BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



           ------------------------------------------------------------ 
          |SENATE RULES COMMITTEE            |                  AB 2629|
          |Office of Senate Floor Analyses   |                         |
          |1020 N Street, Suite 524          |                         |
          |(916) 651-1520         Fax: (916) |                         |
          |327-4478                          |                         |
           ------------------------------------------------------------ 
           
                                         
                                    CONSENT


          Bill No:  AB 2629
          Author:   Bonnie Lowenthal (D)
          Amended:  6/16/10 in Senate
          Vote:     21

           
           SENATE HUMAN SERVICES COMMITTEE  :  5-0, 6/22/10
          AYES:  Liu, Emmerson, Romero, Runner, Yee
           
          SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8

           ASSEMBLY FLOOR  :  72-0, 5/20/10 (Consent) - See last page  
            for vote


           SUBJECT  :    Residential facilities

           SOURCE  :     Community Residential Care Association of  
          California


           DIGEST  :    This bill clarifies admission and retention  
          requirements for temporarily bedridden individuals in adult  
          residential care facilities and residential care facilities  
          for the chronically ill.

           ANALYSIS  :    

          Existing law:

          1. Establishes the California Community Care Act to govern  
             the licensing of community care facilities, including  
             residential facilities, adult day programs, therapeutic  
                                                           CONTINUED





                                                               AB 2629
                                                                Page  
          2

             day services, foster family agencies, foster family  
             homes, child care centers and family child care homes,  
             and other community and residential services.

          2. Establishes the Department of Social Services (DSS) as  
             the entity overseeing residential care facilities,  
             including the following categories:

                  Residential care facilities for the elderly  
                (RCFEs).
                  Community care facilities, including adult  
                residential care facilities.
                  Residential care facilities for the  
                chronically-ill.

          3. Requires a prospective applicant for licensure as a  
             residential care facility to secure and maintain fire  
             clearance approval from the local fire enforcement  
             agency or the State Fire Marshal.

          4. Defines "bedridden" as either requiring assistance in  
             turning and repositioning in bed, or being unable to  
             transfer independently to and from bed, except in  
             facilities with appropriate and sufficient staff,  
             mechanical devices if necessary, and safety precautions  
             as determined by DSS.

          5. Allows a bedridden individual to be admitted to, and  
             remain in, a facility if the facility secures and  
             maintains an appropriate fire clearance.  A fire  
             clearance will be issued to a facility in which a  
             bedridden individual resides if the fire safety  
             requirements are met, or alternative methods of  
             protection are approved.

          6. Specifies that residents who are unable to transfer  
             independently to and from bed, but who do not need  
             assistance to turn or reposition in bed, shall be  
             considered nonambulatory for determining the appropriate  
             fire safety requirements.

          7. Prohibits an RCFE from admitting or retaining a resident  
             if the resident requires 24-hour, skilled nursing or  
             intermediate care.







                                                               AB 2629
                                                                Page  
          3


          8. Allows an RCFE to retain a bedridden resident beyond 14  
             days if all of the following requirements are satisfied:

             A.    The facility notifies DSS in writing regarding the  
                temporary illness or recovery from surgery.

             B.    The facility submits to DSS, the notification and  
                a physician and surgeon's written statement to the  
                effect that the resident's illness or recovery is of  
                a temporary nature.  The statement must contain an  
                estimated date upon which the resident will no longer  
                be confined to a bed.

             C.    DSS determines that the health and safety of the  
                resident is adequately protected in the facility and  
                that the transfer to a higher level of care is not  
                necessary.

             D.    Allowing the resident to remain at the RCFE does  
                not expand the scope of care and supervision of an  
                RCFE.

          9. Requires an RCFE admitting or retaining a bedridden  
             resident to notify the local fire authority within 48  
             hours of the resident's admission or, in the case of  
             retaining a bedridden individual, the estimated length  
             of time the resident will retain his or her bedridden  
             status in the facility.

          This bill:

          1. Specifies that the status of being bedridden shall not  
             include a temporary illness or recovery from surgery  
             that persists for less than two weeks.

          2. Specifies that no client shall be admitted to or  
             retained in a residential facility if he/she requires  
             24-hour skilled nursing care.

          3. Allows a bedridden client to be retained in a  
             residential facility in excess of 14 days if the  
             following requirements are met:








                                                               AB 2629
                                                                Page  
          4

             A.    The facility notifies DSS in writing that the  
                person is recovering from a temporary illness or  
                surgery.

