Amended in Assembly August 22, 2014

Amended in Assembly August 19, 2014

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,begin insert Chesbro,end insert Skinner, Ting, Wieckowski, and Yamada)

January 23, 2014


An act to amend, repeal, and add Sections 1569.616, 1569.62, 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 his or her license.

Existing law requires an 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, and passage of a written test administered by the department.

This bill would change the minimum hours of classroom instruction to 80 hours, includingbegin delete 48end deletebegin insert 60end insert hours of in-person instruction, and would add additional topics to the uniform core of knowledge, including the adverse effects of psychotropic drugs for use in controlling the behavior of persons with dementia. The bill would also require the department to take specific actions with regard to the test, including ensuring that it consists of at least 100 questions.

This bill wouldbegin delete require that noend deletebegin insert prohibit aend insert licensee, or officer or employee of the licensee,begin delete shall discriminate or retaliateend deletebegin insert from discriminating or retaliatingend insert 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, to assist residents with accessing home health or hospice services 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.begin delete Thisend deletebegin insert Theend insert 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 delete Thisend deletebegin insert Theend insert 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 plan that the resident is capable of providing self-care.

(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.begin delete The department is requiredend deletebegin insert Existing law requires the departmentend insert to develop a uniform core 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 uniform core of knowledge jointly with the California Department of Aging for the initial certification of administrators, and add additional topics to the uniform core of knowledge, including, but not limited to, applicable laws and regulations and residents’ rights.

(3) 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,begin insert existing law requiresend insert employeesbegin delete are requiredend delete 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 complete 24 hours of initial training, consisting of 16 hours of hands-on shadowing training and 8 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,begin delete thisend deletebegin insert theend insert bill would increase those training requirements to 10 hours of initial training, consisting of 6 hours of hands-on shadowing training, and 4 hours of other training, to be completed within the first 2 weeks of employment.

This bill would require all residential care facilities for the elderly to provide training to direct care staff on postural supports, restricted conditions or health services, and hospice care that includes 4 hours of training on the care, supervision, and special needs of those residents, prior to providing direct care to residents.begin delete Thisend deletebegin insert Theend insert bill also would require 4 hours of training thereafter of in-service training per year on the subject of serving those residents.

(4) 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.

(5) This bill would make its provisions operative on January 1, 2016.

begin insert

(6) This bill would become operative only if AB 1570 is enacted and takes effect on or before January 1, 2015.

end insert

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

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

P4    1

SECTION 1.  

Section 1569.371 is added to the Health and
2Safety Code
, to read:

3

1569.371.  

(a) No licensee, or officer or employee of the
4licensee, shall discriminate or retaliate in any manner against any
5person receiving the services of the licensee’s residential care
6facility for the elderly, or against any employee of the licensee’s
7facility, on the basis, or for the reason that, the person, employee,
8or any other person dialed or called 911.

9(b) A violation of this section is subject to civil penalty pursuant
10to Section 1569.49.

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

12

SEC. 2.  

Section 1569.39 is added to the Health and Safety
13Code
, to read:

14

1569.39.  

(a) A residential care facility for the elderly that
15accepts or retains residents with prohibited health conditions, as
16defined by the department, in Section 87615 of Title 22 of the
17California Code of Regulations, shall assist residents with accessing
18home health or hospice services, as indicated in the resident’s
19current appraisal, to ensure that residents receive medical care as
20prescribed by the resident’s physician and contained in the
21resident’s service plan.

22(b) A residential care facility for the elderly that accepts or
23retains residents with restricted health conditions, as defined by
24the department, shall ensure that residents receive medical care as
25prescribed by the resident’s physician and contained in the
26resident’s service plan by appropriately skilled professionals acting
27within their scope of practice. An appropriately skilled professional
28may not be required when the resident is providing self-care, as
29defined by the department, and there is documentation in the
30resident’s service plan that the resident is capable of providing
31self-care.

32(c) An “appropriately skilled professional” means, for purposes
33of this section, an individual who has training and is licensed to
P5    1perform the necessary medical procedures prescribed by a
2physician. This includes, but is not limited to, a registered nurse,
3licensed vocational nurse, physical therapist, occupational therapist,
4or respiratory therapist. These professionals may include, but are
5not limited to, those persons employed by a home health agency,
6 the resident, or a facility, and who are currently licensed in this
7state.

8(d) Failure to meet or arrange to meet the needs of those
9residents who require health-related services as specified in the
10resident’s written record of care, defined pursuant to Section
111569.80, or failure to notify the physician of a resident’s illness
12or injury that poses a danger of death or serious bodily harm is a
13licensing violation and subject to civil penalty pursuant to Section
141569.49.

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

16

SEC. 3.  

Section 1569.616 of the Health and Safety Code is
17amended to read:

18

1569.616.  

