By Deborah Schoch, Center for Health Reporting
Gov. Jerry Brown signed into law Monday a bill imposing a 100-fold increase in the top fine for violations of state regulations at assisted-living homes for the elderly.
The top fine will now be $15,000, for violations causing death or serious injury, up from $150.
The relatively low fines were highlighted in a series of stories produced last year by the CHCF Center for Health Reporting and the U-T San Diego. The series focused on 27 deaths and hundreds of injuries at homes in San Diego County caused by abuse and neglect.
The bill to increase fines, co-authored by Assemblyman Brian Maienschein, (R-San Diego), was amended during the legislative process to allow a four-step appeals process. Also, a proposal to boost fines for some lesser offenses to $1,000 from $150 was removed from the bill amid lobbying from smaller assisted living homes.
Brown’s signature on the fine increase came one day after he signed nine other bills tightening state oversight of the more than 7,500 assisted-living homes in California, marking the state’s most sweeping overhaul of the industry in nearly three decades.
For the first time, assisted living residents will have a statutory bill of rights like the one protecting nursing home residents.
The homes’ staffs also will face stiffer training requirements, and owners will pay higher licensing fees. A staff member with CPR training must be present at homes at all times, and operators will be prohibited from punishing employees who call 911 to get emergency care for sick residents.
Brown’s signature on the reform package is a major victory for assisted living residents, said Patricia McGinnis, executive director of California Advocates for Nursing Home Reform, the state’s largest advocacy group for long-term care residents.
“We look at it as a good start,” said McGinnis. “But we’re not finished by any stretch of the imagination. And I don’t think the legislators are, either. I think they like the fact that they’re going to be changing people’s lives on an immediate basis.”
Many of the assisted-living bills that Brown did sign were backed by McGinnis's group and the California Assisted Living Association, the state’s largest industry association.
Both groups had pulled their support of the bill to raise fines after it was, in their view, weakened.
Four San Diego legislators played key roles in the reform effort: Democratic Assembly Speaker Toni Atkins and Democratic Sen. Marty Block; and Republican Assembly members Brian Maienschein of San Diego and Marie Waldron of Escondido.
Brown signed Atkins’ bill last month requiring that all assisted living facilities carry liability insurance. Brown signed Block’s two bills Sunday.
Block said he intentionally chose the bill name SB-911 for one of his measures, which will protect facility employees who call for emergency care for sick residents. Some employees have said they fear calling 911 because managers say it reflects badly on a home’s record, he said.
The same bill raises the training mandate for administrators to 80 hours from 40. Brown also has signed a parallel bill, authored by Assembly Member Wesley Chesbro, D-Arcata, requiring more training for staff caring for residents, including those with dementia.
Sally Michael, president of the industry group California Assisted Living Association -- which, along with McGinnis’ group, supported a number of the reform measures -- said it is pleased by Brown’s actions, particularly his signing of the Chesbro bill and Block’s SB 911.
“These bills increase the number of hours required for assisted living caregiver and administrator training. They also improve the administrator testing process by making it more rigorous,” Michael said.
Block’s second bill boosts facility licensing fees by 10 percent, which, coupled with the administration’s separate 10 percent increase, will boost fees by 20 percent.
Block initially proposed a 30 percent increase. He said Monday that for now, the 20-percent hike is enough to provide much needed funds to the Department of Social Social Services, which regulates assisted living homes.
“This will be a game changer in terms of funding more inspections and other services,” Block said.
The other assisted living bills that Brown signed Sunday:
- SB 895, mandating that homes fix problems found during state inspections within 10 days of being notified (Sen. Ellen Corbett, D-Hayward).
- SB 1153, giving state regulators the power to halt new admissions to an assisted living home that has not immediately fixed major violations (Sen. Mark Leno, D-San Francisco).
- AB 1751, requires residents to be represented on assisted living homes’ governing boards (Richard H. Bloom, D-Santa Monica).
- AB 1899, requires that if an operator’s license is revoked or given up for abandoning a facility, that operator cannot get the license reinstated (Cheryl R. Brown, D-San Bernardino).
- AB 2044, mandates that a supervisor or trained substitute be at the home 24 hours a day (Freddie Rodriguez, D-Chino).
- AB 2171, Establishes a bill of rights for assisted living residents similar to the bill now protecting residents of California nursing homes (Bob Wieckowski, D-Fremont).
Including reform bills previously signed by Brown, the governor has approved all 13 assisted living bills passed by the Legislature.
Four other bills failed to muster the needed votes and get to his desk, including a bill requiring annual inspections of homes – now inspected a minimum of every five years – which foundered in the state Senate. Several legislators predict that a similar bill will be proposed next year. Another bill that would have required the state to build an online consumer rating system so that consumers could compare facilities on quality also failed to get the governor's desk.
The CHCF Center for Health Reporting partners with news organizations to cover California health policy. Based at the University of Southern California’s Annenberg School for Communication and Journalism, the Center is funded by the nonprofit California HealthCare Foundation.