BILL NUMBER: SB 91 CHAPTERED
BILL TEXT
CHAPTER 119
FILED WITH SECRETARY OF STATE JULY 25, 2011
APPROVED BY GOVERNOR JULY 25, 2011
PASSED THE SENATE JULY 14, 2011
PASSED THE ASSEMBLY JULY 14, 2011
AMENDED IN ASSEMBLY JULY 12, 2011
INTRODUCED BY Committee on Budget and Fiscal Review
JANUARY 10, 2011
An act to amend Sections 1570.7, 1574.5, 1576.2, and 1578.1 of,
and to repeal Sections 1575.5 and 1590.3 of, the Health and Safety
Code, and to amend Section 14574 of the Welfare and Institutions
Code, relating to adult day health care, and making an appropriation
therefor, to take effect immediately, bill related to the budget.
LEGISLATIVE COUNSEL'S DIGEST
SB 91, Committee on Budget and Fiscal Review. Adult day health
care centers.
Existing law, the California Adult Day Health Care Act, provides
for the licensure and regulation of adult day health care centers,
with administrative responsibility shared between the State
Department of Public Health, the State Department of Health Care
Services, and the California Department of Aging pursuant to an
interagency agreement. Existing law provides that a negligent,
repeated, or willful violation of a provision of the California Adult
Day Health Care Act is a misdemeanor.
Existing law establishes the Medi-Cal program, administered by the
State Department of Health Care Services, under which health care
services are provided to qualified, low-income persons. The Medi-Cal
program is, in part, governed and funded by federal Medicaid Program
provisions. Existing law provides, to the extent permitted by federal
law, that adult day health care be excluded from coverage under the
Medi-Cal program.
Existing law requires, concurrently with the submission of an
application for initial licensure as an adult day health care center,
an applicant to apply for eligibility certification as a provider of
adult day health care services reimbursable under the Medi-Cal
program. Existing law also prohibits a license from being issued or
renewed for an adult day health care center that is not approved as a
Medi-Cal provider of adult day health care services.
This bill would remove the requirement that an applicant for
initial licensure as an adult day health care center apply for
Medi-Cal certification. This bill would also remove the prohibition
against issuing or renewing a license for an adult day health care
center that is not approved as a Medi-Cal provider of adult day
health care services, and would make conforming changes.
Existing law provides that if an adult day health care center
licensee provides adult day program services, the adult day health
care license is the only license required to provide these additional
services.
This bill would require a provider choosing to add an adult day
program within the adult day health care facility to submit a notice
to the State Department of Public Health. By changing the definition
of a crime, this 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.
This bill would appropriate the sum of $1,000 from the General
Fund to the State Department of Public Health for administrative
costs.
This bill would declare that it is to take effect immediately as a
bill providing for appropriations related to the Budget Bill.
Appropriation: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 1570.7 of the Health and Safety Code is amended
to read:
1570.7. As used in this chapter and in any regulations
promulgated thereunder:
(a) "Adult day health care" means an organized day program of
therapeutic, social, and skilled nursing health activities and
services provided pursuant to this chapter to elderly persons or
adults with disabilities with functional impairments, either physical
or mental, for the purpose of restoring or maintaining optimal
capacity for self-care. Provided on a short-term basis, adult day
health care serves as a transition from a health facility or home
health program to personal independence. Provided on a long-term
basis, it serves as an alternative to institutionalization in a
long-term health care facility when 24-hour skilled nursing care is
not medically necessary or viewed as desirable by the recipient or
his or her family.
(b) "Adult day health center" or "adult day health care center"
means a licensed facility that provides adult day health care.
(c) "Core staff" includes the positions of program director,
registered nurse, social worker, activity director, and program aide.
(d) "Department" or "state department" means the State Department
of Public Health.
(e) "Director" means the State Public Health Officer.
(f) "Elderly" or "older person" means a person 55 years of age or
older, but also includes other adults who are chronically ill or
impaired and who would benefit from adult day health care.
(g) "Extended hours" means those hours of operation prior to or
following the adult day health care program hours of service, as
designated by the adult day health care center in its plan of
operation, during which the adult day health care center may operate
an adult day program, or an Alzheimer's day care resource center, or
both.
(h) "Hours of service" means the program hours defined and posted
by the adult day health care center for the provision of adult day
health care services, pursuant to Section 14550 of the Welfare and
Institutions Code, which shall be no less than four hours, excluding
transportation.
(i) "Individual plan of care" means a plan designed to provide
recipients of adult day health care with appropriate treatment in
accordance with the assessed needs of each individual.
(j) "License" means a basic permit to operate an adult day health
care center. With respect to a health facility licensed pursuant to
Chapter 2 (commencing with Section 1250), "license" means a special
permit, as defined by Section 1251.5, empowering the health facility
to provide adult day health care services.
(k) "Long-term absence" or "long-term vacancy" means an absence or
vacancy lasting, or likely to last, more than one month. An adult
day health care center's policies and procedures shall be specific
regarding coverage in the situation for long-term absences or
vacancies.
(l) "Maintenance program" means procedures and exercises that are
provided to a participant, pursuant to Section 1580, in order to
generally maintain existing function. These procedures and exercises
are planned by a licensed or certified therapist and are provided by
a person who has been trained by a licensed or certified therapist
and who is directly supervised by a nurse or by a licensed or
certified therapist.
