Amended in Assembly August 19, 2014

Amended in Assembly June 19, 2014

Amended in Senate May 27, 2014

Amended in Senate March 27, 2014

Amended in Senate March 4, 2014

Senate Bill No. 911

Introduced by Senator Block

(Coauthors: Senators Correa and Leno)

(Coauthors: Assembly Members Ammiano, Brown, Chávez, Skinner, Ting, Wieckowski, and Yamada)

January 23, 2014

An act to amend, repeal, and add Sections 1569.616, 1569.62, and 1569.69 of, and to add Sections 1569.371, 1569.39, and 1569.696 to, the Health and Safety Code, relating to residential care facilities for the elderly.

LEGISLATIVE COUNSEL’S DIGEST

SB 911, as amended, Block. Residential care facilities for the elderly.

(1) Existing law, the California Residential Care Facilities for the Elderly Act, provides for the licensure and regulation of residential care facilities for the elderly by the State Department of Social Services. A person who violates the act is guilty of a misdemeanor and subject to civil penalty and suspension or revocation of begin insert his or her end insert license.

Existing law requires an administrator of a residential care facility for the elderly to successfully complete a department-approved certification program prior to employment that requires, among other things, a minimum of 40 hours of classroom instruction on a uniform core of knowledge, which includes resident admission, retention, and assessment procedures begin insert , and passage of a written test administered by the department end insert .

This bill would change the minimum hours of classroom instruction to begin delete 100 end delete begin insert 80 end insert hours, including begin delete 60 end delete begin insert 48 end insert hours of in-person begin delete classroom end delete instruction, and would add additional topics to the uniform core of knowledge, begin delete including, but not limited to, end delete begin insert including end insert the adverse effects of psychotropic drugs for use in controlling the behavior of persons with dementia. begin insert The bill would also require the department to take specific actions with regard to the test, including ensuring that it consists of at least 100 questions. end insert

This bill would require that no licensee, or officer or employee of the licensee, shall discriminate or retaliate against any person receiving the services of the licensee’s residential care facility for the elderly, or against any employee of the licensee’s facility, on the basis, or for the reason that, the person, employee, or any other person dialed or called 911.

This bill would require a residential care facility for the elderly that accepts or retains residents with prohibited health conditions, as defined by the department, to assist residents with accessing home health or hospice services by appropriately skilled professionals, acting within their scope of practice, to ensure that residents receive medical care as prescribed by the resident’s physician and contained in the resident’s service plan. This bill would define an “appropriately skilled professional” as an individual who has training and is licensed to perform the necessary medical procedures prescribed by a physician, which includes, but is not limited to, a registered nurse, licensed vocational nurse, physical therapist, occupational therapist, or respiratory therapist. This bill would provide that an appropriately skilled professional is not required if a resident is providing self-care, as defined by the department, and there is documentation in the resident’s service plan that the resident is capable of providing self-care.

(2) Existing law requires the Director of Social Services to ensure that licensees, administrators, and staffs of residential care facilities for the elderly have appropriate training to provide the care and services for which a license or certificate is issued. The department is required to develop a uniform core of knowledge for the continuing education of administrators of residential care facilities for the elderly.

This bill would also require the department to develop a uniform core of knowledge jointly with the California Department of Aging for the initial certification of administrators, and add additional topics to the uniform core of knowledge, including, but not limited to, applicable laws and regulations and residents’ rights.

(3) Existing law requires that employees who assist residents with the self-administration of medications at a licensed residential care facility for the elderly, which provides care for 16 or more persons, complete 16 hours of initial training, consisting of 8 hours of hands-on shadowing training and 8 hours of other training or instruction, to be completed within the first 2 weeks of employment. If that facility provides care for 15 or fewer persons, employees are required to complete 6 hours of initial training, consisting of 2 hours of hands-on shadowing training and 4 hours of other training or instruction, to be completed within the first 2 weeks of employment.

This bill would require employees at a licensed residential care facility for the elderly that provides care for 16 or more persons, to complete 24 hours of initial training, consisting of 16 hours of hands-on shadowing training and 8 hours of other training or instruction, to be completed within the first 4 weeks of employment. For facilities providing care for 15 or fewer persons, this bill would increase those training requirements to 10 hours of initial training, consisting of 6 hours of hands-on shadowing training, and 4 hours of other training, to be completed within the first 2 weeks of employment.

This bill would require all begin delete direct care staff of end delete residential care facilities for the elderly begin delete that serve residents with postural supports, restricted health conditions or health services, or who receive hospice care services to receive, in addition to other training requirements, end delete begin insert to provide training to direct care staff on postural supports, restricted conditions or health services, and hospice care that includes end insert 4 hours of training on the care, supervision, and special needs of those residents, prior to providing direct care to residents. This bill also would require begin delete 2 2-hour trainings end delete begin insert 4 hours of training end insert thereafter of in-service training begin delete every 6 months end delete begin insert per year end insert on the subject of serving those residents.

(4) Because a violation of any of the above provisions would be a misdemeanor, 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.

(5) This bill would make its provisions operative on January 1, 2016.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes.

The people of the State of California do enact as follows:

SECTION 1.  

Section 1569.371 is added to the Health and
Safety Code, to read:

1569.371.  

(a) No licensee, or officer or employee of the
licensee, shall discriminate or retaliate in any manner against any
person receiving the services of the licensee’s residential care
facility for the elderly, or against any employee of the licensee’s
facility, on the basis, or for the reason that, the person, employee,
or any other person dialed or called 911.

(b) A violation of this section is subject to civil penalty pursuant
to Section 1569.49.

(c) This section shall become operative on January 1, 2016.

SEC. 2.  

Section 1569.39 is added to the Health and Safety
Code, to read:

1569.39.  

