BILL NUMBER: SB 1982 CHAPTERED 09/21/02 CHAPTER 773 FILED WITH SECRETARY OF STATE SEPTEMBER 21, 2002 APPROVED BY GOVERNOR SEPTEMBER 20, 2002 PASSED THE SENATE AUGUST 27, 2002 PASSED THE ASSEMBLY AUGUST 24, 2002 AMENDED IN ASSEMBLY AUGUST 20, 2002 AMENDED IN ASSEMBLY AUGUST 13, 2002 AMENDED IN ASSEMBLY JUNE 20, 2002 AMENDED IN SENATE APRIL 17, 2002 INTRODUCED BY Senator Perata (Coauthors: Assembly Members Alquist and Havice) FEBRUARY 22, 2002 An act to amend Sections 1502, 1523.1, and 1531.2 of, to add Section 1530.1, and to repeal Section 1502.2 of, the Health and Safety Code, relating to community care facilities. LEGISLATIVE COUNSEL'S DIGEST SB 1982, Perata. Community care facilities: definition. Existing law, the California Community Care Facilities Act, provides for the licensure and regulation of community care facilities, as defined, by the State Department of Social Services. Existing law defines a community care facility to include an adult day care facility as a facility that provides nonmedical care to persons 18 years of age or older in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of the individual on less than a 24-hour basis. Under existing law, a community care facility also includes an adult day support center, which is a community-based group program designed to meet specified needs of functionally impaired adults, in a protective setting on less than a 24-hour basis. This bill would delete the definition of an adult day care facility for purposes of the act, and would revise the definition of an adult day support center to mean any community-based facility or program that provides care to persons 18 years of age or older in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of these individuals on less than a 24-hour basis. The bill would also redesignate adult day support centers as adult day programs. This bill would require the department to adopt regulations to combine the existing categories of adult day care centers and adult day support centers into the new adult day program category. The bill would make additional conforming changes. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. (a) The Legislature finds and declares as follows: (1) Over the past 20 years, new models of service have emerged for persons with developmental disabilities, elders with functional or cognitive impairments, and other adults needing daytime assistance outside of the home. (2) Day programs provide a wide variety of services, ranging from respite for caregivers to independent living skill training for persons with developmental disabilities. (3) This diversity of programs is a major strength of California's community-based services, which are designed to meet the individual needs of persons using these services. (4) Licensing rules and regulations have not kept pace with changing community practices and service models. (5) There is a need to modernize the rules governing the licensure of adult day programs in keeping with the state's policy to offer consumers choices and to provide services in the least restrictive setting. (6) The current separate community care licensing categories for adult day care and adult day support programs create unnecessary complexity and confusion for consumers, providers, and regulators. (b) Therefore, it is the intent of the Legislature in enacting this act to improve consumer access to community care licensed programs by consolidating the licensure categories of adult day care and adult day support and associated regulations. SEC. 2. Section 1502 of the Health and Safety Code is amended to read: 1502. As used in this chapter: (a) "Community care facility" means any facility, place, or building that is maintained and operated to provide nonmedical residential care, day treatment, adult day care, or foster family agency services for children, adults, or children and adults, including, but not limited to, the physically handicapped, mentally impaired, incompetent persons, and abused or neglected children, and includes the following: (1) "Residential facility" means any family home, group care facility, or similar facility determined by the director, for 24-hour nonmedical care of persons in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of the individual. (2) "Adult day program" means any community-based facility or program that provides care to persons 18 years of age or older in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of these individuals on less than a 24-hour basis. (3) "Therapeutic day services facility" means any facility that provides nonmedical care, counseling, educational or vocational support, or social rehabilitation services on less than a 24-hour basis to persons under 18 years of age who would otherwise be placed in foster care or who are returning to families from foster care. Program standards for these facilities shall be developed by the department, pursuant to Section 1530, in consultation with therapeutic day services and foster care providers. (4) "Foster family agency" means any organization engaged in the recruiting, certifying, and training of, and providing professional support to, foster parents, or in finding homes or other places for placement of children for temporary or permanent care who require that level of care as an alternative to a group home. Private foster family agencies shall be organized and operated on a nonprofit basis. (5) "Foster family home" means any residential facility providing 24-hour care for six or fewer foster children that is owned, leased, or rented and is the residence of the foster parent or parents, including their family, in whose care the foster children have been placed. The placement may be by a public or private child placement agency or by a court order, or by voluntary placement by a parent, parents, or guardian. It also means a foster family home described in Section 1505.2. (6) "Small family home" means any residential facility, in the licensee's family residence, that provides 24-hour care for six or fewer foster children who have mental disorders or developmental or physical