BILL ANALYSIS                                                                                                                                                                                                    �






                                  SENATE HUMAN
                               SERVICES COMMITTEE
                            Senator Jim Beall, Chair


          BILL NO:       AB 1554                                      
          A
          AUTHOR:        Skinner                                      
          B
          VERSION:       May 23, 2014
          HEARING DATE:  June 24, 2014                                
          1
          FISCAL:        Yes                                          
          5
                                                                      
          5
          CONSULTANT:    Sara Rogers                                  
          4

                                        
                                     SUBJECT
                                         
                  Residential Care Facilities for the Elderly

                                     SUMMARY  

          This bill makes numerous changes to the complaint  
          investigation process used by the California Department of  
          Social Services (CDSS) when responding to complaints  
          submitted against Residential Care Facilities for the  
          Elderly (RCFEs). This bill requires CDSS to provide notice  
          to the complainant of specified information regarding the  
          status of the complaint, requiring CDSS to attempt to  
          interview the complainant and subjects of the complaint and  
          permitting the complainant to appeal a decision made by  
          CDSS. Additionally this bill requires CDSS to conduct an  
          onsite investigation within one working day of the receipt  
          of the complaint if a complaint alleges physical abuse,  
          sexual abuse, or a threat of imminent danger of death or  
          serious harm. This bill further establishes an immediate  
          civil penalty of $1,000 for interfering with a complaint  
          investigation and for retaliating against residents or  
          staff involved in the complaint investigation, as  
          specified. This bill additionally establishes timeframes  
          for conducting a complaint investigation, as specified.

                                                         Continued---




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                                     ABSTRACT  

           Existing Law: 


           1.Establishes the Residential Care Facilities for the  
            Elderly Act which provides for the CDSS to license and  
            regulate RCFEs as a separate category within the existing  
            residential care licensing structure of CDSS. (HSC 1569  
            et seq.) 


          2.Provides that RCFEs shall be subject to unannounced  
            visits by CDSS and be visited as often as necessary to  
            ensure the quality of care provided. (HSC 1569.33)


          3.Requires annual unannounced inspections when a license is  
            on probation, when required by the terms of a facility  
            compliance plan, when an accusation is pending, when  
            required for federal financial participation, or to  
            verify that a person who has been ordered out of the  
            facility is no longer present. (HSC 1569.33)


          4.Requires CDSS to perform random inspections each year on  
            no fewer than 20 percent of the RCFE facilities not  
            subject to annual inspections. Provides that this  
            percentage shall increase by 10 percent if the total  
            citations issued by the department exceeds the previous  
            year by 10 percent. As a result of this trigger, CDSS  
            currently is required to perform random inspections on 30  
            percent of the RCFE facilities not subject to annual  
            inspection. Requires CDSS to visit every facility no less  
            than every 5 years. (HSC 1569.33) 


          5.Requires CDSS to visit a newly licensed facility within  
            90 days after a facility accepts its first resident to  
            evaluate compliance with regulatory requirements. (HSC  
            1569.24)


          6.Permits any person to request an inspection of any RCFE  





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            by transmitting notice of an alleged violation orally or  
            in writing. Requires CDSS to make a preliminary review  
            and an onsite inspection within 10 days after receiving  
            the complaint except where the visit would adversely  
            affect the licensing investigation or the investigation  
            of other agencies, including, but not limited to, law  
            enforcement agencies (HSC 1569.35) 


          7.Through regulation, requires CDSS to conduct a follow-up  
            visit within 10 working days following the latest date of  
            correction specified in the notice of deficiency, unless  
            the licensee has demonstrated that the deficiency was  
            corrected as required. Provides that no penalty shall be  
            assessed unless a follow-up visit is conducted. (Title 22  
            CCR 87759)


           This bill:


           1.Permits a person to request an investigation of an RCFE  
            by electronically making a complaint to CDSS alleging a  
            violation state statute or regulation, in addition to  
            current law providing for oral or written submission.


          2.Requires CDSS to notify the complainant of the name of  
            the officer, employee, or agent of the department who  
            will conduct the complaint investigation within two  
            working days of receiving the complaint.


          3.Requires CDSS to conduct an onsite investigation of a  
            complaint alleging physical abuse, sexual abuse, or a  
            threat of imminent danger of death or serious harm,  
            within one working day of the receipt of the complaint.


