Amended in Assembly September 4, 2013

Amended in Assembly July 3, 2013

Amended in Senate April 9, 2013

Senate Bill No. 534

Introduced by Senator Hernandez

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(Principal coauthor: Assembly Member Cooley)

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(Coauthor: Senator Steinberg)

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February 21, 2013

An act to begin insert amend Section 1267.15 of, and to end insert amend, repeal, and add Sections 1225 and 1275.3 of begin insert , end insert the Health and Safety Code, relating to health and care facilities.

LEGISLATIVE COUNSEL’S DIGEST

SB 534, as amended, Hernandez. Health and care facilities.

Existing law establishes the State Department of Public Health and sets forth its powers and duties, including, but not limited to, the licensure and regulation of primary care clinics and specialty clinics. Violation of these provisions is a crime.

This bill would, until the department adopts regulations relating to the provision of services by a chronic dialysis clinic, a surgical clinic, or a rehabilitation clinic, require those clinics to comply with prescribed federal certification standards in effect immediately preceding January 1, 2013. Because a violation of that requirement would be a crime, the bill would impose a state-mandated local program. The bill would require the department, by July 1, 2017, to conduct a public hearing and submit a prescribed report to the appropriate legislative committees. These provisions would become inoperative on January 1, 2018.

Existing law requires the State Department of Public Health and the State Department of Developmental Services to jointly develop and implement licensing regulations appropriate for intermediate care facility/developmentally disabled-nursing and intermediate care facility/developmentally disabled-continuous nursing.

This bill would, until the departments adopt those regulations, require that the facilities comply with applicable federal certification standards for intermediate care facilities for individuals with intellectual disabilities in effect immediately preceding January 1, 2013. These provisions would become inoperative on January 1, 2018.

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Existing law provides for the licensure and regulation by the State Department of Public Health of congregate living health facilities. Under existing law, a congregate living health facility is a residential home with a capacity of no more than 12 beds, except as provided, that provides inpatient care to persons with prescribed conditions, including persons who have a diagnosis of terminal illness or who are catastrophically and severely disabled. Existing law requires that a congregate living health facility be freestanding, but specifies that this does not preclude its location on the premises of a hospital.

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This bill would authorize the establishment of multiple congregate living health facilities in one multifloor building if certain requirements are met, including, among others, that each facility is separated by a wall, floor, or other permanent partition, and is located on former McClellan Air Force Base, as specified.

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This bill would make legislative findings and declarations as to the necessity of a special statute for these congregate living facilities.

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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 1225 of the Health and Safety Code is
amended to read:

1225.  

(a) The department shall adopt, and may from time to
time amend or repeal, in accordance with Chapter 3.5 (commencing
with Section 11340) of Part 1 of Division 3 of Title 2 of the
Government Code, reasonable rules and regulations as may be
necessary or proper to carry out the purposes and intent of this
chapter and to enable the department to exercise the powers and
perform the duties conferred upon it by this chapter, not
inconsistent with any of the provisions of any statute of this state.

(b) The rules and regulations for primary care clinics shall be
separate and distinct from the rules and regulations for specialty
clinics.

(c) All regulations relating to licensed clinics in effect on
December 31, 1977, that were adopted by the department, shall
remain in full force and effect until altered, amended, or repealed
by the director.

(d) Until the department adopts regulations relating to the
provision of services by a chronic dialysis clinic, a surgical clinic,
or a rehabilitation clinic, the following clinics licensed or seeking
licensure shall comply with the following federal certification
standards in effect immediately preceding January 1, 2013:

(1) A chronic dialysis clinic shall comply with federal
certification standards for an end stage renal disease clinic, as
specified in Sections 494.1 to 494.180, inclusive, of Title 42 of
the Code of Federal Regulations.

(2) A surgical clinic, as defined in subdivision (b) of Section
1204, shall comply with federal certification standards for an
ambulatory surgical clinic, as specified in Sections 416.1 to 416.52,
inclusive, of Title 42 of the Code of Federal Regulations.

(3) A rehabilitation clinic shall comply with federal certification
standards for a comprehensive outpatient rehabilitation facility,
as specified in Sections 485.50 to 485.74, inclusive, of Title 42 of
the Code of Federal Regulations.

(e) The department shall, by July 1, 2017, conduct at least one
public hearing and submit a report to the appropriate legislative
committees that describes the extent to which the federal
certification standards are or are not sufficient as a basis for state
licensing standards. The report shall make recommendations for
any California-specific standards that may be necessary.

(f) This section shall remain in effect only until January 1, 2018,
and as of that date is repealed, unless a later enacted statute, that
is enacted before January 1, 2018, deletes or extends that date.

SEC. 2.  

Section 1225 is added to the Health and Safety Code,
to read:

1225.  

(a) The department shall adopt, and may from time to
time amend or repeal, in accordance with Chapter 3.5 (commencing
with Section 11340) of Part 1 of Division 3 of Title 2 of the
Government Code, such reasonable rules and regulations as may
be necessary or proper to carry out the purposes and intent of this
chapter and to enable the department to exercise the powers and
perform the duties conferred upon it by this chapter, not
inconsistent with any of the provisions of any statute of this state.
The rules and regulations for primary care clinics shall be separate
and distinct from the rules and regulations for specialty clinics.

(b) All regulations relating to licensed clinics in effect on
December 31, 1977, which were adopted by the department, shall
remain in full force and effect until altered, amended, or repealed
by the director.

(c) This section shall become operative on January 1, 2018.

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begin insert SEC. 3. end insert   

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begin insert Section 1267.15 of the end insert begin insert Health and Safety Code end insert begin insert is
amended to read: end insert

1267.15.  

begin insert (a) end insert begin insert   end insert Congregate living health facilities shall be
freestanding, but this does not preclude their location on the
premises of a hospital. Congregate living health facilities shall be
separately licensed.

