BILL ANALYSIS                                                                                                                                                                                                    �



                                                                            



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          |SENATE RULES COMMITTEE            |                       AB 1523|
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                                       CONSENT


          Bill No:  AB 1523
          Author:   Atkins (D) and Weber (D), et al.
          Amended:  6/12/14 in Senate
          Vote:     21

           
           SENATE HUMAN SERVICES COMMITTEE  :  4-0, 6/10/14
          AYES:  Beall, DeSaulnier, Liu, Wyland
          NO VOTE RECORDED: Berryhill

           SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8

           ASSEMBLY FLOOR  :  77-0, 5/15/14 - See last page for vote


           SUBJECT  :    Residential care facilities for the elderly

           SOURCE  :     Author


           DIGEST  :    This bill requires residential care facilities for  
          the elderly (RCFEs), by July 1, 2015, to maintain liability  
          insurance in an amount of at least $1 million dollars per  
          occurrence and $3 million in the annual aggregate for the  
          purpose of covering injury to residents and guests caused by the  
          negligence of the licensee or its employees.

           ANALYSIS  :    

          Existing Law:

          1. Establishes the Residential Care Facilities for the Elderly  
             Act which provides for the licensure and regulation of RCFEs  
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             by the Department of Social Services (DSS) as a separate  
             category within the existing residential care licensing  
             structure of DSS. 

          2. Requires RCFE licensees who are entrusted to safeguard  
             resident cash resources to file or have on file with DSS a  
             copy of a bond issued by a surety company admitted to do  
             business in this state in an amount set by DSS. 

          3. Through regulation, provides that any applicable facility  
             shall have at least $1,000 on the bond and establishes a  
             schedule for safeguarded amounts under $3,000.  Additionally  
             provides that for every $1,000 safeguarded above $3,000, the  
             facility shall have an additional $1,000 on the bond. 

          4. Through regulation, provides that DSS may require the  
             licensee to file an additional bond in such amount as the  
             licensing agency determines to be necessary to adequately  
             protect the residents' money. 

          5. Requires continuing care retirement communities (CCRCs) to  
             maintain a fidelity bond for each agent or employee, who, in  
             the course of his/her agency or employment, has access to any  
             substantial amount of funds. 

          This bill:

          1. Provides that on and after July 1, 2015, RCFEs shall maintain  
             at least $1 million per occurrence and $3 million in the  
             total annual aggregate of liability insurance coverage  
             against negligent acts or omissions to act of, or neglect by,  
             the licensee or its employees.

          2. Exempts RCFEs that are an integral part of CCRCs from the  
             above requirement.

           Background 
           
           RCFEs  .  Within California's continuum of long term care,  
          situated between in-home care and skilled nursing facilities, is  
          the RCFE, also commonly called Assisted Living, Board and Care,  
          or Residential Care.  There are approximately 8,000 Assisted  
          Living, Board and Care, and Continuing Care Retirement homes  
          that are licensed as RCFEs in California.  These residences are  

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          designed to provide homelike housing options to seniors and  
          other adults who need some help with activities of daily living,  
          such as cooking, bathing, or getting dressed, but otherwise do  
          not need continuous, 24-hour assistance or nursing care.   
          Increasingly residents are entering RCFEs with significant  
          health needs including diabetes, bedsores, or require the use of  
          oxygen tanks, catheters, colostomies or ileostomies.  

           Financial Structure  .  More than 90% of RCFEs in California are  
          for-profit homes, the majority of which are small facilities.   
          Most residents pay privately or with long-term care insurance  
          since there is very little public funding available through  
          Medi-Cal, Supplemental Security Income (SSI/SSP) or Medicare,  
          and fees can range from $1,500 to more than $8,000 per month. A  
          very few beds are available to seniors who pay their entire  
          SSI/SSP checks in rent.  In 2013 the maximum SSI/SSP grant was  
          $866.40.  Residents who rely on SSI have a maximum payment of  
          $2,642 per month in 2014, although that amount varies widely  
          based on the recipient's prior income while working. 

          As a result, low-income and middle-income seniors who do not  
          have long-term-care insurance are largely unable to afford to  
          reside in an RCFE.  Many low-income seniors receive services  
          through the In Home Supportive Services program, or in a skilled  
          nursing facility if they are Medi-Cal eligible.  Increasingly,  
          complex corporate mergers and acquisitions have meant that many  
          RCFEs are owned by national corporate chains that control  
          numerous facilities.  Administrators employed by these chains  
          may also oversee multiple facilities.  This development has led  
          to regulatory challenges since the Community Care Licensing  
          Division (CCL) citations and other licensing reports are  
          facility specific, and management problems common to multiple  
          RCFEs with the same owner may easily go unnoticed.

           Current Surety Bond Requirements  .  Under existing law, RCFEs (as  
          well as other community care facilities) that are entrusted to  
          safeguard money or property of residents are required to provide  
          to DSS a copy of a surety bond issued by a California company in  
          specified amounts to adequately protect resident's money or  
          property.  DSS establishes the required amount of the bond  
          through regulation in accordance with the following schedule: 

          Total Safeguarded Per Month Bond Required 
          $750 or less ..................................................  

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          $1,000 
          $751 to $1,500. ............................................  
          $2,000 
          $1,501 to $2,500 ..........................................  
          $3,000 

          Additionally, regulation provides that whenever DSS determines  
          that the amount of the bond is insufficient to adequately  
          protect the money of residents, or whenever the amount of any  
          bond is impaired by any recovery against the bond, DSS may  
          require the licensee to file an additional bond in such amount  
          as the licensing agency determines to be necessary to adequately  
          protect the residents' money. 

