BILL ANALYSIS �
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|SENATE RULES COMMITTEE | AB 2044|
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THIRD READING
Bill No: AB 2044
Author: Rodriguez (D)
Amended: 6/12/14 in Senate
Vote: 21
SENATE HUMAN SERVICES COMMITTEE : 4-0, 6/10/14
AYES: Beall, DeSaulnier, Liu, Wyland
NO VOTE RECORDED: Berryhill
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
ASSEMBLY FLOOR : 64-1, 5/19/14 - See last page for vote
SUBJECT : Residential care facilities for the elderly
SOURCE : Author
DIGEST : This bill requires that residential care facilities
for the elderly (RCFEs) maintain at least one administrator,
facility manager, or designated substitute who is at least 21
years of age and has adequate qualifications, as specified, to
be on the premises 24-hours a day. This bill additionally
requires that at least one RCFE staff member who has
cardiopulmonary resuscitation (CPR) training and first aid
training shall be on duty and on the premises at all times and
that training for direct-care staff include building and fire
safety and the appropriate response to emergencies.
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ANALYSIS :
Existing Law:
1. Establishes the RCFE Act, which provides for the licensure
and regulation of RCFEs, defined as a housing arrangement
chosen voluntarily by persons over 60 years of age or over
where varying levels of supervision, or personal care are
provided, as a separate category within the existing
residential care licensing structure of the Department of
Social Services (DSS).
2. Requires a license applicant and an RCFE administrator to
successfully complete a certification program approved by
DSS, which shall include a minimum of 40 hours of classroom
instruction including a uniform core of knowledge, as
specified.
3. Provides that the administrator of an RCFE shall be present
at the facility during normal working hours or that a
facility manager designated by the licensee shall be
responsible for the facility when the administrator is
temporarily absent. Additionally provides that if the
facility manager and the administrator is the same person
then he/she is limited to the management of one facility.
4. Through regulation, provides that administrators shall be on
the premises a sufficient number of hours to permit adequate
attention to the administration of the facility, as
specified. Additionally provides that when the administrator
is not in the facility, there shall be coverage by a
designated substitute who shall have qualifications adequate
to be responsible and accountable for management and
administration of the facility as specified.
5. Provides that RCFE administrators must be at least 21 years
of age and have a valid certificate as an RCFE administrator
and through regulation requires that all staff must be 18
years of age or older and that staff providing care be
trained in first aid.
This bill:
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1. Requires that RCFEs maintain at least one administrator,
facility manager, or designated substitute by the
administrator who is at least 21 years of age and has
qualifications adequate to be responsible and accountable for
the management and administration of the facility, as
specified, to be on the premises 24-hours a day.
2. Requires the facility to employ, and the administrator to
schedule, a sufficient number of staff members to do the
following:
A. Provide the care required in each resident's written
record of care, as specified.
B. Ensure the health, safety, comfort and supervision of
the residents.
C. Ensure that at least one staff member who has CPR
training and first aid training shall be on duty and on
the premises at all times. Clarifies this is not to be
construed to require staff to provide CPR to a resident
who has requested to forgo resuscitative measures, as
specified.
D. Ensure the facility is clean, safe, sanitary and in
good repair at all times.
3. Adds to the required training for direct-care staff to
include building and fire safety and the appropriate response
to emergencies.
Background
This bill is one of a large package of bills that respond to a
series of recent events calling into question the adequacy of
DSS oversight and the state's ability to protect people who
reside in RCFEs. Specifically, in July 2013, ProPublica and
Frontline reporters wrote and produced a series of stories on
Emeritus, the nation's largest RCFE provider. Featured in the
article was a woman who died after receiving poor care at in a
facility in Auburn, California. The series documented chronic
understaffing and a lack of required assessments and substandard
care.
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Additionally, 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 CCL.
Most recently, in late October 2013, 19 frail seniors were
abandoned at Valley Springs Manor in Castro Valley by the
licensee and all but two staff after the state began license
revocation proceedings. DSS inspectors, noting the facility had
been abandoned, left the two unpaid service staff to care for
the abandoned residents with insufficient food and medication,
handing them a $3,800 citation before leaving for the weekend.
