal year. Adequate and qualified management is a
key component in determining the quality of care provided by
any nursing home. This bill includes a number of provisions
to enhance the ability of the industry to hire, train, and
develop quality nursing home administrators.
2)According to the cosponsor of this bill, DCA, this bill would
follow through on recommendations made by the Joint
Legislative Sunset Review Committee. Transferring the program
to DHS will allow DHS to pursue alternative sources of
funding, including federal monies available through the Health
Care Financing Administration. In addition, DHS will be able
to incorporate regulation of administrators with its
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enforcement of nursing home facilities to streamline and
strengthen enforcement efforts. DCA adds that by increasing
examination frequency and implementing a provisional license,
the number of qualified nursing home administrators in the
state should increase.
CAHF states that it appreciates the language of this bill that
addresses the frequency of testing, the examination fees,
reciprocity for out-of-state administrators, provisional
licenses, and changes to the preceptor qualifications and
training program.
Analysis Prepared by : David Gonzalez / HEALTH / (916) 319-2097
FN: 0001487