          CCRCs are required to maintain in effect insurance or a fidelity  
          bond for each employee who has access to a significant amount of  
          funds in addition to the above bond requirements on any RCFEs  
          they may operate.  Residents of CCRCs frequently pay substantial  
          entrance fees in the hundreds of thousands to millions of  
          dollars, of which a portion may be refundable depending on the  
          terms of the contract with the resident.  In exchange, the  
          facility agrees to take a certain amount of financial risk in  
          meeting the long-term-care needs of the resident.  Such fidelity  
          bonds protect the resident against dishonest acts of facility  
          employees pertaining to the management of the refundable monies  
          and of the financial stability of the facility which has  
          accepted a future service obligation to the resident.  The bonds  
          however do not provide general liability coverage although many  
          CCRCs maintain such coverage voluntarily. 

          This bill additionally requires RCFEs to maintain liability  
          insurance or a surety bond for coverage of injury to residents  
          or guests caused by the negligent acts or omissions to act of,  
          or neglect by, the licensee or is employees.  An important  
          distinction between surety bonds and liability insurance is that  
          surety bonds represent a promise to indemnify the injured party  
          only if the bond holder is unable or unwilling to make full  
          payment; the bond company is then free to recover the costs from  
          the bond holder.  Additionally, a bond includes no requirement  
          to defend the bond holder in court, as is the case in liability  
          insurance.


           Recent events  .  A series of recent events has drawn attention to  

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          questions about the adequacy of DSS oversight and the state's  
          ability to protect people who receive services within  
          DSS-licensed facilities. 


           In July 2013, ProPublica and Frontline reporters wrote and  
            produced a series of stories on Emeritus, the nation's largest  
            RCFE provider.  Featured in the article was a woman who died  
            after receiving poor care at in a facility in Auburn,  
            California.  The series documented chronic understaffing and a  
            lack of required assessments and substandard care. 


           Reports in September 2013, prompted by a consumer watchdog  
            group that had hand-culled through stacks of documents in San  
            Diego, revealed that more than two dozen seniors had died in  
            recent years in RCFEs under questionable circumstances that  
            went ignored or unpunished by CCL.  

           In late October 2013, 19 frail seniors were abandoned at  
            Valley Springs Manor in Castro Valley by the licensee and all  
            but two staff after the state began license revocation  
            proceedings for the facility.  DSS inspectors, noting the  
            facility had been abandoned, left the two unpaid service staff  
            to care for the abandoned residents with insufficient food and  
            medication, handing them a $3,800 citation before leaving for  
            the weekend.  The next day sheriff's deputies and paramedics  
            sent the patients to local hospitals.

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

           SUPPORT  :   (Verified  6/20/14)

          California Advocates for Nursing Home Reform
          California Assisted Living Association
          California Long-Term Ombudsman Association
          California School Employees Association
          Consumer Advocates for RCFE Reform
          Consumer Attorneys of California
          County of San Diego
          Donner & Donner Attorneys at Law
          Green Bryant & French, LLP, Attorneys at Law
          Leading Age California

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          National Senior Citizens Law Center
          Progressive Law Group
          Retired Public Employees Association 
          San Diego State University School of Social Work
          Selik Law Services
          Stand Up for Rosie

           ARGUMENTS IN SUPPORT  :    According to the author's office, RCFEs  
          are not required to carry liability insurance as condition of  
          licensure under California statute or regulation.  As a result,  
          the author's office states that many facilities lack even the  
          minimum liability insurance coverage, exposing both them and  
          residents to great financial risk.  The author's office further  
          states that without an RCFE licensee maintaining liability  
          insurance, it will be difficult for a harmed resident to find an  
          attorney willing to litigate a wrongful death or neglect case  
          and that should the case be successfully litigated, an uninsured  
          facility may be forced to consider bankruptcy. 

          The author's office additionally notes that California law  
          requires family day care homes for children to either maintain  
          liability insurance or inform their residents (or resident's  
          guardians) if they don't and that California drivers are  
          required to maintain liability insurance.


           ASSEMBLY FLOOR  :  77-0, 5/15/14
          AYES:  Achadjian, Alejo, Allen, Ammiano, Bigelow, Bloom,  
            Bocanegra, Bonilla, Bonta, Bradford, Brown, Buchanan, Ian  
            Calderon, Campos, Chau, Ch�vez, Chesbro, Conway, Cooley,  
            Dababneh, Dahle, Daly, Dickinson, Eggman, Fong, Fox, Frazier,  
            Beth Gaines, Garcia, Gatto, Gomez, Gonzalez, Gordon, Gorell,  
            Gray, Grove, Hagman, Hall, Harkey, Roger Hern�ndez, Holden,  
            Jones, Jones-Sawyer, Levine, Linder, Logue, Lowenthal,  
            Maienschein, Medina, Melendez, Mullin, Muratsuchi, Nazarian,  
            Nestande, Olsen, Pan, Patterson, Perea, John A. P�rez, V.  
            Manuel P�rez, Quirk, Quirk-Silva, Rendon, Ridley-Thomas,  
            Rodriguez, Salas, Skinner, Stone, Ting, Wagner, Waldron,  
            Weber, Wieckowski, Wilk, Williams, Yamada, Atkins
          NO VOTE RECORDED:  Donnelly, Mansoor, Vacancy


          JL:d  6/24/14   Senate Floor Analyses 


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                           SUPPORT/OPPOSITION:  SEE ABOVE

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