BILL ANALYSIS
------------------------------------------------------------
|SENATE RULES COMMITTEE | AB 762|
|Office of Senate Floor Analyses | |
|1020 N Street, Suite 524 | |
|(916) 651-1520 Fax: (916) | |
|327-4478 | |
------------------------------------------------------------
THIRD READING
Bill No: AB 762
Author: Lowenthal (D)
Amended: 5/28/09 in Assembly
Vote: 21
SENATE HUMAN SERVICES COMMITTEE : 5-0, 6/23/09
AYES: Liu, Maldonado, Alquist, Runner, Yee
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
ASSEMBLY FLOOR : 78-0, 6/1/09 - See last page for vote
SUBJECT : Residential care facilities for the elderly:
admission
SOURCE : California Assisted Living Association
DIGEST : This bill clarifies the requirements for
accepting or retaining a resident in a residential care
facility for the elderly when that individual needs
assistance transferring to and from bed.
ANALYSIS :
Existing law:
1. Establishes the California Residential Care Facilities
for the Elderly Act that includes licensing,
regulations, administration, levels of care, and other
provisions of law governing residential care facilities
CONTINUED
AB 762
Page
2
for the elderly (RCFEs).
2. Defines an RCFE as a housing arrangement chosen
voluntarily by a person 60 years of age and over, or
their authorized representative, where varying levels
and intensities of care and supervision, protective
supervision, or personal care are provided.
3. Establishes the Department of Social Services (DSS) as
the entity that licenses RCFEs and enforces health and
safety regulations.
4. Requires a prospective applicant for licensure as an
RCFE to secure and maintain fire clearance approval from
the local fire enforcement agency or the State Fire
Marshal.
5. Requires each RCFE to provide at least the following
basic services:
A. Care and supervision.
B. Assistance with instrumental activities of daily
living to meet the needs of residents.
C. Helping residents gain access to appropriate
supportive services in the community.
D. Being aware of the resident's general whereabouts,
although the resident may travel independently in the
community.
E. Monitoring the activities of the residents while
they are under the supervision of the facility to
ensure their general health, safety, and well-being.
F. Encouraging the residents to maintain and develop
their maximum functional ability through
participation in planned activities.
6. Prohibits an RCFE from admitting or retaining a resident
if either of the following apply:
A. The resident requires 24-hour, skilled nursing or
AB 762
Page
3
intermediate care.
B. The resident is bedridden, other than for a
temporary illness or for recovery from surgery,
unless the RCFE obtains an appropriate fire
clearance.
7. Defines "bedridden" as either requiring assistance in
turning and repositioning in bed, or being unable to
independently transfer to and from bed, except in
facilities with appropriate and sufficient staff,
mechanical devices if necessary, and safety precautions
as determined by DSS.
8. Allows a bedridden individual to be admitted to, and
remain in, an RCFE if the facility secures and maintains
an appropriate fire clearance. A fire clearance will be
issued to a facility in which a bedridden individual
resides if the fire safety requirements are met, or
alternative methods of protection are approved.
9. Allows a facility to retain a bedridden resident beyond
14 days if all of the following requirements are
satisfied:
A. The facility notifies DSS in writing regarding the
temporary illness or recovery from surgery.
B. The facility submits to DSS, the notification, and
a physician and surgeon's written statement to the
effect that the resident's illness or recovery is of
a temporary nature. The statement must contain an
estimated date upon which the illness or recovery
will end or upon which the resident will no longer be
confined to a bed.
C. DSS determines that the health and safety of the
resident is adequately protected in the facility and
that the transfer to a higher level of care is not
necessary.
D. Allowing the resident to remain at the RCFE does
not expand the scope of care and supervision of an
RCFE.
AB 762
Page
4
10.Requires every facility admitting or retaining a
bedridden resident to notify the local fire authority
within 48 hours of the resident's admission or retention
of the estimated length of time the resident will retain
his/her bedridden status in the facility.
11.Defines "nonambulatory persons" as persons unable to
leave a building unassisted under emergency conditions.
This bill specifies that a resident of an RCFE who needs
assistance transferring to and from bed, but who does not
need assistance repositioning in bed, is "nonambulatory"
for purposes of a fire clearance.
Background
RCFEs offer assisted living services in both large and
small settings and can range in size from six beds or fewer
to over 100 beds. These facilities provide care and
assistance 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.
According to the author's office, for many residents, the
care and support provided by the RCFE is enough to keep the
individual from needing skilled nursing home care.
Prior to 2001, individuals who required assistance
repositioning in bed were defined as permanently bedridden
and were prohibited from living in RCFEs. Residents who
needed assistance in transferring in and out of bed and who
could then move around the facility independently could
live in an RCFE if it received a "nonambulatory" fire
clearance.
In 2000, the Legislature fixed a problem that had occurred
in licensed residential facilities for children. SB 1896
(Ortiz), Chapter 817, Statutes of 2000, changed a
definition of "bedridden" to include those individuals who
are able to reposition themselves in bed; and the bill
extended that definition to all residential facilities
licensed by DSS including RCFEs. This change meant that
RCFEs that previously cared for "nonambulatory" residents
needed to meet stricter fire regulations, and thus a new
AB 762
Page
5
problem arose.
Although fire inspectors could still provide "nonambulatory
fire clearances," the author's office reports instances
where an inspector has ceased to distinguish between
"nonambulatory" and "bedridden" residents, resulting in
threatened or actual eviction of nonambulatory residents
from RCFEs into a skilled nursing facility setting. The
author's office believes that these transfers and evictions
are unnecessary.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
SUPPORT : (Verified 7/2/09)
California Assisted Living Association (source)
Aging Services of California
Alzheimer's Association, California Council
Area 4 Agency on Aging
Area Agency on Aging of Lake and Mendocino Counties PSA 26
Association of Board and Care Homes, Inc.
Bello Villetta Residential Care Facility for the Elderly
Board and Care Owners Association
California Association for Adult Day Services
California Commission on Aging
California Hospice and Palliative Care Association
CalPACE ( California Program of All-inclusive Care for
Elderly)
Community Residential Care Association of California
Congress of California Seniors
Hill Partnership, Inc.
Professional Fiduciary Association of California
Quartz Garden
Royal Garden Board and Care
St. Paul Senior Homes and Services
ASSEMBLY FLOOR :
AYES: Adams, Ammiano, Anderson, Arambula, Beall, Bill
Berryhill, Tom Berryhill, Blakeslee, Blumenfield,
Brownley, Buchanan, Caballero, Carter, Chesbro, Conway,
Cook, Coto, Davis, De La Torre, De Leon, DeVore, Duvall,
Emmerson, Eng, Evans, Feuer, Fletcher, Fong, Fuentes,
Fuller, Furutani, Gaines, Galgiani, Garrick, Gilmore,
AB 762
Page
6
Hagman, Hall, Harkey, Hayashi, Hernandez, Hill, Huber,
Huffman, Jeffries, Jones, Knight, Krekorian, Lieu, Logue,
Bonnie Lowenthal, Ma, Mendoza, Miller, Monning, Nava,
Nestande, Niello, Nielsen, John A. Perez, V. Manuel
Perez, Portantino, Price, Ruskin, Salas, Saldana, Silva,
Skinner, Smyth, Solorio, Audra Strickland, Swanson,
Torlakson, Torres, Torrico, Tran, Villines, Yamada, Bass
NO VOTE RECORDED: Block, Charles Calderon
CTW:mw 7/2/09 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
**** END ****