BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SB 950
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          Date of Hearing:   June 22, 2010

                           ASSEMBLY COMMITTEE ON JUDICIARY
                                  Mike Feuer, Chair
                 SB 950 (Wiggins) - As Introduced:  February 4, 2010

                    PROPOSED CONSENT (As Proposed to Be Amended)

           SENATE VOTE  :  30-0
           
          SUBJECT  :  VETERANS HOMES: ACCOUNTING FOR CHARGES: WRITTEN  
          NOTIFICATION

           KEY ISSUE  :  SHOULD THE WRITTEN NOTICE CURRENTLY PROVIDED TO A  
          RESIDENT OF A VETERANS HOME BE MODIFIED TO ADVISE THAT THE TERMS  
          AND CONDITIONS UPON WHICH THE RESIDENT VETERAN'S FEES AND COSTS  
          CAN BE CHANGED?
           
          FISCAL EFFECT  :  As currently in print this bill is keyed fiscal.

                                      SYNOPSIS
          
          This non-controversial bill is intended to protect veterans  
          admitted to veterans' homes ("members" of the home) by ensuring  
          they are aware of the possibility of changes to their financial  
          responsibilities to the home.  Specifically, this bill requires  
          the terms and conditions upon which the veteran member's fees  
          and costs can be changed to be included in the notice that the  
          administrator of a veteran's home is required to provide to  
          every veteran upon his or her admission into the home.  In  
          addition, this bill requires the notice to be written in plain  
          language so that the veteran member will understand the notice  
          and be able to acknowledge receipt of the terms and conditions  
          of residency at the veterans' home, and also requires the  
          veteran to sign the notice acknowledging that he or she has read  
          and understands the written notice.  As proposed to be amended,  
          this bill would also require a copy of the notification to be  
          conspicuously posted at each veterans home so that current  
          members of the home living on the premises will also have access  
          to the disclosure of the terms and conditions required by this  
          bill for the first time.  The author believes that this modest  
          requirement to post a copy of the notification at each veterans  
          home will help inform current members of those homes at a much  
          lower cost than the alternative of mailing the revised notice to  
          all existing members of veterans' homes.  This bill passed in  








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          the Senate by a 30-0 vote and has no opposition.

           SUMMARY  :  Improves the content and clarity of the written notice  
          that the administrator of a veteran's home is required to  
          provide to every veteran upon his or her admission into the  
          veterans' home.  Specifically,  this bill  :    

          1)Requires that the notice must include the terms and conditions  
            upon which the member fees and costs can be changed.

          2)Requires the member veteran to sign the notice to acknowledge  
            that the member has read and understands the notice.

          3)Requires the notice to be written in plain, straightforward  
            language, with few technical terms and using a coherent and  
            easily readable style.

          4)Requires the veteran home to post a copy of the notice in the  
            home and each time it is changed.

           EXISTING LAW:   

          1)Requires the administrator of a veterans' home to provide the  
            member veteran a quarterly statement or accounting of all  
            charges for the costs of care rendered to the member in excess  
            of and not covered by the member contribution fee, including,  
            but not limited to, the unreimbursed costs of medical or  
            dental services rendered to the member, either by the home or  
            under contract with the home.  (Military & Veterans Code  
            Section 1035.6.)

          2)Provides that the administrator of a veterans' home must  
            provide written notice upon admission to a veteran of the  
            costs of care that may be incurred in excess of the member  
            veteran's contribution fee.  Furthermore, the notice shall:

             a)   Include an explanation of circumstances under which the  
               member may incur costs that are in excess of the  
               contribution fee.

             b)   Specifically indicate that these excess costs of care  
               are costs in addition to, or above and beyond, the member  
               contribution fee.

             c)   Provide examples of "excess costs of care that are  








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               frequently incurred by veterans."

             d)   Inform the member that he or she will receive a  
               quarterly accounting statement of the total excess costs of  
               care, but that the statement is provided for informational  
               purposes only.

             e)   Inform the veteran that, if he or she is a resident of  
               the home at the time of death, the home may disburse his or  
               her moneys or personal property for payment of unreimbursed  
               excess costs of care.

             f)   Include a statement advising the member to seek counsel  
               from a legal expert to protect his or her assets.   
               (Military & Veterans Code Section 1035.7.)

           COMMENTS  :  This non-controversial bill is intended to protect  
          veterans admitted to veterans' homes ("members" of the home) by  
          ensuring they are aware of the possibility of changes to their  
          financial responsibilities to the home.  Specifically, this bill  
          requires the terms and conditions upon which the veteran  
          member's fees and costs can be changed to be included in the  
          notice that the administrator of a veteran's home is required to  
          provide to every veteran upon his or her admission into the  
          home.  In addition, this bill requires the notice to be written  
          in plain language so that the veteran member will understand the  
          notice and be able to acknowledge receipt of the terms and  
          conditions of residency at the veterans' home, and also requires  
          the veteran to sign the notice acknowledging that he or she has  
          read and understands the written notice.

