BILL ANALYSIS �
AB 1571
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ASSEMBLY THIRD READING
AB 1571 (Eggman)
As Amended May 23, 2014
Majority vote
HUMAN SERVICES 6-0 APPROPRIATIONS 13-0
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|Ayes:|Stone, Maienschein, |Ayes:|Gatto, Bocanegra, |
| |Ammiano, | |Bradford, |
| |Ian Calderon, Garcia, | |Ian Calderon, Campos, |
| |Hall | |Eggman, Gomez, Holden, |
| | | |Linder, Pan, Quirk, |
| | | |Ridley-Thomas, Weber |
|-----+--------------------------+-----+--------------------------|
| | | | |
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SUMMARY : Places additional requirements on Residential Care
Facilities for the Elderly (RCFE) licensee applicants and
requires the Department of Social Services (DSS) to establish a
RCFE consumer information service system. Specifically, this
bill :
1)Deletes the requirement that an applicant for a RCFE license
identify whether they are applying as firm, association,
organization, partnership, business trust, corporation, or
company.
2)Requires the applicant to disclose whether they are a
for-profit or not-for-profit provider, which shall include the
names and license numbers of other facilities owned, managed,
or operated by the same licensee, and the names and addresses
of any persons or organizations listed as owner of record in
the real estate, including the buildings and grounds
appurtenant to the buildings.
3)Clarifies the requirement that applicants provide information
relating to any prior involvement with a RCFE in California
and adds an additional requirement that the information
include whether that prior involvement included a facility in
another state or another similarly licensed facility,
including the applicant's history of compliance applicable
state and federal laws, regulations, and licensing
requirements, as specified.
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4)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, as specified.
5)Requires specified information be provided to DSS upon initial
application for licensure, and any change in the information
shall be provided to DSS within 30 calendar days of that
change.
6)Provides that the failure of an applicant to cooperate with
DSS in the completion of an application shall result in the
denial of the application and specifies that failure to
cooperate means statutorily and regulatory required
information, as specified, has not been provided, or has not
been provided in the form requested by DSS.
7)Requires DSS to deny an application for licensure and permits
DSS to subsequently revoke a license on the grounds that the
applicant knowingly made a false statement or withheld
enforcement actions against a previously held license, as
specified.
8)Requires DSS, by July 1, 2015 to post on its Internet Web site
RCFE profiles, with data, including, but not limited to all of
the following:
a) The name, address, and telephone number of the licensed
providers, including the owner and the licensee;
b) The number of licensed beds in the facility, including
the number of nonambulatory beds;
c) Whether the facility is permitted to provide hospice
care services;
d) Whether the facility has a special care unit or program
for people with Alzheimer's disease and other dementias or
has a delayed egress or secured perimeter system in place;
and
e) Aggregate information on each facility, including, for
each of the previous five years, the number of complaints
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filed against the facility, the number of deficiencies,
enforcement actions resulting in fines against the
facility, and the amount of the fines assessed and the
amount collected.
9)Requires the system, by January 1, 2019, to the extent that
DSS's computer system can accommodate additional information,
to include on each RCFE profile all of the following:
a) Information regarding the nature of complaints, results
of complaint investigations, actions taken, and the dates
the complaints were received, investigated and closed;
b) Information regarding violations assessed, including the
type of deficiency, status of the violation, the facility's
plan of correction, when the corrections were completed,
information as to whether an appeal has been filed, whether
fines were assessed and the amount collected, and whether a
deficiency was dismissed on appeal;
c) Inspection reports and plans of correction, including
findings of the most recent inspection report and the date
that the inspection was conducted; and
d) Any resolution of an appeal pertaining to a violation or
complaint shall be updated in a timely manner.
10)Requires that, by July 1, 2019, each RCFE submit a profile of
resident characteristics to DSS on an annual basis, including,
but not limited to, the number of residents in the facility
who are bedridden, nonambulatory, receiving hospice care, have
one or more allowable health conditions, have one or more
restricted or prohibitive health conditions, or have dementia;
and requires DSS to annually include this information on the
facility profile and on the online consumer information
system.
11)Requires DSS, by July 1, 2019, to develop and implement a
RCFE rating system and states the intent of the Legislature
that DSS work with stakeholder groups, including consumer
organizations in the development of the system.