(a) (1) An administrator of a residential care facility
19for the elderly shall be required to successfully complete a
20department-approved certification program prior to employment.

21(2) In those cases where the individual is both the licensee and
22the administrator of a facility, or a licensed nursing home
23administrator, the individual shall comply with the requirements
24of this section unless he or she qualifies for one of the exemptions
25provided for in subdivision (b).

26(3) Failure to comply with this section shall constitute cause for
27revocation of the license of the facility where an individual is
28functioning as the administrator.

29(4) The licensee shall notify the department within 30 days of
30any change in administrators.

31(b) Individuals seeking exemptions under paragraph (2) of
32subdivision (a) shall meet the following criteria and fulfill the
33required portions of the certification program, as the case may be:

34(1) An individual designated as the administrator of a residential
35care facility for the elderly who holds a valid license as a nursing
36home administrator issued in accordance with Chapter 2.35
37(commencing with Section 1416) of Division 2 shall be required
38to complete the areas in the uniform core of knowledge required
39by this section that pertain to the law, regulations, policies, and
40procedural standards that impact the operations of residential care
P6    1facilities for the elderly, the use, misuse, and interaction of
2medication commonly used by the elderly in a residential setting,
3and resident admission, retention, and assessment procedures,
4equal to 12 hours of classroom instruction. An individual meeting
5the requirements of this paragraph shall not be required to take a
6written test.

7(2) In those cases where the individual was both the licensee
8and administrator on or before July 1, 1991, the individual shall
9be required to complete all the areas specified for the certification
10program, but shall not be required to take the written test required
11by this section. Those individuals exempted from the written test
12shall be issued a conditional certification that is valid only for the
13administrator of the facility for which the exemption was granted.

14(A) As a condition to becoming an administrator of another
15facility, the individual shall be required to pass the written test
16provided for in this section.

17(B) As a condition to applying for a new facility license, the
18individual shall be required to pass the written test provided for
19in Section 1569.23.

20(c) (1) The administrator certification program shall require a
21minimum of 40 hours of classroom instruction that provides
22training on a uniform core of knowledge in each of the following
23areas:

24(A) Laws, regulations, and policies and procedural standards
25that impact the operations of residential care facilities for the
26elderly.

27(B) Business operations.

28(C) Management and supervision of staff.

29(D) Psychosocial needs of the elderly.

30(E) Community and support services.

31(F) Physical needs for elderly persons.

32(G) Use, misuse, and interaction of medication commonly used
33by the elderly.

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

35(I) Training focused specifically on serving clients with
36dementia. This training shall be for at least four hours.

37(J) Cultural competency and sensitivity in issues relating to the
38underserved aging lesbian, gay, bisexual, and transgender
39community.

P7    1(2) Individuals applying for certification under this section shall
2successfully complete an approved certification program, pass a
3written test administered by the department within 60 days of
4completing the program, and submit the documentation required
5by subdivision (d) to the department within 30 days of being
6notified of having passed the test. The department may extend
7these time deadlines for good cause. The department shall notify
8the applicant of his or her test results within 30 days of
9administering the test.

10(d) The department shall not begin the process of issuing a
11certificate until receipt of all of the following:

12(1) A certificate of completion of the administrator training
13required pursuant to this chapter.

14(2) The fee required for issuance of the certificate. A fee of one
15hundred dollars ($100) shall be charged by the department to cover
16the costs of processing the application for certification.

17(3) Documentation of passing the written test or of qualifying
18for an exemption pursuant to subdivision (b).

19(4) Submission of fingerprints. The department and the
20Department of Justice shall expedite the criminal record clearance
21for holders of certificates of completion. The department may
22waive the submission for those persons who have a current criminal
23record clearance on file.

24(e) It shall be unlawful for a person not certified under this
25section to hold himself or herself out as a certified administrator
26of a residential care facility for the elderly. Any person willfully
27making a false representation as being a certified administrator is
28guilty of a misdemeanor.

29(f) (1) Certificates issued under this section shall be renewed
30every two years and renewal shall be conditional upon the
31certificate holder submitting documentation of completion of 40
32hours of continuing education related to the core of knowledge
33specified in paragraph (1) of subdivision (c). No more than one-half
34of the required 40 hours of continuing education necessary to renew
35the certificate may be satisfied through online courses. All other
36continuing education hours shall be completed in a classroom
37setting. For purposes of this section, individuals who hold a valid
38license as a nursing home administrator issued in accordance with
39Chapter 2.35 (commencing with Section 1416) of Division 2 of
40the Health and Safety Code and meet the requirements of paragraph
P8    1(1) of subdivision (b) shall only be required to complete 20 hours
2of continuing education.

