BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 1821
                                                                  Page  1


          ASSEMBLY THIRD READING
          AB 1821 (Gordon)
          As Amended  May 23, 2014
          Majority vote

           VETERANS AFFAIRS    9-0         APPROPRIATIONS      16-0        
           
           ----------------------------------------------------------------- 
          |Ayes:|Quirk-Silva, Ch�vez,      |Ayes:|Gatto, Bigelow,           |
          |     |Dababneh, Brown, Eggman,  |     |Bocanegra, Bradford, Ian  |
          |     |Fox, Melendez,            |     |Calderon, Campos, Eggman, |
          |     |Muratsuchi, Salas         |     |Gomez, Holden, Jones,     |
          |     |                          |     |Linder, Pan, Quirk,       |
          |     |                          |     |Ridley-Thomas, Wagner,    |
          |     |                          |     |Weber                     |
          |-----+--------------------------+-----+--------------------------|
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Establishes the Medical Foster Home Pilot Program.   
          Specifically,  this bill  :  

          1)Authorizes, no sooner than June 1, 2015, and only 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.

           FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee:

          1)General Fund costs to the State Auditor in the range of  
            $250,000 for the equivalent of two limited term personnel  
            years to evaluate the MFH program and prepare an audit. 









                                                                  AB 1821
                                                                  Page  2


          2)Unknown out-year cost-avoidance to the extent the MFH concept  
            is successful in California without the cost of state  
            Department of Social Services licensing, regulations and  
            review.. 

           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  








                                                                  AB 1821
                                                                  Page  3


               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 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  








                                                                  AB 1821
                                                                  Page  4


               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 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.

          Amendments suggested in the Assembly Veterans Affairs Committee  
          would:

          1)Delay implementation until June 1, 2015.  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.

            The author has no concerns with the first proposed amendment  








                                                                  AB 1821
                                                                  Page  5


            and is happy to accept the amendment to delay establishing a  
            Medical Foster Home program until June 1, 2015.

          2)Require the California Department of Veterans Affairs to  
            consult with the USDVA to determine with which provisions of  
            the Health and Safety Code MFHs shall comply with to provide  
            for the health and safety of residents. Set a reasonable date  
            by which this shall be accomplished.  The proposed amendment  
            retains a basic "floor" of health and safety standards during  
            this pilot period so the bare 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.  

            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  








                                                                  AB 1821
                                                                  Page  6


            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 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.  

          3)Have DSS rather than the State Auditor evaluate the pilot  
            program.  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.









                                                                  AB 1821
                                                                  Page  7


            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.

          4)Require reporting to the Legislature.  This requires a report  
            to the Legislature so it may make an informed decision about  
            the pilot program.

            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.


           Analysis Prepared by :    John Spangler / V.A. / (916) 319-3550 


                                                                FN: 0003593