(a) A residential care facility for the elderly that
accepts or retains residents with prohibited health conditions, as
defined by the department, in Section 87615 of Title 22 of the
California Code of Regulations, shall assist residents with accessing
home health or hospice services, as indicated in the resident’s
current appraisal, to ensure that residents receive medical care as
prescribed by the resident’s physician and contained in the
resident’s service plan.

(b) A residential care facility for the elderly that accepts or
retains residents with restricted health conditions, as defined by
the department, shall ensure that residents receive medical care as
prescribed by the resident’s physician and contained in the
resident’s service plan by appropriately skilled professionals acting
within their scope of practice. An appropriately skilled professional
may not be required when the resident is providing self-care, as
defined by the department, and there is documentation in the
resident’s service plan that the resident is capable of providing
self-care.

(c) An “appropriately skilled professional” means, for purposes
of this section, an individual who has training and is licensed to
perform the necessary medical procedures prescribed by a
physician. This includes, but is not limited to, a registered nurse,
licensed vocational nurse, physical therapist, occupational therapist,
or respiratory therapist. These professionals may include, but are
not limited to, those persons employed by a home health agency,
the resident, or a facility, and who are currently licensed in this
state.

(d) Failure to meet or arrange to meet the needs of those
residents who require health-related services as specified in the
resident’s written record of care, defined pursuant to Section
1569.80, or failure to notify the physician of a resident’s illness
or injury that poses a danger of death or serious bodily harm is a
licensing violation and subject to civil penalty pursuant to Section
1569.49.

(e) This section shall become operative on January 1, 2016.

SEC. 3.  

Section 1569.616 of the Health and Safety Code is
amended to read:

1569.616.  

(a) (1) An administrator of a residential care facility
for the elderly shall be required to successfully complete a
department-approved certification program prior to employment.

(2) In those cases where the individual is both the licensee and
the administrator of a facility, or a licensed nursing home
administrator, the individual shall comply with the requirements
of this section unless he or she qualifies for one of the exemptions
provided for in subdivision (b).

(3) Failure to comply with this section shall constitute cause for
revocation of the license of the facility where an individual is
functioning as the administrator.

(4) The licensee shall notify the department within 30 days of
any change in administrators.

(b) Individuals seeking exemptions under paragraph (2) of
subdivision (a) shall meet the following criteria and fulfill the
required portions of the certification program, as the case may be:

(1) An individual designated as the administrator of a residential
care facility for the elderly who holds a valid license as a nursing
home administrator issued in accordance with Chapter 2.35
(commencing with Section 1416) of Division 2 shall be required
to complete the areas in the uniform core of knowledge required
by this section that pertain to the law, regulations, policies, and
procedural standards that impact the operations of residential care
facilities for the elderly, the use, misuse, and interaction of
medication commonly used by the elderly in a residential setting,
and resident admission, retention, and assessment procedures,
equal to 12 hours of classroom instruction. An individual meeting
the requirements of this paragraph shall not be required to take a
written test.

(2) In those cases where the individual was both the licensee
and administrator on or before July 1, 1991, the individual shall
be required to complete all the areas specified for the certification
program, but shall not be required to take the written test required
by this section. Those individuals exempted from the written test
shall be issued a conditional certification that is valid only for the
administrator of the facility for which the exemption was granted.

(A) As a condition to becoming an administrator of another
facility, the individual shall be required to pass the written test
provided for in this section.

(B) As a condition to applying for a new facility license, the
individual shall be required to pass the written test provided for
in Section 1569.23.

(c) (1) The administrator certification program shall require a
minimum of 40 hours of classroom instruction that provides
training on a uniform core of knowledge in each of the following
areas:

(A) Laws, regulations, and policies and procedural standards
that impact the operations of residential care facilities for the
elderly.

(B) Business operations.

(C) Management and supervision of staff.

(D) Psychosocial needs of the elderly.

(E) Community and support services.

(F) Physical needs for elderly persons.

(G) Use, misuse, and interaction of medication commonly used
by the elderly.

(H) Resident admission, retention, and assessment procedures.

(I) Training focused specifically on serving clients with
dementia. This training shall be for at least four hours.

(J) Cultural competency and sensitivity in issues relating to the
underserved aging lesbian, gay, bisexual, and transgender
community.

(2) Individuals applying for certification under this section shall
successfully complete an approved certification program, pass a
written test administered by the department within 60 days of
completing the program, and submit the documentation required
by subdivision (d) to the department within 30 days of being
notified of having passed the test. The department may extend
these time deadlines for good cause. The department shall notify
the applicant of his or her test results within 30 days of
administering the test.

(d) The department shall not begin the process of issuing a
certificate until receipt of all of the following:

(1) A certificate of completion of the administrator training
required pursuant to this chapter.

(2) The fee required for issuance of the certificate. A fee of one
hundred dollars ($100) shall be charged by the department to cover
the costs of processing the application for certification.

(3) Documentation of passing the written test or of qualifying
for an exemption pursuant to subdivision (b).

(4) Submission of fingerprints. The department and the
Department of Justice shall expedite the criminal record clearance
for holders of certificates of completion. The department may
waive the submission for those persons who have a current criminal
record clearance on file.

(e) It shall be unlawful for a person not certified under this
section to hold himself or herself out as a certified administrator
of a residential care facility for the elderly. Any person willfully
making a false representation as being a certified administrator is
guilty of a misdemeanor.

