Senate Standing Committee on Human Services

Senate Human Services Committee will come to order. Good afternoon. And we're holding our Committee hearing here at the O Street building in room 2100. I'm asking all Members of our Committee to be present today and to come forward so that we could establish our quorum and begin our hearing. We have one Bill on today's agenda. Senate Bill 875 will be presented by Senator Glacier, and he is here, ready to go. And before we hear the presentation of the Bill, let's establish a quorum. Assistant, will you please call the role.

[Roll Call]

Thank you. We have a quorum, so we will hear from our one and only author. Thank you for welcoming us into the 2024. Senator Glazer, we'd love to hear your Bill. Senate Bill 875. Please proceed when you're ready.

Thank you, chair. Thank you, Members, for being here today and allowing me to present this Bill. I want to thank your staff, too, for the work that they've done on it. Let me mention on the onset, when I introduced this Bill in April, it was a disclosure Bill, required additional disclosure for referring agencies. And based on the feedback that we received from those who had concerns on the Bill, we added a few weeks ago a licensing requirement.

And we're going to hear from some that they would like to see more of that. But that's the evolution of the Bill. Its purpose is to raise the bar to protect seniors by requiring referral agencies to give consumers a crucial disclosure before referring them to a residential care facility. It creates a licensing requirement for referral agencies and Advans certain practices.

We can all imagine or know, and I know many folks listening know how stressful it can be navigating the process for finding a safe setting for an aging family Member or friend who needs some help. And I certainly have had that same experience in my family. Referral agencies provide placement options for families and friends in these situations. Doesn't mean you have to use one. But they're out there today, irrespective of this Bill. They're out there today making referrals.

Their goal, of course, is to match what they have learned about that senior, that person who has the needs and connecting them with residential care facilities that have rooms open, and sometimes that they need rooms very quickly. However, the provisions in our law today only minimally regulate referral agencies. They do that by imposing misdemeanors for referrals to unlicensed facilities or those that provide the wrong level of care.

As I said, last year I introduced a Bill with only a disclosure requirement, and after the feedback, we've made additional amendments to it to do the following. We create a licensure structure so that bad actors can be held accountable. We've placed in explicit language stating that referral agencies have strict liability if they refer to an unfit facility. We've added a requirement that referral agencies provide a written disclosure rather than just a verbal disclosure.

And we've added a requirement that referral agencies provide disclosure in the same language in which the licensee negotiated a referral. The same language. So if you call in in Spanish and talk in Spanish about your needs, that the disclosure requirement must be done in Spanish. If you call and have the conversation in English, it would be done in English. As I said, right now, loving friends and family, it's a wild west when they are trying to find a residential care facility for their loved one.

And this Bill attempts to try to make things a little bit better. Let me address two points that the opposition have raised. First, this issue of opting in on personal information. California law requires businesses, including referral agencies, to allow consumers the choice to stop the sharing of their personal information, of course, is known as an opt out requirement. That is the California standard. It's the standard that's used for businesses and other things in which we regulate and license around the state.

And it's important to note that if you're referring to a facility, it's most likely that under California law, they're referring to a facility that has an opt out provision, because that's a consistent standard. Second, opponents have raised concerns about creating a distinction between a referral agency and a placement agency, and they claim that it would create a loophole to escape strict scrutiny for improper referrals. And it, of course, is not any of our interest to create any loophole.

But it's my understanding, and the witnesses may speak to this in a few minutes, that the current health and safety code defines placement agencies, and it was intended for those who are principally government agencies who refer patients to medical care facilities, not residential care facilities. Furthermore, the language explicitly in the Bill states that referral agencies must comply with strict liability in current law. And I know that has been a criticism in some of the letters that have been written.

As always, I commit to continuing to work on this Bill with opposition to create a strong law that protects consumers. However, and as we've seen from the terrific analysis that was done, this has been worked on for years. Over eight years, that there have been bills to try to create some sort of standard higher bar in regulation, and hopefully we can make progress on this Bill. And I'm committed to doing that with all parties, as we will hear during this testimony.

So with that, I encourage your aye vote today. With me to testify in support are Monica Miller, representing act eight, and Cliff Berg, representing a Place for Mom. Thank you, Madam Chair.

Great. Thank you so much. So we will move on to our lead witnesses in support. We will hear two witnesses for a total of two minutes each. Proceed when ready.

