BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



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          |SENATE RULES COMMITTEE            |                   AB 407|
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                                 THIRD READING


          Bill No:  AB 407
          Author:   Beall (D), et al
          Amended:  9/1/09 in Senate
          Vote:     21

           
           SENATE HUMAN SERVICES COMMITTEE  :  5-0, 6/9/09
          AYES:  Liu, Maldonado, Alquist, Runner, Yee

           SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8

           ASSEMBLY FLOOR  :  80-0, 5/11/9 - See last page for vote


           SUBJECT  :    Continuing care contracts:  retirement  
          communities:  closure

           SOURCE  :     Author


           DIGEST  :    This bill imposes requirements on continuing  
          care retirement communities in the event of their permanent  
          closure.

           Senate Floor Amendments  of 9/1/09 make technical changes to  
          the language of the bill.

           ANALYSIS  :    

           Existing Law
           
          1.Establishes, within the Department of Social Services  
            (DSS), the licensure of community care facilities,  
                                                           CONTINUED





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            including continuing care retirement communities.

          2.Provides for the regulation by DSS of activities relating  
            to continuing care contracts that govern care provided to  
            an elderly resident in a continuing care retirement  
            community for the duration of the resident's life or a  
            term in excess of one year.

          3.Requires that continuing care retirement communities  
            maintain an environment that enhances residents'  
            independence and self-determination.

          4.Deems guilty of a misdemeanor, punishable by a fine not  
            to exceed $10,000 or imprisonment in the county jail for  
            a period not to exceed one year, or both, any entity that  
            abandons a continuing care retirement community or its  
            obligations under a continuing care contract.

          5.Gives the authority to DSS to issue citations for  
            violations of requirements of continuing care retirement  
            communities and to assess civil penalties in the amount  
            of $200 per day for violations.

          This bill:

           1.Defines "permanent closure" of a continuing care  
             retirement community to the voluntary or involuntary  
             termination or forfeiture or a provider's certificate of  
             authority or license or other action that results in the  
             permanent relocation of residents, except in the case of  
             a natural disaster or other event out of the provider's  
             control.

           2.Requires a continuing care contract to include  
             provisions describing how the provider will proceed in  
             the event of a closure.

           3.Requires the continuing care retirement community to  
             provide written notice to DSS and to the affected  
             residents or designated representatives of the affected  
             residents 90 days prior to the intended date of closure  
             of a continuing care retirement community.

           4.Prescribes the content of the closure notice, including  







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             intended date of closure and the requirement of a  
             relocation plan.

           5.Prohibits the provider from accepting new residents or  
             entering into new continuing care contracts once the  
             closure notice has been served.

           6.Requires the provider to offer a resident a choice of  
             four placement options, the terms of which shall not be  
             less than the terms of the continuing care contract  
             between the resident and the provider as if that  
             contract had been fully performed.  The options are:

             A.    Relocation to another continuing care retirement  
                community owned or operated by the provider, if  
                available.

             B.    Relocation to a continuing care retirement  
                community operated by another provider.

             C.    Monetary compensation equal to the value of the  
                remainder of the contract as if the contract had been  
                fully performed.

             D.    an alternative arrangement mutually agreed upon by  
                the provider and the resident or his or her  
                representative.

           7.Requires that replacement housing must be, overall,  
             comparable in cost, size, services, features, and  
             amenities to the unit being vacated.

           8.Requires the provider, within 30 days of submitting the  
             relocation plan for a permanent closure, to fund a  
             reserve, set up a trust fund, or secure a performance  
             bond to ensure fulfillment of costs associated with the  
             relocation, in an amount equal to or greater than the  
             estimated costs of relocating residents and relocation  
             options, funded with qualifying assets not subject to  
             any liens, judgments, garnishments or creditor's claims.

           9.Requires the provider to submit monthly progress reports  
             to DSS detailing the progress and problems associated  
             with the closure until all affected residents are  







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             relocated and all required payments are made.

          10.Requires DSS to monitor the implementation of the  
             closure and to impose penalties if DSS determines that a  
             provider is closing a facility in violation of the  
             requirements established by this bill or is doing so in  
             a manner that endangers the health or safety of  
             residents.

          11.Prohibits the provider from displacing any resident or  
             to close the facility until the relocation plan has been  
             prepared and submitted to DSS and provided to the  
             affected residents, the affected residents'  
             representatives, and the local long-term care ombudsman  
             program.

