Amended in Senate August 18, 2014

Amended in Senate June 26, 2014

Amended in Assembly May 23, 2014

Amended in Assembly April 22, 2014

California Legislature—2013–14 Regular Session

Assembly Bill No. 1570

Introduced by Assembly Member Chesbro

January 30, 2014

An act to amend, repeal, and add Sections 1569.23, 1569.625, and 1569.626 of the Health and Safety Code, relating to care facilities.

LEGISLATIVE COUNSEL’S DIGEST

AB 1570, as amended, Chesbro. Residential care facilities for the elderly.

Existing law provides for the licensure and regulation of residential care facilities for the elderly by the State Department of Social Services. Violation of these provisions is a misdemeanor. Existing law requires, as a requirement for licensure, that the applicant demonstrate that he or she has successfully completed a certification program approved by the department that includes, at a minimum, 40 hours of classroom instruction, and provides that successful completion of the certification program shall be demonstrated by passing a written test and submitting a begin insert $100 end insert fee to the department for the issuance of a certificate of completion. Existing law also requires the department to adopt regulations to require staff members of residential care facilities for the elderly who assist residents with personal activities of daily living to receive appropriate training, which includes 10 hours within the first 4 weeks of employment and 4 hours annually thereafter. Existing law requires all residential care facilities for the elderly that advertise or promote special care, special programming, or a special environment for persons with dementia to meet additional training requirements for all direct staff.

This bill would, effective January 1, 2016, instead, require the certification program for an applicant for licensure to consist of 100 hours of course work and a state-administered examination of no less than 100 questions. The bill would require the examination to reflect the uniform core of knowledge required and would require the department, no later than July 1, 2016, and every other year thereafter, to review and revise the examination to reflect changes in law and regulations in order to ensure the rigor and quality of the examination. begin insert The bill would also change the certification fee to an amount not to exceed $150. end insert The bill would require staff members of residential care facilities for the elderly who assist residents with personal activities of daily living to receive begin delete 40 end delete begin insert 20 end insert hours of training before working independently with residents, begin insert an additional 20 hours within the first 4 weeks of employment, end insert and an additional 20 hours annually, as prescribed. The bill would also apply the training requirements specific to dementia care to all residential care facilities for the elderly.

By expanding the scope 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.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes.

The people of the State of California do enact as follows:

SECTION 1.  

Section 1569.23 of the Health and Safety Code
is amended to read:

1569.23.  

(a)  As a requirement for licensure, the applicant
shall demonstrate that he or she has successfully completed a
certification program approved by the department.

(b)  The certification program shall be for a minimum of 40
hours of classroom instruction and include a uniform core of
knowledge which shall include all of the following:

(1)  Law, regulations, policies, and procedural standards that
impact the operations of residential care facilities for the elderly.

(2)  Business operations.

(3)  Management and supervision of staff.

(4)  Psychosocial need of the elderly residents.

(5)  Physical needs for elderly residents.

(6)  Community and support services.

(7)  Use, misuse, and interaction of drugs commonly used by
the elderly.

(8)  Resident admission, retention, and assessment procedures.

(c)  Successful completion of the certification program shall be
demonstrated by passing a written test and submitting a fee of one
hundred dollars ($100) to the department for the issuance of a
certificate of completion.

(d)  The department shall establish by regulation the program
content, the testing instrument, process for approving certification
programs, and criteria to be used for authorizing individuals or
organizations to conduct certification programs. These regulations
shall be developed with the participation of provider organizations.

(e)  This section shall apply to all applications for licensure
unless the applicant provides evidence that he or she has a current
license for another residential care facility for the elderly which
was initially licensed prior to July 1, 1989, or has successfully
completed an approved certification program within the prior five
years.

(f)  If the applicant is a firm, partnership, association, or
corporation, the chief executive officer, or other person serving in
a like capacity, or the designated administrator of the facility, shall
provide evidence of successfully completing an approved
certification program.

(g) This section shall remain in effect only until January 1, 2016,
and as of that date is repealed, unless a later enacted statute, that
is enacted before January 1, 2016, deletes or extends that date.

SEC. 2.  

Section 1569.23 is added to the Health and Safety
Code, to read:

1569.23.  

(a) As a requirement for licensure, the applicant shall
demonstrate that he or she has successfully completed a
certification program approved by the department.

(b) The certification program shall consist of both of the
following:

(1) One hundred hours of coursework, at least 60 hours of which
shall be attended in person.

(2) A state-administered examination consisting of no less than
100 questions. The examination shall reflect the uniform core of
knowledge required pursuant to subdivision (c).

(c) The certification program shall include a uniform core of
knowledge which shall include all of the following:

(1) Law, including regulations, policies, and procedural
standards that impact the operations of residential care facilities
for the elderly.

(2) Business operations.

