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SB-980 Veterans’ homes.(2015-2016)

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SB980:v96#DOCUMENT

Amended  IN  Assembly  June 22, 2016
Amended  IN  Senate  May 31, 2016
Amended  IN  Senate  April 26, 2016

CALIFORNIA LEGISLATURE— 2015–2016 REGULAR SESSION

Senate Bill
No. 980

Introduced by Senator Nielsen

February 10, 2016

An act to amend Sections 1010, 1012, 1012.1, 1012.2, 1012.3, 1023, 1034, 1035.3, 1038, 1038.5, and 1044 of, to add Sections 79.3, 79.4, 1011.1, 1011.2, 1011.3, and 1011.4 to, to repeal Sections 1012.4, 1012.6, 1014, 1015, 1024, 1033.2, and 1051 of, and to repeal and add Section 1011 Sections 1011 and 1012.4 of, the Military and Veterans Code, relating to veterans, and making an appropriation therefor. veterans.


LEGISLATIVE COUNSEL'S DIGEST


SB 980, as amended, Nielsen. Veterans’ homes.
Existing law provides for the establishment and operation of veterans’ homes at various sites, and provides for an administrator of each home, as specified. Existing law establishes the duties of the Department of Veterans Affairs with regard to the establishment and regulation of veterans’ homes.
This bill would revise and recast those provisions. Among other things, the bill would provide that the administrator is the senior executive appointed to oversee the operations of a veterans’ home. The bill would specify which veterans’ homes are administered by the Department of Veterans Affairs. The bill would require the Secretary of Veterans Affairs to adopt uniform statewide policies and procedures, by regulation, for the operation of those veterans’ homes, as specified. The bill would require the secretary to implement a statewide electronic medical record system for veterans’ homes by a specified date. The bill would require the secretary to annually report to the Senate and Assembly Committees on Veterans Affairs, as specified.
Existing law establishes the criteria for admission to a veterans’ home, as specified. Existing law establishes the fees and charges for residency, as established by each administrator of a home, and requires each administrator to adopt rules and regulations for the administration of the homes.
This bill would instead require that the fees and charges be established by the secretary, rather than by each administrator, and that the secretary adopt rules and regulations that apply to the homes and the criteria for admission. The bill would authorize the secretary to establish needs-based criteria for admission to veterans’ homes, homes and to prioritize admission for veterans with service-related disabilities, as specified.
Existing law authorizes a resident spouse to continue his or her residency after a veteran spouse’s death.
This bill would require a resident spouse who continues residency after a veteran spouse’s death to continue to pay all applicable fees and to comply with all department regulations. regulations, and would expand those provisions to include domestic partners.
Existing law authorizes the department to investigate a veteran’s financial status for admission purposes.
This bill would further authorize the department to determine the total worth of any member’s property or assets for purposes of admission, including to validate income levels for purposes of establishing fees. a resident’s or applicant’s income or suitability for residence at a veterans’ home and would provide that providing false information or failure to pay fees is grounds for financial penalties or discharge from a veterans’ home.
Existing law requires 100% of the moneys received by a veterans’ home from veterans receiving federal aid to be placed to the credit of the home to augment the current appropriation for the support of the home.
This bill would delete that provision, and would instead require moneys received by a veterans’ home from those veterans to be deposited into the Federal Trust Fund, a continuously appropriated fund, to be used for the operating costs of the home. Because the moneys would be continuously appropriated for those purposes, the bill would make an appropriation. provision.
Existing law requires members of a veterans’ home to pay fees and charges as determined by the department, subject to a specified fee schedule.
This bill would prohibit the fees paid by a member from exceeding the average costs of care for the level of care in which the member currently resides. provide that failure to pay fees is cause for the administrator to refer the resident to collections or dismiss the resident from the home.
Existing law, upon the death of a veteran in a home, requires any moneys not in excess of $3,000 held by the home for the veteran to be paid to the home’s Morale, Welfare, and Recreation Fund, if no will or heir or other family member is discovered within a specified number of years after his or her death.
This bill would increase the amount that may be transferred to $15,000.
Existing law, upon the departure of a veteran from a home, requires any moneys not in excess of $3,000 held by the home for the veteran to be paid to the home’s Morale, Welfare, and Recreation Fund, if the money is not requested by the veteran within a specified number of years after his or her departure.
This bill would increase the amount that may be transferred to $5,000.
This bill would make other conforming changes and would delete obsolete provisions and references, as specified.
Vote: MAJORITY   Appropriation: YESNO   Fiscal Committee: YES   Local Program: NO  

The people of the State of California do enact as follows:


SECTION 1.