          4.Requires CDSS to give priority to a complaint filed by a  
            local long-term care ombudsman or the State Long-Term  
            Care Ombudsman alleging denial of a statutory right of  
            access to a residential care facility for the elderly.







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          5.Requires CDSS to make a good-faith effort to contact and  
            interview the complainant and inform the complainant of  
            the proposed course of action and the relevant  
            investigation deadlines; and to the extent practicable,  
            specifies that the officer, employee, or agent of the  
            department who will conduct the investigation will be the  
            representative who interviews and makes contact with the  
            complainant.

          6.Requires CDSS, when conducting an investigation to  
            consult with and, to the extent practicable, coordinate  
            an investigation of an RCFE with the investigation of the  
            facility by other agencies, including, but not limited  
            to, the Office of the State Long-Term Care Ombudsman and  
            law enforcement agencies.


          7.Requires that if CDSS suspends an investigation upon  
            request of a law enforcement agency, it shall maintain  
            written documentation of the request, continue to ensure  
            the safety of all residents, and immediately resume any  
            investigation upon consent of law enforcement or  
            completion of the criminal investigation.


          8.Prohibits CDSS from giving a licensee advance notice of  
            an investigation conducted pursuant to this section.


          9.Prohibits a licensee from interfering with or obstructing  
            a complaint investigation and establishes an immediate  
            civil penalty of one thousand dollars ($1,000) for doing  
            so.


          10.Prohibits a licensee from retaliating or discriminating  
            against residents or staff involved in the complaint  
            investigation and establishes an immediate civil penalty  
            of one thousand dollars ($1,000) for doing so.


          11.Requires CDSS to collect and evaluate all available  
            evidence necessary to complete a complaint investigation,  
            including, but not limited to, the following:






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                 Observed conditions;
                 Statements of witnesses;
                 Interviews with administration, staff, other  
               residents, family members, visitors, the long-term  
               care ombudsman, and other individuals or agencies that  
               provide services at the facility, which may have  
               information about the complaint;
                 Records from the facility and any other relevant  
               sources.


          1.Requires CDSS to complete an investigation of a complaint  
            alleging physical abuse, sexual abuse, or a threat of  
            imminent danger of death or serious harm within 30 days  
            of receiving the complaint.


          2.Requires CDSS to complete an investigation of all other  
            complaints within 90 days of receiving the complaint.


          3.Provides that the 30-day and 90-day deadlines may be  
            extended for an additional 30 days if the department has  
            diligently attempted, but has not been able, to obtain  
            necessary evidence related to the investigation.


          4.Requires CDSS to notify the complainant in writing of the  
            basis for the extension, and to include in the notice any  
            outstanding evidence, the sources from which the evidence  
            has been sought, and the anticipated completion date.


          5.Requires CDSS to notify the complainant in writing of the  
            department's determination and of the complainant's right  
            to appeal and requires the notice to describe the appeal  
            process and to include a copy of any reports and  
            documents describing violations and enforcement actions  
            resulting from the investigation.


          6.Permits a complainant who is dissatisfied with the  
            department's investigation, findings, or enforcement  
            actions resulting from the investigation to file an  





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            appeal by notifying the program manager of the officer,  
            employee, or agent of the department conducting the  
            investigation in writing within 15 days after receiving  
            the notice of the department's determination. 


          7.Requires the CDSS program manager to schedule a meeting  
            or teleconference with the complainant within 30 days of  
            receiving an appeal and to carefully review the concerns,  
            information, and evidence presented by the complainant to  
            determine whether the department's findings or actions  
            should be modified or whether further investigation is  
            necessary. 


          8.Provides that if a complainant is dissatisfied with the  
            program manager's determination on an appeal, the  
            complainant may file an appeal in writing with the  
            department's Deputy Director of the Community Care  
            Licensing Division and  requires the deputy director or  
            his or her designee to interview the complainant,  
            consider any information presented or submitted by the  
            complainant, and review the complaint record to determine  
            whether the department's findings or actions should be  
            modified or whether further investigation is necessary. 


          9.Establishes that the above provisions become operative on  
            July 1, 2015.

                                  FISCAL IMPACT  

           
           An Assembly Appropriations analysis states there are  
          on-going costs to CDSS, likely in the range of $200,000 to  
          $400,000, for additional personnel to review complaints,  
          confer with complainants, and potentially investigate  
          complaints within the required time frame.


