CONCURRENCE IN SENATE AMENDMENTS

CSA1 Bill Id:AB 2377

Author:(Chiu)

As Amended Ver:August 25, 2020

Majority vote

SUMMARY:

Expands closure requirements for Adult Residential Facilities (ARFs) and establishes notification requirements to residents and relevant entities, as specified.

The Senate Amendments:

1. Add language that requires an applicant or licensee of an adult community care facility to maintain an email address on file within the California Department of Social Services (CDSS) and provide notice of the email address and any change to it within 10 days of the change.
2. Delete language that defines an "adult residential facility" as a facility of any capacity that provides 24-hour-a-day non-medical care and supervision to persons 18 to 59 years of age, and instead, add language that defines an ARF as a licensed adult residential facility, as specified.
3. Add language that requires a licensee of an ARF to inform a resident and the resident's representative, if any, of a proposed closure, as specified, no later than 180 days before its proposed closure, or as soon as practicably possible.
4. Add language that requires the licensee specify in the notification of proposed closure that it is not, and should not be seen as, an eviction notice.
5. Make a number of changes to the list of closure requirements for ARF licensees, including:
6. Delete language requiring an ARF licensee prepare a relocation evaluation that includes reference to a resident's right to remain in the facility if purchased by a city or county, and instead, add language that requires the relocation evaluation include reference to the possibility that the resident remain in the facility, as specified.
7. Delete language requiring an ARF licensee to provide each resident with written notice no later than 180 days before the intended eviction, and instead, add language requiring the written notice be provided no later than 60 days before the intended eviction.
8. Delete language that requires no later than 180 days before a proposed closure, a licensee of an ARF to notify the city and county of the proposed closure, and whether the licensee intends to sell the property, as specified, thereby reverting to existing law.
9. Add language that permits an ARF licensee who owns the facility to, after the city or county has made an offer, accept the localities purchase of the facility, or accept any other offer received.
10. Add language that permits any entity planning to continue operating the licensed ARF to make an offer to purchase the facility, as specified, and allows the licensee may accept the offer at any time regardless of whether the city or county has made an offer.
11. Add language requiring an ARF licensee to provide written notification to certain relevant entities if certain circumstances regarding the licensed facility have occurred, as specified, or there is knowledge of those circumstances occurring.
12. Add language that requires an applicant or licensee of an ARF to maintain an email address on file within CDSS, and provide notice of the email address, and any change to it within 10 days of the change.
13. Make technical changes.

COMMENTS:

Senior Homelessness: Over 151,278 individuals are experiencing homelessness in California based on 2019 reports by the United States Department of Housing and Urban Development. While there are many contributing factors to homelessness, obstacles such as lack of affordable housing, dwindling retirement options, and rising healthcare costs leave seniors particularly vulnerable to joining the unhoused population. A study conducted by Los Angeles, Boston, and New York City in 2019 estimates that the number of homeless seniors 65 years and older will triple by the year 2030, spiking to over 100,000 individuals across the country.

Community Care Facilities: The California Community Care Facilities Act (CCFA), enacted in 1973, contains the provisions for a variety of community-based housing options for the elderly and disabled. The CCFA seeks to provide a new system of community-based care for those who require additional supervision and services that are determined to be non-medical. Facilities established under the act provide care to individuals with disabilities, seniors, children in foster care, families who need early child education, and those with severe behavioral, emotional, or mental disorders. Facilities created under the CCFA are administered through CDSS. The department is responsible for licensing facilities across programs, along with ensuring regulatory compliance and enforcement when necessary.

Adult Residential Facilities: ARFs, established under the CCFA, provide non-medical services to residents age 18-59, or those 60 and older who meet certain requirements. These facilities are open 24-hours a day and assist those with a mental, physical, or developmental disability. ARFs, also commonly referred to as Board and Care Homes, are not required to have nurses or doctors on staff.

An RCFE, also created under the CCFA, is another type of facility that provides non-medical care and supervision to individuals with certain daily living needs. However, these facilities primarily offer support to those 60 years or older who do not need 24-hour services. RCFE populations often have functional and cognitive impairments that limit their ability to complete various living tasks, but their medical conditions are managed either by themselves or by an outside medical professional. Under current law, there are several closure requirements for licensees of these types of facilities, enacted to preserve the services and protect the residents.

Need for this bill: This bill seeks to expand ARF closure requirements, mandating a licensee to send advanced notification of the closure to residents and relevant local entities. The language includes provisions to allow a locality ample time to purchase and continue the use of the facility as an ARF if desired. This legislation would strengthen the closure requirements for ARFs, possibly minimizing transfer trauma for residents. Requiring ARF licensees to provide advanced notice of closures would give their vulnerable population time to plan for the change, which could reduce the number of seniors who fall into homelessness.

According to the Author:

"This bill reduces the risk of homelessness for vulnerable residents of ARFs. Throughout the state, these facilities are closing at an alarming rate, with San Francisco alone having lost 43 facilities between 2012 and 2019. In 2019, Los Angeles lost more than 200 beds for low-income people with serious mental illness. ARFs are increasingly serving more significant numbers of vulnerable residents, including individuals with serious mental illnesses and other chronic conditions…By improving closure requirements, California will be better able to reduce the effects of homelessness and protect some of the state's most vulnerable communities."

Arguments in Support:

A supporter of the bill, the City and County of San Francisco's Department of Disability and Aging Services, state "The current closing requirements for ARFs, which are less protective than those for RCFEs, increase the challenges residents face when facilities close. Already, a third of those experiencing homelessness are suffering from mental illness. Because of their vulnerability and the current housing crisis, residents are especially at risk of becoming homeless.

Moreover, the bill addresses a time-sensitive problem related to COVID-19 and could address resources or services that could assist in future emergency or disaster responses. Not only has homelessness become an increasing statewide crisis over the past few years, the intersection between public health and those experiencing homelessness should be at the forefront of California legislative priorities this year."

Arguments in Opposition:

None on file

FISCAL COMMENTS:

According to the Senate Appropriations Committee based on amendments taken in committee on August 20, 2020:

Department of Social Services: Staff anticipates approximately $1.05 million General Fund in fiscal year 2020-21, and ongoing, to CDSS for contract costs of a temporary manager. Although this figure is based on experiences of a temporary manager for residential care facilities for the elderly, staff notes the estimate could greatly vary depending on a number of factors that are unknowable at this time, including, among others: 1) the duration of temporary management: 2) the severity of the situation the temporary manager will enter; 3) and, the number of facilities that may be unable to care for clients,. In addition, as the COVID-19 pandemic continues, there is also an anticipated strain to existing facility administration and costs.

Court costs: Staff indicates unknown, potentially significant ongoing court cost pressures to the courts to adjudicated alleged violations of this measure. While superior courts are not funded on a workload basis, an increase in workload could result in delayed court services and put pressure on the General Fund to fund additional resources. The Budget Act of 2020 provided $273.8 million from the General Fund to backfill the continued reduction in fine and fee revenue for trial court operations.

VOTES:

ASM HUMAN SERVICES: 6-0-2

YES: Reyes, Arambula, Friedman, Gipson, Maienschein, Mark Stone

ABS, ABST OR NV: Mathis, Flora

ASM APPROPRIATIONS: 14-0-4

YES: Gonzalez, Bauer-Kahan, Bloom, Bonta, Calderon, Carrillo, Chau, Diep, Eggman, Gabriel, Eduardo Garcia, Petrie-Norris, McCarty, Robert Rivas

ABS, ABST OR NV: Bigelow, Megan Dahle, Fong, Voepel

ASSEMBLY FLOOR: 64-6-9

YES: Aguiar-Curry, Arambula, Bauer-Kahan, Berman, Bloom, Boerner Horvath, Bonta, Burke, Calderon, Carrillo, Cervantes, Chau, Chiu, Chu, Cooley, Cooper, Daly, Diep, Eggman, Frazier, Friedman, Gabriel, Cristina Garcia, Eduardo Garcia, Gipson, Gloria, Gonzalez, Gray, Grayson, Holden, Irwin, Jones-Sawyer, Kalra, Kamlager, Lackey, Levine, Limón, Low, Maienschein, Mayes, McCarty, Medina, Mullin, Muratsuchi, Nazarian, O'Donnell, Petrie-Norris, Quirk-Silva, Ramos, Reyes, Luz Rivas, Robert Rivas, Rodriguez, Blanca Rubio, Salas, Santiago, Smith, Mark Stone, Ting, Waldron, Weber, Wicks, Wood, Rendon

NO: Brough, Choi, Cunningham, Flora, Obernolte, Voepel

ABS, ABST OR NV: Bigelow, Chen, Megan Dahle, Fong, Gallagher, Kiley, Mathis, Patterson, Quirk

SENATE FLOOR: 39-0-1

YES: Allen, Archuleta, Atkins, Bates, Beall, Borgeas, Bradford, Caballero, Chang, Dahle, Dodd, Durazo, Galgiani, Glazer, Lena Gonzalez, Grove, Hertzberg, Hill, Hueso, Hurtado, Jackson, Leyva, McGuire, Melendez, Mitchell, Monning, Moorlach, Morrell, Nielsen, Pan, Portantino, Roth, Rubio, Skinner, Stern, Umberg, Wieckowski, Wiener, Wilk

ABS, ABST OR NV: Jones

UPDATED:

VERSION: August 25, 2020

CONSULTANT: Emmalynn Mathis / HUM. S. / (916) 319-2089 FN: 0003517

 THIRD READING  

Bill No: AB 2377

Author: Chiu (D), et al.

Amended: 8/25/20 in Senate

Vote: 21

SENATE HUMAN SERVICES COMMITTEE: 5-2, 8/10/20

AYES: Hurtado, Beall, Jackson, Pan, Wiener

NOES: Jones, Melendez

SENATE APPROPRIATIONS COMMITTEE: 5-2, 8/20/20

AYES: Portantino, Bradford, Hill, Leyva, Wieckowski

NOES: Bates, Jones

ASSEMBLY FLOOR: 64-6, 6/10/20 - See last page for vote

SUBJECT: Residential facilities

SOURCE: City and County of San Francisco

DIGEST:

This bill (1) establishes closure requirement for adult residential facilities (ARFs), including specified notifications to the residents or the residents’ responsible person and the city and county; (2) gives the city or county first opportunity to make an offer to purchase the property and continue the operation of the ARF, as specified; and (3) requires specified licensees and applicants to maintain an email address of record with the California Department of Social Services (CDSS).

Senate Floor Amendments of 8/25/20 make technical changes and clarify the circumstances under which a licensee of an ARF must take specified action to inform CDSS, residents of the ARF and the local city and county of certain changes in the planned operation of the ARF.

