Amended in Assembly June 19, 2014

Amended in Senate May 27, 2014

Amended in Senate March 27, 2014

Amended in Senate March 4, 2014

Senate BillNo. 911


Introduced by Senator Block

(Coauthors: Senators Correa and Leno)

(Coauthors: Assembly Members Ammiano, Brown, Chávez, Skinner, Ting, Wieckowski, and Yamada)

January 23, 2014


An act to amend, repeal, and add Sectionsbegin delete 1569.23,end deletebegin insert 1569.616,end insert 1569.62,begin delete 1569.625, 1569.626,end delete and 1569.69 of, and to add Sections 1569.371, 1569.39, and 1569.696 to, the Health and Safety Code, relating to residential care facilities for the elderly.

LEGISLATIVE COUNSEL’S DIGEST

SB 911, as amended, Block. Residential care facilities for the elderly.

(1) Existing law, the California Residential Care Facilities for the Elderly Act, provides for the licensure and regulation of residential care facilities for the elderly by the State Department of Social Services. A person who violates the act is guilty of a misdemeanor and subject to civil penalty and suspension or revocation of license.

Existing law requires anbegin delete applicant for a license to complete, at a minimum, a 40-hour certification program approved by the department that includes instruction in a uniform code of knowledge, and to pass a written test.end deletebegin insert administrator of a residential care facility for the elderly to successfully complete a department-approved certification program prior to employment that requires, among other things, a minimum of 40 hours of classroom instruction on a uniform core of knowledge, which includes resident admission, retention, and assessment procedures.end insert

This bill would change the minimum hours of classroom instruction to 100 hours,begin delete of which 80 hours are classroom instruction,end deletebegin insert including 60 hours of in-person classroom instruction,end insert and would add additional topics to the uniformbegin delete codeend deletebegin insert coreend insert of knowledge, including, but not limited to, the adverse effects of psychotropic drugs for use in controlling the behavior of persons with dementia.begin delete The bill would also require the department to annually review the test and update it as necessary to reflect changes in the law and regulations.end delete

This bill would require that no licensee, or officer or employee of the licensee, shall discriminate or retaliate against any person receiving the services of the licensee’s residential care facility for the elderly, or against any employee of the licensee’s facility, on the basis, or for the reason that, the person, employee, or any other person dialed or called 911.

This bill would require a residential care facility for the elderly that accepts or retains residents with prohibited health conditions, as defined by the department, tobegin delete ensure that residents receiveend deletebegin insert assist residents with accessingend insert home health or hospice servicesbegin delete sufficient in scope and hoursend delete by appropriately skilled professionals, acting within their scope of practice, to ensure that residents receive medical care as prescribed by the resident’s physician and contained in the resident’s service plan. This bill would define an “appropriately skilled professional” as an individual who has training and is licensed to perform the necessary medical procedures prescribed by a physician, which includes, but is not limited to, a registered nurse, licensed vocational nurse, physical therapist, occupational therapist, or respiratory therapist.begin insert This bill would provide that an appropriately skilled professional is not required if a resident is providing self-care, as defined by the department, and there is documentation in the resident’s service planend insertbegin insert that the resident is capable of providing self-care.end insert

(2) Existing law requires the Director of Social Services to ensure that licensees, administrators, and staffs of residential care facilities for the elderly have appropriate training to provide the care and services for which a license or certificate is issued. The department is required to develop a uniformbegin delete codeend deletebegin insert coreend insert of knowledge for the continuing education of administrators of residential care facilities for the elderly.

This bill would also require the department to develop a uniformbegin delete codeend deletebegin insert coreend insert of knowledge jointly with the California Department of Aging for the initial certification of administrators, and add additional topics to the uniformbegin delete codeend deletebegin insert coreend insert of knowledge, including, but not limited to, applicable laws and regulations and residents’ rights.

begin delete

(3) Existing law 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 10 hours of training within the first 4 weeks of employment, and 4 hours of training annually thereafter on topics, including, but not limited to, policies and procedures regarding medications.

end delete
begin delete

This bill would increase that training to 40 hours of training within the first 4 weeks of employment, 20 hours of training annually thereafter, and would also require that at least 24 hours of training be completed prior to providing direct care to residents. This bill would exempt certified nurse assistants with valid certification from those requirements, provided that certified nurse assistants receive 8 hours of training, prior to providing direct care to residents, on resident characteristics, plans of care, resident records, and facility practices and procedures.

end delete
begin delete

(4) Existing law requires all direct care staff of a residential care facility for the elderly, which advertises or promotes special care, programming, or environment for persons with dementia, receive 6 hours of resident care orientation within the first 4 weeks of employment and 8 hours of in-service training per year.

end delete
begin delete

This bill would increase that training to 15 hours of resident care orientation, prior to providing direct care to residents, and 12 hours of in-service training per year on the subject of providing care and supervision to residents with dementia.

end delete
begin delete

(5)

end delete

begin insert(3)end insert Existing law requires that employees who assist residents with the self-administration of medications at a licensed residential care facility for the elderly, which provides care for 16 or more persons, complete 16 hours of initial training, consisting of 8 hours of hands-on shadowing training and 8 hours of other training or instruction, to be completed within the first 2 weeks of employment. If that facility provides care for 15 or fewer persons, employees are required to complete 6 hours of initial training, consisting of 2 hours of hands-on shadowing training and 4 hours of other training or instruction, to be completed within the first 2 weeks of employment.

This bill would require employees at a licensed residential care facility for the elderly that provides care for 16 or more persons, to completebegin delete 32end deletebegin insert 24end insert hours of initial training, consisting ofbegin delete 12end deletebegin insert 16end insert hours of hands-on shadowing training andbegin delete 20end deletebegin insert 8end insert hours of other training or instruction, to be completed within the first 4 weeks of employment. For facilities providing care for 15 or fewer persons, this bill would increase those training requirements tobegin delete 16end deletebegin insert 10end insert hours of initial training, consisting ofbegin delete 8end deletebegin insert 6end insert hours of hands-on shadowing training, andbegin delete 8end deletebegin insert 4end insert hours of other trainingbegin insert, to be completed within the first 2 weeks of employmentend insert.

This bill would require all direct care staff of residential care facilities for the elderly that serve residents with postural supports,begin delete orend delete restricted health conditions or health services, or who receive hospice care servicesbegin delete, as described in specified regulations, in addition to other training requirements,end deletebegin insert toend insert receivebegin delete 15end deletebegin insert, in addition to other training requirements, 4end insert hours of training on the care, supervision, and special needs of those residents, prior to providing direct care to residents. This bill also would requirebegin delete 12 hoursend deletebegin insert 2 2-hour trainings thereafterend insert of in-service trainingbegin delete per yearend deletebegin insert every 6 monthsend insert on the subject of serving those residents.

begin delete

(6)

end delete

begin insert(end insertbegin insert4)end insert Because a violation of any of the above provisions would be a misdemeanor, 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.

begin delete

(7)

end delete

begin insert(end insertbegin insert5)end insert This bill would make its provisions operative on January 1, 2016.

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

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

begin delete
P4    1

SECTION 1.  

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

3

1569.23.  

(a) As a requirement for licensure, the applicant shall
4demonstrate that he or she has successfully completed a
5certification program approved by the department.

P5    1(b) The certification program shall be for a minimum of 40
2hours of classroom instruction and include a uniform core of
3knowledge which shall include all of the following:

4(1) Law, regulations, policies, and procedural standards that
5impact the operations of residential care facilities for the elderly.

6(2) Business operations.

