BILL NUMBER: AB 2609 CHAPTERED 09/29/06 CHAPTER 615 FILED WITH SECRETARY OF STATE SEPTEMBER 29, 2006 APPROVED BY GOVERNOR SEPTEMBER 29, 2006 PASSED THE ASSEMBLY AUGUST 31, 2006 PASSED THE SENATE AUGUST 30, 2006 AMENDED IN SENATE AUGUST 22, 2006 AMENDED IN SENATE AUGUST 9, 2006 AMENDED IN SENATE JUNE 19, 2006 AMENDED IN ASSEMBLY APRIL 6, 2006 AMENDED IN ASSEMBLY MARCH 27, 2006 INTRODUCED BY Assembly Member Evans (Coauthors: Assembly Members Berg, Shirley Horton, Koretz, Laird, Lieber, and Pavley) (Coauthors: Senators Alquist, Kuehl, Romero, and Torlakson) FEBRUARY 24, 2006 An act to add Section 1569.69 to the Health and Safety Code, relating to residential facilities for the elderly. LEGISLATIVE COUNSEL'S DIGEST AB 2609, Evans Residential facilities for the elderly: employee training. Existing law, the California Residential Care Facilities for the Elderly Act, provides for the licensure and regulation of residential care facilities for the elderly by the State Department of Social Services. Under existing law, a violation of any of these provisions is punishable as a misdemeanor. This bill would require, beginning January 1, 2008, that a licensed residential care facility for the elderly ensure that each employee of the facility who assists residents with the self-administration of medications meet specified employee training requirements set forth in the bill. The bill would require these employees to pass an examination subsequent to completion of the training. The bill would require that each residential care facility that provides employee training pursuant to these provisions maintain certain records and documentation related to that training. It would also provide that a facility, licensed to provide care for 16 or more persons, maintain documentation that demonstrates that a consultant pharmacist or nurse has reviewed the facility's medication management program and procedures at least twice a year. By creating a new crime, the bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. Section 1569.69 is added to the Health and Safety Code, to read: 1569.69. (a) Each residential care facility for the elderly licensed under this chapter shall ensure that each employee of the facility who assists residents with the self-administration of medications meets the following training requirements: (1) In facilities licensed to provide care for 16 or more persons, the employee shall complete 16 hours of initial training. This training shall consist of eight hours of hands-on shadowing training, which shall be completed prior to assisting with the self-administration of medications, and eight hours of other training or instruction, as described in subdivision (f), which shall be completed within the first two weeks of employment. (2) In facilities licensed to provide care for 15 or fewer persons, the employee shall complete six hours of initial training. This training shall consist of two hours of hands-on shadowing training, which shall be completed prior to assisting with the self-administration of medications, and four hours of other training or instruction, as described in subdivision (f), which shall be completed within the first two weeks of employment. (3) An employee shall be required to complete the training requirements for hands-on shadowing training described in this subdivision prior to assisting any resident in the self-administration of medications. The training and instruction described in this subdivision shall be completed, in their entirety, within the first two weeks of employment. (4) The training shall cover all of the following areas: (A) The role, responsibilities, and limitations of staff who assist residents with the self-administration of medication, including tasks limited to licensed medical professionals. (B) An explanation of the terminology specific to medication assistance. (C) An explanation of the different types of medication orders: prescription, over-the-counter, controlled, and other medications. (D) An explanation of the basic rules and precautions of medication assistance. (E) Information on medication forms and routes for medication taken by residents. (F) A description of procedures for providing assistance with the self-administration of medications in and out of the facility, and information on the medication documentation system used in the facility. (G) An explanation of guidelines for the proper storage, security, and documentation of centrally stored medications. (H) A description of the processes used for medication ordering, refills and the receipt of medications from the pharmacy. (I) An explanation of medication side effects, adverse reactions, and errors. (5) To complete the training requirements set forth in this subdivision, each employee shall pass an examination that tests the employee's comprehension of, and competency in, the subjects listed in paragraph (3). (6) Residential care facilities for the elderly shall encourage pharmacists and licensed medical professionals to use plain English when preparing labels on medications supplied to residents. As used in this section, "plain English" means that no abbreviations, symbols, or Latin medical terms shall be used in the instructions for the self-administration of medication. (7) The training requirements of this section are not intended to replace or supplant those required of all staff members who assist residents with personal activities of daily living as set forth in Section 1569.625. (8) The training requirements of this section shall be repeated if either of the following occur: (A) An employee returns to work for the same licensee after a break of service of more than 180 consecutive calendar days. (B) An employee goes to work for another licensee in a facility in which he or she assists residents with the self-administration of medication. (b) Each employee who received training and passed the exam required in paragraph (5) of subdivision (a), and who continues to assist with the self-administration of medicines, shall also complete four hours of in-service training on medication-related issues in each succeeding 12-month period. (c) The requirements set forth in subdivisions (a) and (b) do not apply to persons who are licensed medical professionals. (d) Each residential care facility for the elderly that provides employee training under this section shall use the training material and the accompanying examination that are developed by, or in consultation with, a licensed nurse, pharmacist, or physician. The licensed residential care facility for the elderly shall maintain the following documentation for each medical consultant used to develop the training: (1) The name, address, and telephone number of the consultant. (2) The date when consultation was provided. (3) The consultant's organization affiliation, if any, and any educational and professional qualifications specific to medication management. (4) The training topics for which consultation was provided. (e) Each person who provides employee training under this section shall meet the following education and experience requirements: (1) A minimum of five hours of initial, or certified continuing, education or three semester units, or the equivalent, from an accredited educational institution, on topics relevant to medication management. (2) The person shall meet any of the following practical experience or licensure requirements: (A) Two years full-time experience, within the last four years, as a consultant with expertise in medication management in areas covered by the training described is subdivision (a). (B) Two years full-time experience, or the equivalent, within the last four years, as an administrator for a residential care facility for the elderly, during which time the individual has acted in substantial compliance with applicable regulations. (C) Two years full-time experience, or the equivalent, within the last four years, as a direct care provider assisting with the self-administration of medications for a residential care facility for the elderly, during which time the individual has acted in substantial compliance with applicable regulations. (D) Possession of a license as a medical professional. (3) The licensed residential care facility for the elderly shall maintain the following documentation on each person who provides employee training under this section: (A) The person's name, address, and telephone number. (B) Information on the topics or subject matter covered in the training. (C) The time, dates, and hours of training provided. (f) Other training or instruction, as required in paragraphs (1) and (2) of subdivision (a), may be provided off site, and may use various methods of instruction, including, but not limited to, all of the following: (1) Lectures by presenters who are knowledgeable about medication management. (2) Video instruction tapes, interactive material, online training, and books. (3) Other written or visual materials approved by organizations or individuals with expertise in medication management. (g) Residential care facilities for the elderly licensed to provide care for 16 or more persons shall maintain documentation that demonstrates that a consultant pharmacist or nurse has reviewed the facility's medication management program and procedures at least twice a year. (h) Nothing in this section authorizes unlicensed personnel to directly administer medications. (i) This section shall become operative on January 1, 2008. SEC. 2. No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.