ANALYSIS:

Existing law:

1. Establishes the California Community Care Facilities Act, which provides regulatory structure for a coordinated and comprehensive statewide system of care for the mentally ill, developmentally and physically disabled, and children and adults who require care or services provided by licensed community care facilities. (HSC 1500 et seq.)
2. Defines “residential facility” as any family home, group care facility, or similar facility determined by the department, for 24-hour non-medical care of persons in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of the individual. (HSC 1502(a)(1))
3. Requires a licensee of an ARF to inform the city and county in which the facility is located of a proposed closure, including whether the licensee intends to sell the property or business, no later than 180 days before its proposed closure, or as soon as practicably possible. (HSC 1562.2)
4. Establishes licensure and regulatory requirements for ARFs for persons with chronic life-threatening illness. (HSC 1568.01 et seq.)
5. Requires a residential care facility for the elderly (RCFE), prior to transferring a resident to another facility or to an independent living arrangement as a result of the forfeiture of a license or change in use of the facility, to take all reasonable steps to transfer affected residents safely, and minimize possible trauma by taking specified actions. (HSC 1569.682(a))
6. Declares that it is the intent of the Legislature to authorize CDSS to take quick, effective action to protect the health and safety of residents of RCFEs and to minimize the effects of transfer trauma and sets requirements for the appointment and responsibilities of temporary managers (HSC 1569.481 et seq.)
7. Defines “adult residential facility” in regulations to mean any facility of any capacity that provides 24-hour-a-day nonmedical care and supervision to persons 18 years of age through 59 years of age. (22 CCR 80001(a)(5))

This bill:

1. Requires an applicant or licensee of an adult community care facility or an ARF to maintain an email address of record with CDSS, as specified.
2. Defines “adult residential facility” to mean a facility licensed as an ARF.
3. Requires a licensee of an ARF to inform a resident and the resident’s representative, if any, of a proposed closure, including whether the licensee intends to sell the property or business, no later than 180 days before its proposed closure, or as soon as practicably possible.
4. Requires the licensee to specify in the notification that it is not, and should not be construed as, an eviction notice.
5. Requires a licensee of an ARF to, prior to transferring a resident of the facility to another facility or to an independent living arrangement as a result of the forfeiture of a license, as specified, or a closure of the facility for another reason, take all reasonable steps to transfer affected residents safely and to minimize possible transfer trauma, as specified.
6. Requires the licensee to submit a proposed closure plan to CDSS, as specified.
7. Requires CDSS to take any necessary action to minimize trauma for ARF residents, including caring for the residents through the use of a temporary manager or receiver, as specified.
8. Requires CDSS to contact any local agency that may have assessment, placement, protective, or advocacy responsibility for the residents, and to work together with those agencies to locate alternative placement sites, contact relatives or other persons responsible for the care of these residents, provide onsite evaluation of the residents, and assist in the transfer of the residents.
9. Provides that the participation of CDSS and local agencies in the relocation of residents from an ARF does not relieve the licensee of any responsibility and establishes that a licensee that fails to comply shall be required to reimburse CDSS and local agencies for the cost of providing the relocation services or the costs incurred in caring for the residents through the use of a temporary manager or receiver.
10. Permits CDSS to seek injunctive relief and damages, including restitution to the department of any costs incurred in caring for the residents through the use of a temporary manager or receiver, if the licensee fails to provide the relocation services.
11. Requires that a licensee who fails to comply with the closure requirements shall be liable for the imposition of civil penalties of one hundred dollars per violation per day for each day that the licensee is in violation of this section, until the violation has been corrected, as specified.
12. Provides that, on and after January 1, 2021, a licensee who abandons the facility and the residents in care resulting in an immediate and substantial threat to the health and safety of the abandoned residents, in addition to forfeiture of the license, shall be excluded from licensure in facilities licensed by CDSS without the right to petition for reinstatement.
13. Permits a resident of an ARF to bring a civil action against any person, firm, partnership, or corporation who owns, operates, establishes, manages, conducts, or maintains an ARF who violates the rights of a resident, as specified.
14. Requires that a licensee who is also the owner of an ARF who notifies the city and county of an intent to sell the property shall give the city or county the first opportunity to make an offer to purchase the property, as specified.
15. Permits an individual or entity planning to continue operating the licensed ARF to make an offer to purchase the facility, and permits the licensee to accept the offer at any time. Requires the individual or entity that makes an offer to purchase a facility to provide a written statement to the licensee and CDSS that the individual or entity agrees to continue the operation of the ARF and apply for licensure as an ARF upon completion of the sale of the existing facility.
16. Provides that a city or county shall have maximum flexibility in seeking and securing available funding sources to purchase an ARF, including any federal, state, local, as specified.
17. Permits a city or county that purchases an ARF to either take over operation of the facility, or, if possible, enter into a long-term lease for its operation with a nonprofit or for-profit entity, as specified.
18. Requires that a lease entered into include a requirement that the lessee maintain licensure of the property as an ARF.
19. Requires a licensee of an ARF to notify the city and county in which the facility is located, CDSS, all residents, and, if applicable, their legal representatives, in writing, within two business days, and notify all applicants for potential residence, and if applicable, their legal representatives, prior to admission, of any specified events, or knowledge of specified events.

Background

Residential Care Facilities for the Elderly and Adult Residential Facilities

RCFEs (also known as assisted living facilities) are residential facilities that provide 24-hour nonmedical care and supervision for persons in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of the individual who is 60 years of age or older.

ARFs (also known as board and care homes) are residential facilities that provide 24-hour nonmedical care and supervision for persons in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of the individual who is aged 18–59.

Both RCFEs and ARFs provide housing, housekeeping, supervision, and personal care assistance with activities of daily living to individuals who need that level of care. These are nonmedical facilities that are designed for individuals who are unable to live by themselves, but who do not need 24-hour nursing care, and as such the facilities are not required to have nurses, certified nursing assistants or doctors on staff. These facilities usually centrally store and distribute medications for residents to self-administer. Residents in both RCFEs and ARFs may have mental, behavioral, or physical health needs or a developmental disability that results in their inability to live independently. These facilities range in size from small facilities operating out of a single family homes serving a handful of residents to larger buildings that can house over a 100 residents.

There are significant differences between the requirements for operating ARFs versus those for RCFEs, some of which were explored in the background paper prepared for an oversight hearing conducted earlier this year by this committee on the State Oversight of Licensed Homes for Vulnerable Adults. This bill is intended to incorporate provisions of AB 949 (Krekorian, Chapter 686, Statutes of 2007), which established closure requirements for RCFEs. Those requirements include preparing a relocation evaluation of the needs of each resident, and providing written and verbal notification of the impending move within certain timeframes; thereby protecting residents from potentially becoming homeless as the result of an ARF closure.

Impact of ARF Closures on Homelessness

Prior to the COVID-19 outbreak, policy-makers and advocates were exploring the effects that closure of licensed residential facilities were having on homelessness. Counties throughout the state reported that housing options for low-income individuals within licensed residential facilities have been shrinking. It has been observed that this problem is particularly exacerbated in areas with high costs of living and high property values, because the owners of residential facilities may choose to sell the property rather than continue operations.

Many counties use ARFs in their efforts to find residential placements for people experiencing homelessness. For example, the County of Los Angeles has placed over 1,000 people who were experiencing homelessness into board and care homes, many of whom struggle with severe mental illness. This demonstrates a connection between maintaining the operation of board and care facilities and preventing homelessness. This bill requires ARF operators to notify local city and county officials whenever the property owner intends to sell the property in order to give the local entities the opportunity to purchase the property for the purpose of maintaining the operation of ARFs within their communities. According to the author, multiple Bay Area counties have expressed interest in making such purchases.

Comments

According to the author, “this bill reduces the risk of homelessness for vulnerable residents of board and care facilities by creating more stringent closure requirements for Adult Residential Facilities.” The author notes that ARFs “are closing at an alarming rate, with San Francisco alone having lost 43 facilities between 2012 and 2019 (a nine percent decline)” and that ARFs are “increasingly serving greater numbers of vulnerable residents, including individuals with serious mental illnesses and other chronic conditions.” Per the author, “it is imperative that we take preventative measures in 2020 by helping those most vulnerable to homelessness…to ensure the growing vulnerable ARF resident population is provided similar protections that residents of RCFEs have when a facility closes.”

COVID-19 Impact on Committee Jurisdiction

Due to the COVID-19 Pandemic and the unprecedented nature of the 2020 Legislative Session, all Senate Policy Committees are working under a compressed timeline.  This timeline does not allow this bill to be referred and heard by more than one committee as a typical timeline would allow.  In order to fully vet the contents of this bill for the benefit of Senators and the public, this analysis includes information from Senate Judiciary Committee as shown below:

“The Senate Judiciary Committee has historically favored protections for vulnerable individuals housed in care facilities in order to ensure that they have continued access to care and shelter. By adopting requirements for the closing of adult residential facilities comparable to those applicable to residential care facilities under existing law, this bill draws on established processes to protect individuals who require assistance with daily living due to chronic conditions such as mental illness or disability. By reducing closures, giving counties the opportunity to purchase the facilities, and providing residents with advanced notice of closures, this bill would help minimize the trauma that residents may experience from such transitions, giving them more continuity and time to prepare for change, and helping to protect them from experiencing homelessness.”

FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: Yes

According to the Senate Appropriations Committee:

• Approximately $1.05 million General Fund in FY 2020-21, and ongoing, to CDSS for contract costs of a temporary manager. Although this figure is based on experiences of a temporary manager for RCFE, staff notes the estimate could greatly vary depending on a number of factors that are unknowable at this time, including, among others: (1) the duration of temporary management: (2) the severity of the situation the temporary manager will enter; (3) and, the number of facilities that may be unable to care for clients,. In addition, as the COVID-19 pandemic continues, there is also an anticipated strain to existing facility administration and costs.
• Unknown, potentially significant ongoing court cost pressures to the courts to adjudicated alleged violations of this measure. While superior courts are not funded on a workload basis, an increase in workload could result in delayed court services and put pressure on the General Fund to fund additional resources. The Budget Act of 2020 provided $273.8 million from the General Fund to backfill the continued reduction in fine and fee revenue for trial court operations.

SUPPORT: (Verified 8/25/20)

City and County of San Francisco (source)

California Association of Local Behavioral Health Boards and Commissions

County Behavioral Health Directors Association

Heart Forward LA

National Alliance on Mental Illness-California

National Association of Social Workers, California Chapter

The People Concern

OPPOSITION: (Verified 8/25/20)

None received

ASSEMBLY FLOOR: 64-6, 6/10/20

AYES: Aguiar-Curry, Arambula, Bauer-Kahan, Berman, Bloom, Boerner Horvath, Bonta, Burke, Calderon, Carrillo, Cervantes, Chau, Chiu, Chu, Cooley, Cooper, Daly, Diep, Eggman, Frazier, Friedman, Gabriel, Cristina Garcia, Eduardo Garcia, Gipson, Gloria, Gonzalez, Gray, Grayson, Holden, Irwin, Jones-Sawyer, Kalra, Kamlager, Lackey, Levine, Limón, Low, Maienschein, Mayes, McCarty, Medina, Mullin, Muratsuchi, Nazarian, O'Donnell, Petrie-Norris, Quirk-Silva, Ramos, Reyes, Luz Rivas, Robert Rivas, Rodriguez, Blanca Rubio, Salas, Santiago, Smith, Mark Stone, Ting, Waldron, Weber, Wicks, Wood, Rendon

NOES: Brough, Choi, Cunningham, Flora, Obernolte, Voepel

NO VOTE RECORDED: Bigelow, Chen, Megan Dahle, Fong, Gallagher, Kiley, Mathis, Patterson, Quirk

Prepared by: Taryn Smith / HUMAN S. /

8/26/20 14:59:54

**** END ****

 THIRD READING  

Bill No: AB 2377

Author: Chiu (D), et al.

Amended: 8/20/20 in Senate

Vote: 21

SENATE HUMAN SERVICES COMMITTEE: 5-2, 8/10/20

AYES: Hurtado, Beall, Jackson, Pan, Wiener

NOES: Jones, Melendez

SENATE APPROPRIATIONS COMMITTEE: 5-2, 8/20/20

AYES: Portantino, Bradford, Hill, Leyva, Wieckowski

NOES: Bates, Jones

ASSEMBLY FLOOR: 64-6, 6/10/20 - See last page for vote

SUBJECT: Residential facilities

SOURCE: Author

DIGEST:

This bill (1) establishes closure requirement for adult residential facilities (ARFs), including specified notifications to the residents or the residents’ responsible person and the city and county; (2) gives the city or county first opportunity to make an offer to purchase the property and continue the operation of the ARF, as specified; and (3) requires specified licensees and applicants to maintain an email address of record with the California Department of Social Services (CDSS).