             B.    The facility submits to DSS a physician and  
                surgeon's written statement to the effect that the  
                client's illness or recovery is of a temporary  
                nature.  The statement must contain an estimated date  
                upon which the illness or recovery is expected to end  
                or upon which the client is expected to no longer be  
                confined to bed.

             C.    DSS determines that the client's health and safety  
                is adequately protected in the facility and that  
                transfer to a higher level of care is not necessary.

          4. Specifies that by allowing temporarily bedridden  
             individuals to remain in a residential care facility,  
             the scope of care and supervision of that facility is  
             not expanded.

          5. States that notwithstanding the length of stay of a  
             bedridden client, every residential facility admitting  
             or retaining a bedridden client shall, within 48 hours  
             of the client's admission or retention in the facility,  
             notify the local fire authority of the estimated length  
             of time that the client will be bedridden.

          6. Makes clarifying, technical changes to existing law.

          Background  

          DSS is responsible for licensing several types of  
          residential facilities, however only RCFEs have flexibility  
          when it comes to admitting or retaining a temporarily  
          bedridden resident.  This bill will extend the same  
          allowances for temporarily bedridden residents or clients  
          that exist in RCFEs to adult residential facilities and  
          residential care facilities for the chronically-ill  
          licensed by DSS.

          Residential care facilities are currently allowed to admit  
          and retain "bedridden" residents provided the facility  
          meets certain criteria, including fire safety precautions.   







                                                               AB 2629
                                                                Page  
          5

          This bill does not expand the admission or retention  
          criteria for those facilities, nor does it relax existing  
          standards for fire safety, care, or staffing.

          California has approximately 5,310 licensed adult  
          residential facilities, with a total capacity of 41,364  
          residents.  In addition, DSS licenses 21 residential care  
          facilities for the chronically-ill, with a total capacity  
          of 347 residents.

           Prior Legislation

           AB 762 (Lowenthal), Chapter 471, Statutes of 2009,  
          clarified the fire clearance requirements for bedridden  
          residents of RCFEs to distinguish between residents who are  
          nonambulatory and residents who are unable to turn or  
          reposition in bed.

          AB 749 (Wolk), Chapter 477, Statutes of 2008, required  
          RCFEs to have an emergency plan that includes specific  
          provisions and is available, upon request, to residents  
          onsite and available to local emergency responders.

          SB 1896 (Ortiz), Chapter 817, Statutes of 2000, revised the  
          definition of "bedridden" to mean either requiring  
          assistance in turning and repositioning in bed, or being  
          unable to independently transfer to and from bed, except in  
          facilities with appropriate and sufficient care staff and  
          other precautions.  The bill also allowed a bedridden  
          person to be admitted to, and remain in, an RCFE that  
          secures and maintains an appropriate fire clearance.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  Yes

           SUPPORT  :   (Verified  7/29/10)

          Community Residential Care Association of California  
          (source)
          Department of Social Services

           ARGUMENTS IN SUPPORT  :    According to the author's office,  
          this bill will provide uniformity across licensed,  
          non-medical, adult community care facilities regarding fire  







                                                               AB 2629
                                                                Page  
          6

          safety protections for nonambulatory residents who wish to  
          remain in their "home" when they have a condition that  
          renders them temporarily bedridden.


           ASSEMBLY FLOOR  : 
          AYES:  Adams, Ammiano, Anderson, Arambula, Bass, Beall,  
            Bill Berryhill, Tom Berryhill, Blakeslee, Block,  
            Blumenfield, Bradford, Brownley, Buchanan, Caballero,  
            Charles Calderon, Carter, Chesbro, Conway, Cook, Coto,  
            Davis, De Leon, DeVore, Emmerson, Eng, Feuer, Fong,  
            Fuentes, Fuller, Furutani, Gaines, Galgiani, Garrick,  
            Gilmore, Hagman, Hall, Hayashi, Hernandez, Hill, Huber,  
            Huffman, Jeffries, Jones, Knight, Lieu, Logue, Bonnie  
            Lowenthal, Ma, Mendoza, Miller, Monning, Nestande,  
            Niello, Nielsen, Norby, V. Manuel Perez, Portantino,  
            Ruskin, Salas, Saldana, Silva, Skinner, Smyth, Solorio,  
            Audra Strickland, Swanson, Torlakson, Torres, Torrico,  
            Tran, Yamada
          NO VOTE RECORDED:  De La Torre, Evans, Fletcher, Harkey,  
            Nava, Villines, John A. Perez, Vacancy


          CTW:mw  8/3/10   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

                                ****  END  ****