RCFE Reform Act of 2014 Bills Signed into Law

Professor Lillian Hyatt, NASW-CA’s columnist has done it again! 
She has successfully helped fight for the signing of AB 2171 (Wieckowski), which creates statutory Resident Bill of Rights.

Approved by Governor Brown on September 28, 2014, AB 2171, the Residential Care Facilities for the Elderly Act, provides for the licensure and regulation of residential care facilities for the elderly by the State Department of Social Services. A violation of these provisions is a misdemeanor.

This bill would establish specified rights for residents of privately operated residential care facilities for the elderly, including, among other things, to be accorded dignity in their personal relationships with staff, to be granted a reasonable level of personal privacy of accommodations, medical treatment, personal care and assistance, and to confidential treatment of their records and personal information, as specified. The bill would require, at admission, a facility staff person to personally advise a resident and the resident’s representative, as described, of these and other specified rights and to provide them with a written copy of these rights.

SACRAMENTO––Governor Brown has signed a number of bills aimed at increasing protections for residents of California’s 7,500-plus Residential Care Facilities for the Elderly (RCFEs).

As of Sunday, September 28, 2014, the Governor has signed a total of nine bills that were part of the RCFE Reform Act of 2014.  The RCFE Reform Act of 2014 was introduced in response to several scathing investigative reports about the failures in oversight and enforcement regarding California’s Residential Care Facilities for the Elderly, and the scandal at Valley Springs Manor in Castro Valley, where 19 elderly residents were abandoned by the care home’s owner/licensee. The reform bills focused on improving RCFE care, empowering residents, and providing DSS with some new tools to ensure compliance with regulatory standards.

Three important bills, AB 1554 (Skinner), AB 1571 (Eggman) and SB 894 (Corbett), that would have expedited complaint investigations, created an on-line RCFE consumer information system and mandated annual inspections of RCFEs respectively, did not make it through the legislative process dues to costs.  However, these laws are still sorely needed if there is ever to be true RCFE reform in California, and we will continue to advocate for their passage in future bills.

While much work remains to improve RCFE care and oversight, both in implementing the RCFE Reform Act bills and in addressing the remaining policy shortfalls, CANHR is extremely grateful to the individual legislators who authored the bills and to their staff for their unrelenting advocacy. The enactment of key parts of the RCFE Reform Act of 2014 is a victory for California’s long term care system and for RCFE residents.

The following RCFE Reform Act bills have been signed into law:

• SB 895 (Corbett): Requires DSS to post inspection reports; report on annual inspections
• SB 911 (Block): Increases administrator and staff training in RCFEs
• SB 1153 (Leno): Provides a ban on new admissions for out of compliance RCFEs
• SB 1382 (Block): Increases RCFE annual fees by 20%
• AB 1523 (Atkins): Requires all RCFEs to carry liability insurance 
• AB 1572 (Eggman): Increases rights of Resident and Family Councils
• AB 1899 (Brown): Prohibits reinstatement of license when licensee abandons residents
• AB 2044 (Rodriguez): Requires administrator on sight 24/7 and increased staff training
• AB 2171 (Wieckowski): Creates statutory Resident Bill of Rights

Note that AB 2236 (Mainschein and Stone) that would increase the penalties for abuse violations and violations that result in and death, has not yet been signed or vetoed.

According to Pat McGinnis, executive director of California Advocates for Nursing Home Reform, “These laws cannot right the wrongs that were committed against so many RCFE residents over the past years, but they do provide the Department with some better enforcement tools, provide for basic statutory resident rights and provide a path forward to ensure that protecting the health and safety of RCFE residents is a priority.”

CANHR is a statewide nonprofit 501(c)(3) advocacy organization.  CANHR’s mission is to improve the choices, care, and quality of life for California’s long-term care consumers. CANHR released a white paper on RCFE issues in October 2013, “Residential Care in California: Unsafe, Unregulated & Unaccountable,” with recommendations that led to the RCFE Reform Act of 2014.  

