BILL ANALYSIS                                                                                                                                                                                                    �






                                  SENATE HUMAN
                               SERVICES COMMITTEE
                            Senator Jim Beall, Chair


          BILL NO:       AB 1571                                      
          A
          AUTHOR:        Eggman                                       
          B
          VERSION:       May 23, 2014
          HEARING DATE:  June 24, 2014                                
          1
          FISCAL:        Yes                                          
          5
                                                                      
          7
          CONSULTANT:    Sara Rogers                                  
          1

                                        

                                     SUBJECT
                                         
           Residential Care Facilities for the Elderly: licensing and  
                                   regulation

                                     SUMMARY  

          This bill expands the scope of information that prospective  
          Residential Care for the Elderly (RCFE) licensees must  
          provide to the California Department of Social Services  
          (CDSS). Additionally, this bill requires CDSS to  
          cross-check all applicant information with the California  
          Department of Public Health (CDPH). This bill requires CDSS  
          to post specified information regarding RCFE facilities on  
          its internet website within specified timeframes. This bill  
          also requires CDSS, by July 1, 2019, to develop and  
          implement a RCFE rating system designed to allow consumers  
          to compare RCFEs.


                                     ABSTRACT  
          
           Existing Law:


                                                         Continued---




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           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.Requires applicants for an RCFE license to file an  
            application which includes a criminal record clearance,  
            employment history, character references, evidence of  
            certification, and disclosure of previous service in  
            other RCFEs, outpatient health clinics, health facilities  
            (including hospitals, skilled nursing facilities or  
            intermediate care facilities), or a community care  
            facility, and other requirements. (HSC 1569.15)


          3.Within the application, requires the applicant to  
            disclose prior or present service as an administrator,  
            general partner, corporate officer or director of, or as  
            a person who has held or holds a beneficial ownership of  
            10 percent or more in, any RCFE, health facility or  
            community care facility. (HSC 1569.15 (d))


          4.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)


          5.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) 






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          6.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)


          7.Permits any person to request an inspection of any RCFE  
            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) 


           This bill:


           1.Requires an applicant for an RCFE license to disclose  
            whether the licensee is a for-profit or not-for-profit  
            provider, 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 belonging to  
            the buildings.


          2.Expands current requirement to disclose ownership of  
            other community care facilities, health facilities or  
            RCFEs to additionally require disclosure of other  
            similarly licensed facilities, and the applicant's  
            history of compliance with the requirements imposed under  
            those licenses.


          3.Requires a licensee to disclose evidence of the right of  
            possession of the facility at the time the application is  
            granted, as specified and including the names and  
            addresses of any persons or organizations listed as  
            owners of the real estate.







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          4.Requires CDSS to cross-check all applicant information  
            with CDPH to determine an applicant's prior history of  
            operating, holding a position in, or having ownership in  
            a health facility.


          5.Requires an applicant to provide information upon initial  
            application of licensure and requires changes in the  
            information to be disclosed within 30 days of the change.


          6.Requires CDSS to post the following information on its  
            internet website by July 1, 2015:

                     Name, address and telephone number of licensed  
                 providers, including the owner and the licensee;
                     Number of licensed beds in the facility,  
                 including the number of nonambulatory beds; 
                     Whether the facility is permitted to provide  
                 hospice care services;
                     Whether the facility has a special unit or  
                 program for people with Alzheimer's disease and  
                 other dementias and has a delayed egress or secured  
                 perimeter;
                     Other information statutorily required to be  
                 included in an RCFE license application including  
                 evidence that the licensee is of reputable and  
                 responsible character, has financial resources to  
                 meet the regulatory requirements for the level of  
                 care the facility intends to provide, and others.
                     Five years of aggregate information on the  
                 number of complaints, deficiencies, enforcement  
                 actions resulting in fines and the amount of any  
                 fines;
                     Department actions including license  
                 suspensions, revocations, probations, settlements,  
                 stipulations, accusations, audits, noncompliance  
                 conference summaries or other administrative or  
                 legal actions, and when the administrative or legal  
                 action was taken, and will be terminated.


          1.Requires CDSS, to the extent that its computer system can  
            accommodate additional profile information, to post the  
            following information on its internet website as soon as  





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            possible but no later than January 1, 2019:


                     Complaints, including the nature of complaints,  
                 results of complaint investigations, actions taken,  
                 and the dates the complaints were received,  
                 investigated and closed; 
                     Violations assessed, including the type of  
                 deficiency, status of the violation, the facility's  
                 plan of correction, when the corrections were  
                 completed, whether an appeal has been filed, whether  
                 fines were assessed and the amount collected, and  
                 whether a deficiency was dismissed on appeal; 
                     Inspection reports and plans of correction,  
                 including findings of the most recent inspection  
                 report and the date that the inspection was  
                 conducted; and 
                     Any resolution of an appeal pertaining to a  
                 violation or complaint shall be updated in a timely  
                 manner. 


