Legislation March 2017
Support
AB 286 (Gipson): To Allow Medi-Cal Beneficiaries to Return Home
Under current law, a Medi-Cal beneficiary in a nursing home is allowed to retain $209 per month for a “home upkeep allowance” if a physician has certified that the resident is likely to return home within 6 months - while the rest of the resident’s income must go to pay the share of cost. The allowance of $209 has not changed in decades and is insufficient to maintain a home of any value in California. As a result, Medi-Cal beneficiaries who could otherwise go home within 6 months, end up losing their homes or apartments and having to stay long term in the nursing home at the expense of Medi-Cal. AB 286 would change this poor public and economic policy, by basing the upkeep allowance on the actual minimum cost of maintaining the resident’s home. This common sense proposal would not only enable residents to avoid losing their homes, but save needed Medi-Cal resources by reducing the costs of long-term care.
AB 550 (Reyes): Restoring Funding for Long-Term Care Ombudsman Programs
In 2008, the 35 local Long-Term Care Ombudsman (LTCO) programs had all of their state funding cut, leading to enormous reductions in staff and services for residents of long-term care facilities. Since then, the programs have had only sporadic and insufficient funding from the state despite larger numbers of residents to serve. AB 550 partially remedies this problem, by boosting the base funding allocation to the LTCO programs and adding $2.25M in total funding.
AB 275 (Wood): Strengthening Closure Protections for Nursing Home Residents
AB 275 would take modest steps to enhance protections for nursing home residents during a closure by requiring greater advance notice of a closure, clarifying the Department of Public Health’s authority to reject closure plans, and requiring facilities to prepare a community impact report if two or more facilities are planning to close on the same date. The bill responds to a months-long crisis in Eureka in 2016 when Shlomo Rechnitz – who owns all five freestanding skilled nursing facilities in Eureka – threatened to close three of them in an effort to obtain higher Medi-Cal payments for the facilities.
AB 859 (Eggman): Protecting Seniors Abused by Nursing Homes
This bill will protect seniors and dependent adults abused in nursing homes and discourage facilities from intentionally destroying evidence in violation of the law. AB 859 provides that when a judge or arbitrator finds the nursing home has illegally destroyed evidence, the standard of care is reduced from clear and convincing to preponderance of the evidence. Currently the only remedy for the intentional and willful destruction of evidence in such cases is a discretionary sanction or a jury instruction by the judge. AB 859 ensures that such illegal and willful destruction of evidence will not be tolerated.
AB 937 (Eggman): Patients Should Control End of Life Care
This bill will fix a longstanding terrible problem whereby anyone could overrule the written end of life care wishes of a patient through the use of a Physician Order for Life Sustaining Treatment (POLST) form. Current law states that when a request regarding end of life care in a POLST conflicts with a previously signed health care directive, the POLST prevails. The problem is that POLSTs do not need to be signed by the patient, in fact, they can be signed by anyone. Thus, third parties have the effective power to overrule a patient’s expressed wishes. AB 937 fixes this problem by stating that the most recent wishes expressed by the patient herself prevail in any conflict of instructions.
AB 940 (Weber): Transfer and Discharge Notices to Long-Term Care Ombudsman
This bill codifies a federal regulation that requires nursing homes to send copies of resident transfer or discharge notices to the local long-term care Ombudsman. The bill adds a requirement the copy be sent within 24 hours of issuing the notice and specifies enforcement action for non-compliance.
SB 202 (Dodd): Medi-Cal Personal Needs Allowance
This bill would increase the personal needs allowance for residents of long term care facilities from $35 per month to $80 per month.
SB 219 (Weiner): LGBT Senior Bill of Rights
SB 219 prohibits long-term care facilities from taking discriminatory actions based on a resident’s actual or perceived sexual orientation, gender identity, gender expression, or HIV status. It also imposes penalties for violation of these rights and requires facilities to post a notice regarding these practices alongside its current nondiscrimination policies.
Oppose
AB 1026 (Dababneh): Public Financing of For-Profit Nursing Homes Chains
This bill would make low-cost financing and loan guarantees available to for-profit nursing homes through the California Health Facilities Financing Authority Fund and the Health Facility Construction Loan Insurance Fund. These actions would betray the mission of these programs to help nonprofit and public health facilities reduce their cost of capital and would enable the expansion of for-profit nursing home chains that are providing poor quality of care to their residents. Status: Assembly Health
DHCS Trailer Bill Legislation: 610: Fifty Percent Rule and Personal Injury Lien Recovery
The Department of Health Care Services’ trailer bill proposal to amend the laws regarding recovery from personal injury cases should be rejected and the issue should be moved to the policy arena where it belongs. The Department’s proposal to eliminate the 50% recovery rule for personal injury liens should be rejected entirely. This proposal is inequitable to victims of abuse and neglect and will ensure that, rather than increase recoveries, few, if any, aged and disabled abuse victims will even want to pursue justice.
While the Department contends that their proposal will result in increased General Funds, the proposed 100% rule will clearly have the opposite effect and result in additional General Fund losses. If the abused victim will recover nothing – and nothing is what they would recover under the Department’s proposal – there is no incentive to bring a lawsuit. Thus the parties who injured them will pay nothing to the victim or to the state.
Much of the abuse and neglect that occurs in our nursing homes can be directly attributed to the ongoing and systematic failures of the Department of Health’s oversight and enforcement system. It is reprehensible for the Department to seek the lion’s share of a recovery of a pain and suffering award from a deceased elder or dependent adult.
Federal Proposed Laws
HR 1215 - OPPOSE
Congress is fast tracking considering a bill that will effectively end California’s 20-plus year civil protection system for victims of elder abuse or neglect perpetrated by health care providers
H.R. 1215 is a corporate wish list of anti-justice measures to immunize health care providers from accountability for terrible care by limiting justice for victims of health care malpractice. The bill is misleadingly named the “Protecting Access to Care Act of 2017.” A more apt name for H.R. 2115 would be “Obstruction of Justice for the Injured”
While California already has a $250,000 cap on non-economic damages – the centerpiece of H.R. 1215 - elder and dependent adult abuse cases are rightfully exempt. H.R. 1215 would end this critical exemption. H.R. 1215 inoculates an entire class of professionals and the health care industry from being held liable when their actions fall below, even far below, the acceptable standards or when they intentionally hurt a patient.
Affordable Care Act Repeal – OPPOSE
The American Health Care Act is the repeal and replacement of the Affordable Care Act, which enabled approximately 22 million Americans to access health care coverage. With no hearings and no budget estimate from the nonpartisan Congressional Budget Office, the House Republicans hope to move the bill to the full house by early April without addressing how much the bill will cost and how Americans who are currently covered will be impacted. This bill will slash funding for the federal Medicaid program, unfairly target older adults for cuts in services and make it much harder for Americans to access long term care.