ANALYSIS:

Existing law:

1. Establishes the California Community Care Facilities Act, which provides regulatory structure for a coordinated and comprehensive statewide system of care for the mentally ill, developmentally and physically disabled, and children and adults who require care or services provided by licensed community care facilities. (HSC 1500 et seq.)
2. Defines “residential facility” as any family home, group care facility, or similar facility determined by the department, for 24-hour non-medical care of persons in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of the individual. (HSC 1502(a)(1))
3. Requires a licensee of an ARF to inform the city and county in which the facility is located of a proposed closure, including whether the licensee intends to sell the property or business, no later than 180 days before its proposed closure, or as soon as practicably possible. (HSC 1562.2)
4. Establishes licensure and regulatory requirements for ARFs for persons with chronic life-threatening illness. (HSC 1568.01 et seq.)
5. Requires a residential care facility for the elderly (RCFE), prior to transferring a resident to another facility or to an independent living arrangement as a result of the forfeiture of a license or change in use of the facility, to take all reasonable steps to transfer affected residents safely, and minimize possible trauma by taking specified actions. (HSC 1569.682(a))
6. Declares that it is the intent of the Legislature to authorize CDSS to take quick, effective action to protect the health and safety of residents of RCFEs and to minimize the effects of transfer trauma and sets requirements for the appointment and responsibilities of temporary managers (HSC 1569.481 et seq.)
7. Defines “adult residential facility” in regulations to mean any facility of any capacity that provides 24-hour-a-day nonmedical care and supervision to persons 18 years of age through 59 years of age. (22 CCR 80001(a)(5))

This bill:

1. Requires an applicant or licensee of an adult community care facility or an ARF to maintain an email address of record with CDSS, as specified.
2. Defines “adult residential facility” to mean a facility licensed as an ARF.
3. Requires a licensee of an ARF to inform a resident and the resident’s representative, if any, of a proposed closure, including whether the licensee intends to sell the property or business, no later than 180 days before its proposed closure, or as soon as practicably possible.
4. Requires the licensee to specify in the notification that it is not, and should not be construed as, an eviction notice.
5. Requires a licensee of an ARF to, prior to transferring a resident of the facility to another facility or to an independent living arrangement as a result of the forfeiture of a license, as specified, or a closure of the facility for another reason, take all reasonable steps to transfer affected residents safely and to minimize possible transfer trauma, as specified.
6. Requires the licensee to submit a proposed closure plan to CDSS, as specified.
7. Requires CDSS to take any necessary action to minimize trauma for ARF residents, including caring for the residents through the use of a temporary manager or receiver, as specified.
8. Requires CDSS to contact any local agency that may have assessment, placement, protective, or advocacy responsibility for the residents, and to work together with those agencies to locate alternative placement sites, contact relatives or other persons responsible for the care of these residents, provide onsite evaluation of the residents, and assist in the transfer of the residents.
9. Provides that the participation of CDSS and local agencies in the relocation of residents from an ARF does not relieve the licensee of any responsibility and establishes that a licensee that fails to comply shall be required to reimburse CDSS and local agencies for the cost of providing the relocation services or the costs incurred in caring for the residents through the use of a temporary manager or receiver.
10. Permits CDSS to seek injunctive relief and damages, including restitution to the department of any costs incurred in caring for the residents through the use of a temporary manager or receiver, if the licensee fails to provide the relocation services.
11. Requires that a licensee who fails to comply with the closure requirements shall be liable for the imposition of civil penalties of one hundred dollars per violation per day for each day that the licensee is in violation of this section, until the violation has been corrected, as specified.
12. Provides that, on and after January 1, 2021, a licensee who abandons the facility and the residents in care resulting in an immediate and substantial threat to the health and safety of the abandoned residents, in addition to forfeiture of the license, shall be excluded from licensure in facilities licensed by CDSS without the right to petition for reinstatement.
13. Permits a resident of an ARF to bring a civil action against any person, firm, partnership, or corporation who owns, operates, establishes, manages, conducts, or maintains an ARF who violates the rights of a resident, as specified.
14. Requires that a licensee who is also the owner of an ARF who notifies the city and county of an intent to sell the property shall give the city or county the first opportunity to make an offer to purchase the property, as specified.
15. Permits any entity planning to continue operating the licensed ARF to make an offer to purchase the facility, and permits the licensee to accept the offer at any time. Requires an entity that makes an offer to purchase a facility to provide a written statement to the licensee and CDSS that the entity agrees to continue the operation of the ARF and apply for licensure as an ARF upon completion of the sale of the existing facility.
16. Provides that a city or county shall have maximum flexibility in seeking and securing available funding sources to purchase an ARF, including any federal, state, local, as specified.
17. Permits a city or county that purchases an ARF to either take over operation of the facility, or, if possible, enter into a long-term lease for its operation with a nonprofit or for-profit entity, as specified.
18. Requires that a lease entered into include a requirement that the lessee maintain licensure of the property as an ARF.
19. Requires a licensee of an ARF to inform the city and county in which the facility is located, CDSS, current residents, and, if applicable, the residents’ legal representatives, in writing, within two business days, and notify all applicants for potential residence, and if applicable, the potential resident’ legal representatives, prior to admission, if any specified events have occurred, or if the licensee has knowledge will occur.

Background

Residential Care Facilities for the Elderly and Adult Residential Facilities

RCFEs (also known as assisted living facilities) are residential facilities that provide 24-hour nonmedical care and supervision for persons in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of the individual who is 60 years of age or older.

ARFs (also known as board and care homes) are residential facilities that provide 24-hour nonmedical care and supervision for persons in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of the individual who is aged 18–59.

Both RCFEs and ARFs provide housing, housekeeping, supervision, and personal care assistance with activities of daily living to individuals who need that level of care. These are nonmedical facilities that are designed for individuals who are unable to live by themselves, but who do not need 24-hour nursing care, and as such the facilities are not required to have nurses, certified nursing assistants or doctors on staff. These facilities usually centrally store and distribute medications for residents to self-administer. Residents in both RCFEs and ARFs may have mental, behavioral, or physical health needs or a developmental disability that results in their inability to live independently. These facilities range in size from small facilities operating out of a single family homes serving a handful of residents to larger buildings that can house over a 100 residents.

There are significant differences between the requirements for operating ARFs versus those for RCFEs, some of which were explored in the background paper prepared for an oversight hearing conducted earlier this year by this committee on the State Oversight of Licensed Homes for Vulnerable Adults. This bill is intended to incorporate provisions of AB 949 (Krekorian, Chapter 686, Statutes of 2007), which established closure requirements for RCFEs. Those requirements include preparing a relocation evaluation of the needs of each resident, and providing written and verbal notification of the impending move within certain timeframes; thereby protecting residents from potentially becoming homeless as the result of an ARF closure.

Impact of ARF Closures on Homelessness

Prior to the COVID-19 outbreak, policy-makers and advocates were exploring the effects that closure of licensed residential facilities were having on homelessness. Counties throughout the state reported that housing options for low-income individuals within licensed residential facilities have been shrinking. It has been observed that this problem is particularly exacerbated in areas with high costs of living and high property values, because the owners of residential facilities may choose to sell the property rather than continue operations.

Many counties use ARFs in their efforts to find residential placements for people experiencing homelessness. For example, the County of Los Angeles has placed over 1,000 people who were experiencing homelessness into board and care homes, many of whom struggle with severe mental illness. This demonstrates a connection between maintaining the operation of board and care facilities and preventing homelessness. This bill requires ARF operators to notify local city and county officials whenever the property owner intends to sell the property in order to give the local entities the opportunity to purchase the property for the purpose of maintaining the operation of ARFs within their communities. According to the author, multiple Bay Area counties have expressed interest in making such purchases.

Comments

According to the author, “this bill reduces the risk of homelessness for vulnerable residents of board and care facilities by creating more stringent closure requirements for Adult Residential Facilities.” The author notes that ARFs “are closing at an alarming rate, with San Francisco alone having lost 43 facilities between 2012 and 2019 (a nine percent decline)” and that ARFs are “increasingly serving greater numbers of vulnerable residents, including individuals with serious mental illnesses and other chronic conditions.” Per the author, “it is imperative that we take preventative measures in 2020 by helping those most vulnerable to homelessness…to ensure the growing vulnerable ARF resident population is provided similar protections that residents of RCFEs have when a facility closes.”

COVID-19 Impact on Committee Jurisdiction

Due to the COVID-19 Pandemic and the unprecedented nature of the 2020 Legislative Session, all Senate Policy Committees are working under a compressed timeline.  This timeline does not allow this bill to be referred and heard by more than one committee as a typical timeline would allow.  In order to fully vet the contents of this bill for the benefit of Senators and the public, this analysis includes information from Senate Judiciary Committee as shown below:

“The Senate Judiciary Committee has historically favored protections for vulnerable individuals housed in care facilities in order to ensure that they have continued access to care and shelter. By adopting requirements for the closing of adult residential facilities comparable to those applicable to residential care facilities under existing law, this bill draws on established processes to protect individuals who require assistance with daily living due to chronic conditions such as mental illness or disability. By reducing closures, giving counties the opportunity to purchase the facilities, and providing residents with advanced notice of closures, this bill would help minimize the trauma that residents may experience from such transitions, giving them more continuity and time to prepare for change, and helping to protect them from experiencing homelessness.”

FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: Yes

According to the Senate Appropriations Committee:

• Approximately $1.05 million General Fund in FY 2020-21, and ongoing, to CDSS for contract costs of a temporary manager. Although this figure is based on experiences of a temporary manager for RCFE, staff notes the estimate could greatly vary depending on a number of factors that are unknowable at this time, including, among others: (1) the duration of temporary management: (2) the severity of the situation the temporary manager will enter; (3) and, the number of facilities that may be unable to care for clients,. In addition, as the COVID-19 pandemic continues, there is also an anticipated strain to existing facility administration and costs.
• Unknown, potentially significant ongoing court cost pressures to the courts to adjudicated alleged violations of this measure. While superior courts are not funded on a workload basis, an increase in workload could result in delayed court services and put pressure on the General Fund to fund additional resources. The Budget Act of 2020 provided $273.8 million from the General Fund to backfill the continued reduction in fine and fee revenue for trial court operations.

SUPPORT: (Verified 8/21/20)

California Association of Local Behavioral Health Boards and Commissions
City and County of San Francisco
County Behavioral Health Directors Association
Heart Forward LA
National Alliance on Mental Illness-California
National Association of Social Workers, California Chapter
The People Concern

OPPOSITION: (Verified 8/21/20)

6 Beds

ARGUMENTS IN SUPPORT: The City and County of San Francisco writes the following in support of this bill, “To ensure the growing vulnerable ARF resident population is provided similar protections that residents of RCFEs have when a facility closes, AB 2377 will align ARF closure requirements with those of RCFEs. By improving closure requirements, California will be better able to reduce the effects of homelessness and protect some of the State’s most vulnerable communities and reduce the risk of future public health emergencies.”

ARGUMENTS IN OPPOSITION: 6 Beds writes the following in opposition to this bill, “owners of ARFs should not be treated differently from any other property owner in their right to sell their property at the price offered by a willing buyer. These kinds of discriminatory provisions could easily discourage people from investing in ARFs in the first place, which is the opposite of what the author likely intends.”

ASSEMBLY FLOOR: 64-6, 6/10/20

AYES: Aguiar-Curry, Arambula, Bauer-Kahan, Berman, Bloom, Boerner Horvath, Bonta, Burke, Calderon, Carrillo, Cervantes, Chau, Chiu, Chu, Cooley, Cooper, Daly, Diep, Eggman, Frazier, Friedman, Gabriel, Cristina Garcia, Eduardo Garcia, Gipson, Gloria, Gonzalez, Gray, Grayson, Holden, Irwin, Jones-Sawyer, Kalra, Kamlager, Lackey, Levine, Limón, Low, Maienschein, Mayes, McCarty, Medina, Mullin, Muratsuchi, Nazarian, O'Donnell, Petrie-Norris, Quirk-Silva, Ramos, Reyes, Luz Rivas, Robert Rivas, Rodriguez, Blanca Rubio, Salas, Santiago, Smith, Mark Stone, Ting, Waldron, Weber, Wicks, Wood, Rendon

NOES: Brough, Choi, Cunningham, Flora, Obernolte, Voepel

NO VOTE RECORDED: Bigelow, Chen, Megan Dahle, Fong, Gallagher, Kiley, Mathis, Patterson, Quirk

Prepared by: Taryn Smith / HUMAN S. /

8/25/20 13:15:30

**** END ****

SENATE COMMITTEE ON

Senator Anthony Portantino, Chair

2019 - 2020 Regular Session

AB 2377 (Chiu) - Adult residential facilities: closures and resident transfers

Bill Summary:

Assembly Bill 2377 would establish procedures and requirements for transferring a licensed adult residential facility (ARF) resident to another facility or to an independent living arrangement as a result of the forfeiture of a license or a closure of the facility for another reason. Would give the city or county in which an ARF is located the right of first refusal to purchase the property on which an ARF is operating and authorizes the city or county to either take over operation of the facility or enter into a long-term lease for its continued operation, as specified.

