BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 1821
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          Date of Hearing:   April 29, 2014

                       ASSEMBLY COMMITTEE ON VETERANS AFFAIRS
                              Sharon Quirk-Silva, Chair
                    AB 1821 (Gordon) - As Amended:  April 22, 2014
           
          SUBJECT  :    Medical foster homes.

           SUMMARY  :   Establishes the Medical Foster Home Pilot Program.  

          Specifically,  this bill  :  

          1)Authorizes,  until January 1, 2018, a United States Department  
            of Veterans Affairs (USDVA) facility to establish a Medical  
            Foster Home (MFH) that is not subject to licensure or  
            regulation under the California Residential Care Facilities  
            for the Elderly Act provided that specified federal  
            requirements are  satisfied, the USDVA facility establishing  
            the home agrees to be subject to the jurisdiction of the  
            California State Auditor, and the USDVA obtains criminal  
            background information for caregivers and specified  
            individuals residing in the home.

          2)States the intent of the Legislature that the California State  
            Auditor, through a request to the Joint Legislative Audit  
            Committee, conduct an audit evaluating the program created by  
            this bill no sooner than January 1, 2016, as specified.

           EXISTING LAW  : 

          1)Establishes the Department of Veterans Affairs, which is  
            responsible for administering various programs and services  
            for the benefit of veterans. 

          2)Provides for the licensure of residential care facilities for  
            the elderly by the State Department of Social Services under  
            the California Residential Care Facilities for the Elderly  
            Act. 

          3)Exempts from these provisions specified facilities, including  
            general acute care hospitals, clinics, and recovery houses for  
            individuals with drug or alcohol addiction. 

          4)Authorizes the California State Auditor, upon the request by  
            the Joint Legislative Audit Committee and to the extent  








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            funding is available, to audit a state or local governmental  
            agency, as defined, or any other publicly created entity.

           FISCAL EFFECT  :   Unknown at this time. 

           COMMENTS  :   According to the Author:

               MFHs are home-based care models for mostly older and  
               medically frail veterans needing assisted living care. MFHs  
               provide 24-hour a day, 7-days a week care for up to a  
               maximum of 3 eligible veterans in a private home. MFHs are  
               currently operational at more than 83 sites in 39 states. 

               To qualify for the MFH program, a veteran must first be  
               enrolled in the Veterans Health Administration's (VHA's)  
               Home Based Primary Care program (HBPC). In this program the  
               veteran's medical care is provided by an interdisciplinary  
               team of physicians, nurses, aides, and others which are all  
               provided by the VHA. The private home, where the veteran is  
               placed, is also monitored closely by the VHA under strict  
               standards required of the caregivers. Families who  
               volunteer to participate in the MFH program must be  
               approved by the VHA's interdisciplinary team as well as  
               submit income statements, and train in CPR. 

               Additionally, the MFHs are routinely inspected by the VHA.  
               Veterans pay room and board in the MFH program; however,  
               the Veterans Benefits Administration's "Aid and Attendance"  
               benefit and Social Security benefits are generally  
               anticipated to cover these costs. MFHs are distinguished  
               from other typical residential care homes or facilities  
               because a MFH caregiver is required to reside in their own  
               private home while providing 24-hour personal care and  
               supervision to the veteran. The veteran, in turn, receives  
               their medical care through the VHA in a highly regulated,  
               yet independent, community-based setting.

               Currently, the federal Medical Foster Home program can only  
               exist in California if operated as and under the  
               Residential Care Facilities for the Elderly (RCFE) law.  
               Unfortunately, that law does not envision the MFH model  
               under traditional assisted living care such that all  
               potential MFH caregivers would need to have their personal  
               home licensed, they would have to become a Certified  
               Administrator for RCFE, and they would also incur all the  








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               costs associated with their training and licensure. This  
               creates a barrier for caregivers to open their home to a  
               veteran and limits the growth of the program in our state. 

               In addition, placements in existing RCFEs are not  
               financially feasible due to the 3 veteran limitation, as  
               most "board and care" RCFEs have up to 6 residents residing  
               in one location. Therefore, the RCFE requirements impede  
               California veterans from having similar opportunities as  
               veterans in other states who are able to "age in place"  
               with dignity and independence, in a home-like environment  
               with a loving and caring foster family. 

               To ensure the MFH is a feasible alternative to  
               institutionalization for California's veterans, the bill  
               would establish the Medical Foster Home Pilot Program.  
               Under the pilot program, a United States Department of  
               Veterans Affairs (USDVA) facility, such as a VA hospital,  
               may establish a Medical Foster Home program as long as the  
               following conditions are met: the MFH meets the  
               requirements of the federal regulations; the USDVA facility  
               submits a proposal to establish a medical foster home  
               program to the Director of Home and Community-Based Care in  
               Geriatrics and Extended Care Services in the Central Office  
               of the USDVA and that director authorizes the program; and  
               finally that the USDVA facility establishing the MFH agrees  
               to be subject to the jurisdiction of the California State  
               Auditor and agrees to provide data, information, and case  
               files as requested by the California State Auditor to  
               perform all of his or her duties in evaluating the MFH  
               pilot program.  