Madam Chair Members, Monica Miller representing act eight. Thank you for your time today and your staff's time. We really appreciate it. This Bill, as the Senator said, has been something that's been discussed in the Legislature since 2015. And in that time, there's been no protections for our families. My organization that I represent is called act eight, and it's an organization that is designed and intended to protect families and consumers when they're trying to place loved ones in these types of facilities.

Because if you haven't gone around and toured some of these facilities or had the unfortunate experience of having to place a loved one, it is very challenging would be an understatement. You're in complete stress. I personally have a lived experience of having to do it with my mother in law. Complete stress being discharged from a hospital facility.

You are in a room with a social worker, with a photocopy of a photocopy of a photocopy, and you're trying to make this decision of where do we take our loved one to with nowhere to turn. And my husband and I were just completely. The stress level is unbelievable. But you want to make the best decision for your loved one.

So by working with a referral agency, you can go through, she has a cat, she doesn't have a medical issue, but she does have some memory loss issues, et cetera. So you can run through what works for my family and my loved one. And we believe that this Bill puts the protections in there to ensure that they are protected as a consumer, that the families are protected, that they're not. I toured some of these facilities. I can tell you some of them were fantastic.

And some of them, I wouldn't put my worst enemy in. I walked in and thought, zero, dear Lord, how are these people around? This Bill is intended to protect our loved ones, make sure that when families are making these decisions, that they have all of the protections that are needed in place that do not currently exist. As the Senator mentioned, we have worked for many years, but more specifically for the last year, plus with the opposition in an effort to try and reach consensus, some agreements, and while we may not agree on everything, quite frankly, and there's still some outstanding issues and some questions, we are committed to continuing to work with that. Senator Glazer is continuing to work on that. We just want to see this Bill get through today.

We still have another policy Committee hearing this week, Senate Judiciary Committee, as you're aware. So we are hopeful that given all of the hours and hours and hours that we have put in talking with the opponents, talking with the California Department of Aging, talking with the governor's office, trying to get this legislation through, trying to make it make sense in the governor's veto of the Bill last year, the Rubio legislation, he specifically asked us to work with a coordinating care council on elder justice, and we've done that.

We've reached out and we've had several meetings with Adam Willoughby and his team, again, from a technical assistance standpoint from Department of Aging, but we have really worked, attempted to work with the opponents. We believe that this Bill is needed and necessary because, as I mentioned, since 2015, this Bill has been out there and there's been no protections for our family since then, which is why, and I think I'm being told to wrap up. So for these reasons, we urge your aye vote. Thank you.

Thank you so much. We'll move to our next witness, and you'll have two minutes.

All right. Cliff Berg with Governmental Advocates here on behalf of A Place For Mom. Pleased to co sponsor the Bill with act eight. I mean, you may say, hey, why is industry sponsoring a Bill? We're co sponsoring this Bill with act eight. Monica was walking the hallways looking for an author, and I bumped into her and we basically sat down and negotiated a Bill. It's been introduced multiple times. It's been a difficult process.

But the reality is, first off, referral agencies provide a vital service for California families and locating the right facility, they're a tremendous resource. I always like to say I got some courses about being a parent myself when I was younger and took classes and got some lessons in being a parent, but there's nothing courses in high school, college that prepare you for dealing with how do you deal with an older relative who needs extended care?

You often wind up with that relative in an emergency room call from a Doctor saying, hey, you need to find a place that can provide some support for your mom, uncle, fill in the blank. And referral agencies do that. And the reality is California has very little law on the books governing referral agencies. There's basically two provisions in law that cover placement agencies.

They say you can't refer to an unlicensed facility and you can't refer to a facility that we provided an appropriate level of medical care. Other than that, there's been no code. So Senator Mendoza introduced the Bill in 2015. Multiple bills held in appropriations, multiple bills vetoed by the Governor.

This Bill strikes the right balance between strong consumer protections and the amendments that were added this week were all in response to the concerns that we heard about strengthening the Bill and enhancing consumer protections, as the Governor asked for. But the Bill strikes the right balance because you need strong consumer protections, but you need to protect the process, which is often a timely process and a critical time for a family. This Bill, and thanks to Senator Glazer and his staff, I think, strikes the right balance.

