BILL ANALYSIS �
SB 1153
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Date of Hearing: July 2, 2014
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Mike Gatto, Chair
SB 1153 (Leno) - As Amended: April 10, 2014
Policy Committee: Human
ServicesVote:6 - 0
Aging 6 - 0
Urgency: No State Mandated Local Program:
Yes Reimbursable: No
SUMMARY
This bill authorizes the Department of Social Services (DSS) to
suspend admissions to a Residential Care Facility for the
Elderly (RCFE) under specific circumstances. Specifically, this
bill:
1)Authorizes DSS to order a suspension of new admissions for a
facility if either:
a) The RCFE has violated statute or any applicable
regulations, the violation presents a direct and immediate
risk to the health, safety, or personal rights of a
resident or residents of the facility, and the violation is
not corrected immediately.
b) The RCFE has failed to pay a fine assessed by the
department after the facility's appeal rights have been
exhausted.
2)Provides that any suspension of new admissions for a failure
to pay a fine, as specified, shall remain in effect until the
facility pays the assessed find.
3)Requires a suspension of new admissions to remain in effect
until DSS determines the facility has corrected the violation.
4)Requires DSS to conduct a follow-up visit to determine
compliance within 10 working days following the latest date of
correction specified in the notice of deficiency, unless the
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licensee has demonstrated that the deficiency was corrected as
required in the notice.
5)Authorizes DSS to make unannounced visits after the suspension
of new admissions is lifted to ensure that the facility
continues to maintain correction of the violation and permits
DSS to order another suspension of new admissions or take
other appropriate enforcement action if the facility does not
maintain correction of the violation.
6)Provides appeal rights for RCFEs who have received an
admissions suspension and requires DSS to adopt regulations
that specify the appeal procedure.
FISCAL EFFECT
1)One-time costs to DSS of approximately $120,000 (GF) to
develop an implementation plan, write regulations, and update
the Evaluator Manual.
2)On-going costs to DSS, likely in the range of $30,000 to
$60,000 annually, for compliance and case management visits
following admissions bans, assuming between 50% and 100% of
possible admissions bans are imposed.
3)Unknown on-going costs to DSS, likely in the range of $250,000
to $500,000 annually, to process appeals. DSS reports that in
2012-13 there were 509 citations or penalty delinquencies that
could qualify for admissions suspension under this bill.
Assuming between 25% and 50% of RCFEs appeal a suspension and
that each appeal takes approximately 12.75 hours of staff
time, costs to handle the appeals would range from $250,000 to
$500,000. If suspensions were not imposed in all cases, the
costs would be less.
COMMENTS
1)Purpose . The author notes, California needs tougher
enforcement tools to help ensure that assisted living
facilities comply with the state's critical health and
safety regulations, which are designed to keep elderly
people safe during a critical time in their lives. SB
1153 allows Community Care Licensing (CCL) to ban all new
admissions to care facilities that have serious
violations of health and safety regulations. It gives
assisted living facilities an opportunity to focus on
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correcting the identified problems before admitting new,
paying clients. The bill would also ban new admissions
if a facility has not paid its fines. It is unacceptable
to allow elderly Californians, especially those who are
most vulnerable, to become residents of care homes that
we already know are unsafe. Under no circumstances
should new patients enter a facility that has documented
and unaddressed health and safety violations.
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 the needs of the resident.
There are 7,589 licensed RCFEs in California with a capacity
to serve more than 176,000 residents. Licensed by DSS'
Community Care Licensing Division (CCL), RCFEs range in size
from residential homes with six or less beds to more formal
residential facilities with 100 beds or more. DSS is required
to conduct unannounced licensing inspections of the more than
75,000 licensed community care facilities, including RCFEs, at
least once every five years, more often in some circumstances.
3)RCFE Reform Package . In response to a number of highly
publicized events at facilities licensed by CCL that have
raised questions regarding 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.
Analysis Prepared by : Jennifer Swenson / APPR. / (916)
319-2081
SB 1153
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