3(2) Every certified administrator of a residential care facility
4for the elderly is required to renew his or her certificate and shall
5 complete the continuing education requirements of this subdivision
6whether he or she is certified according to subdivision (a) or (b).
7At least 8 hours of the 40-hour continuing education requirement
8for a certified administrator of a residential care facility for the
9elderly shall include instruction on serving clients with dementia,
10including, but not limited to, instruction related to direct care,
11physical environment, and admissions procedures and assessment.

12(3) Certificates issued under this section shall expire every two
13years, on the anniversary date of the initial issuance of the
14certificate, except that any administrator receiving his or her initial
15certification on or after January 1, 1999, shall make an irrevocable
16election to have his or her recertification date for any subsequent
17recertification either on the date two years from the date of issuance
18of the certificate or on the individual’s birthday during the second
19calendar year following certification. The department shall send
20a renewal notice to the certificate holder 90 days prior to the
21expiration date of the certificate. If the certificate is not renewed
22prior to its expiration date, reinstatement shall only be permitted
23after the certificate holder has paid a delinquency fee equal to three
24times the renewal fee and has provided evidence of completion of
25the continuing education required.

26(4) To renew a certificate, the certificate holder shall, on or
27before the certificate expiration date, request renewal by submitting
28to the department documentation of completion of the required
29continuing education courses and pay the renewal fee of one
30hundred dollars ($100), irrespective of receipt of the department’s
31notification of the renewal. A renewal request postmarked on or
32before the expiration of the certificate is proof of compliance with
33this paragraph.

34(5) A suspended or revoked certificate is subject to expiration
35as provided for in this section. If reinstatement of the certificate
36is approved by the department, the certificate holder, as a condition
37precedent to reinstatement, shall pay a fee in an amount equal to
38the renewal fee, plus the delinquency fee, if any, accrued at the
39time of its revocation or suspension.

P9    1(6) A certificate that is not renewed within four years after its
2expiration shall not be renewed, restored, reissued, or reinstated
3except upon completion of a certification program, passing any
4test that may be required of an applicant for a new certificate at
5that time, and paying the appropriate fees provided for in this
6section.

7(7) A fee of twenty-five dollars ($25) shall be charged for the
8reissuance of a lost certificate.

9(8) A certificate holder shall inform the department of his or
10her employment status within 30 days of any change.

11(g) The department may revoke a certificate issued under this
12section for any of the following:

13(1) Procuring a certificate by fraud or misrepresentation.

14(2) Knowingly making or giving any false statement or
15information in conjunction with the application for issuance of a
16certificate.

17(3) Criminal conviction, unless an exemption is granted pursuant
18to Section 1569.17.

19(h) The certificate shall be considered forfeited under either of
20the following conditions:

21(1) The administrator has had a license revoked, suspended, or
22denied as authorized under Section 1569.50.

23(2) The administrator has been denied employment, residence,
24or presence in a facility based on action resulting from an
25administrative hearing pursuant to Section 1569.58.

26(i) (1) The department shall establish, by regulation, the
27program content, the testing instrument, the process for approving
28certification programs, and criteria to be used in authorizing
29individuals, organizations, or educational institutions to conduct
30certification programs and continuing education courses. These
31regulations shall be developed in consultation with provider and
32consumer organizations, and shall be made available at least six
33months prior to the deadline required for certification. The
34department may deny vendor approval to any agency or person
35that has not provided satisfactory evidence of their ability to meet
36the requirements of vendorization set out in the regulations adopted
37pursuant to subdivision (j).

38(2) (A) A vendor of online programs for continuing education
39shall ensure that each online course contains all of the following:

P10   1(i) An interactive portion where the participant receives
2feedback, through online communication, based on input from the
3participant.

4(ii) Required use of a personal identification number or personal
5identification information to confirm the identity of the participant.

6(iii) A final screen displaying a printable statement, to be signed
7by the participant, certifying that the identified participant
8completed the course. The vendor shall obtain a copy of the final
9screen statement with the original signature of the participant prior
10to the issuance of a certificate of completion. The signed statement
11of completion shall be maintained by the vendor for a period of
12three years and be available to the department upon demand. Any
13person who certifies as true any material matter pursuant to this
14section that he or she knows to be false is guilty of a misdemeanor.

15(B) Nothing in this subdivision shall prohibit the department
16from approving online programs for continuing education that do
17not meet the requirements of subparagraph (A) if the vendor
18demonstrates to the department’s satisfaction that, through
19advanced technology, the course and the course delivery meet the
20requirements of this section.

21(3) The department may authorize vendors to conduct the
22administrator certification training program pursuant to provisions
23set forth in this section. The department shall conduct the written
24test pursuant to regulations adopted by the department.

25(4) The department shall prepare and maintain an updated list
26of approved training vendors.

27(5) The department may inspect training programs, continuing
28education courses, and online courses, at no charge to the
29department, in order to determine if content and teaching methods
30comply with paragraphs (1) and (2), if applicable, and with
31regulations. If the department determines that a vendor is not
32complying with the intent of this section, the department shall take
33appropriate action to bring the program into compliance, which
34may include removing the vendor from the approved list.

