BILL ANALYSIS
AB 2629
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Date of Hearing: April 20, 2010
ASSEMBLY COMMITTEE ON AGING AND LONG-TERM CARE
Mariko Yamada, Chair
AB 2629 (Bonnie Lowenthal) - As Introduced: February 19, 2010
SUBJECT : Residential facilities.
SUMMARY : Clarifies admission and retention requirements for
temporarily bedridden individuals in adult residential care
facilities and residential care facilities for the chronically
ill. Specifically, this bill :
1)Specifies that the status of being bedridden shall not include
a temporary illness or recovery from surgery that persists for
less than two weeks.
2)Specifies that no client shall be admitted to or retained in a
residential facility if he or she requires 24-hour skilled
nursing care.
3)Allows a bedridden client to be retained in a residential
facility in excess of 14 days if the following requirements
are met:
a) The facility notifies the Department of Social Services
(DSS) in writing that the person is recovering from a
temporary illness or surgery;
b) The facility submits to DSS a physician and surgeon's
written statement to the effect that the client's illness
or recovery is of a temporary nature. The statement must
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; and,
c) DSS 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)Specifies that by allowing temporarily bedridden individuals
to remain in a residential care facility, the scope of care
and supervision of that facility is not expanded.
5)States that 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 local fire
authority of the estimated length of time that the client will
be bedridden.
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6)Makes clarifying, technical changes to existing law.
EXISTING LAW
1)Establishes the California Community Care Act which governs
community care facilities, residential facilities, adult day
programs, therapeutic day services, foster family agencies,
foster family homes, and other community and residential
services.
2)Establishes DSS as the oversight entity for residential care
facilities, including the following categories:
a) Residential care facilities for the elderly (RCFEs);
b) Community care facilities, including adult residential
care facilities; and,
c) Residential care facilities for the chronically-ill.
3)Requires a prospective applicant for licensure as a
residential care facility to secure and maintain fire
clearance approval from the local fire enforcement agency or
the State Fire Marshal.
4)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.
5)Allows a bedridden individual to be admitted to, and remain
in, a facility 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.
6)Specifies that 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 determining the appropriate fire safety requirements.
7)Prohibits an RCFE from admitting or retaining a resident if
the resident requires 24-hour, skilled nursing or intermediate
care.
8)Allows an RCFE 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;
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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;
and,
d) Allowing the resident to remain at the RCFE does not
expand the scope of care and supervision of a RCFE.
9)Requires an RCFE 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 or her bedridden status in
the facility.
FISCAL EFFECT : Unknown.
COMMENTS :
DSS is responsible for licensing several types of residential
facilities, however only RCFEs have flexibility when it comes to
admitting or retaining a temporarily bedridden resident. This
bill will extend the same allowances for temporarily bedridden
residents or clients that exist in RCFEs to adult residential
facilities and residential care facilities for the
chronically-ill licensed by DSS.
Residential care facilities are currently allowed to admit and
retain "bedridden" residents provided the facility meets certain
criteria, including fire safety precautions. This bill does not
expand the admission or retention criteria, nor does it relax
existing standards for fire safety, care, or staffing.
California has approximately 5,310 licensed adult residential
facilities, with a total capacity of 41,364 residents. In
addition, DSS licenses 21 residential care facilities for the
chronically-ill, with a total capacity of 347 residents.
According to the author, AB 2629 will provide uniformity across
licensed, non-medical, adult community care facilities regarding
fire safety protections for nonambulatory residents who wish to
remain in their "home" when they have a condition that renders
them temporarily bedridden.
Previous Legislation:
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AB 762 (Lowenthal), Chapter 471, Statutes of 2009, clarified the
fire clearance requirements for bedridden residents to
distinguish between residents who are nonambulatory and
residents who are unable to turn or reposition in bed.
AB 749 (Berg) of 2007 would have provided an exemption for
hospice residents who were bedridden. AB 749 was amended in the
Senate to become AB 749 (Wolk), Chapter 477, Statutes of 2008,
which required RCFEs to have an emergency plan that includes
specific provisions and is available, upon request, to residents
onsite and available to local emergency responders.
SB 1896 (Ortiz), Chapter 817, Statutes of 2000, revised the
definition of "bedridden" to mean 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 care staff and other
precautions. SB 1896 also expressly allowed a bedridden person
to be admitted to, and remain in, an RCFE that secures and
maintains an appropriate fire clearance.
Suggested Technical Amendments:
1. Page 2, Line 25, following "care", insert:
, 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).
2. Amend Page 3, Line 9 to read:
(d) Notwithstanding paragraph (2) (3) of subdivision (b)
(a), a
3. Amend Page 3, Line 15 to read:
required in paragraph (1), a physician and and/or surgeon's
written
4. Amend Page 3, Line 28 to read:
facility, notify the local fire authority with having
jurisdiction over the
5. Amend Page 5, Line 30 to read:
required in paragraph (1), a physician and and/or surgeon's
written
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6. Amend Page 6, line 4, to read:
retention in the facility, notify the local fire authority
with having
7. Page 7, following Line 7, insert language amending Section
1507.3 of the Health and Safety Code as follows:
1507.3. (a) Notwithstanding Section 1566.45 or any other
provision of law, a 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 or 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:
(i) Nothing in this section shall be construed to relieve
a licensed residential facility that provides care to adults of
its responsibility to notify the appropriate fire authority of
the
presence of a bedridden resident in the facility as required
under subdivision (e) of Section 1566.45, and to obtain and
maintain a fire clearance from the fire authority.
for purposes of allowing a resident who has been diagnosed as
terminally ill to remain in the facility, to do both of the
following:
(1) With regard to any resident who is bedridden, as defined
in subdivision (a) of Section 1566.45, to, within 48 hours of
the resident's retention in the facility, notify the local fire
authority with jurisdiction in the bedridden resident's location
of the estimated length of time the resident will retain his or
her bedridden status in the facility.
(2) Secure a fire clearance approval from the city or county
fire department, fire district, or any other local agency
providing fire protection services, or the State Fire Marshal,
whichever has primary fire protection jurisdiction.
8. Amend Page 7, Line 8 to read:
SEC.3 . SEC.4.
REGISTERED SUPPORT / OPPOSITION :
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Support
California Commission on Aging
Community Residential Care Association of California
Opposition
None on file.
Analysis Prepared by : Allison Ruff / AGING & L.T.C. / (916)
319-3990