Assembly Standing Committee on Aging and Long-Term Care

All right. Good afternoon. Thank you guys so much for joining us today for the Assembly Committee on Aging and Long Term Care hearing to decide Senate bills. There is an immense amount of work happening in and around the Capitol today.

We are asking all aging Committee Members to join us now to do our due diligence to hear our Senate aging related bills and move everyone on to their other Committee hearings. Senators, your bills will be heard in file item order to ensure Members of the media and public have access to our proceedings today.

This hearing will be streamed on the Assembly's website, and Members of the public can provide testimony in person here in room 444. If any Members of the public in the room would like to speak during public comment after a Bill is presented, I will ask you to approach the microphone at the appropriate time.

So at this time, we will proceed as a Subcommitee. In the absence of a quorum, we will go ahead and start with SB 37. Senator Anna Caballero

Good afternoon, Madam Chair. Thank you for the opportunity to present SB 37, which will create a program to provide housing subsidies to senior adults and adults with disabilities who are experiencing or at risk of experiencing homelessness. Californians on a fixed income find it difficult to afford the rapidly rising rent increases.

Many of these Californians have spent their entire lives working at Low wage jobs, have small pensions, or live on Social Security benefits. They are inadequate to cover the rising rents. As a result, they face insecurity, housing insecurity, and are one emergency away from homelessness for extremely low renters.

Roughly eight out of 10 spend more than 50% of their monthly income on rent, and people with disabilities comprise about 46% of those experiencing homelessness. And as we know, African American households are more than five times as likely to experience homelessness when compared to the general population.

If we do nothing, senior adult homelessness, those are individuals over the age of 65, is expected to triple by 2030, leaving vulnerable seniors on the street. A key goal of the governor's California master plan for aging is to prevent and end adult homelessness.

Targeted programs such as Safe Home Safe Program and the Homeless and Disability Advocacy Program play an important role to help adults access housing, including those who are adult protective service clients and who are eligible for SSI payments. However, no comprehensive state program exists that provides housing subsidies for older and disabled adults who are on fixed incomes.

Again, there's no state program. Meanwhile, housing choice vouchers and other federally subsidized housing programs often take years for applicants to access, and once you sign up for the program, only a fraction become eligible applicants. SB 37 will provide a rent subsidy targeted to older adults and adults with disability or who are homeless or at risk of homelessness.

The Bill will establish the Older Adults and Adults with Disability Housing Stability Act, which is not a really sexy acronym within the Department of Housing and Community Development, to offer competitive grants to nonprofit organizations, continuums of care, and other organization with the resources, expertise and cultural competencies to provide assistance to senior individuals and their family.

Studies show that low income renters that have access to housing subsidies are able to remain housed or to exit homelessness for good. Providing these subsidies for low income renters is also much cheaper than providing shelters for homeless people, so the bill is a cost effective method for addressing the crisis.

By investing in subsidies, we can reach the California master plan for aging's goal to end senior homelessness. With me here to testify today is Yasmin Peled with Justice in Aging and Harrison Linder from Leading Age California.

Thank you, senator. Good afternoon chair and Senator Rubio Yasmin Peled, here with Justice in Aging. We're one of the co sponsors of SB 37. As you've already heard from the senator, older adult homelessness is a crisis in California.

Older adults comprise nearly half of homeless californian adults, and older adults are also the fastest growing age group of people experiencing homelessness in the state. Of those older adults experiencing homelessness, almost half are experiencing homelessness for the first time after the age of 50. So they are aging into homelessness. The primary factor behind this trend is economic.

Older adults living on low fixed incomes cannot keep up with California's rising rental costs, as well as the rising cost of health care and other basic living expenses.

As older renters age, they face an increased likelihood that their fixed incomes haven't kept up with escalating rents or they've depleted their savings, or they've lost a spouse, resulting in older renter households aged 75 and older facing the highest cost burdens. It takes just one crisis to push people onto the streets.

In order to solve this problem, the state must focus on proven homeless prevention strategies, and a known way to do this is with rental subsidies. SB 37, like the senator mentioned, proposes to create a targeted rental subsidy pilot program for older adults and people with disabilities who are at imminent risk of homelessness.

The program would begin in up to five geographically diverse counties, understanding that older adult homelessness is not just a problem in our urban counties, but also in rural areas, studies show that these shallow rent subsidies really make a difference in people being able to stay in their homes.

