BILL ANALYSIS �
SB 411
Page 1
Date of Hearing: July 5, 2011
ASSEMBLY COMMITTEE ON HEALTH
William W. Monning, Chair
SB 411 (Price) - As Amended: June 21, 2011
SENATE VOTE : 25-13
SUBJECT : Home Care Services Act of 2011.
SUMMARY : Establishes the "Home Care Services Act of 2011"
(HCSA) which requires the Department of Public Health (DPH) to
license and regulate home care organizations. Specifically,
this bill :
General Provisions
1)Establishes the HCSA to license and regulate home care
organizations under DPH.
2)Requires DPH to assess licensure, renewal, background check,
and other fees for each location of a home care organization
in amounts sufficient to cover the costs of administering the
HCSA.
3)Makes various definitions including, but not limited to "home
care aide" to mean an individual who provides home care
services to a client in the client's residence and is
synonymous with "caregiver," "custodial care," "personal care
attendant," "homemaker," and "companion." Specifies that
"home care aide" does not include a person who is employed by,
contracts or vendors with a regional center or the State
Department of Developmental Services (DDS) to provide services
and support for persons with developmental disabilities when
funding for those services is provided through DDS.
4)Defines "home care organization" or "organization" to mean an
individual, partnership, corporation, limited liability
company, joint venture, association, or other entity that
arranges for the provision of home care services. Specifies
that "home care organization" does not include any county
providing in-home supportive services (IHSS), a home health
agency, a hospice facility, a health facility specified in
existing law or an organization vendored or contracted through
a regional center or DDS to provide services and support for
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persons with developmental disabilities when funding for
services are provided through DDS.
5)Defines "home care services" to mean services provided by a
home care aide to a client who cannot perform these services
for himself or herself including: a) bathing; b) dressing; c)
feeding; d) exercising; e) personal hygiene and grooming; f)
transferring, ambulating, and positioning; g) toileting and
incontinence care; h) assisting with medication that the
client normally self-administers; i) housekeeping; j) meal
planning and preparation; k) laundry; l) transportation; m)
correspondence and making telephone calls; n) shopping for
personal care items or groceries; and, o) companionship.
Specifies that "home care services" does not include services
provided by a licensed home health agency, licensed hospice,
licensed health facility, or IHSS services.
Licensure
6)Requires an individual, partnership, corporation, limited
liability company, joint venture, association, or other entity
to first obtain a license prior to arranging home care
services by a home care aide to a client.
7)Requires a home care organization with its principal place of
business in another state to have an office in California and
obtain authorization from the Secretary of State to conduct
business in California.
8)Requires DPH to adopt rules and regulations to implement the
HCSA, establish procedures for the receipt, investigation, and
resolution of complaints against home care organizations, and
investigate complaints concerning misconduct by certified home
care aids.
9)Requires DPH to maintain a registry on their Website of the
certification status of the home care aide's employer, home
care organization, and the status of any proposed or completed
disciplinary action against the certified home care aide.
Permits DPH to request and maintain additional employment
information for certified home care aides which will not be
publicly available on the registry.
10)Requires a home care organization, prior to DPH issuing a
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license, to submit an application, pay a licensing fee, submit
proof of general and professional liability, submit proof of a
valid workers' compensation policy, pass a background
clearance, and provide DPH with a list of all of its home care
aides.
11)Requires a home care organization to be accredited by The
Joint Commission, the Community Health Accreditation Program,
or any other nationally recognized accrediting organization
that has an accreditation program for home care organizations,
and that is approved by DPH. Requires the accrediting
organization to forward to DPH copies of all initial and
subsequent onsite inspections and other accreditation reports
or findings.
12)Requires the accreditation organization, at the request of
DPH, to conduct an onsite inspection of an accredited home
care organization to ensure the accreditation requirements are
satisfied. Requires these inspections to be conducted using
selective sample basis.
13)Permits DPH to conduct an onsite inspection of an accredited
home care organization to investigate complaints of
substantial noncompliance, as determined by DPH, with the
accreditation standards.
