SB 980: Veterans’ homes.
- Session Year: 2015-2016
- House: Senate
- Latest Version Date: 2016-06-22
Existing law provides for the establishment and operation of veterans homes at various sites, and provides for an administrator of each home, as specified. Existing law establishes the duties of the Department of Veterans Affairs with regard to the establishment and regulation of veterans homes.
This bill would revise and recast those provisions. Among other things, the bill would provide that the administrator is the senior executive appointed to oversee the operations of a veterans home. The bill would specify which veterans homes are administered by the Department of Veterans Affairs. The bill would require the Secretary of Veterans Affairs to adopt uniform statewide policies and procedures, by regulation, for the operation of those veterans homes, as specified. The bill would require the secretary to implement a statewide electronic medical record system for veterans homes by a specified date. The bill would require the secretary to annually report to the Senate and Assembly Committees on Veterans Affairs, as specified.
Existing law establishes the criteria for admission to a veterans home, as specified. Existing law establishes the fees and charges for residency, as established by each administrator of a home, and requires each administrator to adopt rules and regulations for the administration of the homes.
This bill would instead require that the fees and charges be established by the secretary, rather than by each administrator, and that the secretary adopt rules and regulations that apply to the homes and the criteria for admission. The bill would authorize the secretary to establish needs-based criteria for admission to veterans homes, homes and to prioritize admission for veterans with service-related disabilities, as specified.
Existing law authorizes a resident spouse to continue his or her residency after a veteran spouses death.
This bill would require a resident spouse who continues residency after a veteran spouses death to continue to pay all applicable fees and to comply with all department regulations. regulations, and would expand those provisions to include domestic partners.
Existing law authorizes the department to investigate a veterans financial status for admission purposes.
This bill would further authorize the department to determine the total worth of any members property or assets for purposes of admission, including to validate income levels for purposes of establishing fees. a residents or applicants income or suitability for residence at a veterans home and would provide that providing false information or failure to pay fees is grounds for financial penalties or discharge from a veterans home.
Existing law requires 100% of the moneys received by a veterans home from veterans receiving federal aid to be placed to the credit of the home to augment the current appropriation for the support of the home.
This bill would delete that provision, and would instead require moneys received by a veterans home from those veterans to be deposited into the Federal Trust Fund, a continuously appropriated fund, to be used for the operating costs of the home. Because the moneys would be continuously appropriated for those purposes, the bill would make an appropriation. provision.
Existing law requires members of a veterans home to pay fees and charges as determined by the department, subject to a specified fee schedule.
This bill would prohibit the fees paid by a member from exceeding the average costs of care for the level of care in which the member currently resides. provide that failure to pay fees is cause for the administrator to refer the resident to collections or dismiss the resident from the home.
Existing law, upon the death of a veteran in a home, requires any moneys not in excess of $3,000 held by the home for the veteran to be paid to the homes Morale, Welfare, and Recreation Fund, if no will or heir or other family member is discovered within a specified number of years after his or her death.
This bill would increase the amount that may be transferred to $15,000.
Existing law, upon the departure of a veteran from a home, requires any moneys not in excess of $3,000 held by the home for the veteran to be paid to the homes Morale, Welfare, and Recreation Fund, if the money is not requested by the veteran within a specified number of years after his or her departure.
This bill would increase the amount that may be transferred to $5,000.
This bill would make other conforming changes and would delete obsolete provisions and references, as specified.
Existing law provides for the establishment and operation of veterans homes at various sites, and provides for an administrator of each home, as specified. Existing law establishes the duties of the Department of Veterans Affairs with regard to the establishment and regulation of veterans homes.
This bill would revise and recast those provisions. Among other things, the bill would provide that the administrator is the senior executive appointed to oversee the operations of a veterans home. The bill would specify which veterans homes are administered by the Department of Veterans Affairs. The bill would require the Secretary of Veterans Affairs to adopt uniform statewide policies and procedures, by regulation, for the operation of those veterans homes, as specified. The bill would require the department to establish a quality of care assessment team, by a specified date, to conduct periodic reviews of each veterans home. The bill would require the secretary to implement a statewide electronic medical record system for veterans homes by a specified date. The bill would require the secretary to annually report to the veterans policy committees of the Legislature, Senate and Assembly Committees on Veterans Affairs, as specified.
Existing law establishes the criteria for admission to a veterans home, as specified. Existing law establishes the fees and charges for residency, as established by each administrator of a home, and requires each administrator to adopt rules and regulations for the administration of the homes.
This bill would instead require that the fees and charges be established by the secretary, rather than by each administrator, and that the secretary adopt rules and regulations that apply to the homes and the criteria for admission. The bill would authorize the secretary to establish needs-based criteria for admission to veterans homes, as specified.
Existing law authorizes a resident spouse to continue his or her residency after a veteran spouses death.
This bill would require a resident spouse who continues residency after a veteran spouses death to continue to pay all applicable fees and to comply with all department regulations.
Existing law authorizes the department to investigate a veterans financial status for admission purposes.
This bill would further authorize the department to determine the total worth of any members property or assets for purposes of admission, including to validate income levels for purposes of establishing fees.
Existing law requires 100% of the moneys received by a veterans home from veterans receiving federal aid to be placed to the credit of the home to augment the current appropriation for the support of the home.
This bill would delete that provision, and would instead require moneys received by a veterans home from those veterans to be deposited into the Federal Trust Fund, a continuously appropriated fund, to be used for the operating costs of the home. Because the moneys would be continuously appropriated for those purposes, the bill would make an appropriation.
Existing law requires members of a veterans home to pay fees and charges as determined by the department, subject to a specified fee schedule.
This bill would prohibit the fees paid by a member from exceeding the average costs of care for the level of care in which the member currently resides.
Existing law, upon the death of a veteran in a home, requires any moneys not in excess of $3,000 held by the home for the veteran to be paid to the homes Morale, Welfare, and Recreation Fund, if no will or heir or other family member is discovered within a specified number of years after his or her death.
This bill would increase the amount that may be transferred to $15,000.
Existing law, upon the departure of a veteran from a home, requires any moneys not in excess of $3,000 held by the home for the veteran to be paid to the homes Morale, Welfare, and Recreation Fund, if the money is not requested by the veteran within a specified number of years after his or her departure.
This bill would increase the amount that may be transferred to $5,000.
This bill would make other conforming changes and would delete obsolete provisions and references, as specified.
Existing law provides for the establishment and operation of veterans homes at various sites, and provides for an administrator of each home, as specified. Existing law establishes the duties of the Department of Veterans Affairs with regard to the establishment and regulation of veterans homes.
This bill would revise and recast those provisions. Among other things, the bill would provide that the administrator is the senior executive appointed to oversee the operations of a veterans home. The bill would specify which veterans homes are administered by the Department of Veterans Affairs. The bill would require the Secretary of Veterans Affairs to adopt uniform statewide policies and procedures, by regulation, for the operation of those veterans homes, as specified. The bill would require the department to establish a quality of care assessment team, by a specified date, to conduct periodic reviews of each veterans home. The bill would require the secretary to implement a statewide electronic medical record system for veterans homes by a specified date. The bill would require the secretary to annually report to the veterans policy committees of the Legislature, as specified.
Existing law establishes the criteria for admission to a veterans home, as specified. Existing law establishes the fees and charges for residency, as established by each administrator of a home, and requires each administrator to adopt rules and regulations for the administration of the homes.
This bill would instead require that the fees and charges be established by the secretary, rather than by each administrator, and that the secretary adopt rules and regulations that apply to the homes and the criteria for admission. The bill would authorize the secretary to establish needs-based criteria for admission to veterans homes, as specified.
Existing law authorizes a resident spouse to continue his or her residency after a veteran spouses death.
This bill would require a resident spouse who continues residency after a veteran spouses death to continue to pay all applicable fees and to comply with all department regulations.
Existing law authorizes the department to investigate a veterans financial status for admission purposes.
This bill would further authorize the department to determine the total worth of any members property or assets for purposes of admission, including to validate income levels for purposes of establishing fees.
Existing law requires 100% of the moneys received by a veterans home from veterans receiving federal aid to be placed to the credit of the home to augment the current appropriation for the support of the home.
This bill would delete that provision, and would instead require moneys received by a veterans home from those veterans to be deposited into the Federal Trust Fund, a continuously appropriated fund, to be used for the operating costs of the home. Because the moneys would be continuously appropriated for those purposes, the bill would make an appropriation.
Existing law requires members of a veterans home to pay fees and charges as determined by the department, subject to a specified fee schedule.
This bill would prohibit the fees paid by a member from exceeding the average costs of care for the level of care in which the member currently resides.
Existing law, upon the death of a veteran in a home, requires any moneys not in excess of $3,000 held by the home for the veteran to be paid to the homes Morale, Welfare, and Recreation Fund, if no will or heir or other family member is discovered within a specified number of years after his or her death.
This bill would increase the amount that may be transferred to $15,000.
Existing law, upon the departure of a veteran from a home, requires any moneys not in excess of $3,000 held by the home for the veteran to be paid to the homes Moral, Morale, Welfare, and Recreation Fund, if the money is not requested by the veteran within a specified number of years after his or her departure.
This bill would increase the amount that may be transferred to $5,000.
This bill would make other conforming changes and would delete obsolete provisions and references, as specified.
Existing law provides for the establishment and operation of veterans homes at various sites, and provides for an administrator of each home, as specified. Existing law establishes the duties of the Department of Veterans Affairs with regard to the establishment and regulation of veterans homes.
This bill would revise and recast those provisions. Among other things, the bill would provide that the administrator is the senior executive appointed to oversee the operations of a veterans home. The bill would specify which veterans homes are administered by the Department of Veterans Affairs. The bill would require the Secretary of Veterans Affairs to adopt uniform statewide policies and procedures, by regulation, for the operation of those veterans homes, as specified. The bill would require the department to establish a quality of care assessment team, by a specified date, to conduct periodic reviews of each veterans home. The bill would require the secretary to implement a statewide electronic medical record system for veterans homes by a specified date. The bill would require the secretary to annually report to the veterans policy committees of the Legislature, as specified.
Existing law establishes the criteria for admission to a veterans home, as specified. Existing law establishes the fees and charges for residency, as established by each administrator of a home, and requires each administrator to adopt rules and regulations for the administration of the homes.
This bill would instead require that the fees and charges be established by the secretary, rather than by each administrator, and that the secretary adopt rules and regulations that apply to the homes and the criteria for admission. The bill would authorize the secretary to establish needs-based criteria for admission to veterans homes, as specified.
Existing law authorizes a resident spouse to continue his or her residency after a veteran spouses death.
This bill would require a resident spouse who continues residency after a veteran spouses death to continue to pay all applicable fees and to comply with all department regulations.
Existing law authorizes the department to investigate a veterans financial status for admission purposes.
This bill would further authorize the department to determine the total worth of any members property or assets for purposes of admission, including to validate income levels for purposes of establishing fees.
Existing law requires 100% of the moneys received by a veterans home from veterans receiving federal aid to be placed to the credit of the home to augment the current appropriation for the support of the home.
This bill would delete that provision, and would instead require moneys received by a veterans home from those veterans to be deposited into the Federal Trust Fund, a continuously appropriated fund, to be used for the operating costs of the home. Because the moneys would be continuously appropriated for those purposes, the bill would make an appropriation.
Existing law requires members of a veterans home to pay fees and charges as determined by the department, subject to a specified fee schedule.
This bill would prohibit the fees paid by a member from exceeding the average costs of care for the level of care in which the member currently resides.
Existing law, upon the death of a veteran in a home, requires any moneys not in excess of $3,000 held by the home for the veteran to be paid to the homes Morale, Welfare, and Recreation Fund, if no will or heir or other family member is discovered within a specified number of years after his or her death.
This bill would increase the amount that may be transferred to $15,000.
Existing law, upon the departure of a veteran from a home, requires any moneys not in excess of $3,000 held by the home for the veteran to be paid to the homes Moral, Welfare, and Recreation Fund, if the money is not requested by the veteran within a specified number of years after his or her departure.
This bill would increase the amount that may be transferred to $5,000.
This bill would make other conforming changes and would delete obsolete provisions and references, as specified.
(a)Notwithstanding any other law, the department may adopt, amend, or repeal regulations concerning the administration and operation of the Veterans Home of California. Except as otherwise provided, these regulations shall be adopted pursuant to the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code).
(b)The department may adopt, amend, and repeal emergency regulations concerning the administration and operation of the Veterans Home of California in compliance with Section 11346.1 of the Government Code. However, if special circumstances, as defined in subdivision (c), are present, then those regulations shall not be subject to the requirements regarding findings of emergency in paragraph (2) of subdivision (b) of Section 11346.1 of the Government Code.
(c)Special circumstances shall be deemed to exist if the Secretary of Veterans Affairs states in writing that the adoption, amendment, or repeal is necessary for one or more of the following reasons:
(1)The possible loss or delay in the receipt of federal, state, or local funding.
(2)The need to maintain licensing or certification by any state or federal agency for any Veterans Home of California facility or program.
(3)The need to protect against a serious and immediate threat to the health or safety of residents or staff in one or more of the facilities of the Veterans Home of California.
(4)The urgent need to comply immediately with recommendations of the Department of Finance or the California State Auditor.
SEC. 2.Section 79.4 is added to the Military and Veterans Code, to read:79.4.(a)The department shall do all of the following concerning the operation and administration of the veterans homes:
(1)Take the necessary steps to ensure that all medical or other facilities under its jurisdiction satisfy all applicable federal and state licensing, certification, and other approval requirements, including, but not limited to, the requirements of the United States Department of Veterans Affairs, the federal Centers for Medicare and Medicaid Services, the State Department of Public Health, the State Department of Social Services, and the California State Board of Pharmacy, including preparation of plans of correction as required.
(2)Develop and maintain clinical policies and procedures, including both of the following:
(A)Community standards for best clinical practices, including, but not limited to, practices recommended by the federal Centers for Disease Control and Prevention and the federal Centers for Medicare and Medicaid Services.
(B)The appropriate clinical standard of practice.
(3)Adopt fire and life safety policies and procedures consistent with the requirements of the State Fire Marshal and other applicable regulatory and licensing agencies.
(4)Adopt earthquake and environmental protection policies and procedures.
(b)The department may adopt regulations to implement this section. The adoption, amendment, or repeal of a regulation authorized by this section is hereby exempted from the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code).
SECTION 1.SEC. 3.Section 1010 of the Military and Veterans Code is amended to read:1010.As used in this chapter, the following terms have the following meanings:
(a)Administrator means the senior executive appointed to oversee the operations of a home.
(b)Department means the Department of Veterans Affairs.
(c)Deputy secretary means the Deputy Secretary of Veterans Homes. Affairs.
(d)Director or secretary means the Secretary of Veterans Affairs.
(e)Home means any facility operated by the department for the provision of long-term care, assisted living, adult day health, independent living, or other health care services to eligible veterans.
(f)Member means any veteran or nonveteran spouse or domestic partner who has been admitted to residency at any home.
(g)Veteran means a person who is eligible for benefits under this chapter.
SEC. 2.SEC. 4.Section 1011 of the Military and Veterans Code is repealed.SEC. 3.SEC. 5.Section 1011 is added to the Military and Veterans Code, to read:1011.There is in the department a Veterans Home of California, which the department shall administer. The Veterans Home of California is a system comprising the following subsidiary home locations:
(a)The Veterans Home of California, Yountville, in Napa County.