But we're going to continue to work on it and continue to work with all the parties to strengthen the Bill and get the best possible product to the Governor. But it's been a long time and California still has no law in this area. Moving this Bill today is extremely important if we're going to have an opportunity to do something this session. So we'd urge your support. Thank you.

Thank you so much. All right, we are going to move forward to public comment. Anyone wishing to express their support for this Bill, please approach the microphone. We'll ask for your name, affiliation, and your position only, please. Heather Harrison with the California Assisted Living Association in support. Thank you.

Hi, Roxanne Gould. Sorry. I'm sitting up here as a pinch hitter because I didn't know if Cliff was going to make it, so I was going to do some of the primary testimony. I'm representing six beds, which is a small six bed or fewer residential care facility for the elderly and developmentally disabled. And we're in strong support.

Thank you. Anybody else? All right, we are now going to move on to lead witnesses in opposition. Thank you so much. We're going to hear two witnesses for a total of two minutes each. And we have two with Blanca Castro with the office of State Long Term Care Ombudsman, and Sowet Shajorn. Did I pronounce that correctly? Oh, okay. Thank you. You'll introduce yourself. Are you still with the disability rights California? All right, but Blanca will go first. Okay, proceed when you're ready.

Good afternoon. Good afternoon, Chairwoman. My name is Blanca Castro, and I'm Members of the Senate Human Services Committee. We're really happy to be here today. First of all I do want to acknowledge the Senators staff for working with us, but I'm representing the 320,000 residents that on any given day are in a long term care facility. We have about 7479 residential care facilities in California, and that number is growing.

In six years, there will be over 10 million people in this 40 million population state that are 60 and over. So this is something that's very much part of our population and part of our community. First of all, let me just say that this is a flawed Bill. It has been carried by the industry for eight years. What they are trying to do is protect themselves from accountability and liability. I see firsthand, and we had 40,000 complaints just last year. Top three complaints.

When there is a person in a residential care facility that is either involuntarily evicted because they are in a place that is not appropriate level of care for them, we are seeing more complex cases, people with traumatic brain disorders, people with dementia related diseases, behavioral health, and a number of other chronic conditions that are seeking assistance with finding quality care. And I'm not going to argue that point.

It is incredibly important, one of the most dangerous provisions within this Bill, and we are glad to see that they finally decided to regulate themselves and be licensed. First of all, they have inserted in this Bill a section 14094 that precisely states the state law does not require that we determine whether facilities to which we refer you are suitable for you based upon your care, social needs, my financial means and location. zero, okay. I thought that's what you were helping me do.

Because when you go into the online websites, you have to enter information, where you live, how much money you're willing to pay, what your condition is, where you're located. Last, I will say there are bills, there are statutes already here to protect the consumers health and safety. Code 156947 has been removed from this Bill that is precisely in place in California, and it already exists, and it is stated here to protect people.

All we want is that the referral and placement agencies are included in this. When they tell you they are only referral agencies, I want to disabuse you of that. They are placement agencies. They get paid to refer you only to facilities that are contracted with them. So it's limited. And they get paid once you sign the admission agreement, to be admitted to that facility. So I'm urging you to please vote no. It is a flawed Bill and it is not ready. Thank you.

Thank you. Our next witness will have you introduce yourself as well.

Thank you so much. Good afternoon, Madam Chair. And Members Yasmin Peled, on behalf of Justice in Aging, and here respectfully in opposition to SB 875, justice and aging advocates on behalf of Low income older adults. And we've been in conversation with the Senators, staff, and the opposition, as they noted, for a while now. And unfortunately, we're still here in opposition. As outlined in our letter, SB 875, we believe, still potentially harms older adults seeking these services.

Instead of protecting consumers, this Bill allows referral agencies to escape the current strict liability for improper referrals. It allows agencies to opt out of the bill's own requirements that the referrals be suitable to meet the needs of the consumer, as Blanca just explained, proposes an expensive licensure structure that provides no oversight, sets no service standards, and provides no protections to consumers for bad actors.

In fact, the only requirement for a license under this scheme is for agencies to provide minimal disclosure, contact, organizational and fee schedule information, and fails to require that agencies be physically present in the state. It puts consumers at risk by requiring them to opt out of the sale of their personal data to third parties instead of giving them control over their use of their data.