 Section 79.3 is added to the Military and Veterans Code, to read:

79.3.
 (a) Notwithstanding any other law, the department may adopt, amend, or repeal regulations concerning the administration and operation of the Veterans’ Home of California. Except as otherwise provided, these regulations shall be adopted pursuant to the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code).
(b) The department may adopt, amend, and repeal emergency regulations concerning the administration and operation of the Veterans’ Home of California in compliance with Section 11346.1 of the Government Code. However, if special circumstances, as defined in subdivision (c), are present, then those regulations shall not be subject to the requirements regarding findings of emergency in paragraph (2) of subdivision (b) of Section 11346.1 of the Government Code.
(c) Special circumstances shall be deemed to exist if the Secretary of Veterans Affairs states in writing that the adoption, amendment, or repeal is necessary for one or more of the following reasons:
(1) The possible loss or delay in the receipt of federal, state, or local funding.
(2) The need to maintain licensing or certification by any state or federal agency for any Veterans’ Home of California facility or program.
(3) The need to protect against a serious and immediate threat to the health or safety of residents or staff in one or more of the facilities of the Veterans’ Home of California.
(4) The urgent need to comply immediately with recommendations of the Department of Finance or the California State Auditor.

SEC. 2.

 Section 79.4 is added to the Military and Veterans Code, to read:

79.4.
 (a) The department shall do all of the following concerning the operation and administration of the veterans’ homes:
(1) Take the necessary steps to ensure that all medical or other facilities under its jurisdiction satisfy all applicable federal and state licensing, certification, and other approval requirements, including, but not limited to, the requirements of the United States Department of Veterans Affairs, the federal Centers for Medicare and Medicaid Services, the State Department of Public Health, the State Department of Social Services, and the California State Board of Pharmacy, including preparation of plans of correction as required.
(2) Develop and maintain clinical policies and procedures, including both of the following:
(A) Community standards for best clinical practices, including, but not limited to, practices recommended by the federal Centers for Disease Control and Prevention and the federal Centers for Medicare and Medicaid Services.
(B) The appropriate clinical standard of practice.
(3) Adopt fire and life safety policies and procedures consistent with the requirements of the State Fire Marshal and other applicable regulatory and licensing agencies.
(4) Adopt earthquake and environmental protection policies and procedures.
(b) The department may adopt regulations to implement this section. The adoption, amendment, or repeal of a regulation authorized by this section is hereby exempted from the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code).

SECTION 1.SEC. 3.

 Section 1010 of the Military and Veterans Code is amended to read:

1010.
 As used in this chapter, the following terms have the following meanings:
(a) “Administrator” means the senior executive appointed to oversee the operations of a home.
(b) “Department” means the Department of Veterans Affairs.
(c) “Deputy secretary” means the Deputy Secretary of Veterans Homes. Affairs.
(d) “Director” or “secretary” means the Secretary of Veterans Affairs.
(e) “Home” means any facility operated by the department for the provision of long-term care, assisted living, adult day health, independent living, or other health care services to eligible veterans.
(f) “Member” means any veteran or nonveteran spouse or domestic partner who has been admitted to residency at any home.
(g) “Veteran” means a person who is eligible for benefits under this chapter.

SEC. 2.SEC. 4.

 Section 1011 of the Military and Veterans Code is repealed.

SEC. 3.SEC. 5.

