BILL ANALYSIS
------------------------------------------------------------
|SENATE RULES COMMITTEE | AB 2675|
|Office of Senate Floor Analyses | |
|1020 N Street, Suite 524 | |
|(916) 651-1520 Fax: (916) | |
|327-4478 | |
------------------------------------------------------------
THIRD READING
Bill No: AB 2675
Author: Chesbro (D)
Amended: As introduced
Vote: 21
SENATE HEALTH COMMITTEE : 5-0, 6/9/10
AYES: Alquist, Cedillo, Leno, Negrete McLeod, Pavley
NO VOTE RECORDED: Strickland, Aanestad, Cox, Romero
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
ASSEMBLY FLOOR : 74-0, 5/6/10 - See last page for vote
SUBJECT : Health facilities: licensee orientation
SOURCE : California Association of Health Facilities
DIGEST : This bill requires applicants for an
intermediate care facility for the developmentally
disabled-habilitative (ICF/DD-H) or intermediate care
facility for the developmentally disabled-nursing
(ICF/DD-N) license to attend a 16-hour orientation approved
by the Department of Developmental Services. This bill
increases training from eight hours to 16 hours and
requires the new training hours to address specific
financial issues.
ANALYSIS :
Existing law
CONTINUED
AB 2675
Page
2
1. Establishes the State Department of Public Health (DPH)
and deems DPH responsible for the licensing and
regulation of health facilities, including ICFs/DD-H and
ICFs/DD-N.
2. Establishes Department of Developmental Services (DDS)
and sets forth its powers and duties relating to the
administration of the state developmental centers and
entering into contracts with regional centers for the
provision of ICF/DD-H and ICF/DD-N services to consumers
in the community.
3. Establishes DHCS and deems DHCS responsible for the
certification review process to ensure that ICFs/DD-H
and ICFs/DD-N meet the federal standards of
participation in the Medi-Cal Program.
4. Establishes the Lanterman Developmental Disabilities
Services Act which provides the right of Californians
with developmental disabilities to receive treatment and
habilitation services and supports in the least
restrictive environment.
5. Establishes the Supreme Court decision in Olmstead v.
L.C. (1999) 527 U.S. 581 (Olmstead), which interprets
Title II of the Americans with Disabilities Act to
require federal, state, and local governments to develop
more opportunities for individuals with disabilities
through accessible systems of cost-effective
community-based services.
6. Requires an applicant, or an applicant's designee for
initial licensure of an ICF/DD-H and ICF/DD-N, to attend
an eight-hour orientation program containing the
following components approved by DDS:
A. The scope of responsibility for operation
including regulatory requirements and statutes
governing the facility type.
B. Local planning.
C. Regional center and other community support
AB 2675
Page
3
services.
D. All federal and state agencies responsible for
licensing and certification, and data collection.
E. Government and private agencies responsible for
ensuring the rights of the developmentally
disabled.
7. Requires that the ICF/DD-H and ICF/DD-N orientation
program be conducted by relevant community services and
provider organizations.
8. Requires that organizations conducting the ICF/DD-H and
ICF/DD-N orientation program be responsible for keeping
a record of all attendees and to provide DDS with the
information within 15 working days or upon request.
9. Requires that instructors of the ICF/DD-H and ICF/DD-N
orientation program have knowledge or experience in the
subject area to be taught and to meet any of the
following criteria:
A. Possession of a four-year degree relevant to
the course or courses to be taught.
B. Be a health professional with a valid and
current license to practice in California.
C. Have at least two years experience in
California as an administrator of a long-term
health care facility that provides services to
persons with developmental disabilities within the
last eight years.
10.Requires that, if the licensee can demonstrate to the
satisfaction of DDS that the licensee, or a
representative of the licensee, has taken the
orientation program any year prior to opening a new
facility, the licensee will not be required to repeat
the program to open the facility.
This bill:
AB 2675
Page
4
1. Requires an applicant, or an applicant's designee for
initial licensure of an ICF/DD-H or an ICF/DD-N, to
attend an additional eight-hour orientation program
approved by DDS.
2. Requires the additional eight-hour orientation program
to outline the statutory and regulatory requirements
related to business management. Requires the orientation
program to include, but need not be limited to, all of
the following:
A. Cost reporting.
B General accounting principles.
C. The State Department of Health Care Services'
(DHCS) audit process.
D. The regional center vendorization process.
Background
ICFs/DD-H and ICFs/DD-N are health facilities that provide
24-hour personal care, developmental and habilitative
training and health services in small community settings to
adults and children with developmental disabilities. While
the Licensing and Certification Division of DPH licenses
these facilities, the Health Facilities Program Section at
DDS reviews and approves program plans for potential
facilities and approves the orientation required by each
licensure applicant. The DHCS' Medi-Cal Field Offices
conducts financial audits of these facilities.
In accordance with the Lanterman Act and the federal
American with Disabilities Act Olmstead decision, across
the country, states have been closing large institutions
for people with developmental disabilities and
transitioning them into community settings. According to
the California Alliance for Inclusive Communities, nine
states have eliminated public institutions altogether.
With the closure and relocation of the Agnews Development
Center in San Jose, a large state institution that housed
at one time nearly 350 people with developmental
disabilities, California is in the process of following
this trend. The number of people with developmental
disabilities receiving care in small 4 to 15 bed ICFs/DD-H
and ICFs/DD-N is increasing. According to DPH, there are
AB 2675
Page
5
currently 776 licensed ICFs/DD-H and 405 licensed ICFs/DD-N
in the state, with 54 program plans under review for
potential facilities that are not yet licensed.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
SUPPORT : (Verified 6/21/10)
California Association of Health Facilities (source)
ARGUMENTS IN SUPPORT : According to CAHF, in 1996 the
Legislature recognized the need to educate licensees of
small ICFs/DD about the rules and regulations governing
their operation. As a result, potential ICF/DD providers
are currently required to complete a statutorily mandated
eight-hour orientation prior to licensure. According to
CAHF, the eight-hour course focuses on California's
developmental disabilities system and ICF/DD programmatic
and regulatory requirements. CAHF argues that, while there
is a brief overview of business-related regulatory
requirements, a practical discussion of business
considerations is lacking which could lead to poorly
crafted business plans that may ultimately place some
ICF/DD providers at greater risk of financial insolvency.
CAHF, asserts that adding eight hours of business
management training to the existing course requirement will
address this issue.
ASSEMBLY FLOOR :
AYES: Adams, Ammiano, Anderson, Arambula, Beall, Bill
Berryhill, Tom Berryhill, Blakeslee, Blumenfield,
Bradford, Brownley, Buchanan, Caballero, Charles
Calderon, Carter, Chesbro, Conway, Cook, Coto, Davis, De
Leon, DeVore, Emmerson, Eng, Evans, Feuer, Fletcher,
Fong, Fuentes, Fuller, Furutani, Gaines, Galgiani,
Garrick, Hagman, Hall, Harkey, Hayashi, Hernandez, Hill,
Huber, Huffman, Jeffries, Jones, Knight, Lieu, Logue,
Bonnie Lowenthal, Ma, Miller, Monning, Nava, Nestande,
Niello, Nielsen, Norby, V. Manuel Perez, Portantino,
Ruskin, Salas, Saldana, Silva, Skinner, Smyth, Solorio,
AB 2675
Page
6
Audra Strickland, Swanson, Torlakson, Torres, Torrico,
Tran, Villines, Yamada, John A. Perez
NO VOTE RECORDED: Bass, Block, De La Torre, Gilmore,
Mendoza, Vacancy
CTW:do 6/21/10 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
**** END ****