          1.Requires by July 1, 2019, that each RCFE submit a profile  
            of resident characteristics to CDSS 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 CDSS to  
            include this information on the facility profile and on  
            the online consumer information system annually.


          2.Requires CDSS, by July 1, 2019, to develop and implement  
            a RCFE rating system designed to allow consumers to  
            compare RCFEs.


          3.Requires the rating system to include at a minimum, the  
            most recent inspection report, as specified, and be based  
            upon a facility's inspection, and other factors  
            determined by CDSS and stakeholders. 


          4.Requires CDSS to ensure the confidentiality of personal  





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            and identifying information of residents and employees as  
            specified.


          5.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 IMPACT
                                         
          According to an Assembly Appropriations analysis, this bill  
          would result in ongoing minor costs for CDSS to cross check  
          all applicant information with CDPH for prior history of  
          operating health care facilities. CDSS indicates they do  
          this now for applicants who self-identify with this type of  
          prior history. Additionally, the analysis projects one-time  
          costs to CDSS 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.  
          Finally, the committee projects ongoing costs, likely  
          minor, to maintain and periodically update the facility  
          rating system.



                            BACKGROUND AND DISCUSSION


            Purpose of the bill:


           According to the author, consumers of RCFEs do not have  
          access to substantive facility information that may help  
          them make a more informed choice when selecting a facility.  
          Additionally, the author states that the departments of  
          Public Health and Social Services are not required to  
          communicate when an applicant applies for an RCFE license.   





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          This bill is sponsored by California Advocates for Nursing  
          Home Reform (CANHR) as one of a large package of bills  
          responding to a series of recent events calling into  
          question the adequacy of CDSS oversight and the state's  
          ability to protect people who reside in RCFEs.


          Specifically, 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. 


          Additionally, reports in September 2013, prompted by a  
          consumer watchdog group that had hand-culled through stacks  
          of 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 the Community Care Licensing Division of CDSS.<2> 


          Most recently, 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.
          -------------------------


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


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






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          The author notes that the owner of this facility had  
          previously owned a nursing home facility licensed by CDPH.  
          Over the course of that ownership, the owner lost the  
          nursing home license and had significant accumulated fines.  
          The author states that if CDSS had been required to cross  
          check an applicant's information with CDPH, the incident  
          may have been prevented.


          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  
          diabetes or 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 apartment, 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. 


          Financial Structure





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          More than 90 percent of RCFE licenses in California are  
          held by for-profit providers, and the majority of those  
          facilities have six or fewer beds.<3> Most residents pay  
          privately or with long-term care insurance since there is  
          very little public funding available through Medi-Cal,  
          Supplemental Security Income (SSI/SSP) or Medicare, and  
          fees can range from $2,500 to more than $8,000 per month. A  
          very few beds are available to seniors who pay their entire  
          SSI/SSP checks in rent. In 2013 the maximum SSI/SSP grant  
          was $866.40. Residents who rely solely on Social Security  
          Income may have a maximum payment of $2,642 per month in  
          2014, although the amount varies widely based on the  
          recipient's prior income while working.


          Increasingly, complex corporate mergers and acquisitions  
          have meant that many RCFEs are owned by national corporate  
          chains that control more than one facility. Administrators  
          employed by these chains may also oversee multiple  
          facilities. This development has led to regulatory  
          challenges since Community Care Licensing citations and  
          other licensing reports are facility specific, and  
          management problems common to multiple RCFEs with the same  
          owner may easily go unnoticed.


          Licensee and administrator requirements


          California statute differentiates between facility  
          licensees, who often are the business owners and may be  
          property owners, and administrators, who are charged with  
          overseeing the quality of the day-to-day operations and are  
          generally required to be present at the facility during  
          normal working hours.


          State law requires prospective RCFE licensees to provide  
          -------------------------


          <3> "Residential Care in California: Unsafe, Unregulated &  
          Unaccountable," California Advocates for Nursing Home  
          Reform, 2013






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          evidence that he or she is of "reputable and responsible  
          character"<4> including a criminal background clearance,  
          employment history and character references. Licensees must  
          document sufficient financial resources to maintain the  
          standard of care required by law, must disclose any prior  
          role as an administrator or owner of any community care  
          facility and any prior disciplinary action. In order to be  
          certified, each licensee must complete at least 40 hours of  
          classroom instruction covering relevant laws and  
          regulations, management of staff, physical and psychosocial  
          needs of elderly residents, and other issues.