14)Requires the owners of a home care organization to submit to
a background check. Requires DPH to deny a license if the
background clearance discloses a conviction for a felony or a
crime that evidences an unfitness to operate a home care
organization.
15)Prohibits an organization from representing itself as a home
care organization or from using the words "home care
organization," "homecare," "in-homecare," or any combination
of those terms, within its name unless they are licensed as a
home care facility pursuant to this legislation.
Home Care Organization Operating Requirements
16) Requires a home care organization to do all of the
following:
a) Post its license in its place of business in a location
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visible to clients and its home care aides;
b) Operate the organization in a commercial office space
that complies with local zoning ordinances;
c) Have plans, procedures, and policies in place, including
the following:
i) Plans and procedures to be followed in the event of
emergencies or natural disasters that would result in the
interruption of home care services;
ii) A documented backup staffing plan in the event that
a home care aide scheduled to provide home care services
becomes available;
iii) A written policy regarding advance directives; and,
iv) A receipt and disbursement policy for expenditures
made on behalf of a client to ensure that financial abuse
does not occur.
d) Maintain a valid workers' compensation policy covering
its home care aides;
e) Maintain an employee dishonesty bond, including
third-party coverage, with a minimum limit of $10,000; and,
f) Comply with regulations adopted by DPH.
17)Requires a home care organization to consult DPH's registry
for home care aides before hiring an individual or placing him
or her in direct contact with patients. Requires a home care
organization to also do the following:
a) Ensure that each of its home care aides meets the
requirements established in this legislation;
b) Investigate complaints made by the client, or a client's
family member or guardian, against home care aides and
document the complaints and their resolution;
c) Conduct an annual assessment of the performance and
effectiveness of each home care aide;
d) Supervise, every 62 days, each home care aide providing
home care services in the residence of a client;
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e) Ensure that a home care aid, when providing services to
a client, has access at all times to a representative of
the organization who is in a supervisory capacity and who
does not regularly render home care services to that
client;
f) Require a home care aide, while providing home care
services to a client, to wear a badge that includes the
aide's name, a photograph of the aide, and other
information as specified;
g) Require home care aides to demonstrate that they are
free of active tuberculosis;
h) Require home care aides to annually complete not less
than eight paid hours of DPH-approved training on
job-related topics; and,
i) Prohibit home care aides from accepting money or
property from a client without written permission from the
home care organization.
Client Rights
18)Requires a home care organization to advise a client of any
changes in the client's plan for home care services.
19)Requires a home care organization, prior to arranging for the
provision of home care services, to do the following:
a) Distribute to the client its advance directive policy,
along with a written summary of applicable state law;
b) Advise the client of its policy regarding the disclosure
of client records;
c) Inform the client of the types and hours of available
home care services; and,
d) Inform the client, orally and in writing, of the home
care services that are not covered by Medi-Cal or Medicare,
as applicable, and the extent to which payment may be
expected from the client, from Medicare or Medi-Cal, and
from any other source.
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20)Establishes that home care clients are entitled to the
following rights and requires a home care organization to
provide a written notice citing these rights:
a) The right to have the client's property treated with
respect;
b) The right to voice grievances free from reprisal
regarding a home care service that is or fails to be
provided or regarding the violation of any of the rights
listed in 20) inclusive;
c) The right to be informed of and to participate in the
planning of the client's home care services; and,
d) The right to confidentiality of the client's personal
information.
Home Care Aides
21)Requires DPH, beginning January 1, 2013 to require any person
hired as a home care aide for the elderly or persons with
disabilities to be certified within 30 days from the date of
being hired.
22)Requires a prospective home care aide to complete a minimum
of five hours of entry-level training as follows:
a) Two hours of orientation training regarding his or her
role as caregiver and the applicable terms of employment;
b) Three hours of safety training, including basic safety
precautions, emergency procedures, and infection control;
and,
c) Other training related to core competencies and
population-specific competencies.