(m) "Program director" shall be a person with both of the
following:
(1) One of the following backgrounds:
(A) A person with a bachelor's degree and a minimum of two years
of experience in a management, supervisory, or administrative
position.
(B) A person with a master's degree and a minimum of one year of
experience in a management, supervisory, or administrative position.
(C) A registered nurse with a minimum of two years experience in a
management, supervisory, or administrative position.
(2) Appropriate skills, knowledge, and abilities related to the
health, and mental, cognitive, and social needs of the participant
group being served by the adult day health center.
(n) "Restorative therapy" means physical, occupational, and speech
therapy, and psychiatric and psychological services that are planned
and provided by a licensed or certified therapist. The therapy and
services may also be provided by an assistant or aide under the
appropriate supervision of a licensed therapist, as determined by the
licensed therapist. The therapy and services are provided to restore
function, when there is an expectation that the condition will
improve significantly in a reasonable period of time, as determined
by the multidisciplinary assessment team.
(o) "Short-term absence" or "short-term vacancy" means an absence
or vacancy lasting one month or less, and includes sick leave and
vacations. An adult day health care center shall ensure that
appropriate staff is designated to serve in these positions during
the short-term absence or vacancy and that the center's policies and
procedures are specific regarding coverage of short-term absences or
vacancies.
(p) "Social worker" shall be a person who meets one of the
following:
(1) The person holds a master's degree in social work from an
accredited school of social work.
(2) The person holds a master's degree in psychology, gerontology,
or counseling from an accredited school and has one year of
experience providing social services in one or more of the fields of
aging, health, or long-term care services.
(3) The person is licensed by the California Board of Behavioral
Sciences.
(4) The person holds a bachelor's degree in social work from an
accredited school with two years of experience providing social
services in one or more of the fields of aging, health, or long-term
care services.
SEC. 2. Section 1574.5 of the Health and Safety Code is amended to
read:
1574.5. (a) All adult day health care centers shall maintain
compliance with licensing requirements. These requirements shall not
prohibit program flexibility for the use of alternate concepts,
methods, procedures, techniques, equipment, number and qualifications
of personnel, or the conducting of pilot projects, if these
alternatives or pilot projects are carried out with provisions for
safe and adequate care and with the prior written approval of the
state department. This approval shall provide for the terms and
conditions under which permission to use an alternative or pilot
program is granted. Particular attention shall be given to encourage
the development of models appropriate to rural areas. The department
may allow the substitution of work experience for academic
requirements for the position of program director, administrator, or
activity coordinator.
(b) The applicant or licensee may submit a written request to the
department for program flexibility, and shall submit with the
request substantiating evidence supporting the request.
(c) Any approval by the department granted under this section, or
a true copy thereof, shall be posted immediately adjacent to the
center's license.
SEC. 3. Section 1575.5 of the Health and Safety Code is repealed.
SEC. 4. Section 1576.2 of the Health and Safety Code is amended to
read:
1576.2. Each license issued or renewed pursuant to this chapter
shall not be transferable and the initial license shall expire 12
months from the date of its issuance. The director shall be given the
discretion to approve applications for relicensure for a period of
up to 24 months. Application for annual renewal of a license,
accompanied by the required fee, shall be filed with the department
not less than 30 days prior to the expiration date. Failure to submit
a renewal application prior to that date shall result in expiration
of the license.
SEC. 5. Section 1578.1 of the Health and Safety Code is amended to
read:
1578.1. (a) Notwithstanding subdivisions (b) and (c) of Section
1570.7 or any other provision of law, if an adult day health care
center licensee also provides adult day program services, the adult
day health care license shall be the only license required to provide
these additional services. Costs shall be allocated among the
programs in accordance with generally accepted accounting practices.
(b) A provider choosing to add an adult day program within the
adult day health care facility shall submit a notice to the
department on such forms as may be required.
(c) Review and approval of the application to provide a dual
program shall not require an on-site inspection.
(d) The maximum licensed capacity shall be determined by the local
fire authority and shall include limits for ambulatory and
nonambulatory participants.
SEC. 6. Section 1590.3 of the Health and Safety Code is repealed.
SEC. 7. Section 14574 of the Welfare and Institutions Code is
amended to read:
14574. (a) The director shall terminate the Medi-Cal
certification of any adult day health care provider at any time if he
or she finds the provider is not in compliance with standards
prescribed by this chapter or Chapter 7 (commencing with Section
14000) or regulations adopted pursuant to these chapters. The
director shall give reasonable notice of his or her intention to
terminate the certification to the provider and participants in the
center. The notice shall state the effective date of, and the reason
for, the termination.
(b) The California Department of Aging and the department shall
coordinate proceedings to deny an application for certification, to
terminate or suspend certification, or to revoke or suspend licensure
to the extent appropriate to ensure consistency and uniformity.
(c) The provider shall have the right to appeal the department's
decision made pursuant to Section 14123.
(d) This section is not applicable to denials of initial
certification made pursuant to a moratorium imposed in accordance
with Section 14043.46 of the Welfare and Institutions Code.
SEC. 8. 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.
SEC. 9. The sum of one thousand dollars ($1,000) is hereby
appropriated from the General Fund to the State Department of Public
Health for administrative costs.
SEC. 10. This act is a bill providing for appropriations related
to the Budget Bill within the meaning of subdivision (e) of Section
12 of Article IV of the California Constitution, has been identified
as related to the budget in the Budget Bill, and shall take effect
immediately.