BILL NUMBER: AB 2629 ENROLLED
BILL TEXT
PASSED THE SENATE AUGUST 5, 2010
PASSED THE ASSEMBLY AUGUST 9, 2010
AMENDED IN SENATE JUNE 16, 2010
AMENDED IN ASSEMBLY APRIL 26, 2010
INTRODUCED BY Assembly Member Bonnie Lowenthal
FEBRUARY 19, 2010
An act to amend Sections 1507.3, 1566.45, and 1568.0832 of the
Health and Safety Code, relating to health facilities.
LEGISLATIVE COUNSEL'S DIGEST
AB 2629, Bonnie Lowenthal. Residential facilities.
Existing law provides for the licensing and regulation of
residential facilities under the California Community Care Facilities
Act and residential care facilities for persons with chronic
life-threatening illness by the State Department of Social Services.
Violation of these provisions constitutes a misdemeanor.
Under existing law, bedridden persons may be admitted to, and
remain in, any of the above-described residential facilities if the
facility secures and maintains an appropriate fire clearance. Under
existing law, a person is not classified as "bedridden" if he or she
has a temporary illness that persists for 14 days or less.
This bill would, instead, exclude from the definition of
"bedridden" a temporary illness or recovery from surgery that
persists for 14 days or less. The bill would also permit a
residential facility to retain a bedridden client in excess of 14
days if prescribed conditions are met.
This bill would prohibit a residential facility, except for an
Adult Residential Facility for Persons with Special Health Care Needs
(ARFPSHN), from admitting or retaining a client if he or she
requires 24-hour skilled nursing care. The bill would also require a
residential facility that admits or retains a bedridden person,
within 48 hours of admission or retention, to notify the fire
authority of the estimated length of time that the person will retain
his or her bedridden status in the facility. This bill would make
other conforming changes.
By creating a new crime, 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.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 1507.3 of the Health and Safety Code is amended
to read:
1507.3. (a) Notwithstanding Section 1566.45 or any other
provision of law, a residential facility that provides care to adults
may obtain a waiver from the department for the purpose of allowing
a resident who has been diagnosed as terminally ill by his or her
physician and surgeon to remain in the facility, or allowing a person
who has been diagnosed as terminally ill by his or her physician and
surgeon to become a resident of the facility if that person is
already receiving hospice services and would continue to receive
hospice services without disruption if he or she became a resident,
when all of the following conditions are met:
(1) The facility agrees to retain the terminally ill resident, or
accept as a resident the terminally ill person, and to seek a waiver
on behalf of the individual, provided the individual has requested
the waiver and is capable of deciding to obtain hospice services.
(2) The terminally ill resident, or the terminally ill person to
be accepted as a resident, has obtained the services of a hospice
certified in accordance with federal medicare conditions of
participation and licensed pursuant to Chapter 8 (commencing with
Section 1725) or Chapter 8.5 (commencing with Section 1745).
(3) The facility, in the judgment of the department, has the
ability to provide care and supervision appropriate to meet the needs
of the terminally ill resident, or the terminally ill person to be
accepted as a resident, and is in substantial compliance with
regulations governing the operation of residential facilities that
provide care to adults.
(4) The hospice has agreed to design and provide for care,
services, and necessary medical intervention related to the terminal
illness as necessary to supplement the care and supervision provided
by the facility.
(5) An agreement has been executed between the facility and the
hospice regarding the care plan for the terminally ill resident, or
the terminally ill person to be accepted as a resident. The care plan
shall designate the primary caregiver, identify other caregivers,
and outline the tasks the facility is responsible for performing and
the approximate frequency with which they shall be performed. The
care plan shall specifically limit the facility's role for care and
supervision to those tasks authorized for a residential facility
under this chapter.
(6) The facility has obtained the agreement of those residents who
share the same room with the terminally ill resident, or any
resident who will share a room with the terminally ill person to be
accepted as a resident, to allow the hospice caregivers into their
residence.
(b) At any time that the licensed hospice, the facility, or the
terminally ill resident determines that the resident's condition has
changed so that continued residence in the facility will pose a
threat to the health and safety of the terminally ill resident or any
other resident, the facility may initiate procedures for a transfer.
(c) A facility that has obtained a hospice waiver from the
department pursuant to this section, or an Adult Residential Facility
for Persons with Special Health Care Needs (ARFPSHN) licensed
pursuant to Article 9 (commencing with Section 1567.50), need not
call emergency response services at the time of a life-threatening
emergency if the hospice agency is notified instead and all of the
following conditions are met:
(1) The resident is receiving hospice services from a licensed
hospice agency.
(2) The resident has completed an advance directive, as defined in
Section 4605 of the Probate Code, requesting to forego resuscitative
measures.
(3) The facility has documented that facility staff have received
training from the hospice agency on the expected course of the
resident's illness and the symptoms of impending death.