7(3) Management and supervision of staff.

8(4) Psychosocial need of the elderly residents.

9(5) Physical needs for elderly residents.

10(6) Community and support services.

11(7) Use, misuse, and interaction of drugs commonly used by
12the elderly.

13(8) Resident admission, retention, and assessment procedures.

14(c) Successful completion of the certification program shall be
15demonstrated by passing a written test and submitting a fee of one
16hundred dollars ($100) to the department for the issuance of a
17certificate of completion.

18(d) The department shall establish by regulation the program
19content, the testing instrument, process for approving certification
20programs, and criteria to be used for authorizing individuals or
21organizations to conduct certification programs. These regulations
22shall be developed with the participation of provider organizations.

23(e) This section shall apply to all applications for licensure
24unless the applicant provides evidence that he or she has a current
25license for another residential care facility for the elderly which
26was initially licensed prior to July 1, 1989, or has successfully
27completed an approved certification program within the prior five
28years.

29(f) If the applicant is a firm, partnership, association, or
30corporation, the chief executive officer, or other person serving in
31a like capacity, or the designated administrator of the facility shall
32provide evidence of successfully completing an approved
33certification program.

34(g) This section shall remain in effect only until January 1, 2016,
35and as of that date is repealed, unless a later enacted statute, that
36is enacted before January 1, 2016, deletes or extends that date.

37

SEC. 2.  

Section 1569.23 is added to the Health and Safety
38Code
, to read:

P6    1

1569.23.  

(a) As a requirement for licensure, the applicant shall
2demonstrate that he or she has successfully completed a
3certification program approved by the department.

4(b) The certification program shall be for a minimum of 100
5hours, of which 80 hours are classroom instruction, and include a
6uniform core of knowledge which shall include all of the following:

7(1) Law, regulations, policies, and procedural standards that
8impact the operations of residential care facilities for the elderly.

9(2) Business operations.

10(3) Management and supervision of staff.

11(4) Psychosocial needs of the elderly residents.

12(5) Physical needs of the elderly residents.

13(6) Community and support services.

14(7) Use, misuse, and interaction of drugs commonly used by
15the elderly, and the adverse effects of psychotropic drugs for use
16in controlling the behavior of persons with dementia.

17(8) Nonpharmacologic, person-centered approaches to dementia
18care.

19(9) Resident admission, retention, and assessment procedures.

20(10) Residents’ rights, and the importance of initial and ongoing
21training for all staff to ensure residents’ rights are fully respected
22and implemented.

23(c) Successful completion of the certification program shall be
24demonstrated by passing a written test and submitting a fee of one
25hundred dollars ($100) to the department for the issuance of a
26certificate of completion.

27(d) The department shall establish by regulation the program
28content, the testing instrument, process for approving certification
29programs, and criteria to be used for authorizing individuals or
30organizations to conduct certification programs. These regulations
31shall be developed with the participation of provider organizations
32and other stakeholder groups. The department shall review the test
33annually and update it as necessary to reflect changes in law and
34regulations.

35(e) This section shall apply to all applications for licensure
36unless the applicant provides evidence that he or she has a current
37license for another residential care facility for the elderly which
38was initially licensed prior to July 1, 1989, or has successfully
39completed an approved certification program within the prior five
40years.

P7    1(f) If the applicant is a firm, partnership, association, or
2corporation, the chief executive officer, or other person serving in
3a like capacity, or the designated administrator of the facility shall
4provide evidence of successfully completing an approved
5certification program.

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

end delete
7

begin deleteSEC. 3.end delete
8begin insertSECTION 1.end insert  

Section 1569.371 is added to the Health and Safety
9Code
, to read:

10

1569.371.  

(a) No licensee, or officer or employee of the
11licensee, shall discriminate or retaliate in any manner against any
12person receiving the services of the licensee’s residential care
13facility for the elderly, or against any employee of the licensee’s
14facility, on the basis, or for the reason that, the person, employee,
15or any other person dialed or called 911.

16(b) A violation of this section is subject to civil penalty pursuant
17to Section 1569.49.

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

19

begin deleteSEC. 4.end delete
20begin insertSEC. 2.end insert  

Section 1569.39 is added to the Health and Safety
21Code
, to read:

22

1569.39.  

(a) A residential care facility for the elderly that
23accepts or retains residents with prohibited health conditions, as
24defined by the department, in Section 87615 of Title 22 of the
25California Code of Regulations, shallbegin delete ensure that residents receiveend delete
26begin insert assist residents with accessingend insert home health or hospicebegin delete services
27sufficient in scope and hoursend delete
begin insert services, as indicated in the resident’s
28current appraisal,end insert
to ensure that residents receive medical care as
29prescribed by the resident’s physician and contained in the
30resident’s service plan.

31(b) A residential care facility for the elderly that accepts or
32retains residents with restricted health conditions, as defined by
33the department, shall ensure that residents receive medical care as
34prescribed by the resident’s physician and contained in the
35resident’s service plan by appropriately skilled professionals acting
36within their scope of practice.begin insert An appropriately skilled professional
37may not be required when the resident is providing self-care, as
38defined by the department, and there is documentation in the
39resident’s service plan that the resident is capable of providing
40self-care.end insert

P8    1(c) An “appropriately skilled professional” means, for purposes
2of this section, an individual who has training and is licensed to
3perform the necessary medical procedures prescribed by a
4physician. This includes, but is not limited to, a registered nurse,
5licensed vocational nurse, physical therapist, occupational therapist,
6or respiratory therapist. These professionals may include, but are
7not limited to, those persons employed by a home health agency,
8the resident, or a facility, and who are currently licensed in this
9state.

10(d) Failure to meet or arrange to meet the needs of those
11residents who require health-related services as specified in the
12resident’s written record of care, defined pursuant to Section
131569.80, or failure to notify the physician of a resident’s illness
14or injury that poses a danger of death or serious bodily harm is a
15licensing violation and subject to civil penalty pursuant to Section
161569.49.

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

18begin insert

begin insertSEC. 3.end insert  

end insert

begin insertSection 1569.616 of the end insertbegin insertHealth and Safety Codeend insertbegin insert is
19amended to read:end insert

20

1569.616.  

(a) (1) An administrator of a residential care facility
21for the elderly shall be required to successfully complete a
22department-approved certification program prior to employment.

23(2) In those cases where the individual is both the licensee and
24the administrator of a facility, or a licensed nursing home
25administrator, the individual shall comply with the requirements
26of this section unless he or she qualifies for one of the exemptions
27provided for in subdivision (b).

28(3) Failure to comply with this section shall constitute cause for
29revocation of the license of the facility where an individual is
30functioning as the administrator.

31(4) The licensee shall notify the department within 30 days of
32any change in administrators.

33(b) Individuals seeking exemptions under paragraph (2) of
34subdivision (a) shall meet the following criteria and fulfill the
35required portions of the certification program, as the case may be:

36(1) An individual designated as the administrator of a residential
37care facility for the elderly who holds a valid license as a nursing
38home administrator issued in accordance with Chapter 2.35
39(commencing with Section 1416) of Division 2 shall be required
40to complete the areas in the uniform core of knowledge required
P9    1by this section that pertain to the law, regulations, policies, and
2procedural standards that impact the operations of residential care
3facilities for the elderly, the use, misuse, and interaction of
4medication commonly used by the elderly in a residential setting,
5and resident admission, retention, and assessment procedures,
6equal to 12 hours of classroom instruction. An individual meeting
7the requirements of this paragraph shall not be required to take a
8written test.