For a copy of the white paper, go to http://www.canhr.org/reports/Residential_Care_in_California.pdf

For fact sheets or more information on specific bills, go to http://www.canhr.org/legislation/rcfe_reform_act.html

Please check www.canhr.org for updated details on legislation.

The following bills include the RCFE Reform Act of 2014, the Medi-Cal Recovery reform, and other bills that CANHR sponsored or supported this legislative session.  Two of the bills have been signed into law and two of the bills died in committee. The bills that survived are now on the Governor’s desk for signing or veto.  Please write to the Governor and ask him to sign them into law. To check the status of all of the bills, go to www.canhr.org.

RCFE Reform Act of 2014
AB 1523 (Atkins): RCFE Liability Insurance – Signed into law!
Effective July 1, 2015, each Residential Care Facility for the Elderly, as a condition of licensure, will be required to obtain and maintain liability insurance. Each facility must to maintain liability insurance in the amount of one million dollars per occurrence and three million in the annual aggregate to cover injury to resident or guests caused by the negligent.
(Sponsored by CARR, San Diego)   
Timeline:  By July 1, 2015

AB 1554 (Skinner): Responding to Consumer Complaints – DEAD
This bill would require the Department to start and complete complaint investigations in a timely manner, give complainants written notice of findings and provide complainants an opportunity to appeal.  
Status: Failed in Senate Appropriations. Why? 
Because the budget analysis included “estimated” and “unknown” ongoing costs of $250,000 to $500,000 to provide consumers with a reliable complaint investigation system.  What the analysis failed to take into consideration was the substantial ongoing costs of not responding to complaints in a timely manner: the costs related to serious bodily injury and abuse and neglect that sends residents to acute care hospitals and premature deaths.

AB 1571 (Eggman): Consumer Information System – DEAD
This bill would require the Department of Social Services/Community Care Licensing to establish an on-line RCFE consumer information system to include specified updated and accurate information on every licensed RCFE in California This bill would also require complete disclosure of ownership and prior ownership of any type of facility, including nursing facilities, and would have established a rating system by 2019. 
Failed in Senate Appropriations.Why?  
Because the Administration did not want to spend the funds necessary to allow consumers to make informed choices about placement in RCFEs.

AB 1572 (Eggman): Resident & Family Councils:  Signed into law
This bill would amend current laws to enhance the rights of resident councils and family councils in RCFEs.
Timeline:  Effective January 1, 2015

AB 1899 (Brown): Forfeiture of License – Signed into law
This bill would prohibit a person whose license has been revoked or forfeited for abandonment of the facility permanently ineligible for reinstatement of a license. January 1, 2015

AB 2044 (Rodriguez):  RCFE Staffing Requirements – Signed into law
This bill would require an administrator or facility manager or designated substitute to be on premises 24/7, and for sufficient staff to be on premises 24/7 to carry out required responsibilities.  This bill would require at least one staff member with CPR and first aid training to be on premises at all times.  This bill would also require staff to be trained on building and fire safety and responding to emergencies.
Timeline:  January 1, 2016

AB 2171 (Wieckowski): Statutory Residents’ Bill of Rights – Signed into law
This bill as amended would create a statutory, comprehensive bill of rights for residents of RCFEs. The part of the bill allowing residents to file a lawsuit to obtain an injunction to fight violations of their rights was stripped from the bill in an amendment just prior to its final floor votes. This means the important rights codified in the bill will have to be enforced by DSS, which traditionally has done a poor job of enforcing resident rights.
Effective January 1, 2015

AB 2236 (Stone & Mainschein): Increased Penalties – Signed into law
This bill would have increased civil penalties against RCFEs for violations of laws and regulations from the current maximum of $150. Hijacked by the legislature and by the Executive Branch, the bill now includes an enormously complicated civil penalty system for all categories of facilities; imposes a $10,000 fine against RCFEs for physical abuse or serious bodily harm; imposes a $15,000 fine for deaths due to violations; and creates four (4!!!) levels of appeal for RCFE providers to appeal the fines.
Effective: July 1, 2015
While CANHR supports the increase in penalties for physical abuse, serious bodily injury and deaths for all RCFEs, we have serious reservations about a provider appeal system that is guaranteed to impair the assessment of civil penalties and the collections of such penalties even if they are assessed.  Legislators have committed to work with CANHR in the coming session to address these concerns with the appeal process.