23)Requires DPH to only approve the curriculum for the training
referenced in 22) above if it satisfies the following
conditions:
a) The training curriculum has been developed with input
from consumer and worker representatives; and,
b) The training curriculum requires comprehensive
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instruction by qualified instructors on the competencies
and training topics prescribed.
24)Requires DPH to issue a home care aide certificate to each
individual who meets the training requirements referenced in
22) above.
25)Requires DPH to set a fee for certification and requires the
home care aide's employer to pay the certification fee.
26)Requires an individual who wishes, independent of an
employer-employee relationship, to obtain a certificate to
provide home care aide services, to pay for his or her own
certification.
27)Prohibits a home care organization from hiring an individual
as a home care aide unless that individual complies with
specified requirements.
28)Requires a home care organization that hires an individual to
ensure that the individual, within the first 30 days of
employment, satisfactorily completes the home care
certification training.
29)Requires a home care organization to conduct and pay for a
background clearance through the Department of Justice (DOJ),
as described, on an individual hired as a home care aide,
unless the individual holds a valid, unexpired license or
registration in a health-related field that requires a
background check as a condition of the license or
registration. Requires DPH to request subsequent arrest
notification service from DOJ and requires DOJ to charge a fee
to cover the actual costs related to these activities,
30)Prohibits a home care organization from hiring or retaining
an employee convicted or incarcerated for conviction, within
10 years, for child abuse, senior or dependent adult abuse, a
violent or serious felony, as specified, or a felony offense
for which the person is required to register as a sex
offender, unless the individual has obtained a certificate of
rehabilitation, or the information or accusation has been
dismissed, as specified.
31)Requires DPH to provide notice, as specified, to the
applicant for certification by personal service or registered
mail if a license application is denied based on a prior
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criminal conviction, and specified procedures for requesting
and conducting an administrative hearing.
32)Specifies notice requirements and administrative hearing
procedures in the event a request for a general exception is
denied.
33)Requires as a condition of initial and continuing employment
with a home care organization, an individual hires as a home
care aid to submit to an examination, as specified, to
determine that the individual is free of active tuberculosis.
Requires the home care aide to pay the cost of the
examination.
Revenues
34)Requires DPH to assess licensure, renewal, background check,
and other fees on each home care organization in amounts
sufficient to cover the costs of administering the HCSA,
including the cost of certifying home care aides, and requires
that all fees be deposited in the existing DPH Licensing and
Certification Program Fund.
35)Establishes an initial licensure fee equivalent to the fee
for home health agencies for the fiscal year (FY) 2011-12.
Enforcement and Penalties
36)Requires DPH, in consultation with a working group of
affected stakeholders, to adopt regulations establishing
procedures for notices, correction plans, appeals, and
hearings related to enforcement of HCSA requirements.
37)Requires DPH to verify through annual random, unannounced
inspections that a home care organization meets the
requirements of this chapter and the regulations adopted.
Requires DPH to send a written notice of noncompliance to the
individual or entity and to the Attorney General or
appropriate district attorney for further action.
38)Establishes that an individual or entity will be liable for a
civil penalty not to exceed $900 per day for each calendar day
of violations. Requires collected penalties to be deposited
into the Home Care Organization and Home Care Aide Penalties
Subaccount, which is created within the existing State Health
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Facilities Citation Penalties Account, and requires that, upon
appropriation by the Legislature, funds in the subaccount be
made available to DPH for purposes of enforcing the HCSA.
39)Authorizes DPH to implement and administer the HCSA through
all-facility letters or similar instructions until regulations
are adopted, and requires DPH to adopt emergency regulations
no later than January 1, 2013, which may be readopted once,
pending adoption of final regulations within 180 days.
EXISTING LAW :
1)Provides for the licensing and regulation of various
healthcare facilities by DPH.
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 DSS.
4)Establishes the Community Care Licensing division under DSS
which licenses and oversees both day care and residential
facilities for children and adults in California.
5)Establishes IHSS, a county-administered program, to provide
personal services and home care for eligible poor, aged,
blind, and disabled individuals.