disabilities and who require special care and supervision as a result of their disabilities. A small family home may accept children with special health care needs, pursuant to subdivision (a) of Section 17710 of the Welfare and Institutions Code. In addition to placing children with special health care needs, the department may approve placement of children without special health care needs, up to the licensed capacity. (7) "Social rehabilitation facility" means any residential facility that provides social rehabilitation services for no longer than 18 months in a group setting to adults recovering from mental illness who temporarily need assistance, guidance, or counseling. Program components shall be subject to program standards pursuant to Article 1 (commencing with Section 5670) of Chapter 2.5 of Part 2 of Division 5 of the Welfare and Institutions Code. (8) "Community treatment facility" means any residential facility that provides mental health treatment services to children in a group setting and that has the capacity to provide secure containment. Program components shall be subject to program standards developed and enforced by the State Department of Mental Health pursuant to Section 4094 of the Welfare and Institutions Code. Nothing in this section shall be construed to prohibit or discourage placement of persons who have mental or physical disabilities into any category of community care facility that meets the needs of the individual placed, if the placement is consistent with the licensing regulations of the department. (9) "Full-service adoption agency" means any licensed entity engaged in the business of providing adoption services, that does all of the following: (A) Assumes care, custody, and control of a child through relinquishment of the child to the agency or involuntary termination of parental rights to the child. (B) Assesses the birth parents, prospective adoptive parents, or child. (C) Places children for adoption. (D) Supervises adoptive placements. Private full-service adoption agencies shall be organized and operated on a nonprofit basis. (10) "Noncustodial adoption agency" means any licensed entity engaged in the business of providing adoption services, that does all of the following: (A) Assesses the prospective adoptive parents. (B) Cooperatively matches children freed for adoption, who are under the care, custody, and control of a licensed adoption agency, for adoption, with assessed and approved adoptive applicants. (C) Cooperatively supervises adoptive placements with a full-service adoptive agency, but does not disrupt a placement or remove a child from a placement. Private noncustodial adoption agencies shall be organized and operated on a nonprofit basis. (11) "Transitional shelter care facility" means any group care facility that provides for 24-hour nonmedical care of persons in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of the individual. Program components shall be subject to program standards developed by the State Department of Social Services pursuant to Section 1502.3. (12) "Transitional housing placement facility" means a community care facility licensed by the department pursuant to Section 1559.110 to provide transitional housing opportunities to persons at least 17 years of age, and not more than 18 years of age unless the requirements of Section 11403 of the Welfare and Institutions Code are met, who are in out-of-home placement under the supervision of the county department of social services or the county probation department, and who are participating in an independent living program. (b) "Department" or "state department" means the State Department of Social Services. (c) "Director" means the Director of Social Services. SEC. 3. Section 1502.2 of the Health and Safety Code is repealed. SEC. 4. Section 1523.1 of the Health and Safety Code is amended to read: 1523.1. (a) (1) A fee adjusted by facility and capacity shall be charged by the department for the issuance of an original license or special permit or for processing any application therefor. After initial licensure, the fee shall be charged by the department annually on each anniversary of the effective date of the license or special permit. The fee is for the purpose of financing a portion of the application and annual processing costs and the activities specified in subdivision (b). The fee shall be assessed as follows: Fee Schedule Original Facility Type Capacity Application Annual Foster Family and Adoption Agencies $1,000 $1,000 Other Community 1-6 $300 $300 Care Facilities, 7-15 $450 $450 Except Adult Day 16-49 $600 $600 Programs 50+ $750 $750 Adult Day 1-15 $0 $50 Programs 16-30 $100 $100 31-60 $200 $200 61-75 $250 $250 76-90 $300 $300 91-120 $400 $400 121+ $500 $500 (2) Certified family homes of foster family agencies and foster family homes shall be exempt from the fees imposed pursuant to this subdivision. (3) No local jurisdiction shall impose any business license, fee, or tax for the privilege of operating a facility licensed under this chapter which serves six or fewer persons. (b) (1) The revenues collected from licensing fees pursuant to this section shall be utilized by the department to fund increased assistance and monitoring of facilities with a history of noncompliance with licensing laws and regulations pursuant to this chapter, and other administrative activities in support of the licensing program, when appropriated for these purposes. The revenues collected shall be used in addition to any other funds appropriated in the Budget Act in support of the licensing program. (2) The department shall not utilize any portion of these revenues sooner than 30 days after notification in writing of the purpose and use of this revenue, as approved by the Director of Finance, to the Chairperson of the Joint Legislative Budget Committee, and the chairpersons of the committee in each house that considers appropriations for each fiscal year. For fiscal year 1992-93 and thereafter, the department shall submit a budget change proposal to justify any positions or any other related support