Report 2021-123 All Recommendation Responses

Report 2021-123: California Hospice Licensure and Oversight: The State's Weak Oversight of Hospice Agencies Has Created Opportunities for Large-Scale Fraud and Abuse (Release Date: March 2022)

Recommendation #1 To: Public Health, Department of

Until such time as the Legislature authorizes Public Health to issue the emergency regulations described above, Public Health should pursue its standard regulatory authority to address these issues.

Annual Follow-Up Agency Response From September 2023

Public Health is continuing to develop emergency hospice regulations since the Governor signed AB 2673 into law on September 29, 2022. The regulations are being developed to incorporate the recommendations from the State Auditor's report that are within Public Health's authority to regulate, implement AB 2673, and address stakeholder feedback from public stakeholder meetings held on July 27, 2022, and March 14, 2023.

Additionally, Public Health has convened and continues to work with an internal workgroup made up of Department subject matter experts with a variety of expertise in Public Health on the development of the hospice regulations. Public Health has made substantial progress in developing the regulations and intends to promulgate them by the statutory deadline of January 1, 2024.

California State Auditor's Assessment of Annual Follow-Up Status: Pending

1-Year Agency Response

Public Health is developing emergency hospice regulations. The regulations are being developed to incorporate the recommendations from the State Auditor's report, implement AB 2673, and address stakeholder feedback from a public stakeholder meeting that was held on July 27, 2022. Additionally, Public Health will be convening another stakeholder meeting on March 14, 2023, to solicit additional input on the emergency regulations. In addition to soliciting stakeholder input, Public Health is convening an internal workgroup made up of Department subject matter experts to bolster the development of emergency hospice regulations.

California State Auditor's Assessment of 1-Year Status: Pending

6-Month Agency Response

Public Health is continuing its development of hospice regulations. Public Health convened a public stakeholder meeting on Wednesday, July 27, 2022, to solicit feedback on regulatory issues. The meeting was attended by 71 participants, including the California Association for Health Services at Home (CAHSAH) and the California Hospice and Palliative Care Association (CHAPCA). The questions posed to stakeholders centered around the eight components of the State Auditor's recommendation listed above. Stakeholders have until August 27th to submit their final written comments to Public Health. Once the public comment period has closed, Public Health will begin analyzing the comments received and will incorporate the stakeholder comments in the regulations under development. Additionally, Public Health notes that the Legislature is currently considering AB 2673, which addresses many of the issues raised in the audit report, including a requirement that Public Health develop emergency regulations. The outcome of this legislation will influence the content of the regulations under development.

California State Auditor's Assessment of 6-Month Status: Pending

60-Day Agency Response

Public Health is currently developing regulations in accordance with the State Auditor's recommendations and anticipates scheduling a stakeholder engagement meeting within the next three months. The regulations will include time and distance standards, guidelines for assessing patient to nurse ratios, a limit to the number of hospice agencies that hospice management personnel can be involved with concurrently, and requirements for hospice management personnel to have hospice-specific training or experience.

Additionally, as part of the initial hospice application review, the Centralized Applications Branch (CAB) will update the application form HS 215A - Applicant Individual Information, to request the individual's phone number and CA driver's license, in addition to requesting the Social Security Number (SSN). CAB will also update its procedures to include contacting the hospice management personnel by phone to verify the employment information contained in the HS 215A/resume and conduct an Entity Search in the Electronic Licensing Management System to validate the employment history with other providers licensed by CDPH.

Legislation will be required to deny a hospice license application for disciplinary action related to a medical director's professional license that is still current and active. The grounds for denying a license are specified in statute.

Public Health will conduct stakeholder engagement to determine the appropriate content for the regulations based on the recommendation for space and verification that the hospice is ready to provide care.

Finally, Public Health will develop policies and procedures to include relicensing visits to verify compliance with the hospice standards and once adopted, will verify compliance with regulatory requirements.

California State Auditor's Assessment of 60-Day Status: Pending

We look forward to reviewing Public Health's progress in its next response. However, we disagree with Public Health's statement that our recommendation related to denying a hospice application for certain disciplinary actions imposed on its medical professionals may require legislation. The Licensure Act gives Public Health the authority to establish rules and regulations as may be necessary or proper to exercise its powers and perform its licensure duties. As we stated in our report, Public Health has had the authority to issue regulations since 1991 but has failed to do so.