FISCAL EFFECT : According to the Senate Appropriations
Committee, this bill will result in initial and ongoing
licensing, certification, inspections, and regulations to DPH's
licensing and certification Program Fund in the amount of $3.8
million in FY 2011-12; $6.5 million in FY 2012-13; and, $7.3
million in FY 2013-14.
COMMENTS :
1)PURPOSE OF THIS BILL . According to the author, by 2030 it is
estimated that the number of California residents age 85 and
older will be over 1.3 million people. The author maintains
that the best place to care for seniors and persons with
disabilities is in the least restrictive environment and
private home care organizations are among the options to help
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assist individuals stay in their home. According to the
author, 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. The author argues that 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 states that, according to prosecutors, for every
reported incident of abuse or neglect in the home, four go
unreported. The author asserts that this bill is necessary to
protect our most vulnerable residents and places California on
par with the 28 other states that have moved forward with
licensing private home care services, including Florida,
Illinois, New York, Oregon, Pennsylvania, Washington, and
Texas.
2)BACKGROUND . According to the California Senate Office of
Oversight and Outcomes report, "Caregiver Roulette: California
Fails to Screen those who Care for the Elderly at Home"
(Caregiver report) the percentage of seniors in need of
ongoing help with the tasks of daily living is expected to
double by the year 2025. The Caregiver report finds that the
increasing demand for home and personal care services in
California is occurring in a largely unregulated arena, where
home care organizations and individual contractors compete
with each other, advertising their services through the
Internet or in newspapers. It is estimated that 1,200 home
care organizations operate in California and an unknown number
of individuals look independently for home care aide jobs. As
a part of its study the Caregiver report made the following
findings: a) More than a quarter of home care aides accused or
convicted of crimes that were identified from news accounts
had committed previous offenses; b) Many home care
organizations claim to do "background checks," ranging from a
thorough screening required for certification by a state
association to an instant Internet check that experts say
yields almost no value; c) Few Californians who hire home care
aides on their own know that they have a legal right to
request a statewide criminal background check through DOJ;
and, d) California is part of a small minority of states that
does not regulate home care organizations.
3)HOME CARE SERVICES IN CALIFORNIA . Following are three
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essential means of providing care to seniors and persons with
disabilities in their own homes in California:
a) IHSS Program . IHSS is a publicly-funded program
administered by counties and DSS providing in-home care to
low-income elderly, blind, or disabled persons who are
unable to perform activities of daily living and cannot
remain safely in their own homes without help. Through
IHSS, qualified recipients may receive assistance with
daily tasks, such as bathing, dressing, cooking, cleaning,
and feeding. To be eligible for IHSS services, a person
must receive federal Supplemental Security Income (commonly
known as SSI) or meet income and resource guidelines. In
addition, the individual must be either 65 years or older,
blind, permanently disabled, or be a disabled child
requiring extraordinary care.
b) Home Health Agencies . Home health agencies are
organizations licensed by DPH to provide both skilled
nursing and non-medical personal assistance services. Home
health aides assist clients with personal services
according to a plan of treatment prescribed by a physician.
c) Home Care Organizations . Home care organizations employ
workers to provide many of the same services provided by
home health aides, but do not perform any medical services
such as changing non-sterile dressings, taking vital signs,
etc. The services are more akin to those provided through
the IHSS program for low income individuals. No state or
local agency regulates and licenses these providers. It is
this category of care that is the subject of this bill.
4)SUPPORT . The Service Employees International Union,
California (SEIU California), the sponsor of this bill, writes
in support that for the first time this bill will provide
important consumer protections for seniors and persons with
disabilities who use the services of private, nonmedical, home
care aides to enable them to remain safely in their homes.