(b)The Veterans Home of California, Barstow, in San Bernardino County.
(c)The Veterans Home of California, Chula Vista, in San Diego County.
(d)The Veterans Home of California, West Los Angeles, in Los Angeles County.
(e)The Veterans Home of California, Lancaster, in Los Angeles County.
(f)The Veterans Home of California, Ventura, in Santa Barbara County.
(g)The Veterans Home of California, Fresno, in Fresno County.
(h)The Veterans Home of California, Redding, in Shasta County.
SEC. 4.SEC. 6.Section 1011.1 is added to the Military and Veterans Code, to read:1011.1.(a)The secretary shall adopt uniform statewide policies and procedures, by regulation, in accordance with the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), for the operation of the homes. The policies and procedures shall be in conformity, as nearly as possible, to the rules and regulations of the with all relevant licensing and certification agencies, including, but not limited to, the United States Department of Veterans Affairs for their facilities and Affairs, the federal Centers for Medicare and Medicaid Services, the State Department of Social Services, and the State Department of Public Health to ensure that adequate care and a homelike environment is provided in a cost-effective manner for members of the homes.
(b)These policies and procedures shall implement the requirements to obtain and maintain required licenses and accreditations, as well as to ensure members in all homes throughout the state, to the extent possible, receive equitable treatment, benefits, and services, and to ensure that high-quality care is provided.
(c)These policies and procedures shall include, but are not limited to, all of the following:
(1)The admission of applicants.
(2)The conditions upon which members may enter and remain in the home.
(3)Resident disciplinary procedures.
(4)Quality of care standards.
(5)An internal quality of care review process.
(6)Delineating which services will be provided to members by the state.
(7)Setting staffing standards.
(8)Staff training requirements.
(9)Establishment and operation of allied councils.
(9)Clarifying the relationship between the department and allied councils.
(10)Any other policies and procedures to ensure the safe and effective operation of the homes.
SEC. 5.SEC. 7.Section 1011.2 is added to the Military and Veterans Code, to read:1011.2.(a)There shall be an administrator for each home, who shall be recommended by the secretary and appointed by the Governor, and who shall be located at that home. The salary for each administrator shall be subject to the approval of the Department of Human Resources.
(b)The administrator shall be responsible for ensuring compliance with all state and federal statutes and regulations related to the operation of the home and for implementation of all statewide policies and procedures, as specified in Section 1011.1.
SEC. 6.SEC. 8.Section 1011.3 is added to the Military and Veterans Code, to read:1011.3.The
(a)It is the intent of the Legislature that the department submit the report required pursuant to this section at a level of detail that will provide the Legislature and the public with indicators of the quality of both the health care and the management of facilities of the Veterans Home of California without compromising members privacy while still in compliance with applicable law and regulation. By submitting consistent indicators over the long term, the Legislature will be able to readily see significant changes and more effectively perform its oversight functions.
(b)The secretary shall make an annual report to the Senate and Assembly Committees on Veterans Affairs by January 1 of each year, beginning January 1, 2018, reporting on April 1 of each year, beginning April 1, 2018. This report shall be in compliance with the federal Health Insurance Portability and Accountability Act (HIPAA) (Public Law 104-191) and all relevant laws and regulations related to patient privacy or other protected information. This report shall reflect significant veterans veterans home-related performance issues, which shall include, but are not limited to, all of the following:
(a)
(1)Current census and census changes since last report.
(b)
(2)Any major changes to home policy and the impact of those changes on the residents.
(c)
(3)Changes in provision of care, including licensure changes.
(d)
(4)Significant events that impacted the operations of the home.
(e)Results of regulatory agency inspections or reviews and corrective action taken to address findings.
(5)Copies of annual licensing survey records.
(f)
(6)Significant patient care complaints, results of any investigations into those complaints, and any corrective action taken to address validated complaints.
(g)Results of internal quality of care reviews.
(h)A comparison of veterans home quality of care metrics to industry averages.
(7)Copies of available data from licensing agencies comparing veterans home quality of care metrics to industry averages.
(i)
(8)Other significant issues that may be of interest to the committee members.
SEC. 7.SEC. 9.Section 1011.4 is added to the Military and Veterans Code, to read:1011.4.(a)On or before January 1, 2018, 2019, the secretary shall implement an electronic medical record system. The usage of the electronic medical record system shall be standardized in all homes.
(b)The electronic medical record system required by this section, and all transactions made in that system, shall comply with the Confidentiality of Medical Information Act (Part 2.6 (commencing with Section 56) of Division 1 of the Civil Code), Chapter 1 (commencing with Section 123100) of Part 1 of Division 106 of the Health and Safety Code, the Information Practices Act of 1977 (Chapter 1 (commencing with Section 1798) of Title 1.8 of Part 4 of Division 3 of the Civil Code), the federal Health Insurance Portability and Accountability Act (HIPAA)(Public (HIPAA) (Public Law 104-191), the federal Health Information Technology for Economic and Clinical Health Act (HITECH) (Public Law 111-005), and all corresponding regulations relating to privacy and security.
SEC. 8.SEC. 10.Section 1012 of the Military and Veterans Code is amended to read:1012.(a)The home is for aged and disabled persons who served in the Armed Forces of the United States, who were discharged or released from active duty under honorable conditions from service, who are eligible for hospitalization or domiciliary care in a veterans facility in accordance with the rules and regulations of the United States Department of Veterans Affairs, are unable to pay for necessary domiciliary and licensed long-term care outside the home, and who are bona fide residents of this state at the time of application; and for the spouses of these persons if all of the following conditions, as are applicable, are satisfied:
(1)Space is available.
(2)Joint residency will be in the best interests of the home member, as determined by the administrator.
(3)The spouse is a bona fide resident of this state at the time of application for admission to the home and either is married to, and has resided with, the home member for at least one year, or is the widow or widower of a recipient of the Medal of Honor or a former prisoner of war (POW).
(4)The home member and spouse agree to pay the fees and charges for joint residency, or for a widow or widower, that the secretary may establish.
(b)(1)Veterans who qualify for benefits under this chapter due to service during a time of war shall be given priority over veterans who qualify due to service during a time of peace.
(2)Veterans who qualify for benefits under this chapter who are recipients of the Medal of Honor or who were prisoners of war (POWs) shall be given priority over all other qualified veterans, regardless of the level of care required.
(3)
(3)Veterans who qualify for benefits under this chapter who have disability ratings that have been rated by the United States Department of Veterans Affairs as being service-connected, as determined under Part 4 of Title 38 of the Code of Federal Regulations, may be given priority over other veterans.
(4)The secretary may establish needs-based criteria for admission to the homes, and any veteran meeting those criteria shall be given priority over veterans who do not qualify for prioritization under paragraph (2) or (3) and can afford to provide for their own care elsewhere.
(c)A resident spouse or domestic partner may continue residence after the veterans death, so long as he or she continues to pay all applicable fees and comply with the departments policies, procedures, and regulations.
(d)The property of the home shall be used for this purpose.
SEC. 9.SEC. 11.Section 1012.1 of the Military and Veterans Code is amended to read:1012.1.(a)Prior to the admission of a veteran an applicant as a member of the a veterans
home, and at any time during which a veteran person is a member of the a veterans home, the department may investigate any applicants or members financial status and personal background to determine the total value of the property and assets of any veteran applying for admission to the home, or to ensure that the member is unable to pay for necessary care outside of the home, or to validate income levels for the purposes of establishing fees. the members or applicants income and suitability for residence at a veterans home. The department may contract with any other state or federal agency or private entity to conduct such an investigation in on its behalf.
(b)Providing false financial and other information by an applicant or member or nonpayment of fees may be grounds for financial penalties or denial of admission to, or discharge from, a veterans home.
SEC. 10.SEC. 12.Section 1012.2 of the Military and Veterans Code is amended to read:1012.2.(a)(1)Notwithstanding any other law, any member of the home who is receiving an aid and attendance allowance from the United States Department of Veterans Affairs and who has no dependent spouse, child, grandchild, father, or mother shall pay to the home an amount equal to that allowance in all levels of care excluding domiciliary.
(2)Paragraph (1)
(b)Subdivision (a) shall not apply to a member of the home who is in intermediate care or skilled nursing care and has a disability that has been rated by the United States Department of Veterans Affairs as being 70 percent or more service-connected, as determined under Part 4 of Title 38 of the Code of Federal Regulations.
(b)Moneys received by a home under this section shall be deposited into the Federal Trust Fund and shall be used for the operating costs of the home.
SEC. 11.SEC. 13.Section 1012.3 of the Military and Veterans Code is amended to read:1012.3.(a)Members of the home, including members who are nonveteran spouses, spouses or domestic partners, shall pay fees and charges as determined by the department, department to cover room and board, except that the total of the individual members fees and charges for any fiscal year shall not be greater than as set forth in the following schedule:
(1)Forty-seven and one-half percent of the members annual income for domiciliary care.
(2)Fifty-five percent of the members annual income for residential care for the elderly or assisted living.
(3)Sixty-five percent of the members annual income for intermediate care.
(4)Seventy percent of the members annual income for skilled nursing care.
(b)Subdivision (a) shall not apply to a member of the home who is in intermediate care or skilled nursing care and has a disability that has been rated by the United States Department of Veterans Affairs as being 70 percent or more service-connected, as determined under Part 4 of Title 38 of the Code of Federal Regulations and whose related payments made under Section 51.41 of Title 38 of the Code of Federal Regulations are considered by the United States Department of Veterans Affairs as payment in full for the members care.
(c)Fees paid by a member shall not exceed the average cost of care for the level of care in which the member currently resides.
(c)Subdivision (a) shall not apply to penalties for late fee payment.
(d)Failure to pay the required fees shall be cause for the administrator to refer the resident to collections or dismiss the resident from the home.
(e)Retroactive benefit payments from the United States Department of Veterans Affairs shall be subject to subdivision (a) for the period of the time covered by the benefit award that the veteran resided at a veterans home. The veterans home shall recompute the fees and charges previously determined for the benefit period, and the resident shall be billed for the full amount of fees and charges due for the benefit period.
SEC. 12.SEC. 14.Section 1012.4 of the Military and Veterans Code is repealed.SEC. 15.Section 1012.4 is added to the Military and Veterans Code, to read:1012.4.Notwithstanding Section 1012, the department may arrange by contract or any other form of agreement with the United States Department of Veterans Affairs to leverage federal contracts for the procurement of goods and services.
SEC. 13.SEC. 16.Section 1012.6 of the Military and Veterans Code is repealed.SEC. 14.SEC. 17.Section 1014 of the Military and Veterans Code is repealed.SEC. 15.SEC. 18.Section 1015 of the Military and Veterans Code is repealed.SEC. 16.SEC. 19.Section 1023 of the Military and Veterans Code is amended to read:1023.(a)The department may sue and be sued in any of the courts of this state. All property held by the department for the home shall be held in trust for the state and for the use and benefit of the home. The secretary shall adopt rules and regulations for the administration of the homes conforming as nearly as possible to the rules and regulations of the United States Department of Veterans Affairs and those of other states with veterans homes.
(b)The Director of General Services may lease or let any real property held by the department for the home, and not needed for any direct or immediate purpose of the home, to any entity or person upon terms and conditions determined to be in the best interests of the home. All moneys received in connection therewith shall be deposited in the General Fund as a reimbursement for operating costs of the home.
SEC. 17.SEC. 20.Section 1024 of the Military and Veterans Code is repealed.SEC. 18.SEC. 21.Section 1033.2 of the Military and Veterans Code is repealed.SEC. 19.SEC. 22.Section 1034 of the Military and Veterans Code is amended to read:1034.Except money received from this state for disbursement, all moneys received by the home, or by any officer of the home, including pension and other moneys belonging to veterans and other trust moneys, shall be immediately paid to the administrator of the home. On or before the 10th day of each month, the administrator of the home shall forward to the Treasurer all moneys in his or her possession, except pension and other moneys belonging to veterans, trust moneys, the post funds, the emergency fund, and donations made to each home, hereinafter mentioned, together with a statement of the sources from which the moneys have been received. The moneys shall be deposited by the Treasurer to the credit of the General Fund; provided, however, that abatements of support expenditures shall be credited to the support appropriation current at the time of collection.
SEC. 20.SEC. 23.Section 1035.3 of the Military and Veterans Code is amended to read:1035.3.(a)If no will or heir is discovered within two years after the death of the veteran, any moneys not exceeding fifteen thousand dollars ($15,000) held by the home pursuant to Section 1035 and not paid or otherwise delivered to the heir or heirs or pursuant to the will of the deceased veteran, or otherwise disbursed by the administrator pursuant to Section 1035, shall be paid to the Morale, Welfare, and Recreation Fund.
If no will or heir is discovered within five years after the death of the veteran, any moneys exceeding fifteen thousand dollars ($15,000) held by the home pursuant to Section 1035 and not paid or otherwise delivered to the heir or heirs or pursuant to the will of the deceased veteran, or otherwise disbursed by the administrator pursuant to Section 1035, shall be paid to the Morale, Welfare, and Recreation Fund.
This subdivision applies only to veterans becoming members of the home on or after January 1, 1984.
(b)If no spouse, child, grandchild, or father or mother is discovered within two years after the death of the veteran, any moneys not exceeding fifteen thousand dollars ($15,000) held by the home pursuant to Section 1035 and not paid or otherwise delivered to the spouse, children, grandchildren, or father or mother, or otherwise disbursed by the administrator pursuant to Section 1035, shall be paid to the Morale, Welfare, and Recreation Fund.
If no spouse, child, grandchild, or father or mother is discovered within five years after the death of the veteran, any moneys exceeding fifteen thousand dollars ($15,000) held by the home pursuant to Section 1035 and not paid or otherwise delivered to the spouse, children, grandchildren, or father or mother, or otherwise disbursed by the administrator pursuant to Section 1035, shall be paid to the Morale, Welfare, and Recreation Fund.
This subdivision applies only to veterans who have become members of the home prior to January 1, 1984.
SEC. 21.SEC. 24.Section 1038 of the Military and Veterans Code is amended to read:1038.All money deposited with the home for a veteran shall be paid to him or her on demand, upon his or her discharge or voluntary departure from the home. If the money is not so demanded at the time of his or her discharge or departure or within a period of two years thereafter, if the amount does not exceed five thousand dollars ($5,000), or within a period of five years thereafter, if the amount exceeds five thousand dollars ($5,000) either by the veteran, or, in the event of the veterans death after his or her discharge or departure, by the veterans heirs, devisees, legatees, or qualified executor or administrator of his or her estate, the money shall be paid to the Morale, Welfare, and Recreation Fund.
SEC. 25.Section 1038.5 of the Military and Veterans Code is amended to read:1038.5.Any money deposited with the home by a veteran member shall be credited with interest at no more than the State Monetary Investment Fund rate, less 0.75 percent, interest, pursuant to Section 51.60 of Title 38 and Section 483.10 of Title 42 of the Code of Federal Regulations, and shall be paid to the veteran member or to his or her heirs, devisees, legatees, or the qualified executor or the administrator of his or her estate pursuant to Section 1037 or Section 1038.
SEC. 22.SEC. 26.Section 1044 of the Military and Veterans Code is amended to read:1044.The secretary may adopt rules and regulations governing the admission of applicants and may prescribe the conditions upon which they may enter and remain with the home.