Recommendation #2 To: Justice, Department of

To improve its ability to investigate possible fraud and abuse, DOJ should provide guidance to Public Health about the types of information Public Health should include when it refers complaints that allege fraud to DOJ. Further, DOJ should also document a procedure for following up on complaints that do not include adequate information.

Annual Follow-Up Agency Response From September 2023

Since the Audit was issued, DMFEA met with DPH to discuss several strategies to address hospice fraud, including; streamlining communication channels, improving the quality and quantity of referrals, and updating the agencies' MOU. DMFEA is actively involved in the Hospice Fraud Taskforce, of which DPH is also an active participant.

Additionally, DMFEA and DPH are in the final stages of updating their MOU. Both Departments are reviewing and approving final edits. The revised MOU should be signed this fall.

California State Auditor's Assessment of Annual Follow-Up Status: Pending

1-Year Agency Response

Since the Audit was issued, DMFEA met with DPH to discuss several strategies to address hospice fraud, including; streamlining communication channels, improving the quality and quantity of referrals, and updating the agencies' MOU. DMFEA is actively involved in the Hospice Fraud Taskforce, of which DPH is also an active participant.

Additionally, DMFEA and DPH have put together a working group with representatives from both agencies to collaboratively review and revise the MOU, thereby improving communication and efficiency. The working group has met, reviewed, and discussed the prior MOU and corresponding changes. The agencies have made edits, and the MOU is currently in the process of being updated.

California State Auditor's Assessment of 1-Year Status: Pending

6-Month Agency Response

Since the Audit issued, DMFEA met with DPH to discuss several strategies to address hospice fraud, including; streamlining communication channels, improving the quality and quantity of referrals, and updating the agencies' MOU. DMFEA and DPH agreed to put together a working group with representatives from both agencies to collaboratively review and revise the MOU, thereby improving communication and efficiency.

The working group has met, reviewed, and discussed the prior MOU and corresponding changes. The agencies have made edits, which are currently under review.

California State Auditor's Assessment of 6-Month Status: Pending

60-Day Agency Response

Since the Audit issued, DMFEA met with DPH to discuss several strategies to address hospice fraud, including; streamlining communication channels, improving the quality and quantity of referrals, and updating the agencies' MOU. DMFEA and DPH agreed to put together a working group with representatives from both agencies to collaboratively review and revise the MOU, thereby improving communication and efficiency. Efforts are underway to staff and schedule those working group meetings.

California State Auditor's Assessment of 60-Day Status: Pending

Recommendation for Legislative Action

To address fraud that is likely occurring in Los Angeles County, the Legislature should require Public Health, Health Care Services, DOJ, and Social Services to immediately convene a taskforce to identify, investigate, and prosecute fraud and abuse by hospice agencies in that county. It should also require those four departments to establish a working group to annually meet to conduct a risk assessment of the Medi-Cal hospice program statewide, including performing analyses similar to those we conducted during this audit regarding growth in the number of hospice agencies, clustering of hospice agencies, and instances of medical personnel working at multiple hospice agencies. Because the fraud indicators we identified frequently also involved home health agencies, the four departments should also consider risks related to home health agencies. These departments should adjust their fraud prevention and detection efforts based on the results of this assessment.

Description of Legislative Action

The Budget Act of 2022, SB 154 (Ch. 43, Stats. of 2022) includes $1 million to establish and facilitate a Hospice Fraud Task Force including representation from the California Health and Human Services Agency, State Department of Public Health, State Department of Health Care Services, State Department of Social Services, and Department of Justice. This bill requires the taskforce to work to address fraud in the hospice services industry in California by identifying and investigating fraud and referring identified cases of suspected fraud to the Department of Justice for prosecution. By January 1, 2025, the task force shall provide a recommendation to the Legislature on whether or not the task force should be established permanently to continue its work on an ongoing basis.

California State Auditor's Assessment of 6-Month Status: Partially Implemented

Recommendation for Legislative Action

The Legislature should require fraud training for any Public Health staff who are responsible for licensing and certifying hospice agencies, including training about the types of information that are necessary for making referrals to DOJ when they suspect fraud is occurring.

Description of Legislative Action

The Legislature did not take action in the 2021-2022 Legislative Session to address this specific recommendation.

