BILL ANALYSIS �
AB 1570
Page 1
Date of Hearing: May 7, 2014
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Mike Gatto, Chair
AB 1570 (Chesbro) - As Amended: April 22, 2014
Policy Committee: Human
ServicesVote:6 - 0
Urgency: No State Mandated Local Program:
Yes Reimbursable: No
SUMMARY
This bill increases training requirements for licensees and
staff of RCFEs. Specifically, this bill:
1)Increases the training requirement for RCFE licensee
certification training programs from 40 to 100 hours of
required coursework, which shall include at least 40 hours of
coursework that shall be attended in person.
2)Expands the list of items covered in the RCFE licensee
certification training program.
3)Clarifies that a RCFE licensee applicant is required to pass a
state-administered exam, rather than a written exam, and
requires the Department of Social Services (DSS) to review and
revise the exam every two years to reflect changes in laws and
regulations.
4)Increases the training requirement for a RCFE staff person
from 10 hours of training within the first four weeks of
employment to 40 hours of training prior to working
independently with residents.
5)Requires the staff person training to include 24 hours of
coursework training, which shall include 12 hours of training
relating to dementia care, and 16 hours of hands-on training;.
6)Requires DSS to establish regulations, in consultation with
provider organizations, to develop the staff person training
subject matter, which shall additionally include training on
dementia care and the misuse of antipsychotic medication.
AB 1570
Page 2
7)Expands the requirement to annually complete eight hours of
continuing education in dementia care to include all RCFE
staff.
FISCAL EFFECT
1)Ongoing costs to Department of Social Services in the range of
$300,000 (GF) to review certification training programs,
proctor and process completed tests, review applications,
process certificates and perform related administrative
functions.
2)Significant ongoing increase in training costs to employees
and/or facilities to meet the enhanced initial and continuing
education training requirements imposed.
3)Potential minor non-reimbursable local enforcement costs for
violations of any of the provisions of this measure.
COMMENTS
1)Purpose . The author notes that the current requirements for
RCFE administrator and caregiver training have not been
revised in many years, despite the changes in resident needs
and despite higher standards being imposed by some licensees
themselves. This has led to significant criticism and raised
questions regarding the quality and quantity of staff and
administrator training overall. The administrator exam itself
has come under fire for not having been updated in many years
to reflect changing laws and regulations. This bill will
increase the current requirements and ensure that all RCFE
administrators and direct care staff have the appropriate
level of training and that the training covers the essential
topics.
2)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.
RCFEs range in size from residential homes with six or fewer
beds to more formal residential facilities with 100 beds or
more. These residences provide personal care and supervision
or health related services to persons who are 60 years of age
and over, who voluntarily choose to reside in the facility.
AB 1570
Page 3
RCFEs enable older persons to live independently in a
home-like environment rather than in nursing home or other
institutionalized facility.
More than 20 years have passed since existing RCFE licensing
certification requirements have been changed. The last noted
revision was through the enactment of AB 1615 (Hannigan),
Chapter 848/1991, which required prospective licensees to
undergo an orientation training prior to commencing the
licensee certification process.
3)RCFE licensee requirements . Currently, licensees and
administrators of RCFEs are required to undergo 40 hours of
training and complete a written exam. However, as noted by the
DSS, "Currently, no proctoring protocol exists, resulting in
no statewide uniformity on how the exams are administered.
This lack of consistency and guidance results in errors and
can ultimately result in candidates getting certified who may
not meet the minimum qualifications."
Concerns have also been raised by advocates about the rigor
and relevance of the administrator exam. According to DSS,
approximately 500 people take the administrator certification
test each month. However, there is no requirement under law
that the exam reflects what is provided in the 40 hours of
administrator/licensee training required for completion prior
to taking the certification exam.
4)RCFE staff requirements . Licensees employ a wide range of
staff to privde day-to-day support and care for residents of
RCFEs. Staff who assist residents with personal activities of
daily living are required to be at least 18 years of age and
undergo 10 hours of training within four weeks of being
employed by the RCFE and four hours of training each year
thereafter. There are additional training requirements for
staff who provide dementia care or who assist residents with
managing their medication. All staff must pass a criminal
background check and demonstrate they are physically and
mentally capable of performing assigned tasks.
5)Governor's Budget . In response to recent health and safety
issues discovered at facilities licensed by the CCLD, the
2014-15 Governor's Budget proposes a comprehensive plan to
reform the CCLD program. This proposal includes an increase of
$7.5 million ($5.8 million General Fund) and 71.5 positions to
AB 1570
Page 4
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 increases
civil penalties assessed for violations and increases
licensing and application fees by 10%. Another component of
the plan proposes to strengthen the Administrator
Certification Section to develop regulations, protocols, and
new examinations to ensure the testing environment and
procedures are uniform statewide.
6)Related Legislation . SB 911 (Block, 2014) would increase the
initial and continuing education training requirements for
licensees, administrators, and direct care staff of RCFEs. In
addition, this bill would prohibit discrimination or
retaliation in any manner against a resident or employee for
calling 911. This bill is pending on the Senate Appropriations
Suspense File.
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 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 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.
7)Opposition . Some facility and reform groups are opposed to
this bill. They argue that the increased training required in
this bill will not improve the quality of care provided to
residents because no level of mastery or competency is
required and the exam does not accommodate those not fluent in
English. Small facilities worry about the added costs of
AB 1570
Page 5
meeting the training requirements.
Analysis Prepared by : Jennifer Swenson / APPR. / (916)
319-2081