(d) Nothing in this section is intended to expand the scope of
care and supervision for a residential facility, as defined in this
chapter, that provides care to adults nor shall a facility be
required to alter or extend its license in order to retain a
terminally ill resident, or allow a terminally ill person to become a
resident of the facility, as authorized by this section.
(e) Nothing in this section shall require any care or supervision
to be provided by the residential facility beyond that which is
permitted in this chapter.
(f) Nothing in this section is intended to expand the scope of
life care contracts or the contractual obligation of continuing care
retirement communities as defined in Section 1771.
(g) The department shall not be responsible for the evaluation of
medical services provided to the resident by the hospice and shall
have no liability for the independent acts of the hospice.
(h) The department, in consultation with the State Fire Marshal,
shall develop and expedite implementation of regulations related to
residents who have been diagnosed as terminally ill who remain in the
facility and who are nonambulatory that ensure resident safety but
also provide flexibility to allow residents to remain in the least
restrictive environment.
(i) Nothing in this section shall be construed to relieve a
licensed residential facility that provides care to adults of its
responsibility to do both of the following:
(1) Notify the fire authority having jurisdiction of the presence
of a bedridden resident in the facility as required pursuant to
subdivision (e) of Section 1566.45.
(2) Obtain and maintain a fire clearance from the fire authority
having jurisdiction.
(j) The requirement in paragraph (1) of subdivision (a) to obtain
a waiver, and the requirement in paragraph (1) of subdivision (i)
shall not apply to a facility licensed as an ARFPSHN pursuant to
Article 9 (commencing with Section 1567.50).
SEC. 2. Section 1566.45 of the Health and Safety Code is amended
to read:
1566.45. (a) (1) For purposes of this section, "bedridden" means
requiring assistance in turning and repositioning in bed or being
unable to independently transfer to and from bed, except in a
facility with appropriate and sufficient care staff, mechanical
devices, if necessary, and safety precautions, as determined by the
director in regulations.
(2) In developing the regulations for child residential
facilities, the department shall take into consideration the size and
weight of the child.
(3) For purposes of this section, the status of being bedridden
shall not include a temporary illness or recovery from surgery that
persists for 14 days or less.
(4) The determination of the bedridden status of persons with
developmental disabilities shall be made by the Director of Social
Services or his or her designated representative, in consultation
with the Director of Developmental Services or his or her designated
representative, after consulting the resident's individual safety
plan. The determination of the bedridden status of all other persons
with disabilities who are not developmentally disabled shall be made
by the Director of Social Services, or his or her designated
representative.
(b) No client shall be admitted to or retained in a residential
facility if he or she requires 24-hour skilled nursing care, except
for a facility licensed as an Adult Residential Facility for Persons
with Special Health Care Needs pursuant to Article 9 (commencing with
Section 1567.50).
(c) A bedridden person may be admitted to, and remain in, a
residential facility that secures and maintains an appropriate fire
clearance. A fire clearance shall be issued to a facility in which
one or more bedridden persons reside if either of the following
conditions are met:
(1) The fire safety requirements are met. Clients who are unable
to independently transfer to and from bed, but who do not need
assistance to turn or reposition in bed, shall be considered
nonambulatory for purposes of this paragraph.
(2) Alternative methods of protection are approved.
(d) Notwithstanding paragraph (3) of subdivision (a), a bedridden
client may be retained in a residential facility in excess of 14 days
if all of the following requirements are satisfied:
(1) The facility notifies the department in writing that the
person is recovering from a temporary illness or surgery.
(2) The facility submits to the department, with the notification
required in paragraph (1), a physician and surgeon's written
statement to the effect that the client's illness or recovery is of a
temporary nature. The statement shall contain an estimated date upon
which the illness or recovery is expected to end or upon which the
client is expected to no longer be confined to bed.
(3) The department determines that the client's health and safety
is adequately protected in the facility and that transfer to a higher
level of care is not necessary.
(4) This subdivision does not expand the scope of care and
supervision of a residential facility.
(e) Notwithstanding the length of stay of a bedridden client,
every residential facility admitting or retaining a bedridden client
shall, within 48 hours of the client's admission or retention in the
facility, notify the fire authority having jurisdiction over the
bedridden client's location of the estimated length of time the
client will retain his or her bedridden status in the facility.
(f) (1) The department and the Office of the State Fire Marshal,
in consultation with the State Department of Developmental Services,
shall each promulgate regulations that meet all of the following
conditions:
(A) Are consistent with this section.
(B) Are applicable to facilities regulated under this chapter,
consistent with the regulatory requirements of the California
Building Standards Code for fire and life safety for the respective
occupancy classifications into which the State Department of Social
Services' community care licensing classifications fall.
(C) Permit clients to remain in homelike settings.
(2) At a minimum, these regulations shall do both of the following
with regard to a residential care facility that provides care for
six or fewer clients, at least one of whom is bedridden:
(A) Clarify the fire and life safety requirements for a fire
clearance for the facility.