                            BACKGROUND AND DISCUSSION  

           Purpose of the bill:







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           According to the author, California's current inspection  
          requirements for RCFEs fail to adequately ensure the health  
          and safety of our fast growing elderly population. The  
          author states that due to the lack of regular inspections  
          of RCFEs, it is critical that the Community Care Licensing  
          Division (CCL) have a strong and effective complaint  
          investigation system to identify and stop instances of  
          abuse and neglect. 


          Specifically, the author states that CCL's current  
          complaint investigation system is plagued by problems of  
          inadequate investigation, poor communication with  
          complainants, lack of transparency, weak enforcement, and  
          appeal procedures that protect operators and imperil  
          residents. Additionally, the author notes that CCL does not  
          send written findings to complainants except upon request,  
          and does not give complainants an opportunity to appeal  
          CCL's findings. The author states that even when complaints  
          are substantiated, meaningful enforcement action by CCL is  
          very rare.


          The sponsor states that this bill is one of a package of  
          bills responding to recent events that have led to concerns  
          with the adequacy of CDSS oversight and the state's ability  
          to protect people who reside in RCFEs. 


           In July 2013, ProPublica and Frontline reporters wrote  
            and produced a series of stories on Emeritus, the  
            nation's largest RCFE provider.<1> 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  
          -------------------------


          <1>  
          http://www.propublica.org/article/life-and-death-in-assisted 
          -living-single






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            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.<2> 


           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. CDSS 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.


           In February, 2013, a Sacramento-based RCFE provider with  
            an extensive 17-year history of licensing violations was  
            charged with involuntary manslaughter by the state  
            Attorney General after a resident died as the result of  
            developing stage IV bedsores while under the care of the  
            facility.


           Residential Care Facilities for the Elderly


           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 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  
          -------------------------


          <2> "Care Home Deaths Show System Failures," San Diego  
          Union Tribune, Sept.7, 2013






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          diabetes, bedsores, or require the use of oxygen tanks,  
          catheters, colostomies or ileostomies.  


          The RCFE licensure category includes facilities with as few  
          as six beds to those with hundreds of residents, whose  
          needs may vary widely. Typically, the smaller facilities  
          are homes in residential neighborhoods while the larger  
          facilities resemble apartment complexes with structured  
          activities for their residents. Residents may live in their  
          own apartments, or may share a bedroom. Generally,  
          residents are free to leave the facility if they choose,  
          and may entertain guests, and otherwise maintain a high  
          level of independence. Facilities licensed to serve  
          residents with dementia or Alzheimer's disease, also known  
          as "memory care units" may maintain a secure perimeter. 





          Regulatory Oversight


          The Community Care Licensing (CCL) division of CDSS  
          provides the primary public oversight over the quality and  
          care provided in RCFE facilities. Prior to January 2004,  
          CCL conducted annual visits of all RCFEs and other licensed  
          facilities within its jurisdiction. However, as a result of  
          a series of budget cuts beginning in 2003, CCL began  
          inspecting facilities based on a random sample protocol.  
          Under this scenario, those facilities that warrant close  
          monitoring because of a poor history of compliance are  
          monitored annually, as well as facilities that are  
          federally required to be inspected annually. Typically,  
          this comprises about 10 percent of all facilities. Of the  
          remaining 90 percent, approximately 30 percent are randomly  
          selected for inspection each year. The five-year inspection  
          mandate was intended to catch facilities that are not  
          randomly selected at least that often for inspection.


          A 2008 study published by the California Health Care  
          Foundation investigating the impact on the truncated  
          frequency of visits found that "routine visits were  





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          replaced with significant increases in the number of  
          complaint and problem-driven visits" and that "the  
          monitoring of quality of care in RCFEs has become a  
          complaint and problem driven process."<3> CCL has  
          repeatedly sought to restore the cuts made to licensing,  
          arguing that the cuts to staff and resulting changed  
          protocols "have put client health and safety at risk. By  
          not consistently inspecting facilities, or inspecting a  
          facility only as the result of a complaint, CCL LPAs have  
          lost rapport with licensees, which in turn has not been  
          conducive to helping clients in those facilities."<4>


          Joint Hearing on RCFEs


          On February 11, 2014, the Senate and Assembly Human  
          Services Committees jointly held an informational hearing  
          investigating efforts to increase accountability and  
          oversight of Assisted Living Facilities. Testimony during  
          the hearing highlighted significant technological barriers  
          to the tracking of complaints and deficiencies, limited  
          follow-up practices by the department to ensure that  
          deficiencies are corrected, frequent failure to collect  
          assessed fines and penalties, a lengthy appeals process  
          that hinders immediate action when necessary, and use of a  
          shortened inspection tool that has not been validated for  
          use in RCFEs.   


