BILL ANALYSIS                                                                                                                                                                                                    






                                  SENATE HUMAN
                               SERVICES COMMITTEE
                            Senator Carol Liu, Chair


          BILL NO:       AB 2629                                      
          A
          AUTHOR:        Lowenthal                                    
          B
          VERSION:       June 16, 2010
          HEARING DATE:  June 22, 2010                                
          2
          FISCAL:        Appropriations                               
          6
                                                                      
          2
          CONSULTANT:                                                 
          9
          Hailey
                                        

                                     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.


                                     ABSTRACT  

           Current law  
          1)  Establishes the California Community Care Act to govern  
          the licensing of community care facilities, including  
          residential facilities, adult day programs, therapeutic day  
          services, foster family agencies, foster family homes,  
          child care centers and family child care homes, and other  
          community and residential services.

          2)  Establishes the Department of Social Services (DSS) as  
          the entity overseeing residential care facilities,  
                                                         Continued---



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          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  
          transfer independently 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 transfer  
          independently 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;
              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  




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          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, in the case of retaining a  
          bedridden individual, the estimated length of time the  
          resident will retain his or her bedridden status in the  
          facility.

           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 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  




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          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.

          6)  Makes clarifying, technical changes to existing law.


                                  FISCAL IMPACT  

          The Assembly Appropriations Committee believes that DSS's  
          workload to implement this bill is absorbable.


                            BACKGROUND AND DISCUSSION  

          The Department of Social Services 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 for those facilities, 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.




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           Previous Legislation:
           AB 762 (Lowenthal), Chapter 471, Statutes of 2009,  
          clarified the fire clearance requirements for bedridden  
          residents of RCFEs to distinguish between residents who are  
          nonambulatory and residents who are unable to turn or  
          reposition in bed.

          AB 749 (Wolk), Chapter 477, Statutes of 2008, 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 allowed a bedridden person  
          to be admitted to, and remain in, an RCFE that secures and  
          maintains an appropriate fire clearance.

           Assembly votes
           Aging and Long-term Care  5-0
          Appropriations 16-0
          Floor               72-0


                                    POSITIONS  

          Support:       Community Residential Care Association of  
          California (sponsor)

          Oppose:   None received




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