BILL ANALYSIS �
Senate Appropriations Committee Fiscal Summary
Senator Kevin de Le�n, Chair
AB 1821 (Gordon) - Medical Foster Homes
Amended: June 17, 2014 Policy Vote: VA 6-0
Urgency: No Mandate: No
Hearing Date: August 4, 2014
Consultant: Maureen Ortiz
This bill meets the criteria for referral to the Suspense File.
Bill Summary: AB 1821 authorizes the creation of medical foster
homes through the United States Department of Veterans Affairs
(USDVA).
Fiscal Impact:
State Auditor costs of up to $200,000 (General Fund)
Background: The USDVA oversees the Medical Foster Home (MFH)
program. These are private homes in which a trained caregiver
provides services to a few individuals. Homes are allowed beds
for three veterans. Most residents are veterans but that is not
necessarily a requirement. The USDVA approves and inspects the
homes but does not provide any funding. Veterans who reside in
a medical foster home receive Home Based Primary Care services -
a program that provides medical care by an interdisciplinary
team of physicians, nurses, aides and others who are all
provided by the Veterans Health Administration.
The medical foster homes are routinely inspected by the Veterans
Health Administration. The veteran pays room and board,
however, the Veterans Aid and Attendance benefit and Social
Security benefits generally 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.
Proposed Law: AB 1821 does the following:
1) Authorizes the creation of medical foster homes through the
United States Department of Veterans Affairs no sooner than June
AB 1821 (Gordon)
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1, 2015.
2) Exempts the homes from licensure and regulation under the
California Residential Care Facilities for the Elderly Act and
the California Community Care Facilities Act, and Chapter 3.01
commencing with Section 1568.01 of Division 2 of the Health and
Safety Code if the medical foster home meets federal licensing
requirements.
3) Requires the USDVA to obtain authorization to establish a
medical foster home program from the Director of Home and
Community-Based Care in Geriatrics and Extended Care Services in
the Central Office of the USDVA.
4) States Legislative Intent that the State Auditor conduct an
audit of the pilot program no sooner than January 1, 2016. The
audit is intended to do the following: a) evaluate the success
of the pilot program by confirming that the USDVA facilities are
meeting their goals and standards; and b) make recommendations
to the Legislature regarding the continuation of the program
including recommended changes or reforms to improve the program.
5) Requires the following individuals to submit fingerprint
images and related information to the Department of Justice for
background checks and to pay a fee sufficient to cover all
costs:
a) Medical foster home caregivers.
b) Individuals, other than veteran residents, who are over 18
years of age and are residing the medical foster home.
Staff Comments: AB 1821 creates a pilot program establishing an
undefined number of medical foster homes in California, and
sunsets the program January 1, 2018. The homes will be
regulated by the federal DVA, and residents will pay fees
sufficient to cover the costs.
Although the medical foster home program is established under
the United State Department of Veterans Affairs, it should be
noted that there will be no state regulation of these
facilities. These homes are currently being operated in 39
other states which have varying forms of state regulation.
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