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 ****