12)Requires the rating system to include at a minimum, the most
recent inspection report, as specified, and be based upon a
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facility's inspection, and other factors as determined by DSS
and stakeholders.
13)Permits DSS to deny an application for licensure on the
grounds that the applicant has a history of noncompliance with
the requirements of a licensed health clinic, health care
facility, community care facility, as defined, or a similarly
licensed facility in another state, applicable state and
federal laws and regulations, and the requirements governing
the operators of those facilities, as specified.
FISCAL EFFECT : According to the Assembly Appropriations
Committee:
1)On-going costs, likely minor, 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 as having
this type of prior history.
2)Ongoing costs of approximately $700,000 for project
development, testing and maintenance and other related IT
[information technology] 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 :
Background: It is the intent of the Legislature, in
establishing the RCFE Act, to help provide a system of
residential care to allow older persons to be able to
voluntarily live independently in a homelike environment as
opposed to being forced to live in an institutionalized
facility, such as a nursing home, or having to move between
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medical and nonmedical environments. RCFEs, commonly referred
to as assisted living facilities, are licensed retirement
residential homes and board and care homes that accommodate and
provide services to meet the varying, and at times, fluctuating
health care needs of individuals who are 60 years of age and
over, and persons under the age of 60 with compatible needs.
Licensed by the DSS Community Care Licensing Division (CCLD),
they can range in size from residential homes with six or less
beds to more formal residential facilities with 100 beds or
more.
There is also no uniform common care model; rather the types of
assistive services can vary widely, which can include differing
levels of personal care and protective supervision, based upon
the needs of the resident.
When a resident needs medical care in his or her residence in
order to maintain an independent lifestyle, incidental medical
services are permitted to be provided by a licensed or otherwise
approved external provider, such as a home healthcare agency
(HHA), which is licensed by the California Department of Public
Health. Additionally, some RCFEs, upon approval of DSS and
after having met specified orientation and training
requirements, may provide assistive memory care services to
individuals with dementia or Alzheimer's disease.
Transparency or lack thereof: Under current law, DSS is
required to operate an automated RCFE license information system
to provide information on licensees and former licensees of
licensed RCFEs. Although this requirement was established in
statute in 1985 (SB 185 (Mello) Chapter 1127, Statutes of 1985),
it is unclear how DSS is complying with this requirement. It
currently has available a searchable database of RCFEs on its
website, however 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, the expertise and
certification of staff, or its complaints history, including
whether the complaint was resolved. In order to acquire
additional information relating to the quality of a facility, a
person must travel to one of DSS' eight regional licensing
offices and request the information in person.
DSS also currently operates a webpage entitled "myccl" on its
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departmental Internet Web site. However, it is only accessible
to RCFE licensees, administrators, board members of the RCFE,
staff, or related individuals per the approval of DSS.
Other than DSS' searchable database, which is limited to general
information of RCFEs, there currently does not exist an online
or other automated system provided by DSS whereby the public can
review or learn more about licensed RCFEs. This not only limits
the public's access to information about RCFEs, but it is also
limits CCLD's internal ability to track patterns of poor care
within a single facility, much less across facilities with the
same licensee. Under current practice, when a licensee
undergoes a licensing inspection or is subject to a complaint
investigation, the information reported by CCLD is maintained in
a paper-based format. This limits CCLD's ability to track
licensees' overtime and know whether they operate other
facilities that should undergo additional scrutiny.
According to DSS, there are approximately 462 licensing program
analysts responsible for the more than 75,000 licensed community
care facilities, including RCFEs, and the nearly 1.4 million
individuals they serve, ranging from the earliest stages of life
to the end of life care. This comes to a ratio of one licensing
analyst per 162 facilities and 3,030 individuals in care.
However, due to the current statutory requirement that all
community care facilities, including RCFEs, undergo an
unannounced licensing inspection visit at least once every five
years, rather than annually as required prior to 2003, the
reliability and relevance of information included in this
database will be limited. Whereas more information would be
available for those facilities that have recently been inspected
or undergone a complaint investigation, information for a
facility that has not had any complaints filed against it nor
has undergone a licensing inspection in several years be limited
to basic demographic information related to the facility.
Analysis Prepared by : Chris Reefe / HUM. S. / (916) 319-2089
FN: 0003807
AB 1571
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