35(6) The department shall establish reasonable procedures and
36timeframes, not to exceed 30 days, for the approval of vendor
37training programs.

38(7) The department may charge a reasonable fee, not to exceed
39one hundred fifty dollars ($150) every two years, to certification
40program vendors for review and approval of the initial 40-hour
P11   1training program pursuant to subdivision (c). The department may
2also charge the vendor a fee, not to exceed one hundred dollars
3($100) every two years, for the review and approval of the
4continuing education courses needed for recertification pursuant
5to this subdivision.

6(j) This section shall be operative upon regulations being
7adopted by the department to implement the administrator
8certification program as provided for in this section.

9(k) The department shall establish a registry for holders of
10certificates that shall include, at a minimum, information on
11employment status and criminal record clearance.

12(l) Notwithstanding any law to the contrary, vendors approved
13by the department who exclusively provide either initial or
14continuing education courses for certification of administrators of
15a residential care facility for the elderly, as defined in subdivision
16(k) of Section 1569.2, a group home facility, as defined by
17regulations of the department, or an adult residential care facility,
18as defined by regulations of the department, shall be regulated
19solely by the department pursuant to this chapter. No other state
20or local governmental entity shall be responsible for regulating
21the activity of those vendors.

22(m) This section shall remain in effect only until January 1,
232016, and as of that date is repealed, unless a later enacted statute,
24that is enacted before January 1, 2016, deletes or extends that date.

25

SEC. 4.  

Section 1569.616 is added to the Health and Safety
26Code
, to read:

27

1569.616.  

(a) (1) An administrator of a residential care facility
28for the elderly shall be required to successfully complete a
29department-approved certification program prior to employment.

30(2) In those cases where the individual is both the licensee and
31the administrator of a facility, or a licensed nursing home
32administrator, the individual shall comply with the requirements
33of this section unless he or she qualifies for one of the exemptions
34provided for in subdivision (b).

35(3) Failure to comply with this section shall constitute cause for
36revocation of the license of the facility where an individual is
37functioning as the administrator.

38(4) The licensee shall notify the department within 30 days of
39any change in administrators.

P12   1(b) Individuals seeking exemptions under paragraph (2) of
2subdivision (a) shall meet the following criteria and fulfill the
3required portions of the certification program, as the case may be:

4(1) An individual designated as the administrator of a residential
5care facility for the elderly who holds a valid license as a nursing
6home administrator issued in accordance with Chapter 2.35
7(commencing with Section 1416) of Division 2 shall be required
8to complete the areas in the uniform core of knowledge required
9by this section that pertain to the law, regulations, policies, and
10procedural standards that impact the operations of residential care
11facilities for the elderly, the use, misuse, and interaction of
12medication commonly used by the elderly in a residential setting,
13and resident admission, retention, and assessment procedures,
14equal to 12 hours of classroom instruction. An individual meeting
15the requirements of this paragraph shall not be required to take a
16written test.

17(2) In those cases where the individual was both the licensee
18and administrator on or before July 1, 1991, the individual shall
19be required to complete all the areas specified for the certification
20program, but shall not be required to take the written test required
21by this section. Those individuals exempted from the written test
22shall be issued a conditional certification that is valid only for the
23administrator of the facility for which the exemption was granted.

24(A) As a condition to becoming an administrator of another
25facility, the individual shall be required to pass the written test
26provided for in this section.

27(B) As a condition to applying for a new facility license, the
28individual shall be required to pass the written test provided for
29in Section 1569.23.

30(c) (1) The administrator certification program shall require a
31minimum of 80 hours of coursework, which shall include at least
32begin delete 48end deletebegin insert 60end insert hours of in-person instruction that provides training on a
33uniform core of knowledge in each of the following areas:

34(A) Laws, regulations, and policies and procedural standards
35that impact the operations of residential care facilities for the
36elderly.

37(B) Business operations.

38(C) Management and supervision of staff.

39(D) Psychosocial needs of the elderly.

40(E) Community and support services.

P13   1(F) Physical needs for elderly persons.

2(G) Medication management, including the use, misuse, and
3interaction of medication commonly used by the elderly, including
4antipsychotics and the adverse effects of psychotropic drugs for
5use in controlling the behavior of persons with dementia.

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

7(I) Managing Alzheimer’s disease and related dementias,
8including nonpharmacologic, person-centered approaches to
9dementia care.

10(J) Cultural competency and sensitivity in issues relating to the
11underserved aging lesbian, gay, bisexual, and transgender
12community.

13(K) Residents’ rights and the importance of initial and ongoing
14training for all staff to ensure that residents’ rights are fully
15respected and implemented.

16(L) Managing the physical environment, including, but not
17limited to, maintenance and housekeeping.