The policy proposal in SB 37 has been supported by a large and broad coalition of advocates for the last three years. And again, as the senator mentioned, ending and preventing older adult homelessness is a key goal of the state's master plan for aging. And despite this year's budget deficit, we cannot hold back on investing in homelessness prevention.

For these reasons, we're requesting your support today, and thank you, and I'm happy to answer questions at the appropriate time.

Hello, Chair Bains and members. My name is Harrison Linder. I'm the assistant director of housing policy for Leading Age California, one of the co sponsors of SB 37. Leading Age California is the state's leading advocate for mission driven housing care and service providers for older adults.

Approximately 400 of our over 800 members are nonprofit providers of affordable senior housing today. As my co sponsor mentioned, nearly half of California's unhoused population is 50 and over, and older adults continue to be the fastest growing cohort of California's unhoused population.

This is primarily due to the growing gulf between housing costs and the fixed incomes like Social Security and SSI that many older Californians rely on. According to UCSF, about one fifth of California's entire unhoused population are people 50 and older experiencing homelessness for the first time.

In contrast to the common portrayal of homelessness as something experienced by those with severe substance abuse issues or mental illness, these older Californians experiencing homelessness for the first time were likely stably housed before they fell into homelessness.

The most common cause for homelessness among older Californians is a sudden loss or reduction of income and a shallow rent subsidy, likewise proposed in SB 37, would have been enough to keep them stably housed.

Leading Age California's affordable senior housing provider members hear from older adults like this on a near daily basis, hoping for an available, affordable unit. In almost every case, the best our members can do is is put them on their years long waiting list. Once unhoused, older adults struggle more than others to access services and permanent rehousing.

On average, it takes two years from the time an older adult becomes unhoused to start accessing services, and older adults with common health conditions such as incontinence, are being turned away from shelter beds, in many cases causing older adults to remain unhoused longer and creating more chronic homelessness.

Unhoused older adults often have a functional health status of someone much older, exacerbating chronic disease and disability, resulting in high utilization of our healthcare systems.

SB 37 would begin to address older adult homelessness by creating a three year housing stabilization pilot in up to five diverse counties or geographic reasons for older adults and people with disabilities who are homeless or at imminent risk of homelessness.

This bill has been fine tuned over three years of work by a coalition of housing and homelessness services experts and includes safeguards to ensure funds go to those who need it most. It also requires the state to work with local housing authorities to move subsidy recipients onto long term HUD subsidies, including vouchers or units.

Thank you for your leadership in this policy space, and we respectfully request your aye vote.

Thank you. Thank you so much. We're going to establish a quorum real quick.

[Roll Call]

We now have a quorum. Thank you so much, everyone here here in support of this bill.

Clifton Wilson, on behalf of the County Board of Supervisors for Madera, Marin and Fresno, also on behalf of the cities of Los Angeles and Santa Monica, and then lastly on behalf of the city in the County of San Francisco, all in support. Thank you.

Lauren Rebrovich, I'm here with Housing California, and I'm also here on behalf of the California Housing Partnership, in strong support. Thank you.

Madam Chair, members of the committee, Paul Gonsalves, on behalf of the City of Thousand Oaks, in support. Thank you.

Jason Gapbar, at the Alzheimer's Association, in support.

Good afternoon. Caroline Grinder, on behalf of the League Of California Cities, in support.

Good afternoon. Elizabeth Espinoza, on behalf of the County Welfare Directors Association, as well as the California Community Living Network, in support. Thank you.

Justin Garrett, with the California State Association of Counties, in support.

Eduardo Rubalcava, volunteer with AARP, AARP, and 3.2 million AARP members here in California strongly support SB 37. Thank you.

Karol Swartzlander, California Commission on Aging, in Support.

Clay Kempf, area agency on Aging of Santa Cruz and San Benito counties and original member of the Stakeholder Advisory Committee for the Master Plan for Aging, speaking in very strong support.

I have been moved by Assemblymember Rubio, and second by Assemblymember Friedman, anyone in opposition to this bill, seeing and hearing nothing else. Thank you so much, Senator Ana Caballero, for bringing this important bill forward, and thank you for allowing me to be a principal co author.

This bill has the potential to make the most significant impact on older adult homelessness. We have heard from experts all of the data, but we haven't seen anything put in plan in action to ameliorate the situation. We share representing underserved areas here in Sacramento.

So I just want to emphasize the importance of making these available in communities like ours. In more urban settings, the amount of services and points of contact increases. While there are always financial deficits in serving older adults, in areas like Kern County and yours, they are exacerbated. Housing subsidies are important, and remote and underserved counties as well.