9(2) In those cases where the individual was both the licensee
10and administrator on or before July 1, 1991, the individual shall
11be required to complete all the areas specified for the certification
12program, but shall not be required to take the written test required
13by this section. Those individuals exempted from the written test
14shall be issued a conditional certification that is valid only for the
15administrator of the facility for which the exemption was granted.

16(A) As a condition to becoming an administrator of another
17facility, the individual shall be required to pass the written test
18provided for in this section.

19(B) As a condition to applying for a new facility license, the
20individual shall be required to pass the written test provided for
21in Section 1569.23.

22(c) (1) The administrator certification program shall require a
23minimum of 40 hours of classroom instruction that provides
24training on a uniform core of knowledge in each of the following
25areas:

26(A) Laws, regulations, and policies and procedural standards
27that impact the operations of residential care facilities for the
28elderly.

29(B) Business operations.

30(C) Management and supervision of staff.

31(D) Psychosocial needs of the elderly.

32(E) Community and support services.

33(F) Physical needs for elderly persons.

34(G) Use, misuse, and interaction of medication commonly used
35by the elderly.

36(H) Resident admission, retention, and assessment procedures.

37(I) Training focused specifically on serving clients with
38dementia. This training shall be for at least four hours.

P10   1(J) Cultural competency and sensitivity in issues relating to the
2underserved aging lesbian, gay, bisexual, and transgender
3community.

4(2) Individuals applying for certification under this section shall
5successfully complete an approved certification program, pass a
6written test administered by the department within 60 days of
7completing the program, and submit the documentation required
8by subdivision (d) to the department within 30 days of being
9notified of having passed the test. The department may extend
10these time deadlines for good cause. The department shall notify
11the applicant of his or her test results within 30 days of
12administering the test.

13(d) The department shall not begin the process of issuing a
14certificate until receipt of all of the following:

15(1) A certificate of completion of the administrator training
16required pursuant to this chapter.

17(2) The fee required for issuance of the certificate. A fee of one
18hundred dollars ($100) shall be charged by the department to cover
19the costs of processing the application for certification.

20(3) Documentation of passing the written test or of qualifying
21for an exemption pursuant to subdivision (b).

22(4) Submission of fingerprints. The department and the
23Department of Justice shall expedite the criminal record clearance
24for holders of certificates of completion. The department may
25waive the submission for those persons who have a current criminal
26record clearance on file.

27(e) It shall be unlawful for a person not certified under this
28section to hold himself or herself out as a certified administrator
29of a residential care facility for the elderly. Any person willfully
30making a false representation as being a certified administrator is
31guilty of a misdemeanor.

32(f) (1) Certificates issued under this section shall be renewed
33every two years and renewal shall be conditional upon the
34certificate holder submitting documentation of completion of 40
35hours of continuing education related to the core of knowledge
36specified in paragraph (1) of subdivision (c). No more than one-half
37of the required 40 hours of continuing education necessary to renew
38the certificate may be satisfied through online courses. All other
39continuing education hours shall be completed in a classroom
40setting. For purposes of this section, individuals who hold a valid
P11   1license as a nursing home administrator issued in accordance with
2Chapter 2.35 (commencing with Section 1416) of Division 2 of
3the Health and Safety Code and meet the requirements of paragraph
4(1) of subdivision (b) shall only be required to complete 20 hours
5of continuing education.

6(2) Every certified administrator of a residential care facility
7for the elderly is required to renew his or her certificate and shall
8 complete the continuing education requirements of this subdivision
9whether he or she is certified according to subdivision (a) or (b).
10At least eight hours of the 40-hour continuing education
11requirement for a certified administrator of a residential care facility
12for the elderly shall include instruction on serving clients with
13dementia, including, but not limited to, instruction related to direct
14care, physical environment, and admissions procedures and
15assessment.

16(3) Certificates issued under this section shall expire every two
17years, on the anniversary date of the initial issuance of the
18certificate, except that any administrator receiving his or her initial
19certification on or after January 1, 1999, shall make an irrevocable
20election to have his or her recertification date for any subsequent
21recertification either on the date two years from the date of issuance
22of the certificate or on the individual’s birthday during the second
23calendar year following certification. The department shall send
24a renewal notice to the certificate holder 90 days prior to the
25expiration date of the certificate. If the certificate is not renewed
26prior to its expiration date, reinstatement shall only be permitted
27after the certificate holder has paid a delinquency fee equal to three
28times the renewal fee and has provided evidence of completion of
29the continuing education required.

30(4) To renew a certificate, the certificate holder shall, on or
31before the certificate expiration date, request renewal by submitting
32to the department documentation of completion of the required
33continuing education courses and pay the renewal fee of one
34hundred dollars ($100), irrespective of receipt of the department’s
35notification of the renewal. A renewal request postmarked on or
36before the expiration of the certificate is proof of compliance with
37this paragraph.

38(5) A suspended or revoked certificate is subject to expiration
39as provided for in this section. If reinstatement of the certificate
40is approved by the department, the certificate holder, as a condition
P12   1precedent to reinstatement, shall pay a fee in an amount equal to
2the renewal fee, plus the delinquency fee, if any, accrued at the
3time of its revocation or suspension.

4(6) A certificate that is not renewed within four years after its
5expiration shall not be renewed, restored, reissued, or reinstated
6except upon completion of a certification program, passing any
7test that may be required of an applicant for a new certificate at
8that time, and paying the appropriate fees provided for in this
9section.

10(7) A fee of twenty-five dollars ($25) shall be charged for the
11reissuance of a lost certificate.

12(8) A certificate holder shall inform the department of his or
13her employment status within 30 days of any change.

14(g) The department may revoke a certificate issued under this
15section for any of the following:

16(1) Procuring a certificate by fraud or misrepresentation.

17(2) Knowingly making or giving any false statement or
18information in conjunction with the application for issuance of a
19certificate.

20(3) Criminal conviction, unless an exemption is granted pursuant
21to Section 1569.17.

22(h) The certificate shall be considered forfeited under either of
23the following conditions:

24(1) The administrator has had a license revoked, suspended, or
25denied as authorized under Section 1569.50.

26(2) The administrator has been denied employment, residence,
27or presence in a facility based on action resulting from an
28administrative hearing pursuant to Section 1569.58.

29(i) (1) The department shall establish, by regulation, the
30program content, the testing instrument, the process for approving
31certification programs, and criteria to be used in authorizing
32individuals, organizations, or educational institutions to conduct
33certification programs and continuing education courses. These
34regulations shall be developed in consultation with provider and
35consumer organizations, and shall be made available at least six
36months prior to the deadline required for certification. The
37department may deny vendor approval to any agency or person
38that has not provided satisfactory evidence of their ability to meet
39the requirements of vendorization set out in the regulations adopted
40pursuant to subdivision (j).

P13   1(2) (A) A vendor of online programs for continuing education
2shall ensure that each online course contains all of the following:

3(i) An interactive portion where the participant receives
4feedback, through online communication, based on input from the
5participant.

6(ii) Required use of a personal identification number or personal
7identification information to confirm the identity of the participant.

8(iii) A final screen displaying a printable statement, to be signed
9by the participant, certifying that the identified participant
10completed the course. The vendor shall obtain a copy of the final
11screen statement with the original signature of the participant prior
12to the issuance of a certificate of completion. The signed statement
13of completion shall be maintained by the vendor for a period of
14three years and be available to the department upon demand. Any
15person who certifies as true any material matter pursuant to this
16section that he or she knows to be false is guilty of a misdemeanor.