           Author's Statement  :  According to the author, this bill is  
          intended to address the problem of insufficient notice of key  
          terms and conditions of residence in veterans' homes,  
          particularly those that could result in increased fees being  
          charged to a member veteran unbeknownst to the veteran, or after  
          the veteran dies, charged to the veteran's family.  The author  
          explains:

               The current contract utilized by the California Department  
               of Veterans Affairs needs clarifying so that veterans who  
               desire to enter our state's veterans' homes understand the  
               terms and conditions of residence.  The author's office  
               reports receiving many complaints from the Yountville  
               Veterans Home after the 2009/2010 state budget included a  








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               change in the fees and charges to current residents, and  
               the lack of information in their original contracts.

           As proposed to be amended, this bill requires the notification  
          to be posted at each veterans' home for the benefit of current  
          residents.   According to Senate Judiciary Committee analysis,  
          this bill "will not resolve the confusion of increased fees and  
          charges affecting veterans who are currently living in veterans'  
          homes because it pertains to the requirements of the admission  
          notice they have already received."  This could potentially  
          result in current veterans residing at the home being more  
          uninformed about these important terms and conditions than  
          prospective members who would receive the improved admission  
          notice under this bill.  As proposed to be amended, this bill  
          would also require a copy of the notification to be  
          conspicuously posted at each veterans home so that current  
          members of the home living on the premises will also have access  
          to the disclosure of the terms and conditions required by this  
          bill for the first time.  The author believes that this modest  
          requirement to post a copy of the notification at each veterans  
          home will help inform current members of those homes at a much  
          lower cost than the alternative of mailing the revised notice to  
          all existing members of veterans' homes.  The amendment reads:

          On page 2, after line 31, insert:

               (d) A copy of the notification, containing all of the  
               information specified in subdivision (a) and titled  
               in large font "NOTICE TO RESIDENTS", shall be  
               conspicuously posted in each veterans' home by the  
               administrator of the veterans' home.

           Veterans deserve notice of changes of terms and conditions  
          affecting their financial responsibilities  .  Veterans must be at  
          least 62 years old or disabled to be admitted to a veterans'  
          home.  These veterans may not be fully aware of their financial  
          responsibilities or be able to understand legal jargon which  
          typically describes such financial responsibilities.  There are  
          a number of factors that can create changes in the veteran's  
          financial responsibilities, including:  (1) increased fees and  
          charges billed by the veterans' home; (2) changes in care  
          services; and (3) changes in veterans' benefits.  Providing  
          advance notice to member veterans of these terms and conditions  
          will allow these veterans and their financial caretakers to  
          better plan for necessary financial changes.








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          First, due to the recent budget crisis, some veterans' homes  
          have apparently found it necessary to increase fees.  This bill  
          seeks to prevent unnecessary confusion among California's  
          veterans receiving care in veterans' homes by providing  
          notification of increased financial responsibilities that may  
          result. 

          Second, a member veteran's care needs may change as well during  
          his or her time at a veterans' home.  Pursuant to Military and  
          Veterans Code Section 1012.3, a member veteran must pay the  
          following percentages of his or her income for services provided  
          by a veterans' home:

                 Residential care: 47.5 percent of income. 
                 Residential care for the elderly or assisted living: 55  
               percent of income. 
                 Intermediate Care: 65 percent of income. 
                 Skilled Nursing Home Care: 70 percent of income.

          This means that if an elderly veteran initially is admitted  
          under residential care, but later requires an increased level of  
          care, he or she will need to pay a greater percentage of his or  
          her income.  As the law currently stands, the veterans' home is  
          not required to give the member veteran advance notice of the  
          possibility of increased financial responsibility for increased  
          levels of care. 

          Finally, changes in benefits may complicate the member's  
          financial responsibility.  Compounding the financial complexity  
          is the variety of benefits a veteran may or may not be eligible  
          for at different times.  For example, if a veteran receives aid  
          and attendance (A&A) benefits from the United States Department  
          of Veterans Affairs, the entire A&A amount is payable to the  
          California veterans' home administration.  (Military and  
          Veterans Code Section 1012.2.)  If a later determination results  
          in the loss of A&A benefits, the veteran will have to find an  
          alternative way to pay for his or her care.  This bill will  
          provide member veterans with some advance notice of the  
          possibility of increased financial responsibility due to  
          decreased financial benefits.

           Previous Legislation  :  SB 1281 (Haynes, Chapter 466, Statutes of  
          2002) required a veterans' home administrator to provide a  
          quarterly statement showing the costs of care, as well as  








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          written notice, upon admission to a California veterans' home,  
          of costs that may be incurred by the veteran.

           REGISTERED SUPPORT / OPPOSITION  :

           Support 
           
          None on file
           
            Opposition 
           
          None on file

           Analysis Prepared by  :    Anthony Lew / JUD. / (916) 319-2334