           Comments
          
          SB 489 (Steinberg), 2007-08 Session, would have established  
          procedures and protections governing both permanent and  
          temporary closures of continuing care retirement  
          communities.  In vetoing SB 489, the Governor expressed  
          concerns over the oversight role of DSS under the bill.   
          The Governor concluded that "[t]here are many good consumer  
          protections in this bill and I would encourage the author  
          and stakeholders to work with my Administration next year  
          to find the appropriate balance of government oversight for  
          these types of facilities."

          This bill differs from SB 489 in two ways:  it deletes  
          language implying DSS's acceptance of closure plans; this  
          bill merely requires that DSS receive a copy of the closure  
          plan.  In addition, this bill addresses only permanent  
          closures, not renovations.

          In a letter to the author, a continuing care retirement  
          community named Front Porch offers to support the bill if  
          the definition of "permanent closure" is amended to state  
          that relocation of a resident to a renovated unit at the  
          same location does not constitute permanent closure.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  Yes








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          According to the Assembly Appropriations Committee, this  
          bill has minor and absorbable costs.

           SUPPORT  :   (Verified  9/2/09)

          California Advocates for Nursing Home Reform (co-source)
          California Continuing Care Residents Association  
          (co-source)
          AARP
          Aging Services of California
          American Federation of State, County and Municipal  
          Employees, AFL-CIO
          Disability Rights California
          National Association of Social Workers, California Chapter

           ARGUMENTS IN SUPPORT  :    The author's office notes that,  
          while current law regulates the establishment and operation  
          of continuing care retirement communities, there are  
          minimal regulations governing what happens when a facility  
          must close.  According to California Advocates for Nursing  
          Home Reform (CANHR), one of the sponsors, "[t]here are  
          limited legal protections for consumers when facilities  
          close.  Since thousands of continuing care retirement  
          community residents have collectively entrusted providers  
          with well over $1 billion in entrance fees in return for  
          life-long care, a facility closure translates into serious  
          investment loss for residents.  Moreover, vulnerable  
          displaced residents face severe physical and psychological  
          harm, such as transfer trauma."

          In April of 2006, Marguerite Terrace, a 73-bed continuing  
          care retirement community in San Jose that had a 50 percent  
          occupancy, announced to its residents that it would be  
          closing.  Three residents died soon after being transferred  
          to other facilities, prompting an investigation by the  
          state licensing agency, which issued a $20,000 citation for  
          failure to assess the residents' medical and psychological  
          conditions before they were transferred.  According to the  
          author's office, the failure to plan adequately for the  
          medical needs of residents when they moved from Marguerite  
          Terrace, the limited relocation choices offered, and the  
          residents' dissatisfaction with the facility's buy-out  
          terms, illustrated the need for legislation to govern  
          continuing care retirement community closures.







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          While there have been few closures of continuing care  
          retirement communities to date, the author's office reports  
          that there are an increasing number of such facilities that  
          are aging and have low occupancy rates.  These facilities  
          may require major renovations to enable them to meet  
          current and future market demands and others, according to  
          the author's office, will likely close.


           ASSEMBLY FLOOR  : 
          AYES:  Adams, Ammiano, Anderson, Arambula, Beall, Bill  
            Berryhill, Tom Berryhill, Blakeslee, Block, Blumenfield,  
            Brownley, Buchanan, Caballero, Charles Calderon, Carter,  
            Chesbro, Conway, Cook, Coto, Davis, De La Torre, De Leon,  
            DeVore, Duvall, Emmerson, Eng, Evans, Feuer, Fletcher,  
            Fong, Fuentes, Fuller, Furutani, Gaines, Galgiani,  
            Garrick, Gilmore, Hagman, Hall, Harkey, Hayashi,  
            Hernandez, Hill, Huber, Huffman, Jeffries, Jones, Knight,  
            Krekorian, Lieu, Logue, Bonnie Lowenthal, Ma, Mendoza,  
            Miller, Monning, Nava, Nestande, Niello, Nielsen, John A.  
            Perez, V. Manuel Perez, Portantino, Price, Ruskin, Salas,  
            Saldana, Silva, Skinner, Smyth, Solorio, Audra  
            Strickland, Swanson, Torlakson, Torres, Torrico, Tran,  
            Villines, Yamada, Bass


          CTW:cm  9/2/09   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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