California State Auditor's Assessment of 6-Month Status: No Action Taken

Recommendation for Legislative Action

To help ensure that hospice owners and hospice management personnel are of good moral character, the Legislature should revise state law to require that each hospice agency's owners, and the hospice agency's administrator, director of patient care services, administrator/director of patient care services designee, and medical director (hospice
management personnel) submit electronic fingerprint images to DOJ for the furnishing of the person's criminal record to Public Health. The revision should also include a requirement that hospice owners and management personnel with certain criminal convictions, as determined by the Legislature, are prohibited from obtaining a license and are further prohibited from providing any hospice-related service before obtaining either a criminal record clearance or a criminal record exemption from Public Health.

Description of Legislative Action

The Legislature did not take action in the 2021-2022 Legislative Session to address this specific recommendation.

California State Auditor's Assessment of 6-Month Status: No Action Taken

Recommendation for Legislative Action

To protect against excessive and fraudulent growth in the number of hospice agencies, the Legislature should revise state law to require new, previously unlicensed hospice agencies to demonstrate an unmet need for hospice services in an area where they wish to operate. The
law should require that the number of hospice agencies in a given geographic region closely aligns with measures of the need for hospice services. It should also define appropriate measures of need and identify the methodology hospice agencies must use to demonstrate need.

Description of Legislative Action

AB 2673 (Ch. 797, Stats. of 2022) revises and expands the department's application requirements, and it additionally requires an applicant for a hospice agency license to, as a condition of licensure, demonstrate and provide evidence of an unmet need of hospice services in the geographic region the hospice would serve, except under specified circumstances. However, this bill neither requires that the number of hospice agencies in a given geographic region closely align with measures of need for hospice services, nor does it define the appropriate measures of need and identify the methodology hospice agencies must use to demonstrate need.

California State Auditor's Assessment of 6-Month Status: Partially Implemented

Recommendation for Legislative Action

To enable Public Health to better oversee the licensure of hospice agencies, the Legislature should require as a part of the licensure application the inclusion of financial information that is similar to the information required for home health agencies.

Description of Legislative Action

The Legislature did not take action in the 2021-2022 Legislative Session to address this specific recommendation.

California State Auditor's Assessment of 6-Month Status: No Action Taken

Recommendation for Legislative Action

To protect the health and safety of current and prospective hospice patients, the Legislature should require Public Health to issue emergency regulations within one year, while maintaining the general moratorium on new hospice licenses until Public Health issues the
regulations. The emergency regulations should do the following: Establish time and distance standards that define the maximum time and distance hospice agency staff may travel to reach patients, taking into consideration typical traffic conditions and whether the hospice
agency is serving patients in rural or urban areas.

Description of Legislative Action

AB 2673 (Chapter 797, Statutes of 2022) requires, among other things, the Department of Public Health to issue emergency regulations to implement the recommendations in this audit report. This bill requires Public Health to maintain the moratorium on new hospice agencies until it adopts regulations, but no later than March 29, 2024, two years from the date we issued our audit report. This bill also requires the emergency regulations to establish time and distance standards as described in the audit recommendation.

California State Auditor's Assessment of 6-Month Status: Legislation Enacted

Recommendation for Legislative Action

To protect the health and safety of current and prospective hospice patients, the Legislature should require Public Health to issue emergency regulations within one year, while maintaining the general moratorium on new hospice licenses until Public Health issues the
regulations. The emergency regulations should do the following: Establish guidelines for assessing the appropriateness of a hospice agency's ratio of patients to nurses.

Description of Legislative Action

AB 2673 (Chapter 797, Statutes of 2022) requires, among other things, the Department of Public Health to issue emergency regulations to implement the recommendations in this audit report. This bill requires Public Health to maintain the moratorium on new hospice agencies until it adopts regulations, but no later than March 29, 2024, two years from the date we issued our audit report. This bill also requires the emergency regulations to establish standards for a hospice agency's ratio of nurses to patients.

California State Auditor's Assessment of 6-Month Status: Legislation Enacted

Recommendation for Legislative Action

To protect the health and safety of current and prospective hospice patients, the Legislature should require Public Health to issue emergency regulations within one year, while maintaining the general moratorium on new hospice licenses until Public Health issues the
regulations. The emergency regulations should do the following: Establish a limit to the number of hospice agencies that hospice management personnel can be involved with concurrently.

Description of Legislative Action

AB 2673 (Chapter 797, Statutes of 2022) requires, among other things, the Department of Public Health to issue emergency regulations to implement the recommendations in this audit report. This bill requires Public Health to maintain the moratorium on new hospice agencies until it adopts regulations, but no later than March 29, 2024, two years from the date we issued our audit report. This bill also requires the emergency regulations to establish a limit for the number of hospice agencies that hospice agency management personnel can be involved with concurrently.