SEIU California maintains that the responsibility for
regulating, overseeing, and providing services to California's
rapidly expanding population of seniors and persons with
disabilities is administered by a confusing hodge-podge of
agencies and departments. SEIU California states that the
administration of licensing and certification of this industry
and its workers proposed in this bill was placed in DPH
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because approximately 50% of agencies that provide these
services also provide home health services and are already
regulated by DPH. SEIU California argues that housing
regulatory functions in a single agency reduces redundancy and
the regulatory burden on the regulated industry. SEIU
California also argues that DPH has demonstrated expertise in
effective licensing of a number of health programs and
licenses which this legislation would take advantage of to
manage the program. This bill, according to SEIU California,
takes small steps to begin to build a cohesive system of care
and oversight and follows on the heels of 28 other states who
have led the way in licensing this important industry.
5)OPPOSE UNLESS AMENEDED . The California Association for Health
Services at Home (CAHSAH), a statewide home care association,
states that they are opposed unless amended to this bill
because it would create an unnecessary mandate for home care
aides in California to become certified by the state, along
with imposing significant mandates on companies providing
critical services to the state's most vulnerable population.
CAHSAH voiced views similar to the majority of those with an
opposed unless amended position. CAHSAH proposes the
following amendments to this bill:
a) Remove the provision requiring the certification of all
home care aides by the state of California and the
placement of their names, along with names of the companies
they work for, on a public Website. The rationale for this
amendment, according to CAHSAH, is that home care aides are
non-medical, personal attendant care that are best
regulated and supervised by licensed home care
organizations, not by the state, which struggles to
maintain adequate oversight of its current licensing and
certificaiton requirements. CAHSAH believes that the costs
and burden of adding approximately 120,000 additional
individuals that the state will have to certify and
regulate does not outweigh the minimal benefits that may
occur as a result. Furthermore, CAHSAH maintains, the
creation of a public Website that contains the names of
these aides, along with the names of the companies they
work for is a privacy concern that could force a dangerous
situation onto workers.
b) Remove the provision that mandates the accreditation by
a private accrediting company of all agencies as a
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prerequisite to state licensure. CAHSAH states that
accreditation is costly (approximately $4,000-$8,000
annually) and is performed by private companies that may
not be familiar with non-medical home care. CAHSAH arugues
that this initial survey for licensure should be performed
by the state and shouldn't be outsourced to accrediting
bodies. CAHSAH claims that currently the state allows home
health agencies seeking certificaiton the option to use an
accrediting body if they choose to incur the extra cost, as
opposed to waiting for the state; however, this is an
option and not a required mandate.
c) Place the regulation of home care organizations under
DSS as opposed to DPH. CAHSAH states that home care aides
provide non-medical services such as bathing,
companionship, and hygiene. CAHSAH assertss that IHSS and
Residentail Care Facilities for the Elderly provide similar
services and are currently regulated by the DSS. CAHSAH
claims this is not a medical service therefore should not
be placed under DPH. Additionally, CAHSAH maintains DSS
has existing programs and partnerships, such as Trusline,
that would allow for the licensed home care organizations
to utilize the DOJ's Live Scan capabilities so that the
background checks of workers are portable.
The Network of Domestic Referral Agencies (NODRA) is also
opposed unless amended to this bill. While NODRA states that
it is supportive of the concept of the amendments that the
author has agreed to take in the Assembly Health Committee,
the organization believes that many of the amendments are over
reaching and may have unintended consequences. For these
reasons NODRA opposed unless amended position remains.
6)RELATED LEGISLATION . AB 899 (Yamada) is very similar to this
bill. AB 899 also creates the "Home Care Services Act of
2011" but requires DSS to license and regulate home care
organizations. AB 899 does not require the certification of
employees as required in this bill. AB 899 died on the
Suspense File in Assembly Appropriations Committee.
7)PREVIOUS LEGISLATION .
a) AB 853 (Jones) of 2007 was identical to AB 899 (Yamada).
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AB 853 was held in the Assembly Appropriations Committee.
b) SB 692 (Ashburn), Chapter 2, Statutes of 2007, would
have allowed individuals hiring a private caregiver to
obtain a criminal background check at their own expense.
8)DOUBLE REFERRAL . This bill was previously heard in the
Assembly Humans Services Committee, and was approved on a 4-2
vote.