(f) (1) Certificates issued under this section shall be renewed
every two years and renewal shall be conditional upon the
certificate holder submitting documentation of completion of 40
hours of continuing education related to the core of knowledge
specified in paragraph (1) of subdivision (c). No more than one-half
of the required 40 hours of continuing education necessary to renew
the certificate may be satisfied through online courses. All other
continuing education hours shall be completed in a classroom
setting. For purposes of this section, individuals who hold a valid
license as a nursing home administrator issued in accordance with
Chapter 2.35 (commencing with Section 1416) of Division 2 of
the Health and Safety Code and meet the requirements of paragraph
(1) of subdivision (b) shall only be required to complete 20 hours
of continuing education.

(2) Every certified administrator of a residential care facility
for the elderly is required to renew his or her certificate and shall
complete the continuing education requirements of this subdivision
whether he or she is certified according to subdivision (a) or (b).
At least 8 hours of the 40-hour continuing education requirement
for a certified administrator of a residential care facility for the
elderly shall include instruction on serving clients with dementia,
including, but not limited to, instruction related to direct care,
physical environment, and admissions procedures and assessment.

(3) Certificates issued under this section shall expire every two
years, on the anniversary date of the initial issuance of the
certificate, except that any administrator receiving his or her initial
certification on or after January 1, 1999, shall make an irrevocable
election to have his or her recertification date for any subsequent
recertification either on the date two years from the date of issuance
of the certificate or on the individual’s birthday during the second
calendar year following certification. The department shall send
a renewal notice to the certificate holder 90 days prior to the
expiration date of the certificate. If the certificate is not renewed
prior to its expiration date, reinstatement shall only be permitted
after the certificate holder has paid a delinquency fee equal to three
times the renewal fee and has provided evidence of completion of
the continuing education required.

(4) To renew a certificate, the certificate holder shall, on or
before the certificate expiration date, request renewal by submitting
to the department documentation of completion of the required
continuing education courses and pay the renewal fee of one
hundred dollars ($100), irrespective of receipt of the department’s
notification of the renewal. A renewal request postmarked on or
before the expiration of the certificate is proof of compliance with
this paragraph.

(5) A suspended or revoked certificate is subject to expiration
as provided for in this section. If reinstatement of the certificate
is approved by the department, the certificate holder, as a condition
precedent to reinstatement, shall pay a fee in an amount equal to
the renewal fee, plus the delinquency fee, if any, accrued at the
time of its revocation or suspension.

(6) A certificate that is not renewed within four years after its
expiration shall not be renewed, restored, reissued, or reinstated
except upon completion of a certification program, passing any
test that may be required of an applicant for a new certificate at
that time, and paying the appropriate fees provided for in this
section.

(7) A fee of twenty-five dollars ($25) shall be charged for the
reissuance of a lost certificate.

(8) A certificate holder shall inform the department of his or
her employment status within 30 days of any change.

(g) The department may revoke a certificate issued under this
section for any of the following:

(1) Procuring a certificate by fraud or misrepresentation.

(2) Knowingly making or giving any false statement or
information in conjunction with the application for issuance of a
certificate.

(3) Criminal conviction, unless an exemption is granted pursuant
to Section 1569.17.

(h) The certificate shall be considered forfeited under either of
the following conditions:

(1) The administrator has had a license revoked, suspended, or
denied as authorized under Section 1569.50.

(2) The administrator has been denied employment, residence,
or presence in a facility based on action resulting from an
administrative hearing pursuant to Section 1569.58.

(i) (1) The department shall establish, by regulation, the
program content, the testing instrument, the process for approving
certification programs, and criteria to be used in authorizing
individuals, organizations, or educational institutions to conduct
certification programs and continuing education courses. These
regulations shall be developed in consultation with provider and
consumer organizations, and shall be made available at least six
months prior to the deadline required for certification. The
department may deny vendor approval to any agency or person
that has not provided satisfactory evidence of their ability to meet
the requirements of vendorization set out in the regulations adopted
pursuant to subdivision (j).

(2) (A) A vendor of online programs for continuing education
shall ensure that each online course contains all of the following:

(i) An interactive portion where the participant receives
feedback, through online communication, based on input from the
participant.

(ii) Required use of a personal identification number or personal
identification information to confirm the identity of the participant.

(iii) A final screen displaying a printable statement, to be signed
by the participant, certifying that the identified participant
completed the course. The vendor shall obtain a copy of the final
screen statement with the original signature of the participant prior
to the issuance of a certificate of completion. The signed statement
of completion shall be maintained by the vendor for a period of
three years and be available to the department upon demand. Any
person who certifies as true any material matter pursuant to this
section that he or she knows to be false is guilty of a misdemeanor.

(B) Nothing in this subdivision shall prohibit the department
from approving online programs for continuing education that do
not meet the requirements of subparagraph (A) if the vendor
demonstrates to the department’s satisfaction that, through
advanced technology, the course and the course delivery meet the
requirements of this section.

(3) The department may authorize vendors to conduct the
administrator certification training program pursuant to provisions
set forth in this section. The department shall conduct the written
test pursuant to regulations adopted by the department.

(4) The department shall prepare and maintain an updated list
of approved training vendors.

(5) The department may inspect training programs, continuing
education courses, and online courses, at no charge to the
department, in order to determine if content and teaching methods
comply with paragraphs (1) and (2), if applicable, and with
regulations. If the department determines that a vendor is not
complying with the intent of this section, the department shall take
appropriate action to bring the program into compliance, which
may include removing the vendor from the approved list.

(6) The department shall establish reasonable procedures and
timeframes, not to exceed 30 days, for the approval of vendor
training programs.

(7) The department may charge a reasonable fee, not to exceed
one hundred fifty dollars ($150) every two years, to certification
program vendors for review and approval of the initial 40-hour
training program pursuant to subdivision (c). The department may
also charge the vendor a fee, not to exceed one hundred dollars
($100) every two years, for the review and approval of the
continuing education courses needed for recertification pursuant
to this subdivision.

