BILL ANALYSIS �
Senate Appropriations Committee Fiscal Summary
Senator Kevin de Le�n, Chair
SB 894 (Corbett) - Residential care facilities for the elderly:
revocation of license.
Amended: May 7, 2014 Policy Vote: HS 3-2, JUD 6-0
Urgency: No Mandate: Yes
Hearing Date: May 23, 2014 Consultant: Jolie Onodera
SUSPENSE FILE. AS AMENDED.
Bill Summary: SB 894 would revise existing residential care
facilities for the elderly (RCFE) license suspension and
revocation provisions of law, as follows:
Requires the Department of Social Services (DSS) to notify
the Office of the State Long-Term Care (LTC) Ombudsman upon
the actual or contemplated temporary suspension or
revocation of a license.
Requires additional licensee notices to RCFE residents of
temporary suspension or final revocation orders.
Expands DSS duties of care to RCFE residents being
relocated.
Authorizes current and former RCFE residents to bring a
civil action against any person, firm, partnership, or
corporation that owns, operates, establishes, manages,
conducts, or maintains a RCFE that violates the rights of
the resident.
Fiscal Impact (as approved on May 23, 2014):
Potentially significant initial and future costs in the
high hundreds of thousands of dollars (General Fund/Special
Fund*). One-time costs to establish the response plan and
protocol would likely be in the low hundreds of thousands of
dollars. Future costs would be dependent on the number of
residents requiring DSS to provide the expanded duties of
care enumerated in the bill in the event of a license
suspension or revocation.
Unknown, additional state costs, should the DSS seek
injunctive relief and damages through the Attorney General
for reimbursement of costs from the licensee.
Minor fiscal impact to the Department of Aging (CDA) to
receive additional notifications from DSS of pending
suspension and revocation orders.
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*Technical Assistance Fund
Background: This measure is one of a broader set of bills aimed
at reforming the oversight, standards, and operations of RCFEs.
The Community Care Licensing Division (CCLD) of the DSS
administers the licensure and oversight of over 7,500 assisted
living, board and care, and continuing care retirement homes
that are licensed as RCFEs in California. These residences are
designed to provide home-like environment housing options to
elderly residents who need assistance with activities of daily
living but otherwise do not require continuous, 24-hour
assistance or nursing care. The RCFE licensure category includes
facilities with as few as six beds to facilities with hundreds
of residents whose needs may vary widely.
In response to recent health and safety issues discovered at
facilities licensed by the CCLD, the 2014-15 Governor's Budget
proposes a comprehensive plan to reform the CCLD program. This
proposal includes an increase of $7.5 million ($5.8 million
General Fund) and 71.5 positions to improve the timeliness of
investigations, ensure the CCLD inspects all facilities at least
once every five years, increase staff training, and establish
clear fiscal, program, and corporate accountability. The
proposal also increases civil penalties assessed for violations
and increases licensing and application fees by 10 percent. The
proposed budget for CCLD in 2014-15 is $118 million ($36 million
General Fund). This represents an 11 percent increase above
estimated 2013-14 total expenditures (37 percent above 2013-14
General Fund expenditures).
This bill was prompted in part by the events that occurred in
October 2013 at Valley Springs Manor Residential Care Center in
Castro Valley, in which elderly residents were left without
adequate care after the owners and paid staff members walked out
of the facility while under impending license revocation. The
stranded residents were cared for by two unpaid and untrained
employees - a cook and a janitor - until 911 calls were made and
rescuers arrived to evacuate the residents.
Proposed Law: This bill would amend existing RCFE license
suspension and revocation process provisions of law, as follows:
Requires DSS to provide the State LTC Ombudsman with a
precautionary notice if DSS is reasonably contemplating a
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temporary suspension or revocation of any license.
Prohibits a licensee from accepting new residents or entering
into admission agreements for new residents upon receipt of an
order to suspend or revoke a license.
Requires the licensee to provide written notice of license
suspension to residents or residents' responsible person as
soon as practically possible but not later than within 24
hours of receipt of notice.
Authorizes DSS to secure or permit the licensee to secure, the
services of a person or entity, as specified, to manage the
day-to-day operations of the facility until the matter is
heard, as specified, and for at least 60 days thereafter,
subject to specified execution of agreement and documents
submitted.