It includes inadequate disclosure requirements, which are particularly important when referral agencies have a financial interest in the facility that they refer to. And this was a key point in the governor's veto message of the previous Senator, Assembly Member Rubio Bill. Because the Bill doesn't require agencies to disclose whether agencies withhold non compensating referrals from consumers, consumers can be easily misled into believing that they're receiving a neutral, well informed referral rather than a financially motivated one. For these reasons, we strongly oppose SB 875. Thank you.

Thank you so much to both of you. We will move forward. To Members of the public wishing to express opposition to this Bill, please come forward to the microphone. All right, seeing none, we will now bring our discussion over to our Members. Members, questions or comments? We'll start with Menjivar, then Senator Wahab, and then Senator Ochoa Bogh.

Thank you, ma'am. Chair, a couple of questions. Senator, your witnesses talked about that it would provide the protections. Can you explain a little bit more what the protection to the consumers are?

There's no current. Under current law, there's no disclosure requirement. Referrals go on every day. Yesterday, today, tomorrow, and there's no requirement that they disclose their compensation that they're getting from the agencies in which they're referring. So this sets a brand new standard that's not in place today.

So a consumer under SB 875 would then be disclosed that their referral comes off of a Commission.

In writing. And the Bill specifically says they have to provide that in writing. That's not current law today.

And will the oversight then fall under CDSS or does it currently fall under? Will there be any oversight under.

There's a licensing scheme that's created in the Bill where a public agency would be responsible for ensuring the compliance with that.

And would they be going in person to inspect these facilities?

I don't believe that's a requirement in the Bill. Remember, it's not a facility like a residential care facility. It's an office. Okay? It's not medical facility. It's just a referral agency. As if you had a tenant protection agency advising someone on tenant matters. It's not an apartment or just simply their office.

Lastly, I know as a consumer, I'd like to know which one's the best suitable location for my loved one. In one of the governor's veto, he mentioned that 1 million was put aside to showcase a free website, California long term care. Compare where a consumer can go for free and get a referral that best suits their needs. Wouldn't that in itself be a protection to consumers where they can go, they don't have to use any other referral agency. Wouldn't we then say we're comfortable with this?

I don't think we have a different view than the Governor Newsom's view in this case. And that's a good enhancement. There's no objection to that. It's not really solving the whole problem. I think why industry is engaged in this conversation is because there are bad apples in this space and they're trying to at least create a standard that's above the floor for how the work is done in terms of disclosures and the rest.

And so it will still be my burden or obligation to be aligned with Governor Newsom's and his desire and my desire to make sure we have adequate consumer protection. So the Governor in his veto message, not only talked about the amount of money that he's setting aside, but his willingness to continue to work with the author. In this case, it was an author of a previous Bill on the consumer protections he thinks would create the right level of standards that he would be more comfortable with.

And that is a burden that I share. If this Bill moves forward today, I'm going to continue to work with opposition and Members. This is the first policy hearing, but certainly the governor's office to make sure that we're going to have to meet that test. And we will meet that test.

Thank you, Senator Menjivar. Senator Wahab.

Thank you, Senator, I agree with you that our care facilities are extremely questionable, and even the referral process. And I have aging family Members. Just this past couple of weeks, we were trying to figure out what are our options for more in depth care, long term care. And families are struggling. Right. Not only with costs, but then also what are the options available.

It's not very clear to individuals, but I know that this has been attempted, and I do just want to highlight what one of the witnesses in opposition has stated specifically about Section 149.4. Did you have any comments on that? Because when it says something like, state law does not require that we determine whether facilities to which we refer you are suitable for, you're based upon your care and your social needs, financial means and location.

The list provided is not comprehensive of all options available for a residential care facility in your area. Now, the concern is that this is part of the Bill. That's one concern that I have. And then number two is the fact that, granted, I understand in certain parts of California, maybe there's more ruralness. Right.

It's not going to be in the same city per se. Maybe it's going to be a city. Two cities, three cities over. But financial means is incredibly important. We have a growing senior population. Some refer to it. And I like this term silver tsunami that's going to happen. And it is my generation that really has to balance taking care of their elders and their loved ones, as well as potentially starting a family. And I'm going to be honest, student loan debt. Right. So what is potentially your response to this? And then also, why is it in the Bill?

Very good. So that language about disclosure, we were specifically asked to remove that by the Senate Judiciary Committee, which. Here's the Bill next. And they said, the chair said that staff feels that's an obligation under current law. And it's repetitive, it's duplicative. I don't have any interest in removing that obligation, but was told that language that we were proposing in our Bill in that section was not the right thing to do to advance that same purpose that you have. That I have.

