BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 2044
                                                                  Page  1

          Date of Hearing:   May 14, 2014

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                  Mike Gatto, Chair

                  AB 2044 (Rodriguez) - As Amended:  April 21, 2014 

          Policy Committee:                              Human  
          ServicesVote:6 - 0

          Urgency:     No                   State Mandated Local Program:  
          Yes    Reimbursable:              No

           SUMMARY  

          This bill places additional staffing and health and safety  
          requirements on a residential care facility for the elderly  
          (RCFE).  Specifically, this bill:   

          1)Requires at least one administrator, facility manager, or  
            other person designated by the administrator who is at least  
            21 years of age to be on the premises of a RCFE at all times. 

          2)Clarifies the requirement that RCFEs employ sufficient staff  
            to meet the needs of its residents as provided in their  
            service agreements and to ensure the health, safety, comfort,  
            and supervision of residents.

          3)Requires at least one staff member with CPR and first aid  
            training is on duty at all times.

          4)Clarifies that RCFEs must be clean, safe, sanitary, and in  
            good repair at all times for the safety and well-being of  
            residents, staff, and visitors.

           FISCAL EFFECT  

          1)Minor and absorbable costs to the Department of Social  
            Services to modify their training regulations.

          2)Unknown costs to facility owners or licensees to meet the  
            increased health and safety requirements and ensure adequate  
            staffing levels.

           COMMENTS  








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           1)Purpose  . This measure seeks to increase the skill set and  
            personnel requirements for RCFEs by requiring at least one  
            staff person who is at least 21 years of age be on the  
            premises at all times and that he or she is certified in CPR  
            and first aid.  It also provides additional clarification as  
            to the duties and roles of staff in providing for the health  
            and safety of residents.  

           2)Background  . RCFEs, commonly referred to as assisted living  
            facilities, are licensed retirement  residential homes and  
            board and care homes that provide personal care and  
            supervision or health related services to persons who are 60  
            years of age and over, who voluntarily choose to reside in the  
            facility.  RCFEs enable older persons to live independently in  
            a home-like environment rather than in nursing home or other  
            institutionalized facility.  Services include personal care  
            and protective supervision, including incidental medical  
            services, based upon resident needs.   
           
            There are 7,589 licensed RCFEs in California with a capacity  
            to serve over 176,000 residents.  Licensed by DSS' Community  
            Care Licensing Division (CCLD), RCFEs range in size from  
            residential homes with six or fewer beds to formal residential  
            facilities with 100 beds or more.  

           3)Staff requirements  . Current law requires an administrator  
            designated by the licensee to be present at the facility  
            during normal working hours. An administrator may appoint a  
            facility manager who would serve in his or her place when the  
            administrator is not on the premises of the RCFE.  It also  
            permits the licensee, administrator and facility manager to be  
            the same person.  It does not require a staff person serving  
            as a facility manager to have any additional training or  
            necessary skill set, yet it expects this person to have the  
            "authority and responsibility necessary to manage and control  
            the day-to-day operation of a residential care facility for  
            the elderly and supervise the clients."  In practice, a  
            facility manager is more often appointed in larger facilities  
            that have the need of a staff person to serve in a  
            supervisorial role during graveyard shifts. 

            At a minimum, staff "who assist residents with personal  
            activities of daily living" are required to be at least 18  
            years of age and undergo 10 hours of training initially and  








                                                                  AB 2044
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            four hours of training each year thereafter.  The training is  
            limited to covering the physical limitations and needs of the  
            elderly, the importance and techniques for personal care  
            services, residents' rights, policies and procedures regarding  
            medications, and the psychosocial needs of the elderly. 

           4)RCFE Reform Package  . In response to a number of highly  
            publicized events at facilities that have raised questions  
            about the adequacy of RCFEs and the state's ability to comply  
            with existing oversight and enforcement requirements, a number  
            of legislative measures are being pursued to strengthen,  
            address shortcomings, resolve legal liabilities and gaps in  
            the provision of services, and ultimately reform the RCFE  
            industry.  

           5)Related Legislation  . 

             a)   AB 1570 (Chesbro) would increase training requirements  
               for licensees and staff of RCFEs.  This bill is pending on  
               this committee's Suspense File.

             b)   SB 911 (Block) would increase the initial and continuing  
               education training requirements for licensees,  
               administrators, and direct care staff of RCFEs. In  
               addition, this bill would prohibit discrimination or  
               retaliation in any manner against a resident or employee  
               for calling 911. This bill is pending on the Senate  
               Appropriations Suspense File.


           Analysis Prepared by  :    Jennifer Swenson / APPR. / (916)  
          319-2081