17(B) Nothing in this subdivision shall prohibit the department
18from approving online programs for continuing education that do
19not meet the requirements of subparagraph (A) if the vendor
20demonstrates to the department’s satisfaction that, through
21advanced technology, the course and the course delivery meet the
22requirements of this section.

23(3) The department may authorize vendors to conduct the
24administrator certification training program pursuant to provisions
25set forth in this section. The department shall conduct the written
26test pursuant to regulations adopted by the department.

27(4) The department shall prepare and maintain an updated list
28of approved training vendors.

29(5) The department may inspect training programs, continuing
30education courses, and online courses, at no charge to the
31department, in order to determine if content and teaching methods
32comply with paragraphs (1) and (2), if applicable, and with
33regulations. If the department determines that a vendor is not
34complying with the intent of this section, the department shall take
35appropriate action to bring the program into compliance, which
36may include removing the vendor from the approved list.

37(6) The department shall establish reasonable procedures and
38timeframes, not to exceed 30 days, for the approval of vendor
39training programs.

P14   1(7) The department may charge a reasonable fee, not to exceed
2one hundred fifty dollars ($150) every two years, to certification
3program vendors for review and approval of the initial 40-hour
4training program pursuant to subdivision (c). The department may
5also charge the vendor a fee, not to exceed one hundred dollars
6($100) every two years, for the review and approval of the
7continuing education courses needed for recertification pursuant
8to this subdivision.

9(j) This section shall be operative upon regulations being
10adopted by the department to implement the administrator
11certification program as provided for in this section.

12(k) The department shall establish a registry for holders of
13certificates that shall include, at a minimum, information on
14employment status and criminal record clearance.

15(l) Notwithstanding any law to the contrary, vendors approved
16by the department who exclusively provide either initial or
17continuing education courses for certification of administrators of
18a residential care facility for the elderly, as defined in subdivision
19(k) of Section 1569.2, a group home facility, as defined by
20regulations of the department, or an adult residential care facility,
21as defined by regulations of the department, shall be regulated
22solely by the department pursuant to this chapter. No other state
23or local governmental entity shall be responsible for regulating
24the activity of those vendors.

begin insert

25(m) This section shall remain in effect only until January 1,
262016, and as of that date is repealed, unless a later enacted statute,
27that is enacted before January 1, 2016, deletes or extends that
28 date.

end insert
29begin insert

begin insertSEC. 4.end insert  

end insert

begin insertSection 1569.616 is added to the end insertbegin insertHealth and Safety
30Code
end insert
begin insert, to read:end insert

begin insert
31

begin insert1569.616.end insert  

(a) (1) An administrator of a residential care
32facility for the elderly shall be required to successfully complete
33a department-approved certification program prior to employment.

34(2) In those cases where the individual is both the licensee and
35the administrator of a facility, or a licensed nursing home
36administrator, the individual shall comply with the requirements
37of this section unless he or she qualifies for one of the exemptions
38provided for in subdivision (b).

P15   1(3) Failure to comply with this section shall constitute cause
2for revocation of the license of the facility where an individual is
3functioning as the administrator.

4(4) The licensee shall notify the department within 30 days of
5any change in administrators.

6(b) Individuals seeking exemptions under paragraph (2) of
7subdivision (a) shall meet the following criteria and fulfill the
8required portions of the certification program, as the case may
9be:

10(1) An individual designated as the administrator of a residential
11care facility for the elderly who holds a valid license as a nursing
12home administrator issued in accordance with Chapter 2.35
13(commencing with Section 1416) of Division 2 shall be required
14to complete the areas in the uniform core of knowledge required
15by this section that pertain to the law, regulations, policies, and
16procedural standards that impact the operations of residential
17care facilities for the elderly, the use, misuse, and interaction of
18medication commonly used by the elderly in a residential setting,
19and resident admission, retention, and assessment procedures,
20equal to 12 hours of classroom instruction. An individual meeting
21the requirements of this paragraph shall not be required to take
22a written test.

23(2) In those cases where the individual was both the licensee
24and administrator on or before July 1, 1991, the individual shall
25be required to complete all the areas specified for the certification
26program, but shall not be required to take the written test required
27by this section. Those individuals exempted from the written test
28shall be issued a conditional certification that is valid only for the
29administrator of the facility for which the exemption was granted.

30(A) As a condition to becoming an administrator of another
31facility, the individual shall be required to pass the written test
32provided for in this section.

33(B) As a condition to applying for a new facility license, the
34individual shall be required to pass the written test provided for
35in Section 1569.23.

36(c) (1) The administrator certification program shall require
37a minimum of 100 hours of coursework, which shall include at
38least 60 hours of in-person classroom instruction that provides
39training on a uniform core of knowledge in each of the following
40areas:

P16   1(A) Laws, regulations, and policies and procedural standards
2that impact the operations of residential care facilities for the
3elderly.

4(B) Business operations.

5(C) Management and supervision of staff.

6(D) Psychosocial needs of the elderly.

7(E) Community and support services.

8(F) Physical needs for elderly persons.

9(G) Medication management, including the use, misuse, and
10interaction of medication commonly used by the elderly, including
11antipsychotics and the adverse effects of psychotropic drugs for
12use in controlling the behavior of persons with dementia, as
13required by Section 1569.626.

14(H) Resident admission, retention, and assessment procedures.

15(I) Managing Alzheimer’s disease and related dementias,
16including nonpharmacologic, person-centered approaches to
17dementia care.

18(J) Cultural competency and sensitivity in issues relating to the
19underserved aging lesbian, gay, bisexual, and transgender
20community.

21(K) Residents’ rights and the importance of initial and ongoing
22training for all staff to ensure that resident’s rights are fully
23respected and implemented.

24(2) Individuals applying for certification under this section shall
25successfully complete an approved certification program, pass a
26written test administered by the department within 60 days of
27completing the program, and submit the documentation required
28by subdivision (d) to the department within 30 days of being
29notified of having passed the test. The department may extend these
30time deadlines for good cause. The department shall notify the
31applicant of his or her test results within 30 days of administering
32the test.

33(d) The department shall not begin the process of issuing a
34certificate until receipt of all of the following:

35(1) A certificate of completion of the administrator training
36required pursuant to this chapter.

37(2) The fee required for issuance of the certificate. A fee of one
38hundred dollars ($100) shall be charged by the department to
39cover the costs of processing the application for certification.

P17   1(3) Documentation of passing the written test or of qualifying
2for an exemption pursuant to subdivision (b).

3(4) Submission of fingerprints. The department and the
4Department of Justice shall expedite the criminal record clearance
5for holders of certificates of completion. The department may waive
6the submission for those persons who have a current criminal
7record clearance on file.

8(e) It shall be unlawful for a person not certified under this
9section to hold himself or herself out as a certified administrator
10of a residential care facility for the elderly. Any person willfully
11making a false representation as being a certified administrator
12is guilty of a misdemeanor.

13(f) (1) Certificates issued under this section shall be renewed
14every two years and renewal shall be conditional upon the
15certificate holder submitting documentation of completion of 40
16hours of continuing education related to the core of knowledge
17specified in paragraph (1) of subdivision (c). No more than
18one-half of the required 40 hours of continuing education necessary
19to renew the certificate may be satisfied through online courses.
20All other continuing education hours shall be completed in a
21classroom setting. For purposes of this section, individuals who
22hold a valid license as a nursing home administrator issued in
23accordance with Chapter 2.35 (commencing with Section 1416)
24of Division 2 and meet the requirements of paragraph (1) of
25subdivision (b) shall only be required to complete 20 hours of
26continuing education.

