BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 762
                                                                  Page  1


          ASSEMBLY THIRD READING
          AB 762 (Bonnie Lowenthal)
          As Amended  April 13, 2009
          Majority vote 

           AGING               6-0         APPROPRIATIONS      16-0        
           
           ----------------------------------------------------------------- 
          |Ayes:|Bonnie Lowenthal, Hagman, |Ayes:|De Leon, Nielsen,         |
          |     |Nestande, V. Manuel       |     |Ammiano,                  |
          |     |Perez, Torres, Yamada     |     |Charles Calderon,         |
          |     |                          |     |Krekorian, Duvall,        |
          |     |                          |     |Fuentes, Monning, Harkey, |
          |     |                          |     |Miller, John A. Perez,    |
          |     |                          |     |Price, Skinner, Solorio,  |
          |     |                          |     |Audra Strickland,         |
          |     |                          |     |Torlakson                 |
           ----------------------------------------------------------------- 

           SUMMARY  :   Narrows the definition of "bedridden" residents for  
          residential care facilities for the elderly (RCFEs).   
          Specifically,  this bill  :  

          1)Redefines "bedridden" to mean a resident who requires turning  
            and repositioning in bed, except in facilities with  
            appropriate and sufficient care staff, mechanical devices if  
            necessary, and safety precautions, as determined by the  
            California Department of Social Services (DSS) director in  
            regulations.  

          2)Excludes residents who may require verbal or physical  
            assistance in transferring to and from bed but are then able  
            to move either independently or with the use of an assistive  
            device from the definition of "bedridden." 

           FISCAL EFFECT  :   According to the Assembly Appropriations  
          Committee, no direct fiscal impact to narrow the definition of  
          "bedridden" for RCFE admission and retention criteria and for  
          DSS and local fire agencies to continue oversight of bedridden  
          and non-ambulatory residents of care facilities.

           COMMENTS  :  RCFEs offer assisted living services in both large  
          and small settings and can range in size from six beds or less  
          to over 100 beds.  These facilities provide care and assistance  








                                                                  AB 762
                                                                  Page  2


          to older adults and adults with disabilities in areas such as  
          medication management, food service, bathing, and grooming -  
          they do not provide skilled nursing care.  For many residents,  
          the care and support provided by the RCFE is enough to keep the  
          individual from needing nursing home care.  This bill does not  
          expand RCFE services to include skilled nursing care.

          Prior to 2001, individuals who required assistance repositioning  
          in bed (permanently bedridden) were prohibited in RCFEs.   
          Residents who needed assistance in transferring in and out of  
          bed, but could then move around the facility independently were  
          allowed, but required a "non-ambulatory" fire clearance.  

          However, SB 1896 (Ortiz), Chapter 817, Statutes of 2000, changed  
          the definition of "bedridden" and allowed permanently bedridden  
          individuals to reside in an RCFE and grouped both categories  
          (permanently bedridden and non-ambulatory) under one definition  
          of "bedridden".  RCFEs that admit a "bedridden" individual,  
          whether the resident is only in need of assistance in  
          transferring or unable to reposition in bed, must have a  
          "bedridden" fire clearance.  

          The existing definition of "bedridden" covers not only those who  
          are truly bedridden and confined to bed and unable to  
          reposition, but also residents who need help in and out of bed  
          but are then able to move around the community with the use of a  
          walker or wheelchair and residents with dementia since they  
          might need verbal reminders to get out of bed, but can then walk  
          without assistance.  Proponents argue that the broad definition  
          of "bedridden" can result in the unnecessary transfer of  
          residents to more expensive institutional care when they could  
          easily remain at the RCFE with minimal assistance.


           Analysis Prepared by  :    Allison Ruff / AGING & L.T.C. / (916)  
          319-3990


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