BILL NUMBER: SB 1845 CHAPTERED
BILL TEXT
CHAPTER 797
FILED WITH SECRETARY OF STATE SEPTEMBER 27, 2004
APPROVED BY GOVERNOR SEPTEMBER 27, 2004
PASSED THE SENATE AUGUST 28, 2004
PASSED THE ASSEMBLY AUGUST 28, 2004
AMENDED IN ASSEMBLY AUGUST 23, 2004
AMENDED IN SENATE MAY 24, 2004
AMENDED IN SENATE APRIL 20, 2004
INTRODUCED BY Senators Perata, Alpert, and Romero
(Coauthor: Senator Kuehl)
(Coauthors: Assembly Members Bates, Koretz, and Lieber)
FEBRUARY 20, 2004
An act to amend Sections 14526, 14552, 14573, and 14574.1 of, and
to add Section 14552.2 to, the Welfare and Institutions Code,
relating to adult day health care.
LEGISLATIVE COUNSEL'S DIGEST
SB 1845, Perata. Adult day health care.
The California Adult Day Health Care Act provides for the
licensure and regulation of adult day health care centers, with
administrative responsibility for this program shared between the
State Department of Health Services and the California Department of
Aging.
The Adult Day Health Medi-Cal Law establishes adult day health
care services as a Medi-Cal benefit for Medi-Cal beneficiaries who
meet certain criteria.
The bill would revise the Adult Day Health Medi-Cal Law, including
revising designated Medi-Cal certification standards, including, but
not limited to standards relating to the facility program plan,
deleting the requirement that an adult day health care provider
provide services only to those participants living within its service
area, and deleting the requirement that the State Department of
Health Services conduct reviews prior to approving renewal of
Medi-Cal certification.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 14526 of the Welfare and Institutions Code is
amended to read:
14526. Participation in an adult day health care program shall
require prior authorization by the department. The authorization
request shall be initiated by the provider and shall include the
results of the assessment screening conducted by the provider's
multidisciplinary team and the resulting individualized plan of care.
Participation shall begin upon application by the prospective
participant or upon referral from community or health agencies, or
the physician, hospital, family, or friends of a potential
participant.
SEC. 2. Section 14552 of the Welfare and Institutions Code is
amended to read:
14552. In order to obtain certification as a provider of adult
day health care under this chapter and Chapter 7 (commencing with
Section 14000), the following standards shall be met:
(a) The provider shall have met all other requirements of
licensure as an adult day health care center pursuant to Chapter 3.3
(commencing with Section 1570) of Division 2 of the Health and Safety
Code.
(b) The provider shall comply with requirements of this chapter
regarding program and scope of services.
(c) The provider shall have appropriate licensed personnel.
(d) The provider shall employ required personnel for furnishing of
required services pursuant to Section 14550 consistent with commonly
accepted professional standards.
(e) The provider shall afford to each participant all rights,
including the right to be free from harm and abuse, identified in the
rules and regulations adopted pursuant to Section 1580 of the Health
and Safety Code.
(f) A provider serving a substantial number of participants of a
particular racial or ethnic group, or participants whose primary
language is not English, shall employ staff who can meet the cultural
and linguistic needs of the participant population.
(g) A provider shall have organizational and administrative
capacity to provide services under the provisions of this chapter.
SEC. 3. Section 14552.2 is added to the Welfare and Institutions
Code, to read:
14552.2. (a) "Program plan" means a written description of the
adult day health care center's philosophy, objectives, and processes
for providing required services to the participant populations.
(b) The program plan shall include any of the following elements,
as requested by the California Department of Aging, and shall be
submitted as required in Section 14574.1:
(1) The total number of participants the center proposes to serve,
or currently serves, daily.
(2) A profile of the participant population the center proposes to
serve, or currently serves, that includes a description of the
specific medical, social, and other needs of each population.
(3) A description of the specific program elements and services
that addresses the medical, social, and other needs of each
participant population that the center proposes to serve, or
currently serves, as specified in paragraph (2). "Program elements"
means the components of an adult day health care program, as
specified in Section 14550.
