BILL ANALYSIS                                                                                                                                                                                                    �



                                                                            



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                                    THIRD READING


          Bill No:  AB 557
          Author:   Yamada (D)
          Amended:  6/20/13 in Senate
          Vote:     21

           
           SENATE VETERANS AFFAIRS COMMITTEE  :  7-0, 6/11/13
          AYES:  Hueso, Knight, Block, Correa, Lieu, Nielsen, Roth
          NO VOTE RECORDED:  Vacancy
           
          SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8  

          ASSEMBLY FLOOR  :  75-0, 5/13/13 - See last page for vote


           SUBJECT  :    Veterans homes:  accounting of charges

           SOURCE  :     Author


           DIGEST  :    This bill requires a veterans homes residents  
          quarterly statement or accounting to specify that the home may  
          use the deceased veterans money or personal property that is  
          outside the home for payment of unreimbursed costs of care.   
          This bill also requires the quarterly statement or accounting  
          and any notice relating to quarterly statements posted in any  
          veterans' home to be in 14-point font or larger.

           ANALYSIS  :    

          Existing law:

          1. A member (resident) of a state veterans home is required to  
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             pay fees and charges as determined by the Department of  
             Veterans Affairs (CalVet).

          2. Requires the administrator of a state veterans home to  
             provide each member of the home with a quarterly statement or  
             accounting of all charges for the costs of care rendered to  
             the member in excess of the member fee.  The quarterly  
             statement or accounting of charges must clearly indicate:

             A.    That the costs of care that may be incurred in excess  
                of the member contribution fee.

             B.    That if the veteran is a resident of the home at the  
                time of death, the home may disburse the veteran's moneys  
                or personal property for payment of unreimbursed excess  
                costs of care.

          This bill:

          1. Requires that the quarterly statements of all charges for the  
             costs of care rendered to the member in excess of the member  
             fee include language that if the veteran is a resident of the  
             home at the time of death, the home may use his/her money or  
             personal property that is in possession of the home or  
             outside the home for payment of unreimbursed costs of care.

          2. Requires that the statements and notices relating to the  
             statements shall be in 14-point font or larger.

           Background
           
          CalVet's Veterans Homes Division provides rehabilitative,  
          residential medical care and services in a homelike environment  
          for all veterans (and eligible veteran spouses) residing in the  
          state's six active veterans homes, which are located in  
          Yountville, Barstow, Chula Vista, Ventura, Lancaster, and West  
          Los Angeles.  As of early 2013, more than 1,700 members resided  
          in these veterans homes.  CalVet is scheduled to begin admitting  
          veterans in October 2013 at two new veterans homes located in  
          Fresno and Redding. 

          Funding for the annual operating expenses of the veterans homes  
          comes from the state's General Fund (GF), and any revenues that  
          the Veterans Homes Division receives are subsequently remitted  

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          to the GF.  These sources of revenue include payments from the  
          United States Department of Veterans Affairs; reimbursements  
          from federal, state, or private insurance plans-including the  
          Medicare and Medi-Cal programs; and the fees that existing law  
          requires state home residents to pay fees in accordance with the  
          care they receive.  The fees are determined by CalVet.  There  
          are times when the residents' care exceeds the basic fee (e.g.  
          dental care, acute medical care, etc.).

          CalVet may recover costs from the veteran's estate for payment  
          of funeral expenses or any obligation owed to the home,  
          including the cost of any care rendered by the home in excess of  
          the fees paid by the veteran to the home.  Any funds of the  
          deceased veteran representing the cost of care rendered by the  
          home in excess of the fees paid by the veteran to the home are  
          paid into the Morale, Welfare, and Recreation Fund.  These  
          provisions apply only to veterans who became members of the home  
          on or after January 1, 1984.

           Audit report  .  In May 2013 the State Auditor released Audit  
          Report 2012-119, which examined CalVet's management of the  
          veterans homes.  The Report offered the following conclusions:

          1. CalVet has not maximized its ability to generate revenue for  
             the care provided to its members.  Between fiscal years  
             2009-10 and 2011-12, CalVet generated revenues to offset less  
             than half of the cost to operate its veterans homes.   
             According to the chief financial officer, before 2012 it did  
             not have policies and procedures for consistently monitoring  
             and increasing the amount of revenue generated at the  
             veterans homes.  For example:

             A.    CalVet headquarters did not have adequate controls in  
                place to ensure that the veterans homes were consistently  
                enrolling and monitoring the status of their members in  
                maintaining coverage in all medical insurance and federal  
                government-funded income programs for which the members  
                were eligible.