SEC. 23.SEC. 27.Section 1051 of the Military and Veterans Code is repealed.As used in this chapter, the following terms have the following meanings:
(a)Administrator means the senior executive appointed to oversee the operations of a home.
(b)Department means the Department of Veterans Affairs.
(c)Deputy secretary means the Deputy Secretary of Veterans Homes.
(d)Director or secretary means the Secretary of Veterans Affairs.
(e)Home means any facility operated by the department for the provision of long-term care, assisted living, adult day health, independent living, or other health care services to eligible veterans.
(f)Member means any veteran or nonveteran spouse who has been admitted to residency at any home.
(g)Veteran means a person who is eligible for benefits under this chapter.
SEC. 2.Section 1011 of the Military and Veterans Code is repealed.SEC. 3.Section 1011 is added to the Military and Veterans Code, to read:1011.There is in the department a Veterans Home of California, which the department shall administer. The Veterans Home of California is a system comprising the following subsidiary home locations:
(a)The Veterans Home of California, Yountville, in Napa County.
(b)The Veterans Home of California, Barstow, in San Bernardino County.
(c)The Veterans Home of California, Chula Vista, in San Diego County.
(d)The Veterans Home of California, West Los Angeles, in Los Angeles County.
(e)The Veterans Home of California, Lancaster, in Los Angeles County.
(f)The Veterans Home of California, Ventura, in Santa Barbara County.
(g)The Veterans Home of California, Fresno, in Fresno County.
(h)The Veterans Home of California, Redding, in Shasta County.
SEC. 4.Section 1011.1 is added to the Military and Veterans Code, to read:1011.1.(a)The secretary shall adopt uniform statewide policies and procedures, by regulation, in accordance with the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), for the operation of the homes. The policies and procedures shall be in conformity, as nearly as possible, to the rules and regulations of the United States Department of Veterans Affairs for their facilities and to ensure that adequate care and a homelike environment is provided in a cost-effective manner for members of the homes.
(b)These policies and procedures shall implement the requirements to obtain and maintain required licenses and accreditations, as well as to ensure members in all homes throughout the state, to the extent possible, receive equitable treatment, benefits, and services, and to ensure that high-quality care is provided.
(c)These policies and procedures shall include, but are not limited to, all of the following:
(1)The admission of applicants.
(2)The conditions upon which members may enter and remain in the home.
(3)Resident disciplinary procedures.
(4)Quality of care standards.
(5)An internal quality of care review process.
(6)Delineating which services will be provided to members by the state.
(7)Setting staffing standards.
(8)Staff training requirements.
(9)Establishment and operation of allied councils.
(10)Any other policies and procedures to ensure the safe and effective operation of the homes.
(d)On or before July 1, 2017, the department shall establish a quality of care assessment team, from within existing resources, to conduct periodic reviews of how each home meets the quality of care standards adopted pursuant to this section.
SEC. 5.Section 1011.2 is added to the Military and Veterans Code, to read:1011.2.(a)There shall be an administrator for each home, who shall be recommended by the secretary and appointed by the Governor, and who shall be located at that home. The salary for each administrator shall be subject to the approval of the Department of Human Resources.
(b)The administrator shall be responsible for ensuring compliance with all state and federal statutes and regulations related to the operation of the home and for implementation of all statewide policies and procedures, as specified in Section 1011.1.
SEC. 6.Section 1011.3 is added to the Military and Veterans Code, to read:1011.3.The secretary shall make an annual report to the veterans policy committees of the Legislature Senate and Assembly Committees on Veterans Affairs by January 1 of each year, beginning January 1, 2018, reporting on significant veterans home-related performance issues, which shall include, but are not limited to, all of the following:
(a)Current census and census changes since last report.
(b)Any major changes to home policy and the impact of those changes on the residents.
(c)Changes in provision of care, including licensure changes.
(d)Significant events that impacted the operations of the home.
(e)Results of regulatory agency inspections or reviews and corrective action taken to address findings.
(f)Significant patient care complaints, results of any investigations into those complaints, and any corrective action taken to address validated complaints.
(g)Results of internal quality of care reviews.
(h)A comparison of veterans home quality of care metrics to industry averages.
(i)Other significant issues that may be of interest to the committee members.
SEC. 7.Section 1011.4 is added to the Military and Veterans Code, to read:1011.4.(a)On or before January 1, 2018, the secretary shall implement an electronic medical record system. The usage of the electronic medical record system shall be standardized in all homes.
(b)The electronic medical record system required by this section, and all transactions made in that system, shall comply with the Confidentiality of Medical Information Act (Part 2.6 (commencing with Section 56) of Division 1 of the Civil Code), Chapter 1 (commencing with Section 123100) of Part 1 of Division 106 of the Health and Safety Code, the Information Practices Act of 1977 (Chapter 1 (commencing with Section 1798) of Title 1.8 of Part 4 of Division 3 of the Civil Code), the federal Health Insurance Portability and Accountability Act (HIPAA)(Public Law 104-191), the federal Health Information Technology for Economic and Clinical Health Act (HITECH) (Public Law 111-005), and all corresponding regulations relating to privacy and security.
SEC. 8.Section 1012 of the Military and Veterans Code is amended to read:1012.(a)The home is for aged and disabled persons who served in the Armed Forces of the United States of America, States, who were discharged or released from active duty under honorable conditions from service, who are eligible for hospitalization or domiciliary care in a veterans facility in accordance with the rules and regulations of the United States Department of Veterans Affairs, are unable to pay for necessary domiciliary and licensed long-term care outside the home, and who are bona fide residents of this state at the time of application; and for the spouses of these persons if all of the following conditions, as are applicable, are satisfied:
(1)Space is available.
(2)Joint residency will be in the best interests of the home member, as determined by the administrator.
(3)The spouse is a bona fide resident of this state at the time of application for admission to the home and either is married to, and has resided with, the home member for at least one year, or is the widow or widower of a recipient of the Medal of Honor or a former prisoner of war (POW).
(4)The home member and spouse agree to pay the fees and charges for joint residency, or for a widow or widower, that the secretary may establish.
(b)(1)Veterans who qualify for benefits under this chapter due to service during a time of war shall be given priority over veterans who qualify due to service during a time of peace.
(2)Veterans who qualify for benefits under this chapter who are recipients of the Medal of Honor or who were prisoners of war (POWs) shall be given priority over all other qualified veterans, regardless of the level of care required.
(3)The secretary may establish needs-based criteria for admission to the homes, and any veteran meeting those criteria shall be given priority over veterans who can afford to provide for their own care elsewhere.
(c)A resident spouse may continue residence after the veterans death, so long as he or she continues to pay all applicable fees and comply with the departments policies, procedures, and regulations.
(d)The property of the home shall be used for this purpose.
SEC. 9.Section 1012.1 of the Military and Veterans Code is amended to read:1012.1.Prior to the admission of a veteran as a member of the home, and at any time during which a veteran is a member of the home, the department may investigate any members financial status to determine the total value of the property and assets of any veteran applying for admission to the home, or to ensure that the member is unable to pay for necessary care outside of the home, or to validate income levels for the purposes of establishing fees. The department may contract with any other state agency to conduct such an investigation in its behalf.
SEC. 10.Section 1012.2 of the Military and Veterans Code is amended to read:1012.2.(a)(1)Notwithstanding any other law, any member of the home who is receiving an aid and attendance allowance from the United States Department of Veterans Affairs and who has no dependent spouse, child, grandchild, father, or mother shall pay to the home an amount equal to that allowance in all levels of care excluding domiciliary.
(2)Paragraph (1) shall not apply to a member of the home who is in intermediate care or skilled nursing care and has a disability that has been rated by the United States Department of Veterans Affairs as being 70 percent or more service-connected, as determined under Part 4 of Title 38 of the Code of Federal Regulations.
(b)Moneys received by a home under this section shall be deposited into the Federal Trust Fund and shall be used for the operating costs of the home.
SEC. 11.Section 1012.3 of the Military and Veterans Code is amended to read:1012.3.(a)Members of the home, including members who are nonveteran spouses, shall pay fees and charges as determined by the department, except that the total of the individual members fees and charges for any fiscal year shall not be greater than as set forth in the following schedule:
(1)Forty-seven and one-half percent of the members annual income for domiciliary care.
(2)Fifty-five percent of the members annual income for residential care for the elderly or assisted living.
(3)Sixty-five percent of the members annual income for intermediate care.
(4)Seventy percent of the members annual income for skilled nursing care.
(b)Subdivision (a) shall not apply to a member of the home who is in intermediate care or skilled nursing care and has a disability that has been rated by the United States Department of Veterans Affairs as being 70 percent or more service-connected, as determined under Part 4 of Title 38 of the Code of Federal Regulations and whose related payments made under Section 51.41 of Title 38 of the Code of Federal Regulations are considered by the United States Department of Veterans Affairs as payment in full for the members care.
(c)Fees paid by a member shall not exceed the average cost of care for the level of care in which the member currently resides.
SEC. 12.Section 1012.4 of the Military and Veterans Code is repealed.SEC. 13.Section 1012.6 of the Military and Veterans Code is repealed.SEC. 14.Section 1014 of the Military and Veterans Code is repealed.SEC. 15.Section 1015 of the Military and Veterans Code is repealed.SEC. 16.Section 1023 of the Military and Veterans Code is amended to read:1023.(a)The department may sue and be sued in any of the courts of this state. All property held by the department for the home shall be held in trust for the state and for the use and benefit of the home. The secretary shall adopt rules and regulations for the administration of the homes conforming as nearly as possible to the rules and regulations of the United States Department of Veterans Affairs and those of other states with veterans homes.
(b)The Director of General Services may lease or let any real property held by the department for the home, and not needed for any direct or immediate purpose of the home, to any entity or person upon terms and conditions determined to be in the best interests of the home. All moneys received in connection therewith shall be deposited in the General Fund as a reimbursement for operating costs of the home.
SEC. 17.Section 1024 of the Military and Veterans Code is repealed.SEC. 18.Section 1031 of the Military and Veterans Code is amended to read:1031.All moneys received by the state from the United States for the use of the home shall be deposited into the General Fund as a reimbursement for operating costs of the home.
SEC. 19.SEC. 18.Section 1033.2 of the Military and Veterans Code is repealed.SEC. 20.SEC. 19.Section 1034 of the Military and Veterans Code is amended to read:1034.Except money received from this state for disbursement, all moneys received by the home, or by any officer of the home, including pension and other moneys belonging to veterans and other trust moneys, shall be immediately paid to the administrator of the home. On or before the 10th day of each month, the administrator of the home shall forward to the Treasurer all moneys in his or her possession, except pension and other moneys belonging to veterans, trust moneys, the post funds, the emergency fund, and donations made to each home, hereinafter mentioned, together with a statement of the sources from which the moneys have been received. The moneys shall be deposited by the Treasurer to the credit of the General Fund; provided, however, that abatements of support expenditures shall be credited to the support appropriation current at the time of collection.
SEC. 21.SEC. 20.Section 1035.3 of the Military and Veterans Code is amended to read:1035.3.(a)If no will or heir is discovered within two years after the death of the veteran, any moneys not exceeding fifteen thousand dollars ($15,000) held by the home pursuant to Section 1035 and not paid or otherwise delivered to the heir or heirs or pursuant to the will of the deceased veteran, or otherwise disbursed by the administrator pursuant to Section 1035, shall be paid to the Morale, Welfare, and Recreation Fund.
If no will or heir is discovered within five years after the death of the veteran, any moneys exceeding fifteen thousand dollars ($15,000) held by the home pursuant to Section 1035 and not paid or otherwise delivered to the heir or heirs or pursuant to the will of the deceased veteran, or otherwise disbursed by the administrator pursuant to Section 1035, shall be paid to the Morale, Welfare, and Recreation Fund.
This subdivision applies only to veterans becoming members of the home on or after January 1, 1984.
(b)If no spouse, child, grandchild, or father or mother is discovered within two years after the death of the veteran, any moneys not exceeding fifteen thousand dollars ($15,000) held by the home pursuant to Section 1035 and not paid or otherwise delivered to the spouse, children, grandchildren, or father or mother, or otherwise disbursed by the administrator pursuant to Section 1035, shall be paid to the Morale, Welfare, and Recreation Fund.
If no spouse, child, grandchild, or father or mother is discovered within five years after the death of the veteran, any moneys exceeding fifteen thousand dollars ($15,000) held by the home pursuant to Section 1035 and not paid or otherwise delivered to the spouse, children, grandchildren, or father or mother, or otherwise disbursed by the administrator pursuant to Section 1035, shall be paid to the Morale, Welfare, and Recreation Fund.
This subdivision applies only to veterans who have become members of the home prior to January 1, 1984.
SEC. 22.SEC. 21.Section 1038 of the Military and Veterans Code is amended to read:1038.All money deposited with the home for a veteran shall be paid to him or her on demand, upon his or her discharge or voluntary departure from the home. If the money is not so demanded at the time of his or her discharge or departure or within a period of two years thereafter, if the amount does not exceed five thousand dollars ($5,000), or within a period of five years thereafter, if the amount exceeds five thousand dollars ($5,000) either by the veteran, or, in the event of the veterans death after his or her discharge or departure, by the veterans heirs, devisees, legatees, or qualified executor or administrator of his or her estate, the money shall be paid to the Morale, Welfare, and Recreation Fund.
SEC. 23.SEC. 22.Section 1044 of the Military and Veterans Code is amended to read:1044.The secretary may adopt rules and regulations governing the admission of applicants and may prescribe the conditions upon which they may enter and remain with the home.
SEC. 24.SEC. 23.Section 1051 of the Military and Veterans Code is repealed.As used in this chapter, the following terms have the following meanings:
(a)Administrator means the senior executive appointed to oversee the operations of a home.
(b)Department means the Department of Veterans Affairs.
(c)Deputy secretary means the Deputy Secretary of Veterans Homes.
(d)Director or secretary means the Secretary of Veterans Affairs.
(e)Home means any facility operated by the department for the provision of long-term care, assisted living, adult day health, independent living, or other health care services to eligible veterans.
(f)Member means any veteran or nonveteran spouse who has been admitted to residency at any home.
(g)Veteran means a person who is eligible for benefits under this chapter.
SEC. 2.Section 1011 of the Military and Veterans Code is repealed.SEC. 3.Section 1011 is added to the Military and Veterans Code, to read:1011.There is in the department a Veterans Home of California, which the department shall administer. The Veterans Home of California is a system comprising the following subsidiary home locations:
(a)The Veterans Home of California, Yountville, in Napa County.
(b)The Veterans Home of California, Barstow, in San Bernardino County.
(c)The Veterans Home of California, Chula Vista, in San Diego County.
(d)The Veterans Home of California, West Los Angeles, in Los Angeles County.
(e)The Veterans Home of California, Lancaster, in Los Angeles County.
(f)The Veterans Home of California, Ventura, in Santa Barbara County.
(g)The Veterans Home of California, Fresno, in Fresno County.
(h)The Veterans Home of California, Redding, in Shasta County.
SEC. 4.Section 1011.1 is added to the Military and Veterans Code, to read:1011.1.(a)The secretary shall adopt uniform statewide policies and procedures, by regulation, in accordance with the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), for the operation of the homes. The policies and procedures shall be in conformity, as nearly as possible, to the rules and regulations of the United States Department of Veterans Affairs for their facilities and to ensure that adequate care and a homelike environment is provided in a cost-effective manner for members of the homes.