California State Auditor's Assessment of 6-Month Status: Legislation Enacted

Recommendation for Legislative Action

To protect the health and safety of current and prospective hospice patients, the Legislature should require Public Health to issue emergency regulations within one year, while maintaining the general moratorium on new hospice licenses until Public Health issues the
regulations. The emergency regulations should do the following: Require hospice management personnel to have hospice-specific training or experience.

Description of Legislative Action

AB 2673 (Chapter 797, Statutes of 2022) requires, among other things, the Department of Public Health to issue emergency regulations to implement the recommendations in this audit report. This bill requires Public Health to maintain the moratorium on new hospice agencies until it adopts regulations, but no later than March 29, 2024, two years from the date we issued our audit report. This bill also requires the emergency regulations to require hospice agency management personnel to meet minimum standards of training and experience including, but not limited to, hospice-specific training or experience.

California State Auditor's Assessment of 6-Month Status: Legislation Enacted

Recommendation for Legislative Action

To protect the health and safety of current and prospective hospice patients, the Legislature should require Public Health to issue emergency regulations within one year, while maintaining the general moratorium on new hospice licenses until Public Health issues the
regulations. The emergency regulations should do the following: Require, as part of its review of the initial application, that Public Health verify that the hospice management personnel
listed on the licensing application are, in fact, associated with the hospice agency, such as by contacting them by phone, and verify the work history of hospice management personnel by speaking with these individuals' previous employers by phone.

Description of Legislative Action

AB 2673 (Chapter 797, Statutes of 2022) requires, among other things, the Department of Public Health to issue emergency regulations to implement the recommendations in this audit report. This bill requires Public Health to maintain the moratorium on new hospice agencies until it adopts regulations, but no later than March 29, 2024, two years from the date we issued our audit report. This bill also requires Public Health to verify the status of professional licensure for hospice agency personnel and allows Public Health to verify the association of hospice agency management personnel listed on the licensing application with the hospice agency and to verify the work history of hospice agency management personnel. This bill states that verification may include contacting the hospice agency personnel or previous employers by telephone.

California State Auditor's Assessment of 6-Month Status: Legislation Enacted

Recommendation for Legislative Action

To protect the health and safety of current and prospective hospice patients, the Legislature should require Public Health to issue emergency regulations within one year, while maintaining the general moratorium on new hospice licenses until Public Health issues the regulations. The emergency regulations should do the following: Require Public Health to verify the status of the professional licenses for all hospice medical personnel, including contracted medical directors, as part of the initial license application. The regulations should also establish guidelines for when Public Health must deny the application of a hospice agency that is proposing to use medical personnel whose professional license records indicate the imposition of a disciplinary action. For instance, probation for gross negligence or fraudulent billing should be a cause to deny a hospice agency's application, even if the medical director's license is currently active.

Description of Legislative Action

AB 2673 (Chapter 797, Statutes of 2022) requires, among other things, the Department of Public Health to issue emergency regulations to implement the recommendations in this audit report. This bill requires Public Health to maintain the moratorium on new hospice agencies until it adopts regulations, but no later than March 29, 2024, two years from the date we issued our audit report. This bill also requires Public Health to verify the status of professional licensure for hospice agency personnel. However, this bill does not specifically require the regulations to include guidelines for when Public Health must deny the application of a hospice agency that is proposing to use medical personnel whose professional license records indicate the imposition of a disciplinary action.

California State Auditor's Assessment of 6-Month Status: Partially Implemented

Recommendation for Legislative Action

To protect the health and safety of current and prospective hospice patients, the Legislature should require Public Health to issue emergency regulations within one year, while maintaining the general moratorium on new hospice licenses until Public Health issues the regulations. The emergency regulations should do the following: Establish requirements for conducting an initial licensing site visit that include verifying the identities of all hospice
personnel and ensuring that the hospice agency is set up to provide adequate care. Public Health should develop specific requirements for hospice office space and verify compliance with those requirements during the initial site visit.

Description of Legislative Action

AB 2673 (Chapter 797, Statutes of 2022) requires, among other things, the Department of Public Health to issue emergency regulations to implement the recommendations in this audit report. This bill requires Public Health to maintain the moratorium on new hospice agencies until it adopts regulations, but no later than March 29, 2024, two years from the date we issued our audit report. This bill requires the emergency regulations to establish specific recommendations for hospice agency office space. However, this bill does not specifically require the regulations to include requirements for conducting an initial licensing site visit that include verifying the identities of all hospice personnel and ensuring that the hospice agency is set up to provide adequate care.

