BILL ANALYSIS �
Senate Appropriations Committee Fiscal Summary
Senator Kevin de Le�n, Chair
AB 1554 (Skinner) - Residential care facilities for the elderly:
complaint investigation process.
Amended: June 26, 2014 Policy Vote: Human Services 4-0
Urgency: No Mandate: Yes
Hearing Date: August 4, 2014
Consultant: Jolie Onodera
This bill meets the criteria for referral to the Suspense File.
Bill Summary: AB 1554 would make numerous changes, effective
July 1, 2015, to the complaint investigation process used by the
Department of Social Services (DSS) when responding to
complaints submitted against residential care facilities for the
elderly (RCFEs) and affords complainants with two levels of
appeal. This bill would also require the DSS to assess an
immediate civil penalty, as specified, for interfering with a
complaint investigation or for retaliating against residents or
staff involved in the investigation, as specified.
Fiscal Impact:
Potentially significant ongoing costs in the range of
$250,000 to $500,000 (General Fund) for DSS to review
complaints, confer with complainants, conduct complaint
investigations, provide notifications, and conduct the
two-tiered appeals process within the prescribed timeframes.
Potentially significant enforcement costs (General Fund) to
DSS to immediately assess civil penalties, as specified,
offset to a minor degree by civil penalty collections. Costs
would be dependent not only on the volume of enforcement
actions requiring DSS assessment of the civil penalty, but
also on the level of resources required to determine if such
a civil penalty assessment is warranted.
Background: The Community Care Licensing Division (CCLD) of the
DSS administers the licensure and oversight of over 7,500
assisted living, board and care, and continuing care retirement
homes that are licensed as RCFEs in California. These residences
are designed to provide home-like environment housing options to
elderly residents who need assistance with activities of daily
living but otherwise do not require continuous, 24-hour
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assistance or nursing care. The RCFE licensure category includes
facilities with as few as six beds to facilities with hundreds
of residents whose needs may vary widely.
In response to recent health and safety issues discovered at
facilities licensed by the CCLD, the 2014 Budget Act includes
funding for a comprehensive plan to reform the CCLD program. The
Budget includes 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 Budget
also increases licensing and application fees by 10 percent.
Proposed Law: This bill would make numerous changes, effective
July 1, 2015, to the complaint investigation process used by the
DSS when responding to complaints submitted against RCFEs.
Specifically, this bill:
Permits a person to request an investigation of an RCFE
by electronically making a complaint to DSS, in addition to
current law providing for oral or written submission.
Requires DSS 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.
Requires DSS 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.
Requires DSS to give priority to a complaint filed by a
local LTC ombudsman or the State LTC Ombudsman alleging
denial of a statutory right of access to a RCFE.
Requires DSS 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.
Requires DSS, 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 LTC Ombudsman and law enforcement
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agencies.
Requires that if DSS 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.
Prohibits DSS from giving a licensee advance notice of
an investigation conducted pursuant to this section.
Prohibits a licensee from interfering with or
obstructing a complaint investigation and establishes an
immediate civil penalty, as specified, for doing so.
Prohibits a licensee from retaliating or discriminating
against residents or staff involved in the complaint
investigation and establishes an immediate civil penalty
for doing so.
Requires DSS to collect and evaluate all available
evidence necessary to complete a complaint investigation,
as specified.
Requires DSS 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, with all other investigations to
be completed within 90 days of receiving the complaint.
Provides that the 30-day and 90-day deadlines may be
extended for an additional 30 days if the DSS has
diligently attempted, but has not been able, to obtain
necessary evidence related to the investigation.
Requires DSS 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.
Requires DSS to notify the complainant in writing of the
DSS 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.
Permits a complainant who is dissatisfied with the
department's investigation, findings, or enforcement
actions resulting from the investigation to file an
appeal by notifying the DSS in writing within 15 days after
receiving the notice of the determination.
Requires the DSS program manager to schedule a meeting
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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 DSS findings or actions should be
modified or whether further investigation is necessary.
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 DSS
findings or actions should be modified or whether further
investigation is necessary.
Establishes that the above provisions become operative
on July 1, 2015.
Requires the DSS to assess an immediate civil penalty,
in the amount equal to the penalty established for a
serious violation, as specified, for violations of the
section providing that no licensee shall discriminate or
retaliate in any manner against any person receiving
services or against any employee who has filed a complaint
or grievance with the DSS or requested an investigation, as
specified.
Related Legislation: 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 895 (Corbett) RCFEs: annual inspections.
SB 911 (Block) RCFEs: training and certification.
SB 1153 (Leno) RCFEs: suspension of new admissions.
SB 1382 (Block) RCFEs: licensure fees.
AB 1436 (Waldron) RCFEs: internet posting of inspection reports.
AB 1454 (Calderon) care facilities: annual inspections.
AB 1523 (Atkins) RCFEs: liability insurance.
AB 1570 (Chesbro) RCFE: training.
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.
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AB 2171 (Wieckowski) RCFEs: residents' rights.
AB 2236 (Maienschein) care facilities: penalties.
Staff Comments: In order to comply with the revised complaint
investigation processes and timelines established in this bill,
the DSS would incur additional costs above what was provided in
the 2014 Budget for investigations in the range of $250,000 to
$500,000 annually. Specifically, this bill allows complaints to
be submitted electronically, which could increase the volume of
complaints received, which in turn would increase the workload
involved reviewing complaints, conferring with complainants,
conducting complaint investigations, providing notifications,
and conducting the two-tiered appeals process within the
prescribed timeframes of the bill.
This bill also requires the DSS to assess an immediate civil
penalty for violations of the section providing that no licensee
shall discriminate or retaliate in any manner against any person
receiving services or against any employee who has filed a
complaint or grievance with the DSS or requested an
investigation, as specified. The costs associated with this
provision would be dependent not only on the volume of civil
penalties assessed, but also on the level of workload required
for DSS to determine if such a civil penalty assessment is
warranted in each case.
As noted above, the 2014 Budget Act includes funding for a
comprehensive plan to reform the CCLD program. The Budget
includes 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. While the Budget includes
positions to improve the timeliness of investigations, it did
not contemplate an expedited process for complaint
investigations as mandated under the provisions of this bill,
nor did it provide for the two levels of appeals for
complainants dissatisfied with DSS investigations, findings, or
enforcement actions resulting from the investigations.
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