I think that we all have. So you have my assurance that those requirements and that language are something that I certainly want to see in effect, and I'm told it's effect in current law today. But if there's any concern about that, I'm happy to earnestly work to ensure that that standard is in place. Absolutely.

And I'll be honest with you, I am a little concerned about this language. Right. Just because I really think that a lot of the care facilities aren't even right now at this time built for communities that I come from, immigrant communities, lower income communities, things like that. So I will be abstaining. I do support the effort that you're trying to put into it, but I will be abstaining until more things are resolved in that regard. Thank you. Thank.

Thank you very much, Madam Chair. My question would be the following, and I do have to preface my question with the fact that it is concerning for me, knowing, coming from real estate and knowing how we're not supposed to get referrals for sending or referring people to, say, lenders coming from housing and real estate. I have an issue, or I would say an issue.

I have a concern about having only institutions or facilities that will pay a referral fee to be within the scope of the only facilities being provided as a facility to be referred to. In essence. In essence, that's one of the concerns that I have. But the following question that I have for you is who determines whether a facility will provide an appropriate level of care under current state law, and does this person, staff, or entity, do they need to have any medical background in order to make that assessment?

Well, first, the requirement in law that this bill doesn't change is that you have to refer to a licensed facility, a license by the state. And this, of course, again, the wild west of what we're facing today is there's no regulation in this space at all. So there's no standard. This bill tries to set a standard to how that work is done. They're not medical facilities per se. It's not a facility to take care of the health. It could be a facility that makes sure they have three meals a day, that they take care of their hygiene. These are residential care facilities, not assisted living facilities. So just to make sure that's clarified here.

Okay, I'm trying to find the language.

Just a moment, please. Senator Ochoa Bogh, was your question answered or would you like to direct the question towards any members?

Let me continue with, because I think there were a couple of points that you folks made in statute that were modified. So I believe that might be related to the question that I have right now. If you go to my Madam Chair, through the Chair, would love to hear your answer on that or your comment.

So currently there are referral agencies and placement agencies. They are not licensed by the State of California, but RCFEs, or residential care facilities for the elderly, are our assisted living facilities. They all fall under the same umbrella. So a place for mom and some of the places that actually do have brick and mortar, they're navigators.

They're elder care navigators who will go and from A to Z, will help somebody not only find a place, but will help them with the assessment and determine what they can afford and where they want to be placed. So this bill currently is also including the assisted living facilities. We're recommending that they include also that they require referral agencies and placement agencies. And they not distinguish from the separate. Because even though you're saying you're not a placement agency, you're still being renumerated once somebody is placed in a facility.

Senator, would you like to hear a response from witnesses of support?

Absolutely.

Would you please come forward to the table so that we can, if you feel more comfortable, come forward to the table? Thank you. Just in case we have some more questions for you. Thank you.

Thank you, Madam Chair, on a couple of the points. So this bill does not reproduce the statutes in the health and safety code, but it doesn't take the statutes out. They're not necessary in the bill. So the intent of the bill is to leave the existing law in place. That currently governs the provisions that Senator Glazer referred to, which are current law in California says that you can only refer to a licensed facility and they have to have medically appropriate care. We don't change that in any way. We're adding in this bill additional consumer protections. That law stays intact and is the current law in California. So there are no changes to that law made by this bill.

Madam Chair, so appropriate and what's the word? Appropriate? Current statute.

Using current statute. Yeah.

So appropriate. What's the language?

Like you cannot refer to a facility that does not provide appropriate level of care. If I'm paraphrasing because I don't have it in front of me.

Okay, so going with that, with Senator Glazer's opening statement, in which he said that there is recourse for those who are referred to the facilities that are unfit. Who decides if the facility is unfit?

They have to be licensed by the state. That's a requirement. That's an existing standard that the state sets for what's an appropriate license facility for this care.

So there's two different licenses we're talking about here. Right? This bill creates a new license requirement for referral agencies. Existing law, of course, requires the state to license residential care or assisted living facilities. And that's an entirely separate licensing requirement and program that's not in this bill because it's existing law. So basically, what the current law says is a referral agency or placement agency cannot refer to an unlicensed facility. Those are the facilities that the person would be living in.