18(M) Postural supports, restricted health conditions, and hospice
19care.

20(2) Individuals applying for certification under this section shall
21successfully complete an approved certification program, pass a
22written test administered by the department within 60 days of
23completing the program, and submit the documentation required
24by subdivision (d) to the department within 30 days of being
25notified of having passed the test. The department may extend
26these time deadlines for good cause. The department shall notify
27the applicant of his or her test results within 30 days of
28administering the test.

29(3) The department shall ensure the test consists of at least 100
30questions and allows an applicant to have access to the California
31Residential Care Facility for the Elderly Actbegin delete,end deletebegin insert andend insert related
32regulationsbegin delete, and the evaluator manualend delete during the test. The
33department, no later than July 1 of every other year, shall review
34and revise the test in order to ensure the rigor and quality of the
35test. Each year, the department shall ensure, by January 1, that the
36test is not in conflict with prevailing law. The department may
37convene a stakeholder group to assist in developing and reviewing
38test questions.

39(d) The department shall not begin the process of issuing a
40certificate until receipt of all of the following:

P14   1(1) A certificate of completion of the administrator training
2required pursuant to this chapter.

3(2) The fee required for issuance of the certificate. A fee of one
4hundred dollars ($100) shall be charged by the department to cover
5the costs of processing the application for certification.

6(3) Documentation of passing the written test or of qualifying
7for an exemption pursuant to subdivision (b).

8(4) Submission of fingerprints. The department and the
9Department of Justice shall expedite the criminal record clearance
10for holders of certificates of completion. The department may
11waive the submission for those persons who have a current criminal
12record clearance on file.

13(e) It shall be unlawful for a person not certified under this
14section to hold himself or herself out as a certified administrator
15of a residential care facility for the elderly. Any person willfully
16making a false representation as being a certified administrator is
17guilty of a misdemeanor.

18(f) (1) Certificates issued under this section shall be renewed
19every two years and renewal shall be conditional upon the
20certificate holder submitting documentation of completion of 40
21hours of continuing education related to thebegin insert uniformend insert core of
22knowledge specified in paragraph (1) of subdivision (c). No more
23than one-half of the required 40 hours of continuing education
24necessary to renew the certificate may be satisfied through online
25courses. All other continuing education hours shall be completed
26in a classroom setting. For purposes of this section, individuals
27who hold a valid license as a nursing home administrator issued
28in accordance with Chapter 2.35 (commencing with Section 1416)
29of Division 2 and meet the requirements of paragraph (1) of
30subdivision (b) shall only be required to complete 20 hours of
31continuing education.

32(2) Every certified administrator of a residential care facility
33for the elderly is required to renew his or her certificate and shall
34complete the continuing education requirements of this subdivision
35whether he or she is certified according to subdivision (a) or (b).
36At least eight hours of the 40-hour continuing education
37requirement for a certified administrator of a residential care facility
38for the elderly shall include instruction on serving clients with
39dementia, including, but not limited to, instruction related to direct
P15   1care, physical environment, and admissions procedures and
2assessment.

3(3) Certificates issued under this section shall expire every two
4years, on the anniversary date of the initial issuance of the
5certificate, except that any administrator receiving his or her initial
6certification on or after January 1, 1999, shall make an irrevocable
7election to have his or her recertification date for any subsequent
8recertification either on the date two years from the date of issuance
9of the certificate or on the individual’s birthday during the second
10calendar year following certification. The department shall send
11a renewal notice to the certificate holder 90 days prior to the
12expiration date of the certificate. If the certificate is not renewed
13prior to its expiration date, reinstatement shall only be permitted
14after the certificate holder has paid a delinquency fee equal to three
15times the renewal fee and has provided evidence of completion of
16the continuing education required.

17(4) To renew a certificate, the certificate holder shall, on or
18before the certificate expiration date, request renewal by submitting
19to the department documentation of completion of the required
20continuing education courses and pay the renewal fee of one
21hundred dollars ($100), irrespective of receipt of the department’s
22notification of the renewal. A renewal request postmarked on or
23before the expiration of the certificate is proof of compliance with
24this paragraph.

25(5) A suspended or revoked certificate is subject to expiration
26as provided for in this section. If reinstatement of the certificate
27is approved by the department, the certificate holder, as a condition
28precedent to reinstatement, shall pay a fee in an amount equal to
29the renewal fee, plus the delinquency fee, if any, accrued at the
30time of its revocation or suspension.

31(6) A certificate that is not renewed within four years after its
32expiration shall not be renewed, restored, reissued, or reinstated
33except upon completion of a certification program, passing any
34test that may be required of an applicant for a new certificate at
35that time, and paying the appropriate fees provided for in this
36section.

37(7) A fee of twenty-five dollars ($25) shall be charged for the
38reissuance of a lost certificate.

39(8) A certificate holder shall inform the department of his or
40her employment status within 30 days of any change.

