BILL ANALYSIS �
AB 2044
Page A
CONCURRENCE IN SENATE AMENDMENTS
AB 2044 (Rodriguez)
As Amended August 21, 2014
Majority vote
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|ASSEMBLY: |64-1 |(May 19, 2014) |SENATE: |33-0 |(August 25, |
| | | | | |2014) |
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Original Committee Reference: HUM. S.
SUMMARY : Places additional staffing and health and safety
requirements on residential care facilities for the elderly
(RCFE). Specifically, this bill :
1)This bill would require that at least one administrator,
facility manager, or designated substitute who is at least 21
years of age and has adequate qualifications, as specified, be
on the premises of the facility 24 hours per day.
2)Requires RCFEs to employ, and the administrator to schedule, a
sufficient number of staff members, as prescribed.
3)Requires RCFE staff training also include training on building
and fire safety and how to appropriately respond to
emergencies.
4)Requires that at least one staff member with a certification
in cardiopulmonary resuscitation (CPR) and first aid training
is on duty at all times and provides that this requirement may
not be construed to require staff to provide CPR to a resident
who has requested to forgo resuscitative measures, as
specified.
5)Clarifies that RCFEs must be clean, safe, sanitary, and in
good repair at all times for the safety and well-being of
residents, staff, and visitors, as specified.
FISCAL EFFECT : According to the Senate Appropriations
Committee, pursuant to Senate Rule 28.8, negligible state costs.
The Senate amendments :
1)Clarify that an individual appointed by the administrator to
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serve in the capacity of the administrator shall have the
necessary qualifications to serve that role.
2)Clarify that staff are not required to provide CPR to a
resident who has requested to forgo resuscitative measures, as
specified.
3)Require that at least one administrator, facility manager, or
designated substitute who is at least 21 years of age and has
adequate qualifications, as specified, be on the premises of
the facility 24 hours per day.
4)Require RCFEs to employ, and the administrator to schedule, a
sufficient number of staff members, as prescribed.
5)Require RCFE staff training also include training on building
and fire safety and how to appropriately respond to
emergencies.
6)Makes chaptering out amendments to avoid conflict with AB 1570
(Chesbro) of the current legislative session.
AS PASSED BY THE ASSEMBLY , this bill:
1)Required that at least one administrator, facility manager, or
other person designated to serve in the capacity of the
administrator are on the premises of a RCFE at all times.
2)Clarified the requirement that RCFEs employ a sufficient
number of staff to meet the needs of its residents as provided
in their service agreements and to ensure the health, safety,
comfort, and supervision of residents.
3)Required that at least one staff member with a certification
in CPR and first aid training is on duty at all times, as
specified.
4)Clarified that RCFEs must be clean, safe, sanitary, and in
good repair at all times for the safety and well-being of
residents, staff, and visitors, as specified.
COMMENTS :
Background: RCFEs, commonly referred to as assisted living
facilities, are licensed retirement residential homes and board
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and care homes that accommodate and provide services to meet the
varying, and at times, fluctuating health care needs of
individuals who are 60 years of age and over, and persons under
the age of 60 with compatible needs. Licensed by the Department
of Social Services' (DSS') Community Care Licensing Division
(CCLD), they can range in size from residential homes with six
or less beds to more formal residential facilities with 100 beds
or more.
There is also no uniform common care model; rather the types of
assistive services can vary widely, which can include differing
levels of personal care and protective supervision, based upon
the needs of the resident.
Growing demand: Over the past 30 years, the demand for RCFEs
has grown substantially. Although RCFEs have been generally
available, they experienced explosive growth in the 1990s, more
than doubling the number of beds between 1990 and 2002,<1> and
continued to grow by 16% between 2001 and 2010.<2> Nationwide,
states reported 1.2 million beds in licensed RCFEs in 2010.<3>
In 2010, the national Centers for Disease Control and Prevention
reported that 40% of RCFE residents needed help with three or
more activities of daily living and three-fourths of residents
had at least two of the 10 most common chronic conditions.<4>
According to DSS, as of June 2, 2014, there are 7,587 licensed
RCFEs in California with a capacity to serve 176,891 residents.
RCFE licensee and administrator requirements: California
statute differentiates between facility licensees, who often are
the business owners and may be property owners and
administrators who are charged with overseeing the quality of
the day-to-day operations and are generally required to be
present at the facility during normal working hours. However,
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<1> Flores and Newcomer, "Monitoring Quality of Care in
Residential Care for the Elderly: The Information Challenge".
Journal of Aging and Social Policy, 21:225-242, 2009.
<2> SCAN Foundation. "Long Term Care Fundamentals: Residential
Care Facilities for the Elderly." March 2011.
http://thescanfoundation.org/sites/thescanfoundation.org/files/LT
C_Fundamental_7_0.pdf
<3> "Assisted Living and Residential Care in the States in
2010," Mollica, Robert, AARP Public Policy Institute
<4> "Residents Living in Residential Care Facilities: United
States, 2010, Caffrey, Christine, et al., US Centers for
Disease Control, April 2012
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initial training and certification requirements for licensees
and administrators are similar.
At minimum, in order to be eligible to apply for a RCFE license,
a person must be at least 21 years of age, pass a criminal
background check, and have a high school diploma or pass a
general educational development test. A prospective licensee
must then provide evidence that he or she is of "reputable and
responsible character,"<5> which includes providing their
employment history and character references. A prospective
licensee must also document that he or she has sufficient
financial resources to maintain the standard of care required by
law and disclose any prior role as an administrator or licensee
of another community care facility, including whether any
disciplinary action was taken against him or her.
RCFE staff requirements: Licensees employ a wide range of staff
to provide day-to-day support and care for residents of RCFEs.
Although many employ individuals with specific expertise and
certifications, such as Licensed Vocational Nurses and Certified
Nursing Assistants, at minimum, staff "who assist residents with
personal activities of daily living"<6> are required to be at
least 18 years of age and undergo 10 hours of training within
four weeks of being employed by the RCFE and four hours of
training each year thereafter. The training is somewhat similar
to that required of licensees and administrators, but is
limited to covering the physical limitations and needs of the
elderly, the importance and techniques for personal care
services, residents' rights, policies and procedures regarding
medications, and the psychosocial needs of the elderly.
All personnel, including the licensee, administrator and staff,
are required to undergo and receive a criminal background
clearance, and must demonstrate they are of good health, which
means they must be physically and mentally capable of performing
assigned tasks. In order to ensure that all personnel are of
good health, they are required to undergo a health screening not
more than six months prior to, or seven days after, employment
or licensure.<7>
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<5> Health and Safety Code Section 1569.15
<6> Health and Safety Code Section 1569.625(b)
<7> Section 87411(f) of Title 22, California Code of
Regulations.
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Analysis Prepared by : Chris Reefe / HUM. S. / (916) 319-2089
FN: 0005463