9)AMENDMENTS DISCUSSED IN HUMAN SERVICES . The following
amendments were discussed during the Assembly Human Services
Committee hearing and will be voted on in the Assembly Health
Committee. The amendments primarily attempt to address the
concerns expressed by NODRA, which requested that referral
agencies or agencies that do not employ home care aides but
arranges for home care aides to provide services, be exempted
from the licensing requirements of this bill.
a) Amend Section 1796.12 to add: (F) An employment agency
defined in Civil Code 1812.5095 that procures, offers,
refers, provides, or attempts to provide home care aides
and/or other workers who provide home care services or
domestic services to clients and consumers pursuant to that
section, so long as the agency is not the employer of any
home care aides or other workers who provide domestic
services.
b) Amend Section 1796.20 (a) to read: 1796.20. (a) Subject
to the exception set forth in subsection (d) of this
section, an individual, partnership, corporation, limited
liability company, joint venture, association, or other
entity shall not arrange for the provision of home care
services by a home care aide to a client in this state
without first obtaining a license pursuant to this chapter.
c) Amend Section 1796.20 to add: (d) The requirements of
this section shall not apply to an employment agency
defined in Civil Code 1812.5095 that procures, offers,
refers, provides, or attempts to provide home care aides
and/or other workers who provide home care services or
domestic services to clients and consumers pursuant to that
section, so long as the agency is not the employer of any
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home care aides and/or other workers who provide domestic
services.
d) Amend Section 1796.27 to read: A private or public
organization, with the exceptions set forth in subsection
(c) of this section, of a county providing in-home
supportive services pursuant to Article 7 (commencing with
Section 12300) of Chapter 3 of Part 3 of Division 9 of the
Welfare and Institutions Cod e shall not do any of the
following, unless it is licensed under this chapter:
e) Amend Section 1796.27 to add: (c) This section does not
apply to either of the following: (1) A county providing
in-home supportive services pursuant to Article 7
(commencing with Section 12300) of Chapter 3 of Part 3 of
Division 9 of the Welfare and Institutions Code; or (2) An
employment agency defined in Civil Code 1812.5095 that
procures, offers, refers, provides, or attempts to provide
home care aides and/or other workers who provide home care
services or domestic services to clients and consumers
pursuant to that section, so long as the agency is not the
employer of any home care aides and/or other workers who
provide domestic services.
f) Add Section 1796.45 to read: An employment agency
defined in Civil Code 1812.5095 that procures, offers,
refers, provides, or attempts to provide home care aides
and/or other workers who provide home care services or
domestic services to clients and consumers pursuant to that
section must at all times maintain general and professional
liability insurance in the amount of at least one million
dollars ($1,000,000) per occurrence and three million
dollars ($3,000,000) in the aggregate.
g) Amend Section 1796.60 (a) to read: 1796.60 (a)
Beginning January 1, 2013, the department shall require any
person hired as a home care aide to be certified within 30
days from the date of being hired and that any person
referred by an employment agency defined in Civil Code
1812.5095 be certified prior to any referral.
h) Amend Section 1796.61 to add: (c) Notwithstanding any
other provision of law, an employment agency defined in
Civil Code 1812.5095 shall ensure that any person it refers
to provide home care services has been certified under
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Section 1796.60 prior to any such referral.
i) Amend Section 1796.80. (a) to read: 1796.80 (a) A home
care organization or employment agency defined in Civil
Code 1812.5095 operating in violation of any requirement or
obligation imposed by this chapter or any rule adopted
hereunder may be subject to the penalties or fines levied
or licensure action taken by the department as specified in
this section.
j) Amend Section 1796.80 (b) to read: (b) When the
department determines that a home care organization or
employment agency defined in Civil Code 1812.5095 is in
violation of this chapter or any rules promulgated
hereunder, a notice of violation shall be served upon the
licensee. Each notice of violation shall be prepared in
writing and shall specify the nature of the violation and
the statutory provision or rule alleged to have been
violated. The notice shall inform the licensee of any
action the department may take under this chapter,
including the requirement of an agency plan of correction,
assessment of a penalty, or action to suspend, revoke, or
deny renewal of the license. The director or his or her
designee shall also inform the licensee of rights to a
hearing under this chapter.
