Bill Text: CA SB911 | 2013-2014 | Regular Session | Chaptered
Bill Title: Residential care facilities for the elderly.
Spectrum: Strong Partisan Bill (Democrat 10-1)
Status: (Passed) 2014-09-28 - Chaptered by Secretary of State. Chapter 705, Statutes of 2014. [SB911 Detail]
Download: California-2013-SB911-Chaptered.html
BILL NUMBER: SB 911 CHAPTERED
BILL TEXT
CHAPTER 705
FILED WITH SECRETARY OF STATE SEPTEMBER 28, 2014
APPROVED BY GOVERNOR SEPTEMBER 28, 2014
PASSED THE SENATE AUGUST 28, 2014
PASSED THE ASSEMBLY AUGUST 27, 2014
AMENDED IN ASSEMBLY AUGUST 22, 2014
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
INTRODUCED BY Senator Block
(Coauthors: Senators Correa and Leno)
(Coauthors: Assembly Members Ammiano, Brown, Chávez, Chesbro,
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, 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 his or her 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, and passage of a
written test administered by the department.
This bill would change the minimum hours of classroom instruction
to 80 hours, including 60 hours of in-person instruction, and would
add additional topics to the uniform core of knowledge, including the
adverse effects of psychotropic drugs for use in controlling the
behavior of persons with dementia. 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.
This bill would prohibit a licensee, or officer or employee of the
licensee, from discriminating or retaliating 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. The 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. The 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.
Existing law requires the department 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, existing law
requires employees 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, the 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 residential care facilities for the
elderly to provide training to direct care staff on postural
supports, restricted conditions or health services, and hospice care
that includes 4 hours of training on the care, supervision, and
special needs of those residents, prior to providing direct care to
residents. The bill also would require 4 hours of training thereafter
of in-service training per year 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.
(6) This bill would become operative only if AB 1570 is enacted
and takes effect on or before January 1, 2015.
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 80 hours of coursework, which shall include at least 60
hours of in-person 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 dementia.
(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 residents' rights are fully
respected and implemented.
(L) Managing the physical environment, including, but not limited
to, maintenance and housekeeping.
(M) Postural supports, restricted health conditions, and hospice
care.
(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.
(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 Facilities for the Elderly Act and related
regulations 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.
(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 uniform 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 80-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 California
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 California 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 80 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
shall provide training to direct care staff on postural supports,
restricted conditions or health services, and hospice care as a
component of the training requirements specified in Section 1569.625.
The training shall include all of the following:
(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) Four hours of training thereafter of in-service training per
year on the subject of serving those residents.
(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.
(c) 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.
SEC. 11. This act shall become operative only if Assembly Bill
1570 is enacted and takes effect on or before January 1, 2015.