(3) Management and supervision of staff.

(4) Psychosocial need of the elderly residents.

(5) Physical needs for elderly residents.

(6) Community and support services.

(7) Medication management, including use, misuse, and
interaction of drugs commonly used by the elderly, including
antipsychotics, and the adverse effects of psychotropic drugs for
use in controlling the behavior of persons with dementia.

(8) Resident admission, retention, and assessment procedures.

(9) Managing Alzheimer’s disease and related dementias,
including nonpharmacologic, person-centered approaches to
dementia care.

(10) Managing the physical environment, including maintenance
and housekeeping.

(11) Residents’ rights, and the importance of initial and ongoing
training for all staff to ensure residents’ rights are fully respected
and implemented.

(12) Cultural competency and sensitivity in issues relating to
the underserved, aging, lesbian, gay, bisexual, and transgender
community.

(13) Postural supports, restricted health conditions, and hospice
care.

(d) Successful completion of the certification program shall be
demonstrated by passing the state-administered examination and
submitting a fee begin delete of one hundred dollars ($100) end delete begin insert not to exceed one
hundred fifty dollars ($150) end insert to the department for the issuance of
a certificate of completion.

(e) (1) The department shall establish by regulation the program
content, the testing instrument, process for approving certification
programs, and criteria to be used for authorizing individuals or
organizations to conduct certification programs. These regulations
shall be developed with the participation of provider organizations.

(2) The department shall ensure that the examination consists
of at least 100 questions and allows an applicant to have access to
the California Residential Care Facility for the Elderly begin delete Act, related
regulations, and the evaluator manual end delete begin insert Act and related regulations end insert
during the examination. The department, no later than July 1 of
every other year, shall review and revise the examination in order
to ensure the rigor and quality of the examination. Each year, the
department shall ensure by January 1 that the exam is not in conflict
with current law. The department may convene a stakeholder group
to assist in developing and reviewing test questions.

(f) This section shall apply to all applications for licensure unless
the applicant provides evidence that he or she has a current license
for another residential care facility for the elderly which was
initially licensed prior to July 1, 1989, or has successfully
completed an approved certification program within the prior five
years.

(g) If the applicant is a firm, partnership, association, or
corporation, the chief executive officer, or other person serving in
a like capacity, or the designated administrator of the facility, shall
provide evidence of successfully completing an approved
certification program.

(h) This section shall become operative on January 1, 2016.

SEC. 3.  

Section 1569.625 of the Health and Safety Code is
amended to read:

1569.625.  

(a)  The Legislature finds that the quality of services
provided to residents of residential care facilities for the elderly is
dependent upon the training and skills of staff. It is the intent of
the Legislature in enacting this section to ensure that direct-care
staff have the knowledge and proficiency to carry out the tasks of
their jobs.

(b)  The department shall adopt regulations to require staff
members of residential care facilities for the elderly who assist
residents with personal activities of daily living to receive
appropriate training. This training shall consist of 10 hours of
training within the first four weeks of employment and four hours
annually thereafter. This training shall be administered on the job,
or in a classroom setting, or any combination of the two. The
department shall establish, in consultation with provider
organizations, the subject matter required for this training.

(c)  The training shall include, but not be limited to, all of the
following:

(1)  Physical limitations and needs of the elderly.

(2)  Importance and techniques for personal care services.

(3)  Residents’ rights.

(4)  Policies and procedures regarding medications.

(5)  Psychosocial needs of the elderly.

(d) This section shall remain in effect only until January 1, 2016,
and as of that date is repealed, unless a later enacted statute, that
is enacted before January 1, 2016, deletes or extends that date.

SEC. 4.  

Section 1569.625 is added to the Health and Safety
Code, to read:

1569.625.  

(a) The Legislature finds that the quality of services
provided to residents of residential care facilities for the elderly is
dependent upon the training and skills of the staff. It is the intent
of the Legislature in enacting this section to ensure that direct-care
staff have the knowledge and proficiency to carry out the tasks of
their jobs.

(b) (1) The department shall adopt regulations to require staff
members of residential care facilities for the elderly who assist
residents with personal activities of daily living to receive
appropriate training. This training shall consist of 40 hours begin delete of
training to be completed before a staff member begins working
independently with residents. The 40 hours of training shall consist
of 24 hours of coursework training prior to resident contact,
including 12 end delete begin insert training. A staff member shall complete 20 hours,
including six end insert hours specific to dementia care, as required by
subdivision (a) of Section 1569.626 and four hours specific to
postural supports, restricted health conditions, and hospice care,
as required by subdivision (a) of Section begin delete 1569.696. end delete begin insert 1569.696,
before working independently with residents. The remaining 20
hours shall include six hours specific to dementia care and shall
be completed within the first four weeks of employment. end insert The
training coursework may utilize various methods of instruction,
including, but not limited to, lectures, instructional videos, and
interactive online courses. The additional 16 hours shall be
hands-on training.