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(b) Notwithstanding subdivision (a), multiple congregate living
health facilities may exist in one multifloor building if all of the
following requirements are satisfied:

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(1) Each facility meets other applicable building standards not
related to multiple floors.

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(2) Each facility is separated by a wall, floor, or other
permanent partition but may share an elevator, stairs, or stairwell,
and need not be freestanding.

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(3) Proposals to develop proximate congregate living health
facilities are supported by the county health department and the
board of supervisors in the county in which the facilities are to be
located.

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(4) The congregate living health facilities are proposed for one
of the following locations:

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(A) McClellan Air Force Base Building No. 522, located at
3201 James Way, McClellan, California.

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(B) McClellan Air Force Base Building No. 523, located at
3207 James Way, McClellan, California.

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(C) McClellan Air Force Base Building No. 524, located at
5621 Dudley Blvd, McClellan, California.

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(D) McClellan Air Force Base Building No. 525, located at
5327 Dudley Blvd, McClellan, California.

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begin delete SEC. 3. end delete
begin insert SEC. 4. end insert   

Section 1275.3 of the Health and Safety Code is
amended to read:

1275.3.  

(a) The State Department of Public Health and the
State Department of Developmental Services shall jointly develop
and implement licensing regulations appropriate for intermediate
care facility/developmentally disabled-nursing and intermediate
care facility/developmentally disabled-continuous nursing.

(b) The regulations adopted pursuant to subdivision (a) shall
ensure that residents of intermediate care facility/developmentally
disabled-nursing and intermediate care facility/developmentally
disabled-continuous nursing receive appropriate medical and
nursing services, and developmental program services in a
normalized, least restrictive physical and programmatic
environment appropriate to individual resident need.

In addition, the regulations shall do all of the following:

(1) Include provisions for the completion of a clinical and
developmental assessment of placement needs, including medical
and other needs, and the degree to which they are being met, of
clients placed in an intermediate care facility/developmentally
disabled-nursing and intermediate care facility/developmentally
disabled-continuous nursing and for the monitoring of these needs
at regular intervals.

(2) Provide for maximum utilization of generic community
resources by clients residing in a facility.

(3) Require the State Department of Developmental Services
to review and approve an applicant’s facility program plan as a
prerequisite to the licensing and certification process.

(4) Require that the physician providing the certification that
placement in the intermediate care facility/developmentally
disabled-nursing or intermediate care facility/developmentally
disabled-continuous nursing is needed, consult with the physician
who was the physician of record at the time the person’s proposed
placement is being considered by the interdisciplinary team.

(c) Until the departments adopt regulations pursuant to this
section begin delete , end delete relating to services by intermediate care
facilities/developmentally disabled-nursing, licensed intermediate
care facilities/developmentally disabled-nursing shall comply with
federal certification standards for intermediate care facilities for
individuals with intellectual disabilities, as specified in Sections
483.400 to 483.480, inclusive, of Title 42 of the Code of Federal
Regulations, in effect immediately preceding January 1, 2013.

(d) Nothing in this section supersedes the authority of the State
Fire Marshal pursuant to Sections 13113, 13113.5, 13143, and
13143.6 to the extent that these sections are applicable to
community care facilities.

(e) This section shall remain in effect only until January 1, 2018,
and as of that date is repealed, unless a later enacted statute, that
is enacted before January 1, 2018, deletes or extends that date.

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begin insert SEC. 5. end insert   

Section 1275.3 is added to the Health and Safety Code,
to read:

1275.3.  

(a) The State Department of Public Health and the
State Department of Developmental Services shall jointly develop
and implement licensing regulations appropriate for intermediate
care facility/developmentally disabled-nursing and intermediate
care facility/developmentally disabled-continuous nursing.

(b) The regulations adopted pursuant to subdivision (a) shall
ensure that residents of intermediate care facility/developmentally
disabled-nursing and intermediate care facility/developmentally
disabled-continuous nursing receive appropriate medical and
nursing services, and developmental program services in a
normalized, least restrictive physical and programmatic
environment appropriate to individual resident need.

In addition, the regulations shall do all of the following:

(1) Include provisions for the completion of a clinical and
developmental assessment of placement needs, including medical
and other needs, and the degree to which they are being met, of
clients placed in an intermediate care facility/developmentally
disabled-nursing and intermediate care facility/developmentally
disabled-continuous nursing and for the monitoring of these needs
at regular intervals.

(2) Provide for maximum utilization of generic community
resources by clients residing in a facility.

(3) Require the State Department of Developmental Services
to review and approve an applicant’s program plan as part of the
licensing and certification process.

(4) Require that the physician providing the certification that
placement in the intermediate care facility/developmentally
disabled-nursing or intermediate care facility/developmentally
disabled-continuous nursing is needed, consult with the physician
who was the physician of record at the time the person’s proposed
placement is being considered by the interdisciplinary team.

(c) Regulations developed pursuant to this section shall include
licensing fee schedules appropriate to facilities which will
encourage their development.

(d) Nothing in this section supersedes the authority of the State
Fire Marshal pursuant to Sections 13113, 13113.5, 13143, and
13143.6 to the extent that these sections are applicable to
community care facilities.

(e) This section shall become operative on January 1, 2018.

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begin insert SEC. 6. end insert   

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The Legislature finds and declares that, with respect
to Section 3 of this act, a special law is necessary and a general
law cannot be made applicable within the meaning of Section 16
of Article IV of the California Constitution because of the unique
circumstances relating to the need for congregate living health
facilities in and around the County of Sacramento.

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begin delete SEC. 5. end delete
begin insert SEC. 7. end insert   

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.