(b)These policies and procedures shall implement the requirements to obtain and maintain required licenses and accreditations, as well as to ensure members in all homes throughout the state, to the extent possible, receive equitable treatment, benefits, and services, and to ensure that high-quality care is provided.
(c)These policies and procedures shall include, but are not limited to, all of the following:
(1)The admission of applicants.
(2)The conditions upon which members may enter and remain in the home.
(3)Resident disciplinary procedures.
(4)Quality of care standards.
(5)An internal quality of care review process.
(6)Delineating which services will be provided to members by the state.
(7)Setting staffing standards.
(8)Staff training requirements.
(9)Establishment and operation of allied councils.
(10)Any other policies and procedures to ensure the safe and effective operation of the homes.
(d)On or before July 1, 2017, the department shall establish a quality of care assessment team, from within existing resources, to conduct periodic reviews of how each home meets the quality of care standards adopted pursuant to this section.
SEC. 5.Section 1011.2 is added to the Military and Veterans Code, to read:1011.2.(a)There shall be an administrator for each home, who shall be recommended by the secretary and appointed by the Governor, and who shall be located at that home. The salary for each administrator shall be subject to the approval of the Department of Human Resources.
(b)The administrator shall be responsible for ensuring compliance with all state and federal statutes and regulations related to the operation of the home and for implementation of all statewide policies and procedures, as specified in Section 1011.1.
SEC. 6.Section 1011.3 is added to the Military and Veterans Code, to read:1011.3.The secretary shall make an annual report to the veterans policy committees of the Legislature by January 1 of each year, beginning January 1, 2018, reporting on significant veterans home-related performance issues, which shall include, but are not limited to, all of the following:
(a)Current census and census changes since last report.
(b)Any major changes to home policy and the impact of those changes on the residents.
(c)Changes in provision of care, including licensure changes.
(d)Significant events that impacted the operations of the home.
(e)Results of regulatory agency inspections or reviews and corrective action taken to address findings.
(f)Significant patient care complaints, results of any investigations into those complaints, and any corrective action taken to address validated complaints.
(g)Results of internal quality of care reviews.
(h)A comparison of veterans home quality of care metrics to industry averages.
(i)Other significant issues that may be of interest to the committee members.
SEC. 7.Section 1011.4 is added to the Military and Veterans Code, to read:1011.4.(a)On or before January 1, 2018, the secretary shall implement an electronic medical record system. The usage of the electronic medical record system shall be standardized in all homes.
(b)The electronic medical record system required by this section, and all transactions made in that system, shall comply with the Confidentiality of Medical Information Act (Part 2.6 (commencing with Section 56) of Division 1 of the Civil Code), Chapter 1 (commencing with Section 123100) of Part 1 of Division 106 of the Health and Safety Code, the Information Practices Act of 1977 (Chapter 1 (commencing with Section 1798) of Title 1.8 of Part 4 of Division 3 of the Civil Code), the federal Health Insurance Portability and Accountability Act (HIPAA)(Public Law 104-191), the federal Health Information Technology for Economic and Clinical Health Act (HITECH) (Public Law 111-005), and all corresponding regulations relating to privacy and security.
SEC. 8.Section 1012 of the Military and Veterans Code is amended to read:1012.(a)The home is for aged and disabled persons who served in the Armed Forces of the United States of America, who were discharged or released from active duty under honorable conditions from service, who are eligible for hospitalization or domiciliary care in a veterans facility in accordance with the rules and regulations of the United States Department of Veterans Affairs, are unable to pay for necessary domiciliary and licensed long-term care outside the home, and who are bona fide residents of this state at the time of application; and for the spouses of these persons if all of the following conditions, as are applicable, are satisfied:
(1)Space is available.
(2)Joint residency will be in the best interests of the home member, as determined by the administrator.
(3)The spouse is a bona fide resident of this state at the time of application for admission to the home and either is married to, and has resided with, the home member for at least one year, or is the widow or widower of a recipient of the Medal of Honor or a former prisoner of war (POW).
(4)The home member and spouse agree to pay the fees and charges for joint residency, or for a widow or widower, that the secretary may establish.
(b)(1)Veterans who qualify for benefits under this chapter due to service during a time of war shall be given priority over veterans who qualify due to service during a time of peace.
(2)Veterans who qualify for benefits under this chapter who are recipients of the Medal of Honor or who were prisoners of war (POWs) shall be given priority over all other qualified veterans, regardless of the level of care required.
(3)The secretary may establish needs-based criteria for admission to the homes, and any veteran meeting those criteria shall be given priority over veterans who can afford to provide for their own care elsewhere.
(c)A resident spouse may continue residence after the veterans death, so long as he or she continues to pay all applicable fees and comply with the departments policies, procedures, and regulations.
(d)The property of the home shall be used for this purpose.
SEC. 9.Section 1012.1 of the Military and Veterans Code is amended to read:1012.1.Prior to the admission of a veteran as a member of the home, and at any time during which a veteran is a member of the home, the department may investigate any members financial status to determine the total value of the property and assets of any veteran applying for admission to the home, or to ensure that the member is unable to pay for necessary care outside of the home, or to validate income levels for the purposes of establishing fees. The department may contract with any other state agency to conduct such an investigation in its behalf.
SEC. 10.Section 1012.2 of the Military and Veterans Code is amended to read:1012.2.(a)(1)Notwithstanding any other law, any member of the home who is receiving an aid and attendance allowance from the United States Department of Veterans Affairs and who has no dependent spouse, child, grandchild, father, or mother shall pay to the home an amount equal to that allowance in all levels of care excluding domiciliary.
(2)Paragraph (1) shall not apply to a member of the home who is in intermediate care or skilled nursing care and has a disability that has been rated by the United States Department of Veterans Affairs as being 70 percent or more service-connected, as determined under Part 4 of Title 38 of the Code of Federal Regulations.
(b)Moneys received by a home under this section shall be deposited into the Federal Trust Fund and shall be used for the operating costs of the home.
SEC. 11.Section 1012.3 of the Military and Veterans Code is amended to read:1012.3.(a)Members of the home, including members who are nonveteran spouses, shall pay fees and charges as determined by the department, except that the total of the individual members fees and charges for any fiscal year shall not be greater than as set forth in the following schedule:
(1)Forty-seven and one-half percent of the members annual income for domiciliary care.
(2)Fifty-five percent of the members annual income for residential care for the elderly or assisted living.
(3)Sixty-five percent of the members annual income for intermediate care.
(4)Seventy percent of the members annual income for skilled nursing care.
(b)Subdivision (a) shall not apply to a member of the home who is in intermediate care or skilled nursing care and has a disability that has been rated by the United States Department of Veterans Affairs as being 70 percent or more service-connected, as determined under Part 4 of Title 38 of the Code of Federal Regulations and whose related payments made under Section 51.41 of Title 38 of the Code of Federal Regulations are considered by the United States Department of Veterans Affairs as payment in full for the members care.
(c)Fees paid by a member shall not exceed the average cost of care for the level of care in which the member currently resides.
SEC. 12.Section 1012.4 of the Military and Veterans Code is repealed.SEC. 13.Section 1012.6 of the Military and Veterans Code is repealed.SEC. 14.Section 1014 of the Military and Veterans Code is repealed.SEC. 15.Section 1015 of the Military and Veterans Code is repealed.SEC. 16.Section 1023 of the Military and Veterans Code is amended to read:1023.(a)The department may sue and be sued in any of the courts of this state. All property held by the department for the home shall be held in trust for the state and for the use and benefit of the home. The secretary shall adopt rules and regulations for the administration of the homes conforming as nearly as possible to the rules and regulations of the United States Department of Veterans Affairs and those of other states with veterans homes.
(b)The Director of General Services may lease or let any real property held by the department for the home, and not needed for any direct or immediate purpose of the home, to any entity or person upon terms and conditions determined to be in the best interests of the home. All moneys received in connection therewith shall be deposited in the General Fund as a reimbursement for operating costs of the home.
SEC. 17.Section 1024 of the Military and Veterans Code is repealed.SEC. 18.Section 1031 of the Military and Veterans Code is amended to read:1031.All moneys received by the state from the United States for the use of the home shall be deposited into the General Fund as a reimbursement for operating costs of the home.
SEC. 19.Section 1033.2 of the Military and Veterans Code is repealed.SEC. 20.Section 1034 of the Military and Veterans Code is amended to read:1034.Except money received from this state for disbursement, all moneys received by the home, or by any officer of the home, including pension and other moneys belonging to veterans and other trust moneys, shall be immediately paid to the administrator of the home. On or before the 10th day of each month, the administrator of the home shall forward to the State Treasurer all moneys in his or her possession, except pension and other moneys belonging to veterans, trust moneys, the post funds, the emergency fund, and donations made to each home, hereinafter mentioned, together with a statement of the sources from which the moneys have been received. The moneys shall be deposited by the State Treasurer to the credit of the General Fund of the State; Fund; provided, however, that abatements of support expenditures shall be credited to the support appropriation current at the time of collection.
SEC. 21.Section 1035.3 of the Military and Veterans Code is amended to read:1035.3.(a)If no will or heir is discovered within two years after the death of the veteran, any moneys not exceeding fifteen thousand dollars ($15,000) held by the home pursuant to Section 1035 and not paid or otherwise delivered to the heir or heirs or pursuant to the will of the deceased veteran, or otherwise disbursed by the administrator pursuant to Section 1035, shall be paid to the Morale, Welfare, and Recreation Fund.
If no will or heir is discovered within five years after the death of the veteran, any moneys exceeding fifteen thousand dollars ($15,000) held by the home pursuant to Section 1035 and not paid or otherwise delivered to the heir or heirs or pursuant to the will of the deceased veteran, or otherwise disbursed by the administrator pursuant to Section 1035, shall be paid to the Morale, Welfare, and Recreation Fund.
This subdivision applies only to veterans becoming members of the home on or after January 1, 1984.
(b)If no spouse, child, grandchild, or father or mother is discovered within two years after the death of the veteran, any moneys not exceeding fifteen thousand dollars ($15,000) held by the home pursuant to Section 1035 and not paid or otherwise delivered to the spouse, children, grandchildren, or father or mother, or otherwise disbursed by the administrator pursuant to Section 1035, shall be paid to the Morale, Welfare, and Recreation Fund.
If no spouse, child, grandchild, or father or mother is discovered within five years after the death of the veteran, any moneys exceeding fifteen thousand dollars ($15,000) held by the home pursuant to Section 1035 and not paid or otherwise delivered to the spouse, children, grandchildren, or father or mother, or otherwise disbursed by the administrator pursuant to Section 1035, shall be paid to the Morale, Welfare, and Recreation Fund.
This subdivision applies only to veterans who have become members of the home prior to January 1, 1984.
SEC. 22.Section 1038 of the Military and Veterans Code is amended to read:1038.All money deposited with the home for a veteran shall be paid to him or her on demand, upon his or her discharge or voluntary departure from the home. If the money is not so demanded at the time of his or her discharge or departure or within a period of two years thereafter, if the amount does not exceed five thousand dollars ($5,000), or within a period of five years thereafter, if the amount exceeds five thousand dollars ($5,000) either by the veteran, or, in the event of the veterans death after his or her discharge or departure, by the veterans heirs, devisees, legatees, or qualified executor or administrator of his or her estate, the money shall be paid to the Morale, Welfare, and Recreation Fund.
SEC. 23.Section 1044 of the Military and Veterans Code is amended to read:1044.The secretary may adopt rules and regulations governing the admission of applicants and may prescribe the conditions upon which they may enter and remain with the home.
SEC. 24.Section 1051 of the Military and Veterans Code is repealed.As used in this chapter: chapter, the following terms have the following meanings:
(a)Home means the Veterans Home of California, Yountville, and the Veterans Home of California, Barstow.
(b)
(a)Administrator means the Administrator of the Veterans Home of California, Yountville, and the Administrator of each site of the southern California Veterans Home, including, but not limited to, the Veterans Home of California, Barstow. senior executive appointed to oversee the operations of a home.
(c)
(b)Department means the Department of Veterans Affairs.
(c)Deputy secretary means the Deputy Secretary of Veterans Homes.
(d)Director or secretary means the Director Secretary of Veterans Affairs.
(e)Veteran means a member of the home.
(e)Home means any facility operated by the department for the provision of long-term care, assisted living, adult day health, independent living, or other health care services to eligible veterans.
(f)Member means any veteran or nonveteran spouse who has been admitted to residency at any home.
(g)Veteran means a person who is eligible for benefits under this chapter.
SEC. 2.Section 1011 of the Military and Veterans Code is repealed.1011.(a)There is in the department a Veterans Home of California, Yountville, situated at Veterans Home, Napa County.
(b)(1)The department may establish and construct a second home that shall be situated in the County of Imperial, Los Angeles, Orange, Riverside, San Bernardino, San Diego, or Ventura. The home may be located on one or more sites. The department shall operate the second home concurrently with the first home.
(2)The initial site is the Veterans Home of California, Barstow, situated in Barstow, San Bernardino County. That site may provide skilled nursing care for up to 250 residents.
(3)When completed, the second site shall be the Veterans Home of California, Chula Vista, situated in Chula Vista, San Diego County, pursuant to the recommendations made by the commission established pursuant to former Section 1011.5.
(4)When completed, the third site shall be the Veterans Home of California, Lancaster, situated in Lancaster, Los Angeles County, pursuant to the recommendations made by the commission established pursuant to former Section 1011.5.
(5)When completed, the fourth site shall be the Veterans Home of California, Ventura, situated in the community of Saticoy, Ventura County.
(6)There shall be an administrator for, and located at, each site of the southern California home.
(7)The department may complete any preapplication process necessary with the United States Department of Veterans Affairs for construction of the second home.
(c)The Legislature hereby finds and declares that the second home is a new state function. The department may perform any or all work in operating the second home by independent contractors, except the overall administration and management of the home. Any and all actions of the department taken before September 17, 1996, that are consistent with this subdivision are hereby ratified and confirmed, it having at all times been the intent of the Legislature that the department be so authorized.
(d)There shall be an administrator for each home or homesite, who shall be recommended by the Secretary of Veterans Affairs and appointed by the Governor, and shall be located at that home or homesite. The salary for each administrator shall be subject to the approval of the Department of Human Resources.
SEC. 3.Section 1011 is added to the Military and Veterans Code, to read:1011.There is in the department a Veterans Home of California, which the department shall administer. The Veterans Home of California is a system comprising the following subsidiary home locations:
(a)The Veterans Home of California, Yountville, in Napa County.
(b)The Veterans Home of California, Barstow, in San Bernardino County.
(c)The Veterans Home of California, Chula Vista, in San Diego County.
(d)The Veterans Home of California, West Los Angeles, in Los Angeles County.
(e)The Veterans Home of California, Lancaster, in Los Angeles County.
(f)The Veterans Home of California, Ventura, in Santa Barbara County.
(g)The Veterans Home of California, Fresno, in Fresno County.
(h)The Veterans Home of California, Redding, in Shasta County.
SEC. 4.Section 1011.1 is added to the Military and Veterans Code, to read:1011.1.(a)The secretary shall adopt uniform statewide policies and procedures, by regulation, in accordance with the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), for the operation of the homes. The policies and procedures shall be in conformity, as nearly as possible, to the rules and regulations of the United States Department of Veterans Affairs for their facilities and to ensure that adequate care and a homelike environment is provided in a cost-effective manner for members of the homes.
