BILL ANALYSIS
AB 1409
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB 1409 (Chan)
As Amended July 18, 2001
2/3 vote. Appropriation
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|ASSEMBLY: |72-0 |(June 6, 2001) |SENATE: |40-0 |(August 30, |
| | | | | |2001) |
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Original Committee Reference: HEALTH
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
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
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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
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
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.
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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.
The Senate amendments , make additional technical and conforming
amendments including requiring an individual acting as an
administrator for more than 10 days to have management
experience in a health facility, permitting the program to
accept a waiver exception to a portion of the AIT program that
requires 1,000 hours of training if the applicant and preceptor
provide compelling evidence that previous work experience of the
applicants directly relates to nursing home administrator
duties, and requiring the nursing home administrator within 24
hours after acquiring actual knowledge or credible information
AB 1409
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that specified events have occurred to notify DCA's district
office for licensing and certification of that knowledge or
information.
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.
3)Establishes an administrator-in-training program for nursing
home administrators.
AS PASSED BY THE ASSEMBLY , this bill transferred the authority
to regulate the licensure and regulation of nursing home
administrators from DCA to DHS and makes various technical and
conforming amendments including establishing a procedure for a
provisional one-year license.
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 NHAP 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
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with responsibility for NHAP 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
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: 0002470