BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 2556
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          Date of Hearing:   April 29, 2014

                        ASSEMBLY COMMITTEE ON HUMAN SERVICES
                                  Mark Stone, Chair
                  AB 2556 (Chau) - As Introduced:  February 21, 2014
           
          SUBJECT  :  Home Care Organizations

           SUMMARY  :  Delays implementation of the Home Care Services  
          Consumer Protection Act (Act) from January 1, 2015 until January  
          1, 2016 and makes technical changes to comply with the  
          Department of Justice's (DOJ) criminal background process. 

           EXISTING LAW   

          1)Establishes the Home Care Services Consumer Protection Act and  
            requires DSS to administer and enforce the law.  (H&S Codes  
            1796.10 and 1796.11)

          2)Defines "affiliated home care aide" as an individual, 18 years  
            of age or older, who is employed by a home care organization  
            to provide home care services to a client and is listed on the  
            home care aide registry.  (H&S Code 1796.12(a))

          3)Defines "home care organization" (HCO) as an individual, 18  
            years of age or older, firm, partnership, corporation, limited  
            liability company, joint venture, association, or other entity  
            that arranges for home care services by an affiliated home  
            care aide to a client, and is licensed.  (H&S Code 1796.12(j))  


          4)Defines "home care services" as nonmedical services and  
            assistance provided by a registered home care aide to a client  
            who, because of advanced age or physical or mental disability,  
            cannot perform these services, as specified.  (H&S Code  
            1796.12(m))

          5)Defines a "home care aide applicant" as an individual, 18  
            years of age or older, who is requesting to become a  
            registered home care aide and DSS has received and is  
            processing the individual's complete home care aide  
            application and fees.  (H&S Code 1796.12(g))

          6)Defines a "home care aide registry" as a  
            department-established and department-maintained Internet Web  








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            site of registered home care aides and home care aide  
            applicants, which includes specified information.  (H&S Code  
            1796.12(i))

          7)Allows DSS to adopt rules and regulations to implement the  
            act; establish procedures for the receipt, investigation and  
            resolution of complaints; maintain a registry on its Internet  
            Web site of all certified home care aides, containing limited  
            information that includes their employers, their certification  
            status, and the status of disciplinary actions against them;  
            and, maintain a registry on its Internet Web site of all  
            licensed HCOs containing specified information.  (H&S Code  
            1796.63)

          8)Requires home care aides to receive a criminal background  
            clearance prior to being placed on the home care registry, as  
            specified.  (H&S Code 1796.24)

          9)Allows DSS to investigate complaints against an employment  
            agency if it fails to comply with the HCSA and levy civil  
            penalties of up to $900 per day per violation.  (H&S Code  
            1796.55)
           
           10)Requires DSS to conduct random, unannounced inspections once  
            every five years to ensure compliance with the HCSA.  (H&S  
            Code 1796.52)

          11)Establishes training requirements for home care aide  
            certification, including requiring home care aides to complete  
            five hours of training on job-related topics, as specified.   
            (H&S 1796.44)

          12)Requires that DSS set a fee for a two-year certification to  
            be paid for by the home care aide.  (H&S Code 1796.31)

          13)Requires DSS to assess licensure and certification fees in  
            amounts sufficient to cover the costs of administering the  
            HCSA and prohibits the use of General Fund (GF) moneys for  
            purposes of funding activities under the HCSA unless  
            specifically transferred or appropriated by the Legislature.   
            (H&S Code 1796.47)

          14)Establishes the Home Care Fund within the State Treasury and  
            requires that licensure and certification funds, as well as  
            fines and penalties, be deposited into the Fund, from which  








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            funds shall, upon appropriation by the Legislature, be made  
            available to DSS to administer the HCSA.  (H&S Code 1796.47)

           FISCAL EFFECT  :  Unknown

           COMMENTS  :    

           Regulating the home care market  :  Last year the Legislature  
          passed and the state adopted AB 1217 (Lowenthal), Chapter 790,  
          Statutes of 2013.  AB 1217 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 in order 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 websites 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. 

          As a result, AB 1217 enacted the Home Care Services Consumer  
          Protection Act to be implemented January 1, 2015, which  
          regulates the home care industry, except home care/domestic  








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          referral agencies, by addressing home care organizations, the  
          home care aides they employ, and independent home care aides.   
          AB 1217 provided a structure by which established agencies and  
          individuals provide home care services are held accountable to  
          the public demand for greater standards and accountability for  
          home care aides.  
           
          Need for the bill  :  Stating the need for the bill, the author  
          writes:

               "To address concerns about the need to ensure all consumers  
               of home care services have access to quality care from  
               properly screened and trained caregivers, Governor Brown  
               signed AB 1217 (Bonnie Lowenthal) in 2013 to establish the  
               licensure and regulation of private pay home care  
               organizations by the Department of Social Services (DSS)  
               and the registration of private pay home care aides.  

               However, when Governor Brown signed AB 1217 he stated he  
               was signing it because "legislative leaders committed to  
               delay the bill's effective date by one year to January 1,  
               2016."  The Governor further stated the one year "delay,  
               coupled with other clarifying changes, will give the  
               Department of Social Services enough time to accomplish  
               what the bill seeks to achieve, and ultimately provide for  
               smoother implementation of these good consumer  
               protections."

          Further, as a co-sponsor of the bill, the Service Employees  
          International Union, California writes:

               The language in [this bill] is technical in nature and will  
               address the Governor's signing message by delaying the  
               requirement that the Home Care Service Providers be  
               licensed one year to give DSS more time to implement the  
               licensure provisions more effectively.  It also makes  
               technical changes dealing with background checks so the  
               Department of Justice may comply with current law. 

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          SEIU California, co-sponsor 









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           Opposition 
           
          None on file.
           
          Analysis Prepared by  :    Chris Reefe / HUM. S. / (916) 319-2089