(B) Identify procedures for requesting the approval of alternative
means of providing equivalent levels of fire and life safety
protection. Either the facility, the client or client's
representative, or local fire official may request from the Office of
the State Fire Marshal a written opinion concerning the
interpretation of the regulations promulgated by the State Fire
Marshal pursuant to this section for a particular factual dispute.
The State Fire Marshal shall issue the written opinion within 45 days
following the request.
(g) For facilities that care for six or fewer clients, a local
fire official shall not impose fire safety requirements stricter than
the fire safety regulations promulgated for the particular type of
facility by the Office of the State Fire Marshal or the local fire
safety requirements imposed on any other single family dwelling,
whichever is more strict.
(h) This section and regulations promulgated thereunder shall be
interpreted in a manner that provides flexibility to allow bedridden
persons to avoid institutionalization and be admitted to, and safely
remain in, community-based residential care facilities.
SEC. 3. Section 1568.0832 of the Health and Safety Code is amended
to read:
1568.0832. (a) (1) For purposes of this section, "bedridden"
means requiring assistance in turning and repositioning in bed or
being unable to independently transfer to and from bed, except in a
facility with appropriate and sufficient care staff, mechanical
devices, if necessary, and safety precautions, as determined by the
director in regulations.
(2) For purposes of this section, the status of being bedridden
shall not include a temporary illness or recovery from surgery that
persists for 14 days or less.
(3) The determination of the bedridden status of persons with
developmental disabilities shall be made by the Director of Social
Services or his or her designated representative, in consultation
with the Director of Developmental Services or his or her designated
representative, after consulting the resident's individual safety
plan. The determination of the bedridden status of all other persons
with disabilities who are not developmentally disabled shall be made
by the Director of Social Services, or his or her designated
representative.
(b) A bedridden person may be admitted to, and remain in, a
residential facility that secures and maintains an appropriate fire
clearance. A fire clearance shall be issued to a facility in which
one or more bedridden persons reside if either of the following
conditions are met:
(1) The fire safety requirements are met. Residents who are unable
to independently transfer to and from bed, but who do not need
assistance to turn or reposition in bed, shall be considered
nonambulatory for purposes of this paragraph.
(2) Alternative methods of protection are approved.
(c) Notwithstanding paragraph (2) of subdivision (a), a bedridden
resident may be retained in a residential care facility in excess of
14 days if all of the following conditions are met:
(1) The facility notifies the department in writing that the
person is recovering from a temporary illness or surgery.
(2) The facility submits to the department, with the notification
required in paragraph (1), a physician and surgeon's written
statement to the effect that the resident's illness or recovery is of
a temporary nature. The statement shall contain an estimated date
upon which the illness or recovery is expected to end or upon which
the resident is expected to no longer be confined to bed.
(3) The department determines that the resident's health and
safety is adequately protected in the facility and that transfer to a
higher level of care is not necessary.
(4) This subdivision does not expand the scope of care and
supervision of a residential care facility.
(d) Notwithstanding the length of stay of a bedridden resident,
every residential facility admitting or retaining a bedridden
resident shall, within 48 hours of the resident's admission or
retention in the facility, notify the fire authority having
jurisdiction over the bedridden resident's location of the estimated
length of time the resident will retain his or her bedridden status
in the facility.
(e) (1) The department and the Office of the State Fire Marshal,
in consultation with the State Department of Developmental Services,
shall each promulgate regulations that meet all of the following
conditions:
(A) Are consistent with this section.
(B) Are applicable to facilities regulated under this chapter,
consistent with the regulatory requirements of the California
Building Standards Code for fire and life safety for the respective
occupancy classifications into which the State Department of Social
Services' community care licensing classifications fall.
(C) Permit residents to remain in homelike settings.
(2) At a minimum, these regulations shall do both of the following
with regard to a residential care facility that provides care for
six or fewer residents, at least one of whom is bedridden:
(A) Clarify the fire and life safety requirements for a fire
clearance for the facility.
(B) Identify procedures for requesting the approval of alternative
means of providing equivalent levels of fire and life safety
protection. Either the facility, the resident or resident's
representative, or local fire official may request from the Office of
the State Fire Marshal a written opinion concerning the
interpretation of the regulations promulgated by the State Fire
Marshal pursuant to this section for a particular factual dispute.
The State Fire Marshal shall issue the written opinion within 45 days
following the request.
(f) For facilities that care for six or fewer residents, a local
fire official shall not impose fire safety requirements stricter than
the fire safety regulations promulgated for the particular type of
facility by the Office of the State Fire Marshal or the local fire
safety requirements imposed on any other single family dwelling,
whichever is more strict.
(g) This section and any regulations promulgated thereunder shall
be interpreted in a manner that provides flexibility to allow
bedridden persons to avoid institutionalization and be admitted to,
and safely remain in, community-based residential care facilities.
SEC. 4. No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.