P16   1(g) The department may revoke a certificate issued under this
2section for any of the following:

3(1) Procuring a certificate by fraud or misrepresentation.

4(2) Knowingly making or giving any false statement or
5information in conjunction with the application for issuance of a
6certificate.

7(3) Criminal conviction, unless an exemption is granted pursuant
8to Section 1569.17.

9(h) The certificate shall be considered forfeited under either of
10the following conditions:

11(1) The administrator has had a license revoked, suspended, or
12denied as authorized under Section 1569.50.

13(2) The administrator has been denied employment, residence,
14or presence in a facility based on action resulting from an
15administrative hearing pursuant to Section 1569.58.

16(i) (1) The department shall establish, by regulation, the
17program content, the testing instrument, the process for approving
18certification programs, and criteria to be used in authorizing
19individuals, organizations, or educational institutions to conduct
20certification programs and continuing education courses. These
21regulations shall be developed in consultation with provider and
22consumer organizations, and shall be made available at least six
23months prior to the deadline required for certification. The
24department may deny vendor approval to any agency or person
25that has not provided satisfactory evidence of their ability to meet
26the requirements of vendorization set out in the regulations adopted
27pursuant to subdivision (j).

28(2) (A) A vendor of online programs for continuing education
29shall ensure that each online course contains all of the following:

30(i) An interactive portion where the participant receives
31feedback, through online communication, based on input from the
32participant.

33(ii) Required use of a personal identification number or personal
34identification information to confirm the identity of the participant.

35(iii) A final screen displaying a printable statement, to be signed
36by the participant, certifying that the identified participant
37completed the course. The vendor shall obtain a copy of the final
38screen statement with the original signature of the participant prior
39to the issuance of a certificate of completion. The signed statement
40of completion shall be maintained by the vendor for a period of
P17   1three years and be available to the department upon demand. Any
2person who certifies as true any material matter pursuant to this
3section that he or she knows to be false is guilty of a misdemeanor.

4(B) Nothing in this subdivision shall prohibit the department
5from approving online programs for continuing education that do
6not meet the requirements of subparagraph (A) if the vendor
7demonstrates to the department’s satisfaction that, through
8advanced technology, the course and the course delivery meet the
9requirements of this section.

10(3) The department may authorize vendors to conduct the
11administrator certification training program pursuant to provisions
12set forth in this section. The department shall conduct the written
13test pursuant to regulations adopted by the department.

14(4) The department shall prepare and maintain an updated list
15of approved training vendors.

16(5) The department may inspect training programs, continuing
17education courses, and online courses, at no charge to the
18department, in order to determine if content and teaching methods
19comply with paragraphs (1) and (2), if applicable, and with
20regulations. If the department determines that a vendor is not
21complying with the intent of this section, the department shall take
22appropriate action to bring the program into compliance, which
23may include removing the vendor from the approved list.

24(6) The department shall establish reasonable procedures and
25timeframes, not to exceed 30 days, for the approval of vendor
26training programs.

27(7) The department may charge a reasonable fee, not to exceed
28one hundred fifty dollars ($150) every two years, to certification
29program vendors for review and approval of the initialbegin delete 40-hourend delete
30begin insert 80-hourend insert training program pursuant to subdivision (c). The
31department may also charge the vendor a fee, not to exceed one
32hundred dollars ($100) every two years, for the review and approval
33of the continuing education courses needed for recertification
34pursuant to this subdivision.

35(j) This section shall be operative upon regulations being
36adopted by the department to implement the administrator
37certification program as provided for in this section.

38(k) The department shall establish a registry for holders of
39certificates that shall include, at a minimum, information on
40employment status and criminal record clearance.

P18   1(l) Notwithstanding any law to the contrary, vendors approved
2by the department who exclusively provide either initial or
3continuing education courses for certification of administrators of
4a residential care facility for the elderly, as defined in subdivision
5(k) of Section 1569.2, a group home facility, as defined by
6regulations of the department, or an adult residential care facility,
7as defined by regulations of the department, shall be regulated
8solely by the department pursuant to this chapter. No other state
9or local governmental entity shall be responsible for regulating
10the activity of those vendors.

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

12

SEC. 5.  

Section 1569.62 of the Health and Safety Code is
13amended to read:

14

1569.62.  

(a) The director shall ensure that licensees,
15administrators, and staffs of residential care facilities for the elderly
16have appropriate training to provide the care and services for which
17a license or certificate is issued.

18(b) The department shall develop jointly with the California
19Department of Aging, with input from provider organizations,
20requirements for a uniform core of knowledge within the required
2120 hours of continuing education for administrators, and their
22designated substitutes, and for recertification of administrators of
23residential care facilities for the elderly. This knowledge base shall
24include, as a minimum, basic understanding of the psychosocial
25and physical care needs of elderly persons and administration. The
26department shall develop jointly with the California Department
27of Aging, with input from provider organizations, a uniform
28resident assessment tool to be used by all residential care facilities
29for the elderly. The assessment tool shall, in lay terms, help to
30identify resident needs for service and assistance with activities
31of daily living.