*********** ANALYSIS ADDENDUM – SUSPENSE FILE ***********

The following information is revised to reflect amendments

adopted by the committee on August 20, 2020

Fiscal Impact:

• Department of Social Services. Staff anticipates approximately $1.05 million General Fund in FY 2020-21, and ongoing, to the Department of Social Services (CDSS) for contract costs of a temporary manager. Although this figure is based on experiences of a temporary manager for residential care facilities for the elderly, staff notes the estimate could greatly vary depending on a number of factors that are unknowable at this time, including, among others: (1) the duration of temporary management: (2) the severity of the situation the temporary manager will enter; (3) and, the number of facilities that may be unable to care for clients,. In addition, as the COVID-19 pandemic continues, there is also an anticipated strain to existing facility administration and costs.
• Court costs. Staff indicates unknown, potentially significant ongoing court cost pressures to the courts to adjudicated alleged violations of this measure. While superior courts are not funded on a workload basis, an increase in workload could result in delayed court services and put pressure on the General Fund to fund additional resources. The Budget Act of 2020 provided $273.8 million from the General Fund to backfill the continued reduction in fine and fee revenue for trial court operations

Author Amendments:

The author’s amendments would include the following, among other provisions:

• Require an ARF licensee to inform a resident and the resident’s representative, if any, of a proposed closure, no later than 180 days before its proposed closure, or as soon as practicably possible, and to specify in the notification that it is not to be construed as an eviction notice.
• Reduce, from 180-days to 60-days, the time period a licensee must provide each resident or the resident’s responsible person with a written notice before an intended eviction.
• Require an ARF licensee who is also the owner of an ARF to give the city or county the first opportunity to make an offer to purchase the property, at a price that reflects its fair market value and continue the operation of the ARF.
• Provide the licensee may accept an offer or any other offer after a city or county has made an offer.
• Authorize any entity that plans to continue operating the ARF to make an offer, and the licensee may accept that offer at any time.
• Require an entity that makes an offer to purchase a facility to provide a written statement, as specified, to the licensee at the CDSS.
• Require an ARF applicant or licensee to maintain an email contact with the CDSS, and must notify the department of any change within 10 business days of the change.

-- END --

SENATE COMMITTEE ON

Senator Anthony Portantino, Chair

2019 - 2020 Regular Session

AB 2377 (Chiu) - Adult residential facilities: closures and resident transfers.

Bill Summary:

This bill establishes procedures and requirements for transferring a licensed adult residential facility (ARF) resident to another facility or to an independent living arrangement as a result of the forfeiture of a license or a closure of the facility for another reason. The bill also gives the city or county in which an ARF is located the right of first refusal to purchase the property on which an ARF is operating and authorizes the city or county to either take over operation of the facility or enter into a long-term lease for its continued operation, as specified.

Fiscal Impact:

Department of Social Services. Staff anticipates approximately $1.05 million General Fund in FY 2020-21, and ongoing, to the Department of Social Services (CDSS) for contract costs of a temporary manager. Although this figure is based on experiences of a temporary manager for residential care facilities for the elderly, staff notes the estimate could greatly vary depending on a number of factors that are unknowable at this time, including, among others: (1) the duration of temporary management: (2) the severity of the situation the temporary manager will enter; (3) and, the number of facilities that may be unable to care for clients,. In addition, as the COVID-19 pandemic continues, there is also an anticipated strain to existing facility administration and costs.

Court costs. Staff indicates unknown, potentially significant ongoing court cost pressures to the courts to adjudicated alleged violations of this measure. While superior courts are not funded on a workload basis, an increase in workload could result in delayed court services and put pressure on the General Fund to fund additional resources. The Budget Act of 2020 provided $273.8 million from the General Fund to backfill the continued reduction in fine and fee revenue for trial court operations

Background:

The CDSS Community Care Licensing Division (CCLD) licenses and conducts oversight of community care facilities, including ARFs and RCFEs, throughout California.

• RCFEs (also known as assisted living facilities) are residential facilities that provide 24-hour nonmedical care and supervision for persons in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of the individual who is 60 years of age or older;
• ARFs (also known as board and care homes) are residential facilities that provide 24-hour nonmedical care and supervision for persons in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of the individual who is aged 18 – 59.

Both RCFEs and ARFs provide housing, housekeeping, supervision, and personal care assistance with activities of daily living. Residents in both RCFEs and ARFs may have mental, behavioral, or physical health needs or a developmental disability that results in their inability to live independently. These facilities range in size from small facilities operating out of a single family homes serving a handful of residents to larger buildings that can house over a 100 residents.

According to the Senate Human Services Committee: CDSS reports there were about 7,360 licensed ARFs with a capacity to serve about 37,240 residents in FY 2018-19. While the number of licensed ARFs increased by 132 from 2014-15 to 2018-19, overall capacity decreased by 1,572, suggesting newly opened ARFs have less capacity than those that closed.

Proposed Law:

AB 2377 would require a licensee of an adult residential facility, prior to transferring a resident of the facility to another facility or to an independent living arrangement as a result of the forfeiture of a license, or a closure of the facility for another reason, take all reasonable steps to transfer affected residents safely and to minimize possible transfer trauma and sets forth a number of processes the licensee must complete, including a relocation evaluation, written notice to the resident or resident’s person, and refunds, as applicable.

Proposed closure plan. The bill would require the licensee submit a proposed closure plan to CDSS for approval, if seven or more residents of an adult residential facility will be transferred as a result of the forfeiture of a license or change in the use of the facility. The CDSS must approve or disapprove the closure plan, and monitor its implementation, in accordance with specified requirements.

Temporary manager or receiver. The bill would require the CDSS to use a temporary manager or receiver, if a licensee fails to comply with the requirements of this section, or if the CDSS director determines that it is necessary to protect the residents of a facility from substantial threats to health or safety and to minimize trauma for the residents. The CDSS must contact any local agency that may have assessment, placement, protective, or advocacy responsibility for the residents, and must work together with those agencies to locate alternative placement sites, contact relatives or other persons responsible for the care of these residents, provide onsite evaluation of the residents, and assist in the transfer of the residents.

The bill would provide that CDSS and local government participation does not relieve the licensee of any existing responsibility under the bill.

Reimbursement. The bill would require a licensee that fails to comply with the requirements of this section to reimburse the department and local agencies for the cost of providing the relocation services or the costs incurred in caring for the residents through the use of a temporary manager or receiver.

Injunctive relief. If the licensee fails to provide the relocation services, then the CDSS may request that the Attorney General’s office, the city attorney’s office, or the local district attorney’s office seek injunctive relief and damages in the same manner, including restitution to the department of any costs incurred in caring for the residents through the use of a temporary manager or receiver.

Penalties and violations. A licensee who fails to comply with the requirements are subject to a $100 penalty per violation per day for each day that the licensee is in violation, until the violation has been corrected. The civil penalties must be issued immediately following the written notice of violation. However, if the violation does not present an immediate or substantial threat to the health or safety of residents and the licensee corrects the violation within three days after receiving the notice of violation, the licensee shall not be liable for payment of any civil penalties related to the corrected violation.

On and after January 1, 2021, a licensee who fails to comply with this section and abandons the facility and the residents in care resulting in an immediate and substantial threat to the health and safety of the abandoned residents, in addition to forfeiture of the license pursuant to Section 1524, shall be excluded from licensure in facilities licensed by the department without the right to petition for reinstatement.

Civil action. The bill would authorize a resident of an adult residential facility covered to bring a civil action against any person, firm, partnership, or corporation who owns, operates, establishes, manages, conducts, or maintains an adult residential facility who violates the rights of a resident, as set forth in this section. Any person, firm, partnership, or corporation who owns, operates, establishes, manages, conducts, or maintains an adult residential facility who violates this section shall be responsible for the acts of the facility’s employees and shall be liable for costs and attorney’s fees. The adult residential facility may also be enjoined from permitting the violation to continue. The remedies specified in this section are in addition to any other remedy provided by law.

Intent to sell property. The bill would require the property owner of an ARF to notify the city and county of their intent to sell the property and give the city or county the right of first refusal to purchase the property, at a price that reflects its fair market value, and continue the operation of the ARF. The city or county must notify the property owner of its intent to purchase the property within 60 days after the specified notice.

The bill would require a city or county to have maximum flexibility in seeking and securing available funding sources to purchase a residential care facility, including any federal, state, local, and private funds. Funding from multiple sources may be combined. The purchase of property under this bill’s provisions is subject to all existing requirements otherwise applicable by law to the purchasing city or county.

The bill would authorize a city or county that purchases an ARF may either take over operation of the facility, or, if possible, enter into a long-term lease for its operation with a nonprofit or for-profit entity. A nonprofit or for-profit entity selected by the city or county shall have a demonstrated history of providing adult residential facility services to individuals in need of those services, including, but not limited to, Medi-Cal and Supplemental Security Income (SSI) recipients.

The bill would require a lease to include a requirement that the lessee maintain licensure of the property as an adult residential facility.

State-local mandate. The bill would provide no reimbursement is required by the bill because costs incurred by a local agency would be incurred because the bill creates a new crime or infraction, as defined.

Related Legislation:

• AB 79 (Committee on Budget, Chapter 11, Statutes of 2020), among other provisions, required a licensee of an ARF to inform the city and county in which the facility is located of a proposed closure, including whether the licensee intends to sell the property or business, no later than 180 days before its proposed closure, or as soon as practicably possible.
• AB 1766 (Bloom, 2020) requires CDSS to collect and post certain information regarding licensed ARFs and RCFEs and their capacity to serve certain defined populations, including people with serious mental disorders, those with developmental disabilities and those who receive SSI/SSP payments. AB 1766 is pending consideration in this committee.
• AB 275 (Wood, Chapter 185, Statutes of 2017) revised procedures for long-term health care facilities as the result of license change or closure.

Staff Comments: The fiscal impact of AB 2377 on the courts will depend on unknown factors, including whether parties settle the matter before the filing of an action, and the factors unique to each case.  While it is not known how many actions would be filed, in 2018, it cost the court around $2,600, on average, in personnel and resources to adjudicate a limited civil case and over $11,600, on average, to adjudicate an unlimited civil case. In FY 2019-20, it costs approximately $7,896 a day (or $987 an hour), on average, to operate a courtroom (exclusive of the judge’s salary). So if there were more than nineteen limited civil cases, more than four unlimited civil cases, or a few complex cases (such as class actions) that took longer than seven days that otherwise would not have been brought, the cost pressures of this bill to the court would surpass the Suspense File threshold.

-- END --

SENATE COMMITTEE ON HUMAN SERVICES

Senator Hurtado, Chair

2019 - 2020 Regular

Subject: Adult residential facilities: closures and resident transfers.

SUMMARY

This bill establishes procedures and requirements for transferring a licensed adult residential facility (ARF) resident to another facility or to an independent living arrangement as a result of the forfeiture of a license or a closure of the facility for another reason. The bill also gives the city or county in which an AFR is located the right of first refusal to purchase the property on which an ARF is operating and authorizes the city or county to either take over operation of the facility or enter into a long-term lease for its continued operation, as specified.