(4) A description of the specialized professional and program
staff that will provide, or currently provide, the adult day health
care center's program services, as specified in paragraph (3), and
that staff's responsibilities. The plan shall demonstrate that the
adult day health care center is organized and staffed to carry out
the requirements as specified in the regulations adopted pursuant to
Section 1580 of the Health and Safety Code.
(5) An in-service training plan for each center staff member to
commence within the first six months of employment. The training
plan shall address, at a minimum, the specific medical, social, and
other needs of each participant population the center proposes to
serve, as specified in paragraph (2).
(6) A sample individual plan of care for each specialty population
the adult day health care center proposes to serve, or currently
serves, and a sample of a one-week schedule of daily program services
for each sample individual plan of care. The individual plan of
care shall demonstrate the specific medical, social, and other needs
of each participant population the adult day health center proposes
to serve.
(7) A plan for a behavior modification program if such a program
will be used as a basic intervention for meeting the needs of a
special population, such as persons with developmental disabilities
or persons with mental disabilities.
(c) This section shall be implemented only to the extent funds are
made available for the purposes of this section in the annual Budget
Act or another statute.
(d) The implementation of the program plan requirements does not
require adoption of regulations pursuant to the Administrative
Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1
of Division 3 of Title 2 of the Government Code).
SEC. 4. Section 14573 of the Welfare and Institutions Code is
amended to read:
14573. (a) Initial Medi-Cal certification for adult day health
care providers shall expire 12 months from the date of issuance. The
director shall specify any date he or she determines is reasonably
necessary because of the record of the applicant and to carry out the
purposes of this chapter, but not more than 24 months from the date
of issuance, when renewal of the certification shall expire. The
certification may be extended for periods of not more than 60 days if
the department determines it to be necessary.
(b) Before certification renewal the provider shall submit with
the application for renewal a report according to department
specifications that includes an analysis of income and expenditures,
continued demonstrated community need, services, participant
statistics and outcome, and adherence to policies and procedures.
(c) Prior to approving renewal of Medi-Cal certification, the
California Department of Aging shall conduct a financial review and
onsite medical and management reviews. The reviews shall be
conducted by a team of persons with appropriate technical skills.
The management review shall be performed by the entity responsible
for directing and coordinating the program, as specified in the
interagency agreement entered into pursuant to Section 1572 of the
Health and Safety Code.
(d) Where the director determines that the public interests would
be served thereby, a public hearing may be held on any renewal
application subject to this section. The findings of the
departmental program and licensing reviews and the provider's annual
evaluation report shall be presented at the hearing.
SEC. 5. Section 14574.1 of the Welfare and Institutions Code is
amended to read:
14574.1. (a) Every adult day health care center shall be
periodically inspected and evaluated for quality of care by a
representative or representatives designated by the director, unless
otherwise specified in the interagency agreement entered into
pursuant to Section 1572 of the Health and Safety Code. Inspections
shall be conducted prior to the expiration of certification, but at
least every two years, and as often as necessary to ensure the
quality of care being provided. As resources permit, an inspection
may be conducted prior to, as well as within, the first 90 days of
operation.
(b) If, as a result of the inspection, the department or the
California Department of Aging, as specified in the interagency
agreement, determines that the adult day health care center has
serious deficiencies that pose a risk to the health and safety of the
participants, the department or the California Department of Aging,
as specified in the interagency agreement, may immediately take any
of the following actions, including, but not limited to:
(1) Require a plan of correction, including as requested, a
program plan pursuant to Section 14552.2.
(2) Limit participant enrollment.
(3) Prohibit new participant enrollment.
(c) The provider shall have the right to dispute an action taken
under paragraphs (2) and (3) of subdivision (b). The department or
the California Department of Aging, as specified in the interagency
agreement, shall accept, consider, and resolve disputes filed
pursuant to this subdivision in a timely manner. The dispute
resolution process shall be determined by the California Department
of Aging in consultation with the department.
(d) The director shall ensure that public records accurately
reflect the current status of any potential actions including the
resolution of disputes.