All right. Thank you, Madam Chair.

Thank you. I have follow up questions. Senator Wahab.

I think there's a number of questions I have, but I will stick to. Okay, so when we talk about residential facility versus, and you said that it was not a nursing facility. Correct?

It's my understanding that there are some definition issues that may go over my head, but I'll.

Current law governs the referrals to long term care facilities. This bill only applies to referral agencies that refer to people to assisted living facilities.

So this is only for assisted living?

Only for assisted living.

Okay. So not retirement homes? Not anything like that.

Generally, I don't think that we do that.

Okay. Because assisted living. So there's a number of retirement homes or assisted living facilities in my district in particular. Right? And to be quite frank with you, a lot of the seniors also trust entrust these organizations with their full assets, everything to pay for it. Right? Maybe a slightly different issue, but there's a lot of concern as to. Okay, so who is the bad actor and what are you guys trying to actually solve?

Well, the original concern that underlies this bill is not related to the bad actors in the assisted living residential space. It was referral agencies. So California has no law governing referral agencies. Families use referral agencies. So the thought was consumers deserve more information or should get more information when they utilize a referral agency. And so that was the genesis of the history of the legislation. And so what this bill does is it provides a long list of disclosures that families will get when they contact a referral agency to use their services in helping find an assisted living facility, as well as other provisions like cease contact.

And I just want to walk this through. Right? This is something that is incredibly important. So if you have an elder that you're trying to potentially put in an assisted living facility, and they're in the hospital, you're talking to the case worker and social worker, and you're like, okay, so what is the next step? How do they get to the referral agency? How does the referral agency refer?

Generally speaking, the family is looking for an assisted living facility, and they go online. They look up assisted living facility like I did, because my mom was in Las Vegas and I was living here in Sacramento, and I got a call from an emergency room doctor saying, your mom shouldn't be living on their own in Las Vegas. 20 years ago, you might go to the yellow pages. Now, most people go online looking for information, and then you have the opportunity.

You'll get, like, hits on referral agencies, like a place for mom. If you go to their website and you choose to enter your information, then you will get a call from what we call a senior advisor who will go through with you in an interview what you're looking for, what kind of facility, whether there's any particular medical illness, whether they want a facility that's dog friendly, pet friendly. And then you'll get, like, three referrals. If you agree, and you must agree, they'll give your information to those three facilities. But there is no obligation, there's no contract, there's no charge. So it's totally up to you.

What is the funding mechanism? So do the individual homes or agencies pay to be bumped up on the top three, as you said to an individual?

No. No. Basically, like a company, like a place for mom, literally has hundreds of contracts with assisted living facilities throughout the State of California and across the country. And so they contract with assisted living facilities to provide referrals. Or another way of looking at it is facility contracts with them to provide referrals.

But do you see that? So they do pay to some degree.

Yeah. One of the bills or disclosures is that fact. So right now, if you contact. So right now in California, if you use that referral agency, there's no requirement of a disclosure that they're getting paid by the assisted living facility. This bill requires that disclosure as one of the disclosures so that families get that information so they know it. Right now, there's no requirement in California law that they get that disclosure.

Similarly, the bill adds a requirement to California law that tells you that we only refer to entities with which we have a contract, not a requirement in California law today. So the intent of this bill is to provide you, the family who's using the referral agency right now without any of those disclosures, those disclosures.

So I'm going to give space. Would you guys like to respond to that?

I would. First of all, we do have statute 1569.47. It is a health and safety code. We have asked the sponsors to include referral agencies under that code. We already have existing law that protects consumers. I don't understand why they're trying to create a separate thing only for referral agencies. This applies to placement agencies. The law that they reference in this bill is for referral and placement agencies that refer and place for skilled nursing facilities, and that is overseen by the Department of Public Health.

And that already exists. So that's why in my opening, I said, this is a very confusing bill. I am not sure what they're trying to achieve. And if we do want to protect consumers, yes, I believe that referral and placement agencies, regardless of whether you're online or have a brick and mortar, need to be licensed by an entity. CDSS is not interested in that because it's too expensive. DOJ maybe, but we haven't had any conversations with them, so there's a lot of work to be done before this is ready.

As the sponsors on that.

Just a moment. Senator Wahab, was your question answered or would you like.

Thank you. I appreciate it. Thank you for your explanation as well. Thank you.