27(2) Every certified administrator of a residential care facility
28for the elderly is required to renew his or her certificate and shall
29complete the continuing education requirements of this subdivision
30whether he or she is certified according to subdivision (a) or (b).
31At least eight hours of the 40-hour continuing education
32requirement for a certified administrator of a residential care
33facility for the elderly shall include instruction on serving clients
34with dementia, including, but not limited to, instruction related to
35direct care, physical environment, and admissions procedures and
36assessment.

37(3) Certificates issued under this section shall expire every two
38years, on the anniversary date of the initial issuance of the
39certificate, except that any administrator receiving his or her initial
40certification on or after January 1, 1999, shall make an irrevocable
P18   1election to have his or her recertification date for any subsequent
2recertification either on the date two years from the date of
3issuance of the certificate or on the individual’s birthday during
4the second calendar year following certification. The department
5shall send a renewal notice to the certificate holder 90 days prior
6to the expiration date of the certificate. If the certificate is not
7renewed prior to its expiration date, reinstatement shall only be
8permitted after the certificate holder has paid a delinquency fee
9equal to three times the renewal fee and has provided evidence of
10completion of the continuing education required.

11(4) To renew a certificate, the certificate holder shall, on or
12before the certificate expiration date, request renewal by submitting
13to the department documentation of completion of the required
14continuing education courses and pay the renewal fee of one
15hundred dollars ($100), irrespective of receipt of the department’s
16notification of the renewal. A renewal request postmarked on or
17before the expiration of the certificate is proof of compliance with
18this paragraph.

19(5) A suspended or revoked certificate is subject to expiration
20as provided for in this section. If reinstatement of the certificate
21is approved by the department, the certificate holder, as a condition
22precedent to reinstatement, shall pay a fee in an amount equal to
23the renewal fee, plus the delinquency fee, if any, accrued at the
24time of its revocation or suspension.

25(6) A certificate that is not renewed within four years after its
26expiration shall not be renewed, restored, reissued, or reinstated
27except upon completion of a certification program, passing any
28test that may be required of an applicant for a new certificate at
29that time, and paying the appropriate fees provided for in this
30section.

31(7) A fee of twenty-five dollars ($25) shall be charged for the
32reissuance of a lost certificate.

33(8) A certificate holder shall inform the department of his or
34her employment status within 30 days of any change.

35(g) The department may revoke a certificate issued under this
36section for any of the following:

37(1) Procuring a certificate by fraud or misrepresentation.

38(2) Knowingly making or giving any false statement or
39information in conjunction with the application for issuance of a
40certificate.

P19   1(3) Criminal conviction, unless an exemption is granted pursuant
2to Section 1569.17.

3(h) The certificate shall be considered forfeited under either of
4the following conditions:

5(1) The administrator has had a license revoked, suspended, or
6denied as authorized under Section 1569.50.

7(2) The administrator has been denied employment, residence,
8or presence in a facility based on action resulting from an
9administrative hearing pursuant to Section 1569.58.

10(i) (1) The department shall establish, by regulation, the
11program content, the testing instrument, the process for approving
12certification programs, and criteria to be used in authorizing
13 individuals, organizations, or educational institutions to conduct
14certification programs and continuing education courses. These
15regulations shall be developed in consultation with provider and
16consumer organizations, and shall be made available at least six
17months prior to the deadline required for certification. The
18department may deny vendor approval to any agency or person
19that has not provided satisfactory evidence of their ability to meet
20the requirements of vendorization set out in the regulations adopted
21pursuant to subdivision (j).

22(2) (A) A vendor of online programs for continuing education
23shall ensure that each online course contains all of the following:

24(i) An interactive portion where the participant receives
25feedback, through online communication, based on input from the
26participant.

27(ii) Required use of a personal identification number or personal
28identification information to confirm the identity of the participant.

29(iii) A final screen displaying a printable statement, to be signed
30by the participant, certifying that the identified participant
31completed the course. The vendor shall obtain a copy of the final
32screen statement with the original signature of the participant
33prior to the issuance of a certificate of completion. The signed
34statement of completion shall be maintained by the vendor for a
35period of three years and be available to the department upon
36demand. Any person who certifies as true any material matter
37pursuant to this section that he or she knows to be false is guilty
38of a misdemeanor.

39(B) Nothing in this subdivision shall prohibit the department
40from approving online programs for continuing education that do
P20   1not meet the requirements of subparagraph (A) if the vendor
2demonstrates to the department’s satisfaction that, through
3advanced technology, the course and the course delivery meet the
4requirements of this section.

5(3) The department may authorize vendors to conduct the
6administrator certification training program pursuant to provisions
7set forth in this section. The department shall conduct the written
8test pursuant to regulations adopted by the department.

9(4) The department shall prepare and maintain an updated list
10of approved training vendors.

11(5) The department may inspect training programs, continuing
12education courses, and online courses, at no charge to the
13department, in order to determine if content and teaching methods
14comply with paragraphs (1) and (2), if applicable, and with
15regulations. If the department determines that a vendor is not
16complying with the intent of this section, the department shall take
17appropriate action to bring the program into compliance, which
18may include removing the vendor from the approved list.

19(6) The department shall establish reasonable procedures and
20timeframes, not to exceed 30 days, for the approval of vendor
21training programs.

22(7) The department may charge a reasonable fee, not to exceed
23one hundred fifty dollars ($150) every two years, to certification
24program vendors for review and approval of the initial 40-hour
25training program pursuant to subdivision (c). The department may
26also charge the vendor a fee, not to exceed one hundred dollars
27($100) every two years, for the review and approval of the
28continuing education courses needed for recertification pursuant
29to this subdivision.

30(j) This section shall be operative upon regulations being
31adopted by the department to implement the administrator
32certification program as provided for in this section.

33(k) The department shall establish a registry for holders of
34certificates that shall include, at a minimum, information on
35employment status and criminal record clearance.

36(l) Notwithstanding any law to the contrary, vendors approved
37by the department who exclusively provide either initial or
38continuing education courses for certification of administrators
39of a residential care facility for the elderly, as defined in
40subdivision (k) of Section 1569.2, a group home facility, as defined
P21   1by regulations of the department, or an adult residential care
2facility, as defined by regulations of the department, shall be
3regulated solely by the department pursuant to this chapter. No
4other state or local governmental entity shall be responsible for
5regulating the activity of those vendors.

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

end insert
7

SEC. 5.  

Section 1569.62 of the Health and Safety Code is
8amended to read:

9

1569.62.  

(a) The director shall ensure that licensees,
10administrators, and staffs of residential care facilities for the elderly
11have appropriate training to provide the care and services for which
12a license or certificate is issued.

13(b) The department shall develop jointly with the Department
14of Aging, with input from provider organizations, requirements
15for a uniform core of knowledge within the required 20 hours of
16continuing education for administrators, and their designated
17substitutes, and for recertification of administrators of residential
18care facilities for the elderly. This knowledge base shall include,
19as a minimum, basic understanding of the psychosocial and
20physical care needs of elderly persons and administration. The
21department shall develop jointly with the Department of Aging,
22with input from provider organizations, a uniform resident
23assessment tool to be used by all residential care facilities for the
24elderly. The assessment tool shall, in lay terms, help to identify
25resident needs for service and assistance with activities of daily
26living.

27The departments shall develop a mandatory training program
28on the utilization of the assessment tool to be given to
29administrators and their designated substitutes.

30(c) This section shall remain in effect only until January 1, 2016,
31and as of that date is repealed, unless a later enacted statute, that
32is enacted before January 1, 2016, deletes or extends that date.