10)AUTHOR'S AMENDMENTS . The author is proposing the following
amendments that clarify an exemption for organizations
vendored or contracted through a regional center or DDS,
clarify information required for the registry of home care
organizations and aides on DPH's Website, and provide for
provisions for home care aide certification training if the
training is not offered in an individual's county:
a) Amend Section 1796.23, add: (e) Maintain a registry, on
the department's Internet Web site, to include the
licensure status of all licensed home care organizations as
defined in section 1796.12 (d)(1), along with the name,
address and phone number of the home care organization, and
the status of any proposed or completed disciplinary action
against the licensed home care organization. The department
also may request and maintain additional information for
licensed home care agencies, as necessary, which shall not
be publicly available on the registry.
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b) On page 7, strike out lines 29 to 32, inclusive, in line
33 strike out "disciplinary action against the certified
home care aide.", and insert: (d) Maintain on the
department's Internet Website a capability to look up the
certification status of any certified home care aide, the
name and location of the home care aide's employer, if
there is one, and any disciplinary action taken against the
home care aide. In the case of the home care aide being an
independent contractor and not employed by an organization,
the site shall indicate that status. To expedite the
ability of a consumer to search and locate an appropriate
home care aide, the site shall enable consumers to look up
the certification status, including any disciplinary action
taken against the home care aide, by providing the home
care aide's name, certificate number, and geographic
location. The site shall not provide any additional
individually identifiable information about a home care
aide.
c) On page 21, strike out lines 23 to 40 inclusive, and on
page 22, strike out lines 1 to 6 inclusive.
d) Amend Section 1796.62 to read: (c) If the background
check required by subdivision (b) discloses a conviction or
incarceration for a conviction of any of the following
provisions of the Penal Code within 10 years, the
Department shall deny the home care aide certification of
that individual.
e) Amend Section 1796.12 (c) to add: (2) "Home care aide"
does not include any person who is employed by, or
contracts with, an organization vendored or contracted
through a regional center or the State Department of
Developmental Services pursuant to the Lanterman
Developmental Disabilities Services Act (Division 4.5
(commencing with Section 4500) of the Welfare and
Institutions Code) and the California Early Intervention
Services Act (Title 14 (commencing with Section 95000) of
the Government Code) to provide services and support for
persons with developmental disabilities, as defined in
Section 4512 of the Welfare and Institutions Code, when
funding for those services is provided through the State
Department of Developmental Services and meets the criteria
defined in 1796.12 d(2)(G) .
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f) Amend Section 1796.12 d (2) to add: (G) An organization
vendored or contracted through a regional center or the
State Department of Developmental Services pursuant to the
Lanterman Developmental Disabilities Services Act (Division
4.5 (commencing with Section 4500) of the Welfare and
Institutions Code) and the California Early Intervention
Services Act (Title 14 (commencing with Section 95000) of
the Government Code) to provide services and support for
persons with developmental disabilities, as defined in
Section 4512 of the Welfare and Institutions Code, when
funding for those services is provided through the State
Department of Developmental Services and 51% or more of the
recipients of the home care services as defined by 1796.13
are persons with developmental disabilities.
g) Amend Section 1796.60 (a) to add: (1) If the department
determines training required by (c) of this section is
unavailable in an applicant's county within 30 days of the
deadline specified in this section, the Department shall
issue a temporary home care aide certificate to that
individual that will be valid until the date that proper
training is made available in that region. (2) Upon
completion of the mandatory training as defined in (c) of
this section, the Department shall replace the temporary
home care aide certification and a permanent home care aide
certificate shall be given to the individual by the
Department.
h) Amend Section 1796.60 to add: (e) The mandatory
training requirements for home care aide certification as
defined in (c) of this section may be completed through
online training program.