(j) This section shall be operative upon regulations being
adopted by the department to implement the administrator
certification program as provided for in this section.

(k) The department shall establish a registry for holders of
certificates that shall include, at a minimum, information on
employment status and criminal record clearance.

(l) Notwithstanding any law to the contrary, vendors approved
by the department who exclusively provide either initial or
continuing education courses for certification of administrators of
a residential care facility for the elderly, as defined in subdivision
(k) of Section 1569.2, a group home facility, as defined by
regulations of the department, or an adult residential care facility,
as defined by regulations of the department, shall be regulated
solely by the department pursuant to this chapter. No other state
or local governmental entity shall be responsible for regulating
the activity of those vendors.

(m) This section shall remain in effect only until January 1,
2016, and as of that date is repealed, unless a later enacted statute,
that is enacted before January 1, 2016, deletes or extends that date.

SEC. 4.  

Section 1569.616 is added to the Health and Safety
Code, to read:

1569.616.  

(a) (1) An administrator of a residential care facility
for the elderly shall be required to successfully complete a
department-approved certification program prior to employment.

(2) In those cases where the individual is both the licensee and
the administrator of a facility, or a licensed nursing home
administrator, the individual shall comply with the requirements
of this section unless he or she qualifies for one of the exemptions
provided for in subdivision (b).

(3) Failure to comply with this section shall constitute cause for
revocation of the license of the facility where an individual is
functioning as the administrator.

(4) The licensee shall notify the department within 30 days of
any change in administrators.

(b) Individuals seeking exemptions under paragraph (2) of
subdivision (a) shall meet the following criteria and fulfill the
required portions of the certification program, as the case may be:

(1) An individual designated as the administrator of a residential
care facility for the elderly who holds a valid license as a nursing
home administrator issued in accordance with Chapter 2.35
(commencing with Section 1416) of Division 2 shall be required
to complete the areas in the uniform core of knowledge required
by this section that pertain to the law, regulations, policies, and
procedural standards that impact the operations of residential care
facilities for the elderly, the use, misuse, and interaction of
medication commonly used by the elderly in a residential setting,
and resident admission, retention, and assessment procedures,
equal to 12 hours of classroom instruction. An individual meeting
the requirements of this paragraph shall not be required to take a
written test.

(2) In those cases where the individual was both the licensee
and administrator on or before July 1, 1991, the individual shall
be required to complete all the areas specified for the certification
program, but shall not be required to take the written test required
by this section. Those individuals exempted from the written test
shall be issued a conditional certification that is valid only for the
administrator of the facility for which the exemption was granted.

(A) As a condition to becoming an administrator of another
facility, the individual shall be required to pass the written test
provided for in this section.

(B) As a condition to applying for a new facility license, the
individual shall be required to pass the written test provided for
in Section 1569.23.

(c) (1) The administrator certification program shall require a
minimum of begin delete 100 end delete begin insert 80 end insert hours of coursework, which shall include at
least begin delete 60 end delete begin insert 48 end insert hours of in-person begin delete classroom end delete instruction that provides
training on a uniform core of knowledge in each of the following
areas:

(A) Laws, regulations, and policies and procedural standards
that impact the operations of residential care facilities for the
elderly.

(B) Business operations.

(C) Management and supervision of staff.

(D) Psychosocial needs of the elderly.

(E) Community and support services.

(F) Physical needs for elderly persons.

(G) Medication management, including the use, misuse, and
interaction of medication commonly used by the elderly, including
antipsychotics and the adverse effects of psychotropic drugs for
use in controlling the behavior of persons with begin delete dementia, as
required by Section 1569.626. end delete begin insert dementia. end insert

(H) Resident admission, retention, and assessment procedures.

(I) Managing Alzheimer’s disease and related dementias,
including nonpharmacologic, person-centered approaches to
dementia care.

(J) Cultural competency and sensitivity in issues relating to the
underserved aging lesbian, gay, bisexual, and transgender
community.

(K) Residents’ rights and the importance of initial and ongoing
training for all staff to ensure that begin delete resident’s end delete begin insert residents’ end insert rights are
fully respected and implemented.

begin insert

(L) Managing the physical environment, including, but not
limited to, maintenance and housekeeping.

end insert begin insert

(M) Postural supports, restricted health conditions, and hospice
care.

end insert

(2) Individuals applying for certification under this section shall
successfully complete an approved certification program, pass a
written test administered by the department within 60 days of
completing the program, and submit the documentation required
by subdivision (d) to the department within 30 days of being
notified of having passed the test. The department may extend
these time deadlines for good cause. The department shall notify
the applicant of his or her test results within 30 days of
administering the test.

begin insert

(3) The department shall ensure the test consists of at least 100
questions and allows an applicant to have access to the California
Residential Care Facility for the Elderly Act, related regulations,
and the evaluator manual during the test. The department, no later
than July 1 of every other year, shall review and revise the test in
order to ensure the rigor and quality of the test. Each year, the
department shall ensure, by January 1, that the test is not in conflict
with prevailing law. The department may convene a stakeholder
group to assist in developing and reviewing test questions.

end insert

(d) The department shall not begin the process of issuing a
certificate until receipt of all of the following:

(1) A certificate of completion of the administrator training
required pursuant to this chapter.

(2) The fee required for issuance of the certificate. A fee of one
hundred dollars ($100) shall be charged by the department to cover
the costs of processing the application for certification.

(3) Documentation of passing the written test or of qualifying
for an exemption pursuant to subdivision (b).

(4) Submission of fingerprints. The department and the
Department of Justice shall expedite the criminal record clearance
for holders of certificates of completion. The department may
waive the submission for those persons who have a current criminal
record clearance on file.