California State Auditor's Assessment of 6-Month Status: Partially Implemented

Recommendation for Legislative Action

To protect the health and safety of current and prospective hospice patients, the Legislature should require Public Health to issue emergency regulations within one year, while maintaining the general moratorium on new hospice licenses until Public Health issues the regulations. The emergency regulations should do the following: Establish requirements for follow-up inspections to the initial site visits within one year of initial licensing to verify that hospice agencies are complying with those hospice standards that cannot be assessed before the agencies begin providing care to patients. These inspections should be unannounced and take place after the hospice agency has begun caring for patients. During these inspections, Public Health should visit patients, ensure that the certifications of terminal illness are accurate, confirm that the hospice agency is providing adequate care, check hospice personnel identities and medical licenses, and ensure that the hospice agency has reported any personnel changes.

Description of Legislative Action

AB 2673 (Chapter 797, Statutes of 2022) requires, among other things, the Department of Public Health to issue emergency regulations to implement the recommendations in this audit report. This bill requires Public Health to maintain the moratorium on new hospice agencies until it adopts regulations, but no later than March 29, 2024, two years from the date we issued our audit report. However, this bill does not specifically require the regulations to include requirements for follow-up inspections to the initial site visits within one year of initial licensing to verify that hospice agencies are complying with those hospice standards that cannot be assessed before the agencies begin providing care to patients.

California State Auditor's Assessment of 6-Month Status: Partially Implemented

Recommendation for Legislative Action

To ensure that all licensed hospice agencies comply with Public Health's newly adopted regulations, the Legislature should revise state law to require Public Health to conduct a license renewal for all currently licensed hospice agencies within two years after the regulations are adopted. It should also revise state law to require Public Health to perform license renewal inspections for all licensed hospice agencies periodically. If it performs them at least every 18 months, every other cycle will coincide with Medicare recertification inspections, which are required at least every 36 months.

Description of Legislative Action

The Legislature did not take action in the 2021-2022 Legislative Session to address this specific recommendation.

California State Auditor's Assessment of 6-Month Status: No Action Taken

Recommendation for Legislative Action

To increase oversight of deemed-status hospice agencies, the Legislature should amend state law to require Public Health to do the following: Collect and monitor full reports from accreditors for all current and future deemed-status hospice agencies.

Description of Legislative Action

The Legislature did not take action in the 2021-2022 Legislative Session to address this specific recommendation.

California State Auditor's Assessment of 6-Month Status: No Action Taken

Recommendation for Legislative Action

To increase oversight of deemed-status hospice agencies, the Legislature should amend state law to require Public Health to do the following: Annually audit a selection of at least 5 percent of deemed-status hospice agencies and monitor these agencies to ensure that they
take any necessary corrective actions.

Description of Legislative Action

The Legislature did not take action in the 2021-2022 Legislative Session to address this specific recommendation.

California State Auditor's Assessment of 6-Month Status: No Action Taken

Recommendation for Legislative Action

The Legislature should revise state law to include a system of sanctions for Public Health to levy, including fines or license revocation, for the following: Violations of state law, regulations, or hospice standards by a hospice agency, including improperly certifying a patient as
eligible for hospice care.

Description of Legislative Action

AB 2673 (Chapter 797, Statutes of 2022) adds to the list of reasons for which the department may deny, suspend, or revoke a hospice agency license, including, improperly certifying a patient as eligible for hospice care, and demonstrating a pattern and practice of violations of state or federal standards during the last 3 years of a hospice agency owned, operated, or managed by the applicant or licensee.

California State Auditor's Assessment of 6-Month Status: Partially Implemented

Recommendation for Legislative Action

The Legislature should revise state law to include a system of sanctions for Public Health to levy, including fines or license revocation, for the following: Failure by hospice management personnel to be present for an inspection or complaint investigation.

Description of Legislative Action

AB 2673 (Chapter 797, Statutes of 2022) adds to the list of reasons for which the department may deny, suspend, or revoke a hospice agency license, including failure by hospice agency management personnel to cooperate with the department for the purposes of conducting an inspection or complaint investigation.