ABSTRACT

Existing Law:

1. Establishes the California Community Care Facilities Act, which provides regulatory structure for a coordinated and comprehensive statewide system of care for the mentally ill, developmentally and physically disabled, and children and adults who require care or services provided by licensed community care facilities. (HSC 1500 et seq.)
2. Defines “community care facility” to mean any facility, place, or building that is maintained and operated to provide non-medical residential care, day treatment, adult day care, or foster family agency services for children, adults, or children and adults, including, but not limited to, the physically handicapped, mentally impaired, incompetent persons, and abused or neglected children. (HSC 1502(a))
3. Defines “residential facility” as any family home, group care facility, or similar facility determined by the department, for 24-hour non-medical care of persons in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of the individual. (HSC 1502(a)(1))
4. Requires a licensee of an ARF to inform the city and county in which the facility is located of a proposed closure, including whether the licensee intends to sell the property or business, no later than 180 days before its proposed closure, or as soon as practicably possible. (HSC 1562.2)
5. Defines “residential care facility for the elderly” (RCFE) to mean a housing arrangement chosen voluntarily by individuals ages 60 and older, or their authorized representative, where varying levels and intensities of care and supervision, protective supervision, personal care, or health-related services are provided, based upon residents varying needs, as determined in order to be admitted and to remain in the facility. (HSC 1569.2(p)(1))
6. Requires an RCFE, prior to transferring a resident to another facility or to an independent living arrangement as a result of the forfeiture of a license or change in use of the facility, to take all reasonable steps to transfer affected residents safely, and minimize possible trauma by taking specified actions. (HSC 1569.682(a))
7. Declares that it is the intent of the Legislature to authorize the California Department of Social Services (CDSS) to take quick, effective action to protect the health and safety of residents of RCFEs and to minimize the effects of transfer trauma that accompany the abrupt transfer of residents by appointing a temporary manager to assume the operation of a facility that is found to be in a condition in which continued operation by the licensee or their representative presents a substantial probability of imminent danger of serious physical harm or death to the residents. Further sets requirements for the appointment and responsibilities of temporary managers (HSC 1569.481 et seq.)
8. Defines “adult residential facility” in regulations to mean any facility of any capacity that provides 24-hour-a-day nonmedical care and supervision to persons 18 years of age through 59 years of age. (22 CCR 80001(a)(5))
9. Permits an ARF licensee to evict a client by serving the client with a 30-day written notice to quit for specified reasons, including a change of use of the facility. (22 CCR 85068.5)

This Bill:

Defines “adult residential facility” to mean a facility of any capacity that provides 24-hour-a-day nonmedical care and supervision to persons 18 to 59 years of age, inclusive.

1. Requires a licensee of an ARF to, prior to transferring a resident of the facility to another facility or to an independent living arrangement as a result of the forfeiture of a license, as specified, or a closure of the facility for another reason, take all reasonable steps to transfer affected residents safely and to minimize possible transfer trauma, and shall, at a minimum, do all of the following:
   1. Prepare, for each resident, a relocation evaluation of the needs of that resident, as specified;
   2. Provide each resident or the resident’s responsible person with a written notice no later than 180 days before the intended eviction, as specified;
   3. Discuss the relocation evaluation with the resident and their legal representative within 30 days of issuing the notice of eviction;
   4. Submit a written report of any eviction to the licensing agency within five days;
   5. Upon issuing the written notice of eviction, not accept new residents or enter into new admission agreements;
   6. Provide that a resident who paid preadmission fees in excess of five hundred dollars ($500) is entitled to a refund, as specified;
   7. Require the licensee to refund a proportional per diem amount of any prepaid monthly fees at the time the resident leaves the facility and the unit is vacated if the resident gives notice five days before leaving the facility. Otherwise, requires the licensee to pay the refund within seven days from the date that the resident leaves the facility and the unit is vacated; and
   8. Require the licensee, based on information provided by the resident or the resident’s legal representative, to submit a final list of names and new locations of all residents to CDSS within 10 days of all residents having left the facility.
2. Requires the licensee to submit a proposed closure plan to CDSS for approval if seven or more residents of an ARF will be transferred as a result of the forfeiture of a license or change in the use of the facility.
3. Requires CDSS to approve or disapprove the closure plan, and monitor its implementation, in accordance with the specified requirements, including that the facility may not accept new residents.
4. Requires CDSS to take any necessary action to minimize trauma for the residents, including caring for the residents through the use of a temporary manager or receiver when the director determines the immediate relocation of the residents is not feasible based on transfer trauma or other considerations such as the unavailability of alternative placements, if a licensee fails to comply with the closure plan requirements, or if the director determines that it is necessary to protect the residents of a facility from physical or mental abuse, abandonment, or any other substantial threat to health or safety.
5. Requires CDSS to contact any local agency that may have assessment, placement, protective, or advocacy responsibility for the residents, and to work together with those agencies to locate alternative placement sites, contact relatives or other persons responsible for the care of these residents, provide onsite evaluation of the residents, and assist in the transfer of the residents.
6. Provides that the participation of CDSS and local agencies in the relocation of residents from an ARF does not relieve the licensee of any responsibility and establishes that a licensee that fails to comply shall be required to reimburse CDSS and local agencies for the cost of providing the relocation services or the costs incurred in caring for the residents through the use of a temporary manager or receiver.
7. Permits CDSS to seek injunctive relief and damages, including restitution to the department of any costs incurred in caring for the residents through the use of a temporary manager or receiver, if the licensee fails to provide the relocation services.
8. Requires that a licensee who fails to comply with the closure requirements shall be liable for the imposition of civil penalties in the amount of one hundred dollars ($100) per violation per day for each day that the licensee is in violation of this section, until the violation has been corrected, as specified.
9. Provides that, on and after January 1, 2021, a licensee who abandons the facility and the residents in care resulting in an immediate and substantial threat to the health and safety of the abandoned residents, in addition to forfeiture of the license, shall be excluded from licensure in facilities licensed by CDSS without the right to petition for reinstatement.
10. Permits a resident of an ARF to bring a civil action against any person, firm, partnership, or corporation who owns, operates, establishes, manages, conducts, or maintains an ARF who violates the rights of a resident, as specified.
11. Requires if an owner of an ARF notifies the city and county of an intent to sell the property, the property owner shall give the city or county the right of first refusal to purchase the property, at a price that reflects its fair market value, and continue the operation of the ARF.
12. Requires the city or county to notify the property owner of its intent to purchase the property within 60 days after the notice.
13. Provides that a city or county shall have maximum flexibility in seeking and securing available funding sources to purchase an ARF, including any federal, state, local, and private funds. Permits that funding from multiple sources may be combined to purchase the property and requires that the purchase of the property is subject to all existing requirements otherwise applicable by law to the purchasing city or county.
14. Permits a city or county that purchases an ARF to either take over operation of the facility, or, if possible, enter into a long-term lease for its operation with a nonprofit or for-profit entity. Further requires that a nonprofit or for-profit entity selected by the city or county shall have a demonstrated history of providing ARF services to individuals in need of those services, including, but not limited to, Medi-Cal and Supplemental Security Income (SSI) recipients.
15. Requires that a lease entered into include a requirement that the lessee maintain licensure of the property as an ARF.

FISCAL IMPACT

According to an analysis prepared by the Assembly Appropriations Committee, the May 4, 2020 version of this bill would likely have the following fiscal impact:

• Minor and absorbable costs to CDSS to review relocation plans.
• Possible cost pressures in the low hundreds of thousands of dollars annually (Trial Court Trust Fund/GF) to the trial courts in increased workload given this bill allows residents to bring civil actions against owners and operators of ARFs. The estimated cost of one eight hour court day is approximately $7,644. Although it is unknown how many claims may be filed, if five cases are filed in civil court requiring 48 total hours (six days) of workload, the cost would be approximately $229,320. Although courts are not funded on the basis of workload, increased pressure on the courts and staff may create a need for increased funding for staff and infrastructure. This is particularly true given that courts have delayed hundreds of trials and civil motion during the COVID-19 pandemic, resulting in a serious backlog that must be resolved.

BACKGROUND AND DISCUSSION

Purpose of the Bill:

According to the author, “this bill reduces the risk of homelessness for vulnerable residents of board and care facilities by creating more stringent closure requirements for Adult Residential Facilities.” These facilities, which are often referred to as board and care facilities, offer supportive residential living for individuals who are no longer able to live safely and independently. The author notes that ARFs “are closing at an alarming rate, with San Francisco alone having lost 43 facilities between 2012 and 2019 (a nine percent decline)” and that ARFs are “increasingly serving greater numbers of vulnerable residents, including individuals with serious mental illnesses and other chronic conditions.”

Per the author, “it is imperative that we take preventative measures in 2020 by helping those most vulnerable to homelessness…to ensure the growing vulnerable ARF resident population is provided similar protections that residents of RCFEs have when a facility closes.”

Homelessness in California

Homelessness is a pervasive and growing problem throughout California. Urban, rural and suburban areas are seeing increasing numbers of people living on the streets, in parks, along rivers, in cars, and other places not meant for human habitation. The U.S. Department of Housing and Urban Development’s (HUD) 2019 Annual Homeless Assessment Report to Congress found that over 150,000 individuals were experiencing homelessness in California on the day of HUD’s point-in-time count. The same HUD report found that almost 35,000 people living in California and experiencing homelessness self-reported having a severe mental illness.^[1] By some estimates, about third of those experiencing homelessness are suffering from some form of mental illness. This means tens of thousands of Californians are living with the combined challenges of mental illness and homelessness.

Prior to the COVID-19 outbreak and ensuing efforts to reduce exposure to the virus, addressing homelessness was a top priority for policy makers and the people of California. The COVID-19 pandemic has enhanced concerns about homelessness and highlighted the intersection between public health and homelessness. This is because people experiencing homelessness often suffer from chronic health conditions, have little or no access to medical care, and lack the ability to practice the social distancing and frequent handwashing necessary to avoid the transmission of COVID-19.

Community Care Licensing Division (CCLD)

CDSS’s Community Care Licensing Division (CCLD) is responsible for regulating the facilities it licenses in order to protect the health and safety of children, adults, and seniors who are cared for within those facilities. CCLD licenses and oversees community care facilities—including ARFs and RCFEs—throughout California. These facilities typically provide non-medical care and supervision for children and adults in need, which includes persons with disabilities, seniors in need of residential care, children in foster care and at-risk children needing shelter services, families in need of early childhood education, and adult care services. While there are many types of licensed facilities, this bill intends to bring closure requirements for ARFs into alignment with closure requirements already in place for RCFEs.

Residential Care Facilities for the Elderly (RCFE) and Adult Residential Facilities (ARF)

Licensed residential facilities that provide care and housing to adults typically fall into one of two categories:

• RCFEs (also known as assisted living facilities) are residential facilities that provide 24-hour nonmedical care and supervision for persons in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of the individual who is 60 years of age or older;
• ARFs (also known as board and care homes) are residential facilities that provide 24-hour nonmedical care and supervision for persons in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of the individual who is aged 18 – 59.

Both RCFEs and ARFs provide housing, housekeeping, supervision, and personal care assistance with activities of daily living to individuals who need that level of care. These are nonmedical facilities that are designed for individuals who are unable to live by themselves, but who do not need 24-hour nursing care, and as such the facilities are not required to have nurses, certified nursing assistants or doctors on staff. These facilities usually centrally store and distribute medications for residents to self-administer. Residents in both RCFEs and ARFs may have mental, behavioral, or physical health needs or a developmental disability that results in their inability to live independently. These facilities range in size from small facilities operating out of a single family homes serving a handful of residents to larger buildings that can house over a 100 residents.

Differing Standards for RCFEs and ARFs

There are significant differences between the requirements for operating ARFs versus those for RCFEs, some of which were highlighted in the background paper prepared for an oversight hearing conducted earlier this year by this committee on the State Oversight of Licensed Homes for Vulnerable Adults. The background paper noted that, “another area that may warrant exploration is the difference between requirements for ARFs and RCFEs. In 2014, a broad package of bills, referred to as the RCFE Reform Act of 2014, responded to growing concern regarding the oversight of and care provided by RCFEs. This body of new law increases civil penalties for licensed facilities throughout the state; prohibits problem licensees from admitting new residents; strengthens residents’ personal rights; and expands training to increase compliance. Since then, additional bills have further expanded requirements for RCFEs, including enhanced disaster preparedness requirements and enhanced rights for residents who are Lesbian, Gay, Bisexual or Transgender. None of these policy changes have been applied to ARFs or their residents.”