          2014-15 Budget Act

          The 2014-2015 budget includes new staff resources, proposed  
          by the Governor, to establish a statewide quality assurance  
          unit, which will report directly to the Deputy Director of  
          Community Care Licensing to focus on conducting reviews at  
          -------------------------


          <3> Inspection Visits in Residential Care Facilities for  
          the Elderly. C. Flores, A. Bostrom, and R. Newcomer.  
          California Health Care Foundation, 2008.


          <4> Department of Social Services spring finance letter  
          CCLD-1, 2011-12






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          the division, program and regional office levels to do the  
          following:


           Identify immediate health and safety risks to clients and  
            ensure appropriate follow-up
           Develop a statewide quality assurance review model
           Identify training needs on the basis of quality assurance  
            reviews
           Coordinate licensing case file responses to Public Record  
            Act requests, include redaction as necessary
           Identify policy, procedural, and information systems  
            weaknesses, and
           Ensure that policies, procedures, laws and regulations  
            are followed consistently.


          Additionally, the Governor proposed the addition of six new  
          Special Investigator Assistants to support the CDSS  
          Investigators who have peace officer status and who are  
          cited as essential to improving the timeliness of  
          investigations, and the establishment of a statewide  
          toll-free hotline to receive and review public complaints.  
          He also proposed an expansion of the Licensing Program  
          Analyst training for the LPAs who are responsible for  
          responding to complaints.


           Related Legislation


           SB 895 (Corbett) 2014 requires CDSS to conduct annual  
          unannounced comprehensive inspections for all facilities by  
          2018, requires CDSS to verify compliance following  
          deficiencies within 10 days, and requires results of  
          inspections to be available on the CDSS website. This bill  
          is before the Assembly Appropriations Committee.


          AB 1436 (Waldron) 2014 would have required the results of  
          all reports of inspections, evaluations or consultations  
          and lists of deficiencies to be posted on the department's  
          Internet Web site. This bill was held in Assembly  
          Appropriations.






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          AB 1454 (Calderon) 2014 would require all licensed  
          community care facilities, RCFEs, and child day care  
          centers to be subject to an annual unannounced visits visit  
          by CDSS. This bill is before the Senate Appropriations  
          Committee.


          AB 2171 (Wieckowski) 2014 would establish specified RCFE  
          resident's rights and require facilities to inform  
          residents of these rights as specified. This bill is before  
          the Senate Judiciary Committee.


          AB 2236 (Mainschein) 2014 would establish a new civil  
          penalty structure for RCFEs. This bill is being heard by  
          this committee today.


          AB 581 (Ammiano) Chapter 295, Statutes of 2013 strengthened  
          protections against retaliation or discrimination when  
          complaints are made. 



                                     COMMENTS

           CDSS is unable to provide any substantive information  
          regarding the actions taken in response to complaints aside  
          from whether the complaint was substantiated. It is not  
          clear whether the department returns to the facility to  
          ensure compliance, despite existing law that requires they  
          do so, and despite daily penalties that are required to be  
          assessed until the facility complies with the requirements  
          of the deficiency notice. 


          Currently, CDSS is required to visit RCFE facilities only  
          once every five years and those required inspections have  
          been significantly abbreviated using a "key indicator tool"  
          which has not been validated as a sound method for  
          predicting whether a facility is adequately meeting the  
          needs of residents. As a result, the complaint process is  
          often the only effective tool to enforce quality issues in  
          community care facilities, including RCFEs. In this regard,  





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          this bill makes helpful statutory changes that increase the  
          department's accountability to ensuring that complaints are  
          thoroughly considered.


          Staff notes that provisions of this bill that permit any  
                                                                                     and every complaint to be brought before the Deputy  
          Director of the Community Care Licensing Division appear  
          excessive, though an internal level of review within the  
          department may be appropriate. Additionally, provisions of  
          this bill require the department to provide notice to a  
          complainant of any "outstanding evidence and the sources  
          from which the evidence has been sought" when seeking to  
          extend the timeframe needed to conduct an investigation.  