33

SEC. 6.  

Section 1569.62 is added to the Health and Safety
34Code
, to read:

35

1569.62.  

(a) The director shall ensure that licensees,
36administrators, and staff of residential care facilities for the elderly
37have appropriate training to provide the care and services for which
38a license or certificate is issued.

39(b) The department shall develop jointly with the California
40Department of Aging requirements for a uniform core of knowledge
P22   1for the required initial certification and continuing education for
2administrators, and their designated substitutes, and for
3recertification of administrators of residential care facilities for
4the elderly. This knowledge base shall include, as a minimum,
5basic understanding of the psychosocial and physical care needs
6of elderly persons, applicable laws and regulations, residents’
7rights, and administration. This training shall be developed in
8consultation with individuals or organizations with specific
9expertise in residential care facilities for the elderly or assisted
10living services, or by an outside source with expertise in residential
11care facilities for the elderly or assisted living services.

12(1) The initial certification training for administrators shall
13consist of at least 100 hours.

14(2) The continuing education requirement for administrators is
15at leastbegin delete 60end deletebegin insert 40end insert hours of training during each two-year certification
16periodbegin insert, as specified in paragraph (1) of subdivision (f) of Section
171569.616end insert
.

18(c) (1) The department shall develop a uniform resident
19assessment tool to be used by all residential care facilities for the
20elderly. The assessment tool shall, in lay terms, help to identify
21resident needs for service and assistance with activities of daily
22living.

23(2) The departments shall develop a mandatory training program
24on the utilization of the assessment tool to be given to
25administrators and their designated substitutes.

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

begin delete
27

SEC. 7.  

Section 1569.625 of the Health and Safety Code is
28amended to read:

29

1569.625.  

(a) The Legislature finds that the quality of services
30provided to residents of residential care facilities for the elderly is
31dependent upon the training and skills of staff. It is the intent of
32the Legislature in enacting this section to ensure that direct-care
33staff have the knowledge and proficiency to carry out the tasks of
34their jobs.

35(b) The department shall adopt regulations to require staff
36members of residential care facilities for the elderly who assist
37residents with personal activities of daily living to receive
38appropriate training. This training shall consist of 10 hours of
39training within the first four weeks of employment and four hours
40annually thereafter. This training shall be administered on the job,
P23   1or in a classroom setting, or any combination of the two. The
2 department shall establish, in consultation with provider
3organizations, the subject matter required for this training.

4(c) The training shall include, but not be limited to, the
5following:

6(1) Physical limitations and needs of the elderly.

7(2) Importance and techniques for personal care services.

8(3) Residents’ rights.

9(4) Policies and procedures regarding medications.

10(5) Psychosocial needs of the elderly.

11(d) This section shall remain in effect only until January 1, 2016,
12and as of that date is repealed, unless a later enacted statute, that
13is enacted before January 1, 2016, deletes or extends that date.

14

SEC. 8.  

Section 1569.625 is added to the Health and Safety
15Code
, to read:

16

1569.625.  

(a) The Legislature finds that the quality of services
17provided to residents of residential care facilities for the elderly is
18dependent upon the training and skills of staff.

19(b) The current training requirements for staff of residential care
20facilities for the elderly are insufficient to meet the range of care
21needs of the residents of those facilities. It is the intent of the
22Legislature in enacting this section to ensure that direct care staff
23have the knowledge and proficiency to carry out the tasks of their
24jobs.

25(c) The department shall adopt regulations to require staff
26members of residential care facilities for the elderly who assist
27residents with personal activities of daily living to receive
28appropriate training. This training shall consist of 40 hours of
29training within the first four weeks of employment, at least 24
30hours of which shall be completed prior to providing direct care
31to residents, and 20 hours annually thereafter. This training shall
32be administered on the job, or in a classroom setting, or any
33combination of the two. The department shall establish the subject
34matter required for this training. This training shall be developed
35in consultation with individuals or organizations with specific
36expertise in residential care facilities for the elderly or assisted
37living services, or by an outside source with expertise in residential
38care facilities for the elderly or assisted living services, as defined
39in Section 1771.

P24   1(d) The training shall include, but not be limited to, the
2following:

3(1) Physical limitations and needs of the elderly.

4(2) Importance and techniques for personal care services.

5(3) Residents’ rights.

6(4) Policies and procedures regarding medications.

7(5) Use, misuse, and interaction of drugs commonly used by
8the elderly, and the adverse effects of psychotropic drugs for use
9in controlling the behavior of persons with dementia.

10(6) The special needs of persons with Alzheimer’s disease and
11dementia, including nonpharmacologic person-centered approaches
12to dementia care.

13(7) Psychosocial needs of the elderly.

14(8) This subdivision shall not apply to certified nurse assistants,
15certified pursuant to Section 1337.2, except that certified nurse
16assistants with valid certification shall receive eight hours of
17training prior to providing direct care to residents, on resident
18characteristics, resident records, and facility practices and
19procedures.

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

21

SEC. 9.  

Section 1569.626 of the Health and Safety Code is
22amended to read:

23

1569.626.  

All residential care facilities for the elderly that
24advertise or promote special care, special programming, or a special
25environment for persons with dementia, in addition to complying
26with the training requirements described in Section 1569.625, shall
27meet the following training requirements for all direct care staff:

28(a) Six hours of resident care orientation within the first four
29weeks of employment. All six hours shall be devoted to the care
30of persons with dementia. The facility may utilize various methods
31of instruction including, but not limited to, preceptorship,
32mentoring, and other forms of observation and demonstration. The
33orientation time shall be exclusive of any administrative instruction.

34(b) Eight hours of in-service training per year on the subject of
35serving residents with dementia. This training shall be developed
36in consultation with individuals or organizations with specific
37expertise in dementia care or by an outside source with expertise
38in dementia care. In formulating and providing this training,
39reference may be made to written materials and literature on
40dementia and the care and treatment of persons with dementia.
P25   1This training requirement may be satisfied in one day or over a
2period of time. This training requirement may be provided at the
3facility or offsite and may include a combination of observation
4and practical application.

5(c) This section shall remain in effect only until January 1, 2016,
6and as of that date is repealed, unless a later enacted statute, that
7is enacted before January 1, 2016, deletes or extends that date.

8

SEC. 10.  

Section 1569.626 is added to the Health and Safety
9Code
, to read:

10

1569.626.  

All residential care facilities for the elderly that
11advertise or promote special care, special programming, or a special
12environment for persons with dementia, in addition to complying
13with the training requirements described in Section 1569.625, shall
14meet the following training requirements for all direct care staff:

15(a) Fifteen hours of resident care orientation prior to providing
16direct care to residents. All 15 hours shall be devoted to the care
17of persons with dementia. The facility may utilize various methods
18of instruction including, but not limited to, preceptorship,
19mentoring, and other forms of observation and demonstration. The
20orientation time shall be exclusive of any administrative instruction.

21(b) Twelve hours of in-service training per year on the subject
22of providing care and supervision to residents with dementia. This
23training shall be developed in consultation with individuals or
24organizations with specific expertise in dementia care or by an
25outside source with expertise in dementia care. In formulating and
26providing this training, reference may be made to written materials
27and literature on dementia and the care and treatment of persons
28with dementia. This training requirement may be provided at the
29facility or offsite and may include a combination of observation
30and practical application.

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

end delete
32

begin deleteSEC. 11.end delete
33begin insertSEC. 7.end insert  

Section 1569.69 of the Health and Safety Code is
34amended to read:

35

1569.69.  