(b)These policies and procedures shall implement the requirements to obtain and maintain required licenses and accreditations, as well as to ensure members in all homes throughout the state, to the extent possible, receive equitable treatment, benefits, and services, and to ensure that high-quality care is provided.
(c)These policies and procedures shall include, but are not limited to, all of the following:
(1)The admission of applicants.
(2)The conditions upon which members may enter and remain in the home.
(3)Resident disciplinary procedures.
(4)Quality of care standards.
(5)An internal quality of care review process.
(6)Delineating which services will be provided to members by the state.
(7)Setting staffing standards.
(8)Staff training requirements.
(9)Establishment and operation of allied councils.
(10)Any other policies and procedures to ensure the safe and effective operation of the homes.
(d)On or before July 1, 2017, the department shall establish a quality of care assessment team, from within existing resources, to conduct periodic reviews of how each home meets the quality of care standards adopted pursuant to this section.
SEC. 5.Section 1011.2 is added to the Military and Veterans Code, to read:1011.2.(a)There shall be an administrator for each home, who shall be recommended by the secretary and appointed by the Governor, and who shall be located at that home. The salary for each administrator shall be subject to the approval of the Department of Human Resources.
(b)The administrator shall be responsible for ensuring compliance with all state and federal statutes and regulations related to the operation of the home and for implementation of all statewide policies and procedures, as specified in Section 1011.1.
SEC. 6.Section 1011.3 is added to the Military and Veterans Code, to read:1011.3.The secretary shall make an annual report to the veterans policy committees of the Legislature by January 1 of each year, beginning January 1, 2018, reporting on significant veterans home-related performance issues, which shall include, but are not limited to, all of the following:
(a)Current census and census changes since last report.
(b)Any major changes to home policy and the impact of those changes on the residents.
(c)Changes in provision of care, including licensure changes.
(d)Significant events that impacted the operations of the home.
(e)Results of regulatory agency inspections or reviews and corrective action taken to address findings.
(f)Significant patient care complaints, results of any investigations into those complaints, and any corrective action taken to address validated complaints.
(g)Results of internal quality of care reviews.
(h)A comparison of veterans home quality of care metrics to industry averages.
(i)Other significant issues that may be of interest to the committee members.
SEC. 7.Section 1011.4 is added to the Military and Veterans Code, to read:1011.4.On or before January 1, 2018, the secretary shall implement an electronic medical record system. The usage of the electronic medical record system shall be standardized in all homes.
SEC. 8.Section 1012 of the Military and Veterans Code is amended to read:1012.(a)Except as provided in Section 1012.4, the The home is for aged and disabled persons who served in the Armed Forces of the United States of America America, who were discharged or released from active duty under honorable conditions from service, who are eligible for hospitalization or domiciliary care in a veterans facility in accordance with the rules and regulations of the United States Department of Veterans Affairs, are unable to pay for necessary domiciliary and licensed long-term care outside the home, and who are bona fide residents of this state at the time of application; and for the spouses of these persons if all of the following conditions, as are applicable, are satisfied:
(1)Space is available.
(2)Joint residency will be in the best interests of the home member, as determined by the administrator.
(3)The spouse is a bona fide resident of this state at the time of application for admission to the home and either is married to, and has resided with, the home member for at least one year, or is the widow or widower of a recipient of the Medal of Honor or a former prisoner of war (POW).
(4)The home member and spouse agree to pay the fees and charges for joint residency, or for a widow or widower, for the residency, that the administrator secretary may establish.
(b)(1)Veterans who qualify for benefits under this chapter due to service during a time of war shall be given priority over veterans who qualify due to service during a time of peace.
(2)Veterans who qualify for benefits under this chapter who are recipients of the Medal of Honor or who were prisoners of war (POWs) shall be given priority over all other qualified veterans, regardless of the level of care required.
(3)The secretary may establish needs-based criteria for admission to the homes, and any veteran meeting those criteria shall be given priority over veterans who can afford to provide for their own care elsewhere.
(c)A resident spouse may continue residence after the veterans death. death, so long as he or she continues to pay all applicable fees and comply with the departments policies, procedures, and regulations.
(d)The property of the home shall be used for this purpose.
SEC. 9.Section 1012.1 of the Military and Veterans Code is amended to read:1012.1.Prior to the admission of a veteran as a member of the home, and at any time during which a veteran is a member of the home, the department may investigate the veterans any members financial status to determine the total value of the property and assets of any veteran applying for admission to the home, or to insure ensure that the veteran member is unable to pay for necessary hospital or domiciliary care outside of the home. home, or to validate income levels for the purposes of establishing fees. The department may contract with any other state agency to conduct such an investigation in its behalf.
SEC. 10.Section 1012.2 of the Military and Veterans Code is amended to read:1012.2.(a)(1)Notwithstanding any other law, any member of the home who is receiving an aid and attendance allowance from the United States Department of Veterans Affairs and who has no dependent spouse, child, grandchild, father, or mother shall pay to the home an amount equal to that allowance in all levels of care excluding domiciliary.
(2)Paragraph (1) shall not apply to a member of the home who is in intermediate care or skilled nursing care and has a disability that has been rated by the United States Department of Veterans Affairs as being 70 percent or more service-connected, as determined under Part 4 of Title 38 of the Code of Federal Regulations.
(b)One hundred percent of the moneys received by the home under this section shall be placed to the credit of the home and shall augment the current appropriation for the support of the home.
(b)Moneys received by a home under this section shall be deposited into the Federal Trust Fund and shall be used for the operating costs of the home.
SEC. 11.Section 1012.3 of the Military and Veterans Code is amended to read:1012.3.(a)Members of the home, including members who are nonveteran spouses, shall pay fees and charges as determined by the department, except that the total of the individual members fees and charges for any fiscal year shall not be greater than as set forth in the following schedule:
(1)Forty-seven and one-half percent of the members annual income for domiciliary care.
(2)Fifty-five percent of the members annual income for residential care for the elderly or assisted living.
(3)Sixty-five percent of the members annual income for intermediate care.
(4)Seventy percent of the members annual income for skilled nursing care.
(b)Subdivision (a) shall not apply to a member of the home who is in intermediate care or skilled nursing care and has a disability that has been rated by the United States Department of Veterans Affairs as being 70 percent or more service-connected, as determined under Part 4 of Title 38 of the Code of Federal Regulations and whose related payments made under Section 51.41 of Title 38 of the Code of Federal Regulations are considered by the United States Department of Veterans Affairs as payment in full for the members care.
(c)Fees paid by a member shall not exceed the average cost of care for the level of care in which the member currently resides.
SEC. 12.Section 1012.4 of the Military and Veterans Code is repealed.1012.4.Notwithstanding Section 1012, the department may arrange by contract or any other form of agreement with the United States Department of Veterans Affairs to do both of the following:
(a)Authorize veterans, collateral dependents, and other beneficiaries authorized by the United States Department of Veterans Affairs, who are not residents of the Veterans Home of California, Yountville, to receive outpatient medical services at that home.
(b)Establish rates for reimbursement from the federal government to the State of California for outpatient services rendered by the Veterans Home of California, Yountville to veterans who are authorized under subdivision (a).
(c)The outpatient services and reimbursement procedures authorized under subdivisions (a) and (b) may be established for the veterans home located in Barstow, California, and any veterans home constructed within the state on or after January 1, 2000.
SEC. 13.Section 1012.6 of the Military and Veterans Code is repealed.1012.6.The department may accept and process applications from veterans who are seeking residency at a home, beginning on the start date of construction of that particular home.
SEC. 14.Section 1014 of the Military and Veterans Code is repealed.1014.The home shall be under the management and control of the department and subject to the policies adopted by the California Veterans Board.
SEC. 15.Section 1015 of the Military and Veterans Code is repealed.1015.(a)It is the intent of the Legislature that installation of air-conditioning at the hospital and related buildings of the home be given high priority whenever any new construction or reconstruction is done, and that this construction or reconstruction be accelerated so as to accomplish the purposes of this section. The department shall, in this connection, consider whether construction of a new hospital facility at the home may be more cost-effective than renovation of the existing facility. The Master Plan for the Veterans Home of California construction schedule shall be revised to reflect this acceleration. The department shall submit the revised schedule to the Legislature on or before November 1, 1984. For each additional year of the master plan following the 198485 fiscal year, the Governors Budget shall include an appropriation in an amount necessary to complete all projects relating to the installation of air-conditioning as shown in the revised schedule.
(b)The sum of ninety-one thousand dollars ($91,000) is hereby appropriated from the Special Account for Capital Outlay in the General Fund to the Department of Veterans Affairs for expenditure during the 198485 fiscal year for the purposes of subdivision (a) in accordance with the following schedule:
Renovate hospital support services (preliminary plans) | 16,000 |
Hospital wards 1, 2, 3A (SNF) (preliminary plans) | 45,000 |
Section B (ICF) (preliminary plans) | 30,000 |
(c)Notwithstanding any other provision of law, the department, through the Office of the State Architect, may prepare and advertise bids for any master plan project in advance of funds being appropriated by the Legislature, but shall not award any contract for construction of the project until construction funds are available and appropriated therefor.
(d)No contract for construction of any project related to the master plan shall be entered into prior to the departments obtaining a written commitment from the federal government to fund either 65 percent of the project cost, as approved by the federal government, or the maximum amount available to the state.
SEC. 16.Section 1023 of the Military and Veterans Code is amended to read:1023.(a)The department may sue and be sued in any of the courts of this state. All property held by the department for the home shall be held in trust for the state and for the use and benefit of the home. The administrator shall manage the home and administer its affairs, and, subject to the direction of the director, adopt rules and regulations for the government of the home in conformity, as nearly as possible, to the rules and regulations of the United States Department of Veterans Affairs for their facilities. secretary shall adopt rules and regulations for the administration of the homes conforming as nearly as possible to the rules and regulations of the United States Department of Veterans Affairs and those of other states with veterans homes.
(b)The Director of General Services may lease or let any real property held by the department for the home, and not needed for any direct or immediate purpose of the home, to any entity or person upon terms and conditions determined to be in the best interests of the home. In any leasing or letting, primary consideration shall be given to the use of real property for agricultural purposes, and except as provided in Section 1048, all All moneys received in connection therewith shall be deposited in the General Fund to the credit of, and shall augment the current appropriation for the support of, the home. as a reimbursement for operating costs of the home.
SEC. 17.Section 1024 of the Military and Veterans Code is repealed.1024.The department may conduct such investigation as may be required to determine the total value of the property and assets of any veteran applying for admission to the home, and may contract with any other state agency to conduct such an investigation in its behalf.
SEC. 18.Section 1031 of the Military and Veterans Code is amended to read:1031.All moneys received by the State state from the United States for the use of the home shall be placed to the credit of and shall augment the current appropriation for the support of the home. deposited into the General Fund as a reimbursement for operating costs of the home.
SEC. 19.Section 1033.2 of the Military and Veterans Code is repealed.1033.2.If the total amount collected for reimbursements for Medi-Cal and Medicare services provided in any fiscal year by a veterans home exceeds the budgeted reimbursements for that home, the additional funds collected shall be used to repay any unpaid General Fund loans provided to the veterans home in prior fiscal years for the operation of that home.
SEC. 20.Section 1034 of the Military and Veterans Code is amended to read:1034.Except money received from this State state for disbursement, all moneys received by the home, or by any officer of the home, including pension and other moneys belonging to veterans and other trust moneys, shall be immediately paid to the executive officer administrator of the home. On or before the tenth 10th day of each month the executive officer month, the administrator of the home shall forward to the State Treasurer all moneys in his or her possession, except pension and other moneys belonging to veterans, trust moneys, the post funds, and the emergency fund, and donations made to each home, hereinafter mentioned, together with a statement of the sources from which the same moneys have been received. The moneys shall be deposited by the State Treasurer to the credit of the General Fund of the State; provided, however, that abatements of support expenditures shall be credited to the support appropriation current at the time of collection.
SEC. 21.Section 1035.3 of the Military and Veterans Code is amended to read:1035.3.(a)If no will or heir is discovered within two years after the death of the veteran, any moneys not exceeding three fifteen thousand dollars ($3,000) ($15,000) held by the home pursuant to Section 1035 and not paid or otherwise delivered to the heir or heirs or pursuant to the will of the deceased veteran, or otherwise disbursed by the administrator pursuant to Section 1035, shall be paid to the Morale, Welfare, and Recreation Fund.
If no will or heir is discovered within five years after the death of the veteran, any moneys exceeding three fifteen thousand dollars ($3,000) ($15,000) held by the home pursuant to Section 1035 and not paid or otherwise delivered to the heir or heirs or pursuant to the will of the deceased veteran, or otherwise disbursed by the administrator pursuant to Section 1035, shall be paid to the Morale, Welfare, and Recreation Fund.
This subdivision applies only to veterans becoming members of the home on or after January 1, 1984.
(b)If no spouse, child, grandchild, or father or mother is discovered within two years after the death of the veteran, any moneys not exceeding three fifteen thousand dollars ($3,000) ($15,000) held by the home pursuant to Section 1035 and not paid or otherwise delivered to the spouse, children, grandchildren, or father or mother, or otherwise disbursed by the administrator pursuant to Section 1035, shall be paid to the Morale, Welfare, and Recreation Fund.
If no spouse, child, grandchild, or father or mother is discovered within five years after the death of the veteran, any moneys exceeding three fifteen thousand dollars ($3,000) ($15,000) held by the home pursuant to Section 1035 and not paid or otherwise delivered to the spouse, children, grandchildren, or father or mother, or otherwise disbursed by the administrator pursuant to Section 1035, shall be paid to the Morale, Welfare, and Recreation Fund.
This subdivision applies only to veterans who have become members of the home prior to January 1, 1984.
SEC. 22.Section 1038 of the Military and Veterans Code is amended to read:1038.All money deposited with the home for a veteran shall be paid to him or her on demand, upon his or her discharge or voluntary departure from the home. If the money is not so demanded at the time of his or her discharge or departure or within a period of two years thereafter, if the amount does not exceed three five thousand dollars ($3,000), ($5,000), or within a period of five years thereafter, if the amount exceeds three five thousand dollars ($3,000) ($5,000) either by the veteran, or, in the event of the veterans death after his or her discharge or departure, by the veterans heirs, devisees, legatees, or qualified executor or administrator of his or her estate, the money shall be paid to the Morale, Welfare, and Recreation Fund.
SEC. 23.Section 1044 of the Military and Veterans Code is amended to read:1044.The administrator, in accordance with the policies adopted by the California Veterans Board and subject to the direction of the director, secretary may adopt rules and regulations governing the admission of applicants and may prescribe the conditions upon which they may enter and remain with the home.
SEC. 24.Section 1051 of the Military and Veterans Code is repealed.1051.(a)There is hereby established in the State Treasury the California Veterans Homes Fund to receive those amounts transferred to the fund pursuant to Section 18811 of the Revenue and Taxation Code.
