CALCRA's legislative efforts matter now more than ever. With more than 25,000 California residents living in CCRCs - a number that will only continue to grow - our work is critical. We support legislation that protects the quality of life and financial security of all CCRC residents, working with state legislators and other advocacy organizations.
History of CALCRA’s Legislative Efforts
1993: AB 668 was the first bill with which CALCRA was involved. The bill required providers to report and justify monthly care increases, updating of the mortality table and other technical changes that impacted reserves.
1994: AB 2847 specified that that CCRC resident contracts could not be terminated due to participation in a residents’ coalition or filing a complaint with an oversight agency was passed.
Throughout 1994 there were many meetings with residents at CCRCs and with legislators who were interested in the cause.
1996: AB 827 provided residents with more autonomy by requiring providers to permit the formation of resident councils and established procedures promoting the sharing of information between residents and management. It also:
• Required providers to attach to new resident contracts a schedule of monthly fees for each of the past five years and a schedule of proposed monthly fee increases for the next five years.
• Covered the areas of advertising, selling, reserve funding, construction and other information to be included with resident contracts.
• It proposed resident members on the provider boards of directors but this provision was eliminated after opposition by the providers.
1998: AB 1255 was passed requiring semi-annual meetings of providers with residents, 30 days notice and a meeting with residents before monthly fees are increased, at least one non-voting resident representative on the provider governing body and set forth the rights of the resident representatives.
1999: SB 1082 required providers to give each resident a copy of the resident’s bill of rights before admission to the community; make available to the resident council, not less than semi-annually, detailed financial statements; make a copy of the annual statements to the Department of Social Services available to residents; provide residents access to the minutes of the provider board of directors; notify residents of plans to initiate construction or to close, sell or transfer a CCRC; required providers to adopt a comprehensive disaster preparedness plan; and established a committee to prepare a legislative proposal to establish reserves to ensure sufficient funds to meet commitments to residents and financial integrity.
2000: AB 2077 established liquid reserve requirements for debt service and operating expenses, required providers to inform the resident association of applications for permits for new financing or the sale or transfer of a CCRC or for expansion or construction of a new CCRC, and required providers of Type A contracts to obtain an actuarial study and file the actuarial opinion with the Department.
2001: SB 739 required the Department of Social Services to enter and review each CCRC every three years, required each CCRC to file a disaster preparedness plan with the Department, required the Continuing Care Contracts Branch of the Department to respond to resident complaints within 15 days and gave residents access to documents filed with the Department by the provider.
2002: SB 309 required the provider to conduct a biennial resident satisfaction survey every two years and post a copy of the survey in a conspicuous location at each facility. It also required that data be available at least 14 days prior to a meeting to discuss monthly care fee increases and mandated a continuing care provider to prepare and provide certain reports to residents, and to allow residents to make presentations at specified meetings.
2004: AB 2550, based on recommendations of the actuarial study panel, implemented increasing the amount a continuing care provider must include in its liquid reserve from 45 to 75 days of net operating expenses; required designated LIFE CARE facilities submit studies every five years certifying that the facility is in actuarial balance; and required all continuing care providers to file annually a “Key Indicator Report” containing financial ratios and statistical information, including occupancy rates and liquidity indicators.
2005: SB 244 gave residents the right to have the Continuing Care Contracts Branch review the process followed by a provider in deciding to transfer the resident from one level of care to another, and to seek the assistance of the local Long-Term Care Ombudsperson.
2006: SB 1212 required disclosure of any funds accumulated for identified projects or purposes and any funds maintained or designated for specific contingencies; and full details on the status, description, and amount of all reserves that the provider currently designates and maintains.
2007: Because of the negative impact on residents by the closure of Marguerite Terrace CCRC, CALCRA sponsored SB 489 setting forth the requirements on a provider with respect to the permanent or temporary closure of a CCRC. The Assembly and Senate passed the bill but due to provider opposition, the governor vetoed it.
2009: AB 407 required the Department to monitor the implementation of a permanent closure and relocation plan, preventing a provider from taking any action to relocate a resident or to close a CCRC until the plan had been prepared and submitted to the Department by the provider and provided to the affected residents of the facility, the affected residents’ designated representatives, and the local Long-Term Care Ombudsman program. It also required the provider, in the case of a permanent closure, to offer the resident the choice of replacement housing, monetary compensation equal to the remaining value of the contract, or an alternative arrangement mutually agreed upon by the provider and the resident. This is the first bill sponsored by CALCRA that was supported by Aging Services (now LeadingAge), the nonprofit provider organization. This support was obtained by eliminating coverage of temporary closures, to be pursued in subsequent legislation.
