Amended  IN  Senate  June 24, 2021

CALIFORNIA LEGISLATURE— 2021–2022 REGULAR SESSION

Assembly Bill
No. 499


Introduced by Assembly Member Blanca Rubio
(Coauthor: Assembly Member Calderon)

February 09, 2021


An act to repeal and add Section 1569.47 of the Health and Safety Code, relating to referral sources.


LEGISLATIVE COUNSEL'S DIGEST


AB 499, as amended, Blanca Rubio. Referral source for residential care facilities for the elderly: duties.
(1) The California Residential Care Facilities for the Elderly Act generally requires the State Department of Social Services to license, inspect, and regulate residential care facilities for the elderly and imposes criminal penalties on a person who violates the act or who willfully or repeatedly violates any rule or regulation adopted under the act. The act prohibits a placement agency, as defined, from placing an individual in a licensed residential care facility for the elderly if the individual, because of a health condition, cannot be cared for within the limits of the license or requires inpatient care in a health facility. The act requires an employee of a placement agency who knows, or reasonably suspects, that a facility is improperly operating without a license to report the facility to the department, and requires the department to investigate those reports. The act further requires a placement agency to notify the appropriate licensing agency of any known or suspected incidents that would jeopardize the health or safety of residents in a facility. The act specifically makes a violation of these requirements a crime.
This bill would recast the requirements on a placement agency and its employees to instead be requirements on a referral source, defined to mean a person or entity that provides a referral to a residential care facility for the elderly, as specified. any specified county department, stated-funded program, agency, or person that is engaged in identifying senior housing options at residential care facilities for the elderly. The bill would prohibit a referral source from, among other things, referring a person to a residential care facility for the elderly in which the referral source has an ownership or management interest without a waiver. The bill would require a referral source, before sending a compensated referral to a residential care facility for the elderly, to provide a senior person or their representative with specific written, electronic, or verbal disclosures that include, among others, the referral source’s privacy policy. The bill would additionally require a compensated referral source to comply with additional requirements that include, among others, maintaining a minimum amount of liability insurance coverage. The bill would impose criminal penalties and civil penalties for a violation of these provisions, as specified. By expanding the existing crime under the act and specifying new criminal penalties, this bill would impose a state-mandated local program.
(2) The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: YES  

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


SECTION 1.

 Section 1569.47 of the Health and Safety Code is repealed.

SEC. 2.

 Section 1569.47 is added to the Health and Safety Code, to read:

1569.47.
 (a) The following definitions shall apply to this section:
(1) “Compensated referral” means a referral by a private, for-profit or nonprofit agency that is engaged in the business of referring persons to residential care facilities for the elderly in exchange for any consideration or thing of value, including a fee, commission, gift, or any reciprocal benefit.
(2) “Referral” means identifying and connecting a senior person or that senior’s person’s representative to a residential care facility for the elderly to facilitate the further evaluation, in consultation with the facility, of whether that facility is a suitable senior housing option for that senior. person.
(3) (A) “Referral source” means a person or entity that provides a referral to a residential care facility for the elderly on behalf of a any county welfare department, county social service department, county mental health department, county public guardian, general acute care hospital discharge planner or coordinator, state-funded program or private, for-profit, or nonprofit agency providing referral services, conservator pursuant to Part 3 (commencing with Section 1800) of Division 4 of the Probate Code, conservator pursuant to Chapter 3 (commencing with Section 5350) of Part 1 of Division 5 of the Welfare and Institutions Code, and regional center for persons with developmental disabilities disabilities, or a person or entity that provides a referral to a residential care facility for the elderly on behalf of the aformentioned entities, that is engaged in identifying senior housing options at residential care facilities for the elderly.
(B) A referral source does not include a licensee of a residential care facility for the elderly, or any professional services staff member of a residential care facility for the elderly, who on behalf of that facility facility, makes a referral, even if they have received a discount or other remuneration from the facility.
(b) (1) A referral source shall not knowingly refer a person to a facility providing care and supervision or protective supervision unless the facility is licensed as a residential care facility for the elderly or is exempt from licensing under Section 1569.145. Violation of this paragraph is a misdemeanor.
(2) A referral source shall not knowingly refer an individual to a residential care facility for the elderly if the individual, because of their health condition, cannot be cared for within the limits of the facility’s license or requires inpatient care in a health facility. Violation of this paragraph is a misdemeanor.
(3) A referral source shall not refer a person to a residential care facility for the elderly in which the referral source, and an affiliated group under Section 1585 of the Financial Code or an immediate family member of the referral source, has an ownership or management interest or a common employee in an executive management position, unless the referral source obtains a written waiver from the senior person or that senior’s person’s representative before making the referral. For purposes of this subparagraph, “immediate family” means a spouse, parent, child, or any person related by consanguinity or affinity within the second degree. Violation of this paragraph is a misdemeanor.
(4) (A) A referral source who knows, or reasonably suspects, that a facility that is not exempt from licensing is operating without a license shall report the name and address of the facility to the department. Failure to report as required by this subparagraph is a misdemeanor.
(B) The department shall investigate any report filed under subparagraph (A). If the department has probable cause to believe that the facility that is the subject of the report is operating without a license, the department shall investigate the facility within 10 days after receipt of the report.
(5) A referral source shall notify the appropriate licensing agency of any known or suspected incidents that would jeopardize the health or safety of residents in a residential care facility for the elderly. A violation of this paragraph is a misdemeanor. Reportable incidents include, but are not limited to, all of the following:
(A) Incidents of physical abuse.
(B) Any violation of personal rights.
(C) Any situation in which a facility is unclean, unsafe, unsanitary, or in poor condition.
(D) Any situation in which a facility has insufficient personnel or incompetent personnel on duty.
(E) Any situation in which residents experience mental or verbal abuse.
(c) (1) Before sending a compensated referral to a residential care facility for the elderly located in California, a referral source shall provide the senior person or their representative with information that includes all of the following disclosures:
(A) A description of the referral source’s service.
(B) The referral source’s contact information, including business address, email address, and telephone number.
(C) A referral source’s privacy policy, or if the referral source maintains an internet website, a link or URL to the privacy policy on the internet website.
(D) A statement regarding whether and under what circumstances the referral source will be paid a fee by residential care facilities for the elderly to which the senior person is referred.
(E) A statement that the senior or person or their representative may request in writing at any time via email or by submitting a letter that the referral source cease contact with the senior or the senior’s person or their representative at points of contact they designate, such as telephone numbers and email addresses, and that the referral source will cease contact in response to that request and also cease making additional referrals on behalf of the senior person or the senior’s their representative.
(F) The following language: “Information regarding inspections, evaluations, complaints, and citations associated with any of California’s residential care facilities for the elderly, also known as assisted living facilities, can be viewed at the State Department of Social Services Community Care Licensing website at: www.cdss.ca.gov. Additionally, during a health-related state of emergency, information about the active cases within residential care facilities for the elderly may also be posted on this website.”
(2) The information and disclosures required by paragraph (1) shall be provided to the senior person or their representative in a clear manner designed to give actual notice of its contents and may be provided, together or separately, in any the following methods:
(A) A written disclosure at least in 12-point bold font either in hardcopy form or by electronic means.
(B)  A link to an electronic disclosure displayed on a web page in a larger font than the surrounding text.
(C) Verbally, if the verbal disclosure is given telephonically and recorded with the consent of the senior or the senior’s person or their representative. At the time of the verbal disclosure, a senior or senior’s person or their representative may verbally request a written or electronic disclosure be provided to them. If, in a subsequent phone conversation, the senior person or their representative verbally requests a written disclosure, the referral agency shall inform them of the procedure for submitting the request in writing pursuant to paragraph (3).
(3) The referral source shall maintain records of the disclosures set forth pursuant to this subdivision for a period of three years and shall provide a copy of the disclosures provided to the senior, person, representative, or the residential care facility for the elderly, upon written request.
(4) In addition to the requirements of paragraph (1), a compensated referral source shall comply with all of the following:
(A) Use a nationally accredited service provider to perform background checks on referral sources who have direct contact with seniors persons or their representatives.
(B) Maintain liability insurance coverage in an amount of at least one million dollars ($1,000,000) per occurrence and two million dollars ($2,000,000) in total annual aggregate for negligent acts or omissions by the referral source or any of its employees.
(C) Accept remuneration only from residential care facilities for the elderly with which the referral source has a written contract.
(D) Maintain and prominently display a privacy policy on every internet website it operates or, if the referral source does not maintain an internet website, then it shall provide the senior or the senior’s person or their representative with a written copy of the privacy policy.
(E) Refrain from holding any power of attorney for a resident or potential resident or from holding that person’s property in any capacity.
(F) Cease making referrals on behalf of the senior or the senior’s person or their representative within 15 days after receipt of a written request, pursuant to subparagraph (E) of paragraph (1).
(G) Cease contacting a senior or senior’s a person or their representative within 15 days after receipt of a written request, pursuant to subparagraph (E) of paragraph (1).
(d) A referral source that violates subdivision (c) is subject to a civil penalty of between two hundred fifty dollars ($250) and one thousand dollars ($1,000) for each violation, and Section 1569.40 shall not apply. A district attorney may institute a proceeding in superior court to recover the civil penalty under this subdivision and to restrain and enjoin a violation of subdivision (c).

SEC. 3.

 No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.