 Section 1011 is added to the Military and Veterans Code, to read:

1011.
 There is in the department a Veterans’ Home of California, which the department shall administer. The Veterans’ Home of California is a system comprising the following subsidiary home locations:
(a) The Veterans’ Home of California, Yountville, in Napa County.
(b) The Veterans’ Home of California, Barstow, in San Bernardino County.
(c) The Veterans’ Home of California, Chula Vista, in San Diego County.
(d) The Veterans’ Home of California, West Los Angeles, in Los Angeles County.
(e) The Veterans’ Home of California, Lancaster, in Los Angeles County.
(f) The Veterans’ Home of California, Ventura, in Santa Barbara County.
(g) The Veterans’ Home of California, Fresno, in Fresno County.
(h) The Veterans’ Home of California, Redding, in Shasta County.

SEC. 4.SEC. 6.

 Section 1011.1 is added to the Military and Veterans Code, to read:

1011.1.
 (a) The secretary shall adopt uniform statewide policies and procedures, by regulation, in accordance with the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), for the operation of the homes. The policies and procedures shall be in conformity, as nearly as possible, to the rules and regulations of the with all relevant licensing and certification agencies, including, but not limited to, the United States Department of Veterans Affairs for their facilities and Affairs, the federal Centers for Medicare and Medicaid Services, the State Department of Social Services, and the State Department of Public Health to ensure that adequate care and a homelike environment is provided in a cost-effective manner for members of the homes.
(b) These policies and procedures shall implement the requirements to obtain and maintain required licenses and accreditations, as well as to ensure members in all homes throughout the state, to the extent possible, receive equitable treatment, benefits, and services, and to ensure that high-quality care is provided.
(c) These policies and procedures shall include, but are not limited to, all of the following:
(1) The admission of applicants.
(2) The conditions upon which members may enter and remain in the home.
(3) Resident disciplinary procedures.
(4) Quality of care standards.
(5) An internal quality of care review process.
(6) Delineating which services will be provided to members by the state.
(7) Setting staffing standards.
(8) Staff training requirements.

(9)Establishment and operation of allied councils.

(9) Clarifying the relationship between the department and allied councils.
(10) Any other policies and procedures to ensure the safe and effective operation of the homes.

SEC. 5.SEC. 7.

 Section 1011.2 is added to the Military and Veterans Code, to read:

1011.2.
 (a) There shall be an administrator for each home, who shall be recommended by the secretary and appointed by the Governor, and who shall be located at that home. The salary for each administrator shall be subject to the approval of the Department of Human Resources.
(b) The administrator shall be responsible for ensuring compliance with all state and federal statutes and regulations related to the operation of the home and for implementation of all statewide policies and procedures, as specified in Section 1011.1.

SEC. 6.SEC. 8.

 Section 1011.3 is added to the Military and Veterans Code, to read:

The

1011.3.
 (a) It is the intent of the Legislature that the department submit the report required pursuant to this section at a level of detail that will provide the Legislature and the public with indicators of the quality of both the health care and the management of facilities of the Veterans’ Home of California without compromising members’ privacy while still in compliance with applicable law and regulation. By submitting consistent indicators over the long term, the Legislature will be able to readily see significant changes and more effectively perform its oversight functions.
(b) The secretary shall make an annual report to the Senate and Assembly Committees on Veterans Affairs by January 1 of each year, beginning January 1, 2018, reporting on April 1 of each year, beginning April 1, 2018. This report shall be in compliance with the federal Health Insurance Portability and Accountability Act (HIPAA) (Public Law 104-191) and all relevant laws and regulations related to patient privacy or other protected information. This report shall reflect significant veterans veterans’ home-related performance issues, which shall include, but are not limited to, all of the following:

(a)

(1) Current census and census changes since last report.

(b)

(2) Any major changes to home policy and the impact of those changes on the residents.

(c)

(3) Changes in provision of care, including licensure changes.

(d)

(4) Significant events that impacted the operations of the home.

(e)Results of regulatory agency inspections or reviews and corrective action taken to address findings.

(5) Copies of annual licensing survey records.

(f)

(6) Significant patient care complaints, results of any investigations into those complaints, and any corrective action taken to address validated complaints.

(g)Results of internal quality of care reviews.

(h)A comparison of veterans home quality of care metrics to industry averages.