Any other members wishing to comment on this bill? Again, thank you so much. Senator Caballero, if you would like to close.

I know that you are very aware of the needs of the community, in particular the seniors in our community. I appreciate your comments. Thank you for joining me as a principal co author.

When you think about the lives that our seniors have led and the, and the care or lack of care with which they have been treated, it's incumbent upon us to do everything possible to make sure that their last years are lived in comfort and that they're not on the street. So I respectfully ask your aye vote.

Thank you so much. All right, clerk, please call the roll. And the motion is to do pass and re-refer to the Committee on Appropriations.

File item one, SB 37. [Roll Call]

That is three votes. Bill's on call. Thank you so much, Senator Caballero. Next item we have is File Item Two: SB 1249. Senator Roth.

Thank you, Madam Chair and Members. First, I'd like to thank the Chair and her staff for working diligently and collaboratively with my office and stakeholders to develop amendments that greatly improve this bill. The bill seeks to address the needs of California's rapidly aging population by modernizing California's older Californians Act.

Currently, as you know, aging services are delivered by 33 Area Agencies on Aging, covering all 58 counties. This network was first put in place nearly 50 years ago when the older adult population was much smaller and less diverse. A lot has changed in the last 50 years, and by 2030, one in four Californians will be aged 60 or older. This dramatic demographic shift, as well as the changing needs of families and communities, requires that we reexamine how the current system delivers aging services.

The bill modernizes and strengthens state aging services in several ways, which the most recent set of amendments clarify and outline in more detail. I should note that the amendments were the product of many stakeholder meetings with our office to sponsor the Commission on Aging, the California Department on Aging, who will be implementing the bill, committee staff and CFAR members that represent both nonprofit and county-run AAAs.

During these stakeholder meetings, CFAR members raised concerns about the bill's lack of clarity regarding the Department on Aging's stakeholder engagement process and the content to be addressed in the development of rules and regulations. By providing that clarity, members of C4A, both counties and nonprofits should feel assured that there will be a clear, transparent process that welcomes their engagement on these critical issues.

Basically, the amendments outline the actions the Department will take in consultation with Area Agencies and stakeholders, and those include identifying core programs and services for all local AAAs to provide, updating the Intrastate Funding Formula based on any revised area aging on aging--Area Agency on Aging designations and any modifications to planning service area map boundaries, developing objectives, key results, and performance measurements for core programs and services, developing an engagement plan to increase public awareness and access to aging services, especially for older adults and families and underserved populations such as Black, Latino, Indigenous, Asian American, and LGBTQ adults, through a statewide engagement plan.

The amendments also define what will be addressed at a minimum in rules and regulations in the process, which are: the application process to determining an Area Agency on Aging designation, the criteria used for an Area Agency on Aging designation, and three, the criteria used to remove an Area Agency on Aging designation, substantive and substantive updates to the Intrastate Funding Formula.

Basically, the intent is to ensure that changes, if any, will be noticed with adequate time, due process and appeals. At its core, the bill focuses on ensuring that older adults receive the most coordinated care delivered by the entity that would serve them best. I'm pleased to have here with me today to testify in support of the bill and answer any questions, my friend, former Assembly Member and former Chair of this committee and current Chair of the California Commission on Aging, Assembly Members Cheryl Brown, as well as the Immediate Past President and current Commissioner of the California Commission on Aging, Ellen Schmedling. Thank you.

Wow, it is so good to see you all. I don't know if I have--it's on. Yes. It's really good to sit on this side of the table, but it's wonderful to be back in the Capitol and be doing this most important work. As he said, I am Chair of the California Commission on Aging and we sponsored this bill, 1249. I support this bill and recognize its value, not just in my current capacity, but also as a former member of the Assembly and former Chair of this committee and perhaps more importantly, a caregiver for my husband.

I appreciate the value of the provisions and the quality and the consistent core programs and services throughout California. The bill's provisions build on years of stakeholder engagement, resulting in the Master Plan for Aging and our state's ten-year blueprint. And I worked on that from the beginning of the Master Plan on Aging.

SB 1249 advances priorities of the Master Plan for Aging by modernizing, as my friend said here, and strengthening California's aging service network and preparing for 2030, when one-quarter of the state's population will be 60 years and older. Can you imagine? The bill's provisions build on years of stakeholder engagement, resulting in that master plan that I spoke of and our state's ten-year blueprint.

