BILL ANALYSIS Ó
AB 620
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CONCURRENCE IN SENATE AMENDMENTS
AB 620 (Buchanan)
As Amended September 5, 2013
Majority vote
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|ASSEMBLY: |75-0 |(May 9, 2013) |SENATE: |39-0 |(September 9, |
| | | | | |2013) |
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Original Committee Reference: HEALTH
SUMMARY : Requires intermediate care facilities, nursing
facilities, congregate living facilities, and adult day centers
to develop and comply with a patient or resident absentee
notification plan for the purpose of addressing issues that
arise when a resident is missing from the facility.
The Senate amendments clarify that the absentee notification
plans must include, and are limited to, provisions requiring a
resident's or participant's authorized representative be
notified when the resident or participant is missing and include
the circumstances in which an administrator of a facility or
program shall notify local law enforcement when a resident or
participant is missing. Senate amendments also clarify that the
patient safety plans be either stand-alone plans, or a part of
the written plans and procedures required by existing federal or
state law, depending on the type of facility, and exempt State
Hospitals from the requirements of this bill if it is determined
that informing the patient's authorized representative will
create a risk to the safety and security of the State Hospital.
AS PASSED BY THE ASSEMBLY , this bill required specified health
facilities offering adult day health programs and adult day
health centers to develop, implement, comply with, and review
annually a patient safety plan for the purposes of addressing
issues that arise when a patient is missing from the facility.
FISCAL EFFECT : According to the Senate Appropriations
Committee, pursuant to Senate Rule 28.8, negligible state costs.
COMMENTS : According to the author, current state regulations
require these long-term care facilities (LTFs) to report to
regulators when the facility has filed a missing persons report
with a law enforcement agency. However, LTFs are not required
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to file a missing persons report with law enforcement or to
notify relevant family members or caregivers when a person is
missing. The author states that the safety of individuals
living in care facilities, or participating in a day program, is
at risk, as is evidenced by recent cases. According to an
October 10, 2012, article in the Contra Costs Times provided by
the author, an 86-year old female resident went missing from
Julia's Home, an adult care home in Concord. The woman was
discovered missing by a caretaker at approximately 4:30 pm, who
then conducted a search for an hour before notifying the police
at 5:30 pm. The resident, an Alzheimer's patient who also
suffered from terminal heart failure, was found dead later that
evening after a police dog traced her scent. The woman's
relatives were never notified she was missing.
According to information provided by the Department of Social
Services (DSS), community care facilities offer a home-like
environment that is less restrictive than the institutionalized
setting of a nursing home or developmental center, for example.
Resident care and supervision needs are determined on a case by
case basis by the residents, their responsible parties, and the
licensee, and the care plans are documented in the resident
record. The residents have personal rights allowing them to
leave the facility if they wish to do so. However, supervision
is to be provided in cases where it is needed when a resident
wants to leave. Statute prohibits residents from being in a
locked environment. Licensees are currently required to contact
emergency personnel when needed. Law enforcement and some
family members have expressed concerns with the licensee calling
9-1-1 whenever an independent resident leaves the facility. If
the resident is not an immediate danger to themselves or others,
law enforcement has communicated that it is an abuse of the
9-1-1 system. Overuse of 9-1-1 has also strained the
relationship between licensees and law enforcement.
Adult residential facilities are facilities of any capacity that
provide 24-hour non-medical care for adults ages 18 through 59,
who are unable to provide for their own daily needs. Adults in
these facilities may be physically handicapped, developmentally
disabled, and/or mentally disabled. Adult day programs are
community-based facilities or programs that provide care to
persons 18 years of age or older in need of personal services,
supervision, or assistance essential for sustaining the
activities of daily living or for the protection of these
individuals on less than a 24-hour basis. Residential care
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facilities for the elderly (RCFEs) provide care, supervision,
and assistance with activities of daily living, such as bathing
and grooming. RCFEs may also provide incidental medical
services under special care plans. RCFEs provide services to
persons 60 years of age and over and persons under 60 with
compatible needs. RCFEs may also be known as assisted living
facilities, retirement homes, and board and care homes and can
range in size from six beds or less to over 100 beds. The
residents in these facilities require varying levels of personal
care and protective supervision.
According to DSS, regulations state that if a client requires
protective supervision because of running or wandering away,
supervision may be enhanced by fencing yards, using self-closing
latches and gates, and installing operational bells, buzzers, or
other auditory devices on exterior doors to alert staff when the
door is opened. However, DSS notes that the fencing and devices
must not substitute for appropriate staffing.
According to federal skilled nursing facility regulations,
elopement occurs when a resident leaves the premises or a safe
area without authorization (i.e., an order for discharge or
leave of absence) and/or any necessary supervision to do so. A
resident who leaves a safe area may be at risk of (or has the
potential to experience) heat or cold exposure, dehydration,
and/or other medical complications, drowning, or being struck by
a motor vehicle. A facility's disaster and emergency
preparedness plan should include a plan to locate a missing
resident.
The Alzheimer's Association writes in support of this bill that
they believe it is of great importance for these facilities to
have plans and procedures in place when patients go missing
under circumstances that are unusual or suspicious. This is of
particular importance for those living with Alzheimer's, as six
in 10 wander at some point and in these instances, it is
critical that steps are taken immediately since roughly 50% of
these individuals risk serious injury or death if not found in
the first 24 hours.
Analysis Prepared by : Lara Flynn / HEALTH / (916) 319-2097
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AB 620
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