          Administrators are required to hold a department-approved  
          certificate, similar to the licensee certificate, which  
          must be renewed every two years. Other requirements for  
          administrators are that they must be at least 21 years of  
          age, have a high-school diploma and undergo a criminal  
          record clearance. Those working in larger facilities are  
          required to meet additional educational or experience  
          requirements. Facility administrators may lose  
          certification if they are found to have "engaged in conduct  
          which is inimical to the health, morals, welfare, or safety  
          of either an individual in or receiving services from the  
          facility or the people of the State of California."<5>


          2014-15 Budget Act

          Included in the 2014-2015 budget are new staff resources to  
          establish a statewide quality assurance unit, which will  
          report directly to the Deputy Director of Community Care  
          Licensing. The unit will focus on conducting reviews at the  
          division, program and regional office levels to do the  
          following:


           Identify immediate health and safety risks to clients and  
            ensure appropriate follow-up
          -------------------------
          <4> HSC 1569.15


          <5> Title 22 CCR 87408






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           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 proposal calls for 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. The proposal also calls for the  
          establishment of a statewide toll-free hotline to receive  
          and review public complaints and for an expansion of the  
          Licensing Program Analyst training for the LPAs who are  
          responsible for responding to complaints.


          Transparency


          Existing law requires CDSS to publish and make available  
          lists of all licensed RCFEs and to develop a written notice  
          to be provided by RCFEs to interested parties, informing  
          them that the department licensing analyst inspection  
          reports on all RCFEs are on file and are available for  
          public view in the departments community care licensing  
          district office nearest to each RCFE.<6> RCFEs are required  
          to publish the current license number in all outreach  
          materials and correspondence. These materials, while  
          available online in other states, can only be accessed by  
          the public by physically visiting a regional office and  
          requesting the inspection reports.


          CDSS publishes on its website a "myccl" webpage in which  
          the public can search for providers of adult residential  
          care and child care by zip code. Information found on the  
          -------------------------


          <6> HSC 1569.76






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          website includes the facility's license number, its  
          capacity and which CDSS district office houses additional  
          materials. However, the website does not provide  
          information about citations or sanctions against providers.  
          The primary reason for this is a technology barrier,  
          according CDSS.


          Currently, LPAs input survey results, including citation  
          information, into an antiquated word processing system,  
          Lotus Notes, that does not interact with any of the  
          department's other data collection tools. As a result, the  
          department is unable to track patterns of poor care within  
          a single facility, much less across facilities with the  
          same owner. CDSS is also unable to upload information to  
          its web site for the public to see citation information on  
          facilities. Efforts have been made to bridge the antiquated  
          field information system to data collection systems,  
          including a grant from the California Health Care  
          Foundation in 2008. However the Lotus system is so old  
          those technology patches have been unsuccessful. In order  
          for CDSS to comply with some of the 2015 requirements and  
          all of the 2019 requirements, a new licensing database  
          would need to be developed and implemented.


           Related Legislation:


           AB 1436 (Waldron) 2014 would have required CDSS to post  
          specified 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  
           facility. This bill was held in the Assembly Appropriations  
          Committee.


          AB 1899 (Brown) 2014 requires CDSS 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  





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          bill is set to be heard in this committee on June 24.


          AB 2621 (Garcia) 2014 would require CDSS to post specified  
          information on their website regarding child day care  
          facilities. This bill is set to be heard in this committee  
          on June 24.


          SB 895 (Corbett) 2014 would require all inspection reports,  
          consultation reports, lists of deficiencies, and plans of  
          correction to be open to public inspection on the  
          department's Internet Web site and in its district offices.  
          That bill passed the Assembly Human Services Committee on  
          June 17.


                                     COMMENTS

           1.CDSS released an online searchable database this month  
            with up to five years of historical information on RCFEs,  
            including:


                     The name of the facility and its licensee's  
                 name and contact information;
                     The number of substantiated, unsubstantiated,  
                 and inconclusive complaints filed against the  
                 facility, including complaint severity and whether a  
                 complaint resulted in a citation;
                     The number of inspections, complaint  
                 investigations, and general visits to the facility.


          The current language of this bill is significantly broader  
          than what the department has indicated it is able to  
          provide online prior to completion of a new data system.


          Staff recommends amending this bill to reflect the  
          information the department has currently made available.  
          Additionally, staff recommends that the provisions of this  
          bill requiring additional information to be provided by  
          2019, instead require the information to be provided upon  
          completion of a new data system.





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          2. There is little detail provided regarding the quality  
          rating system and although the bill calls for the  
          consultation with stakeholders, the author may wish to  
          consider amending the bill to instead require the creation  
          of a stakeholder workgroup to develop a proposed rating  
          system for future consideration by the legislature. 


          Staff recommends that Section 2 be amended as follows:



          1569.356.