Thank you. Okay. Follow up question, Senator Menjivar.

Thank you so much, Madam Chair. Senator, I wanted to confirm what you were, and the senator here were talking about the suitable referrals and what you committed. So I just want to make sure that while they are going to be disclosed to the consumer that they're getting referrals to places that they have contracts with. Am I correct in hearing that you are committing to working on removing language that they will only get referrals that are suitable to them? Because one of the arguments of the opposition for justice in aging was that they're going to continue to give referrals that aren't suitable to them.

Right. Yes, you have my commitment on that.

And then my second question is kind of the question that the Senator asked around the bad actors. Is everyone currently licensed right now?

No. And in fact, I want to go to Senator Ochoa Bogh's point that she made earlier. Look at today. You contact referring agent A and ask for help. Referring agent A could have an investment that could manage a residential care facility. Never disclose it. They have a financial interest in the referral today that can happen right now. There's no limitation. This bill says you can't do that. It's a conflict of interest. That's an example of trying to raise the bar to where there is nothing today.

And we're trying to at least set some standards. Opposition would like us to go further. And in fact, by the way, when Governor Brown vetoed a similar type bill, he said, I don't want to make any regulation in this area. And Governor Newsom says, I want some, but it has to be at the right level. Well, that's what we're working on here right now. It's a wild west. It could be a conflict of interest and there's nothing to disclose it.

There's no requirement they post these information on their website, et cetera. So I know it's a tough issue to wrestle with, and you can tell it's been wrestled with for a long time. But we're trying to set some minimum standards in the space.

Madam Chair, just one last question. If I could direct it to the two women here. If this bill doesn't move forward, everything stays the same. People are still going to, consumers are still going to be referred to sites that aren't suitable for them. If this bill moves forward, they will no longer be referred to sites that are not suitable for them, and they'll be disclosed that there's a contract. Help me.

It's unclear to us. It's really hard to read this bill and figure out how a consumer. How this makes a meaningful difference and an improvement in the experience.

I agree with that.

Somebody going through the process of using these placement and referral agencies. As I think we all agree here, people use these agencies in times of extreme crisis. A family member ends up in the emergency room, a family member is starting to rapidly decline in terms of their Alzheimer's or dementia, and people feel desperate to find a solution and a safe place to send their family member. And it is imperative to us that people get put in the right place that meets their level of care.

And I think we all agree on that. The language here, I'm not sure that we're still in opposition because we don't think the language here meets that bar. And we're very concerned that there are some unintended consequences here, like the subsection here that Blanca read subsection G. It's in the policy making process. We want to make sure that we're improving what we have, not making what we have worse. And right now, what we have, I'll agree, it's not great. It's the bare minimum that what we have in existing law, but it is something, and there are protections for people in existing law. This muddies the waters, in our opinion.

Senator Hurtado.

Thank you, Madam Chair. I think that when it comes to this bill, there's a lot of room for improvement. It seems like there's willingness on the author's end to work on the issues or the concerns that have been brought forward. I do think this is an issue that needs to move forward. And while not perfect, I will support it today, moving and making sure that we get it right and that all parties come on board and feel comfortable about where it's at. With that said, I will move the bill.

You have a motion when ready. Have another comment, please. Senator Ochoa Bogh.

Just one final question. So I understand the points that you're trying to make. I understand the intent of what is being done here on that end, and I'm trying to find that milk run. I'm gravitating towards supporting the bill today and seeing the final language at the very end and reserving my right on abstaining or opposing or supporting once I see the final language, because I know you're a diligent worker when it comes to your policy.

But I understand both sides on this end, and I do see a need, though not perfect right now and what we need to work towards. But a statement was made earlier with regards to the intent of trying to regulate this space since 2015, I believe is what you stated, and nothing has come through. So my question to you is, who at this point has authored the best bill at this point, and who's taking the lead on that, if not you or in your end, who has come together to move forward a bill and why hasn't it been done yet, as of yet?

Who's your question to, Senator?

I'll leave it open to, I guess to the authors.

To the authors first.

Well, look, in many ways, this is a friendly conversation because we all really have the same goal. And I think, Senator, as you indicated, I mean, look at all the authors since 2015, Rubio, Calderon, Reyes, Mendoza, Mendoza again. We've all been trying to raise the bar, and we're having these fights among friends who want the bar to be higher, lower. Governor Brown says this, Newsom says that. We're trying to make progress in this very difficult space where I think maybe we're not in agreement.

