BILL ANALYSIS �
AB 641
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ASSEMBLY THIRD READING
AB 641 (Feuer)
As Amended May 10, 2011
Majority vote
HEALTH 13-4 JUDICIARY 7-2
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|Ayes:|Monning, Ammiano, Atkins, |Ayes:|Feuer, Atkins, Dickinson, |
| |Bonilla, Eng, Gordon, | |Huber, Huffman, Monning, |
| |Hayashi, | |Wieckowski |
| |Roger Hern�ndez, Bonnie | | |
| |Lowenthal, Mitchell, Pan, | | |
| |V. Manuel P�rez, Williams | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Garrick, Mansoor, Silva, |Nays:|Wagner, Jones |
| |Smyth | | |
| | | | |
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APPROPRIATIONS 12-5
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|Ayes:|Fuentes, Blumenfield, | | |
| |Bradford, Charles | | |
| |Calderon, Campos, Davis, | | |
| |Gatto, Hall, Hill, Lara, | | |
| |Mitchell, Solorio | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Harkey, Donnelly, | | |
| |Nielsen, Smyth, Wagner | | |
| | | | |
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SUMMARY : Streamlines the citation appeals process for long-term
health care facilities (LTC
facilities), increases the maximum fine for class "B" citations
for LTC facilities and allows fines to be levied from both state
and federal agencies when an incident violates both state and
federal laws. Specifically, this bill :
1)Repeals existing law requesting the Department of Public Health
(DPH) to develop recommendations to address the findings
published in the June 2010 report entitled, "Department of
Public Health: It Reported Inaccurate Financial Information and
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Can Likely Increase Revenues for the State and Federal Health
Facilities Citation Penalties Accounts (State Auditor report)."
2)Revises state law to enable DPH to recommend that the federal
Centers for Medicare and Medicaid Services (CMS) impose a
federal civil monetary penalty when DPH's Licensing and
Certification Division determines that a LTC facility is out of
compliance with both state and federal requirements.
3)Increases the maximum penalty amount for class "B" citations for
LTC facilities from $1,000 to $2,000.
4)Eliminates the citation review conference (CRC) appeals process
for all levels of state citations.
EXISTING LAW :
1)Provides for the inspection and licensure of LTC facilities by
DPH.
2)Establishes the Long-Term Care, Health, Safety, and Security Act
of 1973 (LTC Safety Act), which permits DPH to assess penalties
against LTC facilities for violation of prescribed state
statutes, regulations, and federal standards pertaining to
patient care. Prohibits the issuance of both a citation
pursuant to state laws and the recommendation that a federal
civil monetary penalty be imposed for the same action.
3)Requires monies collected as a result of the penalties imposed
pursuant to the LTC Safety Act, to be deposited into either the
State Health Facilities Citation Penalties Account or the
Federal Health Facilities Citation Penalties Account (State and
Federal Accounts), and used, upon appropriation by the
Legislature, for the protection of health or property of
residents of LTC facilities.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, this bill will have the following fiscal impact:
1)The elimination of CRCs will likely have a minimal fiscal impact
on DPH operations. DPH indicates the total annual costs for
CRCs are $470,000, but that staff is redirected from other
priority assignments in order to complete work for CRCs.
Eliminating CRCs would free up staff resources within the
Licensing and Certification program to focus on other
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activities, some of which currently have a backlog.
2)Estimated increased penalty revenues from increasing the maximum
penalty for a class "B" citation in the range of
$400,000-$800,000.
COMMENTS : According to the author, LTC facilities are unable to
resolve citations they feel are unwarranted and LTC facility
residents, who may have been violated, do not receive justice in a
timely manner due to the prolonged CRC appeals process which at
times can take years. The author maintains that it makes sense to
remove the CRC appeals process as an available option to LTC
facilities in favor of the more trusted appeals processes in
existing law, such as an administrative law judge or a California
Superior Court.
The author further argues that class "B" citations for LTC
facilities include serious pest infestation, providing an
inadequate or unimplemented care plan, and a wide range of
emotional, physical, and sexual abuse. The author maintains that
even though a monetary penalty of $100 to $1,000 may be
appropriate for some violations in this category, the most
injurious and serious cases warrant a monetary penalty of up to
$2,000. Additionally, according to the author, class "B"
citations for LTC facilities have not been modified since 1985.
The author also argues that California is one of a few states that
bars a monetary penalty from both a state and federal agency when
a LTC facility action involves noncompliance with both a state and
federal law. The author asserts that it makes sense to allow both
entities to act if the laws of either were violated. By removing
this prohibition, this bill allows DPH to make a recommendation to
the CMS to levy a monetary penalty. According to the author,
there are no requirements in this bill that such levies should be
done for each and every citation and this bill provides DPH with
the discretion to cite a higher penalty for the most egregious
violations.
Analysis Prepared by : Tanya Robinson-Taylor / HEALTH / (916)
319-2097 FN: 0000698
AB 641
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