costs on an ongoing basis. (c) A facility may use a bona fide business check to pay the license fee required under this section. (d) Failure to pay required license fees, including the finding of insufficient funds to cover bona fide business checks submitted for the purpose shall constitute grounds for denial of a license or special permit or forfeiture of a license or special permit. SEC. 5. Section 1530.1 is added to the Health and Safety Code, to read: 1530.1. (a) The department shall adopt regulations, in consultation with providers, consumers, and other interested parties, to combine adult day care and adult day support centers licensing categories into one category, which shall be designated adult day programs. (b) The consolidated regulations shall take into account the diversity of consumers and their caregivers, and the role of licensing in promoting consumer choice, health and safety, independence, and inclusion in the community. (c) The department shall also take into account the diversity of existing programs designed to meet unique consumer needs, including, but not limited to, programs serving elders with cognitive or physical impairments, non-facility-based programs serving persons with developmental disabilities, respite-only programs, and other programs serving a unique population. SEC. 6. Section 1531.2 of the Health and Safety Code, as added by Chapter 729 of the Statutes of 1998, is amended to read: 1531.2. (a) Upon the filing by the department of emergency regulations with the Secretary of State, an adult day program, as defined in Division 6 of Title 22 of the California Code of Regulations, or Section 1502, that provides care and supervision for adults with Alzheimer's disease and other dementias may install for the safety and security of these persons secured perimeter fences or egress control devices of the time-delay type on exit doors if they meet all of the requirements for additional safeguards required by those regulations. The initial adoption of new emergency regulations on and after January 1, 1999, shall be deemed to be an emergency and necessary for the immediate preservation of the public peace, health and safety, or general welfare. (b) As used in this section, "egress control device" means a device that precludes the use of exits for a predetermined period of time. An egress control device shall not delay any client's departure from the facility for longer than 30 seconds. Facility staff may attempt to redirect a client who attempts to leave the facility. (c) A facility that installs an egress control device pursuant to this section shall meet all of the following requirements: (1) The facility shall be subject to all fire and building codes, regulations, and standards applicable to adult day programs using egress control devices or secured perimeter fences and before using an egress control device shall receive a fire clearance from the fire authority having jurisdiction for the egress control devices. (2) The facility shall require any client entering the facility to provide documentation of a diagnosis by a physician of Alzheimer's disease or other dementias, if such a diagnosis has been made. For purposes of this section, Alzheimer's disease shall include dementia and related disorders that increase the tendency to wander, decrease hazard awareness, and decrease the ability to communicate. (3) The facility shall provide staff training regarding the use and operation of the egress control devices used by the facility, the protection of clients' personal rights, wandering behavior and acceptable methods of redirection, and emergency evacuation procedures for persons with dementia. (4) All admissions to the facility shall continue to be voluntary on the part of the client or with the lawful consent of the client's conservator or a person who has the authority to act on behalf of the client. Persons who have the authority to act on behalf of a client may include the client's spouse, relative or relatives, or designated care giver or care givers. (5) Any client entering a facility pursuant to this section who does not have a conservator or does not have a person with the authority to act on his or her behalf shall sign a statement of voluntary entry. The facility shall retain the original statement in the client's file at the facility. (6) The use of egress control devices or secured perimeter fences shall not substitute for adequate staff. Staffing ratios shall at all times meet the requirements of applicable regulations. (7) Emergency fire and earthquake drills shall be conducted at least once every three months, or more frequently as required by a county or city fire department or local fire prevention district. The drills shall include all facility staff and volunteers providing client care and supervision. (8) The facility shall develop a plan of operation approved by the department that includes a description of how the facility is to be equipped with egress control devices that are consistent with regulations adopted by the State Fire Marshal pursuant to Section 13143. The plan shall include, but not be limited to, all of the following: (A) A description of how the facility will provide training to staff regarding the use and operation of the egress control device utilized by the facility. (B) A description of how the facility will ensure the protection of the residents' personal rights consistent with Sections 4502, 4503, and 4504 of the Welfare and Institutions Code. (C) A description of the facility's emergency evacuation procedures for persons with Alzheimer's disease and other dementias. (d) This section does not require an adult day program to use secured perimeters or egress control devices in providing care for persons with Alzheimer's disease or other dementias. (e) The department shall adopt regulations to implement this section in accordance with those provisions of the Administrative Procedure Act contained in Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code. (f) The State Fire Marshal may also adopt regulations to implement this section.