California State Auditor's Assessment of 6-Month Status: Partially Implemented

Recommendation for Legislative Action

The Legislature should revise state law to include a system of sanctions for Public Health to levy, including fines or license revocation, for the following: Failure by a hospice agency to report a change in owner, hospice management personnel, or location.

Description of Legislative Action

AB 2673 (Chapter 797, Statutes of 2022) adds to the list of reasons for which the department may deny, suspend, or revoke a hospice agency license, including failure by a hospice agency to report a change in owner, hospice agency management personnel, service area, or location.

California State Auditor's Assessment of 6-Month Status: Partially Implemented

Recommendation for Legislative Action

To ensure that Public Health appropriately addresses the complaints it receives, the Legislature should require it to do the following: Establish time frames within which Public Health must initiate and complete its investigations of hospice complaints.

Description of Legislative Action

AB 2673 (Chapter 797, Statutes of 2022) requires, upon receipt of a complaint, the department to make a preliminary review and, unless the department determines that the complaint is willfully intended to harass a licensee or is without any reasonable basis, it shall make an onsite investigation within 10 business days after receiving the complaint, except when the visit would adversely affect the licensing investigation or the investigation of other agencies including, but not limited to, law enforcement agencies. In either event, the complainant shall be promptly informed of the department's proposed course of action.

California State Auditor's Assessment of 6-Month Status: Partially Implemented

Recommendation for Legislative Action

To ensure that Public Health appropriately addresses the complaints it receives, the Legislature should require it to do the following: Develop a comprehensive training manual regarding performing investigations. The manual should include specific guidance for
interviewing witnesses, collecting and reviewing documents, and following up on discrepancies to properly and thoroughly address complaints.

Description of Legislative Action

The Legislature did not take action in the 2021-2022 Legislative Session to address this specific recommendation.

California State Auditor's Assessment of 6-Month Status: No Action Taken

Recommendation for Legislative Action

To help ensure that residents of long-term care facilities are not taken advantage of by unscrupulous hospice agencies, the Legislature should require Public Health and Social Services to develop materials to educate current and future residents of these facilities and their families about common hospice fraud schemes, including efforts to mislead residents to sign up for hospice care. It should also require Public Health to include this information on
its website.

Description of Legislative Action

The Legislature did not take action in the 2021-2022 Legislative Session to address this specific recommendation.

California State Auditor's Assessment of 6-Month Status: No Action Taken

Recommendation for Legislative Action

To ensure that the public has adequate information when selecting a hospice agency to provide care, the Legislature should require Public Health to revise its Cal Health Find website by October 2022, to include the following: Up-to-date information about the ownership and license status for each hospice agency licensed by Public Health.

Description of Legislative Action

The Legislature did not take action in the 2021-2022 Legislative Session to address this specific recommendation.

California State Auditor's Assessment of 6-Month Status: No Action Taken

Recommendation for Legislative Action

To ensure that the public has adequate information when selecting a hospice agency to provide care, the Legislature should require Public Health to revise its Cal Health Find website by October 2022, to include the following: Specific identifiers to differentiate between complaints that were unsubstantiated based on a review of sufficient evidence and
complaints that were undetermined because it could not reach a conclusion because of lack of evidence.

Description of Legislative Action

The Legislature did not take action in the 2021-2022 Legislative Session to address this specific recommendation.

California State Auditor's Assessment of 6-Month Status: No Action Taken

Recommendation for Legislative Action

To ensure that the public has adequate information when selecting a hospice agency to provide care, the Legislature should require Public Health to revise its Cal Health Find website by October 2022, to include the following: A quality-of-care rating system for hospice agencies similar to the one that CMS uses for Care Compare. After all hospices have been inspected based on the new regulations, Public Health should begin reporting the quality-of-care ratings.

Description of Legislative Action

The Legislature did not take action in the 2021-2022 Legislative Session to address this specific recommendation.

California State Auditor's Assessment of 6-Month Status: No Action Taken

Recommendation for Legislative Action

To ensure that the public has adequate information when selecting a hospice agency to provide care, the Legislature should require Public Health to revise its Cal Health Find website by October 2022, to include the following: An indicator or icon identifying a hospice agency that has received citations for abuse and neglect in the past year.

Description of Legislative Action

The Legislature did not take action in the 2021-2022 Legislative Session to address this specific recommendation.

California State Auditor's Assessment of 6-Month Status: No Action Taken

All Recommendations in 2021-123

Agency responses received are posted verbatim.