The next day sheriff's deputies and paramedics sent the patients
to local hospitals.
RCFEs . Within California's continuum of long term care,
situated between in-home care and skilled nursing facilities, is
the RCFE, also commonly called Assisted Living, Board and Care,
or Residential Care. There are approximately 8,000 Assisted
Living, Board and Care, and Continuing Care Retirement homes
that are licensed as RCFEs in California. RCFEs are designed to
provide homelike housing options to seniors and other adults who
need some help with activities of daily living, such as cooking,
bathing, or getting dressed, but otherwise do not need
continuous, 24-hour care. Increasingly, however, residents are
entering RCFEs with significant health needs including diabetes,
bedsores, or require the use of oxygen tanks, catheters,
colostomies or ileostomies.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
SUPPORT : (Verified 6/20/14)
AFSCME
Association of Regional Center Agencies
California Advocates for Nursing Home Reform
California Assisted Living Association
California Long-Term Care Ombudsman Association
California Senior Legislature
California State Retirees
Long-Term Care Ombudsman, San Luis Obispo County
National Association of Social Workers-California Chapter
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Retired Public Employees Association
San Diego County
OPPOSITION : (Verified 6/20/14)
Community Residential Care of California
United Filipino Care Providers and Caregivers, Inc.
ARGUMENTS IN SUPPORT : California Advocates for Nursing Home
Reform (CANHR) writes in support that this bill helps protect
the state's frail and vulnerable seniors in RCFEs by enhancing
staffing requirements. CANHR states that sufficient staff will
enable RCFEs to address problems before they endanger the
health, safety, and security of residents. Many of the
organizations in support write they are in favor of increased
staffing and health and safety requirements for RCFEs and
believe this bill improves oversight and management of RCFEs.
ARGUMENTS IN OPPOSITION : The United Filipino Care Providers
and Caregivers, Inc. (UFil) opposes this bill, stating the
requirement for the administrator, facility manager or
designated substitute to be on the premises 24-hours a day
unfairly impacts six-bed RCFEs. UFil states these additional
costs needed to meet this requirement will eliminate the six-bed
RCFEs and limits choices to elderly needing care and
supervision.
The Community Residential Care Association of California (CRCA)
opposes this bill stating the requirement to have at least one
employee over the age of 21 on the premises at all time is to
suggest that a person who is 18 is not capable of providing the
care and supervision of the residents. CRCA states that the age
of the employee shouldn't be a factor, but rather the maturity
and competence of the individual, for the amount of
responsibility he/she can assume.
ASSEMBLY FLOOR : 64-1, 5/19/14
AYES: Achadjian, Alejo, Ammiano, Bloom, Bocanegra, Bonilla,
Bonta, Bradford, Brown, Buchanan, Ian Calderon, Campos, Chau,
Ch�vez, Chesbro, Conway, Cooley, Dababneh, Daly, Dickinson,
Eggman, Fong, Fox, Frazier, Garcia, Gatto, Gomez, Gonzalez,
Gordon, Gorell, Gray, Grove, Hagman, Hall, Roger Hern�ndez,
Holden, Jones-Sawyer, Levine, Linder, Lowenthal, Maienschein,
Medina, Mullin, Muratsuchi, Pan, Perea, John A. P�rez, V.
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Manuel P�rez, Quirk, Quirk-Silva, Rendon, Ridley-Thomas,
Rodriguez, Salas, Skinner, Stone, Ting, Waldron, Weber,
Wieckowski, Wilk, Williams, Yamada, Atkins
NOES: Jones
NO VOTE RECORDED: Allen, Bigelow, Dahle, Donnelly, Beth Gaines,
Harkey, Logue, Mansoor, Melendez, Nazarian, Nestande, Olsen,
Patterson, Wagner, Vacancy
JL:d 6/25/14 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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