Additionally, AB 949 (Krekorian, Chapter 686, Statutes of 2007) established closure requirements for RCFEs, which includes preparing a relocation evaluation of the needs of each resident, and providing written and verbal notification of the impending move within certain timeframes. RCFEs are also required to notify CDSS of impending evictions. No such requirements exist in statute for ARFs. However, there are regulations that require a written 30-day notice of eviction when an ARF plans to change the use of the facility. Furthermore, there are regulations that set procedures for maintaining care and supervision in any instance where the CDSS requires that an ARF client/resident must be relocated.

This bill seeks to bring ARFs into alignment with current closure requirements for RCFEs; thereby protecting residents from potentially becoming homeless as the result of an ARF closure.

Impact of ARF Closures on Homelessness

Prior to the COVID-19 outbreak, policy-makers and advocates were exploring the effects that closure of licensed residential facilities were having on homelessness. Counties throughout the state reported that housing options for low-income individuals within licensed residential facilities have been shrinking. Low reimbursement rates for facilities that accept Supplemental Security Income/State Supplementary Payment (SSI/SSP) recipients and facilities’ generally high operating costs are two commonly cited reasons for closure of such facilities. It is feared that this problem is particularly exacerbated in areas with high costs of living and high property values, because the owners of residential facilities may choose to sell the property rather than continue operations.

According to the San Francisco Department of Public Health, ARFs are closing at an alarming rate, with San Francisco alone having lost 43 facilities, or a total of 243 beds, between 2012 and 2019, a nine percent decline.^[2] In 2019, Los Angeles lost more than 200 beds for low-income people with serious mental illness.^[3]

CCLD reports that there were about 7,360 licensed ARFs with a capacity to serve about 37,240 residents in Fiscal Year 2018-19. While the number of licensed ARFs increased by 132 from 2014-15 to 2018-19, overall capacity decreased by 1,572. This suggests newly opened ARFs have less capacity than those that closed.

Many counties use ARFs in their efforts to find residential placements for people experiencing homelessness. For example, the County of Los Angeles has placed over 1,000 people who were experiencing homelessness into board and care homes, many of whom struggle with severe mental illness. This demonstrates a connection between maintaining the operation of board and care facilities and preventing homelessness.

This bill requires ARF operators to notify local city and county officials whenever the property owner intends to sell the property in order to give the local entities the opportunity to purchase the property for the purpose of maintaining the operation of ARFs within their communities. According to the author, multiple Bay Area counties have expressed interest in making such purchases.

COVID-19 Impact on Committee Jurisdiction

Due to the COVID-19 Pandemic and the unprecedented nature of the 2020 Legislative Session, all Senate Policy Committees are working under a compressed timeline.  This timeline does not allow this bill to be referred and heard by more than one committee as a typical timeline would allow.  In order to fully vet the contents of this measure for the benefit of Senators and the public, this analysis includes information from Senate Judiciary Committee as shown below:

“The Senate Judiciary Committee has historically favored protections for vulnerable individuals housed in care facilities in order to ensure that they have continued access to care and shelter. By adopting requirements for the closing of adult residential facilities comparable to those applicable to residential care facilities under existing law, this bill draws on established processes to protect individuals who require assistance with daily living due to chronic conditions such as mental illness or disability. By reducing closures, giving counties the opportunity to purchase the facilities, and providing residents with advanced notice of closures, this bill would help minimize the trauma that residents may experience from such transitions, giving them more continuity and time to prepare for change, and helping to protect them from experiencing homelessness.”

Related/Prior Legislation:

AB 79 (Committee on Budget, Chapter 11, Statutes of 2020), among other things, required a licensee of an ARF to inform the city and county in which the facility is located of a proposed closure, including whether the licensee intends to sell the property or business, no later than 180 days before its proposed closure, or as soon as practicably possible.

SB 1259 (Hurtado, 2020) requires the CDSS to establish a task force for the purpose of issuing a report that includes recommendations on how to meet the housing and care needs of low-income individuals who are blind, disabled or over 65 years of age and receiving Supplemental Security Income/State Supplementary Payment (SSI/SSP).  This bill is currently in Assembly Appropriations Committee.

AB 1766 (Bloom, 2020) requires CDSS to collect and post certain information regarding licensed ARFs and RCFEs and their capacity to serve certain defined populations, including people with serious mental disorders, those with developmental disabilities and those who receive SSI/SSP payments. AB 1766 is scheduled to be heard in this committee on August 10, 2020.

AB 1034 (Friedman, 2019) would have required community care facilities that serve children or nonminor dependents, resource families, certified or licensed foster family homes, small family homes, community care facilities that serve adults, residential care facilities for persons with a chronic, life-threatening illness, and child care centers to have emergency and disaster plans. AB 1034 was held in Assembly Appropriations Committee.

AB 275 (Wood, Chapter 185, Statutes of 2017) revised procedures for long-term health care facilities as the result of license change or closure.

SB 1329 (Leno, 2010) would have required RCFEs to notify residents and CDSS of specified events related to missed or delated facility upkeep payments and would have required the department to initiate a compliance plan or other appropriate actions upon notice of such event. SB 1329 was vetoed by Governor Schwarzenegger.

AB 949 (Krekorian, Chapter 686, Statutes of 2007) established procedures for RCFEs to transfer residents as the result of a change in facility use or license forfeiture.

COMMENTS

As California continues to struggle with homelessness, especially among populations that are extremely vulnerable due to age or disability, it is important that the state make efforts to preserve and perhaps even increase the placements available for persons with disabilities – especially those with serious mental illness. The purpose of an ARF is to provide housing and assistance to these vulnerable populations.

This bill creates new protections for ARF residents who are going to be transferred due to a planned closure of the facility in which they reside. These new protections are in line with those for residents of RCFEs, which serve elderly residents. However, the bill currently requires a 180-day notice of such a transfer. Current law applied to RCFEs requires such notice within 60 days, which may be a more realistic timeframe. The author may wish to consider amending the bill to more closely reflect the RCFE transfer notification requirement of 60 days.

The bill also creates a process through which local jurisdictions may invest in keeping ARFs operational in the event of a planned closure. There have been questions about the language in the bill that provides local jurisdictions the “right of first refusal” to purchase property on which an ARF is operating when the property owner intends to sell the property. The author might consider amending this language to ensure it does not limit the property owner’s options to sell at a fair price and within reasonable timelines.

PRIOR VOTES

POSITIONS

Support:

City and County of San Francisco
County Behavioral Health Directors Association
Heart Forward LA
National Alliance on Mental Illness (NAMI-CA)
National Association of Social Workers, California Chapter
The California Association of Local Behavioral Health Boards and Commissions
The People Concern

Oppose:

None received

-- END --

1. While the above data is helpful in providing an understanding of the scope of the homelessness problem in California, it is important to note that HUD’s point-in-time count is commonly understood as reflecting an undercount. The numbers above are thus a useful estimate, and not an exact reflection of California’s current homeless population. ↑

2. Adult Residential Care Facilities Background Proposal” San Francisco Department of Public Health, Grant Colfax, MD, Director of Health ↑

3. Overlooked Mental Health Catastrophe: Vanishing Board and Care Homes Leave Residents With Few Options,” CAL Matters, April 2019 ↑

ASSEMBLY THIRD READING

ATR Bill Id:AB 2377

Author:(Chiu)

As Amended Ver:May 4, 2020

Majority vote

SUMMARY:

Establishes closure requirements for Adult Residential Facilities (ARFs) and expands protections for the residents of these centers.

Major Provisions

1. Defines "adult residential facility" as a facility of any capacity that provides 24-hour-a-day non-medical care and supervision to persons 18 to 59 years of age.
2. Requires a licensee of an ARF, prior to transferring a resident to another facility or to an independent living arrangement as a result of facility closure, to take the following steps, at minimum:
   1. Prepare a relocation evaluation of the needs of each resident, as specified.
   2. Provide each resident, or individual deemed responsible for the recipient, with written notice no later than 180 days before the intended eviction, as specified.
   3. Discuss the relocation evaluation with the resident and their legal representative within 30 days of issuing the eviction;
   4. Submit a written report of any eviction to the licensing agency within five days;
   5. Require that once a licensee has issued the written notice of eviction, they shall not accept any new resident or enter into new admission agreements;
   6. Refund residents a percentage of preadmission fees in excess of $500 depending upon the date of payment of the fee in accordance with a specified schedule;
   7. Refund the resident or their legal representative a proportional per diem amount of any prepaid monthly fees if the resident gives five days' notice before leaving the facility. In other cases, pay the refund within seven days from the date that the resident leaves the facility; and,
   8. Submit a final list of names and new locations of all residents to the California Department of Social Services (CDSS) within 10 days of all residents leaving the facility.
3. Requires the ARF licensee to submit a closure plan to CDSS if seven or more residents require transfer as a result of facility closure. The closure plan must be in accordance with specified requirements.
4. Requires CDSS to contact and work with any local agency that may have assessment, placement, protective or advocacy responsibly for the residents if the licensee fails to comply with the requirements of this section, or if the director determines it is necessary to protect the residents of the facility from physical or mental abuse, abandonment, or any other substantial threat to health or safety. The director may also care for residents through a temporary manager or receiver if it is determined immediate relocation of the residents is not feasible.
5. Provides that an ARF licensee who fails to comply with the requirements of this section is liable for civil penalties of up to $100 per violation, per day, until the violation has been corrected and requires that written notice of violation immediately follow. If the violation does not present an immediate threat to the health or safety of residents, the licensee may correct the violation within three days of receiving the notice and will not be liable for the payment of any civil penalties as related to the notice.
6. Establishes that a licensee that fails to comply with the requirements of this section and abandons their facility and its residents, on or after January 1, 2021, in addition to the forfeiture of license will be excluded from licensure in facilities under CDSS purview without the right to petition for reinstatement.
7. Authorizes a resident of an residential care facility for the elderly (RCFE) to bring a civil action against any person, firm, partnership, or corporation who owns, operates, establishes, manages, conducts or maintains an ARF who violates the rights of a resident outlined in the bill, and provides that the owners, operators, and managers of ARFs are responsible for the acts of the facility's employees and liable for costs and attorney fees.
8. Establishes that in addition to resident notification requirements, a licensee of an ARF must inform the city and county which the facility is located in of the proposed closure, including whether there are plans to sell the property.
9. Requires that if an ARF licensee notifies the city and county that the facility is located in of an intent to sell the property, the local governments must be given the right of first refusal to purchase the property, at a fair market value price, and continue the operation of the ARF. Within 60 days of the notice of intent to sell, the local government must notify the licensee of its intent to purchase the property, as specified.
10. Authorizes a city or county maximum flexibility in finding and securing available funding sources, including federal, state, local, or private funds, or a combination of the named, to purchase a facility under this section. Establishes that a purchase of property under this section is subject to all existing requirements applicable by law to the purchasing city or county.
11. Authorizes a city or county that purchases an ARF under this section to take over operation of the facility or, if possible, enter into a long-term lease for operation under a nonprofit or for-profit entity. Requires that the nonprofit or for-profit entity selected to operate the ARF have a history of providing adult residential facility services to individuals in need of those services, including but not limited to, Medi-Cal and Supplemental Security Income (SSI) recipients.
12. Requires that a lease for the operation of an ARF under this section between a city or county and a nonprofit or for-profit entity include a requirement that the lessee maintains the licensure of the property as an ARF.
13. Makes technical changes.

COMMENTS:

Senior Homelessness: Over 151,278 individuals are experiencing homelessness in California based on 2019 reports by the United States Department of Housing and Urban Development. While there are many contributing factors to homelessness, obstacles such as lack of affordable housing, dwindling retirement options, and rising healthcare costs leave seniors particularly vulnerable to joining the unhoused population. A study conducted by Los Angeles, Boston, and New York City in 2019 estimates that the number of homeless seniors 65 years and older will triple by the year 2030, spiking to over 100,000 individuals across the country.

