BILL ANALYSIS �
AB 1571
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Date of Hearing: May 21, 2014
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Mike Gatto, Chair
AB 1571 (Eggman) - As Amended: April 22, 2014
Policy Committee: Human
ServicesVote:6 - 0
Urgency: No State Mandated Local Program:
Yes Reimbursable: No
SUMMARY
This bill places additional requirements on residential care
facility for the elderly (RCFE) licensee applicants and requires
the Department of Social Services (DSS) to establish a RCFE
consumer information service system, including posting
information on its website. Specifically, this bill:
1)Requires the applicant to disclose whether they are a
for-profit or not-for-profit provider.
2)Clarifies that applicants must provide information regarding
prior involvement with a RCFE in California, including a
facility located in another state or another similarly
licensed facility.
3)Requires DSS to cross check all applicant information with the
Department of Public Health (DPH) to determine if the
applicant has a prior history of operating health care
facilities.
4)Requires DSS to deny an application for licensure and
subsequently revoke a license on the grounds that the
applicant knowingly made a false statement or withheld
enforcement actions against a previously held license.
5)Requires DSS, by July 1, 2015 to post RCFE profiles on its
Internet Web site, and requires by July 1, 2017, to include on
each RCFE profile, information regarding complaints,
violations, appeals, Inspection reports and plans of
correction.
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6)Requires that, by July 1, 2019, each RCFE submit a profile of
resident characteristics to DSS.
7)Requires DSS, by July 1, 2019, to develop and implement a RCFE
rating system and states that DSS work with stakeholder
groups, in the development of the system.
8)Permits DSS to deny an application for licensure on the
grounds that the applicant has a history of noncompliance with
the requirements of a health-related facility, or a similarly
licensed facility in another state, applicable state and
federal laws and regulations, and the requirements governing
the operators of those facilities.
FISCAL EFFECT
1)On-going costs, likely minor, to DSS to cross check all
applicant information with the Department of Public Health for
prior history of operating health care facilities. DSS
indicates they do this now for applicants who self-identify
with this type of prior history.
2)One-time costs to DSS in the range of $1 million in 2014/15
and ongoing costs of approximately $700,000 for project
development, testing and maintenance and other related IT
contract work related to website improvement and the
development and implementation of a RCFE rating system.
3)On-going costs, likely minor, to maintain and periodically
update the facility rating system.
4)The Governor has proposed several budget initiatives to assist
DSS with its oversight activities, including centralized
application processing and establishing a statewide quality
assurance unit to track complaints and performance. These
budget proposals could assist with some of the requirements
outlined in this bill.
COMMENTS
1)Purpose . The author notes that consumers do not have online
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access to public information that could help them make an
informed choice when choosing a RCFE. If a consumer wants to
view a facility's record, the consumer must drive to a
regional office that may be far away and require hours of
driving. This bill seeks to remedy this by requiring DSS to
establish an on-line Consumer Information System so that
consumers have important information readily accessible.
This bill will also require complete disclosure of ownership
and prior ownership of any type of facility, in any state,
including a history of compliance and will require DSS to
cross check applicant information with the Department of
Public Health.
2)Background . RCFEs, commonly referred to as assisted living
facilities, are licensed retirement residential homes and
board and care homes that 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. RCFEs enable older persons to live independently in
a home-like environment rather than in nursing home or other
institutionalized facility. Services include personal care and
protective supervision, including incidental medical services,
based upon the needs of the resident.
There are 7,589 licensed RCFEs in California with a capacity
to serve over 176,000 residents. Licensed by DSS' Community
Care Licensing Division (CCL), RCFEs range in size from
residential homes with six or less beds to more formal
residential facilities with 100 beds or more. DSS is required
to conduct unannounced licensing inspections of the more than
75,000 licensed community care facilities, including RCFEs, at
least once every five years, more often in some circumstances.
3)DSS Website . DSS is required to operate an automated RCFE
license information system to provide information on licensees
and former licensees of RCFEs. It currently has a searchable
database of RCFEs on its website, but information is limited
to the name, location, contact information, type of facility
and whether the facility's license is current or pending. It
does not provide information such as a facility's licensing
history, staff, or its complaints history. Under current
practice, when a licensee undergoes a licensing inspection or
is subject to a complaint investigation, the information
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reported by CCLD is maintained in a paper-based format. To
acquire information on the quality of a facility, a person
must travel to one of DSS' eight regional licensing offices
and request the information in person.
In response to recent incidences in RCFEs, DSS is working to
provide more robust information of licensed RCFEs on its
website. DSS anticipates having an online searchable database
with up to five years of historical information on RCFEs,
including:
a) the name of the facility and its licensee's name and
contact information;
b) the number of substantiated, unsubstantiated, and
inconclusive complaints filed against the facility,
including complaint severity and whether a complaint
resulted in a citation;
c) the number of inspections, complaint investigations, and
general visits to the facility.
DSS anticipates the database will be available in the next few
months.
1)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
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%.
2)Related Legislation .
a) AB 1436 (Waldron, 2014) requires the DSS to post
information on its website regarding Residential Care
Facilities for the Elderly (RCFE), including results of
licensing inspections reports, consultation reports,
violations, plans of correction, appeal requests, and the
number, nature and status of complaints filed against a
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facility. This bill is pending on this committee's Suspense
File.
b) AB 1899 (Brown, 2014) requires the Department of Social
Services (DSS) to establish and maintain a telephone
hotline and an internet-based website to accept public
complaints regarding RCFEs, and requires the website to
include final actions resulting in citation, suspension, or
revocation against each licensee, indexed by name of the
licensee and by the name of the facility. This bill is
pending on this committee's Suspense File.
c) AB 2621 (Garcia, 2014) requires DSS to post similar
information on their website regarding child day care
facilities. This bill is before this committee today.
1)RCFE Reform Package . In response to a number of highly
publicized events at facilities licensed by CCL that have
raised questions regarding the state's ability to comply with
existing oversight and enforcement requirements, a number of
legislative measures are being pursued to strengthen, address
shortcomings, resolve legal liabilities and gaps in the
provision of services, and ultimately reform the RCFE
industry. Several of these measures are pending on this
committee's Suspense File.
Analysis Prepared by : Jennifer Swenson / APPR. / (916)
319-2081