32The departments shall develop a mandatory training program
33on the utilization of the assessment tool to be given to
34administrators and their designated substitutes.

35(c) This section shall remain in effect only until January 1, 2016,
36and as of that date is repealed, unless a later enacted statute, that
37is enacted before January 1, 2016, deletes or extends that date.

38

SEC. 6.  

Section 1569.62 is added to the Health and Safety
39Code
, to read:

P19   1

1569.62.  

(a) The director shall ensure that licensees,
2administrators, and staff of residential care facilities for the elderly
3have appropriate training to provide the care and services for which
4a license or certificate is issued.

5(b) The department shall develop jointly with the California
6Department of Aging requirements for a uniform core of knowledge
7for the required initial certification and continuing education for
8administrators, and their designated substitutes, and for
9recertification of administrators of residential care facilities for
10the elderly. This knowledge base shall include, as a minimum,
11basic understanding of the psychosocial and physical care needs
12of elderly persons, applicable laws and regulations, residents’
13rights, and administration. This training shall be developed in
14consultation with individuals or organizations with specific
15expertise in residential care facilities for the elderly or assisted
16living services, or by an outside source with expertise in residential
17care facilities for the elderly or assisted living services.

18(1) The initial certification training for administrators shall
19consist of at leastbegin delete 100end deletebegin insert 80end insert hours.

20(2) The continuing education requirement for administrators is
21at least 40 hours of training during each two-year certification
22period, as specified in paragraph (1) of subdivision (f) of Section
231569.616.

24(c) (1) The department shall develop a uniform resident
25assessment tool to be used by all residential care facilities for the
26elderly. The assessment tool shall, in lay terms, help to identify
27resident needs for service and assistance with activities of daily
28living.

29(2) The departments shall develop a mandatory training program
30on the utilization of the assessment tool to be given to
31 administrators and their designated substitutes.

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

33

SEC. 7.  

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
P20   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.

P21   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.

P22   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.

P23   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

SEC. 8.  

Section 1569.69 is added to the Health and Safety
12Code
, to read:

13

1569.69.  

(a) Each residential care facility for the elderly
14licensed under this chapter shall ensure that each employee of the
15facility who assists residents with the self-administration of
16medications meets all of the following training requirements:

17(1) In facilities licensed to provide care for 16 or more persons,
18the employee shall complete 24 hours of initial training. This
19training shall consist of 16 hours of hands-on shadowing training,
20which shall be completed prior to assisting with the
21self-administration of medications, and 8 hours of other training
22or instruction, as described in subdivision (f), which shall be
23completed within the first four weeks of employment.

24(2) In facilities licensed to provide care for 15 or fewer persons,
25the employee shall complete 10 hours of initial training. This
26training shall consist of 6 hours of hands-on shadowing training,
27which shall be completed prior to assisting with the
28self-administration of medications, and 4 hours of other training
29or instruction, as described in subdivision (f), which shall be
30completed within the first two weeks of employment.

31(3) An employee shall be required to complete the training
32requirements for hands-on shadowing training described in this
33subdivision prior to assisting any resident in the self-administration
34of medications. The training and instruction described in this
35subdivision shall be completed, in their entirety, within the first
36two weeks of employment.

37(4) The training shall cover all of the following areas:

38(A) The role, responsibilities, and limitations of staff who assist
39residents with the self-administration of medication, including
40tasks limited to licensed medical professionals.

P24   1(B) An explanation of the terminology specific to medication
2assistance.

3(C) An explanation of the different types of medication orders:
4prescription, over-the-counter, controlled, and other medications.

5(D) An explanation of the basic rules and precautions of
6medication assistance.

7(E) Information on medication forms and routes for medication
8taken by residents.

9(F) A description of procedures for providing assistance with
10the self-administration of medications in and out of the facility,
11and information on the medication documentation system used in
12the facility.

13(G) An explanation of guidelines for the proper storage, security,
14and documentation of centrally stored medications.

15(H) A description of the processes used for medication ordering,
16refills, and the receipt of medications from the pharmacy.

17(I) An explanation of medication side effects, adverse reactions,
18errors, the adverse effects of psychotropic drugs for use in
19controlling the behavior of persons with dementia, and the
20increased risk of death when elderly residents with dementia are
21given antipsychotic medications.

22(5) To complete the training requirements set forth in this
23subdivision, each employee shall pass an examination that tests
24the employee’s comprehension of, and competency in, the subjects
25listed in paragraph (4).