(b)Any funds remaining in the Veterans Quality of Life Fund, as established by Section 2 of Chapter 143 of the Statutes of 2005, shall be transferred to the California Veterans Homes Fund established by subdivision (a).
|
Date
|
Status
|
|---|---|
| May 20, 2016 | Set for hearing May 27. |
| Aug 11, 2016 | August 11 hearing. Held in committee and under submission. |
| Aug 3, 2016 | August 3 set for first hearing. Placed on APPR. suspense file. |
| Jun 29, 2016 | From committee: Do pass and re-refer to Com. on APPR. (Ayes 7. Noes 0.) (June 28). Re-referred to Com. on APPR. |
| Jun 22, 2016 | From committee with author's amendments. Read second time and amended. Re-referred to Com. on V.A. |
| Jun 9, 2016 | Referred to Com. on V.A. |
| Jun 2, 2016 | Read third time. Passed. (Ayes 39. Noes 0.) Ordered to the Assembly. |
| Jun 2, 2016 | Read third time. Passed. (Ayes 39. Noes 0. Page 4150.) Ordered to the Assembly. |
| Jun 2, 2016 | In Assembly. Read first time. Held at Desk. |
| May 31, 2016 | Read second time and amended. Ordered to third reading. |
| May 31, 2016 | Ordered to special consent calendar. |
| May 27, 2016 | From committee: Do pass as amended. (Ayes 7. Noes 0.) (May 27). |
| May 27, 2016 | From committee: Do pass as amended. (Ayes 7. Noes 0. Page 4000.) (May 27). |
| Feb 10, 2016 | Introduced. Read first time. To Com. on RLS. for assignment. To print. |
| May 9, 2016 | May 9 hearing: Placed on APPR. suspense file. |
| Apr 29, 2016 | Set for hearing May 9. |
| Apr 26, 2016 | Read second time and amended. Re-referred to Com. on APPR. |
| Apr 25, 2016 | From committee: Do pass as amended and re-refer to Com. on APPR. with recommendation: To consent calendar. (Ayes 7. Noes 0.) (April 19). |
| Apr 25, 2016 | From committee: Do pass as amended and re-refer to Com. on APPR. with recommendation: To consent calendar. (Ayes 7. Noes 0. Page 3610.) (April 19). |
| Apr 14, 2016 | Set for hearing April 19. |
| Apr 13, 2016 | From committee: Do pass and re-refer to Com. on JUD. (Ayes 4. Noes 0.) (April 12). Re-referred to Com. on JUD. |
| Apr 13, 2016 | From committee: Do pass and re-refer to Com. on JUD. (Ayes 4. Noes 0. Page 3523.) (April 12). Re-referred to Com. on JUD. |
| Mar 11, 2016 | Set for hearing April 12. |
| Feb 18, 2016 | Referred to Coms. on V.A. and JUD. |
| Feb 11, 2016 | From printer. May be acted upon on or after March 12. |
|
Date
|
Description
|
Location
|
Votes
|
|
|---|---|---|---|---|
| Jun 28, 2016 | Do pass and be re-referred to the Committee on [Appropriations] | Assembly Standing Committee on Veterans Affairs |
Passed |
|
| Jun 2, 2016 | Special Consent # SB980 Nielsen | Senate Floor |
Passed |
|
| May 27, 2016 | Do pass as amended | Senate Standing Committee on Appropriations |
Passed |
|
| May 9, 2016 | Placed on suspense file | Senate Standing Committee on Appropriations |
Passed |
|
| Apr 19, 2016 | Do pass as amended, but first amend, and re-refer to the Committee on [Appropriations] with the recommendation: To Consent Calendar | Senate Standing Committee on Judiciary |
Passed |
|
| Apr 12, 2016 | Do pass, but first be re-referred to the Committee on [Judiciary] | Senate Standing Committee on Veterans Affairs |
Passed |
This list shows positions taken on this bill by organizations on the date displayed, which is linked to the original source.
Positions by individuals are not included.
|
Organization
|
Position
|
Date
|
|---|---|---|
| American Legion | * Support | Apr 12, 2016 |
| AMVETS - Department of California | ** Support | Jun 28, 2016 |
| California Association Of County Veterans Service Officers | ** Support | Jun 28, 2016 |
| California State Commanders Veteran Council | ** Support | Jun 28, 2016 |
| California Veteran Services Association | * Support | Jun 28, 2016 |
| Military Officer's Association | * Support | Jun 28, 2016 |
| Veterans of Foreign Wars - Department of California | ** Support | Jun 28, 2016 |
| Veterans of Foreign Wars- Department of CA | ** Support | Apr 12, 2016 |
| Vietnam Veterans of America | * Support | Jun 28, 2016 |
| Vietnam Veterans of America-CA State Council | ** Support | Apr 12, 2016 |
| Vietnam Veterans of American - California State Council | ** Support | Jun 28, 2016 |
Date of Hearing: August 3, 2016
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Lorena Gonzalez, Chair
SBPCA Bill Id:SB 980
Author:(Nielsen) – As Amended Ver:June 22, 2016
Policy Committee: | Veterans Affairs | Vote: | 7 - 0 |
Urgency: No State Mandated Local Program: No Reimbursable: No
SUMMARY:
This bill updates code sections governing state veterans’ homes, and among other things, requires the Department of Veterans Affairs (CalVet) to:
- Adopt statewide policies and procedures, by regulation, for the operation of the state veterans home system;
- Implement a statewide electronic health records system; and
- Submit an annual report that reflects significant veteran’s home-related performance issues, as specified.
FISCAL EFFECT:
Finance estimates the CalVet will require multiple positions and potentially several million ongoing General Fund dollars that are largely attributable to the adoption of uniform regulations, requirement for a statewide electronic medical record system, and changes to veteran home admissions eligibility. A portion of the costs include 11 permanent positions and $1.8 million General Fund in 2016-17 and $1.7 million General Fund annually thereafter in order to implement a uniform quality of care review process.
COMMENTS:
Background and Purpose. The entire Military and Veterans Code is in need of modernization and cleanup. The department undertook a project to address the code cleanup, but it has been postponed indefinitely. The code sections for the Homes are particularly out of date despite the fact that the operation of the Homes is the department’s largest program by far. For example, current law omits reference to six of the eight Veterans Home locations.
According to the author, the Military and Veterans Code is out of date, containing obsolete references and archaic terminology in dire need of updates. None of the eight homes in the system follow standardized regulations or procedures. This bill seeks to update, clarify, and standardize the code sections governing veterans’ homes to increase efficiency and give veterans the high quality of care they deserve
Analysis Prepared by: Pedro Reyes / APPR. / (916) 319-2081
Date of Hearing: June 28, 2016
ASSEMBLY COMMITTEE ON VETERANS AFFAIRS
Jacqui Irwin, Chair
SBPCA Bill Id:SB 980
Author:(Nielsen) – As Amended Ver:June 22, 2016
SENATE VOTE: 39-0
SUBJECT: Veterans’ homes
SUMMARY: Requires the Department of Veterans Affairs (CalVet) to:
- Adopt statewide policies and procedures, by regulation, for operation of the state veterans home system;
- Implement a statewide electronic medical records (EMR) system; and
- Correct and update outdated terminology and references within the portion of the Military and Veterans Code (MVC) that governs state veterans’ homes.
EXISTING LAW:
- Provides for the establishment and operation of veterans’ homes at various sites, and provides for an administrator of each home, as specified.
- Establishes the duties of the Department of Veterans Affairs with regard to the establishment and regulation of veterans’ homes.
- Establishes the criteria for admission to a veterans’ home, as specified.
- Establishes the fees and charges for residency, as established by each administrator of a home, and requires each administrator to adopt rules and regulations for the administration of the homes.
- Authorizes a resident spouse to continue his or her residency after a veteran spouse’s death.
- Authorizes the department to investigate a veteran’s financial status for admission purposes.
- Requires 100% of the moneys received by a veterans’ home from veterans receiving federal aid to be placed to the credit of the home to augment the current appropriation for the support of the home.
- Requires members of a veterans’ home to pay fees and charges as determined by the department, subject to a specified fee schedule.
- Requires any moneys not in excess of $3,000 held by the home for the veteran to be paid to the home’s Morale, Welfare, and Recreation (MWR)Fund upon the death of a veteran in a home if no will or heir or other family member is discovered within a specified number of years after his or her death.
- Requires any moneys not in excess of $3,000 held by the home for the veteran to be paid to the home’s MWR Fund upon the departure of a veteran from a home if the money is not requested by the veteran within a specified number of years after his or her departure.
This Bill:
- Requires that the fees and charges be established by the secretary, rather than by each administrator, and that the secretary adopt rules and regulations that apply to the homes and the criteria for admission.
- Authorizes the secretary to establish needs-based criteria for admission to veterans’ homes and to prioritize admission for veterans with service-related disabilities, as specified.
- Requires a resident spouse who continues residency after a veteran spouse’s death to continue to pay all applicable fees and to comply with all department regulations, and would expand those provisions to include domestic partners.
- Authorizes the department to determine a resident’s or applicant’s income or suitability for residence at a veterans’ home and would provide that providing false information or failure to pay fees is grounds for financial penalties or discharge from a veterans’ home.
- Provides that failure to pay fees is cause for the administrator to refer the resident to collections or dismiss the resident from the home.
- Increases the amount that may be transferred to the MWR fund upon the death of a veteran in a home if no will or heir or other family member is discovered within a specified number of years after his or her death to $15,000.
- Increases the amount that may be transferred to the home’s MWR Fund upon the departure of a veteran from a home if the money is not requested by the veteran within a specified number of years after his or her departure to $5,000.
- Makes other conforming changes and would delete obsolete provisions and references, as specified.
FISCAL EFFECT: According to the Senate Appropriations Committee:
Though a precise estimate is unavailable at this time, this bill would likely result in costs to CalVet in the mid hundreds of thousands to update existing and develop new regulations. Additional unknown one-time costs would be incurred for the implementation of a statewide EMR system. These costs could range from negligible to significant depending upon the option used to fulfill this requirement (i.e. purchasing an off-the-shelf system or modeling the system off of one that exists in other state departments). Ongoing costs for CalVet to report to the Legislature on veterans’ home-related performance issues, likely in the tens of thousands. (General Fund)
COMMENTS:
According to the author:
Significant portions of the Military and Veterans Code are out of date, containing obsolete references and archaic terminology in dire need of updates. Additionally, over the past decade the veterans’ home system has exploded from three to eight homes, none of which follow standardized regulations or procedures.
This bill seeks to update, clarify, and standardize the code sections governing veterans’ homes to increase efficiency and give veterans the high quality of care they deserve.
The author is correct, the entire Military and Veterans Code is in need of modernization and cleanup. The department undertook a project to address the code cleanup but it has been postponed indefinitely. The code sections for the Homes are particularly out of date despite the fact that the operation of the Homes is the department’s largest program by far. Military and Veterans Code section 1010(a) for example omits reference to six of the eight Veterans Home locations:
(a) “Home” means the Veterans’ Home of California, Yountville, and the Veterans’ Home of California, Barstow.
A bill such as this one is long overdue, in fact, CalVet undertook a re-write of the Military and Veterans Code in the recent past, but that effort stalled and its status is unknown. This bill does not enjoy any official support from the department; it is the product of input and collaboration to be sure, but it is the bill’s author, not the department who showed leadership on this issue. CalVet is the state department tasked with being the expert on veterans issues and which knows the pros and cons of the existing code better than any other department. Therefore, if an overhaul and reimagining of the code is needed, the architecture of the veteran sections of the Military and Veterans Code reasonably should flow from the leadership and vision of the department and be the subject of an officially sponsored proposal. This bill logically focused on the department’s largest program leaving the rest of the code for a future effort thus it presents an opportunity for CalVet to occupy the field for future changes.
There are numerous amendments to existing code in the bill, however, these may generally be summarized and grouped as follows:
- Modernization and Cleanup
- Various amendments correct anachronisms or other technical issues in the current code.
- Operations and Administration- Amendments in the bill create new or clarify existing operations and administration issues such as:
- Statutory/Regulatory compliance planning and action.
- Development and maintenance of policies and procedures.
- Regulatory development to support the above and the operations of the Homes generally.
- Reporting and enhanced transparency provisions
- Mandate for implementation of electronic medical record system by January 1, 2019.
- Changes to eligibility and admissions priorities
Annual reporting provisions
The expressed intent of the Legislature in the bill is:
…that the department submit the report required pursuant to this section at a level of detail that will provide the Legislature and the public with indicators of the quality of both the health care and the management of facilities of the Veterans’ Home of California without compromising members’ privacy while still in compliance with applicable law and regulation. …
The department must include at least the following in the report:
- Current census and census changes since last report.
- Any major changes to home policy and the impact of those changes on the residents.
- Changes in provision of care, including licensure changes.
- Significant events that impacted the operations of the home.
- Copies of annual licensing survey records.
- Significant patient care complaints, results of any investigations into those complaints, and any corrective action taken to address validated complaints.
- Copies of available data from licensing agencies comparing veterans’ home quality of care metrics to industry averages.
Changes to eligibility and admissions priorities
This bill:
Removes the requirement in the existing statute that applicants be unable to pay for care elsewhere.
- Permits the department to give admission priority to service-connected disabled veterans.
- Allows the department to establish needs-based admissions criteria.
- Prioritizes applicants as follows:
- MOH or POW
If no needs based criteria:
- Service connected disabled vets (any disability level) serving in time of war*
- Service connected disabled vets (any disability level) serving in time of peace
If needs based criteria are implemented:
- Service connected disabled vets who demonstrate the need and who served in a time of war
- Service connected disabled vets who demonstrate the need and but who served in a time of peace
- Non-service connected disabled veterans who can pay for care elsewhere.
Enhanced Authority to Investigate Finances of Applicants and Home Members
- The bill enhances the authority of the department to investigate applicants and members finances. At any time during which a person is a member of a veterans’ home, the department may investigate any applicant’s or member’s financial status and personal background to determine the member’s or applicant’s income and suitability for residence at a veterans’ home. The department may contract with any other state or federal agency or private entity to conduct such an investigation on its behalf. The bill authorizes the department to levy financial penalties, to deny admission to the home, and to discharge a member from the home if the applicant or member provides the department with false financial information.
- Existing section 1012.2 of the Military and Veterans Code requires home members receiving an aid and attendance allowance from the United States Department of Veterans Affairs and who have no dependents or relatives, as specified, to pay to the home an amount equal to that allowance in all levels of care excluding domiciliary. The bill removes the requirement that the veteran have no specified dependents so that all members receiving an aid and attendance benefit must pay the department an amount equal to that benefit. The rationale is that in the case of home members, regardless of their spousal or immediate family situation, it is the department that provides aid and attendance. There is an exception for those members with a USDVA disability rating greater than 70%
Fee Structure Changes
The bill changes some aspects of the fee structure of the Homes. This bill:
- Modernizes the code to include spouses and domestic partners.
- Requires fees and charges imposed on members to be based on the cost of room and board, except as specified in the existing law. Late fees are permitted above the room and board cost. The department is authorized to refer member fees to a collection agency and/or to dismiss a member from the Home. The department is authorized to subject retroactive awards from USDVA to fee assessments.
Authority to Contract
The bill authorizes the department to arrange by contract or any other form of agreement with the United States Department of Veterans Affairs to leverage federal contracts for the procurement of goods and services.
Repealer of Code Sections
The bill repeals Military and Veterans Code Sections:
- 1012.6- Pertaining to authority to process admission applications.
- 1014 – Pertaining to the management authority of the department and the policymaking authority of the California Veterans Board.
- 1024- Pertaining to financial investigations of applicants.
- 1033.2- Pertaining to repayment of General Fund Loans.
- 1051- Pertaining to establishment of the California Veterans Homes Fund.
