BILL NUMBER: AB 528	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  MARCH 27, 2003

INTRODUCED BY   Assembly Member Mullin

                        FEBRUARY 18, 2003

    An act to amend Section 125275 of the Health and Safety
Code,  An act to amend Section 1569.2 of, and to add
Section 1569.6 to, the Health and Safety Code,  relating to
Alzheimer's disease.



	LEGISLATIVE COUNSEL'S DIGEST


   AB 528, as amended, Mullin.  Alzheimer's disease:  
diagnostic and treatment center   residential care
facilities for the elderly  . 
   Existing law provides for the licensure and regulation of
residential care facilities for the elderly by the State Department
of Social Services. Existing law requires the director of the
department to adopt regulations for these facilities.
   This bill would require the department to encourage residential
care facilities for the elderly that serve Alzheimer's patients to
create activities and programs that are designed to decrease the
effects of sundown syndrome by creating more activities in the late
afternoon and evening hours. This bill would define sundown syndrome
to mean recurring confusion and increasing levels of agitation that
coincide with the onset of late afternoon and early evening. 

   Existing law permits the State Department of Health Services to
award grants to postsecondary higher education institutions with a
medical center for the establishment of diagnostic and treatment
centers for Alzheimer's disease.
   Existing law provides that the functions of these centers shall be
designed to serve specified purposes.
   This bill would add to these purposes that of designing activities
and programs adapted for the unique needs of Alzheimer's patients,
including programs designed to decrease the effects of sundown
syndrome, as prescribed. 
   Vote:  majority.  Appropriation:  no.  Fiscal committee:  yes.
State-mandated local program:  no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  
  SECTION 1.  Section 125275 of the Health and Safety Code 