               The MFHs in the pilot program are not subject to existing  
               RCFE law; however, it is the intention of the author and  
               stated in the bill that a request will be made to the Joint  
               Legislative Audit Committee for the California State  
               Auditor to audit and evaluate the success of the pilot  
               program providing a safeguarding mechanism to protect  
               California's veterans. In addition, the State Auditor will  
               make recommendations regarding the continuation of the  
               program in order to determine if the state should have a  
               role in the federal MFH program as the pilot program will  
               sunset on January 1, 2018. This bill would allow the MFH  
               program to be a viable option for our veterans who want to  
               live and receive care in a smaller setting that feels more  








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               like home.

          The concept of providing veterans with an additional  
          federally-funded health care delivery setting option from which  
          to choose is an excellent one.  Being treated in a home-like  
          setting will surely be an attractive option for many veterans.   
          Staff is aware that the program is running successfully in other  
          states.  Furthermore, this model of care seems in keeping with  
          the United States Supreme Court's decision in Olmstead v. L.C.,  
          a ruling that requires states to eliminate unnecessary  
          segregation of persons with disabilities and to ensure that  
          persons with disabilities receive services in the most  
          integrated setting appropriate to their needs.  

          The step of exempting MFH's from state regulation and oversight  
          should be carefully evaluated.  The author realizes this and has  
          proposed a pilot program, sunset, audit, and certain other steps  
          as safeguards, as well as noted the rigorous federal regulatory  
          and oversight scheme.  Still, removing care from state oversight  
          and regulation in this way for our some of our most vulnerable  
          veterans, even as a pilot program, should give pause.

           Policy Question for Members and Suggested Amendments  :

          Should MFHs be exempted from state regulation and oversight,  
          even with the bill's proposed safeguards and limits? There have  
          been several recent media reports alleging serious misconduct at  
          the USDVA Veterans Health Administration (VHA) including  
          destruction of patient records (which has been the subject of  
          investigation by the U.S. House Veterans Affairs Committee) and  
          the VHA has allegedly refused state inspectors in Florida access  
          to patient records.  

          Will our veterans will be properly and safely cared for without  
          state oversight during the pilot program?

          If the MFH model does not fit within the RCFE rubric, rather  
          than exempting it from state regulation, why are the relevant  
          state agencies not proposing a new a regulatory model?  The  
          pilot program will provide a testing period for the new program,  
          but is it good policy to test this program on California  
          veterans first and then later decide what the state's role  
          should be?  
           
          Proposed Amendments:








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          All proposed amendments are to the Military and Veterans Code.

          Amendment 1.   

          Section 1851. No sooner than  June 1, 2015  a USDVA facility may  
          establish a medical foster home program in this state. A medical  
          foster home established pursuant to that program is not subject  
          to licensure or regulation under the California Residential Care  
          Facilities for the Elderly Act (Chapter 3.2 (commencing with  
          Section 1569) of Division 2 of the Health and Safety Code)  
          unless all of the following requirements are satisfied?

           Rationale  : It takes some time to safely and carefully launch a  
          new program, Assuming this bill proceeds to the Governor, it  
          might not considered by the Governor until September 2014, which  
          is not enough time to launch a program on January 1.  Further  
          this bill would not take effect until January 1, 2015, so an  
          additional small delay is not unreasonable.

           According to the Author:  

                The author has no concerns with the first proposed  
               amendment and is happy to accept the amendment to delay  
               establishing a Medical Foster Home program until June 1,  
               2015.

          Amendment  2.  

          Section 1851  (e)   The medical foster home complies with and  
          provides for the basic health and safety standards as determined  
          by the Department of Social Services. In implementation of this  
          section, the Department of Social Services shall consult with  
          the USDVA to determine with which provisions of Chapter 3.2 of  
          Division 2 (Commencing with Section 1560) of the Health and  
          Safety Code Medical Foster Homes shall comply to provide for the  
          health and safety of its residents. Notwithstanding the  
          Administrative Procedure Act (Chapter 3.5 (commencing with  
          Section 11340) of Part 1 of Division 3 of Title 2 of the  
          Government Code) the Department of Social Services shall  
          implement this section through all-county letters or similar  
          instructions from the director no later than May 31, 2015.
           
