BILL ANALYSIS �
AB 1142
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Date of Hearing: April 26, 2011
ASSEMBLY COMMITTEE ON HUMAN SERVICES
Jim Beall Jr., Chair
AB 1142 (Chesbro) - As Amended: April 14, 2011
SUBJECT : Residential care facilities for the elderly
SUMMARY : Prohibits Residential Care Facilities for the Elderly
(RCFEs) from assessing specified fees related to deceased
residents. Specifically, this bill :
1)Prohibits an RCFE from assessing the following:
a) Personal care fees upon notice of the death of a
resident; and,
b) Fees for the living unit of a deceased resident once all
of the resident's personal property is removed.
2)Requires admission agreements to explain the foregoing policy
concerning deceased residents.
3)Limits liability for payment to the individual, individuals,
or entity contractually responsible for the payment of monthly
fees.
4)Requires the licensee to meet requirements for the SSI/SSP
program for residents receiving SSI/SSP.
EXISTING LAW
1)Under the Residential Care Facilities for the Elderly Act,
provides for the licensure and regulation of RCFEs by the
state Department of Social Services.
2)Establishes requirements for RCFE admissions agreements,
including provisions related to fees assessed on residents.
3)By regulation concerning RCFE admission agreements, provides
that the agreement "shall be automatically terminated by the
death of the resident, whose relatives shall not be liable for
any payment beyond that due at the date of death, unless
agreed to in writing or ordered by court." 22 California Code
of Regulations (CCR) Section 87507(h).
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FISCAL EFFECT : Unknown
COMMENTS : RCFEs are licensed assisted living facilities for
persons 60 years of age and over and persons under 60 with
compatible needs. Varying levels of care and supervision,
protective supervision, or personal care are provided, based
upon residents' needs. As of February 2011, there were 7,668
licensed RCFEs in the state with a total capacity of 170,376
residents.
The author points out that administrative regulations pertaining
to RCFEs allow for admission agreements to include a 30-day
cancellation notice. The RCFE regulations also provide that the
agreement is "automatically terminated by the death of the
resident, whose relatives shall not be liable for any payment
beyond that due at the date of death, unless agreed to in
writing or ordered by court." 22 CCR Section 87507(h).
Although, the author notes, it appears to be an uncommon
practice, some RCFEs apparently apply these regulations together
to include provisions in admission agreements holding relatives
responsible for payment of fees for 30 days, even after the
death of the resident. According to the author, "the policy
needs to be clarified to eliminate confusion or distress for
residents and their families."
This bill, the author says, "ensures that all fees for resident
care end immediately once the community is notified of a
resident's death and fees for the residential living unit are no
longer charged after a deceased resident's personal property has
been removed." Because this bill requires that specified
provisions must be included in admissions agreements, however-as
opposed to simply clarifying financial liability upon the death
of a resident-it may result in additional workload costs for DDS
in reviewing existing admission agreements for compliance.
Arguments in opposition : California Advocates for Nursing Home
Reform (CANHR) argues that this bill would actually make it more
likely that relatives would be responsible for fees. Whereas
the regulation at Section 87507(h) presumes no liability absent
a written agreement (or court order) to the contrary, CANHR
says, this bill flips the presumption on its head. Under this
bill, family members could be liable for personal care fees
until the facility is notified of the resident's death (e.g., in
circumstances when the resident dies while in a hospital or
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while otherwise away from the facility) even though personal
care services haven't been provided. Moreover, CANHR notes,
family members may remain liable for residential living unit
fees until the resident's personal property is removed despite
the fact that the facility is not required to immediately notify
the responsible family member of the resident's death. CANHR
also says that "most admissions agreements do not break down
fees for personal care services versus �residential living unit]
fees." This would make it difficult to assess living unit fees
pending removal of the resident's personal property.
Finally, CANHR contends, this bill would establish liability on
family members for living unit fees of a deceased relative where
none exists. According to CANHR, "liability should be expressly
limited to the deceased resident's estate because estate
liability is consistent with basic contractual law ?." On this
point, however, this bill does not contemplate that someone
other than the resident's estate would be responsible for
payment except in those instances where another person is
"contractually responsible" for payment-i.e., where another
party previously agreed to be financially responsible on behalf
of a resident.
It does not appear that the author, the sponsor, and CANHR
differ fundamentally as to the nature of the problem the bill
seeks to address or the ultimate desired outcome. It is
recommended, therefore, that these parties continue discussions,
and involve committee staff as needed, to address CANHR's
concerns.
REGISTERED SUPPORT / OPPOSITION :
Support
AARP
Aging Services of California
Alzheimer's Association
California Assisted Living Association (CALA) (sponsor)
Community Residential Care Association of California
Opposition
California Advocates for Nursing Home Reform (CANHR) (unless
amended)
AB 1142
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Analysis Prepared by : Eric Gelber / HUM. S. / (916) 319-2089