In this Issue
- RCFE Reform Act of 2014 Ready for Hearings
- Human Services Hearing on RCFEs/Assisted Living
- NSCLC Report Concludes California Lags Other States in Regulating Assisted Living Facilities
- Legislation Introduced to Force Timely Completion of Nursing Home Complaint Investigations
- Medi-Cal Expansion and Medi-Cal Recovery – Buyer Beware
- “Failure to Improve” – No Longer A Valid Excuse to Discontinue Nursing Home Medicare
- DOJ Issues Guidelines on Mobility Devices
- Upcoming Events
RCFE Reform Act of 2014 Ready for Hearings
Over the next month, most of the bills constituting the RCFE Reform Act of 2014 will be heard in policy committees. All of these bills are aimed at protecting the health, safety and security of California’s RCFE residents and enhancing the ability of the Department of Social Services’ Community Care Licensing Agency to enforce the laws and regulations governing these facilities. Most of the bills will be heard in either the Senate Human Services Committee or Assembly Human Services Committee. We need you to send letters of support for each bill to the key committees.
You can do this easily by completing our form here:
(please use your correct email address) Don’t wait! If you want to see changes, act now.
Human Services Hearing on RCFEs/Assisted Living
On February 11, 2014, the California Senate and Assembly Human Services Committees held a joint hearing on the crisis in assisted living facilities in California. The hearing comes after intense media scrutiny regarding the lack of regulatory oversight in RCFEs and the quality of life for residents. CANHR Executive Director Pat McGinnis testified at the hearing on the problems with inadequate enforcement, inspections and response to consumer complaints, and asked the legislators to support CANHR’s RCFE Reform Act package of bills. The full committee hearing can be viewed here:
Watch the hearing on CalChannel: 2/11/2014 Joint Legislative Hearing Human Services Committees
NSCLC Report Concludes California Lags Other States in Regulating Assisted Living Facilities
A new report by the National Senior Citizens Law Center, Best Practices in Assisted Living: Considering Potential Reforms for California, examines and compares California’s assisted living laws with 11 other states. The report finds that California’s assisted living policy is significantly out of date. Unlike many other states, California law does not reflect the sharp increase in residents’ care needs over the past 10 to 15 years. The report concludes that California’s laws require significant revision to keep pace with the new realities of assisted living, and makes recommendations based on best practices noted in other states.
Legislation Introduced to Force Timely Completion of Nursing Home Complaint Investigations
Following a January 21 hearing on the failure of the Department of Public Health, Licensing and Certification to respond to thousands of nursing home complaints on a timely basis – or at all – Assembly Member Mariko Yamada has introduced AB 1816, which would require the California Department of Public Health to complete investigations of nursing home complaints within 40 working days of receipt, with certain exceptions. Although the Legislature passed AB 399, a similar bill sponsored by CANHR, by a near unanimous vote in 2007, former Governor Schwarzenegger vetoed it. For a copy of the AB 1816 as introduced, see http://www.leginfo.ca.gov/bilinfo.html.
Medi-Cal Expansion and Medi-Cal Recovery – Buyer Beware!
Jack is 56 years of age and does not have health insurance. If he doesn’t purchase insurance, he can be penalized. So he decides he’d better sign up for California’s version of Obamacare – Covered California. Because his income is too low, he is not able to purchase medical insurance through the Covered California website, so he is sent to the Medi-Cal Expansion site to sign up for Medi-Cal. What Jack doesn’t know is that he will be forced into a Medi-Cal Managed Care program that is paid a monthly (capitated) rate to pay for his medical services. What he also doesn’t know is that, since he is 55+ years of age, his estate will be subject to a Medi-Cal recovery claim after he dies to collect whatever payments were made to the managed care plan. Even if Jack goes off of Medi-Cal when he is 60 years of age, the payments made to the managed care plan for the four years he was on it will still be a bill that his estate will be liable for. Can he find out how much Medi-Cal pays the managed care plan each month so he can at least make an informed decision before enrolling? No – because, under California law, that information is “confidential.” For more information about Medi-Cal Recovery, see CANHR’s website at:
“Failure to Improve” – No Longer A Valid Excuse to Discontinue Nursing Home Medicare
A recent settlement in a case against the Center for Medicare and Medicaid Services (CMS) has clarified once and for all, that Medicare coverage is available for skilled services to maintain an individual’s condition. (Jimmo v. Sebelius) Under the maintenance coverage standard articulated in the Jimmo Settlement, the determining issue regarding Medicare coverage is whether the skilled services of a health care professional are needed, not whether the Medicare beneficiary will “improve.” Pursuant to Jimmo, medically necessary nursing and therapy services, provided by or under the supervision of skilled personnel, are coverable by Medicare if the services are needed to maintain the individual’s condition, or prevent or slow their decline. The standards for Medicare coverage of skilled maintenance services apply now, but many nursing homes are still not aware of them. If you or someone you know is being denied skilled nursing Medicare coverage because they fail to “improve,” make sure to inform the facility of the Jimmo standards.
The Jimmo Settlement Agreement also provides for the re-review of certain Medicare claims under the clarified maintenance coverage standards, applicable when a patient has no restoration or improvement potential, but that patient requires skilled nursing home, home health or occupational therapy services to maintain, or to prevent or slow further deterioration of his or her clinical condition. Anyone wishing to obtain a re-review request form or to find out more information about this important issue should visit: www.medicareadvocacy.org/
DOJ Issues Guidelines on Mobility Devices
On January 31, 2014, the U.S. Department of Justice issued a technical assistance publication entitled ADA Requirements: Wheelchairs, Mobility Aids, and Other Power-Driven Mobility Devices. This six-page document provides guidance on the Department’s 2010 regulations regarding the use of wheelchairs, mobility aids and other power-driven mobility devices. The publication is designed to help state and local governments, businesses and non-profit organizations understand how the rules for mobility devices apply to them. Click here to read the publication:
Medi-Cal Estate Recovery Community Presentation Translated in Spanish – RSVP Today!
Come join CANHR for a community information session about Medi-Cal Recovery, presented in English and Spanish. This presentation will cover the laws governing Medi-Cal Estate Recovery and recovery exceptions and provides information about protecting your home. Presented by Patricia McGinnis, CANHR Executive Director. The event is co-sponsored by Neighborhood Legal Services of Los Angeles County and One LA.
Mary Immaculate Church Auditorium
10390 Remick Ave.,
Pacoima, CA 91331
Saturday, March 7, 2014
7:00pm – 9:00pm
RSVP to Edward Chavez for more information:
Medi-Cal Estate Recovery Community Presentation Translated in Chinese – RSVP Today!
Come join CANHR for a community information session about Medi-Cal Recovery, presented in English and Chinese. This presentation will cover the laws governing Medi-Cal Estate Recovery and recovery exceptions and provides information about protecting your home. Presented by Patricia McGinnis, CANHR Executive Director. The event is co-sponsored by Legal Aid Foundation of Los Angeles County, Chinatown Service Center, Asian Americans Advancing Justice, and the Library Foundation of Los Angeles.
639 N. Hill Street,
Los Angeles, CA 90012
Saturday, March 8, 2014
12:00pm – 2:00pm
RSVP to Connie Lo for more information: