BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 416
                                                                  Page  1

          Date of Hearing:   May 13, 2009 

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Kevin De Leon, Chair

                 AB 416 (Block) - As Introduced:  February 23, 2009  

          Policy Committee:                              Human Services  
          Vote:        4-1
                       Health                                 16-0    

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              

           SUMMARY  

          This bill requires the Department of Developmental Services  
          (DDS) to develop a registry for tracking and investigating  
          reports of substantiated abuse of Developmental Center (DC) and  
          Regional Center (RC) consumers (consumers). In addition, this  
          bill requires DDS service providers to report "any evidence" of  
          abuse of a consumer by a worker to appropriate agencies  
          investigating such abuse under current law and requires the  
          establishment of penalties for the hiring of workers found in  
          the abuse registry.

           FISCAL EFFECT  

          1)One-time GF costs of $2 million to $4 million for DDS to  
            establish the registry with input from numerous stakeholders  
            and with precise functionality required by the bill. Unknown  
            on-going registry maintenance costs of more than $200,000 GF  
            depending on the volume and complexity of information related  
            to the registry that is established. Under current law, some  
            of the abuse screening data and tools are automated. Others  
            require intense review and legal and criminal justice  
            expertise to determine the seriousness and circumstances of a  
            crime. 

          2)Annual GF investigation costs to DDS of more than $1 million.  
            The bill increase DDS investigation responsibilities as  
            compared to current law. 

          3)Annual GF costs of more than $1 million to the extent this  
            bill increases the reporting of "any evidence" of abuse. It is  








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            unclear what this provision means in terms of employees and  
            providers mandated or not mandated under current law to report  
            neglect and abuse. This vague and overreaching term in the  
            abuse and neglect statutory and regulatory landscape increases  
            costs and appeals accordingly. Allegations of abuse and  
            neglect are handled very specifically under current law to  
            protect both alleged victims and employees not found to be  
            perpetrators of neglect or abuse. 

          4)Annual GF increased costs of more than $200,000 for criminal  
            background checks to the extent this bill's requirements  
            generate more criminal background checks among the work force  
            in question. Depending on the agency conducting the background  
            checks and what data is accessed, each check is between $30  
            and $130. 

           


          COMMENTS  

           1)Rationale  .  This bill is sponsored by the Registry to End  
            Abusive Caregiver Hiring (REACH) Project to increase the  
            information collected about abusive workers and provided to  
            employers and consumers. The sponsors and author are concerned  
            about serious risk of abuse and neglect of a very vulnerable  
            population of consumers. According to the sponsors, children  
            and elderly people have specific protections and reporting  
            under current law with respect to neglect and abuse, but  
            developmentally disabled consumers are not similarly  
            protected. This bill is intended to increase health and safety  
            for these consumers. 

           2)Existing law  . The DDS contracts with 21 private non-profit RCs  
            to provide services that meet the needs of 200,000 individuals  
            with developmental disabilities. The state's five DCs (Agnews,  
            Fairview, Lanterman, Porterville, and Sonoma) and two smaller,  
            leased facilities (Sierra Vista and Canyon Springs) provide  
            24-hour care to about 3,600 individuals with developmental  
            disabilities. The DCs, with 8,600 state staff provide a full  
            range of care, including medical and recreational services.  
            Agnews, in the Bay Area, is in the process of moving all  
            residents into the community or to other inpatient settings as  
            an effort to comply with the Olmstead Act. 









                                                                  AB 416
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           3)Abuse Reporting Landscape  . Mandated reporters must report  
            incidents that reasonably appear to be abuse or neglect of  
            elder or dependent adults or children to at least one of the  
            following investigating agencies, as appropriate: local law  
            enforcement, county Child Protective Services (CPS), Adult  
            Protective Services (APS), or the state agency responsible for  
            licensing the facility in which the abuse is believed to have  
            occurred. This bill establishes a fair amount of overlapping  
            requirements with current law abuse and neglect reporting. 

          Several state agencies license facilities that serve consumers  
            and have related abuse reporting processes.  The Office of the  
            State Long-Term Care Ombudsman investigates reports of abuse  
            that occur in a nursing home, board and care home, residential  
            facility for the elderly, or long-term care facility.  Cases  
            of alleged abuse by hospital or health clinic staff are  
            handled by the Department of Public Health Licensing &  
            Certification Division.  Alleged abuse of consumers in  
            Regional Centers is reported to local CPS or APS agencies or  
            law enforcement for investigation.  County APS also  
            investigates allegations of abuse of elder and dependent  
            adults who live in private homes and hotels or hospitals and  
            health clinics when the abuser is not a staff member.  The  
            Community Care Licensing Program of the Department of Social  
            Services is responsible for investigating consumer abuse in  
            community or non-medical facilities.  DDS investigates  
            allegations of abuse at its Developmental Centers. 

           4)Related Legislation  . AB 1192 (Evans) in 2007 and AB 1183  
            (Evans) in 2008 were similar to this bill. AB 1192 was vetoed  
            due to concerns about increased costs and unclear improvements  
            in health and safety. AB 1183 was held on the Suspense File of  
            this committee.  

           Analysis Prepared by :    Mary Ader / APPR. / (916) 319-2081