Community Care Facilities: The California Community Care Facilities Act (CCFA), enacted in 1973, contains the provisions for a variety of community-based housing options for the elderly and disabled. The CCFA seeks to provide a new system of community-based care for those who require additional supervision and services that are determined to be non-medical. Facilities established under the act provide care to individuals with disabilities, seniors, children in foster care, families who need early child education, and those with severe behavioral, emotional, or mental disorders. Facilities created under the CCFA are administered through CDSS. The department is responsible for licensing facilities across programs, along with ensuring regulatory compliance and enforcement when necessary.

Adult Residential Facilities: ARFs, established under the CCFA, provide non-medical services to residents age 18-59, or those 60 and older who meet certain requirements. These facilities are open 24-hours a day and assist those with a mental, physical, or developmental disability. ARFs, also commonly referred to as Board and Care Homes, are not required to have nurses or doctors on staff.

An RCFE, also created under the CCFA, is another type of facility that provides non-medical care and supervision to individuals with certain daily living needs. However, these facilities primarily offer support to those 60 years or older who do not need 24-hour services. RCFE populations often have functional and cognitive impairments that limit their ability to complete various living tasks, but their medical conditions are managed either by themselves or by an outside medical professional. Under current law, there are several closure requirements for licensees of these types of facilities, enacted to preserve the services and protect the residents.

Need for this bill: This bill seeks to expand ARF closure requirements, mandating a licensee to send advanced notification of the closure to residents and local governments. The language includes provisions to allow a locality ample time to purchase and continue the use of the facility as an ARF, if desired. This legislation would strengthen the closure requirements for ARFs, possibly minimizing transfer trauma for residents. Requiring ARF licensees to provide advanced notice of closures would give their vulnerable population time to plan for the change, which could reduce the number of seniors who fall into homelessness.

According to the Author:

"This bill reduces the risk of homelessness for vulnerable residents of ARFs. Throughout the state, these facilities are closing at an alarming rate, with San Francisco alone having lost 43 facilities between 2012 and 2019. In 2019, Los Angeles lost more than 200 beds for low-income people with serious mental illness. ARFs are increasingly serving more significant numbers of vulnerable residents, including individuals with serious mental illnesses and other chronic conditions…By improving closure requirements, California will be better able to reduce the effects of homelessness and protect some of the state's most vulnerable communities."

Arguments in Support:

A supporter of the bill, the San Francisco Long-Term Care Ombudsman Program, states that "[This bill] shows an increasing recognition of the vital role ARFs play in housing the homeless and the mentally ill…This bill might also provide more incentives for cities and counties to invest in the remaining ARFs and to work toward raising the quality of care and quality of life provided within these homes."

Arguments in Opposition:

None on file

FISCAL COMMENTS:

According to the Assembly Appropriations Committee on June 2, 2020:

1. Minor and absorbable costs to CDSS to review relocation plans.
2. Possible cost pressures in the low hundreds of thousands of dollars annually (Trial Court Trust Fund/General Fund) to the trial courts in increased workload given this bill allows residents to bring civil actions against owners and operators of ARFs. The estimated cost of one eight hour court day is approximately $7,644. Although it is unknown how many claims may be filed, if five cases are filed in civil court requiring 48 total hours (six days) of workload, the cost would be approximately $229,320.

Although courts are not funded on the basis of workload, increased pressure on the courts and staff may create a need for increased funding for staff and infrastructure. This is particularly true given that courts have delayed hundreds of trials and civil motion during the COVID-19 pandemic, resulting in a serious backlog that must be resolved.

Please see the policy committee analysis for full discussion of this bill.

VOTES:

ASM HUMAN SERVICES: 6-0-2

YES: Reyes, Arambula, Friedman, Gipson, Maienschein, Mark Stone

ABS, ABST OR NV: Mathis, Flora

ASM APPROPRIATIONS: 14-0-4

YES: Gonzalez, Bauer-Kahan, Bloom, Bonta, Calderon, Carrillo, Chau, Diep, Eggman, Gabriel, Eduardo Garcia, Petrie-Norris, McCarty, Robert Rivas

ABS, ABST OR NV: Bigelow, Megan Dahle, Fong, Voepel

UPDATED:

VERSION: May 4, 2020

CONSULTANT: Emmalynn Mathis / HUM. S. / (916) 319-2089 FN: 0002856

Date of Hearing: June 2, 2020

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Lorena Gonzalez, Chair

ABPCA Bill Id:AB 2377

Author:(Chiu) – As Amended Ver:May 4, 2020

Urgency: No State Mandated Local Program: Yes Reimbursable: No

SUMMARY:

This bill establishes closure requirements and procedures for adult residential facilities (ARFs) similar to the existing requirements for residential care facilities for the elderly (RCFEs). Among its provisions, this bill:

1. Requires an ARF to provide written notice to affected residents at least 180 days prior to a facility closure.
2. Requires an ARF to prepare an evaluation of the relocation needs of each resident.
3. Establishes provisions for refunding preadmission fees.
4. Requires an ARF to submit a closure plan to the California Department of Social Services (CDSS) if seven or more residents require transfer as a result of facility closure.
5. Requires CDSS to approve the closure plan prior to an ARF issuing notices to residents.
6. Requires CDSS to take any necessary action to minimize trauma for the residents if an ARF fails to comply with the requirements of this bill, or if the director determines it is necessary to protect residents from abuse, abandonment or a threat to health or safety.
7. Requires an ARF to inform the city and county in which the facility is located at least 180 days prior to the proposed closure. If there is intent to sell the property, the city or county must be given the right of first refusal to purchase the property, at a fair market value, and continue the operation of the ARF.
8. Provides for civil penalties and license forfeiture for an ARF that fails to comply with the requirements of this bill and allows a resident of an ARF to bring civil action for violations.
9. Defines “adult residential facility” as a facility of any capacity that provides 24-hour-a-day non-medical care and supervision to persons 18 to 59 years of age.

FISCAL EFFECT:

1. Minor and absorbable costs to CDSS to review relocation plans.
2. Possible cost pressures in the low hundreds of thousands of dollars annually (Trial Court Trust Fund/GF) to the trial courts in increased workload given this bill allows residents to bring civil actions against owners and operators of ARFs. The estimated cost of one eight hour court day is approximately $7,644. Although it is unknown how many claims may be filed, if five cases are filed in civil court requiring 48 total hours (six days) of workload, the cost would be approximately $229,320.

Although courts are not funded on the basis of workload, increased pressure on the courts and staff may create a need for increased funding for staff and infrastructure. This is particularly true given that courts have delayed hundreds of trials and civil motion during the COVID-19 pandemic, resulting in a serious backlog that must be resolved.

COMMENTS:

1. Purpose. This bill seeks to minimize trauma and reduce the risk of homelessness to residents of ARFs by strengthening the closure requirements for ARFs, including mandating advanced notice of a facility closure to residents and local governments. This bill is modeled, in part, after current requirements for the closure of RCFEs. According to the author:

Throughout the state, these facilities are closing at an alarming rate, with San Francisco alone having lost 43 facilities between 2012 and 2019. In 2019, Los Angeles lost more than 200 beds for low-income people with serious mental illness. To ensure the growing vulnerable ARF resident population is provided similar protections that residents of RCFEs have when a facility closes, this bill will align ARF closure requirements with those of RCFEs.

1. Background. ARFs are established under the California Community Care Facilities Act (CCFA) and administered through CDSS. ARFs are board and care homes that provide non-medical, 24-hour supportive residential living to residents 18-59 years of age with a mental, physical, or developmental disability. Residents of ARFs receive assistance with a variety of daily living tasks such as housekeeping, bathing, dressing, distribution of medication, and general supervision.

RCFEs, also created under the CCFA and commonly known as assisted living facilities, provide non-medical care and supervision to individuals 60 years or older who can no longer live independently. Existing law contains several closure requirements for licensees of RCFEs, enacted to preserve services and protect the residents.

Current closing requirements for ARFs are less protective of residents than those of RCFEs. This bill aligns ARF closure requirements with those of RCFEs.

1. Implementations issues. CDSS has identified several implementation issues with this bill, including, among other issues, the right of first refusal for local agencies to purchase property being sold by a closing ARF. These issues should continue to be addressed if the bill moves forward.
2. Prior Legislation. AB 949 (Krekorian), Chapter 686, Statutes of 2007, established procedures for RCFEs to transfer residents as the result of a change in facility use or license forfeiture.

Analysis Prepared by: Jennifer Swenson / APPR. / (916) 319-2081

Date of Hearing: May 7, 2020

ASSEMBLY COMMITTEE ON HUMAN SERVICES

Eloise Gómez Reyes, Chair

ABPCA Bill Id:AB 2377 (

Author:Chiu) – As Amended Ver:May 4, 2020

SUBJECT: Adult residential facilities: closures and resident transfers

SUMMARY: Establishes closure requirements for Adult Residential Facilities (ARFs) and expands protections for the residents of these centers. Specifically, this bill:

1. Defines “adult residential facility” as a facility of any capacity that provides 24-hour-a-day non-medical care and supervision to persons 18 to 59 years of age.
2. Requires a licensee of an ARF, prior to transferring a resident to another facility or to an independent living arrangement as a result of facility closure, to take the following steps, at minimum:
   1. Prepare a relocation evaluation of the needs of each resident which shall include all of the following:
3. Recommendations on the type of facility that would meet the needs of the resident based on the current service plan;

ii) A list of facilities, within a 60-mile radius of the resident’s current facility that meet the resident’s present needs; and,

iii) If applicable, the resident’s right to remain in the facility, if purchased by the city or county, as specified.

• 1. Provide each resident, or individual deemed responsible for the recipient, with written notice no later than 180 days before the intended eviction that includes all of the following:

1. The reason for the eviction, with specific facts to permit a determination of the date, place, witness, and circumstances concerning the reasons;

ii) A copy of the resident’s current service plan; and,

iii) A list of referral agencies.

• 1. Discuss the relocation evaluation with the resident and their legal representative within 30 days of issuing the eviction;
  2. Submit a written report of any eviction to the licensing agency within five days;
  3. Require that once a licensee has issued the written notice of eviction, they shall not accept any new resident or enter into new admission agreements;
  4. Refund residents a percentage of preadmission fees in excess of $500 depending upon the date of payment of the fee in accordance with the following schedule:

1. A 100% refund if preadmission fees were paid within six months of notice of eviction;

ii) A 75% refund if preadmission fees were paid more than six months but not more than 12 months before notice of eviction;

iii) A 50% refund if preadmission fees were paid more than 12 months but not more than 18 months before notice of eviction; and,

iv) A 25% refund if preadmission fees were paid more than 18 months but less than 25 months before notice of eviction.

• 1. Refund the resident or their legal representative a proportional per diem amount of any prepaid monthly fees if the resident gives five days’ notice before leaving the facility. In other cases, pay the refund within seven days from the date that the resident leaves the facility; and,
  2. Submit a final list of names and new locations of all residents to the California Department of Social Services (CDSS) within 10 days of all residents leaving the facility.

