BILL ANALYSIS �
AB 1899
Page A
ASSEMBLY THIRD READING
AB 1899 (Brown)
As Amended May 23, 2014
Majority vote
HUMAN SERVICES 6-0 AGING 7-0
-----------------------------------------------------------------
|Ayes:|Stone, Maienschein, |Ayes:|Yamada, Wagner, Brown, |
| |Ammiano, | |Daly, Gray, Grove, Levine |
| |Ian Calderon, Garcia, | | |
| |Grove | | |
|-----+--------------------------+-----+--------------------------|
| | | | |
-----------------------------------------------------------------
APPROPRIATIONS 17-0
-----------------------------------------------------------------
|Ayes:|Gatto, Bigelow, | | |
| |Bocanegra, Bradford, Ian | | |
| |Calderon, Campos, | | |
| |Donnelly, Eggman, Gomez, | | |
| |Holden, Jones, Linder, | | |
| |Pan, Quirk, | | |
| |Ridley-Thomas, Wagner, | | |
| |Weber | | |
|-----+--------------------------+-----+--------------------------|
| | | | |
-----------------------------------------------------------------
SUMMARY : Prohibits an individual who abandons a Residential
Care Facility for the Elderly (RCFE) from being able to
reinstate his or her license and requires the Department of
Social Services (DSS) to operate a RCFE complaint telephone
hotline and Internet Web site. Specifically, this bill :
1)Prohibits a RCFE licensee, who abandons his or her facility,
from becoming eligible for reinstatement or another RCFE
license.
2)Requires the Internet Web site to make available to the public
all final complaint actions resulting in citation, suspension,
or revocation taken against each licensee, listed both by the
licensee's name and by the facility's name, and for all
information to be listed in a manner that protects the privacy
AB 1899
Page B
of the residents and the confidentiality of resident
information.
FISCAL EFFECT : According to the Assembly Appropriations
Committee:
1)One-time costs to DSS in the range of $1 million in 2014/15
and ongoing costs of approximately $700,000 for project
development, testing and maintenance and other related IT
[information technology] contract work related to the
telephone hotline and Web site.
2)On-going administrative costs, likely minor, to identify and
track banned licensees.
3)DSS notes they are proposing a hotline in their Community Care
Licensing Quality Enhancement BCP [Budget Change Proposal].
COMMENTS :
Background: It is the intent of the Legislature, in
establishing the RCFE Act, to help provide a system of
residential care to allow older persons be able to voluntarily
live independently in a homelike environment as opposed to being
forced to live in an institutionalized facility, such as a
nursing home, or having to move between medical and nonmedical
environments. RCFEs, commonly referred to as assisted living
facilities, are licensed retirement residential homes and board
and care homes that accommodate and provide services to meet the
varying, and at times, fluctuating health care needs of
individuals who are 60 years of age and over, and persons under
the age of 60 with compatible needs. Licensed by the DSS
Community Care Licensing Division (CCLD), they can range in size
from residential homes with six or less beds to more formal
residential facilities with 100 beds or more.
There is also no uniform common care model; rather the types of
assistive services can vary widely, which can include differing
levels of personal care and protective supervision, based upon
the needs of the resident.
If a resident needs medical care in his or her residence in
order to maintain an independent lifestyle, incidental medical
services are permitted to be provided by a licensed or otherwise
AB 1899
Page C
approved external provider, such as a home healthcare agency
(HHA), which is licensed by the California Department of Public
Health. Additionally, some RCFEs, upon approval of DSS and
after having met specified orientation and training
requirements, may provide assistive memory care services to
individuals with dementia or Alzheimer's disease.
Recent events: A series of recent events has drawn attention to
questions about the adequacy of RCFEs and the CCLD's ability to
comply with existing oversight and enforcement requirements to
help ensure for the health and safety of individuals who receive
services within CCLD-licensed facilities. Over the last several
years, numerous media outlets have documented chronic
understaffing and a lack of required assessments and substandard
care. Reports in September 2013, prompted by a consumer
watchdog group that had hand-culled through stacks of documents
in San Diego, revealed that more than two dozen seniors had died
in recent years in RCFEs under questionable circumstances that
went ignored or unpunished by CCLD.<1>
Lack of transparency: Under current law, DSS is required to
operate an automated RCFE license information system to provide
information on licensees and former licensees of licensed RCFEs.
Although this requirement was established in SB 185 (Mello),
Chapter 1127, Statutes of 1985, it is unclear how DSS is
complying with it. DSS currently has available a searchable
database of RCFEs on its Web site, however, information is
limited to the name, location, contact information, type of
facility and whether the facility's license is current or
pending. It does not provide information such as a facility's
licensing history, the expertise and certification of staff, or
its complaints history, including whether the complaint was
resolved. In order to acquire additional information relating
to the quality of a facility, a person must travel to one of
DSS' eight regional licensing offices and request the
information in person.
DSS also currently operates a Web page entitled "myccl" on its
departmental Web site. However, it is only accessible to RCFE
licensees, administrators, board members of the RCFE, staff, or
related individuals per the approval of DSS.
---------------------------
<1> "Care Home Deaths Show System Failures," San Diego Union
Tribune, Sept.7, 2013
AB 1899
Page D
Other than DSS' searchable database, which is limited to general
information of RCFEs, there currently does not exist an online
or other automated system provided by DSS whereby the public can
review or learn more about licensed RCFEs. This not only limits
the public's access to information about RCFEs, but it is also
limits CCLD's internal ability to track patterns of poor care
within a single facility, much less across facilities with the
same licensee. Under current practice, when a license undergoes
a licensing inspection or is subject to a complaint
investigation, the information reported by CCLD is maintained in
a paper-based format. This limits CCLD's ability to track
licensees' overtime and whether they operate other facilities
that should undergo additional scrutiny.
Analysis Prepared by : Chris Reefe / HUM. S. / (916) 319-2089
FN: 0003824