BILL ANALYSIS                                                                                                                                                                                                    Ó






                                  SENATE HUMAN
                               SERVICES COMMITTEE
                            Senator Jim Beall, Chair


          BILL NO:       AB 2386                                      
          A
          AUTHOR:        Mullin                                       
          B
          VERSION:       May 7, 2014
          HEARING DATE:  June 24, 2014                                
          2
          FISCAL:        Yes                                          
          3
                                                                      
          8
          CONSULTANT:    Sara Rogers                                  
          6

                                        

                                     SUBJECT
                                         
                   Care facilities: carbon monoxide detectors

                                     SUMMARY  

          This bill requires community care facilities, residential  
          care facilities for the elderly and child day care  
          facilities and homes to have one or more functioning carbon  
          monoxide detectors, as specified.

                                     ABSTRACT  

           Existing Law:


           1.Establishes the Community Care Facilities Act, which  
            provides for the licensure and regulation by CDSS of CCFs  
            defined as nonmedical residential and non-residential  
            facilities for mentally ill, developmentally and  
            physically disabled, and children and adults who require  
            care or services. (HSC Section 1500 et seq.)



                                                         Continued---




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          2.Establishes the Residential Care Facilities for the  
            Elderly Act, which provides for the licensure and  
            regulation of Residential Care Facilities for the Elderly  
            (RCFEs) as a separate category within the existing  
            residential care licensing structure of CDSS. (HSC 1569  
            et seq.)


          3.Establishes the California Child Day Care Facilities Act  
            to provide for the licensure and regulation of child day  
            care and family day care facilities as a separate  
            licensing category within the existing licensing  
            structure of CDSS (HSC 1596.72 et seq.)


          4.Provides for the CDSS licensure and regulation of small  
            family day care homes serving between six and eight  
            children, as specified, in a residentially zoned and  
            occupied property. (HSC 1597.30 et seq.)


          5.Provides that facilities licensed by CDSS shall be  
            subject to unannounced visits by CDSS and that the  
            department shall visit facilities as often as necessary  
            to ensure the quality of care provided. (HSC 1534,  
            1569.33, 1597.09 and 1597.55a)


          6.Requires annual unannounced inspections when a license is  
            on probation, when required by the terms of a facility  
            compliance plan, when an accusation is pending, when  
            required for federal financial participation (CCFs and  
            RCFEs), or to verify that a person who has been ordered  
            out of the facility is no longer present. (HSC 1534,  
            1569.33, 1597.09 and 1597.55a)


          7.Requires CDSS to perform random inspections each year on  
            no fewer than 20 percent of facilities not subject to  
            annual inspections. Provides that this percentage shall  
            increase by 10 percent if the total citations issued by  
            the department exceeds the previous year by 10 percent.  
            As a result of this trigger, CDSS currently is required  
            to perform random inspections on 30 percent of the  
            facilities not subject to annual inspection. Requires  





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            CDSS to visit every facility no less than every 5 years.  
            (HSC 1534, 1569.33, 1597.09 and 1597.55a)


           This bill:


           1.Requires community care facilities, residential care  
            facilities for the elderly and child day care facilities  
            and homes to have one or more functioning carbon monoxide  
            detectors in the facility, as specified.


          2.Requires, as a condition of initial licensure, community  
            care facilities, residential care facilities for the  
            elderly and child day care facilities and homes to  
            provide satisfactory evidence to CDSS that there is one  
            or more functioning carbon monoxide detectors in the  
            facility, as specified.


                                  FISCAL IMPACT  

          An Assembly Appropriations Committee stated there are minor  
          and absorbable costs to CDSS to check compliance during  
          inspections.

                            BACKGROUND AND DISCUSSION 

          According the author, this bill aligns existing health and  
          safety requirements with the Carbon Monoxide Poisoning  
          Prevention Act of 2010, which requires all existing  
          dwellings intended for human occupancy that have a fossil  
          fuel burning appliance, a fireplace, or an attached garage  
          to install a carbon monoxide detector on or before January  
          1, 2013. 


          The author states that although these detectors are  
          required for single family homes, as well as schools and  
          child care facilities that operate on school campuses,  
          there is no requirement that a carbon monoxide detector be  
          installed in non-residential facilities, such as a  
          non-residential child care facility. This bill would  
          require community care facilities, residential care  





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          facilities for the elderly, day care centers and family day  
          care homes to have one or more functioning carbon monoxide  
          detectors that meet specified statutory requirements, and  
          would require CDSS to account for the presence of the  
          detectors during inspections.








          Carbon Monoxide Poisoning Prevention Act


          SB 183 (Lowenthal) Chapter 19, Statutes of 2010 enacted the  
          Carbon Monoxide Poisoning Prevention Act of 2010 which  
          required the State Fire Marshal to develop a certification  
          and decertification process to approve and list carbon  
          monoxide devices and required an owner of a dwelling unit  
          intended for human occupancy to install an approved carbon  
          monoxide device, in each existing dwelling unit having a  
          fossil fuel burning heater or appliance, fireplace, or an  
          attached garage. The law provided that failure to comply,  
          following a 30-day notice, is subject to a maximum fine of  
          two hundred dollars for each offense.<1>


          Carbon monoxide poisoning



          Carbon monoxide is an odorless, colorless, and potentially  
          deadly gas.  At low levels of exposure, it can cause health  
          problems such as headaches, fatigue, nausea, dizzy spells,  
          confusion and irritability. Unnoticed, carbon monoxide  
          poisoning can cause vomiting, loss of consciousness and  
          eventually brain damage or death.  Carbon monoxide is  
          produced through combustion fumes, such as those produced  
          by cars and trucks, small gasoline engines, stoves,  
          -------------------------

          <1> Health and Safety Code Section 17926.