(e) It shall be unlawful for a person not certified under this
section to hold himself or herself out as a certified administrator
of a residential care facility for the elderly. Any person willfully
making a false representation as being a certified administrator is
guilty of a misdemeanor.

(f) (1) Certificates issued under this section shall be renewed
every two years and renewal shall be conditional upon the
certificate holder submitting documentation of completion of 40
hours of continuing education related to the core of knowledge
specified in paragraph (1) of subdivision (c). No more than one-half
of the required 40 hours of continuing education necessary to renew
the certificate may be satisfied through online courses. All other
continuing education hours shall be completed in a classroom
setting. For purposes of this section, individuals who hold a valid
license as a nursing home administrator issued in accordance with
Chapter 2.35 (commencing with Section 1416) of Division 2 and
meet the requirements of paragraph (1) of subdivision (b) shall
only be required to complete 20 hours of continuing education.

(2) Every certified administrator of a residential care facility
for the elderly is required to renew his or her certificate and shall
complete the continuing education requirements of this subdivision
whether he or she is certified according to subdivision (a) or (b).
At least eight hours of the 40-hour continuing education
requirement for a certified administrator of a residential care facility
for the elderly shall include instruction on serving clients with
dementia, including, but not limited to, instruction related to direct
care, physical environment, and admissions procedures and
assessment.

(3) Certificates issued under this section shall expire every two
years, on the anniversary date of the initial issuance of the
certificate, except that any administrator receiving his or her initial
certification on or after January 1, 1999, shall make an irrevocable
election to have his or her recertification date for any subsequent
recertification either on the date two years from the date of issuance
of the certificate or on the individual’s birthday during the second
calendar year following certification. The department shall send
a renewal notice to the certificate holder 90 days prior to the
expiration date of the certificate. If the certificate is not renewed
prior to its expiration date, reinstatement shall only be permitted
after the certificate holder has paid a delinquency fee equal to three
times the renewal fee and has provided evidence of completion of
the continuing education required.

(4) To renew a certificate, the certificate holder shall, on or
before the certificate expiration date, request renewal by submitting
to the department documentation of completion of the required
continuing education courses and pay the renewal fee of one
hundred dollars ($100), irrespective of receipt of the department’s
notification of the renewal. A renewal request postmarked on or
before the expiration of the certificate is proof of compliance with
this paragraph.

(5) A suspended or revoked certificate is subject to expiration
as provided for in this section. If reinstatement of the certificate
is approved by the department, the certificate holder, as a condition
precedent to reinstatement, shall pay a fee in an amount equal to
the renewal fee, plus the delinquency fee, if any, accrued at the
time of its revocation or suspension.

(6) A certificate that is not renewed within four years after its
expiration shall not be renewed, restored, reissued, or reinstated
except upon completion of a certification program, passing any
test that may be required of an applicant for a new certificate at
that time, and paying the appropriate fees provided for in this
section.

(7) A fee of twenty-five dollars ($25) shall be charged for the
reissuance of a lost certificate.

(8) A certificate holder shall inform the department of his or
her employment status within 30 days of any change.

(g) The department may revoke a certificate issued under this
section for any of the following:

(1) Procuring a certificate by fraud or misrepresentation.

(2) Knowingly making or giving any false statement or
information in conjunction with the application for issuance of a
certificate.

(3) Criminal conviction, unless an exemption is granted pursuant
to Section 1569.17.

(h) The certificate shall be considered forfeited under either of
the following conditions:

(1) The administrator has had a license revoked, suspended, or
denied as authorized under Section 1569.50.

(2) The administrator has been denied employment, residence,
or presence in a facility based on action resulting from an
administrative hearing pursuant to Section 1569.58.

(i) (1) The department shall establish, by regulation, the
program content, the testing instrument, the process for approving
certification programs, and criteria to be used in authorizing
individuals, organizations, or educational institutions to conduct
certification programs and continuing education courses. These
regulations shall be developed in consultation with provider and
consumer organizations, and shall be made available at least six
months prior to the deadline required for certification. The
department may deny vendor approval to any agency or person
that has not provided satisfactory evidence of their ability to meet
the requirements of vendorization set out in the regulations adopted
pursuant to subdivision (j).

(2) (A) A vendor of online programs for continuing education
shall ensure that each online course contains all of the following:

(i) An interactive portion where the participant receives
feedback, through online communication, based on input from the
participant.

(ii) Required use of a personal identification number or personal
identification information to confirm the identity of the participant.

(iii) A final screen displaying a printable statement, to be signed
by the participant, certifying that the identified participant
completed the course. The vendor shall obtain a copy of the final
screen statement with the original signature of the participant prior
to the issuance of a certificate of completion. The signed statement
of completion shall be maintained by the vendor for a period of
three years and be available to the department upon demand. Any
person who certifies as true any material matter pursuant to this
section that he or she knows to be false is guilty of a misdemeanor.

(B) Nothing in this subdivision shall prohibit the department
from approving online programs for continuing education that do
not meet the requirements of subparagraph (A) if the vendor
demonstrates to the department’s satisfaction that, through
advanced technology, the course and the course delivery meet the
requirements of this section.

(3) The department may authorize vendors to conduct the
administrator certification training program pursuant to provisions
set forth in this section. The department shall conduct the written
test pursuant to regulations adopted by the department.

(4) The department shall prepare and maintain an updated list
of approved training vendors.

(5) The department may inspect training programs, continuing
education courses, and online courses, at no charge to the
department, in order to determine if content and teaching methods
comply with paragraphs (1) and (2), if applicable, and with
regulations. If the department determines that a vendor is not
complying with the intent of this section, the department shall take
appropriate action to bring the program into compliance, which
may include removing the vendor from the approved list.