(a) Each residential care facility for the elderly
36licensed under this chapter shall ensure that each employee of the
37facility who assists residents with the self-administration of
38medications meets the following training requirements:

39(1) In facilities licensed to provide care for 16 or more persons,
40the employee shall complete 16 hours of initial training. This
P26   1training shall consist of eight hours of hands-on shadowing training,
2which shall be completed prior to assisting with the
3self-administration of medications, and eight hours of other training
4or instruction, as described in subdivision (f), which shall be
5completed within the first two weeks of employment.

6(2) In facilities licensed to provide care for 15 or fewer persons,
7the employee shall complete six hours of initial training. This
8training shall consist of two hours of hands-on shadowing training,
9which shall be completed prior to assisting with the
10self-administration of medications, and four hours of other training
11or instruction, as described in subdivision (f), which shall be
12completed within the first two weeks of employment.

13(3) An employee shall be required to complete the training
14requirements for hands-on shadowing training described in this
15subdivision prior to assisting any resident in the self-administration
16of medications. The training and instruction described in this
17subdivision shall be completed, in their entirety, within the first
18two weeks of employment.

19(4) The training shall cover all of the following areas:

20(A) The role, responsibilities, and limitations of staff who assist
21residents with the self-administration of medication, including
22tasks limited to licensed medical professionals.

23(B) An explanation of the terminology specific to medication
24assistance.

25(C) An explanation of the different types of medication orders:
26prescription, over-the-counter, controlled, and other medications.

27(D) An explanation of the basic rules and precautions of
28medication assistance.

29(E) Information on medication forms and routes for medication
30taken by residents.

31(F) A description of procedures for providing assistance with
32the self-administration of medications in and out of the facility,
33and information on the medication documentation system used in
34the facility.

35(G) An explanation of guidelines for the proper storage, security,
36and documentation of centrally stored medications.

37(H) A description of the processes used for medication ordering,
38refills, and the receipt of medications from the pharmacy.

39(I) An explanation of medication side effects, adverse reactions,
40and errors.

P27   1(5) To complete the training requirements set forth in this
2subdivision, each employee shall pass an examination that tests
3the employee’s comprehension of, and competency in, the subjects
4listed in paragraph (4).

5(6) Residential care facilities for the elderly shall encourage
6pharmacists and licensed medical professionals to use plain English
7when preparing labels on medications supplied to residents. As
8used in this section, “plain English” means that no abbreviations,
9symbols, or Latin medical terms shall be used in the instructions
10for the self-administration of medication.

11(7) The training requirements of this section are not intended
12to replace or supplant those required of all staff members who
13assist residents with personal activities of daily living as set forth
14in Section 1569.625.

15(8) The training requirements of this section shall be repeated
16if either of the following occurs:

17(A) An employee returns to work for the same licensee after a
18break of service of more than 180 consecutive calendar days.

19(B) An employee goes to work for another licensee in a facility
20in which he or she assists residents with the self-administration of
21medication.

22(b) Each employee who received training and passed the
23examination required in paragraph (5) of subdivision (a), and who
24continues to assist with the self-administration of medicines, shall
25also complete four hours of in-service training on
26medication-related issues in each succeeding 12-month period.

27(c) The requirements set forth in subdivisions (a) and (b) do not
28apply to persons who are licensed medical professionals.

29(d) Each residential care facility for the elderly that provides
30employee training under this section shall use the training material
31and the accompanying examination that are developed by, or in
32consultation with, a licensed nurse, pharmacist, or physician. The
33licensed residential care facility for the elderly shall maintain the
34following documentation for each medical consultant used to
35develop the training:

36(1) The name, address, and telephone number of the consultant.

37(2) The date when consultation was provided.

38(3) The consultant’s organization affiliation, if any, and any
39educational and professional qualifications specific to medication
40management.

P28   1(4) The training topics for which consultation was provided.

2(e) Each person who provides employee training under this
3section shall meet the following education and experience
4requirements:

5(1) A minimum of five hours of initial, or certified continuing,
6education or three semester units, or the equivalent, from an
7accredited educational institution, on topics relevant to medication
8management.

9(2) The person shall meet any of the following practical
10experience or licensure requirements:

11(A) Two years of full-time experience, within the last four years,
12as a consultant with expertise in medication management in areas
13covered by the training described in subdivision (a).

14(B) Two years of full-time experience, or the equivalent, within
15the last four years, as an administrator for a residential care facility
16for the elderly, during which time the individual has acted in
17substantial compliance with applicable regulations.

18(C) Two years of full-time experience, or the equivalent, within
19the last four years, as a direct care provider assisting with the
20self-administration of medications for a residential care facility
21for the elderly, during which time the individual has acted in
22substantial compliance with applicable regulations.

23(D) Possession of a license as a medical professional.

24(3) The licensed residential care facility for the elderly shall
25maintain the following documentation on each person who provides
26employee training under this section:

27(A) The person’s name, address, and telephone number.

28(B) Information on the topics or subject matter covered in the
29training.

30(C) The time, dates, and hours of training provided.

31(f) Other training or instruction, as required in paragraphs (1)
32and (2) of subdivision (a), may be provided offsite, and may use
33various methods of instruction, including, but not limited to, all
34of the following:

35(1) Lectures by presenters who are knowledgeable about
36medication management.

37(2) Video recorded instruction, interactive material, online
38training, and books.

39(3) Other written or visual materials approved by organizations
40or individuals with expertise in medication management.

P29   1(g) Residential care facilities for the elderly licensed to provide
2care for 16 or more persons shall maintain documentation that
3demonstrates that a consultant pharmacist or nurse has reviewed
4the facility’s medication management program and procedures at
5least twice a year.

6(h) Nothing in this section authorizes unlicensed personnel to
7directly administer medications.

8(i) This section shall remain in effect only until January 1, 2016,
9and as of that date is repealed, unless a later enacted statute, that
10is enacted before January 1, 2016, deletes or extends that date.

11

begin deleteSEC. 12.end delete
12begin insertSEC. 8.end insert  

Section 1569.69 is added to the Health and Safety
13Code
, to read:

14

1569.69.  

(a) Each residential care facility for the elderly
15licensed under this chapter shall ensure that each employee of the
16facility who assists residents with the self-administration of
17medications meets all of the following training requirements:

18(1) In facilities licensed to provide care for 16 or more persons,
19the employee shall completebegin delete 32end deletebegin insert 24end insert hours of initial training. This
20training shall consist ofbegin delete 12end deletebegin insert 16end insert hours of hands-on shadowing
21training, which shall be completed prior to assisting with the
22self-administration of medications, andbegin delete 20end deletebegin insert eightend insert hours of other
23training or instruction, as described in subdivision (f), which shall
24be completed within the first four weeks of employment.

25(2) In facilities licensed to provide care for 15 or fewer persons,
26the employee shall completebegin delete 16end deletebegin insert 10end insert hours of initial training. This
27training shall consist ofbegin delete eightend deletebegin insert sixend insert hours of hands-on shadowing
28training, which shall be completed prior to assisting with the
29self-administration of medications, andbegin delete eightend deletebegin insert fourend insert hours of other
30training or instruction, as described in subdivision (f), which shall
31be completed within the first two weeks of employment.

32(3) An employee shall be required to complete the training
33requirements for hands-on shadowing training described in this
34subdivision prior to assisting any resident in the self-administration
35of medications. The training and instruction described in this
36subdivision shall be completed, in their entirety, within the first
37two weeks of employment.