(2) In addition to paragraph (1), training requirements shall also
include an additional 20 hours annually, begin delete including the first year
of employment, end delete eight hours of which shall be dementia care
training, as required by subdivision begin delete (b) end delete begin insert (a) end insert of Section 1569.626,
and begin delete two end delete begin insert four end insert hours of which shall be specific to postural supports,
restricted health conditions, and hospice care, as required by
subdivision (a) of Section 1569.696. This training shall be
administered on the job, or in a classroom setting, or begin delete both. end delete begin insert both,
and may include online training. end insert

(3) The department shall establish, in consultation with provider
organizations, the subject matter required for the training required
by this section.

(c) The training shall include, but not be limited to, all of the
following:

(1) Physical limitations and needs of the elderly.

(2) Importance and techniques for personal care services.

(3) Residents’ rights.

(4) Policies and procedures regarding medications.

(5) Psychosocial needs of the elderly.

(6) Dementia care, including the use and misuse of
antipsychotics, the interaction of drugs commonly used by the
elderly, and the adverse effects of psychotropic drugs for use in
controlling the behavior of persons with dementia.

(7) The special needs of persons with Alzheimer’s disease and
dementia, including nonpharmacologic, person-centered approaches
to dementia care.

(8) Cultural competency and sensitivity in issues relating to the
underserved, aging, lesbian, gay, bisexual, and transgender
community.

(d) This section shall not apply to certified nurse assistants,
certified pursuant to Article 9 (commencing with Section 1337)
of Chapter 2, licensed vocational nurses, licensed pursuant to
Chapter 6.5 (commencing with Section 2840) of Division 2 of the
Business and Professions Code, and registered nurses, licensed
pursuant to Chapter 6 (commencing with Section 2700) of Division
2 of the Business and Professions Code, except both of the
following shall apply:

(1) A licensed or certified health professional with valid
certification shall receive eight hours of training on resident
characteristics, resident records, and facility practices and
procedures prior to providing direct care to residents.

(2) In addition to paragraph (1), a certified nurse assistant shall
also receive the 12 hours of dementia care training specified in
Section 1569.626 and the annual training specified in paragraph
(2) of subdivision (b).

(e) This section shall become operative on January 1, 2016.

SEC. 5.  

Section 1569.626 of the Health and Safety Code is
amended to read:

1569.626.  

(a) All residential care facilities for the elderly that
advertise or promote special care, special programming, or a special
environment for persons with dementia, in addition to complying
with the training requirements described in Section 1569.625, shall
meet the following training requirements for all direct care staff:

(1) Six hours of resident care orientation within the first four
weeks of employment. All six hours shall be devoted to the care
of persons with dementia. The facility may utilize various methods
of instruction, including, but not limited to, preceptorship,
mentoring, and other forms of observation and demonstration. The
orientation time shall be exclusive of any administrative instruction.

(2) Eight hours of in-service training per year on the subject of
serving residents with dementia. This training shall be developed
in consultation with individuals or organizations with specific
expertise in dementia care or by an outside source with expertise
in dementia care. In formulating and providing this training,
reference may be made to written materials and literature on
dementia and the care and treatment of persons with dementia.
This training requirement may be satisfied in one day or over a
period of time. This training requirement may be provided at the
facility or offsite and may include a combination of observation
and practical application.

(b) This section shall remain in effect only until January 1, 2016,
and as of that date is repealed, unless a later enacted statute, that
is enacted before January 1, 2016, deletes or extends that date.

SEC. 6.  

Section 1569.626 is added to the Health and Safety
Code, to read:

1569.626.  

(a) All residential care facilities for the elderly shall
meet the following training requirements, as described in Section
1569.625, for all direct care staff:

(1) Twelve hours of dementia care training begin insert , six of which shall
be completed end insert before a staff member begins working independently
with begin delete residents. end delete begin insert residents, and the remaining six hours of which
shall be completed within the first four weeks of employment. end insert All
12 hours shall be devoted to the care of persons with dementia.
The facility may utilize various methods of instruction, including,
but not limited to, preceptorship, mentoring, and other forms of
observation and demonstration. The orientation time shall be
exclusive of any administrative instruction.

(2) Eight hours of in-service training per year on the subject of
serving residents with dementia. This training shall be developed
in consultation with individuals or organizations with specific
expertise in dementia care or by an outside source with expertise
in dementia care. In formulating and providing this training,
reference may be made to written materials and literature on
dementia and the care and treatment of persons with dementia.
This training requirement may be satisfied in one day or over a
period of time. This training requirement may be provided at the
facility or offsite and may include a combination of observation
and practical application.

(b) This section shall become operative on January 1, 2016.

SEC. 7.  

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.