AB 1169 required that the reserve reporting, required under SB 1212 (Statutes of 2006), disclose funds that are expended for identified projects or projects designated to meet the needs of the CCRC as permitted by a provider’s nonprofit status. It also required:
Disclosure by a nonprofit provider stating how the project or purpose is consistent with the provider’s tax-exempt status; and
Disclosure by a for-profit provider to identify amounts accumulated for specific projects or purposes and amounts maintained for contingencies.
AB 1433 required continuing care contracts to state that the resident has a right to terminate his or her contract after 18 months of residential temporary relocation and set forth provisions for refunds. This bill required providers to include in resident contracts the procedures to be followed to ensure that residential temporary relocations provide comparable levels of care, service, and living accommodations. The bill also specified procedures to be taken for residential temporary relocation, return to the unit vacated, and the extension of residential temporary relocation. Aging Services (now LeadingAge) also supported this bill, per the agreement reached on AB 407.
AB 1044 was introduced without CALCRA’s involvement or support. Among other provisions, it would have transferred financial oversight of CCRCs from the Department of Social Services to the Department of Insurance. Because of the bill’s complexity, it died in the Assembly.
2011: AB 748 was introduced. CALCRA rewrote and simplified AB 1044 to transfer financial oversight from the Department of Social Services to the Department of Insurance. AB 748 became a two-year bill; however, it was subsequently withdrawn in the face of substantial provider opposition, turmoil surrounding the state budget, and lack of support from the DOI.
2012: Aging Services introduced AB 1698. It would have allowed CCRCs to offer “care-at-home” or “CCRC-without-walls.” CALCRA opposed this bill (along with CANHR and the Consumer Attorneys of California) because it did not contain sufficient protections for CCRC residents. Aging Services withdrew the bill.
2013: AB 581 was supported by CALCRA. Existing law prohibits an RCFE from retaliating against anyone who initiates or participates in an inspection by DSS. This bill extends these protections to those who file a complaint or grievance with DSS.
2014: CALCRA sponsored AB 1751. This bill accomplished three things: 1) increased the frequency of financial reporting residents receive from providers; 2) required providers to post on their website the annual reports they submit to Social Services; and 3) required non-profit providers to allow at least one resident as a voting member on their governing board and for-profit providers to allow for resident input to and communication with governing body members.
2015: CALCRA sponsored SB 475. This bill would have addressed problems that have arisen with the repayment of funds due on resale of a resident’s unit. After passing through both houses of the Legislature, Governor Brown declined to sign this bill.
2016: CALCRA sponsored SB 939. This bill brought forward most of the issues in the previous year’s SB 475; however, the governor signed SB 939 into law. SB 939 required the timely repayment of deposits made in repay-on-resale contracts (a portion of the entrance fee is repaid to the resident or their estate when the contract is terminated). Any balance owed that has not been paid to the resident or their estate within 180 days accrues interest at a rate of 4%; balances owed after 240 days accrue interest at 6%; thereafter interest accrues annually at 6% compounded annually until fully repaid. Providers must make a good faith effort to resell a unit and, unless part of an equity interest contract (e.g., a condominium), providers cannot charge additional fees against the unit once it has been vacated. Contracts that provide for repayment on resale must state the average and longest amount of time that it has taken to resell a unit within the last 5 years.
2017: CALCRA sponsored AB 713. This bill requires a format assessment of a resident's physical and cognitive capacities when the provider is considering initiating a transfer of that resident to a higher level of care. Allows the resident to dispute the transfer decision and request a review by the Department of Social Services as to the necessity and appropriateness of the transfer.
2018: CALCRA sponsored AB 3088. This bill would have required all CCRC’s to obtain periodic actuarial analyses (current law imposes this requirement only on provider of Type A or Life Care contracts); and would have required all CCRC’s to also obtain a periodic maintenance and repair study of their buildings and grounds. After passing through both houses of the Legislature, Governor Brown declined to sign this bill.
AB 2033 (Choi): This bill, sponsored by Erickson Living, would have allowed Erickson to offer their “pooling model” of a repayment CCRC contract. CALCRA opposed this bill, concerned that it would also allow Erickson, which currently doesn’t operate in California, to avoid current statutory requirements for CCRCs in this state. AB 2033 died in committee.