(6) The department shall establish reasonable procedures and
timeframes, not to exceed 30 days, for the approval of vendor
training programs.

(7) The department may charge a reasonable fee, not to exceed
one hundred fifty dollars ($150) every two years, to certification
program vendors for review and approval of the initial 40-hour
training program pursuant to subdivision (c). The department may
also charge the vendor a fee, not to exceed one hundred dollars
($100) every two years, for the review and approval of the
continuing education courses needed for recertification pursuant
to this subdivision.

(j) This section shall be operative upon regulations being
adopted by the department to implement the administrator
certification program as provided for in this section.

(k) The department shall establish a registry for holders of
certificates that shall include, at a minimum, information on
employment status and criminal record clearance.

(l) Notwithstanding any law to the contrary, vendors approved
by the department who exclusively provide either initial or
continuing education courses for certification of administrators of
a residential care facility for the elderly, as defined in subdivision
(k) of Section 1569.2, a group home facility, as defined by
regulations of the department, or an adult residential care facility,
as defined by regulations of the department, shall be regulated
solely by the department pursuant to this chapter. No other state
or local governmental entity shall be responsible for regulating
the activity of those vendors.

(m) This section shall become operative on January 1, 2016.

SEC. 5.  

Section 1569.62 of the Health and Safety Code is
amended to read:

1569.62.  

(a) The director shall ensure that licensees,
administrators, and staffs of residential care facilities for the elderly
have appropriate training to provide the care and services for which
a license or certificate is issued.

(b) The department shall develop jointly with the begin insert California end insert
Department of Aging, with input from provider organizations,
requirements for a uniform core of knowledge within the required
20 hours of continuing education for administrators, and their
designated substitutes, and for recertification of administrators of
residential care facilities for the elderly. This knowledge base shall
include, as a minimum, basic understanding of the psychosocial
and physical care needs of elderly persons and administration. The
department shall develop jointly with the begin insert California end insert Department
of Aging, with input from provider organizations, a uniform
resident assessment tool to be used by all residential care facilities
for the elderly. The assessment tool shall, in lay terms, help to
identify resident needs for service and assistance with activities
of daily living.

The departments shall develop a mandatory training program
on the utilization of the assessment tool to be given to
administrators and their designated substitutes.

(c) This section shall remain in effect only until January 1, 2016,
and as of that date is repealed, unless a later enacted statute, that
is enacted before January 1, 2016, deletes or extends that date.

SEC. 6.  

Section 1569.62 is added to the Health and Safety
Code, to read:

1569.62.  

(a) The director shall ensure that licensees,
administrators, and staff of residential care facilities for the elderly
have appropriate training to provide the care and services for which
a license or certificate is issued.

(b) The department shall develop jointly with the California
Department of Aging requirements for a uniform core of knowledge
for the required initial certification and continuing education for
administrators, and their designated substitutes, and for
recertification of administrators of residential care facilities for
the elderly. This knowledge base shall include, as a minimum,
basic understanding of the psychosocial and physical care needs
of elderly persons, applicable laws and regulations, residents’
rights, and administration. This training shall be developed in
consultation with individuals or organizations with specific
expertise in residential care facilities for the elderly or assisted
living services, or by an outside source with expertise in residential
care facilities for the elderly or assisted living services.

(1) The initial certification training for administrators shall
consist of at least 100 hours.

(2) The continuing education requirement for administrators is
at least 40 hours of training during each two-year certification
period, as specified in paragraph (1) of subdivision (f) of Section
1569.616.

(c) (1) The department shall develop a uniform resident
assessment tool to be used by all residential care facilities for the
elderly. The assessment tool shall, in lay terms, help to identify
resident needs for service and assistance with activities of daily
living.

(2) The departments shall develop a mandatory training program
on the utilization of the assessment tool to be given to
administrators and their designated substitutes.

(d) This section shall become operative on January 1, 2016.

SEC. 7.  

Section 1569.69 of the Health and Safety Code is
amended to read:

1569.69.  

(a) Each residential care facility for the elderly
licensed under this chapter shall ensure that each employee of the
facility who assists residents with the self-administration of
medications meets the following training requirements:

(1) In facilities licensed to provide care for 16 or more persons,
the employee shall complete 16 hours of initial training. This
training shall consist of eight hours of hands-on shadowing training,
which shall be completed prior to assisting with the
self-administration of medications, and eight hours of other training
or instruction, as described in subdivision (f), which shall be
completed within the first two weeks of employment.

(2) In facilities licensed to provide care for 15 or fewer persons,
the employee shall complete six hours of initial training. This
training shall consist of two hours of hands-on shadowing training,
which shall be completed prior to assisting with the
self-administration of medications, and four hours of other training
or instruction, as described in subdivision (f), which shall be
completed within the first two weeks of employment.

(3) An employee shall be required to complete the training
requirements for hands-on shadowing training described in this
subdivision prior to assisting any resident in the self-administration
of medications. The training and instruction described in this
subdivision shall be completed, in their entirety, within the first
two weeks of employment.

(4) The training shall cover all of the following areas:

(A) The role, responsibilities, and limitations of staff who assist
residents with the self-administration of medication, including
tasks limited to licensed medical professionals.

(B) An explanation of the terminology specific to medication
assistance.

(C) An explanation of the different types of medication orders:
prescription, over-the-counter, controlled, and other medications.

(D) An explanation of the basic rules and precautions of
medication assistance.

(E) Information on medication forms and routes for medication
taken by residents.

(F) A description of procedures for providing assistance with
the self-administration of medications in and out of the facility,
and information on the medication documentation system used in
the facility.

(G) An explanation of guidelines for the proper storage, security,
and documentation of centrally stored medications.