11)POLICY COMMENTS :
a) Regulatory Agency . This bill requires home care
organizations to be licensed and regulated by DPH. The
bill further requires DPH to certify home care aides.
DPH's Licensing and Certification Division currently
licenses health facilities in California as well as
oversees the certification of nurse assistants, home health
aides, and hemodialysis technicians. Typically DPH
licenses and certifies medical care type professions and
facilities. Home care agencies and home care aides do not
perform medical duties.
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It is recommended that the author require DSS to perform the
licensing and regulatory activities instead of DPH. DSS
currently administers the IHSS program, which provides
services that are similar to those provided by home care
agencies, to low-income aged, blind, and disabled
consumers.
b) Certification Timeframe . This bill requires that,
beginning January 1, 2013, any person hired as a home care
aide be certified within 30 days of hire. This bill also
requires, for purposes of meeting training requirements for
certification, that curricula be developed with input from
consumer and worker representatives and be approved by
DPH. A period of one year from the effective date of this
bill may not be sufficient time to develop training
curricula, complete trainings, and conduct background
checks to certify sufficient numbers of home care aides to
meet the demand for home care services, thereby creating
the "bottleneck" that opponents predict. It is recommended
that the author consider amending the bill to extend the
deadline for home care worker certification, at least as it
applies to current employees.
c) National Accreditation Requirement . According to the
author, accreditation simplifies the licensing process and,
thus, reduces the cost to DPH for licensing. This bill
establishes an initial licensure fee equivalent to the fee
for home health agencies for the 2011-12 FY, which is
$4,129.63. The costs of accreditation, according to
opponents of this bill, are in the range of $7,500 to
$10,000. Thus, while accreditation may result in a saving
of resources for DPH, which might be passed on to home care
organizations in the form of lower fees, accreditation
would still likely result in a substantial net cost to home
care organizations. These added costs would then likely be
passed on to home care organization clients in the form of
higher fees. The cost issue should be examined more
closely to determine the extent of savings to DPH and
whether accreditation will result in a net savings or
minimal costs to home care organizations.
REGISTERED SUPPORT / OPPOSITION :
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Support
Service Employees International Union, California (cosponsor)
California Senior Legislature (cosponsor)
Congress of California Seniors (cosponsor)
Addus Healthcare
Alzheimer's Association
Association of California Caregivers Resource Centers
California Alliance for Retired Americans
Coalition for Humane Immigrant Rights of Los Angeles
Consumer Attorneys of California
Gray Panthers California
National Association of Social Workers, California Chapter
Older Women's League of California
Older Women's League, Sacramento Capitol Chapter
United Domestic Providers of America/AFSCME
Oppose Unless Amended
A Better Choice-in Home Care
Accredited Nursing Care
Agility Health
Arcadia Home Care and Staffing
Around the Clock Care
California Association for Health Services at Home
California Disability Services Association
Cambrian Homecare
Care to Stay Home
ComForCare Senior Services
ComForCare Senior Services - Arcadia
Comfort Keepers
Competent Care Home Health Nursing
Craig Cares
DialMED Home Care
Help Unlimited
Hillendale Home Care
Hired Hands Homecare
Home and Health Care Management
Home Instead Senior Care
Homecare Consultants Unlimited, Inc.
HomeCare Professionals
Innovative Healthcare Consultants
Interim Healthcare
Kaweah Delta Home Services
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Koved Care
Love 2 Live Care Services
LWF Home Care, Inc.
Mad River Community Hospital Home Health Agency
Matched CareGivers
Medical Home Care Professionals, Inc.
Network of Domestic Referral Agencies
Northern and Southern California Chapters of the National
Private Duty Association
Nursing & Rehab at Home
Pioneer Home Health Care
Reliant In-Home Care
Right at Home
Select Home Care
Sencare, Inc.
Senior Helpers
St. Joseph Health System Home Health Agency
Visiting Angels Living Assistance Services, Inc.
Opposition
None on file.
Analysis Prepared by : Tanya Robinson-Taylor / HEALTH / (916)
319-2097