           Rationale  :  The proposed amendment retains a basic "floor" of  
          health and safety standards during this pilot period so the bare  








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          health and safety minimums are being met, yet still preserves  
          the author's intent to exempt MFHs from state regulation to the  
          maximum extent.  The Author has provided a comparison of the  
          RCFE state regulations and the MFH federal regulations.   The  
          federal regulatory scheme appears very rigorous.  It may even be  
          more rigorous than the RCFE scheme.  If that is the case then  
          this proposal should not impose a burden other than an official  
          verification before the pilot starts.  This proposal also  
          requires compliance before the implementation date proposed  
          above so as not to delay implementation.  

           According to the Author: 

                The author believes that if the second amendment is taken  
               to require Department of Social Services (DSS) to determine  
               what provisions from RCFE law should be complied with and  
               requires DSS to implement this through county letters or  
               similar instructions, this amendment will add substantial  
               costs to the bill effectively killing it and not allowing  
               veterans this option.  

               The reason the author would even consider exempting state  
               oversight is that fact that the federal VA standards for  
               the Medical Foster Home program are higher and more  
               stringent than are offered under RCFE.  DSS has told the  
               author's office this directly and even mentioned that if  
               the state were to have oversight it could be duplicative.   
               Moreover, if this amendment were taken, would VA have to  
               lower their standards to be in compliance with RCFE, if DSS  
               was involved in determining what provision from the RCFE  
               law would have to be followed?  

               In addition, the state has no oversight over VA hospitals.   
               Veterans under the Medical Foster Home program are  
               receiving the exact same care as if they were in the VA  
               hospital; the only difference is that the veteran is in the  
               private medical foster home receiving care from an  
               interdisciplinary team.  

               The author is cognizant of the policy question of exempting  
               state regulation and oversight; however, the bill proposes  
               multiple safeguards and limits.  First, this is a pilot  
               program so the number of Medical Foster Homes would be  
               limited.  Second, the bill has a sunset date requiring the  
               policy to be reexamined.  Third, the bill requires federal  








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               and state background checks on Medical Foster Home  
               caregivers and residents of the Medical Foster Home over  
               the age of 18.  Lastly, and most importantly, the bill  
               states the author's intent for the state auditor to conduct  
               an audit of the Medical Foster Home pilot program and  
               evaluate the program and determine whether the state should  
               have a role in this federal program.  Further, as a  
               condition of establishing the Medical Foster Home program  
               in California, USDVA facilities must agree to be subject to  
               the jurisdiction of the California State Auditor for the  
               purpose of evaluating the program. This means that the  
               USDVA facility must provide data, information, and case  
               files as requested by the California State Auditor to  
               perform all of his or her duties in evaluating the program.  
                Therefore, this provides an essential safeguard in that  
               the VA must comply with the audit and provide all necessary  
               information to be evaluated effectively.  

               This bill does not leave California's veterans on their own  
               with no protections, in fact the higher federal protections  
               justify why this worthwhile program should be piloted.  AB  
               1821 attempts to strike a balance between ensuring that  
               there are protections for our veterans (after all our first  
               priority is the health and safety of California's veterans)  
               while providing a Medical Foster Home that is a viable  
               model.  

          Amendment 3.   

          Section 1852. It is the intent of the Legislature that the  
           Department of Social Services, in consultation with the  
          Department of Veterans Affairs, shall assess and evaluate,  the  
          pilot program created by this chapter no sooner than January 1,  
          2017. ?

           Rationale  :  An entity with regulatory compliance expertise in  
          these kinds of health care models (or their closest analogues)  
          should be the one assessing the pilot program.  DSS is the most  
          logical entity to entrust with this step of protecting the  
          health and safety of what are likely to be some of our most  
          vulnerable veterans.  Substantially similar oversight is already  
          one mission of the DSS.  The proposed amendment also gives an  
          additional year to run the pilot, compensating for the delayed  
          implementation.









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           According to the Author  :

               The author has concerns with the [DSS] conducting the  
               evaluation.  The first concern is the fiscal cost this  
               would entail.  But, more importantly, the author believes  
               that the state auditor is the appropriate entity to conduct  
               the evaluation because the state auditor does not have skin  
               in the game and would be a neutral entity best able to  
               evaluate the program without any biases.  Furthermore, the  
               state auditor conducts many audits on a range of topics.   
               If the state auditor feels that they may not have the  
               needed subject expertise, the state auditor has and can  
               contract to get an expert to assist in the audit.


          Amendment 4.   

          Section 1852(b) Make recommendations  to the Legislature  ?

           Rationale  : This requires a report to the Legislature so it may  
          make an informed decision about the pilot program.
           
          According to the Author  :

               The author has no concerns with the fourth proposed  
               amendment and is happy to accept the amendment to report to  
               the Legislature the findings and recommendations of the  
               state audit.

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          Public Law Center
          Leading Age California
          California Commission on Aging 

           Opposition 
           
          None. 
           
          Analysis Prepared by  :    John Spangler / V. A. / (916) 319-3550 











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