(H) A description of the processes used for medication ordering,
refills, and the receipt of medications from the pharmacy.

(I) An explanation of medication side effects, adverse reactions,
and errors.

(5) To complete the training requirements set forth in this
subdivision, each employee shall pass an examination that tests
the employee’s comprehension of, and competency in, the subjects
listed in paragraph (4).

(6) Residential care facilities for the elderly shall encourage
pharmacists and licensed medical professionals to use plain English
when preparing labels on medications supplied to residents. As
used in this section, “plain English” means that no abbreviations,
symbols, or Latin medical terms shall be used in the instructions
for the self-administration of medication.

(7) The training requirements of this section are not intended
to replace or supplant those required of all staff members who
assist residents with personal activities of daily living as set forth
in Section 1569.625.

(8) The training requirements of this section shall be repeated
if either of the following occurs:

(A) An employee returns to work for the same licensee after a
break of service of more than 180 consecutive calendar days.

(B) An employee goes to work for another licensee in a facility
in which he or she assists residents with the self-administration of
medication.

(b) Each employee who received training and passed the
examination required in paragraph (5) of subdivision (a), and who
continues to assist with the self-administration of medicines, shall
also complete four hours of in-service training on
medication-related issues in each succeeding 12-month period.

(c) The requirements set forth in subdivisions (a) and (b) do not
apply to persons who are licensed medical professionals.

(d) Each residential care facility for the elderly that provides
employee training under this section shall use the training material
and the accompanying examination that are developed by, or in
consultation with, a licensed nurse, pharmacist, or physician. The
licensed residential care facility for the elderly shall maintain the
following documentation for each medical consultant used to
develop the training:

(1) The name, address, and telephone number of the consultant.

(2) The date when consultation was provided.

(3) The consultant’s organization affiliation, if any, and any
educational and professional qualifications specific to medication
management.

(4) The training topics for which consultation was provided.

(e) Each person who provides employee training under this
section shall meet the following education and experience
requirements:

(1) A minimum of five hours of initial, or certified continuing,
education or three semester units, or the equivalent, from an
accredited educational institution, on topics relevant to medication
management.

(2) The person shall meet any of the following practical
experience or licensure requirements:

(A) Two years of full-time experience, within the last four years,
as a consultant with expertise in medication management in areas
covered by the training described in subdivision (a).

(B) Two years of full-time experience, or the equivalent, within
the last four years, as an administrator for a residential care facility
for the elderly, during which time the individual has acted in
substantial compliance with applicable regulations.

(C) Two years of full-time experience, or the equivalent, within
the last four years, as a direct care provider assisting with the
self-administration of medications for a residential care facility
for the elderly, during which time the individual has acted in
substantial compliance with applicable regulations.

(D) Possession of a license as a medical professional.

(3) The licensed residential care facility for the elderly shall
maintain the following documentation on each person who provides
employee training under this section:

(A) The person’s name, address, and telephone number.

(B) Information on the topics or subject matter covered in the
training.

(C) The time, dates, and hours of training provided.

(f) Other training or instruction, as required in paragraphs (1)
and (2) of subdivision (a), may be provided offsite, and may use
various methods of instruction, including, but not limited to, all
of the following:

(1) Lectures by presenters who are knowledgeable about
medication management.

(2) Video recorded instruction, interactive material, online
training, and books.

(3) Other written or visual materials approved by organizations
or individuals with expertise in medication management.

(g) Residential care facilities for the elderly licensed to provide
care for 16 or more persons shall maintain documentation that
demonstrates that a consultant pharmacist or nurse has reviewed
the facility’s medication management program and procedures at
least twice a year.

(h) Nothing in this section authorizes unlicensed personnel to
directly administer medications.

(i) This section shall remain in effect only until January 1, 2016,
and as of that date is repealed, unless a later enacted statute, that
is enacted before January 1, 2016, deletes or extends that date.

SEC. 8.  

Section 1569.69 is added to the Health and Safety
Code, to read:

1569.69.  

(a) Each residential care facility for the elderly
licensed under this chapter shall ensure that each employee of the
facility who assists residents with the self-administration of
medications meets all of the following training requirements:

(1) In facilities licensed to provide care for 16 or more persons,
the employee shall complete 24 hours of initial training. This
training shall consist of 16 hours of hands-on shadowing training,
which shall be completed prior to assisting with the
self-administration of medications, and 8 hours of other training
or instruction, as described in subdivision (f), which shall be
completed within the first four weeks of employment.

(2) In facilities licensed to provide care for 15 or fewer persons,
the employee shall complete 10 hours of initial training. This
training shall consist of 6 hours of hands-on shadowing training,
which shall be completed prior to assisting with the
self-administration of medications, and 4 hours of other training
or instruction, as described in subdivision (f), which shall be
completed within the first two weeks of employment.

(3) An employee shall be required to complete the training
requirements for hands-on shadowing training described in this
subdivision prior to assisting any resident in the self-administration
of medications. The training and instruction described in this
subdivision shall be completed, in their entirety, within the first
two weeks of employment.

(4) The training shall cover all of the following areas:

(A) The role, responsibilities, and limitations of staff who assist
residents with the self-administration of medication, including
tasks limited to licensed medical professionals.

(B) An explanation of the terminology specific to medication
assistance.

(C) An explanation of the different types of medication orders:
prescription, over-the-counter, controlled, and other medications.

(D) An explanation of the basic rules and precautions of
medication assistance.

(E) Information on medication forms and routes for medication
taken by residents.

(F) A description of procedures for providing assistance with
the self-administration of medications in and out of the facility,
and information on the medication documentation system used in
the facility.

(G) An explanation of guidelines for the proper storage, security,
and documentation of centrally stored medications.