          (a) By July 1, 2015, the department shall post on its  
          Internet Web site residential care facility for the elderly  
          profiles, with data, including, but not limited to, all of  
          the following:
           (1) The name, address and telephone number of the licensed  
          providers, the status of the license, and the facility  
          capacity.
           (1) The name, address, and telephone number of the licensed  
          providers, including the owner and the licensee, the number  
          of licensed beds in the facility, including the number of  
          nonambulatory beds, whether the facility is permitted to  
          provide hospice care services, whether the facility has a  
          special care unit or program for people with Alzheimer's  
          disease and other dementias and has a delayed egress or  
          secured perimeter system in place, and information required  
          pursuant to Section 1569.15.   


          (2) Aggregate information on each facility, including, for  
          each of the previous five years,  the number of site visits  
          and inspections, the number of substantiated and  
          inconclusive complaint allegations filed against the  
          facility, and the number and type of citations assessed  
          against the facility.  the number of complaints 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.   






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          (3) Department actions, including license suspensions,  
          revocations,  and  probations.   settlements, stipulations,  
          accusations, audits, noncompliance conference summaries or  
          other administrative or legal actions, and when the  
          administrative or legal action was taken and will be  
          terminated   .


          (b)  The department shall actively seek technologies that  
          enable it to post the following information on its Internet  
          Web site, or if none exist, upon completion of a new  
          Community Care Licensing data  system  ,  To the extent that  
          the department's computer system can accommodate additional  
          residential care facility for the elderly profile  
          information,   the department shall,   as soon as possible but  
          no later than January 1, 2019,  post on its Internet Web  
          site the following information:


          (1)  The name, address, and telephone number of the licensed  
          providers, including the owner and the licensee, the number  
          of licensed beds in the facility, including the number of  
          nonambulatory beds, whether the facility is permitted to  
          provide hospice care services, whether the facility has a  
          special care unit or program for people with Alzheimer's  
          disease and other dementias and has a delayed egress or  
          secured perimeter system in place, and information required  
          pursuant to Section 1569.15.  
            (2)  Complaints, including the nature of the complaint,  
          results of the complaint investigation, actions taken, and  
          the dates that the complaint was received, investigated,  
          and closed.
           (3)  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.
           (4)  Posting of the facility inspection reports and plans of  
          correction, including findings of the most recent  
          inspection report and the date that the inspection was  
          conducted.
          (c) Any resolution of an appeal pertaining to a violation  
          or complaint shall be updated in a timely manner.





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           (c)    By July 1, 2019,    Upon completion of a new Community  
          Care Licensing data system, or as soon as the current data  
          system permits,  each licensee of a residential care  
          facility for the elderly shall submit a profile of resident  
          characteristics to the department 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. The department shall include  
          this information on the facility profile and on the online  
          consumer information system annually.
           (d)  By July 1, 2019, the department shall develop and  
          implement a ratings system designed to allow consumers to  
          compare residential care facilities for the elderly.
          (1) At a minimum, the ratings system shall be updated to  
          reflect the most recent inspection report, as required by  
          Section 1569.33.
          (2) The ratings shall be based on a facility's inspection,  
          and other factors as determined by the department in  
          consultation with stakeholders.
           (e)  It is the intent of the Legislature that the  
          department, in developing and establishing the system  
          pursuant to this section, shall work with stakeholder  
          groups, including consumer organizations.
          (f) In implementing this section, the department shall  
          ensure the confidentiality of personal and identifying  
          information of residents and employees and shall not  
          disclose this information through the consumer information  
          service system developed pursuant to this section.

                                   PRIOR VOTES  

          Assembly Floor      72 - 1
          Assembly Appropriations  13 - 0
          Assembly Human Services    6 - 0

                                    POSITIONS  

          Support:       California Advocates for Nursing Home Reform  
          (sponsor)
                         Assisted Living Consumer Alliance 
                         California Alliance for Retired Americans
                         California Assisted Living Association
                         California Continuing Care Residents  





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          Association
                         California Long-Term Care Ombudsman  
          Association
                         California Senior Legislature
                         Consumer Attorneys of California
                         Consumer Federation of California
                         Contra Costa Advisory Council on Aging
                         County of San Diego
                         Disability Rights California
                         Elder Law & Advocacy
                         Jewish Family Services of Los Angeles
                         Johnson Moore Trial Lawyers
                         Law Offices of Sanford Horowitz
                         Long Term Care Services of Ventura County,  
                    Inc.
                         National Association of Social Workers
                         National Consumer Voice for Quality  
                    Long-Term Care
                         Ombudsman Services of Contra Costa 
                         Stanislaus County Commission on Aging
                         Valentine Law Group, APC
                         2 individuals

          Oppose:   California Right to Life Committee, Inc.

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