I'm Ellen Schmeding. It's good to be here and see you all today. I am currently serving on the Commission on Aging. I'm the Immediate Past President and a current commissioner that's here in support of SB 1249. Thank you, Senator Roth. I have 28 years of experience as the former Chief Operating Officer with St. Paul Senior Services and a Director of the AAA in San Diego County. I've seen many of the pressing challenges that face older Californians that all require a new way of thinking and acting.

We know that these include challenges like housing and homelessness, as we just heard on the previous presentation, behavioral health, and increasing rates of Alzheimer's and dementia. In 2022, the Department of Aging convened key Area Agency on Aging and county stakeholders, including our Commission on Aging, to launch the California 2030 initiative.

More than 200 stakeholder interviews were held, with all 33 AAAs in the state participating in the process. This bill now responds to new federal regulations, and we're required to do so, and it includes a response to the 2030 recommendations to identify core services, create performance metrics, focus on those with the greatest social and economic need, and develop policies and procedures that affirm this critical role of local governments in providing aging services.

It will also include updating the Interstate Funding Formula and developing a consumer engagement plan to raise public awareness of available services for older adults. So the Department on Aging has their hands full and can only succeed with the stakeholder participation. Our current planning and service area boundaries were last adjusted in the late seventies. A lot has changed. The state's population over 65 was just ten percent at that time, and the majority of our elders were White or Caucasian. How much has changed?

I believe that SB 1249 will improve equity, quality, and consistency of services provided to older adults and their families, regardless of where they live in the state. In developing and refining the bill's provisions, the Department of Aging, as well as the Commission and my friend, Senator Roth, and his staff and the committee, have conducted numerous meetings with Area Agencies on Aging, stakeholders, and interested parties.

As a result of these meetings, the recent amendments address the concerns regarding the process for letters of intent being sent by the counties to the Department of Aging, as well as the assurance that the core programs identified will be those funded through the Older Americans Act.

The bill requires CDA to continue this open process through consultation with the stakeholders in the development of all regulations related to this bill. This transparent process builds upon the previous collaborative efforts to build an aging network that provides necessary services throughout the state.

Finally, I want to recognize and appreciate the hard work of Senator Roth and his staff and Elizabeth Fuller, the Chief Consultant for the Assembly Aging and Long-Term Care Committee, who convened the meetings with many interested parties and spent many hours crafting the most recent amendments. I thank you for--we thank you for your time, and we strongly encourage and ask you to support and pass the bill, 1249, authored by none other than Senator Roth.

Thank you so much. Moved by Assembly Member Rubio; seconded by Assembly Member Rodriguez. Welcome to the chambers. It's an honor to have you back. We will go ahead and proceed to anyone in support of this bill.

Chair and Members, Kathy Mossburg with the California Association of Area Agencies on Aging. We want to restate the comments that were made. We really very much appreciate the stakeholder engagement, all the work done by your staff. We really thank Senator Roth and his staff as well, and certainly the Department for working with us to make this a better bill. We now support. We are sorry our letter didn't get in till much later. It just got in the last hour, so we do support the bill. We needed time to vet the language.

We do still have some lingering concerns as it relates to moving forward and realignment, what it will mean fiscally to local areas, making sure we can provide all those services to seniors, but we do know we have good partners to work with, and we look forward to doing that. So again, thank you. We do support.

Yasmin Peled with Justice in Aging, in support.

Jason Gabhart with the Alzheimer's Association, in support.

Selena Coppi Hornback with the California Assisted Living Association, in support.

Elizabeth Espinosa, on behalf of the County Riverside, in support. Thank you.

Again, Eduardo Rubalcava, AARP volunteer, representing 3.2 million AARP volunteers here in the great State of California, strongly support SB--this bill. Thank you.

Thank you so much. Anyone in opposition? Speakers have two minutes.

Do you want me at the table as the opposition voice?

Whichever you would like.

Ellen's nodding yes to me, so I'll never pass up an invitation.

Welcome.

Thanks, everybody, for your consideration. Clay Kemp, Executive Director of the AAA of Santa Cruz and San Benito Counties. We are speaking in opposition. A couple things. First of all, I just want to say that the amendments are great. Really happy to see those. I thank the Senator and committee staff for putting those in place. Much improved.

There's a few things we still need to address, I think, and just so everybody's aware, I'm speaking about that, and these are all my normal allies, so it's a little bit awkward to speak in opposition to what they're saying, but a couple ways to improve the bill: I totally support the idea of setting criteria by which AAAs are measured. I think there needs to be more equity in that process because the bill currently focuses on nonprofits and on joint powers agreement, and it seems like counties are held exempt from that criteria.