1. Requires the ARF licensee to submit a closure plan to CDSS if seven or more residents require transfer as a result of facility closure. The closure plan must be in accordance with the following requirements:
   1. Upon submission of the closure plan, the ARF is prohibited from accepting new residents and entering into new admission agreements;
   2. The closure plan must meet all specified requirements and describe the staff available to assist in resident transfers. CDSS must include in their review a determination as to whether the licensee’s closure plan contains a relocation evaluation for each resident;
   3. CDSS must approve or disapprove the licensee’s closure plan within 15 days of receipt and, if approved, the plan will become effective upon the date the department grants its written approval of the plan;
   4. Allows a licensee if CDSS disapproves of their closure plan to resubmit an amended plan to the department. If CDSS again disapproves of a licensee’s closure plan, the department must explain in writing the reasons for denying approval;
   5. States that if CDSS fails to take action on a closure plan, whether original or amended, within 20 working days of receipt, the case shall be deemed approved; and,
   6. A facility may not issue notice of transfer or require any resident to transfer until CDSS has approved of a licensee’s closure plan.
2. Requires CDSS to contact and work with any local agency that may have assessment, placement, protective or advocacy responsibly for the residents if the licensee fails to comply with the requirements of this section, or if the director determines it is necessary to protect the residents of the facility from physical or mental abuse, abandonment, or any other substantial threat to health or safety. The director may also care for residents through a temporary manager or receiver if it is determined immediate relocation of the residents is not feasible.
3. Provides that an ARF licensee who fails to comply with the requirements of this section is liable for civil penalties of up to $100 per violation, per day, until the violation has been corrected and requires that written notice of violation immediately follow. If the violation does not present an immediate threat to the health or safety of residents, the licensee may correct the violation within three days of receiving the notice and will not be liable for the payment of any civil penalties as related to the notice.
4. Establishes that a licensee that fails to comply with the requirements of this section and abandons their facility and its residents, on or after January 1, 2021, in addition to the forfeiture of license will be excluded from licensure in facilities under CDSS purview without the right to petition for reinstatement.
5. Authorizes a resident of an residential care facility for the elderly (RCFE) to bring a civil action against any person, firm, partnership, or corporation who owns, operates, establishes, manages, conducts or maintains an ARF who violates the rights of a resident outlined in the bill, and provides that the owners, operators, and managers of ARFs are responsible for the acts of the facility’s employees and liable for costs and attorney fees.
6. Establishes that in addition to resident notification requirements, a licensee of an ARF must inform the city and county which the facility is located in of the proposed closure, including whether there are plans to sell the property.
7. Requires that if an ARF licensee notifies the city and county that the facility is located in of an intent to sell the property, the local governments must be given the right of first refusal to purchase the property, at a fair market value price, and continue the operation of the ARF. Within 60 days of the notice of intent to sell, the local government must notify the licensee of its intent to purchase the property, as specified.
8. Authorizes a city or county maximum flexibility in finding and securing available funding sources, including federal, state, local, or private funds, or a combination of the named, to purchase a facility under this section. Establishes that a purchase of property under this section is subject to all existing requirements applicable by law to the purchasing city or county.
9. Authorizes a city or county that purchases an ARF under this section to take over operation of the facility or, if possible, enter into a long-term lease for operation under a nonprofit or for-profit entity. Requires that the nonprofit or for-profit entity selected to operate the ARF have a history of providing adult residential facility services to individuals in need of those services, including but not limited to, Medi-Cal and Supplemental Security Income (SSI) recipients.
10. Requires that a lease for the operation of an ARF under this section between a city or county and a nonprofit or for-profit entity include a requirement that the lessee maintains the licensure of the property as an ARF.
11. Makes technical changes.

EXISTING LAW:

1. Establishes the California Community Care Facilities Act and requires CDSS to administer and license community care facilities providing non-medical services, including ARFs. (Health and Safety Code Section [HSC] 1500 et seq.)
2. Defines “community care facility” to mean any facility, place, or building that is maintained and operated to provide non-medical residential care, day treatment, adult day care, or foster family agency services for children, adults, or children and adults, including, but not limited to, individuals with physical disabilities or mental impairments and abused or neglected children. (HSC 1502 (a))
3. Defines “residential facility” as any family home, group care facility, or similar facility determined by the department, for 24-hour non-medical care of persons in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of the individual. (HSC 1502 (a)(1))
4. Establishes that a licensee of a RCFE shall not require any form of preadmission fee or deposit from a recipient under the State Supplementary Program for the Aged, Blind, and Disabled. (HSC 1569.651 (a))
5. Requires that a licensee of a RCFE shall, prior to transferring a resident of the facility to another facility or an independent living arrangement as a result of the forfeiture of a license, or change of use of the facility pursuant to the department’s regulations, take all reasonable steps to transfer affected residents safely and to minimize possible transfer trauma. (HSC 1569.682 et seq.)
6. Requires a RCFE, prior to transferring a resident to another facility or to an independent living arrangement as a result of the forfeiture of a license or change in use of the facility, to take all reasonable steps to transfer affected residents safely, and minimize possible trauma by taking the following specified actions:
   1. Prepare, for each resident, a relocation evaluation of the needs of that resident;
   2. Provide each resident or the resident’s responsible person with written notice no later than 60 days before the intended eviction;
   3. Discuss the relocation evaluation with the resident and their legal representative within 30 days of issuing the notice of eviction;
   4. Submit a written report of any eviction to the licensing agency within five days;
   5. Require that upon issuing the written notice of eviction a licensee shall not accept new residents or enter into new admission agreements;
   6. Ensure that for paid preadmission fees in excess of five hundred dollars ($500), and the resident is entitled to a refund in accordance with specified criteria;
   7. Require that if the resident gives notice five days before leaving the facility, the licensee shall refund to the resident or their legal representative a proportional per diem amount of any prepaid monthly fees at the time the resident leaves the facility, and the unit is vacated. Otherwise, the licensee shall pay the refund within seven days from the date that the resident leaves the facility and the unit is vacated; and,
   8. Require that within 10 days of all residents having left the facility, the licensee, based on information provided by the resident or resident’s legal representative, shall submit a final list of names and new locations of all residents to the department and the local ombudsman program. (HSC 1569.682(a))
7. Declares that it is the intent of the Legislature to authorize CDSS to take quick, effective action to protect the health and safety of residents of RCFEs and to minimize the effects of transfer trauma that accompany the abrupt transfer of residents by appointing a temporary manager to assume the operation of a facility that is found to be in a condition in which continued operation by the licensee or their representative presents a substantial probability of imminent danger of serious physical harm or death to the residents. (HSC 1569.481 (a))
8. Requires that a RCFE admission agreement include an explanation of the facility’s responsibility to prepare a relocation evaluation for each resident and a closure plan and to provide notice in the case of an eviction. (HSC 1569.884 (j))

FISCAL EFFECT: Unknown

COMMENTS:

Senior Homelessness: Over 151,278 individuals are experiencing homelessness in California based on 2019 reports by the United States Department of Housing and Urban Development. Unfortunately, these numbers are likely undercounted due to the many homeless who never enter the shelter system and instead rely on personal supports to survive. While there are many contributing factors to homelessness, obstacles such as lack of affordable housing, dwindling retirement options, and rising healthcare costs leave seniors particularly vulnerable to joining the unhoused population. A study conducted by Los Angeles, Boston, and New York City in 2019 estimates that the number of homeless seniors 65 years and older will triple by the year 2030, spiking to over 100,000 individuals across the country. In attempts to counteract the rising rate of senior homelessness, California continues to offer early intervention methods and social welfare supports through shelters and nonprofit organizations throughout the state.

Community Care Facilities: The California Community Care Facilities Act (CCFA), enacted in 1973, contains the provisions for a variety of community-based housing options for the elderly and disabled. The CCFA seeks to provide a new system of community-based care for those who require additional supervision and services that are determined to be non-medical. Facilities established under the act provide care to individuals with disabilities, seniors, children in foster care, families who need early child education, and those with severe behavioral, emotional, or mental disorders.

Facilities created under the CCFA are administered through CDSS. The department is responsible for licensing facilities across programs, along with ensuring regulatory compliance and enforcement when necessary. Within CDSS is the Community Care Licensing Division (CCLD), responsible for a variety of community care facilities. According to the state, the mission of the CCLD is to “promote the health, safety, and quality of life of each person in community care through the administration of an effective collaborative regulatory enforcement system.” The types of facilities under the purview of the CCLD include adult day programs, transitional shelters, group homes, foster family homes, homeless youth shelters, child care centers, and others.

Adult Residential Facilities: ARFs, established under the CCFA, provide non-medical services to residents age 18-59, or those 60 and older who meet certain requirements. These facilities are open 24-hours a day and assist those with a mental, physical, or developmental disability. ARFs, also commonly referred to as Board and Care Homes, are not required to have nurses or doctors on staff.

Residents of ARFs can receive assistance with a variety of daily living tasks such as: housekeeping, personal hygiene upkeep, bathing, dressing, distribution of medication, and general supervision. While ARFs do not commonly provide skilled nursing services, these facilities may offer this option if a credentialed Registered Nurse (RN) or Licensed Vocational Nurse (LVN) is on staff. Also created under the CCFA, and regulated under different licensing procedures, are RCFEs.

An RCFE, also created under the CCFA, is another type of facility that provides non-medical care and supervision to individuals with certain daily living needs. However, these facilities primarily offer support to those 60 years or older who do not need 24-hour services. RCFE populations often have functional and cognitive impairments that limit their ability to complete various living tasks, but their medical conditions are managed either by themselves or by an outside medical professional. Under current law, there are several closure requirements for licensees of these types of facilities, enacted to preserve the services and protect the residents.

Need for this bill: This bill seeks to expand ARF closure requirements, mandating a licensee to send advanced notification of the closure to residents and local governments. The language includes provisions to allow a locality ample time to purchase and continue the use of the facility as an ARF, if desired. These facilities house residents that require assistance with daily living tasks due to disability, age, or mental illness, yet, current law contains limited protections for these populations when facing eviction from their primary facility. This legislation would strengthen the closure requirements for ARFs, possibly minimizing transfer trauma for residents. Requiring ARF licensees to provide advanced notice of closures would give their vulnerable population time to plan for the change, which could reduce the number of seniors who fall into homelessness.

According to the author, “This bill reduces the risk of homelessness for vulnerable residents of ARFs. Throughout the state, these facilities are closing at an alarming rate, with San Francisco alone having lost 43 facilities between 2012 and 2019. In 2019, Los Angeles lost more than 200 beds for low-income people with serious mental illness. ARFs are increasingly serving more significant numbers of vulnerable residents, including individuals with serious mental illnesses and other chronic conditions. The current closing requirements for ARFs, which are less protective than those for Residential Care Facilities (RCFEs, serving seniors), increase the challenges residents face when facilities close. Already, a third of those experiencing homelessness are suffering from mental illness. Because of their vulnerability and the current housing crisis, residents are especially at risk of becoming homeless. To ensure the growing vulnerable ARF resident population is provided similar protections that residents of RCFEs have when a facility closes, this bill will align ARF closure requirements with those of RCFEs. By improving closure requirements, California will be better able to reduce the effects of homelessness and protect some of the state’s most vulnerable communities.”

Double referral: This bill was originally double-referred with the Assembly Judiciary Committee; however, due to the Legislature’s unanticipated recess in the response to the COVID-19 pandemic and the truncated timeframe in which committees may hear bills, this bill has been single-referred to the Human Services Committee.

RELATED AND PRIOR LEGISLATION:

AB 1034 (Friedman) of 2019 would have required community care facilities that serve children or nonminor dependents, resource families, certified or licensed foster family homes, small family homes, community care facilities that serve adults, residential care facilities for persons with a chronic, life-threatening illness, and child care centers to have emergency and disaster plans. AB 1034 was held in the Assembly Appropriations Committee.

AB 275 (Wood), Chapter 185, Statutes of 2017, revised procedures for long-term health care facilities as the result of license change or closure.

SB 1329 (Leno) of 2010 would have required RCFEs to notify residents and CDSS of specified events related to missed or delated facility upkeep payments and would have required the department to initiate a compliance plan or other appropriate actions upon notice of such event. SB 1329 was vetoed by Governor Schwarzenegger.

AB 949 (Krekorian), Chapter 686, Statutes of 2007, established procedures for RCFEs to transfer residents as the result of a change in facility use or license forfeiture.

REGISTERED SUPPORT / OPPOSITION:

Support

CANHR

City and County of San Francisco

Family Caregiver Alliance (FCA)

Homebridge

Justice in Aging

Life Skills Training and Educational Programs, INC. (LIFESTEPS)

National Association of Social Workers, California Chapter

St. Anthony Foundation

Steinberg Institute

Swords to Plowshares - Vets Helping Vets

Opposition

None on file

Analysis Prepared by: Emmalynn Mathis / HUM. S. / (916) 319-2089