BILL ANALYSIS �
AB 1816
Page 1
ASSEMBLY THIRD READING
AB 1816 (Yamada)
As Amended May 23, 2014
Majority vote
HEALTH 19-0 APPROPRIATIONS 16-0
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|Ayes:|Pan, Maienschein, |Ayes:|Gatto, Bigelow, |
| |Ammiano, Atkins, Bonilla, | |Bocanegra, Bradford, Ian |
| |Rendon, Ch�vez, Chesbro, | |Calderon, Campos, Eggman, |
| |Gomez, Gonzalez, Roger | |Gomez, Holden, Jones, |
| |Hern�ndez, Mansoor, | |Linder, Pan, Quirk, |
| |Nazarian, Nestande, | |Ridley-Thomas, Wagner, |
| |Patterson, Ridley-Thomas, | |Weber |
| |Wagner, Wieckowski, | | |
| |Bocanegra | | |
| | | | |
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SUMMARY : Requires the Department of Public Health (DPH) to set
a performance benchmark, not to exceed 60 days, to complete a
long-term care facility complaint investigation and requires DPH
to provide additional information about the investigation of the
complainant. Specifically, among other provisions, this bill :
1)Requires DPH, by July 1, 2015, to complete investigations of
complaints against long-term health care facilities within the
number of days specified by the benchmark after receipt of the
complaint.
2) Requires DPH, when it extends an investigation in 1)
above, to notify the complainant and provide the basis for
the extension, the status of the investigation and the
anticipated completion date.
3) Effective July 1, 2015, requires DPH to include specific
findings concerning each alleged violation and a summary of
the evidence in the written determination it is required to
make at the investigation's conclusion.
4) Requires DPH to analyze its compliance with the
benchmark in its annual system and staffing analysis,
including specified data on the department's compliance
with the benchmark.
AB 1816
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FISCAL EFFECT : Unknown, significant costs, potentially in the
low millions of dollars annually to the Licensing and
Certification (L&C) Fund within DPH to meet the imposed time
frames for completion of investigations from the, paid for by
facility licensing fees. Of this amount, about 5% is
attributable to state-run facilities, whose licensure fees are
paid for with General Fund dollars.
COMMENTS : The author of this bill writes that testimony
received by the Legislature in a joint oversight hearing of the
Assembly Aging and Long-Term Care Committee and the Assembly
Health Committee indicated that DPH struggles to meet its
workload demands. Testimony revealed that thousands of
complaints of mistreatment, misconduct, and abuse have
languished for years with incomplete investigation. The author
writes that each day that a complaint is left open, medically
fragile and vulnerable adults in long-term health care
facilities are placed at risk of harm. Timely investigations
are critical to reduce risk by identifying and acting to protect
dependent adults in state care from dangerous situations. This
bill is intended to address this issue by establishing a
performance benchmarks by which DPH can evaluate the length of
an investigation.
The L&C division within DPH is responsible for ensuring and
promoting a high standard of medical care in approximately 8,000
health care facilities and agencies in California, including
about a total of 2,500 long-term health care facilities: 1,270
skilled nursing facilities; 1,187 intermediate care facilities;
65 congregate living health facilities; and, 16 pediatric day
health and respite care facilities. In addition to inspecting
long-term health care facilities for compliance with state law,
L&C is also the state survey agency for the federal Centers for
Medicare and Medicaid Services (CMS). DPH is responsible for
certifying to the federal government that nursing homes are
eligible for payments under CMS programs. CMS requires L&C to
promptly review complaints/incidents, conduct unannounced onsite
investigations of reports alleging noncompliance, and inform CMS
of any certification requirements that are found to be out of
compliance.
The timeliness of the L&C complaint investigation process has
been a subject of criticism for several years. This matter has
AB 1816
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been the subject of lawsuits against the state, investigative
reporting articles, and increased oversight from CMS.
State law requires DPH to prepare an analysis along with the
annual fee report that includes, among other data, information
on the number and timeliness of complaint investigations. The
law does not specify how DPH should measure the timeliness of
complaint investigation. From 2007-08 to 2009-10, DPH reported
the percentage of investigations completed within specified
timeframes. The reported timeframes vary from year to year.
Beginning with the 2012-13 report's information on 2010-11
complaints, DPH has not included any information on timeliness
of complaint investigation completion.
In support, California Advocates for Nursing Home Reform
(CANHR), writes that this bill, by requiring timely
investigation of complaints, will prevent nursing home
residents from continuing to be subject to neglect or abuse
after it has been reported, and that this bill will help
ensure that DPH's findings are fair, accurate, and efficient
because investigations will be conducted and completed while
evidence is readily available and still fresh. CANHR writes
that the timely investigation of nursing home complaints is
a matter of life and death for nursing home residents and
that this bill will help protect nursing home residents from
neglect and abuse and help restore public confidence in
California's nursing home oversight system.
There is no known opposition to this bill.
Analysis Prepared by : Dharia McGrew / HEALTH / (916) 319-2097
FN: 0003774