So it would be good to just create a more level playing field about that and make it clear that the criteria is held to all AAAs, not just certain ones. Also concerned about the priority setting by the state. The Older Americans Act allows for local priority and determination of what services should be provided in each local area because we know not one size fits all.

We know that what's good and what works in some place like rural San Benito County is really different than Downtown Los Angeles or in the far north, et cetera, et cetera. So really like to just highlight that one size doesn't fit all. Another piece of that is that funding we receive comes categorically. California only provides funding in one category, and that's senior nutrition. So if we're going to reprioritize services, to provide any meaningful services, there needs to be resources that go with it. The only way to do that would be shifting money away from nutrition.

And due to some complexities of the funding, we couldn't even move the state funding. We would have to move federal nutrition, home delivered meals, dollars into whatever the state determines as priority and we think that's not a great model.

Could you please wrap up comments?

Let me wrap up. Diversity of all AAAs, I think, is--or a diversity in AAA models, I think, is a strong asset of what we have now. There's things we can do as nonprofits that county-based systems can't, and there's things that county-based systems can do that nonprofits can't. So the entire network is really strengthened by having that mixture of service types, and we would just encourage to make sure that equity remains and that diversity and agency structure continues.

Thank you so much. Anyone else in opposition? All right, seeing none, to the sponsors of the bill and to the opposition, let's definitely work on establishing this bill, as it has seen a lengthy and robust discussion in the Assembly Committee process. Thank you, Senator Roth, for bringing this bill before the committee.

I think the bill before us today is a reflection of the deeply involved Aging Committee process, and the concerns that remain will ultimately find resolution through the mandated rules and regulations developed because of this bill. I encourage and I know there's still processes to be happening and, you know, appreciate the comments from the opposition as well.

And I definite feel confident that Senator Roth will continue negotiations and talks on that. With that, anyone else from the committee that would like to add comments? All right. Clerk, if you can please call roll? The motion is: do pass and re-refer to the Committee on Appropriations.

File Item Two: SB 1249. [Roll Call].

Has four votes; the bill is out. We will leave the roll call open for absent members. Thank you so much.

Thank you so much, Chair and Members for your consideration.

Thank you.

Thank you. Hey, Freddie. How you doing?

We are currently just waiting for Senator Wahab and Senator Allen to make their way to the chambers, and we will continue with our final two bills. Thank you.

Senator Allen, welcome to the chambers. We'll proceed with item number four, SB 1406.

Thank you. Thank you so much. Appreciate this opportunity to present. Let me first start by thanking the Committee and the chair for your consideration and feedback on this Bill, which ultimately is all about affordability and fairness for seniors. We know that seniors are the fastest growing population that people experience experiencing homelessness.

You know, by between 2017-2021 the homeless population, sorry, the senior population only grew by 7%. Get the number of people 55 and over who sought homelessness services increased by 84%. Of course, we had the pandemic in there and other shocks to our economy, but what a wild data point.

By 2030, the number of seniors experiencing homelessness, unfortunately, is expected to triple. And so, amidst this growing crisis, we have this proliferation of assisted living facilities, also known as residential care facilities for the elderly. RcFes, we always come up with great acronyms.

They, in many cases, have been raising the costs, the rates that they charge residents like never before. And now you see a proliferation of investors, regional companies, international real estate trusts have been jumping into the business.

So we saw an industry survey that showed something like half of the operators in the business of assisted living earn returns of 20% or more above the cost to run the facilities. And, you know, that's. You know, that's the private sector, it's open market. But let's remember who we're talking about here.

On the service recipient end, we have older people who can afford, you know, those that actually can afford an assisted living facility oftentimes find their life savings totally drained from the experience. And unlike residents of nursing homes, where care is generally paid for by Medicaid assistant living residents or their families usually shoulder the full cost.

Most seniors are on fixed incomes. Rates have soared well above the rate of inflation or Social Security cost of living adjustments. And so this Bill seeks to step into this area by giving assisted living residents and their families greater autonomy over their care and help to avoid undue financial burdens.

You know, we've just heard some horror stories, many, many, actually, of families that people who. Whose entire life savings have been drained. New costs that people don't even find out about until their loved one is dead. So what are we seeking to do here?

We're requiring facilities to provide a detailed justification for any rate increase while capping annual increases at 5%, plus the percentage change in the cost of living index, plus one half the percentage change in the annual median wage.