(7) Copies of available data from licensing agencies comparing veterans’ home quality of care metrics to industry averages.

(i)

(8) Other significant issues that may be of interest to the committee members.

SEC. 7.SEC. 9.

 Section 1011.4 is added to the Military and Veterans Code, to read:

1011.4.
 (a) On or before January 1, 2018, 2019, the secretary shall implement an electronic medical record system. The usage of the electronic medical record system shall be standardized in all homes.
(b) The electronic medical record system required by this section, and all transactions made in that system, shall comply with the Confidentiality of Medical Information Act (Part 2.6 (commencing with Section 56) of Division 1 of the Civil Code), Chapter 1 (commencing with Section 123100) of Part 1 of Division 106 of the Health and Safety Code, the Information Practices Act of 1977 (Chapter 1 (commencing with Section 1798) of Title 1.8 of Part 4 of Division 3 of the Civil Code), the federal Health Insurance Portability and Accountability Act (HIPAA)(Public (HIPAA) (Public Law 104-191), the federal Health Information Technology for Economic and Clinical Health Act (HITECH) (Public Law 111-005), and all corresponding regulations relating to privacy and security.

SEC. 8.SEC. 10.

 Section 1012 of the Military and Veterans Code is amended to read:

1012.
 (a) The home is for aged and disabled persons who served in the Armed Forces of the United States, who were discharged or released from active duty under honorable conditions from service, who are eligible for hospitalization or domiciliary care in a veterans’ facility in accordance with the rules and regulations of the United States Department of Veterans Affairs, are unable to pay for necessary domiciliary and licensed long-term care outside the home, and who are bona fide residents of this state at the time of application; and for the spouses of these persons if all of the following conditions, as are applicable, are satisfied:
(1) Space is available.
(2) Joint residency will be in the best interests of the home member, as determined by the administrator.
(3) The spouse is a bona fide resident of this state at the time of application for admission to the home and either is married to, and has resided with, the home member for at least one year, or is the widow or widower of a recipient of the Medal of Honor or a former prisoner of war (POW).
(4) The home member and spouse agree to pay the fees and charges for joint residency, or for a widow or widower, that the secretary may establish.
(b) (1) Veterans who qualify for benefits under this chapter due to service during a time of war shall be given priority over veterans who qualify due to service during a time of peace.
(2) Veterans who qualify for benefits under this chapter who are recipients of the Medal of Honor or who were prisoners of war (POWs) shall be given priority over all other qualified veterans, regardless of the level of care required.

(3)

(3) Veterans who qualify for benefits under this chapter who have disability ratings that have been rated by the United States Department of Veterans Affairs as being service-connected, as determined under Part 4 of Title 38 of the Code of Federal Regulations, may be given priority over other veterans.
(4) The secretary may establish needs-based criteria for admission to the homes, and any veteran meeting those criteria shall be given priority over veterans who do not qualify for prioritization under paragraph (2) or (3) and can afford to provide for their own care elsewhere.
(c) A resident spouse or domestic partner may continue residence after the veteran’s death, so long as he or she continues to pay all applicable fees and comply with the department’s policies, procedures, and regulations.
(d) The property of the home shall be used for this purpose.

SEC. 9.SEC. 11.

 Section 1012.1 of the Military and Veterans Code is amended to read:

1012.1.
 (a) Prior to the admission of a veteran an applicant as a member of the a veterans’
home, and at any time during which a veteran person is a member of the a veterans’ home, the department may investigate any applicant’s or member’s financial status and personal background to determine the total value of the property and assets of any veteran applying for admission to the home, or to ensure that the member is unable to pay for necessary care outside of the home, or to validate income levels for the purposes of establishing fees. the member’s or applicant’s income and suitability for residence at a veterans’ home. The department may contract with any other state or federal agency or private entity to conduct such an investigation in on its behalf.
(b) Providing false financial and other information by an applicant or member or nonpayment of fees may be grounds for financial penalties or denial of admission to, or discharge from, a veterans’ home.

SEC. 10.SEC. 12.

