Clarifying the New Mandated Reporting Process for Long-Term Care Under AB-1417
There have been a lot of questions about AB 1417 (Wood), the bill that revised the mandated reporting system in long-term care facilities in California, since it was passed in 2023 and went into effect on January 1, 2024. The California Long-Term Care Ombudsman Association (CLTCOA) has provided monthly trainings since December 2023 educating mandated reporters on the new system, which was sponsored by the Association and included feedback from CALTCM, the California Association of Health Facilities (CAHF), the California Assisted Living Association (CALA), and many other stakeholders. As someone who was intimately involved in the drafting of AB-1417 and has led the Association’s trainings on its implementation since then, I’m happy to provide more context to alleviate some of the confusion around the new law and why it was passed.
Prior to AB 1417, California had one of the most complex, illogical, and protracted mandated reporting processes in long-term care in the country. The former law, AB-40, which was in effect since 2013, required mandated reports to make subjective judgments about the level of abuse that occurred and confusingly provided multiple ways of reporting the same types of incidents to law enforcement, the Long-Term Care Ombudsman, and relevant licensing agencies, the California Department of Social Services (CDSS) and the California Department of Public Health (CDPH). This not only made it extremely difficult for mandated reporters to remember the reporting system during those emergencies, but also increased the likelihood that mandated reporters would report instances of abuse or neglect incorrectly and therefore be potentially criminally liable for failure to report. Ultimately, these problems with the former system actually resulted in less mandated reports being submitted to the responding agencies than would otherwise be expected under state law, which left many of California’s aging and dependent adults more vulnerable to abuse and neglect in long-term care facilities.
AB 1417 was introduced with the intention of simplifying the reporting process for mandated reporters working in facilities as well as making California’s reporting system more consistent with federal laws, which changed following AB 40 being signed into law in 2012. Under current federal regulations, certain instances of abuse, such as resident-on-resident abuse where the abuser has been diagnosed with dementia, must be reported to law enforcement regardless of the level of injury to the victim, which is why the so-called “dementia carve-out” from AB-40 remains in AB 1417 but was revised to include reporting to law enforcement in such instances. Fortunately, we were able to improve the system so that a phone call to law enforcement – which isn’t explicitly required by federal regulations – is no longer necessary, therefore reducing the likelihood that law enforcement would respond inappropriately to those calls while still ensuring that law enforcement would receive the same reports as the Long-Term Care Ombudsman required.
AB 1417’s requirement to report all other types of cases of abuse and neglect (95-99% of cases) to law enforcement, the Long-Term Care Ombudsman, and the relevant licensing agency was similarly constructed so that all the responding agencies would receive the same information from the reporting party, as required by federal regulations, enabling them to coordinate an appropriate response together, since cross-reporting and coordination among these agencies is already required by the California Welfare & Institutions Code (see §15630). The timelines for reporting were similarly revised to be more consistent with federal regulations, which allow up to 2 hours to report most cases of abuse and neglect. In this way, AB 1417 did a lot to both eliminate the need for subjective judgments among mandated reporters and to synthesize existing state law and new federal laws around this topic while also making the system much easier to remember without a flowchart.
Some long-term care providers have asked how AB 1417 impacted other reporting requirements around abuse and neglect in facilities, such as the requirement for administrators to submit Unusual Incident & Injury Reports to the licensing agency in cases of resident-on-resident abuse. The short answer is that AB 1417 did nothing to change those requirements, which still exist under both state and federal law. AB 1417 only focused on revising the system from the mandated reporter’s perspective, which is usually the witness to the abuse or neglect or has first-hand information about it (as opposed to the administrator, who is often just passing on the information as a third party). AB 1417 did not alter administrators’ requirements to submit an Unusual Incident & Injury Report to the licensing agency even when the same incident is not required to be reported by the mandated reporter under AB 1417. This is primarily due to the fact that, as a category, “unusual incidents” can be much broader than just abuse and neglect and include all types of situations that would otherwise not be covered under the mandated reporting statutes, such as when a fire breaks out in a facility or resident self-harm. Facility administrators are still required to report these hazardous conditions and injuries to the relevant licensing agency as an Unusual Incident & Injury Report. We advise administrators to contact their licensing agency’s local field office directly to learn more about those additional reporting requirements since they are by definition not within the scope of AB 1417’s requirements for mandated reporters.
Unfortunately, no statute will be able to solve all of the problems surrounding reporting elder and dependent adult abuse and neglect in long-term care facilities in California, such as the need for more training among facility staff, fear of retaliation among mandated reporters, and inability for responding agencies to coordinate effectively in every possible instance. But CLTCOA believes that AB 1417 is a big step in the right direction toward making California’s mandated reporting system more streamlined, easier for reporters to remember, and consistent with federal law. California shouldn’t make reporting any more difficult than it must be on well-intentioned mandated reporters working in facilities. We hope AB 1417 will be well-received by them, and by the administrators who manage the long-term care facilities that must provide reporters with this training on an ongoing basis.
You can access the new flowchart or register for an upcoming training on AB 1417 on CLTCOA’s website: www.CLTCOA.org/AB-1417. You may reach out to your local Long-Term Care Ombudsman to request free customized training for your staff on this topic too. In the meantime, please refer to AFL 24-09 and PIN 23-19-ASC for official guidance from the relevant licensing agencies, and don’t hesitate to reach out to your licensing agency’s field office or the Office of the State Long-Term Care Ombudsman for more information.