In 2022, AB2119 became law. The “Medical Foster Home Program” allowed the Department of Social Services (DSS) to create a new licensed facility for veterans. In June 2026, DSS released a poorly worded provider information notice (PIN) that lacked vital information about how to become a licensee of a medical foster home for veterans (MFHV).
Is this veteran’s housing and care worth pursuing? Absolutely not!
The PIN states that DSS established the MFHV with “written directives” that will be used and enforced under Health and Safety Code 1568.22 to operate a care home for veterans. All MFHVs must comply with “the rules, regulations, and written directives adopted” by the department. The word adopted implies the Office of Administrative Law approved the written directives, and the Secretary of State approved the directives as state regulation, but neither has happened.
The 173 pages of the undated written directives are “Version 1, Chapter 2.5.” The sections are 8110 – 81195.5. It appears the directives were completed on April 30, 2026. Two months later, these have been released.
Unfortunately, H&S Code 1569.40 gave DSS permission to not seek full and legal adoption of “regulations,” and that is dangerous. DSS has no deadline to formerly adopt regulations. Version 1 is likely to evolve into Versions 2, 3, 4, etc. until DSS gets approval of a Title 22 chapter, 2.5.
The H&S Codes addressing MFVH are 1568.21-1568.40 and are in the Community Care Facilities Act. These laws do not legally apply to RCFEs just ARFs. RCFEs are exempt from all laws not contained in the RCFE Act. But that leads to more confusion. An ARF and/or RCFE must surrender its licensure to become a veteran’s home. Perhaps it does not matter where the laws appear. If you have an ARF or RCFE license and want to seek a veteran’s care license, you must forfeit your current DSS-issued license. The confusion is clearly the fault of the state legislature. H&S Code 1568.23 does NOT allow any facility holding a DSS-issued license to be an MFHV.
CFR section 17.73 of Title 38 states the “placement of veterans” is voluntary, and only the VA makes placement referrals to licensed facilities. The VA is also to conduct inspections “to ensure that the home continues to meet the requirements.”
A big problem for prospective licensees is found in the directives’ Section 81101(c)(1): ‘“Capacity’ means the maximum number of persons authorized, not to exceed three veteran residents…,” but that reflects Title 38 of CFR Section 17.73(b)(iii): “There are not more than three residents receiving care (including veteran and non-veteran residents).” A MFHV cannot provide care for more than three people at any time. That means these private homes can never have more than three residents; a maximum capacity of three! An MFHV is “a private home in which a medical foster home caregiver (primary care person) provides care, lives in the home, with not more than three residents receiving care.” The limit to three residents includes both veterans and non-veterans.
The VA will conduct a clinical evaluation to ensure that each placed veteran is “unable to live independently safely or needs a ‘nursing home level of care.’” A medical foster home caregiver must “provide a safe environment, room and board, supervision, and personal assistance, as appropriate for each veteran.”
DSS will eventually have specific MFHV application forms, but those forms are not yet available.
CFR section §17.74 of Title 38 has additional requirements: compliance with “state and local regulations” including “construction, maintenance, and sanitation regulations;” have safe and functioning systems for heating, hot and cold water, electricity, plumbing, sewage, cooking, laundry, artificial and natural light, and ventilation; meet the applicable provisions of the National Fire Protection Association (Life Safety Code); provide a “single occupancy” for each resident with a door that closes and latches; comply with specific safety sections of CFR §17.63 including comfortable dining and living room areas; provide food services meeting resident “preferences;” provide specific resident rights; plan and facilitate recreational and leisure activities; and although not currently required, but could be required, that a facility have an automatic sprinkler system.
Who pays for the veterans’ care? It is NOT the VA nor the state. The resident or the resident’s representative must agree to the facility’s pricing and payment procedures. Thus, there is no incentive to get a license for only three persons with a private payment system.
There are two pluses: the application fee is $88, and the application must be approved in 60 days or less. Right. Sixty days. There are several laws already mandating a 60-day turnaround of applications, but DSS has consistently failed to obey its law.