  SECTION 1.  The Legislature finds and declares the following:
   (a) Alzheimer's disease is a devastating disease that destroys
certain vital cells of the brain, and affects more than 1,500,000
Americans.
   (b) Alzheimer's disease and related disorders are responsible for
50 percent of all nursing home admissions and Alzheimer's disease is
the fourth leading cause of death in adults.
   (c) Alzheimer's disease has serious emotional, financial, and
social consequences for its victims and their families.
   (d) It is important to provide for the best quality of life for
those affected by this disease by providing activities and programs
that are adapted for the unique needs of Alzheimer's patients,
including programs designed to decrease the effects of "sundown
syndrome."
  SEC. 2.  Section 1569.2 of the Health and Safety Code is amended to
read: 
   1569.2.  As used in this chapter:
   (a) "Administrator" means the individual designated by the
licensee to act in behalf of the licensee in the overall management
of the facility.  The licensee, if an individual, and the
administrator may be one and the same person.
   (b) "Care and supervision" means the facility assumes
responsibility for, or provides or promises to provide in the future,
ongoing assistance with activities of daily living without which the
resident's physical health, mental health, safety or welfare would
be endangered.  Assistance includes assistance with taking
medications, money management, or personal care.
   (c) "Department" means the State Department of Social Services.
   (d) "Director" means the Director of Social Services.
   (e) "Health-related services" mean services which shall be
directly provided by an appropriate skilled professional, including a
registered nurse, licensed vocational nurse, physical therapist, or
occupational therapist.
   (f) "Instrumental activities of daily living" means any of the
following:  housework, meals, laundry, taking of medication, money
management, appropriate transportation, correspondence, telephoning,
and related tasks.
   (g) "License" means a basic permit to operate a residential care
facility for the elderly.
   (h) "Personal activities of daily living" means any of the
following:  dressing, feeding, toileting, bathing, grooming, and
mobility and associated tasks.
   (i) "Personal care" means assistance with personal activities of
daily living, to help provide for and maintain physical and
psychosocial comfort.
   (j) "Protective supervision" means observing and assisting
confused residents, including persons with dementia, to safeguard
them against injury.
   (k) "Residential care facility for the elderly" means a housing
arrangement chosen voluntarily by persons 60 years of age or over, or
their authorized representative, where varying levels and
intensities of care and supervision, protective supervision, or
personal care are provided, based upon their varying needs, as
determined in order to be admitted and to remain in the facility.
Persons under 60 years of age with compatible needs may be allowed to
be admitted or retained in a residential care facility for the
elderly as specified in Section 1569.316.
   This subdivision shall be operative only until the enactment of
legislation implementing the three levels of care in residential care
facilities for the elderly pursuant to Section 1569.70.
   (l) "Residential care facility for the elderly" means a housing
arrangement chosen voluntarily by persons 60 years of age or over, or
their authorized representative, where varying levels and
intensities of care and supervision, protective supervision, personal
care, or health-related services are provided, based upon their
varying needs, as determined in order to be admitted and to remain in
the facility.  Persons under 60 years of age with compatible needs
may be allowed to be admitted or retained in a residential care
facility for the elderly as specified in Section 1569.316.
   This subdivision shall become operative upon the enactment of
legislation implementing the three levels of care in residential care
facilities for the elderly pursuant to Section 1569.70.
   (m)  "Sundown syndrome" means recurring confusion and
increasing levels of agitation that coincide with the onset of late
afternoon and early evening.
   (n)  "Supportive services" means resources available to the
resident in the community which help to maintain their functional
ability and meet their needs as identified in the individual resident
assessment.  Supportive services may include any of the following:
medical, dental, and other health care services; transportation;
recreational and leisure activities; social services; and counseling
services.   
  SEC. 3.  Section 1569.6 is added to the Health and Safety Code, to
read:
   1569.6.  The department shall encourage residential care
facilities for the elderly that serve Alzheimer's patients to create
activities and programs that are designed to decrease the effects of
sundown syndrome by creating more activities in the late afternoon
and evening hours.   is amended to read:
   125275.  (a) The Legislature finds that Alzheimer's disease, a
devastating disease which destroys certain vital cells of the brain,
affects more than 1,500,000 Americans.  The Legislature also finds
that Alzheimer's disease and related disorders are responsible for 50
percent of all nursing home admissions and that Alzheimer's disease
is the fourth leading cause of death in adults.  The Legislature
recognizes that the disease has serious emotional, financial, and
social consequences for its victims and their families.
   (b) The Legislature recognizes that the cause of Alzheimer's
disease is presently unknown, and there is no established treatment
which can cure, reverse, or stop the progression of Alzheimer's
disease.  The Legislature also recognizes that research is the only
hope for victims and families.  The Legislature finds that existing
diagnostic and treatment centers have improved the quality of care
available to the victims of Alzheimer's disease and increased
knowledge with respect to Alzheimer's disease and related disorders.
These centers provide clinical opportunities for research and
facilitate the collection of essential data regarding Alzheimer's
disease and related disorders, while at the same time providing
valuable services like information and referral, counseling, and
training to victims and their families.  It is the intent of the
Legislature, in enacting this article, to encourage the establishment
of geographically dispersed diagnostic and treatment centers for
Alzheimer's disease within every postsecondary higher educational
institution with a medical center, and to encourage research to
discover the cause of, and a cure for, Alzheimer's disease.
   (c) The functions of the diagnostic and treatment centers shall be
designed to serve all of the following purposes:
   (1) To provide diagnostic and treatment services and improve the
quality of care to victims of Alzheimer's disease.
   (2) To increase research by faculty and students in discovering
the cause of, and a cure for, Alzheimer's disease.
   (3) To provide training, monitoring, consultation, and continuing
education to the families of those who are affected by Alzheimer's
disease.
   (4) To increase the training of health care professionals with
respect to Alzheimer's disease and other acquired brain impairments
to the extent that the centers have the requisite expertise.
   (5) To design activities and programs that are adapted for the
unique needs of Alzheimer's patients, including programs designed to
decrease the effects of "sundown syndrome" by creating more
activities in the late afternoon and evening hours.
   (d) The diagnostic and treatment centers may collaborate with the
Statewide Resources Consultant designated pursuant to Section 4364 of
the Welfare and Institutions Code, to the extent that the centers
deem necessary in order to fulfill the functions set forth in
subdivision (c).