BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 1863
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          ASSEMBLY THIRD READING
          AB 1863 (Jones)
          As Amended  May 7, 2014
          Majority vote 

           HUMAN SERVICES      5-0         APPROPRIATIONS      14-0        
           
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          |Ayes:|Stone, Maienschein, Ian   |Ayes:|Gatto, Bocanegra,         |
          |     |Calderon, Garcia, Hall    |     |Bradford,                 |
          |     |                          |     |Ian Calderon, Campos,     |
          |     |                          |     |Eggman, Gomez, Holden,    |
          |     |                          |     |Jones, Linder, Pan,       |
          |     |                          |     |Quirk, Ridley-Thomas,     |
          |     |                          |     |Weber                     |
          |-----+--------------------------+-----+--------------------------|
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Amends the Home Care Services Consumer Protection Act  
          (Act) to include home care domestic referral agencies.   
          Specifically,  this bill  :   

          1)Defines a "domestic home care referral organization" (DHCRO)  
            as an employment agency that arranges for home care services  
            to be provided by a registered home care aide to a client, as  
            specified.

          2)Defines a "domestic home care referral organization applicant"  
            as an individual who is at least 18 years of age or entity, as  
            specified, that is requesting to become a home care referral  
            agency and the Department of Social Services (DSS) has  
            received and is processing the application, as specified.

          3)Provides that an "independent home care aide" may be  
            considered a "registered home care aide," and is an individual  
            who is at least 18 years of age or older who is listed on the  
            home care aide registry, is not employed by a home care  
            organization, but is providing home care services through a  
            direct agreement with the client. 

          4)Defines a "domestic home care referral organization  
            application" as the official form to request a DHCRO license,  
            as specified. 









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          5)Defines a "domestic home care referral organization licensee"  
            as an individual who is at least 18 years of age or entity, as  
            specified, that has been licensed to operate a licensed DHCRO.

          6)Requires DHCROs to be licensed by DSS, as specified. 

          7)Requires licensees to undergo a criminal background check and  
            receive a background clearance prior to operation of a DHCRO.

          8)Requires DSS to issue a civil penalty of $900 per day to an  
            entity that is operating as a DHCRO but is unlicensed, as  
            specified.

          9)Requires licensees to post their licenses in a conspicuous  
            place, comply with existing bond requirements for purposes of  
            liability, and to act as mandatory reporters of suspected  
            child abuse or neglect, as specified. 

          10)Requires the state's General Fund to loan moneys to DSS for  
            implementation of the Act and for the establishment of the  
            DHCRO Fund in the State Treasury for the receipt of all  
            application fees and civil penalties. 
                                          
          11)Authorizes funds deposited into the DHCRO Fund to be used to  
            repay the General Fund for implementation of the Act, to  
            conduct outreach activities to identify and notice DHCROs of  
            their responsibility to be licensed, and to fund operational  
            costs incurred by DSS in administration of the Act. 

          12)Permits DSS to establish rules and regulations relating to  
            the receipt of complaints, investigation of complaints and  
            unannounced inspections, as specified.

          13)Permits DSS to issue a civil penalty of $900 per day for each  
            violation committed by a DHCRO, as specified.

          14)Authorizes DSS to adopt regulations to implement the Act, as  
            specified. 

          15)Implements the Act on January 1, 2016, and requires DHCROs to  
            comply with the Act no later than July 1, 2016. 

           FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee, on-going costs to DSS, likely less than $100,000  








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          General Fund, for workload associated with adding 200 to 300  
          licensees to the framework established by last year's AB 1217  
          (Lowenthal), Chapter 790, Statutes of 2013.  These costs could  
          be partially offset by fees DSS would be authorized to charge  
          under the proposed framework.

           COMMENTS  :    

          Regulating the home care market:  Last year the Legislature  
          passed and the state adopted AB 1217 which sought to regulate  
          the home care industry, which has existed for many years, but  
          has begun to increase as the nation's elderly population expands  
          and the demand for in-home care increases to allow individuals  
          to live comfortably at home with the assistance of a day-to-day  
          home care provider.  Home care providers provide basic daily  
          non-medical living assistance, such as cooking, cleaning,  
          dressing, feeding, and other regular daily needs.  However,  
          unlike their In-Home Supportive Services (IHSS) and Home Health  
          Agency (HHA) counterparts, there are no requirements in current  
          law that require home care aides to have minimum levels of  
          training, undergo a criminal background check, or comply with  
          basic standards of service.

          Due to the lack of a regulatory structure and related  
          enforcement, until AB 1217 there was no framework or definition  
          for what is considered a home care aide.  Although the title  
          "home care aide" implies a level of expertise and integrity  
          associated with a minimum level of care, any person may  
          represent him or herself as a home care aide.  In some  
          instances, individuals may solicit their services through  
          notifications posted online on Web sites such as Craigslist or  
          in newspaper classified ads.  This can place consumers who are  
          in need of day-to-day living assistance services in the home in  
          potentially vulnerable situations, as there are little to no  
          existing legal requirements and protections established.  In  
          some respects, it is not unreasonable to associate home care  
          aides unaffiliated with reputable or established organizations  
          or who operate as independent contractors as part of an  
          underground home care industry whereby the public rests their  
          faith in the hope that the elderly and disabled are receiving  
          adequate and beneficial care in the home. 

          AB 1217 provided a structure by which established agencies and  
          individuals provide home care services are held accountable to  








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          the public demand for greater standards and accountability for  
          home care aides.  As a result, AB 1217 enacted the Act to be  
          implemented January 1, 2015, which regulates the home care  
          industry, except home care/domestic referral agencies, by  
          addressing home care organizations, the home care aides they  
          employ, and independent home care aides. 

          Need for the bill:  Stating the need for the bill, the author  
          writes:

               Last year, the Legislature passed and the Governor  
               signed AB 1217 which enacted a series of consumer  
               protections for persons seeking home care services  
               from agencies that employ workers, but not from  
               referral agencies that refer independent workers to  
               clients that are seeking home care services.  Both  
               agency models, prior to AB 1217, prescreen workers to  
               verify worker competence, references, work history,  
               background-checks before sending workers to the  
               client.  This bill will extend similar additional  
               protections enacted by AB 1217 to the referral home  
               care agency, consistent with model's statutory,  
               Employment Development Department and Internal Revenue  
               Service requirements which govern independent workers.  
                It is appropriate that consumers enjoy a consumer  
               protection standard applied to the whole industry, not  
               just part of the industry to minimize "bad actors."  

               In addition, the entire industry, not just the  
               employer based model, should have access to the  
               proverbial "good housekeeping seal of approval"  
               accorded the employer based model.  The referral based  
               model provides legitimate, cost-effective, and  
               flexibility of choice to the consumer while providing  
               the assurance that workers have been pre-screened.   
               Currently, referral agencies are exempted from [this  
               bill's] mandates that only Health Care Organizations  
               can provide specific home care services.  To do so,  
               the Home Care Organization must meet certain  
               requirements in a certain form that runs afoul of  
               Civil Code 1812.5095 [Section] and IRS [Internal  
               Revenue Service] regulations that govern Domestic  
               Referral Agencies.  This bill will impose similar  
               requirements, but consistent with the provision of law  








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               and federal regulation that govern Domestic Referral  
               Agencies.  This will ensure a full breadth of industry  
               consumer protection and a level playing field for both  
               models.

           
          Analysis Prepared by  :    Chris Reefe / HUM. S. / (916) 319-2089 


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