BILL ANALYSIS �
Senate Appropriations Committee Fiscal Summary
Senator Kevin de Le�n, Chair
AB 1571 (Eggman) - Residential care facilities for the elderly:
licensing and regulation.
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 1571 would expand the scope of information that
prospective residential care facility for the elderly (RCFE)
licensees must provide to the Department of Social Services
(DSS). Additionally, this bill requires the DSS to do the
following:
Develop and implement an RCFE ratings system by July 1,
2019, designed to allow consumers to compare RCFEs.
Actively seek technologies that would enable DSS to post
specified and detailed information regarding RCFE
licensees, complaints, violations, and inspection reports
on its website within specified timeframes.
"Cross-check" all RCFE licensee applicant information
with the Department of Public Health (DPH).
Fiscal Impact:
Significant one-time automation and resource costs to the
DSS potentially in excess of $750,000 (General Fund) to
develop and implement an RCFE ratings system. Ongoing costs
to maintain the system could exceed $500,000 (General Fund),
depending on the functionality and scope of the ratings
system.
Potentially significant cost pressure (General Fund) to DSS
to purchase and obtain available technology that would
enable posting of detailed RCFE information on its website.
Unknown, potentially significant costs to DSS to
"cross-check" information against DPH information, dependent
on the process (manual vs. automated) utilized to
cross-check information, which is unspecified.
Minor future costs (General Fund) to post additional
information on RCFEs upon completion of a new CCL data
system.
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Potential minor non-reimbursable local enforcement costs
for misdemeanor violations of the provisions of this bill by
RCFE licensees.
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
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.
This bill seeks to provide consumers with greater transparency
related to RCFEs to enable a more informed choice when selecting
a facility. This bill also seeks to improve communication
between the DSS and DPH with respect to information about the
management and operation of the facilities that each department
licenses.
Proposed Law: This bill would expand the scope of information
that prospective RCFE licensees must provide to the DSS to
include the names and license numbers of other facilities owned,
managed, or operated by the same licensee, as well as other
information on owners of record in the real estate, as
specified. Additionally, this bill:
Requires DSS to develop and implement an RCFE rating
system by July 1, 2019, designed to allow consumers to
compare RCFEs, as follows:
o Requires the rating system to include at a
minimum the most recent inspection report, as
specified, and to be based upon a facility's
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inspection and other factors determined by DSS and
stakeholders.
o Requires DSS to ensure the confidentiality of
personal and identifying information of residents and
employees, as specified.
Requires DSS to post specified information regarding
RCFE licensees on its website by July 1, 2015, including
but not limited to licensed capacity, services provided,
and five years of aggregate data on complaints,
deficiencies, and enforcement actions resulting in fines
against the facility.
o Requires DSS to actively seek technologies
that enable it to post additional specified
information on its website, or if none exist, upon
completion of a new CCL data system. The information
would include more detailed information on the types
of complaints and violations assessed, and an
RCFE-specific profile of resident characteristics.
Requires DSS to cross-check all RCFE licensee applicant
information with the DPH to determine an applicant's prior
history of operating, holding a position in, or having
ownership of, a health facility.
Permits DSS to deny an application for RCFE 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, or
similarly licensed facility in another state, applicable
state and federal laws and regulations, and the
requirements governing the operators of those facilities.
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 1554 (Skinner) RCFEs: complaint procedures.
AB 1570 (Chesbro) RCFEs: training.
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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.
AB 2236 (Maienschein/Stone) RCFEs: civil penalties.
Staff Comments: Mandating the development and implementation of
an RCFE ratings system by January 1, 2019, will result in
significant one-time automation and resource costs to the DSS
potentially in excess of $750,000 (General Fund). The ongoing
costs to maintain the system could exceed $500,000 (General
Fund), depending on the functionality and scope of the ratings
system, which are to be determined based on factors as
determined by the DSS in consultation with stakeholders.
This bill requires the DSS to actively seek technologies that
enable it to post specified and detailed information on RCFEs on
its website, or if none exist, upon completion of a new CCL data
system, to post the specified information. To the extent such
technology exists, the DSS could potentially incur costs
(General Fund) to purchase and obtain the available software, as
well as incur additional costs for staff training and automation
changes that could be required.
This bill requires the DSS to "cross-check" all applicant
information disclosed to DSS against DPH information to
determine if the applicant has a prior history of operating,
holding a position in, or having ownership in, any specified
entity. Because it is unclear in what manner the information
will be checked against DPH data, the costs to complete this
requirement are unknown and would be dependent on the process
(manual vs. automated) utilized to cross-check information.
Under existing law, any person who violates the California
Residential Care Facilities for the Elderly Act (Act), is guilty
of a misdemeanor and subject to civil penalties and suspension
or revocation of his or her license. To the extent the
provisions of this measure result in future violations of the
Act, could result in non-reimbursable local enforcement costs.
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