So we give a lot of leeway, but we want to make sure that before folks really see their rates jacked up, that there has to be some justification.

And then we also ask that we extend the notice period for rate increases from 60 to 90 days to give seniors and their families the necessary time to determine if they can afford the higher rates or if they should appeal the rate change or find an alternative setting that might work better for them.

This is not like a restaurant that jacks up its rates, and you can make a quick decision as you want to eat there or not. These are places where people are living, and oftentimes the people are very vulnerable. They don't have a lot of flexibility.

So I do want to thank all the stakeholders for their continued engagement on the Bill if the Bill moves forward today, I'm very committed to ensuring adequate time for discussions with everyone to address remaining concerns about the cap in the rare event of financial hardship.

And joining me today here is Tony Chickatel from the California Advocates for nursing home reform to provide some expert testimony on this matter.

Thank you. Good afternoon, everybody. I'm Tony Chicotel, Senior Staff Attorney for California Advocates for Nursing Home Reform. We're the sponsor of the Bill. And first of all, I want to thank the Committee for all of its help in trying to craft amendments that work for everybody and putting a lot of time and effort on that.

So over the last couple years, we generally operate a hotline for California's long term care consumers in California and their family Members. And over the last couple years, we've had an inordinate amount of calls related to RCFE rate increases beyond what we would normally get 30/40/50% I cited in our letter of support.

One facility in Riverside increased their rates by 265% when they had a management change. Residents are very ill suited for these enormous rate increases. They have fixed incomes and dwindling assets. The New York Times recently did a series on the enormous costs. They called the series dying broke and called the fees oftentimes crushingly high.

So SB 1406 caps rate increases similarly to how we cap rent increases in all rental units. Using a formula that takes into account General inflation plus wage increases for the caregivers, 1406 also gives residents 90 days instead of 60 days advance notice of rate increases.

This will address the fact that the disabled residents of RCFEs have significant challenges in finding and moving into new homes. When they are priced out of their current home, more time will be very helpful to them.

SB 1406 clarifies and expands rate increase protections for assisted living residents and thus provides housing stability for a highly vulnerable population of Californians with limited housing options and stops excessive rate increases in assisted living. Thank you.

Thank you so much. Anyone in support? Seeing none. Anyone in opposition? You guys have two minutes each. Thank you.

Thank you. Madam Chair Members Amber King with Leading Age California, representing nonprofit providers of care, services and housing for older adults, including RCFE. Unfortunately, we are here in respectful opposition. We really appreciate all of the conversations that we've had with the author's office and the sponsor and the Committee staff.

We are very appreciative of where the Bill is at this current point. We unfortunately are still in opposition to the unintended consequences that we believe could come about if this Bill were to become law in its current form.

We hope to continue working with the author and sponsor to address those RCFEs that are in financial hardship and may need to increase their rates above the cap, the formula that is in the Bill.

Many of our Members are choosing to serve older adults with increase higher levels of need and with that they're having to increase their clinical staff at a much higher rate.

Many of our Members are choosing to employ RNs and LVNs to staff to be able to treat all those patients and that cost is not necessarily covered by the wage index formula that's included in the Bill.

And so we continue to hope to have these conversations and work out our differences in in that space as the older adult demographic is shifting in California, Leading Edge California remains committed to increasing access to long term care services and supports, including RCFE. And we want to make sure that we're not hindering that progress with this Bill.

Thank you.

Good afternoon, Madam Chair and Members. My name is Rick Jensen and I am the President and CEO of Northstar Senior Living and a board Member of the California Assisted Living Association. We are based in Reading, California. We currently operate 18 assisted living communities throughout the state and serve about 1500 older adults in California.

I'm here today in my role as a California board Member, CALA board Member, to express our great appreciation to the author, the sponsor, and also to this Committee, particularly Liz, who have really helped us work through our differences and to ensure the integrity of the model of care of assisted living, which is a critical and necessary model for our seniors and their families in the State of California.

I shudder just a little bit with the introduction, a little bit, because this is a great service industry for families who want somewhere for their mom or dad to go and need somewhere for their mom or dad to go. And it needs to continue to be a viable business option.

And I do appreciate though all of the work that has gone into the Committee meetings and work behind the scenes because at this point, the California Assisted Living Association is gratefully removing our opposition to this Bill, and we appreciate everybody's work in getting us to that point. Thank you.

Thank you so much. Anyone else in opposition?

Madam Chairman and Roxanne Gould, with a very deep voice today, must be allergies. I'm representing Six Beds, an Association of small residential care facilities for the elderly. Six beds or fewer.

