Advocacy History

Shared Success

CALA members are committed to a responsive and vibrant resident experience. With this in mind, CALA regularly collaborates with legislators, regulators, issue experts and other stakeholders to establish new policies, revise out-of-date laws, and bring clarity to existing rules governing care and services in Assisted Living, Memory Care and Continuing Care Retirement Communities. The following are a few of CALA’s efforts impacting the resident experience and the strength of these models of care.

RENT CONTROL DEFEATED

In 2024 and 2008, CALA defeated proposals that would have imposed apartment-style rent control on RCFEs. With strong support of members, we successfully communicated the difference between rental housing and 24/7 licensed care communities, and the negative impact the proposed restrictions would have on residents in need of care and services.

Background Check Improvements

CALA worked successfully to secure funding through the state budget for additional staff to process background checks while efforts are underway to replace the failed Guardian background check system! The budget provided $4 million over four years to DSS to fund six additional staff for background check processing, providing technical assistance and customer service. The budget bill also included oversight and accountability and requires DSS to provide quarterly updates to legislative staff and the Legislative Analyst’s Office on the status of backlogs. These provisions are in addition to the direction to DSS to begin planning for a Guardian replacement. CALA staff and members continue to provide feedback to help ensure a system that works for a wide range of users.

EMERGENCY PREPAREDNESS ENHANCED

Disaster plans have long been required. With CALA’s leadership, today’s plans are stronger. AB 3098 (Chapter 348, Statutes of 2018), authored by Assemblymember Laura Friedman (D-Glendale) and sponsored by CALA, took effect Jan. 1, 2019. The results are strengthened emergency preparedness across the state and clarified applicability to RCFEs and CCRCs alike.

ASSISTED LIVING WAIVER PROGRAM RENEWAL

CALA was successful in advocating for changes to the waiver renewal that was effective from March 1, 2019 through the end of February 2024, and those successful changes are continued in the most recent ALW that became effective March 1, 2024.

STATE OVERSIGHT SUPPORTED

Thanks to CALA’s advocacy, the leadership of Assemblymember Ian Calderon, strong legislative support and acknowledgement by Governor Jerry Brown, California returned to annual inspections in 2019.

CALA was instrumental in overhauling the outdated civil penalty system. Updates to the level of fines, addition of appropriate due process and stronger transparency were achieved in legislation over this three-year period:

AB 2231 Civil Penalties (2015)
AB 1387 Appeal Process (2015)
AB 2236 New Civil Penalty Structure (2014)

CALA has also supported a host of reforms at the Department of Social Services (DSS) that are strengthening oversight, increasing departmental efficiency and responsiveness, and providing additional transparency.

ADMINISTRATOR CERTIFICATION PROGRAM STRENGTHENED

As sponsor of AB 1570 (Chapter 698, Statutes of 2014) and supporter of SB 911 (Chapter 705, Statutes of 2014), CALA fought for a doubling of the training hours required to become certified as an administrator, as well as an increase in the length of the administrator exam and the integrity of the exam questions themselves. Certified administrators are responsible for managing the community, and a strong certification foundation is key to their success. These bills represent a significant step forward.

Dementia Care Training Increased

CALA joined with the Alzheimer’s Association to increase dementia care staff training and expand the training to all Residential Care Facilities for the Elderly (RCFEs), not just those that advertise dementia care. AB 1570 (Chapter 698, Statutes of 2014) was a follow-up to AB 1753 (Chapter 434, Statutes of 2000) the two groups passed in 2000 to establish new dementia care training and disclosure requirements. AB 1753 was one of the first in the nation to focus on the special training needs related to care for people with dementia.

Caregiver Training Dramatically Increased

CALA partnered with stakeholders to quadruple the training required to be an RCFE caregiver. AB 1570 (Chapter 698, Statutes of 2014)) and SB 911 (Chapter 705, Statutes of 2014) ensure that caregivers have the knowledge necessary to meet the needs of today’s residents.

Barriers to Hospice Care Removed

CALA successfully advocated for a change in law to allow a resident who is using hospice services to move into and remain in an RCFE when appropriate planning and communication takes place. Prior to AB 1961 (Chapter 109, Statutes of 2002), residents were forced to move to a nursing home or other setting in order to receive hospice care. Today, residents have the choice of remaining in their community—their home—while receiving hospice services.

In addition, AB 1166 (Chapter 312, Statutes of 2003) allowed communities to call the hospice agency instead of 9-1-1 for residents receiving hospice care. This avoids unwanted transfers to the hospital at the end of life and helps ensure that residents’ wishes are honored.

Consumer Disclosure Promoted

CALA has worked with a variety of stakeholders over the years to ensure that residents and families receive advance notice of changing rates (SB 1662 (Chapter 401, Statues of 2004)), history of rate increases (AB 2370 (Chapter 478, Statutes of 2008)), special services available (SB 540 (Chapter 322, Statutes of 2003)), and detailed information in admission agreements (SB 211, Chapter 409, Statutes of 2003)), in order to promote well-informed decisions.

Medication Management Training Strengthened

CALA helped enact legislation that significantly increases the training required for staff members who assist residents with medications. Most recently, SB 911 (Chapter 705, Statutes of 2014) increased the requirement for communities of all sizes. In 2006, CALA co-sponsored AB 2609 (Chapter 615, Statutes of 2006) with the Alzheimer’s Association to strengthen training for Assisted Living caregivers who assist residents with medications. The additional training hours, specialized topics, exam component and professional consultation significantly raised the bar for medication management in RCFEs.

Institutionalization of Residents with Mobility Challenges Prevented

CALA led the fight to preserve access and prevent institutionalization for those who simply need a hand getting out of bed. Before CALA’s intervention, an unintended consequence of an unrelated code change mistakenly classified seniors who need any assistance getting out of bed as “bedridden” instead of “non-ambulatory.” This inaccurate label was leading fire inspectors to deny fire clearances, which led to eviction notices. Working closely with the Office of the State Fire Marshal, Alzheimer’s Association and other stakeholders, CALA sponsored AB 762 (Chapter 471, Statutes of 2009), which clarified that residents who need assistance transferring are considered “non-ambulatory” for fire clearance purposes.

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