 Section 1012.2 of the Military and Veterans Code is amended to read:

1012.2.
 (a) (1)Notwithstanding any other law, any member of the home who is receiving an aid and attendance allowance from the United States Department of Veterans Affairs and who has no dependent spouse, child, grandchild, father, or mother shall pay to the home an amount equal to that allowance in all levels of care excluding domiciliary.

(2)Paragraph (1)

(b) Subdivision (a) shall not apply to a member of the home who is in intermediate care or skilled nursing care and has a disability that has been rated by the United States Department of Veterans Affairs as being 70 percent or more service-connected, as determined under Part 4 of Title 38 of the Code of Federal Regulations.

(b)Moneys received by a home under this section shall be deposited into the Federal Trust Fund and shall be used for the operating costs of the home.

SEC. 11.SEC. 13.

 Section 1012.3 of the Military and Veterans Code is amended to read:

1012.3.
 (a) Members of the home, including members who are nonveteran spouses, spouses or domestic partners, shall pay fees and charges as determined by the department, department to cover room and board, except that the total of the individual member’s fees and charges for any fiscal year shall not be greater than as set forth in the following schedule:
(1) Forty-seven and one-half percent of the member’s annual income for domiciliary care.
(2) Fifty-five percent of the member’s annual income for residential care for the elderly or assisted living.
(3) Sixty-five percent of the member’s annual income for intermediate care.
(4) Seventy percent of the member’s annual income for skilled nursing care.
(b) Subdivision (a) shall not apply to a member of the home who is in intermediate care or skilled nursing care and has a disability that has been rated by the United States Department of Veterans Affairs as being 70 percent or more service-connected, as determined under Part 4 of Title 38 of the Code of Federal Regulations and whose related payments made under Section 51.41 of Title 38 of the Code of Federal Regulations are considered by the United States Department of Veterans Affairs as payment in full for the member’s care.

(c)Fees paid by a member shall not exceed the average cost of care for the level of care in which the member currently resides.

(c) Subdivision (a) shall not apply to penalties for late fee payment.
(d) Failure to pay the required fees shall be cause for the administrator to refer the resident to collections or dismiss the resident from the home.
(e) Retroactive benefit payments from the United States Department of Veterans Affairs shall be subject to subdivision (a) for the period of the time covered by the benefit award that the veteran resided at a veterans’ home. The veterans’ home shall recompute the fees and charges previously determined for the benefit period, and the resident shall be billed for the full amount of fees and charges due for the benefit period.

SEC. 12.SEC. 14.

 Section 1012.4 of the Military and Veterans Code is repealed.

SEC. 15.

 Section 1012.4 is added to the Military and Veterans Code, to read:

1012.4.
 Notwithstanding Section 1012, the department may arrange by contract or any other form of agreement with the United States Department of Veterans Affairs to leverage federal contracts for the procurement of goods and services.

SEC. 13.SEC. 16.

 Section 1012.6 of the Military and Veterans Code is repealed.

SEC. 14.SEC. 17.

 Section 1014 of the Military and Veterans Code is repealed.

SEC. 15.SEC. 18.

 Section 1015 of the Military and Veterans Code is repealed.

SEC. 16.SEC. 19.

 Section 1023 of the Military and Veterans Code is amended to read:

1023.
 (a) The department may sue and be sued in any of the courts of this state. All property held by the department for the home shall be held in trust for the state and for the use and benefit of the home. The secretary shall adopt rules and regulations for the administration of the homes conforming as nearly as possible to the rules and regulations of the United States Department of Veterans Affairs and those of other states with veterans’ homes.
(b) The Director of General Services may lease or let any real property held by the department for the home, and not needed for any direct or immediate purpose of the home, to any entity or person upon terms and conditions determined to be in the best interests of the home. All moneys received in connection therewith shall be deposited in the General Fund as a reimbursement for operating costs of the home.

SEC. 17.SEC. 20.

 Section 1024 of the Military and Veterans Code is repealed.

SEC. 18.SEC. 21.

 Section 1033.2 of the Military and Veterans Code is repealed.

SEC. 19.SEC. 22.