We'd like to thank the author for going above and beyond and including stakeholders in the dialogue and for accepting many amendments and your incredibly talented staff for working with us. We would just like to have the caveat. If the two parties agree to a higher rate due to whatever circumstances, we would remove our opposition.

Thank you so much. The Committee was notified earlier today that this Bill is now moving to the Assembly Committee on Human Services as a dual referral. This is another measure that has had significant time put into amendments, and I want to acknowledge the work done prior to this hearing.

I know staff from the authors office, Committee staff and sponsor and stakeholders have worked collaboratively. I want to recognize and thank everyone. We need to hold tight to our values as we move aging policy forward. The amendment taken last week removing the provisions relating to refusing service was a huge hurdle.

All involved seem to understand the need to see residents as fellow humans, and how we move forward demands longer, healthier conversation. Committee staff remain committed to working on that policy as soon as we end this session.

But we do need to find a balance here, and I wish we could have found a resolution before this Bill was heard today. It highlights the tight constraints we have when we are hearing bills in the second house.

I know the author recognizes the need to work with facilities that can operate under the constraints of this Bill, and we have to find a solution. Daily conversations are happening, and I'm confident by the time this Bill moves through the second policy Committee and appropriations, we will have language that all parties feel meets their needs.

We can't favor one type of facility over another. I want to support the Bill today moving forward, but will again stress that the author and sponsor work together to find resolution for facilities in financial distress. Anything you would like to add, Senator Allen to close?

No. I very much appreciate those comments and some sort of mechanism where folks in financial distress can get some more flexibility. One of the challenges is finding fairness across the board, nonprofits for profit. So the folks around the table know all about how we're struggling with trying to find some good common ground in the language.

But I do want to just reiterate my thanks. And it's true that there are some bad actors, but there are so many great actors in this space who are providing an important service for our elderly and for our aging, and we want to make sure that they're able to grow and thrive.

And ultimately, this is, quite frankly, about creating confidence in the market market so that families and people in need feel confident going to these facilities, that they're going to be well treated.

And hopefully, this Bill will actually reward all the good actors in the space because our families will feel better, will feel really confident about sending our loved ones to these facilities. That's what this is ultimately all about.

So it's in that spirit that I certainly appreciate your comments, Madam Chair, and look forward to continuing this work on honing various aspects of the Bill. There are some challenging things we continue to struggle with in terms of landing specifics, but I very much would appreciate the opportunity to continue work on this and ask for your aye vote.

Thank you so much. Any comments from the Committee?

Thank you very much for the work that you've put into it. I've worked with Senator Allen on great negotiations before, so I'm confident that you can come to an agreement. I just want to make sure that no unintended consequences come from this. For those good actors you mentioned, you know, the intent is for the bad actors.

The people that are doing right by our families should be able to. To find some remedy or to be compensated, or at least even if a kind word of, hey, you guys are doing a good job, because I think sometimes we tend to paint everybody with the same brush and the good actors are penalized over that.

So, again, I know that you will work with both sides to make sure that everybody or everything is done fairly and not really throw a wrench in the system. Want to commend you and thank you for working with the Senator to make sure that we come to an agreement. Thank you.

Item number four, SB 1406 by Senator Allen. [Roll Call] Item number four, SB 1406 by Senator Allen. [Roll Call]

Thank you. Assemblymember Rubio. All right, moved by Assemblymember Rubio. Seconded by Rodriguez Clark. Can you please call the roll? Oh, the motion is do pass. And re-referred to the Committee on Human Services.

Item number four, SB 1406 by Senator Allen. Doctor Baines. Aye. Mathis Cervantes. Aye. Assailey, Friedman, Rodriguez, aye. Blanco, Rubio. Aye. Aye. Assailey, Friedman, Rodriguez, aye. Blanco, Rubio. Aye.

Aye. Assailey, Friedman, Rodriguez, aye. Blanco, Rubio. Aye.

Assailey, Friedman, Rodriguez, aye. Blanco, Rubio. Aye.

That is five votes. The Bill is out. We will hold four additional Members that are absent. We have one last Bill, SB 1352, waiting for Senator Wahab.

Thank you so much, Senator Wahab, for joining us. If you can come forward and we'll get started on file item number three. SB 1352.

Thank you, guys. All right, chair colleagues and Members of the public, I'd like to thank the Committee for their work on the amendments I will be accepting them.

