Basic Care, Medical Home, Home Care Act All Clear First Hurdle

by David Gorn

A number of health care-related bills just met the deadline for passage out of house of origin. In a way, it's a litmus test for whether or not bills have the political capital to become law, and quite a few health proposals made the initial cut.

The bills recently passed by the Assembly now head to the state Senate, and vice versa. Beyond the high-profile AB 52 by Mike Feuer (D-Los Angeles)  to regulate health insurance rate hikes, there were several health-related bills that moved on:

An estimated one million home health care aides are unlicensed, and the Home Care Act of 2011 aims to change that.

SB 411 by Sen. Curren Price (D-Inglewood) would require background checks and licensure of home care aides. "It would set some basic standards, and require private home-care companies to supervise and review their employees," Price said. "At this point, we have removed all general fund costs from the bill."

Sen. Elaine Alquist (D-Santa Clara) had a personal story to tell.

"You may recall that my late husband, Al Alquist, passed away in 2006," she said. "I had the honor of taking care of him about 95% of the time, but for the rest of that time, I needed some help. I remember using a home care agency at one point and just assuming it was licensed and that these people had clear backgrounds. I was really shocked to find that's not the case."

With the huge number of home health care workers in California, the state's seniors need some kind of basic protection, Alquist said. "This bill is for seniors who need this kind of care," she said. "Seniors are left at home alone many times with that home care worker."

Sen. Mark DeSaulnier (D-Concord), author of SB 575, said California's smoking regulations are outdated.

"In 1994, California led the country and the world, and passed the first bill on smoking in the workplace," DeSaulnier said. "Now, 25 states plus the District of Columbia are smoke-free indoors. This bill just closes some loopholes so we can approach what [other states] are doing."

The bill moves the hotel requirement from 35% nonsmoking rooms to 80% nonsmoking, and eliminates smoking in hotel lobbies. DeSaulnier said he removed provisions around smoking and cigar shops in hotel lobbies.

At least one health facility in California will get its Maddy funds, if AB 412 by Assembly member Das Williams (D-Santa Barbara) becomes law.

"Santa Barbara Cottage Hospital has the only Level II trauma center in a huge area," Williams said. "All the way up to San Jose in the north, Fresno to the east and Los Angeles to the south."

The Maddy Fund was supposed to ease the financial crunch on emergency service centers throughout California, but those funds are currently being held back in the budget debate.

"Santa Barbara County needs those Maddy funds reinstated," Williams said, and the Assembly agreed, 72-0. It's now in the Senate Rules committee.

The patient-centered medical home got a vote of confidence from the state Senate.

"The goal of the medical home model is to have a team of professionals offering a broad spectrum of care for the patient," Senate member Ed Hernadez (D-Los Angeles) said.

Hernandez is author of SB 393, which establishes the Patient Centered Medical Home Act of 2011.

Hernandez also authored SB 703, which would create a basic health insurance option for Californians who are between 133% and 200% of federal poverty level.

"We're looking at cheaper premiums, lower cost-sharing and better benefits," Hernandez said. "I'm glad to report that the financing pencils out for the state, and for the people enrolled in the program."

SB 411, SB 575, SB 703 and SB 393 move on to the Assembly. AB 412 and AB 52 now go to the Senate.

Tim Colling
John, I agree with you that this bill will result in more "underground economy", as well as harm to home care workers and consumers. The only ones who benefit are union bosses and the politicians that they own.
John Brown
We have employees. But they are able to say no if want to put them in a case. They decide when they are available for work. We encourage them to register with other companies because many of our cases are not full time. It is only a matter of time before the companies using 1099 contractors get shut down. This bill does nothing about private hires which carry the greatest risk for the people being cared for.
Tim Colling
Actually, I'm pretty sure that SB 411 does NOT apply to people working for "registries", because the bill only applies to employees. By definition, home care aides, nurses and others who are sent by true "registries" are not employees of the registries. The registries usually take the position that they are not the employer of the person(s) that they're sending to the client. But you're absolutely right that this is one way for the SEIU to bedevil the honest agencies who act as employers, both by increasing our costs and therefore the fees that we must charge, and by gaining access to a list of all the home care aides in the state and their contact info. This bill should be called the Union Bosses Income Guarantee Act or the Elderly Home Care Consumer Cost Increase Guarantee act. Or maybe the Requiring Home Care Aides To Work For Multiple Employers Act.
John Brown
This bill doesn't deal with people who hire themselves out on craigslist or under the table. Only caregivers who work with agencies or registries. Most companies already run background checks. IHSS does too but they hire felons and people convicted of fraud or elder abuse anyway. SEIU has been looking for a way to gain union membership outside of IHSS with private companies. They have been unable to do so because they can't get employee lists from those companies and there are no central meeting places for employees. Most caregivers go directly from home to work in private homes.
Milan Moravec
State Senator Mark Desaulnier authored the bill that allows public employees to spike their pensions so that pension payments are greater than salary! Who pays? California Democrats and Republicans -you pay! Remember Desaulnie in November 2012!

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