BILL ANALYSIS Ó
AB 2297
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Date of Hearing: May 9, 2012
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
AB 2297 (Hayashi) - As Amended: April 24, 2012
Policy Committee: HealthVote:19-0
Urgency: No State Mandated Local Program:
Yes Reimbursable: No
SUMMARY
This bill, as proposed to be amended , would exempt intermediate
care facilities for the developmentally disabled (ICF/DDs) with
a capacity of six or fewer beds from local permitting and
inspection as food facilities. Specifically, this bill:
1)Exempts ICF/DDs with six beds or fewer from regulation as food
facilities under the California Retail Food Code (CRFC).
2)Requires facilities to report food-borne illness outbreaks to
CDPH and local health departments.
3)Provides that, with respect to structural changes to long-term
care facilities, approval of plans by the Office of Statewide
Health Planning and Development (OSHPD) shall be deemed
compliance with a plan approval process for food facilities
required by a local enforcement agency. States that OSHPD
retains primary jurisdiction over plan approval.
FISCAL EFFECT
Negligible state fiscal effect.
COMMENTS
1)Rationale . According to the author, under current law, all
long-term health facilities, including six-bed ICF/DDs, are
classified as food facilities. Because of this
classification, these facilities experience a duplication of
inspections at both the state and local levels. The sponsor of
this bill, California Association of Health Facilities (CAHF),
argues that ICF/DDs should be excluded from the CRFC because
AB 2297
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they are typically six-bed facilities located in residential
neighborhoods equipped with the same type of kitchen and
pantry as those of a single family residence. In addition,
CAHF points out that ICF/DDs are subject to multiple
inspections relating to food safety and sanitation, including
annual licensing surveys and separate certification surveys
for participation in the Medicare or Medicaid programs by
CDPH, and additional inspections by county inspectors during
the year, because they currently fall under the definition of
a food facility.
2)ICF/DDs . ICF/DDs provide less intensive nursing care than
skilled nursing, and also provide dietary, pharmacy, personal
care, and social and activity services to developmentally
disabled individuals who need occasional or continuous nursing
care.
3)Inspections . According to CDPH, the CRFC contains the
structural, equipment, and operational requirements for all
California retail food facilities. Provisions of the CRFC are
enforced by 62 local environmental health regulatory agencies
through inspections and enforcement activities.
CDPH also performs required licensing and certification
inspections for ICF/DDs and other health facilities. These
inspections include specific requirements related to food
preparation and dietary services.
4)DPH Report . In 2008, CAHF sponsored AB 1773 (Hayashi), which
would have exempted all LTCFs from CRFC requirements, but
suspended the development of legislation when CDPH agreed to
conduct a comprehensive review of the food safety and food
services provisions in the federal certification and state
licensure regulations and compare them to the CRFC
requirements used by local environmental health directors
(LEHDs) during the inspection of LTCFs. CDPH's review
indicates that:
a) The CRFC is much more detailed, scientifically current,
and public health protective than either state or federal
regulations as they pertain to food services.
b) Each inspection/survey entity has unique and separate
compliance authority.
c) While some overlap exists in four of 33 food safety
requirements that were reviewed, the scope of the CPDH
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survey is done by registered nurses and is different from
the scope of the LEHD inspection that is often done by
registered environmental health specialists who are trained
to focus on factors that contribute to foodborne illnesses
and outbreaks.
d) LEHDs have a higher inspection frequency of two to four
times per year compared to L&C surveys every 15 months.
e) LEHDs have more enforcement authority and options
available to gain compliance in the food safety arena than
CPDH.
5)OSHPD . The Facilities Development Division at OSHPD is
responsible for reviewing and inspecting health facility
construction projects. This bill would deem approval of plans
by OSHPD as compliance with local enforcement agency
requirements in order to prevent what the sponsor sees as
duplicative, sometimes conflicting reviews and approvals of
facility improvement plans.
6)The recommended amendment removes a provision that requires
CDPH to inspect facilities for compliance with the applicable
food and facility sanitation requirements during the annual
licensing and certification surveys. This provision is
unnecessary; current law and regulation already specifies the
sanitation-related content of the licensing inspections.
Analysis Prepared by : Lisa Murawski / APPR. / (916) 319-2081