             B.    CalVet headquarters did not have a process to monitor  
                whether eligible members were enrolled in private medical  
                insurance plans or in the Medicare and Medi-Cal programs.

          2. State laws and CalVet policies also limit CalVet's ability to  

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             recover the full cost of providing care to members of  
             veterans homes while they are living at a home and from using  
             funds collected from members' estates after they pass away to  
             offset the costs of their care.

             A.    Under state law, CalVet can use only a member's annual  
                income in determining the member's fee that CalVet may  
                charge; it is not allowed to consider a member's assets  
                other than income-which may include personal or real  
                property, stocks and bonds, and automobiles-in the  
                calculation.

             B.    In addition, state law limits the total fees members  
                pay to a certain percentage of their annual income,  
                depending on the level of care he/she receives.  For  
                example, according to state law, members at the  
                domiciliary level of care may be charged no more than  
                47.5% of their annual income for member fees, while  
                members in skilled nursing care may be charged no more  
                than 70% of their annual income.  Therefore, most members  
                pay only a portion of their actual costs of care while  
                living at the veterans home.  Because CalVet offsets less  
                than half of its annual operating expenditures for the  
                veterans homes with funds from existing revenue sources,  
                it should analyze its cost-recovery models, including an  
                evaluation of the state laws that limit the amount of  
                revenue CalVet can collect for the care it provides to its  
                members at the homes.  The State Auditor believes such an  
                analysis would provide CalVet with useful information that  
                could help it determine how best to offset the costs  
                charged to the GF for providing care to members.

           Prior Legislation
           
          AB 1823 (Yamada, Chapter 158, Statutes of 2012) required that  
          routine quarterly financial statements provided to residents of  
          California's six Veteran Homes also include clearly written  
          information about any prospective charges that would be due at  
          the time of the veteran's death, consistent with the terms  
          agreed to upon admission to the Veterans Home.  

          SB 950 (Wiggins, Chapter 509, Stattutes of 2010) required (1)  
          the written notice to veterans to also include the terms and  
          conditions upon which the member fees and costs can be changed,  

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          and (2) a signature from the veteran to acknowledge that he or  
          she has read and understands the notice.

          SB 1281 (Haynes, Chapter 466, Statutes of 2002) required a  
          Veteran's Home administrator to provide a quarterly statement  
          showing the costs of care, as well as written notice, upon  
          admission to a California veterans' home, of costs that may be  
          incurred by the veteran.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No



           ASSEMBLY FLOOR  :  75-0, 5/13/13
          AYES:  Achadjian, Alejo, Atkins, Bigelow, Bloom, Blumenfield,  
            Bocanegra, Bonilla, Bonta, Bradford, Brown, Buchanan, Ian  
            Calderon, Campos, Chau, Ch�vez, Chesbro, Conway, Cooley,  
            Dahle, Daly, Dickinson, Donnelly, Eggman, Fong, Fox, Frazier,  
            Beth Gaines, Garcia, Gatto, Gomez, Gordon, Gorell, Gray,  
            Grove, Hagman, Hall, Harkey, Roger Hern�ndez, Jones,  
            Jones-Sawyer, Levine, Linder, Logue, Maienschein, Mansoor,  
            Medina, Melendez, Mitchell, Morrell, Mullin, Muratsuchi,  
            Nazarian, Nestande, Olsen, Pan, Patterson, Perea, V. Manuel  
            P�rez, Quirk, Quirk-Silva, Rendon, Salas, Skinner, Stone,  
            Ting, Torres, Wagner, Waldron, Weber, Wieckowski, Wilk,  
            Williams, Yamada, John A. P�rez
          NO VOTE RECORDED:  Allen, Ammiano, Holden, Lowenthal, Vacancy


          AL:k  7/1/13   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  NONE RECEIVED

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