Deletes the minimum preadmission fee entitling a resident to
fee refunds.
Requires the revoked licensee, within 24 hours (instead of 10
days) after all residents have been transferred, to submit a
final list of names and new locations of all residents to DSS
and local ombudsman program.
Requires DSS to take any necessary actions to minimize trauma
for residents at any time during or following a temporary
suspension or revocation of a license, to include:
o Contacting local agency, as specified.
o Contacting residents' relatives, legal
representatives, authorized agents in a health care
directive, or responsible party.
o Assisting in the transfer of residents, and
arranging or coordinating transportation.
o Providing onsite evaluation of residents.
o Arranging for or coordinating care and
supervision.
o Arranging for the distribution of medications,
preparation of meals.
o Assisting in any way necessary to facilitate a
safe transfer of all residents.
o Checking on the status of transferred
residents within 24 hours of transfer.
Provides that a licensee who fails to comply with all
requirements is liable for civil penalties of $500 per
violation per day, until the violation has been corrected.
Allows current or former RCFE residents to bring a civil
action against any person, firm, partnership, or corporation
who owns, operates, establishes, manages, conducts, or
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maintains an RCFE who violates the rights of a resident, as
specified.
Provides that violators of provisions of this bill would be
responsible for the acts of the facility employees and be
liable for costs and attorney's fees.
Related Legislation: SB 1153 (Leno) 2014 would permit the DSS to
order a suspension of new admissions to a RCFE under specified
conditions. This bill is pending referral to committee in the
Assembly.
The following bills regarding licensing and inspections at
community care facilities, and RCFEs specifically, have been
introduced this session:
SB 895 (Corbett) RCFEs: annual inspections.
SB 911 (Block) RCFEs: licensing and training requirements.
SB 1382 (Block) RCFEs: licensure fees.
AB 1436 (Waldron) RCFEs: internet posting of inspection reports.
AB 1523 (Atkins) RCFEs: liability insurance.
AB 1554 (Skinner) RCFEs: complaint procedures.
AB 1570 (Chesbro) RCFEs: training requirements.
AB 1571 (Eggman) RCFEs: disclosure requirements.
AB 1572 (Eggman) RCFEs: single resident council.
AB 1899 (Brown) RCFEs: prohibitions on licensure reinstatement.
AB 2044 (Rodriguez) RCFEs: 24-hour presence of
administrator/staff.
AB 2171 (Wieckowski) RCFEs: residents' rights.
Staff Comments: This bill expands the actions DSS must take
following a temporary suspension or revocation of an RCFE
license to include duties such as arranging for or coordinating
care and supervision, arranging for the distribution of
medications, arranging for the preparation and service of meals
and snacks, arranging for the preparation of the residents'
records and medications for transfer of each resident, assisting
in any way necessary to facilitate a safe transfer of all
residents, and checking on the status of each transferred
resident within 24 hours of transfer.
The DSS would likely incur one-time potentially significant
costs to establish the framework for the response plan and
protocol to implement the expanded duties, to ensure DSS is
prepared to respond effectively and efficiently in the event of
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a temporary suspension or revocation requiring DSS action.
Future costs for providing or arranging for the services would
be dependent on the number of residents requiring the services
enumerated in the bill in the event of a license suspension or
revocation, and could be substantial.
While the bill provides that a licensee that fails to comply
with the "requirements of this section" shall be required to
reimburse the department and local agencies for the cost of
providing these services, the provision mandating DSS to request
the Attorney General or local prosecutors to seek injunctive
relief and damages, as specified, would also incur additional
costs, with reimbursement, if successful, potentially not
realized for an extended period of time.
This bill authorizes current and former RCFE residents to bring
a civil action against any person, firm, partnership, or
corporation that owns, operates, establishes, manages, conducts,
or maintains a RCFE that violates the rights of the resident.
Due to the expanded duties of care required under the provisions
of this bill that could generally place DSS and its employees as
persons "managing or maintaining" an RCFE, this appears to place
undue liability on DSS and its employees during any period in
which the expanded duties of care are being provided.
Author amendments remove the potential undue liability to the
state and DSS employees.