BILL ANALYSIS �
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|SENATE RULES COMMITTEE | SB 411|
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THIRD READING
Bill No: SB 411
Author: Price (D), et al.
Amended: 5/31/11
Vote: 21
SENATE HEALTH COMMITTEE : 5-2, 4/13/11
AYES: Hernandez, Alquist, De Le�n, DeSaulnier, Rubio
NOES: Strickland, Anderson
NO VOTE RECORDED: Blakeslee, Wolk
SENATE APPROPRIATIONS COMMITTEE : 6-2, 5/26/11
AYES: Kehoe, Alquist, Lieu, Pavley, Price, Steinberg
NOES: Walters, Runner
NO VOTE RECORDED: Emmerson
SUBJECT : Home Care Services Act of 2011
SOURCE : Service Employees International Union
DIGEST : This bill requires the Department of Public
Health to license and regulate home care organizations and
certify home care aides.
ANALYSIS :
Existing law:
1. Provides for the licensing and regulation of various
healthcare facilities by the Department of Public Health
(DPH).
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2. Establishes home health agencies and requires all
organizations that provide skilled nursing services to
patients in the home to obtain a home health agency
license issued by DPH.
3. Provides for the licensing and regulation of various
community care facilities by the Department of Social
Services (DSS).
4. Establishes the Community Care Licensing division (CCL)
under DSS which licenses and oversees both day care and
residential facilities for children and adults in
California.
5. Establishes the In-Home Supportive Services (IHSS)
program, a county-administered program, to provide
personal services and home care for eligible poor, aged,
blind and disabled individuals.
This bill enacts the "Home Care Services Act of 2011." It
requires DPH, among other requirements, to:
1. Commencing January 1, 2012, license and regulate home
care organizations that meet specified criteria,
including proof of liability insurance and a workers'
compensation policy. Licenses would be valid for one
year. This bill prohibits a home care organization from
arranging for home care services provided by a home care
aide without a license.
2. Commencing January 1, 2013, certify home care aides, as
specified, and approve a home care aide training
curriculum.
3. Conduct onsite inspections of home care organizations
that submit applications for licensure or annual
renewal.
4. Provide for the submission of fingerprint images to the
Department of Justice (DOJ) of all home care
organization owners, as specified. DOJ would be
permitted to assess a fee to cover any costs this bill
would impose.
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5. Set and collect licensing, certification, annual
renewal, background check, and other fees for each
location of a home care organization in an amount
sufficient to cover the costs of this program.
6. Promulgate rules and regulations to implement these
provisions.
7. Establish procedures for the receipt, investigation, and
resolution of complaints against home care organizations
and home care aides as well as conduct annual random,
unannounced inspections on home care organizations.
8. Maintain a registry on its Internet Web site of the
certification status of all certified home care aides.
This bill:
9. Adds accreditation by the Joint Commission on
Accreditation of Healthcare Organizations, the Community
Health Accreditation Program, or any other nationally
recognized accrediting body to the list of requirements
for licensing.
10.Permits DPH to require a survey of an accredited home
care organization to investigate complaints.
11.Provides that if one accrediting agency denies, revokes,
or suspends accreditation of a home care organization,
it would apply to all other accrediting agencies. A
home care agency would be permitted to reapply for
accreditation. Requires an accreditation agency that
denies, revokes, or suspends accreditation to report
specified information to the department. It is unclear
if California can compel accreditation agencies to
comply with these provisions since they are nationally
recognized agencies.
12.Permits DPH to implement and administer this licensing
program through all-facility letters or other
instructions, but requires DPH to adopt emergency
regulations by January 1, 2013, and permits one
readoption of the emergency regulations.
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Background
California's senior population is rapidly increasing. By
2030, it is estimated that the number of residents age 85
and older will be over 1.3 million people. The best place
to care for seniors and persons with disabilities is in the
least restrictive environment. Private home care agencies
are among the options to help assist individuals stay in
their home. According to the author's office, private
agencies that place care providers in the homes of our most
vulnerable residents do so without any regulatory oversight
from the state and without any requirement that they meet
minimum standards of employee screening and training. With
an increasing number of caregivers entering peoples' homes
essentially unchecked, the number of incidents of abuse and
neglect by home care aides being reported is alarming the
author argues.
The author's office believes this bill is necessary to
protect our most vulnerable residents. This bill will
require private home care agencies to annually assess home
care aide performance and effectiveness, supervise their
employees once every 62 days, provide consumers access to a
supervisor at all times services are being provided,
document a backup staffing plan in the event that a
particular home care aide is unavailable, and require a
background check of all home care aides as well as eight
hours of annual training. According to prosecutors, for
every reported incident of abuse or neglect in the home,
four go unreported.
Twenty-eight other states have moved forward with licensing
private home care services, including Florida, Illinois,
New York, Oregon, Pennsylvania, Washington, and Texas.
FISCAL EFFECT : Appropriation: Yes Fiscal Com.: Yes
Local: No
According to the Senate Appropriations Committee:
Fiscal Impact (in thousands)
Major Provisions 2011-12 2012-13 2013-14 Fund
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Initial/ongoing licensing, $3,800* $6,500*
$7,300Special/**
certification, inspections,
General
and regulations
* This bill does not provide for a baseline fee structure;
therefore, the department would need a General Fund loan
to pay for the initial year of licensure. Ongoing costs
would be offset by licensing and certification fees.
**Department of Public Health Licensing and Certification
Program Fund
SUPPORT : (Verified 5/31/11)
Service Employees International Union (source)
Alzheimer's Association
American Federation of State, County and Municipal
Employees
California Alliance for Retired Americans
California Senior Legislature
Congress of California Seniors
Gray Panthers California
Older Women's League of California
Sacramento Capitol Chapter of the Older Women's League
United Domestic Workers of America/AFSCME
OPPOSITION : (Verified 5/31/11)
California Association for Health Services at Home
Network of Domestic Referral Agencies
ARGUMENTS IN SUPPORT : United Domestic Workers of America
writes that this bill stands to uphold basic consumer
protections and will ensure that private home care agencies
have the proper state oversight to ensure our most
vulnerable population is getting the care they need and
deserve. Supporters state they have heard many complaints
over the years against agencies including inadequate care,
financial abuse, and even physical abuse. Supporters
contend that this bill will protect seniors and disabled
individuals and help ensure they receive long-term care
services in the least restrictive environment.
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ARGUMENTS IN OPPOSITION : The California Association for
Health Services at Home (CAHSAH) is opposed to this bill,
unless amended. CAHSAH is opposed to the bill's
requirement requiring all long-term care workers in
California to be certified by the state. CAHSAH argues
this new mandate will create a bottleneck in the ability to
meet the needs of the state's growing senior population,
thus restricting access to care. CAHSAH also opposes
placing the licensure of home care organizations under DPH.
CAHSAH argues this is an inappropriate placement since
home care aides are nonmedical.
The Network of Domestic Referral Agencies (NODRA) opposes
the approach of this bill and is concerned the bill would
have a negative impact on those who chose to use a referral
agency model. NODRA supports protecting clients by setting
standards and criteria but argues for using the same
structure currently used for Certified Nursing Assistants
and Home Health Aid licensing.
CTW:mw 5/31/11 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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