SB 895 (Corbett) – Signed into law
RCFE Suspension/Revocation of Licenses (formerly SB 894) and Inspections/Evaluations of RCFEs (formerly SB 895): 
These bills have been substantially amended and combined into one bill which variously requires facilities to correct deficiencies within 10 days unless otherwise specified and requires the Department to post online instructions on how to obtain inspection reports offline, design an informational poster on reporting complaints and emergencies for display in RCFEs and notify the State Ombudsman Office when it plans to issue a temporary suspension or revocation of a facility license.
Leg intent to post by 1/1/2020; report to Legislatire on annual inspections by 1/1/2018.

SB 911 (Block): Training and qualifications of RCFE staff – Signed into law
This bill would increase the qualifications and training requirements for RCFE administrators from 40 hours to 80 hours and require facilities who accept and retain residents with restricted or prohibited health conditions to employ trained medical personnel as appropriate.
Effective: January 1, 2016

SB 1153 (Leno): Ban on Admissions — Signed into law
This bill would create new penalties for non-compliance, including authorizing the Department of Social Services to suspend the admission of new residents in facilities where there is a substantial probability of harm.
Effective January 1, 2015

SB 1382 (Block):  Increase in RCFE Fees – Signed into law
This bill increases the initial and annual licensing fees for RCFEs for every sized facility and makes legislative findings that it is imperative that DSS be given adequate resources to support its mandate to provide consumer protection.
Effective: January 1, 2015   

CANHR Support
AB 1700 (Medina): Reverse Mortgage Protections – Signed into law
This bill helps borrowers make informed decisions about whether a reverse mortgage is a suitable choice for their individual circumstances.  AB 1700 requires reverse mortgage sellers to give prospective borrowers a self-evaluation worksheet, to be completed before the existing mandatory counseling session.  The worksheet flags five possible pitfalls for reverse mortgage borrowers.  

AB 2603 (Perez): Access to Medications – Signed into law
This bill would clarify current law so that those trying to help an infirm family member or friend will not inadvertently break the law by picking up or transporting a prescription that is not in their name.

AB 1804 (Perea):  Consumer Protections from Insurance Lapses – Signed into law
This bill would expand the ability of consumers to designate additional persons to receive notices of lapse or termination of insurance policies due to non-payment of the premium.

Other CANHR Sponsored Bills
SB 1124 (Hernandez): Medi-Cal Recovery – Vetoed by the Governor.
This bill would limit Medi-Cal recovery for those who are 55+ years of age to only what is required by federal law, and eliminate optional recovery for other services; eliminate recovery on surviving spouses’ estates; and requires the Department of provide estate claim itemization to consumers for free upon request.  Note:  Co-sponsored with Western Center on Law and Poverty, this bill has unanimous bipartisan support, passing the Assembly Floor by 78-0 and the Senate Floor by 33-0.

Other RCFE Bills of Interest
AB 1436 (Waldron): Consumer Information – DIED in Assembly Appropriations
This bill would require DSS to post inspection reports and plans of correction for RCFEs on a consumer web site.

AB 1454 (Calderon): Annual Inspections – Died in Senate Appropriations
This bill would require annual inspections of RCFEs and other community care facilities.

AB 1570 (Chesbro): Residential Care Facilities for the Elderly – Signed into law
This bill would strengthen certification requirements for RCFE administrators and increase training requirements for direct care staff. It would also extend and expand certain dementia care training requirements to all RCFEs rather than just those that advertise or promote special dementia care.