Member Deposits Held by Home, Interest Calculation
The bill conforms the interest calculation method to the Code of Federal Regulations.
REGISTERED SUPPORT / OPPOSITION:
Support
AMVETS - Department of California
California Association of County Veterans Service Officers
California Long-Term Care Ombudsman Association
California State Commanders Veteran Council
Military Officers Association of America - California Council of Chapters
Veterans of Foreign Wars - Department of California
Vietnam Veterans of American - California State Council
Opposition
None on File.
Analysis Prepared by: Jenny Callison / V.A. / (916) 319-3550
Office of Senate Floor Analyses (916) 651-1520 Fax: (916) 327-4478 | SB |
THIRD READING
Bill No: SB 980
:
SENATE VETERANS AFFAIRS COMMITTEE: 4-0, 4/12/16
AYES: Nielsen, Hueso, Allen, Roth
NO VOTE RECORDED: Nguyen
SENATE JUDICIARY COMMITTEE: 7-0, 4/19/16
AYES: Jackson, Moorlach, Anderson, Hertzberg, Leno, Monning, Wieckowski
SENATE APPROPRIATIONS COMMITTEE: 7-0, 5/27/16
AYES: Lara, Bates, Beall, Hill, McGuire, Mendoza, Nielsen
California Association of County Veterans Service Officers
DIGEST: This bill requires the Department of Veterans Affairs (CalVet) to (1) adopt statewide policies and procedures, by regulation, for operation of the state veterans home system; (2) implement a statewide electronic medical records (EMR) system; and (3) correct and update outdated terminology and references within the portion of the Military and Veterans Code (MVC) that governs state veterans’ homes.
Existing law:
- Authorizes establishment and operation of the Veterans’ Home of California system.
- Establishes CalVet’s authority and responsibilities in administering the system.
- Requires each on-site home administrator to adopt rules and regulations for the administration of each home.
- Defines criteria for admission to a veterans’ home.
- Requires that home members (residents) pay fees and charges as determined by CalVet, subject to a specified fee schedule.
- Authorizes CalVet to investigate a veteran’s financial status for admission purposes.
- Requires that − upon the death of a veteran in a home – any monies not in excess of $3,000 held by the home for the veteran to be paid to the home’s Morale, Welfare, and Recreation Fund, if no will or heir or other family member is discovered.
- Authorizes:
- Married veteran home members to have their non-veteran spouses domicile with them.
- A resident spouse to continue residency after a veteran spouse’s death.
This bill:
- Corrects and updates archaic and outdated terminology and references within the portion of the MVC that governs state veterans’ homes.
- Clarifies that the on-site home administrator to be the senior executive appointed to oversee the operations of a veterans’ home.
- Requires the CalVet Secretary (Secretary) to adopt uniform statewide policies and procedures, by regulation, for the operation of the veterans’ home system.
- Requires the Secretary to implement a statewide EMR system.
- Requires the EMR system and all transactions made in that system to comply with the privacy and security protections, which the Legislature has enacted and the federal government mandated with regard to EMRs, in general.
- Requires the Secretary to annually report to the veterans policy committees of the Legislature.
- Requires that fees and charges be established by the Secretary.
- Requires the Secretary to adopt rules and regulations that apply to the homes and the criteria for admission.
- Provides that a resident spouse who continues residency after a veteran spouse’s death to continue to pay all applicable fees and comply with all department regulations.
- Requires CalVet to determine the total worth of any member’s property or assets for purposes of admission, including validating income levels for purposes of establishing fees.
Background
State veterans homes. The State of California provides veterans’ homes to help provide for the state's aged or disabled veterans to acknowledge the service and tremendous sacrifices California veterans have made on behalf of our nation.
CalVet's Veterans Homes Division provides rehabilitative, residential medical care and services in a homelike environment for aged and disabled veterans (and eligible veteran spouses) residing in eight veterans homes, which are located in Barstow, Chula Vista, Fresno, Lancaster. Redding, Ventura, West Los Angeles, and Yountville. As of April 2016, a total of 2,158 members resided in the homes.
Many of the homes were built in the last 10 years and the state’s laws and regulations governing the homes are not standardized. Also, some policies and procedures are outdated and need to be updated to reflect the level of care provided at the homes.
Levels of care. The eight campuses offer different combinations of the following levels of care that generate increasing levels of cost:
- Independent living/domiciliary care (Barstow, Chula Vista, Yountville):
This level of care is for residents able to perform activities of daily living with, at most, minimal assistance. Non-nursing employees provide limited supervision. Residents have access to all of the Home's services, activities, and medical care. Individuals can transfer to higher levels of care as needed. Independent living is also referred to as Domiciliary by CalVet and the United States Department of Veterans Affairs.
- Residential care/assisted living (All homes except Barstow):
Residential Care Facilities for the Elderly (RCFE) are available for residents who require minimal assistance and supervision with some activities of daily living. RCFE services may include care by licensed nurses. In the future, memory care programs may be established within the RCFEs.
- Intermediate care (Barstow, Yountville):
This level is for residents who often require licensed nursing assistance with medications and treatments, and generally require unlicensed nursing assistance with several daily living activities.
- Skilled nursing (Barstow, Chula Vista, Fresno, Redding, West LA, Yountville):
This level of care provides 24-hour services of licensed nurses and certified nursing assistants, and is more comprehensive than intermediate care. Skilled nursing residents have greater access to rehabilitation therapies, nursing care, pharmacy management, structured activities and clinical dietary services.
- Memory care:
The Fresno, Redding, West LA and Yountville homes provide memory care programs within their skilled nursing facilities.
- Outpatient clinic:
In addition to the above, each home provides an outpatient clinic to serve its members. The clinics provide comprehensive multidisciplinary assessments as well as ongoing primary care. The clinics address the veteran's routine care needs and also will arrange visits with outside medical specialists as necessary.
Electronic medical records. New technologies and financial incentives have resulted in health care providers increasingly and actively using EMRs. An EMR is an electronic version of a patient‘s medical history, which is maintained by the provider over time, and may include all of the key administrative clinical data relevant to that persons care under a particular provider, including demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports The EMR automates access to the information and has the potential to streamline clinician workflow. The EMR also has the ability to support other care-related activities directly or indirectly through various interfaces, including evidence-based decision support, quality management, and outcomes reporting.
FISCAL EFFECT: Appropriation: Fiscal Com.: Local:
According to the Senate Appropriations Committee, though a precise estimate is unavailable at this time, this bill would likely result in costs to CalVet in the mid hundreds of thousands to update existing and develop new regulations. Additional unknown one-time costs would be incurred for the implementation of a statewide EMR system. These costs could range from negligible to significant depending upon the option used to fulfill this requirement (i.e. purchasing an off-the-shelf system or modeling the system off of one that exists in other state departments). Ongoing costs for CalVet to report to the Legislature on veterans’ home-related performance issues, likely in the tens of thousands. (General Fund)
AMVETS - Department of California (co-source)
California Association of County Veterans Service Officers (co-source)
California Long-Term Care Ombudsman Association
California State Commanders Veteran Council
Military Officers Association of America - California Council of Chapters
Veterans of Foreign Wars - Department of California
Vietnam Veterans of American - California State Council
OPPOSITION: (Verified 5/31/16)
None received
5/31/16 21:31:46
**** END ****
SENATE COMMITTEE ON
Senator Ricardo Lara, Chair
2015 - 2016 Regular Session
SB 980 (Nielsen) - Veterans’ homes
Version: | Policy Vote: |
Urgency: | Mandate: |
Hearing Date: | Consultant: |
Bill Summary:
This bill updates code sections governing state veterans’ homes and among other things, requires the Department of Veterans Affairs (CalVet) to: (1) adopt statewide policies and procedures, by regulation, for the operation of the state veterans home system; (2) establish a quality of care assessment team; and (3) implement a statewide electronic health records system.
*********** ANALYSIS ADDENDUM – SUSPENSE FILE ***********
The following information is revised to reflect amendments
adopted by the committee on May 27, 2016
Fiscal Impact:
- Though a precise estimate is unavailable at this time, this bill would likely result in costs to CalVet in the mid hundreds of thousands to update existing and develop new regulations. Additional unknown one-time costs would be incurred for the implementation of a statewide electronic health records system. These costs could range from negligible to significant depending upon the option used to fulfill this requirement (i.e. purchasing an off-the-shelf system or modeling the system off of one that exists in other state departments). Ongoing costs for CalVet to report to the Legislature on veterans’ home-related performance issues, likely in the tens of thousands. (General Fund)
Author Amendments:
Remove the requirement that CalVet establish a quality of care assessment team and clarify how federal funding is to be treated when it is received.
-- END --
SENATE COMMITTEE ON APPROPRIATIONS
Senator Ricardo Lara, Chair
2015 - 2016 Regular Session
SB 980 (Nielsen) - Veterans’ homes
Version: April 26, 2016 | Policy Vote: V.A. 4 - 0, JUD. 7 - 0 |
Urgency: No | Mandate: No |
Hearing Date: May 9, 2016 | Consultant: Jillian Kissee |
This bill meets the criteria for referral to the Suspense File.
Bill Summary:
This bill updates code sections governing state veterans’ homes and among other things, requires the Department of Veterans Affairs (CalVet) to: (1) adopt statewide policies and procedures, by regulation, for the operation of the state veterans home system; (2) establish a quality of care assessment team; and (3) implement a statewide electronic health records system.
Fiscal Impact:
- Though a precise estimate is unavailable at this time, this bill would likely result in costs to CalVet in the low millions and would require several additional positions. Some of these costs are one-time. See staff comments. (General Fund)
- Potential cash flow and deficiency issues for homes related to requiring federal funds to be deposited into the General Fund as a reimbursement for operating costs instead of being treated as revenue.
Background:
The state provides veterans’ homes to help provide for the state’s aged or disabled veterans. CalVet provides rehabilitative, residential medical care and services in a homelike environment for veterans and eligible veteran spouses residing in the homes. Eight homes in California currently serve over 2,000 veterans. The homes are located in Barstow, Chula Vista, Fresno, Lancaster, Redding, Ventura, West Los Angeles, and Yountville.
Many of the homes were built within the last 10 years and the state’s laws and regulations governing the homes are not standardized. The eight campuses offer different combinations of levels of care that result in varied levels of cost.
Proposed Law:
This bill updates code sections governing state veterans’ homes. In addition, this bill:
- Requires the Secretary of Veterans Affairs to adopt uniform statewide policies and procedures, by regulation, for the operation of the veterans’ home system. Authorizes the Secretary to adopt rules and regulation governing the admission of applicants and may prescribe the conditions upon which they may enter and remain with the home. Requires the administrator to be responsible for ensuring compliance with all state and federal statutes and regulations related to the operation of the home and for implementation of all statewide policies and procedures, as specified.
- Requires, by July 1, 2017, CalVet to establish a quality of care assessment team, from within existing resources, to conduct periodic reviews of how each home meets the quality of care standards, as specified.
- Requires, by January 1, 2018, CalVet to implement an electronic medical record system in which the usage of the system is standardized in all homes.
- Requires the Secretary to annually report to the Legislature on significant veterans’ home-related performance issues, as specified.
- Expands CalVet’s authority to investigate a member’s, not just a veteran’s, financial status to determine the total value of the property and assets of any veteran applying for admission to the home; to ensure the member is able to pay for necessary care outside of the home; or to validate income levels for the purposes of establishing fees. A member is defined as any veteran or nonveteran spouse who has been admitted to residency at any home.
- Requires moneys received by a home from veterans who receive federal aid to be deposited into the Federal Trust Fund, a continuously appropriated fund, to be used for the operating costs of the home. Requires all moneys received by the state from the United States for the use of the home to be deposited into the General Fund as a reimbursement for operating costs of the home.
- Prohibits fees paid by a member from exceeding the average cost of care for the level of care in which the member currently resides. Authorizes the Secretary to establish fees for residency, instead of the administrator of a home. Authorizes a spouse to continue residence after the veteran’s death as long as he or she continues to pay all applicable fees and comply with CalVet’s rules.
- Changes the amounts that are able to be paid to the Morale, Welfare, and Recreation Fund after the death of a veteran or upon a veteran’s departure from the home.
- Specifies that veterans’ homes are for those aged and disabled veterans who are unable to pay for necessary domiciliary and licensed long-term care outside the home.
Related Legislation:
SB 543 (Wolk, 2016) with regard to the Veterans Home of California system, creates a single system-wide Morale, Welfare, and Recreation Fund that consolidates existing and future moneys generated by individual veterans home campuses, and establishes procedures and restrictions on the budgeting and spending of moneys in the Fund. SB 543 is pending in the Assembly Veterans Affairs Committee.
SB 1410 (Wolk, Chapter 659, Statutes of 2014) requires nonveteran spouses to pay the same fees and charges as paid by veteran members of a veterans’ home, as determined by CalVet, and subjects them to the same prohibitions.
Staff Comments:
Though this bill requires CalVet to establish a quality of care assessment team from within existing resources, it will likely be one of the major cost drivers of this bill. The bill specifies that the team would be required to conduct periodic reviews of how each home meets the quality of care standards adopted by the Secretary. Assuming a team of six, funding for the quality care assessment team would be over $700,000 for salaries and benefits only. There would also likely be additional travel costs.
This bill also requires the implementation of an electronic medical record system that is standardized in all homes. It is unclear as to whether CalVet could update its existing system or would have to develop and transition to a new system. However, it is likely that either option would result in significant limited-term administrative costs at least in the hundreds of thousands.
This bill requires the Secretary to develop policies and procedures through regulations for the operations of the homes and, to the extent possible, are required to be in conformity to federal regulations. The policies and procedures are required to include specified topics including: admission of applicants, resident disciplinary procedures, and quality of care standards. This requirement could drive additional limited-term costs to CalVet in the hundreds of thousands but could be more depending upon the complexity of developing these policies and procedures.
The annual reporting requirements of the Secretary to the Legislature regarding significant veterans home-related performance issues, as specified, is likely to drive ongoing costs in the tens of thousands.
Finally, this bill makes several amendments impacting fees and other revenue streams. The increase to the caps on the amounts that may be transferred to the Morale, Welfare, and Recreation Fund upon a veteran’s death or departure if he or she has unclaimed assets by an heir or relative after a specified period of time, is not anticipated to have a state fiscal impact. These revenues remain at the local level. In addition, the bill prohibits fees paid by a member from exceeding the average cost of care for the level of care in which the member currently resides is not expected to have a state fiscal impact as the fees currently do not cover the full cost of care that members receive. The bill’s authorization for the Secretary to establish fees for residency, instead of the administrator of a home, will have an unknown impact on revenue from those fees.
-- END --
Senator Hannah-Beth Jackson, Chair
2015-2016 Regular Session
Bill No: SB 980 (Author:Nielsen)
Version: February 10, 2016
Hearing Date: April 19, 2016
Fiscal: Yes
Urgency: No
Consultant: NR
SUBJECT
Veterans’ homes
DESCRIPTION
Existing law provides for the establishment and operation of veterans’ homes at various sites, and provides for the administration of these homes. This bill would revise and recast those provisions. This bill would specify which veterans’ homes are administered by the Department of Veterans Affairs and would require the Secretary of Veterans Affairs to implement a statewide electronic medical record system for veterans’ homes by January 1, 2018. This bill would make other conforming changes.