SB 1352 ensures independent living residents of continuing care retirement communities, also known as CCRCs, are made aware of their civil rights under the law when they sign contracts to live there. When independent living residents sign their contracts, the extent of their rights are not disclosed to them.

Many residents then remain unaware of their resident of their rights and feel uncertain about asserting them. CCRCs are licensed as residential care facilities for the elderly, also known as RCFEs. Existing law requires residents receive a copy of the CCRC Bill of Rights upon signing their contract.

SB 1352 requires resident also receive a copy of the RCFE Bill of Rights, and if they are moved to skilled nursing facility, a Bill of rights specific to them shall be provided.

I would like to introduce my first witness, Tony Chicotel, senior Staff Attorney of the California Advocates for nursing home reform, CANHR, and Margaret Griffin, President, California Continuing Care Residents Association. Thank you.

Good afternoon. Tony Chicotel with CANHR. CCRCs are identified by having multiple levels of care. That's what distinguishes them from other long term care facilities. They're each licensed differently. There's different sets of rights and levels of care related to the residents and different protections that we offer them through the regulations and statutes.

So matching the list of rights to the residents, SB 1352, matches the level of care to the residents rights that they are going to be informed of. It's simple, it's informative. Knowing the rights is the first step to making sure there's compliance with those rights. And oftentimes the most important step.

Residents of CCRCs tend to be pretty successful individuals, pretty savvy individuals, and I'm confident that being more aware, being made more aware of their rights will go a long way in ensuring better compliance in the facilities. So respectfully ask for your aye vote. Thank you.

Good afternoon. Good afternoon, Madam Chair, Members of the Committee. I'm Margaret Griffin, President of the California Continuing Care Residents Association, or CalCRA, resident of a CCRC in Davis. Calcra is the only organization whose sole purpose is representing and advocating for seniors living in CCRCs, and we are in strong support of SB 1352.

While it's true that all CCRCs are licensed as RCFEs, and the RCFE section of the Health and Safety Code does address residents being free from discrimination. But in addition to, hopefully our residents being competent, they're also in their eighties and nineties.

And even though we are covered by most sections of the RCFE statute, I really can only think of maybe a couple of my fellow residents who would think to look there for information on their rights.

They would be more likely to look at the CCRC section of the health and Safety Code, and there is a Bill of rights in that section. But to cite one deficiency, that list does not address the issue of discrimination. And with bullying discriminatory practices more evident in our society today, this omission is worse than problematic.

Current law does require that a copy of the CCRC rights be given to prospective residents prior to contract execution, that the rights be attached to every contract, and that they be prominently posted at the facility. But again, that version, that list of rights, does not address discrimination.

I'm aware of an incident at one CCRC where it was suggested to a gay couple that they tone it down a bit because management was concerned that they would get a reputation as being a gay facility.

Stipulating the anti discrimination provisions provided in SB 1352 and that they will be upheld is important, as these provisions will serve to inform, reassure and empower residents.

Since these rights are not specified in our section of the health and safety code, at the very least they need to be distributed to residents so that we can be aware of these rights and protections for your I vote. Thank you.

Thank you so much. Anyone in support of this Bill please come forward.

Madam Chair and Members of the Committee, Peter Kellison. On behalf of the California Assisted Living Association, we want to thank the author, her staff. Special thanks to your staff. We've had many discussions on this issue, lots of going around, and we're very pleased to support the Bill as amended here.

Anyone else in support? Anyone in opposition seeing and hearing? None. Thank you so much, Senator Wahab, for this Bill. Thank you for all the witnesses testifying the analysis reflects the clarifying amendments. Thank you so much for accepting them.

This morning, the Committee was notified that this Bill is now moving to the Assembly Committee on Human Services to expedite the process and allow them to hear this Bill next Tuesday. This Bill will move as a do pass and the clarifying amendments will be taken in the next Committee.

We ask for an aye vote. Thank you.

Thank you so much. SB 1352, Senator Wahab. Motion is do pass and we refer to the Committee on Human Services.

Any Members would like to express any questions or concerns moved by assemblymember Rubio? Seconded by someone, Member Essayli. Would you like to close? Senator Wahab.

Clerk, please call the roll.

[Roll Call]

Aye.

That is six. The Bill is out. We will keep the roll open for... we are good, thank you so much.

Oh, we are good. Thank you guys so much. File item SB 37 is now out with six votes.

[Roll Call]

SB 1249 is now out with six votes. Roll call for file item four.

[Roll Call]

The Bill is out. Ayes five no's, one. We will now adjourn this meeting. Thank you guys so much.