BILL ANALYSIS �
Senate Appropriations Committee Fiscal Summary
Senator Kevin de Le�n, Chair
AB 1454 (I. Calderon) - Care facilities: regulatory visits.
Amended: May 23, 2014 Policy Vote: Human Services 4-0
Urgency: No Mandate: No
Hearing Date: June 30, 2014
Consultant: Jolie Onodera
This bill meets the criteria for referral to the Suspense File.
Bill Summary: AB 1454 would require the Department of Social
Services (DSS) to increase the frequency of unannounced
licensing visits of community care facilities (CCFs),
residential care facilities for the elderly (RCFEs), child day
care centers, and family day care homes incrementally over three
years, so by July 1, 2017, every facility would be visited
annually. This bill additionally permits the DSS to complete a
prelicensure survey for a new licensee of a currently licensed
RCFE for which there will be no material change to management or
operations when he license changes hands.
Fiscal Impact: Ongoing major future costs of approximately $25
million (General Fund) once the frequency of inspections in all
facility types is completed annually. Costs to phase-in the
frequency of facility visits are estimated at $5.6 million in FY
2014-15, $15.2 million in FY 2015-16, $22.6 million in FY
2016-17, and $24.6 million in FY 2017-18 and annually
thereafter.
Background: The Community Care Licensing Division (CCLD) of the
DSS administers the licensure and oversight of over 66,000
licensed community care facilities in California. These
facilities are classified under 23 separate licensure categories
including adoption agencies, foster family homes, RCFEs, group
homes, adult residential facilities, adult day care, child day
care facilities and others that provide primarily non-medical
care and supervision to 1.4 million children and adults in
California.
Prior to 2003, the required frequency of CCLD facility visits
was annually for most facility types. Subsequently, in response
to the state's fiscal situation, legislation was enacted to
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lengthen the interval between visits in an effort to reduce
program costs. As a result, the CCLD is now required to conduct
unannounced visits annually only in circumstances in which a
facility has a history of compliance issues. For those
residential facilities not subject to annual inspections, the
CCLD is currently required to conduct comprehensive compliance
inspections on a 30 percent random sample basis each year, with
no facility being visited less than once every five years.
In response to recent health and safety issues discovered at
facilities licensed by the CCLD, the 2014-15 Governor's Budget
proposed a comprehensive plan to reform the CCLD program. This
proposal included an increase of $7.5 million ($5.8 million
General Fund) and 71.5 positions to improve the timeliness of
investigations, ensure the CCLD inspects all facilities at least
once every five years, increase staff training, and establish
clear fiscal, program, and corporate accountability. The
proposal also increased civil penalties assessed for violations
and increased licensing and application fees by 10 percent.
While the proposal did not include any statutory changes to the
mandated inspection frequency, the number and frequency of
visits was expected to increase due to the addition of resources
dedicated to specialized workloads, thereby permitting licensing
program analysts to conduct more facility inspections.
Proposed Law: This bill would require the DSS to increase the
frequency of unannounced licensing visits of community care
facilities, RCFEs, child day care centers, and family day care
homes, as follows:
On or before July 1, 2015, requires DSS to conduct
annual unannounced visits to no less than 30 percent of
facilities, as specified, and visit all facilities at least
once every three years.
On or before July 1, 2016, requires DSS to conduct
annual unannounced visits to no less than 20 percent of
facilities, as specified, and visit all facilities at least
once every two years.
On or before July 1, 2017, requires DSS to conduct at
least one annual unannounced visit to each facility.
This bill would also provide that if DSS determines that an
application for RCFE licensure is for a currently licensed
facility for which there will be no material change to the
management or operations of the facility, the prelicensure
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survey is optional at the discretion of the department.
Related Legislation: SB 895 (Corbett) 2014 would require all
RCFEs to be subject to annual unannounced inspections by the DSS
and phases-in the annual inspection requirement over three years
This bill also requires deficiencies must be verified to be have
been corrected within 10 days following notification to the
facility. This bill is currently pending hearing in the Assembly
Committee on Appropriations.
Due to long-term reform efforts by the California Advocates for
Nursing Home Reform (CANHR), as well as in response to a growing
number of highly publicized incidents at licensed community care
facilities throughout the state, the following bills regarding
licensing and inspections at community care facilities, and
RCFEs specifically, have been introduced this session:
SB 894 (Corbett) RCFEs: revocation of license.
SB 911 (Block) RCFEs: licensing and training requirements.
SB 1153 (Leno) RCFEs: suspension of new admissions.
SB 1382 (Block) RCFEs: licensure fees.
AB 1436 (Waldron) RCFEs: internet posting of inspection reports.
AB 1523 (Atkins) RCFEs: liability insurance.
AB 1554 (Skinner) RCFEs: complaint procedures.
AB 1570 (Chesbro) RCFEs: training requirements.
AB 1571 (Eggman) RCFEs: disclosure requirements.
AB 1572 (Eggman) RCFEs: single resident council.
AB 1899 (Brown) RCFEs: prohibitions on licensure reinstatement.
AB 2044 (Rodriguez) RCFEs: 24-hour presence of
administrator/staff.
AB 2171 (Wieckowski) RCFEs: residents' rights.
Prior Legislation: AB 364 (Calderon) 2013 would have required
the DSS CCLD inspectors to make unannounced visits to most
licensed facilities (with the exception of licensed child care
facilities) at least once every two years. This bill was held on
the Suspense File of the Assembly Committee on Appropriations.
AB 419 (Mitchell) 2011 would have required the DSS to conduct an
unannounced inspection of a care facility at least once each
year and as often as necessary to ensure the quality of care
provided. This bill was held on the Suspense File of the
Assembly Committee on Appropriations.
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Staff Comments: By increasing the frequency of facility
inspections over a three-year period, the provisions of this
bill are estimated to result in increased costs to DSS of $5.6
million in 2014-15, $15.2 million in FY 2015-16, $22.6 million
in FY 2016-17, and $24.6 million in FY 2017-18 and annually
thereafter to conduct annual visits of over 66,000 licensed
facilities.
Staff notes legislative intent language was included in SB 855
(Committee on Budget and Fiscal Review) Chapter 29/2014, stating
"it is the intent of the Legislature to, over a period of time,
increase the frequency of facility inspections resulting in
annual inspections for some or all facility types. The bill
would require the DSS to update the Legislature on the status of
the structural and quality enhancement improvements during the
2015-16 legislative budget subcommittee hearings." However, no
statutory increase to the frequency of licensed facility visits
was included in SB 855.
Recommended Amendments: The provisions of this bill would
require the DSS to meet the requirement of visiting facilities
no less often than once every three years within six months of
implementation of this bill. The author may wish to consider an
amendment to revise the dates out six months or more to allow
the department to comply with the scheduled visitation
requirements.