BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



           ------------------------------------------------------------ 
          |SENATE RULES COMMITTEE            |                  AB 1433|
          |Office of Senate Floor Analyses   |                         |
          |1020 N Street, Suite 524          |                         |
          |(916) 651-1520         Fax: (916) |                         |
          |327-4478                          |                         |
           ------------------------------------------------------------ 
           
                                         
                                 THIRD READING


          Bill No:  AB 1433
          Author:   Eng (D), et al
          Amended:  6/30/10 in Senate
          Vote:     21

           
           SENATE HUMAN SERVICES COMMITTEE  :  5-0, 6/22/10
          AYES:  Liu, Emmerson, Romero, Runner, Yee

           SENATE APPROPRIATIONS COMMITTEE  : Senate Rule 28.8

           ASSEMBLY FLOOR  :  68-0, 1/27/10 (Consent) - See last page  
            for vote


           SUBJECT  :    Continuing care contracts:  residential  
          temporary relocation

           SOURCE  :     Aging Services of California


           DIGEST  :    This bill defines residential temporary  
          relocations in the context of continuing care contracts of  
          residents who live in continuing care retirement  
          communities, and establishes related rights, requirements,  
          and procedures.

           ANALYSIS  :    

           Existing law
           
          1. Provides for the regulation by the Department of Social  
             Services (DSS) of activities relating to continuing care  
                                                           CONTINUED





                                                               AB 1433
                                                                Page  
          2

             contracts that govern care provided to elderly residents  
             in continuing care retirement communities (CCRCs) for  
             the duration of the resident's life or a term in excess  
             of one year. 

          2. Defines "permanent closure" of a CCRC as the voluntary  
             or involuntary termination or forfeiture of 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. 

          3. Provides for notice to residents of a "permanent  
             closure" of a CCRC and regulates the permanent closure  
             of CCRCs, including as follows: 

             A.    Requires that continuing care contracts include  
                provisions describing how the provider will proceed  
                in the event of a closure.

             B.    Requires that CCRCs provide written notice to  
                DSS and to the affected residents or designated  
                representatives of the affected residents 120 days  
                prior to the intended date of closure of a  
                continuing care retirement community.

             C.    Requires closure notices to include the intended  
                date of closure and the requirement of a relocation  
                plan.

             D.    Requires that providers offer a resident a  
                choice of specified 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.

             E.    Requires that providers, within 30 days of  
                submitting the relocation plan for a permanent  
                closure, 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  







                                                               AB 1433
                                                                Page  
          3

                with qualifying assets not subject to any liens,  
                judgments, garnishments or creditor's claims.

             F.    Requires that providers submit monthly progress  
                reports to DSS detailing the progress and problems  
                associated with the closure until all affected  
                residents are relocated and all required payments  
                are made.

             G.    Requires DSS monitor the implementation of the  
                closure and impose penalties if DSS determines that  
                a provider is closing a facility in violation of  
                the permanent closure requirements or is doing so  
                in a manner that endangers the health or safety of  
                residents.

             H.    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. 

          This bill:

          1. Defines a "residential temporary relocation" to mean the  
             relocation of one or more residents, except in the case  
             of a natural disaster that is out of the provider's  
             control, from one or more residential living units,  
             assisted living units, skilled nursing units, or a wing,  
             floor or entire CCRC due to a change of use or major  
             repairs or renovations.

          2. Further defines "residential temporary relocation" to  
             mean a relocation that lasts for a period of at least  
             nine months but does not exceed 18 months without the  
             written agreement of the resident.  Allows a provider to  
             extend the period of temporary closure for up to six  
             months, if that resident has agreed to the extension in  
             writing.  Provides that the written agreement shall  
             state that by signing, the resident waives all rights to  
             the same relocation options offered in the case of  
             permanent closure for the period of the extension.








                                                               AB 1433
                                                                Page  
          4

          3. Requires a continuing care contract to state that the  
             resident has a right to terminate his or her contract  
             after 18 months of residential temporary relocation, and  
             that the contract have provisions related to monthly fee  
             and entrance fee refunds upon termination of the  
             contract for this reason.

          4. Requires all providers to include in resident contracts  
             the procedures to be followed to ensure that temporary  
             relocations provide comparable levels of care, services,  
             and living accommodations as described in the resident's  
             contract.

          5. Requires a provider to notify the resident of the  
             impending relocation at least 60 days in advance of the  
             relocation, and requires a provider to meet with the  
             resident and, at the resident's request, family members  
             or other individuals at least 30 days in advance of the  
             transfer to discuss all aspects of the transfer,  
             including, but not limited to, the rights, requirements,  
             and procedures set forth in this article.  Requires  
             notice of this meeting to be provided in writing and at  
             least seven days in advance of the meeting and to  
             include the date of the transfer; the available  
             replacement unit or units and monthly fees; the time  
             when the resident will be able to inspect the  
             replacement unit or units; and the estimated date when  
             the resident will be able to return to his or her unit  
             or may move to a substitute permanent unit.

          6. Requires a provider to provide a unit in a facility,  
             agreed to by the resident, that most closely provides  
             the services, size, features, and amenities provided in  
             the unit being vacated, if accommodations are not  
             available at a CCRC operated by the provider within a  
             30-mile radius.  

          7. Requires the provider to arrange and pay for all moving  
             costs to the new facility and moving costs to the  
             reconstructed facility, if the resident returns, as well  
             as storage costs.

