Muratsuchi Advances Bill on Culturally Sensitive Senior Health Care

The former Keiro Nursing Homes in Gardena (pictured) and Lincoln Heights are now known as Kei-Ai Healthcare Centers. (Rafu Shimpo photos)

SACRAMENTO — Assembly Bill 651, authored by Assemblymember Al Muratsuchi (D-Torrance), passed the Assembly Health Committee on March 28 on a bipartisan vote of 11-1.

This bill strengthens the state attorney general’s oversight authority to preserve and promote culturally sensitive and language-appropriate health care for the state’s increasingly diverse seniors.

Under this bill, the attorney general is given additional time to approve or reject a nonprofit health care facility’s sale to a for-profit buyer from 60 to 90 days. It additionally requires public notice of a hearing to be provided not only in English but also in the languages spoken by the health care recipient community, and requires the attorney general to consider whether the transaction will have an adverse impact on the significant cultural interests of the affected community.

“Many seniors in the South Bay and throughout the state are deeply concerned about culturally sensitive and language-appropriate health care services,” said Muratsuchi. “We need to strengthen the attorney general’s public interest oversight authority so that we can preserve and promote culturally sensitive health care when a nonprofit provider is sold to a for-profit buyer.”

The attorney general is, by law, required to review and approve the sale of nonprofit health care facilities to for-profit buyers. Recently, a number of these transactions have involved facilities originally established to serve elderly immigrant communities requiring culturally sensitive and language-appropriate services.

Assemblymember Al Muratsuchi

As part of the approval process, the attorney general may conduct one or more public hearings, one of which must be in the county where the facility is located, to hear comments from health care recipients and their families, stakeholders, and the community. The written notice of these hearings, including their time and location, do not have to be in a language spoken by the health care recipients or community members. This can lead to immigrant communities being left out not only of the hearings, but also the attorney general’s review and approval process.

The bill now moves to the Assembly Judiciary Committee, and will be heard in this month.

The Keiro Sale Experience

“This bill came out of the Keiro sale experience,” Muratsuchi told The Rafu Shimpo. “We want to make sure that we have learned the lessons from the Keiro sale in order to again strengthen the AG’s oversight role to preserve culturally sensitive health care.

“Although the Keiro sale is done and over with, we want to make sure that for any future sales of nonprofit health care facilities that target immigrants and other monolingual communities that the AG exercise his or her proper public interest authority to preserve.

“We are planning on adding to the bill a requirement that a hearing be mandatory.”

Keiro’s four facilities — nursing homes in Lincoln Heights and Gardena and a retirement home and an intermediate care facility in Boyle Heights — have been sold to Pacifica Companies, a for-profit entity. Opponents of the sale criticized not only Keiro but also then-Attorney General Kamala Harris for approving the sale without holding a public hearing.

As a condition of the sale, the Office of the Attorney General required Pacifica to maintain culturally appropriate care at the facilities for five years.

“I’ve had discussions with Keiro although the emphasis was more on how we can work together moving forward,” Muratsuchi said. “I also recently visited the former South Bay Keiro facility and we had a lengthy discussion about not only the Keiro sale but also the current and future status of Kei Ai [the facility’s new name].

“I’m very concerned about making sure that the conditions of the sale that were approved by the AG as part of the a Keiro sale are enforced and abided by to ensure that the current residents of Kei Ai continue to receive culturally sensitive and language services.”

“We received hundreds of letters from the Koreisha in support of this bill and I want to thank all of the letter-writers. We invited them to testify but they did not testify at the Health Committee.”

Koreisha Senior Care and Advocacy, formerly the Ad Hoc Committee to Save Keiro, has been monitoring the welfare of the facilities’ residents and has urged Keiro to use the money from the sale to help them.

“When I visited the South Bay Kei Ai facility, it was clear that over 95 percent of current residents continue to be Japanese American, and I was very moved to see the history of community involvement at the South Bay Kei Ai facility, everything from the wall of donors with all the JA names … as well as the courtyard, [which]when I visited had cherry blossom trees that started to bloom, as well as the fuji wisteria trees,” Muratsuchi said.

“So it was very touching to see all the signs of many years of the JA community’s support for this facility, and it just really struck me that we need to continue to ensure that the Kei Ai facility will provide culturally sensitive services.”

Keiro declined to comment on the bill. Representatives of Aspen Healthcare, which operates the nursing homes and intermediate care facility, emphasized their commitment to provide culturally sensitive care.

Koreisha’s Comments

Koreisha President Takeshi Matsumoto, M.D., and other leaders of the organization met with Muratsuchi at his Torrance office in December to discuss legislative remedies for issues encountered by the Ad Hoc Committee.

“In the course of our movement to stop the sale of Keiro, we identified statutory limitations of the Office of the Attorney General which prevented our movement from stopping the sale of Keiro and in conducting a public hearing: the attorney general cannot rescind a prior approval of the sale or a waiver for a public hearing,” Matsumoto said.

“For the future benefit of nonprofit health facilities and their stakeholders, we suggested legislative remedies: to make public hearings mandatory for the sale of nonprofit health facilities with assets greater than $1 million and prior to the closure of escrow, grant the AG the statutory power to rescind the prior approval of the sale if it is deemed in the best interest of the public.”

He noted that SB 1094, which would have granted the attorney general the statutory power to rescind a prior decision, was vetoed by Gov. Jerry Brown in September 2014.

“Albeit AB 651 … falls short of what we wanted, it is a step forward,” Matsumoto said. “We are greatly appreciative of Assemblymember Muratsuchi and his prompt action in this regard. We have sent hundreds of letters in support of AB 651.

“We will collaborate with Assemblymember Muratsuchi for legislative remedies for other issues affecting all Californians: to grant the AG the power to remove officers and board members of a nonprofit organization for gross negligence, to grant the AG punitive powers to enforce violations of post-sale ‘conditions for the sale,’ to grant the AG the power to remove the nonprofit status of an organization violating laws governing NPOs [nonprofit organizations], and to exempt Medi-Cal residents of skilled nursing facilities from paying bed hold fees after sevens of hospitalization.”