          Further, staff notes that this bill would establish an  
          immediate civil penalty of $1,000 for interfering with a  
          complaint investigation, which is substantially higher than  
          the $150 maximum for serious offenses under current law,  
          including death of a resident. Staff notes that the  
          recently enacted budget included intent language for the  
          legislature to comprehensively address penalties for all  
          community care facilities.


          Staff recommends the following amendments:


          Page 6, Lines 16-23:


          (2) The 30-day and 90-day deadlines in paragraph (1) may be  
          extended for an additional 30 days if the department has  
          diligently attempted, but has not been able, to obtain  
          necessary evidence related to the investigation. Whenever  
          the department exercises this authority, it shall notify  
          the complainant in writing of the basis for the extension,  
          and shall include   in the notice any outstanding evidence,  
          the sources from which the evidence has been sought, and    
          the anticipated completion date.


          Page 6, Lines 36-40 and Page 7, Lines 1-11:






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          (j) (1) A complainant who is dissatisfied with the  
          department's investigation, findings, or enforcement  
          actions resulting from the investigation may file an appeal  
          by notifying the program manager of the officer, employee,  
          or agent of the department conducting the investigation in  
          writing within 15  working  days after receiving the notice  
          described in subdivision (i). The program manager shall  
          schedule a meeting or teleconference with the complainant  
          within 30  working  days of receiving an appeal. The program  
          manager shall carefully review the concerns, information,  
          and evidence presented by the complainant to determine  
          whether the department's findings or actions should be  
          modified or whether further investigation is necessary.  
          Within 10  working  days after conducting the meeting or  
          teleconference with the complainant, the program manager  
          shall notify the complainant in writing of the department's  
          determinations and actions concerning the appeal and of the  
          appeal rights provided in paragraph (2).


          (2) If a complainant is dissatisfied with the program  
          manager's determination on an appeal, the complainant may,  
          within 15  working  days after receipt of this determination,  
          file an appeal in writing with the   department's Deputy  
          Director    Quality Assurance Unit  of the Community Care  
          Licensing Division. Within 30  working  days of receiving an  
          appeal,  a representative of the Quality Assurance Unit   
          shall interview the complainant, consider any information  
          presented or submitted by the complainant, and review the  
          complaint record to determine whether the department's  
          findings or actions should be modified or whether further  
          investigation is necessary. No later than 10  working  days  
          after completing this review, the deputy director shall  
          notify the complainant in writing of the department's  
          determinations and actions concerning the appeal.


          Page 5, Lines 31-38 


          (f) A licensee, or officer or employee of the licensee,  
          shall not interfere with or obstruct an investigation  
          conducted pursuant to this section. The department shall  
          assess an immediate civil penalty   of one thousand dollars  





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          ($1,000)    equal to the penalty established for a serious  
          violation under Section 1569.49 (c)  per day per violation  
          for violations of this subdivision. In addition to  
          assessing that penalty, the department may take any other  
          enforcement actions authorized by this chapter for  
          violations of this subdivision. 


          Page 11, Lines 17-23


          (b) The department shall assess an immediate civil penalty  
          in the amount   of one thousand dollars ($1,000)    equal to the  
          penalty established for a serious violation under Section  
          1569.49 (c)  per day for each violation of this section. In  
          addition to assessing that penalty, the department may take  
          any other enforcement actions authorized by this chapter  
          for violations of this section.


                                   PRIOR VOTES  

          Assembly Floor           78 - 0
          Assembly Appropriations       16 - 0
          Assembly Aging and Long Term Care  7 - 0
          Assembly Human Services         6 - 0
           

                                   POSITIONS  

          Support:       California Advocates for Nursing Home Reform  
          (Sponsor)
                         AARP
                         California Long-Term Care Ombudsman  
                    Association
                         California Retired Teachers Association
                         Consumer Federation of California
                         County of San Diego
                         County Welfare Directors Association
                         Law Offices of Sanford Horowitz 
                         National Association of Social Workers
                         Retired Public Employees Association
                         Stanislaus County Commission on Aging
                         2 individuals






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          Oppose:   None received.

                                   -- END --