(H) A description of the processes used for medication ordering,
refills, and the receipt of medications from the pharmacy.

(I) An explanation of medication side effects, adverse reactions,
errors, the adverse effects of psychotropic drugs for use in
controlling the behavior of persons with dementia, and the
increased risk of death when elderly residents with dementia are
given antipsychotic medications.

(5) To complete the training requirements set forth in this
subdivision, each employee shall pass an examination that tests
the employee’s comprehension of, and competency in, the subjects
listed in paragraph (4).

(6) Residential care facilities for the elderly shall encourage
pharmacists and licensed medical professionals to use plain English
when preparing labels on medications supplied to residents. As
used in this section, “plain English” means that no abbreviations,
symbols, or Latin medical terms shall be used in the instructions
for the self-administration of medication.

(7) The training requirements of this section are not intended
to replace or supplant those required of all staff members who
assist residents with personal activities of daily living as set forth
in Sections 1569.625 and 1569.696.

(8) The training requirements of this section shall be repeated
if either of the following occur:

(A) An employee returns to work for the same licensee after a
break of service of more than 180 consecutive calendar days.

(B) An employee goes to work for another licensee in a facility
in which he or she assists residents with the self-administration of
medication.

(b) Each employee who received training and passed the
examination required in paragraph (5) of subdivision (a), and who
continues to assist with the self-administration of medicines, shall
also complete eight hours of in-service training on
medication-related issues in each succeeding 12-month period.

(c) The requirements set forth in subdivisions (a) and (b) do not
apply to persons who are licensed medical professionals.

(d) Each residential care facility for the elderly that provides
employee training under this section shall use the training material
and the accompanying examination that are developed by, or in
consultation with, a licensed nurse, pharmacist, or physician. The
licensed residential care facility for the elderly shall maintain the
following documentation for each medical consultant used to
develop the training:

(1) The name, address, and telephone number of the consultant.

(2) The date when consultation was provided.

(3) The consultant’s organization affiliation, if any, and any
educational and professional qualifications specific to medication
management.

(4) The training topics for which consultation was provided.

(e) Each person who provides employee training under this
section shall meet the following education and experience
requirements:

(1) A minimum of five hours of initial, or certified continuing,
education or three semester units, or the equivalent, from an
accredited educational institution, on topics relevant to medication
management.

(2) The person shall meet any of the following practical
experience or licensure requirements:

(A) Two years of full-time experience, within the last four years,
as a consultant with expertise in medication management in areas
covered by the training described in subdivision (a).

(B) Two years of full-time experience, or the equivalent, within
the last four years, as an administrator for a residential care facility
for the elderly, during which time the individual has acted in
substantial compliance with applicable regulations.

(C) Two years of full-time experience, or the equivalent, within
the last four years, as a direct care provider assisting with the
self-administration of medications for a residential care facility
for the elderly, during which time the individual has acted in
substantial compliance with applicable regulations.

(D) Possession of a license as a medical professional.

(3) The licensed residential care facility for the elderly shall
maintain the following documentation on each person who provides
employee training under this section:

(A) The person’s name, address, and telephone number.

(B) Information on the topics or subject matter covered in the
training.

(C) The times, dates, and hours of training provided.

(f) Other training or instruction, as required in paragraphs (1)
and (2) of subdivision (a), may be provided offsite, and may use
various methods of instruction, including, but not limited to, all
of the following:

(1) Lectures by presenters who are knowledgeable about
medication management.

(2) Video recorded instruction, interactive material, online
training, and books.

(3) Other written or visual materials approved by organizations
or individuals with expertise in medication management.

(g) Residential care facilities for the elderly licensed to provide
care for 16 or more persons shall maintain documentation that
demonstrates that a consultant pharmacist or nurse has reviewed
the facility’s medication management program and procedures at
least twice a year.

(h) Nothing in this section authorizes unlicensed personnel to
directly administer medications.

(i) This section shall become operative on January 1, 2016.

SEC. 9.  

Section 1569.696 is added to the Health and Safety
Code, to read:

1569.696.  

(a) All residential care facilities for the elderly begin delete that
serve residents with postural supports, restricted health conditions
or health services, or who receive hospice services shall include, end delete
begin insert shall provide training to direct care staff on postural supports,
restricted conditions or health services, and hospice care end insert as a
component of the training requirements specified in begin delete Sections
1569.23, 1569.616, and 1569.625, the following training
requirements for all direct care staff: end delete begin insert Section 1569.625. The
training shall include all of the following: end insert

(1) Four hours of training on the care, supervision, and special
needs of those residents, prior to providing direct care to residents.
The facility may utilize various methods of instruction, including,
but not limited to, preceptorship, mentoring, and other forms of
observation and demonstration. The orientation time shall be
exclusive of any administrative instruction.

(2)  begin delete Two two-hour trainings end delete begin insert Four hours of training end insert thereafter
of in-service training begin delete every six months end delete begin insert per year end insert on the subject of
serving those residents. begin delete This training shall be in addition to the
trainings specified in Sections 1569.23, 1569.616, and 1569.625. end delete

(b) This training shall be developed in consultation with
individuals or organizations with specific expertise in the care of
those residents described in subdivision (a). In formulating and
providing this training, reference may be made to written materials
and literature. This training requirement may be provided at the
facility or offsite and may include a combination of observation
and practical application.

begin delete

(c) At the request of the department, and immediately if the
request is made during an inspection, licensees shall provide the
department with a confidential list of residents and their conditions,
as specified in subdivision (a), which is to be kept confidential to
the extent permitted by law. This list shall be maintained in an
accurate and current status at all times.

(d)

end delete

begin insert (c) end insert  This section shall become operative on January 1, 2016.

SEC. 10.  

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.