          




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          lanterns, burning charcoal and wood, and gas ranges and  
          heating systems. Exposure occurs when fumes from these  
          sources build up in enclosed or semi-enclosed spaces making  
          the air toxic. People and animals in these spaces can be  
          poisoned by breathing it.


          According to the Centers for Disease Control and Prevention  
          (CDC), certain groups such as unborn babies, infants, and  
          people with chronic heart disease, anemia, or respiratory  
          problems are most susceptible to carbon monoxide poisoning,  
          though prolonged exposure will affect any persons or  
          animals exposed. The CDC states that each year, more than  
          400 Americans die from unintentional CO poisoning, more  
          than 20,000 visit the emergency room and more than 4,000  
          are hospitalized due to CO poisoning. Fatality is highest  
          among Americans 65 and older.

          The California Air Resources Board has determine that on  
          average 30 to 40 "avoidable deaths" occur just in  
          California each year due to unintentional carbon monoxide  
          poisoning. Additionally, there are between 175 and 700  
          "avoidable" emergency room visits and hospitalizations in  
          California alone.  In 2001, 25 percent of the carbon  
          monoxide poisoning deaths from home-related products were  
          of adults 65 years or older.    


          A recent incident at a day care center in Quebec led to  
          carbon monoxide poisoning of 71 children after a floor  
          cleaning device that uses propane may have begun leaking.  
          The day care center did not have a carbon monoxide detector  
          installed.


          Regulatory Oversight


          The Community Care Licensing Division (CCLD) of CDSS  
          provides the primary regulatory oversight over the quality  
          and care in 76,627 licensed community care facilities.  
          These facilities fall under 23 separate licensure  
          categories including adoption agencies, foster family  
          homes, RCFEs, group homes, adult residential facilities,  
          adult day care, child day care facilities and others which  





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          provide primarily non-medical care and supervision to 1.4  
          million children and adults in California.<2> 


          In support, Safe Kids California writes "Carbon Monoxide  
          (CO), called the silent killer because it is invisible,  
          odorless, tasteless and hard to detect with one's own  
          senses, is the primary cause of accidental poisoning deaths  
          in the United States. The Centers for Disease Control and  
          Prevention report that each year CO poisoning kills more  
          than 400 people in the United States. A majority of these  
          deaths occur in residential setting. Yet carbon monoxide  
          poisoning is preventable in a home - or a day care setting  
          - with working carbon monoxide alarms."

                                     COMMENTS

           Although state law requires buildings intended for human  
          occupancy to have carbon monoxide detectors installed, the  
          law does not specifically include facilities that are not  
          24-hour facilities such as child day care facilities or  
          adult day care centers. Additionally, community care  
          licensing statute or regulations do not specifically  
          require compliance with this relatively new law, and  
          licensing staff do not document compliance with this law in  
          site visits, nor issue civil penalties for failure to  
          comply. 

          Staff recommends the following amendments to ensure that  
          all community care facilities, including certified family  
          homes of foster family agencies, and residential care  
          facilities of the elderly for persons with chronic illness  
          are included in the provisions of this bill:

          1. Page 2, Line 3 


               1503.2. Every facility licensed  or certified  pursuant  
               to this chapter shall have one or more carbon monoxide  
               detectors in the facility that meet the standards  
               established in Chapter 8 (commencing with Section  
               13260) of Part 2 of Division 12. The department shall  
               ----------------------

          <2>  http://ccld.ca.gov/res/pdf/countylist.pdf  






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               account for the presence of these detectors during  
               inspections.


          2. Insert a new bill section adding a new Section to Health  
          and Safety Code Chapter 3.01 regarding Residential Care  
          Facilities for Persons With Chronic Life-Threatening  
          Illness:

               Section 1568.043 is added to the Health and Safety  
          Code to read:


               Every residential care facility for persons with  
               chronic, life-threatening illness shall have one or  
               more carbon monoxide detectors in the facility that  
               meet the standards established in Chapter 8  
               (commencing with Section 13260) of Part 2 of Division  
               12. The department shall account for the presence of  
               these detectors during inspections.

           3. Page 6, line 15
               (d)  A small family day care home shall not be subject  
               to Article 1 (commencing with Section 13100) or  
               Article 2 (commencing with Section 13140) of Chapter 1  
               of Part 2 of Division  12  , except?

                                   PRIOR VOTES 

          Assembly Floor      77 - 0
          Assembly Appropriations  17 - 0
          Assembly Human Services    7 - 0

                                         

                                   POSITIONS  

          

          Support:       AFSCME
                         California State Fire Fighters Association
                         Safe Kids California
                         

          Oppose:   None received.





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