38(4) The training shall cover all of the following areas:

P30   1(A) The role, responsibilities, and limitations of staff who assist
2residents with the self-administration of medication, including
3tasks limited to licensed medical professionals.

4(B) An explanation of the terminology specific to medication
5assistance.

6(C) An explanation of the different types of medication orders:
7prescription, over-the-counter, controlled, and other medications.

8(D) An explanation of the basic rules and precautions of
9medication assistance.

10(E) Information on medication forms and routes for medication
11taken by residents.

12(F) A description of procedures for providing assistance with
13the self-administration of medications in and out of the facility,
14and information on the medication documentation system used in
15the facility.

16(G) An explanation of guidelines for the proper storage, security,
17and documentation of centrally stored medications.

18(H) A description of the processes used for medication ordering,
19refills, and the receipt of medications from the pharmacy.

20(I) An explanation of medication side effects, adverse reactions,
21errors, the adverse effects of psychotropic drugs for use in
22controlling the behavior of persons with dementia, and the
23increased risk of death when elderly residents with dementia are
24given antipsychotic medications.

25(5) To complete the training requirements set forth in this
26subdivision, each employee shall pass an examination that tests
27the employee’s comprehension of, and competency in, the subjects
28listed in paragraph (4).

29(6) Residential care facilities for the elderly shall encourage
30pharmacists and licensed medical professionals to use plain English
31when preparing labels on medications supplied to residents. As
32used in this section, “plain English” means that no abbreviations,
33symbols, or Latin medical terms shall be used in the instructions
34for the self-administration of medication.

35(7) The training requirements of this section are not intended
36to replace or supplant those required of all staff members who
37assist residents with personal activities of daily living as set forth
38in Sections 1569.625 and 1569.696.

39(8) The training requirements of this section shall be repeated
40if either of the following occur:

P31   1(A) An employee returns to work for the same licensee after a
2break of service of more than 180 consecutive calendar days.

3(B) An employee goes to work for another licensee in a facility
4in which he or she assists residents with the self-administration of
5medication.

6(b) Each employee who received training and passed the
7examination required in paragraph (5) of subdivision (a), and who
8continues to assist with the self-administration of medicines, shall
9also complete eight hours of in-service training on
10medication-related issues in each succeeding 12-month period.

11(c) The requirements set forth in subdivisions (a) and (b) do not
12apply to persons who are licensed medical professionals.

13(d) Each residential care facility for the elderly that provides
14employee training under this section shall use the training material
15and the accompanying examination that are developed by, or in
16consultation with, a licensed nurse, pharmacist, or physician. The
17licensed residential care facility for the elderly shall maintain the
18following documentation for each medical consultant used to
19develop the training:

20(1) The name, address, and telephone number of the consultant.

21(2) The date when consultation was provided.

22(3) The consultant’s organization affiliation, if any, and any
23educational and professional qualifications specific to medication
24management.

25(4) The training topics for which consultation was provided.

26(e) Each person who provides employee training under this
27section shall meet the following education and experience
28requirements:

29(1) A minimum of five hours of initial, or certified continuing,
30education or three semester units, or the equivalent, from an
31accredited educational institution, on topics relevant to medication
32management.

33(2) The person shall meet any of the following practical
34experience or licensure requirements:

35(A) Two years of full-time experience, within the last four years,
36as a consultant with expertise in medication management in areas
37covered by the training described in subdivision (a).

38(B) Two years of full-time experience, or the equivalent, within
39the last four years, as an administrator for a residential care facility
P32   1for the elderly, during which time the individual has acted in
2substantial compliance with applicable regulations.

3(C) Two years of full-time experience, or the equivalent, within
4the last four years, as a direct care provider assisting with the
5self-administration of medications for a residential care facility
6for the elderly, during which time the individual has acted in
7substantial compliance with applicable regulations.

8(D) Possession of a license as a medical professional.

9(3) The licensed residential care facility for the elderly shall
10maintain the following documentation on each person who provides
11employee training under this section:

12(A) The person’s name, address, and telephone number.

13(B) Information on the topics or subject matter covered in the
14training.

15(C) The times, dates, and hours of training provided.

16(f) Other training or instruction, as required in paragraphs (1)
17and (2) of subdivision (a), may be provided offsite, and may use
18various methods of instruction, including, but not limited to, all
19of the following:

20(1) Lectures by presenters who are knowledgeable about
21medication management.

22(2) Video recorded instruction, interactive material, online
23training, and books.

24(3) Other written or visual materials approved by organizations
25or individuals with expertise in medication management.

26(g) Residential care facilities for the elderly licensed to provide
27care for 16 or more persons shall maintain documentation that
28demonstrates that a consultant pharmacist or nurse has reviewed
29the facility’s medication management program and procedures at
30least twice a year.

31(h) Nothing in this section authorizes unlicensed personnel to
32directly administer medications.

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

34

begin deleteSEC. 13.end delete
35begin insertSEC. 9.end insert  

Section 1569.696 is added to the Health and Safety
36Code
, to read:

37

1569.696.  

(a) All residential care facilities for the elderly that
38serve residents with postural supports,begin delete as described in Section
3987608 of Title 22 of the California Code of Regulations, orend delete

40 restricted health conditions or health services, begin deleteas described in
P33   1Section 87612 of Title 22 of the California Code of Regulations,end delete

2 or who receive hospice servicesbegin delete, as described in Section 87633 of
3Title 22 of the California Code of Regulations, in addition to
4complying withend delete
begin insert shall include, as a component ofend insert the training
5requirementsbegin insert specifiedend insert inbegin delete Sectionend deletebegin insert Sections 1569.23, 1569.616, andend insert
6 1569.625,begin delete shall meetend delete the following training requirements for all
7direct care staff:

8(1) begin deleteFifteen end deletebegin insertFourend insert hours of training on the care, supervision, and
9special needs of those residents, prior to providing direct care to
10residents. The facility may utilize various methods of instruction,
11including, but not limited to, preceptorship, mentoring, and other
12forms of observation and demonstration. The orientation time shall
13be exclusive of any administrative instruction.

14(2) begin deleteTwelve hours end deletebegin insertTwo two-hour trainings end insertthereafter of in-service
15trainingbegin delete per yearend deletebegin insert every six monthsend insert on the subject of serving those
16residents.begin insert This training shall be in addition to the trainings
17specified in Sections 1569.23, 1569.616, and 1569.625.end insert

18(b) This training shall be developed in consultation with
19individuals or organizations with specific expertise in the care of
20those residents described in subdivision (a). In formulating and
21providing this training, reference may be made to written materials
22and literature. This training requirement may be provided at the
23facility or offsite and may include a combination of observation
24and practical application.

begin insert

25(c) At the request of the department, and immediately if the
26request is made during an inspection, licensees shall provide the
27department with a confidential list of residents and their conditions,
28as specified in subdivision (a), which is to be kept confidential to
29the extent permitted by law. This list shall be maintained in an
30accurate and current status at all times.

end insert
begin delete

31(c)

end delete

32begin insert(d)end insert This section shall become operative on January 1, 2016.

33

begin deleteSEC. 14.end delete
34begin insertSEC. 10.end insert  

No reimbursement is required by this act pursuant to
35Section 6 of Article XIII B of the California Constitution because
36the only costs that may be incurred by a local agency or school
37district will be incurred because this act creates a new crime or
38infraction, eliminates a crime or infraction, or changes the penalty
39for a crime or infraction, within the meaning of Section 17556 of
40the Government Code, or changes the definition of a crime within
P34   1the meaning of Section 6 of Article XIII B of the California
2Constitution.



O

    95