I think that the floor that we're on right now isn't good enough because you can have conflict of interest. You can have bad actors that aren't getting any review whatsoever. And look, originally I was just into disclosure, and because of the good comments from friends on the other side, we added licensing. Now they want to license everything, placement agencies. We're actually placing someone, and we're not doing that. We're only dealing with referrals. So we're going to continue.

If in the committee's judgment, this bill moves forward, we're going to continue to work with our friends because we want to try to create a higher standard and we don't want it to be muddy. Nobody wants that. It's going to have to be regulated properly. I don't even like regulation. But if we're trying to create standards of fairness, I'm into that. And let's see if we can figure it out as this bill goes on.

Okay. Any further comments or questions from our members? All right. Thank you so much, Senator Glazer. I just want a point of clarification because we talked about different terms that were used, particularly assisted living facilities. And I just want to make sure that we understand that assisted living facilities are used to describe a variety of facilities providing both housing and personal care, and they do include residential care facilities. So it's all encompassing. And these are facilities that primarily serve adults over the age of 60. So I just want, for clarity's sake, that this is not a bill that excludes certain types of facilities, but it's all inclusive. Is that correct?

Yeah, that's correct.

Thank you for that clarification. The other thing I want to say is that, noting that this bill has been worked mostly in the Assembly, I can't think of a better colleague to bring forward this bill. And so thank you, Senator Glazer, for working so diligently on this. And I know that you also gracefully agreed to make it a two year bill so that we could have that time for you to work with the opposition and to really get that language right.

I don't believe in perfection, and this is not a perfect bill, but I do understand the underlying intent. And this is a preventative bill for me. This is a Bill that looks at the silver tsunami, as my wonderful colleague coined it, and puts the responsibility on this governing board, on this Legislature, to make those decisions around our aging population.

And being that this has been debated for eight years, I feel that now there's an urgency here, because if there are loopholes, if there are crevices that are creating more bad actors, more situations where some of our most vulnerable populations are becoming victims or targets, I want to be part of that solution. So I want to encourage you to continue to work on this Bill.

I know it will be double referred, and I have faith of my colleagues in the Judiciary Committee to continue to press hard on the language of this Bill. So I will be supporting the Bill today and will also Reserve my right, if and when it comes to us on the floor, to look at the final composition of the Bill.

But I want to thank you for continuing to be diligent, to be a good partner in this, and to bringing forth all the voices to the table today. Okay. Without any further comments or questions, we'll invite you to close.

Thank you, chair. And I'm sure my colleagues have heard me say that this is really a two year Bill, and they get uncomfortable when it's their Bill. I did it to my own Bill last spring. I said, you know, we need more time, that we haven't been able to work out these issues. I know that I see a path still not as clear as I'd like it to be, but I did it to my own Bill called my own two year Bill.

And you can see that it's a difficult path to kind of get through. And, yeah, if, in the interest of the Committee, you let me continue to work on it, I will. This isn't a space that I naturally legislate in, but it's a space we all feel in our hearts, because we all have friends and family who have gone through these circumstances. And to my friends who are in the opposition, I understand it.

And they come with the best of intentions because they do incredible work for our senior community that gets ignored. And these dilemmas that we're talking about here are not dilemmas that we face in our legislative life very often. Yet, as been said, one out of four Californians will be over the age of 60 in six years. And there are bad actors out there. I'm not here to protect anybody. We have to have some minimum standards. The Bill attempts to try to set a little higher bar. Can we do it better? Yes, let's work on it if you desire. And with that, respectfully ask for an aye vote.

Thank you. And thank you so much for acknowledging the work that our consumer advocates for our aging population do. This is certainly a difficult table to be at. And thank you for continuing to bring your voices forward. Absolutely. So we have a motion. The Bill has been moved by Senator Schiavo. Please call the roll.

SB 875. The motion is do passed to Judiciary Committee. [Roll Call]

Okay, so the vote is three ayes and two abstentions. That Bill passes. And with all Members present today, we have finished our business today. I want to thank the staff for working diligently with us. Happy 2024. Welcome back. It was nice to get some visits from our public safety staff. So thank you so much. We will be ending today's Human Services Committee. Thank you.