BILL ANALYSIS                                                                                                                                                                                                    






                                 SENATE HEALTH
                               COMMITTEE ANALYSIS
                        Senator Elaine K Alquist, Chair


          BILL NO:       AB 249                                       
          A
          AUTHOR:        Carter                                       
          B
          AMENDED:       May 5, 2009
          HEARING DATE:  June 17, 2009                                
          2
          CONSULTANT:                                                 
          4
          Bain/                                                       
          9
                                        

                                     SUBJECT
                                         
                  Health facilities:  marking patient devices

                                     SUMMARY  

          Requires the patient's written personal property inventory  
          in long-term health care (LTC) facilities to include a  
          listing, by a unique identification number, of all  
          patient-owned mobility, hearing, or breathing equipment. 


                             CHANGES TO EXISTING LAW  

          Existing law:
          Under existing law, LTC facilities must have a theft and  
          loss program that includes a written patient personal  
          property inventory upon admission that is retained during  
          the resident's stay in the LTC facility.  Existing law  
          requires the program to include the establishment of a  
          method of marking, to the extent feasible, personal  
          property items for identification purposes upon admission  
          and, as added to the property inventory list, including  
          engraving of dentures and tagging of other prosthetic  
          devices.

          Existing law requires a copy of the written inventory to be  
          provided to the resident or the person acting on the  
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          resident's behalf.  Upon a written request, subsequent  
          items brought into or removed from the facility must be  
          added to or deleted from the personal property inventory by  
          the LTC facility.  

          Existing law prohibits a LTC facility from being liable for  
          items which have not been requested for inclusion in the  
          inventory, or for items which have been deleted from the  
          inventory.  Existing law requires a copy of a current  
          inventory to be made available upon request to the  
          resident, responsible party, or other authorized  
          representative.  

          Existing law permits the resident, resident's family, or a  
          responsible party to list those items which are not subject  
          to addition or deletion from the inventory, such as  
          personal clothing or laundry items which are subject to  
          frequent removal from the facility.  
          
          This bill:
          This bill requires, as part of the written patient personal  
          property inventory in LTC facilities, the inventory to  
          include a listing by a unique identification number, of all  
          patient-owned mobility, hearing, or breathing equipment,  
          including, but not limited to, canes, walkers, wheelchairs,  
          hearing aids, and oxygen equipment. 

          Additionally, this bill requires the LTC facility, at the  
          request of the resident, the resident's family, or another  
          responsible party, to assign a unique identification number  
          and place a tag with that number on the item if it would  
          not cause permanent damage to the item, if the equipment  
          does not have a serial number or other unique  
          identification number.
          
                                  FISCAL IMPACT 

          According to the Assembly Appropriations Committee, no  
          direct fiscal impact to the California Department of Public  
          Health (DPH) to continue oversight of LTC facilities.


                            BACKGROUND AND DISCUSSION  

          According to the author, this bill is intended to address  




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          the growing problem of patient equipment theft and to  
          enlist the assistance of long-term care facilities in this  
          effort.  The author states the victims - largely the  
          elderly and disabled - of this growing problem find that  
          they cannot file a police report because they cannot  
          properly identify the equipment by serial number.  The  
          author argues that LTC facilities generally do not have a  
          policy for marking or otherwise identifying by owner a  
          patient's vital mobility, hearing, or breathing equipment  
          such as canes, walkers, hearing aids, and oxygen equipment.  
           Failure to mark such equipment, the author further argues,  
          creates confusion for both patients and staff because  
          different patients often have similar equipment, which  
          impedes law enforcement efforts to protect seniors.

          Existing law and complaint data received by DPH
          Current law requires that a theft and loss program  
          implemented by a LTC facility must include a written  
          patient personal property inventory, which is established  
          upon admission and is retained during the resident's stay  
          in the LTC facility.  The policy must include the  
          establishment of a method of marking, to the extent  
          feasible, personal property items for identification  
          purposes upon admission and, as added to the property  
          inventory list, including engraving of dentures and tagging  
          of other prosthetic devices.  

          The facility's policy regarding theft and investigative  
          procedures must be posted, and all employees must receive  
          an orientation on the policies and procedures within 90  
          days of employment.  Documentation of lost and stolen  
          patient property with a value of $25 or more and, upon  
          request, the documented theft and loss record for the past  
          12 months must be made available to the state, the county  
          health department, or law enforcement agencies and to the  
          office of the State Long-Term Care Ombudsman in response to  
          a specific complaint.  The documentation must, at minimum,  
          include a description of the article, its estimated value,  
          the date and time the theft or loss was discovered (if  
          determinable), the date and time the loss or theft  
          occurred, and the action taken.  

          LTC facilities must report to the local law enforcement  
          agency within 36 hours when the facility administrator has  
          reason to believe patient property with a current value of  




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          $100 or more has been stolen.  Copies of those reports for  
          the preceding 12 months must be made available to the state  
          and law enforcement agencies.  LTC facilities must also  
          maintain a secured area for patients' property upon the  
          request of the patient or the patient's responsible party.   
          LTC facilities must provide a lock for the resident's  
          bedside drawer or cabinet upon the request of, and at the  
          expense of, the resident, the resident's family, or  
          authorized representative.  

          The Licensing and Certification Division of DPH responds to  
          complaints regarding theft.  DPH indicates over the last  
          four calendar years (from January 1, 2005 to December 31,  
          2008) that it has received a total of 955 intakes  
          (including complaints and facility reported incidents) from  
          LTC facilities of "Misappropriation of Property," the  
          allegation category that captures incidents such as theft  
          and loss.  
           
           Argument in Support
          This bill is sponsored by the California Senior Legislature  
          (CSL) and supported by senior advocacy groups, who argue  
          that its implementation will help patients recover their  
          medical equipment should it be stolen.  CSL argues marking  
          patient-owned mobility, hearing, or breathing equipment  
          such as canes, walkers, wheelchairs, hearing aids, and  
          oxygen equipment will prevent unnecessary confusion for  
          staff and patients as patients often have similar  
          equipment, and unmarked equipment can be misplaced or  
          stolen, resulting in the patient being left without the  
          property they depend on for their comfort.

          Arguments in Opposition
          DPH writes in opposition that it currently reviews a LTC  
          facility's patient's personal property inventory during an  
          investigation of a complaint of lost or stolen property, or  
          any other time it is warranted.  DPH indicates if it finds  
          that requiring a listing of all patient-owned mobility,  
          hearing, or breathing equipment, by unique identification  
          number is necessary, this requirement could be accomplished  
          administratively under its current statutory authorities.

          Aging Services of California argues this bill micro-manages  
          existing facility property tracking systems and adds more  
          uncompensated tasks that are focused away from patient  




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          care.

                                  PRIOR ACTIONS

           Assembly Floor:     76-0
          Appropriations:          15-0
          Assembly Health:    17-0

                                    POSITIONS  
                                        
          Support:  California Senior Legislature (sponsor) 
                    AARP California
                 California Advocates for Nursing Home Reform 
                 California Alliance for Retired Americans
                 Contra Costa County Advisory Council on Aging


          Support (prior version):
                 Area Agency on Aging
                 American Federation of State, County and Municipal  
          Employees, AFL-CIO

          Oppose:  California Department of Public Health
                 Aging Services of California


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