          8. Provides that the resident shall only be required to pay  
             to the provider the monthly fee required in the  







                                                               AB 1433
                                                                Page  
          5

             resident's contract, or the monthly fee in the new  
             facility, whichever is less.  Requires the provider to  
             make payment to the facility at which the resident is  
             relocated.

          9. Requires the provider to make available the services of  
             a licensed medical or geriatric professional to advise  
             the resident, the resident's representative, and the  
             provider regarding the relocation of the resident, upon  
             request by the resident or the resident's  
             representative.  Allows a provider to place a reasonable  
             limit on the cost of the services of the medical or  
             geriatric professional.

          10.Requires the provider to identify unique service and  
             care needs, if applicable, for a resident directly  
             affected by the residential temporary relocation.   
             Requires the unique services and care needs identified  
             to be in writing and become a part of the resident's  
             plan of care.

          11.Requires the provider to set forth specific procedures  
             for the resident to follow regarding relocation to the  
             unit originally vacated, the selection of a new unit,  
             and timeframes for making choices.  Requires specified  
             procedures for returning the relocated resident when  
             residential units are ready for occupancy, including  
             compliance with notice requirements, and selection and  
             characteristics of units.

          12.Provides that if the residential temporary relocation of  
             a resident of a continuing care retirement community  
             will exceed 18 months, the resident shall have all  
             options that are available in the case of permanent  
             closure, unless there is a written agreement between the  
             affected resident and the provider that the provider may  
             extend the period of temporary closure for up to six  
             months.

           Background
           
          A continuing care retirement community is a community where  
          services promised in a continuing care contract are  
          provided.  Continuing care retirement communities can be  







                                                               AB 1433
                                                                Page  
          6

          apartment-type dwellings, high-rise buildings, a  
          subdivision setting, or any other housing design.  Most  
          continuing care communities have three levels of care:  
          independent living, assisted living and skilled nursing  
          care.  As a resident's needs increase, he/she moves to a  
          higher level of care within the facility. 

           Comment
           
          A prior bill, AB 407 (Beall and Eng), Chapter 442, Statutes  
          of 2009, establishes requirements for the permanent closure  
          of a CCRC.  Prior to AB 407, while the law regulated the  
          establishment and operation of CCRCs, there were minimal  
          regulations governing what happens when a facility must  
          close.  The author's office reports that AB 407, as  
          introduced, addresses both permanent and temporary  
          closures.  Due to provider concerns over prevailing  
          economic conditions, however, AB 407 was amended to address  
          only permanent closures.  AB 407 passed with no opposition  
          and no negative votes in either house.  The joint authors  
          of both AB 407 and this bill note that they and stakeholder  
          organizations representing CCRC providers and CCRC  
          residents agreed to address temporary closures--or,  
          residential temporary relocations--this year.  This bill is  
          the result of that agreement. 

          This bill establishes guidelines for continuing care  
          contracts and for protecting CCRC residents' rights during  
          a remodel, renovation, or rebuilding of a CCRC or part of a  
          CCRC that will temporarily displace residents.  This bill  
          requires that continuing care contracts provide that a  
          resident has the right to terminate his/her contract if a  
          residential temporary relocation exceeds 18 months.  This  
          bill further requires that the contract provide for the  
          refund of monthly and entrance fees if the contract is  
          terminated.

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

           SUPPORT  :   (Verified  8/2/10)

          Aging Services of California (source)








                                                               AB 1433
                                                                Page  
          7


           ARGUMENTS IN SUPPORT  :    Aging Services of California, the  
          sponsor of this bill states this bill is a product of  
          several months of work with stakeholders and will establish  
          new provisions in the CCRC statutes that address temporary  
          resident relocations in CCRCs.  Aging Services states that,  
          while most CCRC remodeling and renovation projects are  
          executed with minimal impact on residents, the Health &  
          Safety Code does not provide guidance to operators and  
          residents of CCRCs on how to handle temporary construction  
          relocations when disputes arise.  The sponsor states, the  
          bill will provide equity and certainty to residents and  
          providers facing remodeling projects that require residents  
          to temporarily relocate from their homes or apartments  
          during construction.  The sponsor believes that the bill  
          strikes a balance between the need of CCRCs to remain  
          attractive to future residents and protecting the rights of  
          existing residents. 

           ASSEMBLY FLOOR  : 
          AYES:  Adams, Ammiano, Anderson, Arambula, Beall, Bill  
            Berryhill, Tom Berryhill, Blakeslee, Block, Blumenfield,  
            Bradford, Brownley, Buchanan, Caballero, Charles  
            Calderon, Chesbro, Cook, Coto, De La Torre, Emmerson,  
            Eng, Evans, Feuer, Fletcher, Fong, Fuentes, Fuller,  
            Furutani, Gaines, Galgiani, Garrick, Gilmore, Hagman,  
            Harkey, Hayashi, Hernandez, Hill, Huber, Huffman,  
            Jeffries, Jones, Knight, Lieu, Logue, Bonnie Lowenthal,  
            Ma, Mendoza, Miller, Monning, Nava, Nestande, Niello,  
            Nielsen, John A. Perez, Portantino, Ruskin, Saldana,  
            Silva, Skinner, Smyth, Solorio, Audra Strickland,  
            Swanson, Torres, Torrico, Tran, Villines, Yamada
          NO VOTE RECORDED:  Carter, Conway, Davis, De Leon, DeVore,  
            Hall, V. Manuel Perez, Salas, Torlakson, Bass


          CTW:do  8/2/10   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

                                ****  END  ****