 Section 1034 of the Military and Veterans Code is amended to read:

1034.
 Except money received from this state for disbursement, all moneys received by the home, or by any officer of the home, including pension and other moneys belonging to veterans and other trust moneys, shall be immediately paid to the administrator of the home. On or before the 10th day of each month, the administrator of the home shall forward to the Treasurer all moneys in his or her possession, except pension and other moneys belonging to veterans, trust moneys, the post funds, the emergency fund, and donations made to each home, hereinafter mentioned, together with a statement of the sources from which the moneys have been received. The moneys shall be deposited by the Treasurer to the credit of the General Fund; provided, however, that abatements of support expenditures shall be credited to the support appropriation current at the time of collection.

SEC. 20.SEC. 23.

 Section 1035.3 of the Military and Veterans Code is amended to read:

1035.3.
 (a) If no will or heir is discovered within two years after the death of the veteran, any moneys not exceeding fifteen thousand dollars ($15,000) held by the home pursuant to Section 1035 and not paid or otherwise delivered to the heir or heirs or pursuant to the will of the deceased veteran, or otherwise disbursed by the administrator pursuant to Section 1035, shall be paid to the Morale, Welfare, and Recreation Fund.
If no will or heir is discovered within five years after the death of the veteran, any moneys exceeding fifteen thousand dollars ($15,000) held by the home pursuant to Section 1035 and not paid or otherwise delivered to the heir or heirs or pursuant to the will of the deceased veteran, or otherwise disbursed by the administrator pursuant to Section 1035, shall be paid to the Morale, Welfare, and Recreation Fund.
This subdivision applies only to veterans becoming members of the home on or after January 1, 1984.
(b) If no spouse, child, grandchild, or father or mother is discovered within two years after the death of the veteran, any moneys not exceeding fifteen thousand dollars ($15,000) held by the home pursuant to Section 1035 and not paid or otherwise delivered to the spouse, children, grandchildren, or father or mother, or otherwise disbursed by the administrator pursuant to Section 1035, shall be paid to the Morale, Welfare, and Recreation Fund.
If no spouse, child, grandchild, or father or mother is discovered within five years after the death of the veteran, any moneys exceeding fifteen thousand dollars ($15,000) held by the home pursuant to Section 1035 and not paid or otherwise delivered to the spouse, children, grandchildren, or father or mother, or otherwise disbursed by the administrator pursuant to Section 1035, shall be paid to the Morale, Welfare, and Recreation Fund.
This subdivision applies only to veterans who have become members of the home prior to January 1, 1984.

SEC. 21.SEC. 24.

 Section 1038 of the Military and Veterans Code is amended to read:

1038.
 All money deposited with the home for a veteran shall be paid to him or her on demand, upon his or her discharge or voluntary departure from the home. If the money is not so demanded at the time of his or her discharge or departure or within a period of two years thereafter, if the amount does not exceed five thousand dollars ($5,000), or within a period of five years thereafter, if the amount exceeds five thousand dollars ($5,000) either by the veteran, or, in the event of the veteran’s death after his or her discharge or departure, by the veteran’s heirs, devisees, legatees, or qualified executor or administrator of his or her estate, the money shall be paid to the Morale, Welfare, and Recreation Fund.

SEC. 25.

 Section 1038.5 of the Military and Veterans Code is amended to read:

1038.5.
 Any money deposited with the home by a veteran member shall be credited with interest at no more than the State Monetary Investment Fund rate, less 0.75 percent, interest, pursuant to Section 51.60 of Title 38 and Section 483.10 of Title 42 of the Code of Federal Regulations, and shall be paid to the veteran member or to his or her heirs, devisees, legatees, or the qualified executor or the administrator of his or her estate pursuant to Section 1037 or Section 1038.

SEC. 22.SEC. 26.

 Section 1044 of the Military and Veterans Code is amended to read:

1044.
 The secretary may adopt rules and regulations governing the admission of applicants and may prescribe the conditions upon which they may enter and remain with the home.

SEC. 23.SEC. 27.

 Section 1051 of the Military and Veterans Code is repealed.