26(6) Residential care facilities for the elderly shall encourage
27pharmacists and licensed medical professionals to use plain English
28when preparing labels on medications supplied to residents. As
29used in this section, “plain English” means that no abbreviations,
30symbols, or Latin medical terms shall be used in the instructions
31for the self-administration of medication.

32(7) The training requirements of this section are not intended
33to replace or supplant those required of all staff members who
34assist residents with personal activities of daily living as set forth
35in Sections 1569.625 and 1569.696.

36(8) The training requirements of this section shall be repeated
37if either of the following occur:

38(A) An employee returns to work for the same licensee after a
39break of service of more than 180 consecutive calendar days.

P25   1(B) An employee goes to work for another licensee in a facility
2in which he or she assists residents with the self-administration of
3medication.

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

9(c) The requirements set forth in subdivisions (a) and (b) do not
10apply to persons who are licensed medical professionals.

11(d) Each residential care facility for the elderly that provides
12employee training under this section shall use the training material
13and the accompanying examination that are developed by, or in
14consultation with, a licensed nurse, pharmacist, or physician. The
15licensed residential care facility for the elderly shall maintain the
16following documentation for each medical consultant used to
17develop the training:

18(1) The name, address, and telephone number of the consultant.

19(2) The date when consultation was provided.

20(3) The consultant’s organization affiliation, if any, and any
21educational and professional qualifications specific to medication
22management.

23(4) The training topics for which consultation was provided.

24(e) Each person who provides employee training under this
25section shall meet the following education and experience
26requirements:

27(1) A minimum of five hours of initial, or certified continuing,
28education or three semester units, or the equivalent, from an
29accredited educational institution, on topics relevant to medication
30management.

31(2) The person shall meet any of the following practical
32experience or licensure requirements:

33(A) Two years of full-time experience, within the last four years,
34as a consultant with expertise in medication management in areas
35covered by the training described in subdivision (a).

36(B) Two years of full-time experience, or the equivalent, within
37the last four years, as an administrator for a residential care facility
38for the elderly, during which time the individual has acted in
39substantial compliance with applicable regulations.

P26   1(C) Two years of full-time experience, or the equivalent, within
2the last four years, as a direct care provider assisting with the
3self-administration of medications for a residential care facility
4for the elderly, during which time the individual has acted in
5substantial compliance with applicable regulations.

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

7(3) The licensed residential care facility for the elderly shall
8maintain the following documentation on each person who provides
9employee training under this section:

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

11(B) Information on the topics or subject matter covered in the
12training.

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

14(f) Other training or instruction, as required in paragraphs (1)
15and (2) of subdivision (a), may be provided offsite, and may use
16various methods of instruction, including, but not limited to, all
17of the following:

18(1) Lectures by presenters who are knowledgeable about
19medication management.

20(2) Video recorded instruction, interactive material, online
21training, and books.

22(3) Other written or visual materials approved by organizations
23or individuals with expertise in medication management.

24(g) Residential care facilities for the elderly licensed to provide
25care for 16 or more persons shall maintain documentation that
26demonstrates that a consultant pharmacist or nurse has reviewed
27the facility’s medication management program and procedures at
28least twice a year.

29(h) Nothing in this section authorizes unlicensed personnel to
30directly administer medications.

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

32

SEC. 9.  

Section 1569.696 is added to the Health and Safety
33Code
, to read:

34

1569.696.  

(a) All residential care facilities for the elderly shall
35provide training to direct care staff on postural supports, restricted
36conditions or health services, and hospice care as a component of
37the training requirements specified in Section 1569.625. The
38training shall include all of the following:

39(1) Four hours of training on the care, supervision, and special
40needs of those residents, prior to providing direct care to residents.
P27   1The facility may utilize various methods of instruction, including,
2but not limited to, preceptorship, mentoring, and other forms of
3observation and demonstration. The orientation time shall be
4exclusive of any administrative instruction.

5(2) Four hours of training thereafter of in-service training per
6year on the subject of serving those residents.

7(b) This training shall be developed in consultation with
8individuals or organizations with specific expertise in the care of
9those residents described in subdivision (a). In formulating and
10providing this training, reference may be made to written materials
11and literature. This training requirement may be provided at the
12facility or offsite and may include a combination of observation
13and practical application.

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

15

SEC. 10.  

No reimbursement is required by this act pursuant to
16Section 6 of Article XIII B of the California Constitution because
17the only costs that may be incurred by a local agency or school
18district will be incurred because this act creates a new crime or
19infraction, eliminates a crime or infraction, or changes the penalty
20for a crime or infraction, within the meaning of Section 17556 of
21the Government Code, or changes the definition of a crime within
22the meaning of Section 6 of Article XIII B of the California
23Constitution.

24begin insert

begin insertSEC. 11.end insert  

end insert

begin insertThis act shall become operative only if Assembly Bill
251570 is enacted and takes effect on or before January 1, 2015.end insert



O

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