BACKGROUND
The State of California, acknowledging the service and sacrifices California veterans have made, established veterans’ homes to help provide for the state’s aged or disabled veterans. The Veterans Homes Division provides rehabilitative, residential medical care, and other services in a homelike environment for eligible veterans and their spouses. Eight homes in California currently serve over 2,000 veterans.
Seeking to ensure that California’s veterans receive quality care, this bill would update laws, policies, and procedures governing the homes, and would require the Secretary of Veteran’s Affairs (secretary) to implement an electronic medical record system for standardized use in the homes. The use of electronic health records has been on the rise since 2009 when the President signed the American Recovery and Reinvestment Act which included the establishment of the Office of the National Coordinator for Health Information Technology to facilitate and expand the use of health information technology pursuant to national standards. Using electronic health record systems is intended to reduce medical errors and increase patient accessibility to personal medical information. However, according to Privacy Rights Clearing House, 1,263 data breaches involving medical and healthcare providers have been made public since 2005. Those breaches involved over 45 million records. Accordingly, both the state and federal governments continue to enact measures to ensure the protection of patient medical information, and closely monitor legislation involving electronic health records.
CHANGES TO EXISTING LAW
Existing law, the California Constitution, provides that all people have inalienable rights, including the right to pursue and obtain privacy. (Cal. Const. art. I, Sec. 1.)
Existing federal law, the Health Insurance Portability and Accountability Act (HIPAA), specifies privacy protections for patients’ protected health information and generally provides that a covered entity, as defined (health plan, health care provider, and health care clearing house), may not use or disclose protected health information except as specified or as authorized by the patient in writing. (45 C.F.R. Sec. 164.500 et seq.)
Existing law prohibits, under the State Confidentiality of Medical Information Act (CMIA), providers of health care, health care service plans, or contractors, as defined, from sharing medical information without the patient’s written authorization, subject to certain exceptions. (Civ. Code Sec. 56 et seq.)
This bill would update outdated terminology and references within the Military and Veterans Code governing state veterans’ homes.
This bill would require the Secretary of Veterans Affairs (secretary) to adopt uniform statewide policies and procedures, by regulation, for the operation of the veterans’ home system, and would specifically require:
- the Department of Veterans Affairs to establish a quality of care assessment team;
- the secretary to adopt criteria for admission, as specified;
- the secretary to annually report to the veterans policy committees of the Legislature;
- that fees and charges be established by the Secretary; and
- that a resident spouse who continues residency after a veteran spouse’s death to continue to pay all applicable fees and comply with all department regulations.
This bill would require the Secretary to implement a statewide electronic health record system, and would specify that the usage of the electronic medical record system shall be standardized in all homes.
COMMENT
- Stated need for the bill
According to the author:
CalVet should have a standardized electronic system of medical records that reflects the emerging industry standard. The veterans home system has exploded from three homes to eight homes in the last several years and has become more challenging in terms of guaranteeing quality of care. In general, CalVet has lagged behind other state departments in promulgating regulations that codify its policies and procedures. Major portions of the Military and Veterans Code are outdated and still include archaic and irrelevant terms and references. This includes numerous provisions within the areas of the Military and Veterans Code that govern state veterans homes.
- Protecting patient privacy and integrity of information when using electronic medical records
The federal Health Insurance Portability and Accountability Act (HIPAA), enacted in 1996, guarantees privacy protection for individuals with regard to specific health information (Pub.L. 104–191, 110 Stat. 1936). Generally, protected health information (PHI) is any information held by a covered entity which concerns health status, provision of health care, or payment for health care that can be connected to an individual. HIPAA privacy regulations require health care providers and organizations to develop and follow procedures that ensure the confidentiality and security of PHI when it is transferred, received, handled, or shared. HIPAA further requires reasonable efforts when using, disclosing, or requesting PHI, to limit disclosure of that information to the minimum amount necessary to accomplish the intended purpose. California’s Confidentiality of Medical Information Act (CMIA) also protects PHI and restricts the disclosure of medical information by health care providers, and health care service plans, as specified. (Civ. Code Sec. 56 et seq.)
The Legislature has considered a number of bills aimed at ensuring patient privacy and the accuracy of information within electronic health records, including ensuring that electronic conveyance of laboratory test results are protected (see AB 2253, Pan, Ch. 698, Stats. 2012), clarifying that businesses that offer electronic medical records through mobile applications are subject to CMIA requirements (see AB 658, Ch. 296, Stats. 2013), and ensuring that there is a record of any changes to an electronic record (SB 850, Leno, Ch. 714, Stats. 2011). When considering a state-wide electronic registry for Physician Orders for Life Sustaining Treatment (POLST), this Committee also required that a patient be able to review a POLST form for accuracy and make any necessary amendments prior to the form being available to authorized users.
This bill would require an electronic medical record system for individuals living in veterans’ homes in California. Of the veteran population, Dr. Stephen Hunt, national director of the U.S. Department of Veterans Affairs Post Deployment Integrative Care Initiative said “folks returning from combat have a constellation of health concerns, including physical issues, psychological issues and psychosocial issues concerning things like work and family.” Clearly, the wounds of war can go far beyond what meets the eye. From mental health issues to pain and illness that persist long after they have left the battlefield, veterans face a multitude of health troubles more frequent among them than the general population. (Salamon, After the Battle: 7 Health Problems Facing Veterans, Live Science (2010) <http://www.livescience. com/8916-battle-7-health-problems-facing-veterans.html> [as of 4/12/2016].)
Given the unique needs of the veteran population, and how information held in a medical record may affect anything from medical treatment, to mental health treatment, to employment prospects, privacy and accuracy with regard to veteran patient information are of the utmost importance. Accordingly, the following amendments would ensure that the protections the Legislature has enacted with regard to electronic medical records in general, will also protect veterans receiving their care from the Department of Veterans Affairs.
Author’s amendments:
Ensure that the medical record system implemented by the secretary, and all transactions made pursuant to that system, comply with the Confidentiality of Medical Information Act (Part 2.6 (commencing with Section 56) of Division 1 of the Civil Code), Chapter 1 (commencing with Section 123100) of Part 1 of Division 106 of the Health and Safety Code, the Information Practices Act (Chapter 1 (commencing with Section 1798) of Title 1.8 of Part 4 of Division 3 of the Civil Code), the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) (Public Law 104-191), the federal Health Information Technology for Clinical Health Act (HITECH) (Public Law 111-005), and the corresponding implementing regulations relating to privacy and security in Parts 160 and 164 of Title 45 of the Code of Federal Regulations.
Support: California Council of Chapters; California State Commanders Veteran Council; California Long-Term Care Ombudsman Association; Military Officers Association of America-California Council of Chapters; Veterans of Foreign Wars-Department of California; Vietnam Veterans of America-California State Council
Opposition: None Known
HISTORY
Source: AMVETS—Department of California; California Association of County Veterans Service Officers
Related Pending Legislation: None Known
Prior Legislation: None Known
Prior Vote: Senate Committee on Veterans Affairs (Ayes 4, Noes 0)
**************
SENATE COMMITTEE ON
Senator Jim Nielsen, Chair
2015 - 2016 Regular
Bill No: Hearing Date: 4/12/16
Author: | Nielsen | ||
Version: |
| ||
Urgency: | Fiscal: | ||
Consultant: | |||
Subject:
DESCRIPTION
Summary:
- Requires the Department of Veterans Affairs (CalVet) (a) to adopt statewide policies and procedures, by regulation, for operation of the state veterans home system; (b) to establish a quality of care assessment team; (c) to implement a statewide electronic health records system; and (d) correct and update outdated terminology and references within the portion of the Military and Veterans Code (MVC) that governs state veterans’ homes.
Existing law:
- Authorizes establishment and operation of the Veterans’ Home of California system.
- Establishes the authority and responsibilities of CalVet in administering the system.
- Requires each on-site home administrator to adopt rules and regulations for the administration of each home.
- Defines criteria for admission to a veterans’ home.
- Requires that home members (residents) pay fees and charges as determined by CalVet, subject to a specified fee schedule.
- Authorizes CalVet to investigate a veteran’s financial status for admission purposes.
- Requires 100% of the monies received by a veterans’ home from veterans receiving federal aid to be placed to the credit of the home to offset the costs of being in the home.
- Requires that -- upon the death of a veteran in a home – any monies not in excess of $3,000 held by the home for the veteran to be paid to the home’s Morale, Welfare, and Recreation Fund, if no will or heir or other family member is discovered.
- Authorizes:
- Married veteran home members to have their non-veteran spouses domicile with them.
- A resident spouse to continue residency after a veteran spouse’s death.
This bill:
- Corrects and updates archaic and outdated terminology and references within the portion of the MVC that governs state veterans’ homes.
- Clarifies that the on-site home administrator to be the senior executive appointed to oversee the operations of a veterans’ home.
- Requires the Secretary of Veterans Affairs to adopt uniform statewide policies and procedures, by regulation, for the operation of the veterans’ home system.
- Requires CalVet to establish a quality of care assessment team.
- Requires the Secretary to implement a statewide electronic health record system.
- Requires the Secretary to annually report to the veterans policy committees of the Legislature.
- Requires that fees and charges be established by the Secretary.
- Requires the Secretary to adopt rules and regulations that apply to the homes and the criteria for admission.
- Provides that a resident spouse who continues residency after a veteran spouse’s death to continue to pay all applicable fees and comply with all department regulations.
- Requires CalVet to determine the total worth of any member’s property or assets for purposes of admission, including validating income levels for purposes of establishing fees.
- Provides that monies received by a veterans’ home from veterans who receive federal aid to be deposited into the Federal Trust Fund, a continuously appropriated fund, to be used for the operating costs of the home.
BACKGROUND
State Veterans Homes
The State of California provides veterans’ homes to help provide for the state's aged or disabled veterans to acknowledge the service and tremendous sacrifices California veterans have made on behalf of our nation.
CalVet's Veterans Homes Division provides rehabilitative, residential medical care and services in a homelike environment for aged and disabled veterans (and eligible veteran spouses) residing in the State's eight veterans homes, which are located in Barstow, Chula Vista, Fresno, Lancaster. Redding, Ventura, West Los Angeles, and Yountville. As of mid-March 2016, a total of 2,158 members resided in the homes.
Many of the homes were built in the last 10 years and the state’s laws and regulations governing the homes are not standardized. Also, some policies and procedures are outdated and need to be updated to reflect the level of care provided at the homes.
Levels of Care
The eight campuses offer different combinations of the following levels of care that generate increasing levels of cost:
- Independent living/domiciliary care (Barstow, Chula Vista, Yountville):
This level of care is for residents able to perform activities of daily living with, at most, minimal assistance. Non-nursing employees provide limited supervision. Residents have access to all of the Home's services, activities, and medical care. Individuals can transfer to higher levels of care as needed. Independent living is also referred to as Domiciliary by CalVet and the USDVA.
- Residential care/assisted living (All homes except Barstow):
Residential Care Facilities for the Elderly (RCFE) are available for residents who require minimal assistance and supervision with some activities of daily living. RCFE services may include care by licensed nurses. In the future, memory care programs may be established within the RCFEs.
- Intermediate care (Barstow, Yountville):
This level is for residents who often require licensed nursing assistance with medications and treatments, and generally require unlicensed nursing assistance with several daily living activities.
- Skilled nursing care (Barstow, Chula Vista, Fresno, Redding, West LA, Yountville)
This level of care provides 24-hour services of licensed nurses and certified nursing assistants, and is more comprehensive than intermediate care. Skilled nursing residents have greater access to rehabilitation therapies, nursing care, pharmacy management, structured activities and clinical dietary services.
- Memory care:
The Fresno, Redding, West LA and Yountville homes provide memory care programs within their skilled nursing facilities.
- Outpatient clinic:
In addition to the above levels of care, each home provides an outpatient clinic to serve its members. The clinics provide comprehensive multidisciplinary assessments as well as ongoing primary care. The clinics address the veteran's routine care needs and also will arrange visits with outside medical specialists as necessary.
Electronic Health Records
New technologies and financial incentives have resulted in health care providers increasingly and actively using electronic health records (EHR). An EHR is an electronic version of a patient‘s medical history, which is maintained by the provider over time, and may include all of the key administrative clinical data relevant to that persons care under a particular provider, including demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports The EHR automates access to the information and has the potential to streamline clinician workflow. The EHR also has the ability to support other care-related activities directly or indirectly through various interfaces, including evidence-based decision support, quality management, and outcomes reporting.
In 2009, the President signed the American Recovery and Reinvestment Act which included the establishment of the Office of the National Coordinator for Health Information Technology to facilitate and expand the use of health information technology pursuant to national standards. Using electronic health record systems is intended to reduce medical errors and increase patient accessibility to personal medical information. However, according to Privacy Rights Clearing House, 1263 data breaches involving medical and healthcare providers have been made public since 2005. Those breaches involved over 45 million records. Accordingly, both the state and federal governments continue enact measures to ensure the protection of patient medical information, and closely monitor legislation involving EHRs.
COMMENT
Committee Comments:
- This bill is double-referred to Senate Judiciary at that that Committee’s request. Judiciary staff says their interest is exclusively in the EHR provisions.
- The state veterans home system has expanded rapidly from three homes to eight within the past decade. This has challenged CalVet’s departmental ability to ensure a standardized, high quality of care in all the homes. New CalVet Secretary Vito Imbasciani, a physician, has announced this as a priority concern.
- According to CalVet, the dollar amounts in MVC Sec. 1035.3 have been unchanged since at least 1983, when that section was amended last. They have not been adjusted for inflation nor have they been adjusted to address increases in court and administrative costs associated with collecting and disposing of assets. In many cases the department has had to spend more in court fees and administrative costs than what is actually recovered from the assets. Additionally, since Sec. 1035.5 references Secs. 1035 through 1035.4 for disposal of assets for residents admitted after January 1, 1984, the sections are still relevant and need to be updated. This bill updates the dollar amounts.
Related/Prior Legislation
SB 543 (Wolk, pending Assembly, 2016), with regard to the Veterans Home of California system, creates a single system-wide Morale, Welfare, and Recreation Fund (MWR Fund) that consolidates existing and future MWR moneys generated by individual veterans home campuses, and establishes procedures and restrictions on the budgeting and spending of moneys in the Fund.
SB 1410 (Wolk, Chapter 659, Statutes of 2014) requires non-veteran spouses to pay the same fees and charges as paid by veteran members of a veterans’ home, as determined by CalVet, and subjects them to the same prohibitions.
AB 1580 (Yamada, died Senate 3rd Reading, 2014) consolidates the separate MWR Funds at each veterans home into a newly created fund in the State Treasury.
SB 10 (Evans, Chapter 265, Statutes of 2011) provides for the establishment of a Veteran’s Home Allied Council for each veterans home, and would additionally permit each council to represent veterans who reside in that same home in matters before the Legislature if each council, in the course of providing that representation, complies with specified requirements, as prescribed.
POSITIONS
Sponsor:
AMVETS
CA Association of County Veterans Service Officers
Support:
California State Commanders Veteran Council
California Long-Term Care Ombudsman Association
Military Officers Association of America-CA Council of Chapters
Veterans of Foreign Wars- Department of CA
Vietnam Veterans of America-CA State Council
Oppose: None on file
-- END --
Discussed in Hearing
8MIN
Assembly Standing Committee on Veterans Affairs
11MIN
Senate Standing Committee on Veterans Affairs
Bill Author
Bill Co-Author(s):