Bill Text: CA SB911 | 2013-2014 | Regular Session | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft
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-Amended.html
BILL NUMBER: SB 911	AMENDED
	BILL TEXT

	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, Skinner,
Ting, Wieckowski, and Yamada)

                        JANUARY 23, 2014

   An act to amend, repeal, and add Sections  1569.23,
  1569.616,  1569.62, 1569.625, 1569.626,
 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 license.
   Existing law requires an  applicant for a license to
complete, at a minimum, a 40-hour certification program approved by
the department that includes instruction in a uniform code of
knowledge, and to pass a written test.   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.

   This bill would change the minimum hours of classroom instruction
to 100 hours,  of which 80 hours are classroom instruction,
  including 60 hours of in-person classroom instruction,
 and would add additional topics to the uniform  code
  core  of knowledge, including, but not limited
to, the adverse effects of psychotropic drugs for use in controlling
the behavior of persons with dementia.  The bill would also
require the department to annually review the test and update it as
necessary to reflect changes in the law and regulations. 
   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  ensure that
residents receive   assist residents with accessing
 home health or hospice services  sufficient in scope
and hours  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  code 
 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
 code   core  of knowledge jointly with the
California Department of Aging for the initial certification of
administrators, and add additional topics to the uniform 
code   core  of knowledge, including, but not
limited to, applicable laws and regulations and residents' rights.

   (3) Existing law requires the department to adopt regulations to
require staff members of residential care facilities for the elderly
who assist residents with personal activities of daily living to
receive 10 hours of training within the first 4 weeks of employment,
and 4 hours of training annually thereafter on topics, including, but
not limited to, policies and procedures regarding medications.
 
   This bill would increase that training to 40 hours of training
within the first 4 weeks of employment, 20 hours of training annually
thereafter, and would also require that at least 24 hours of
training be completed prior to providing direct care to residents.
This bill would exempt certified nurse assistants with valid
certification from those requirements, provided that certified nurse
assistants receive 8 hours of training, prior to providing direct
care to residents, on resident characteristics, plans of care,
resident records, and facility practices and procedures. 

   (4) Existing law requires all direct care staff of a residential
care facility for the elderly, which advertises or promotes special
care, programming, or environment for persons with dementia, receive
6 hours of resident care orientation within the first 4 weeks of
employment and 8 hours of in-service training per year. 

   This bill would increase that training to 15 hours of resident
care orientation, prior to providing direct care to residents, and 12
hours of in-service training per year on the subject of providing
care and supervision to residents with dementia.  
   (5) 
    (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  32   24  hours of initial
training, consisting of  12   16  hours of
hands-on shadowing training and  20   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  16   10  hours of initial training,
consisting of  8   6  hours of hands-on
shadowing training, and  8   4  hours of
other training ,   to be completed within the first 2
weeks of employment  .
   This bill would require all direct care staff of residential care
facilities for the elderly that serve residents with postural
supports,  or  restricted health conditions or
health services, or who receive hospice care services  , as
described in specified regulations, in addition to other training
requirements,   to  receive  15 
 , in addition to other training requirements, 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  12 hours   2 2-hour
trainings thereafter  of in-service training  per year
 every 6 months  on the subject of serving those
residents. 
   (6) 
   (   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. 
   (7) 
    (   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 1569.23 of the Health and
Safety Code is amended to read:
   1569.23.  (a) As a requirement for licensure, the applicant shall
demonstrate that he or she has successfully completed a certification
program approved by the department.
   (b) The certification program shall be for a minimum of 40 hours
of classroom instruction and include a uniform core of knowledge
which shall include all of the following:
   (1) Law, regulations, policies, and procedural standards that
impact the operations of residential care facilities for the elderly.

   (2) Business operations.
   (3) Management and supervision of staff.
   (4) Psychosocial need of the elderly residents.
   (5) Physical needs for elderly residents.
   (6) Community and support services.
   (7) Use, misuse, and interaction of drugs commonly used by the
elderly.
   (8) Resident admission, retention, and assessment procedures.
   (c) Successful completion of the certification program shall be
demonstrated by passing a written test and submitting a fee of one
hundred dollars ($100) to the department for the issuance of a
certificate of completion.
   (d) The department shall establish by regulation the program
content, the testing instrument, process for approving certification
programs, and criteria to be used for authorizing individuals or
organizations to conduct certification programs. These regulations
shall be developed with the participation of provider organizations.
   (e) This section shall apply to all applications for licensure
unless the applicant provides evidence that he or she has a current
license for another residential care facility for the elderly which
was initially licensed prior to July 1, 1989, or has successfully
completed an approved certification program within the prior five
years.
   (f) If the applicant is a firm, partnership, association, or
corporation, the chief executive officer, or other person serving in
a like capacity, or the designated administrator of the facility
shall provide evidence of successfully completing an approved
certification program.
   (g) 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. 2.    Section 1569.23 is added to the Health
and Safety Code, to read:
   1569.23.  (a) As a requirement for licensure, the applicant shall
demonstrate that he or she has successfully completed a certification
program approved by the department.
   (b) The certification program shall be for a minimum of 100 hours,
of which 80 hours are classroom instruction, and include a uniform
core of knowledge which shall include all of the following:
   (1) Law, regulations, policies, and procedural standards that
impact the operations of residential care facilities for the elderly.

   (2) Business operations.
   (3) Management and supervision of staff.
   (4) Psychosocial needs of the elderly residents.
   (5) Physical needs of the elderly residents.
   (6) Community and support services.
   (7) Use, misuse, and interaction of drugs commonly used by the
elderly, and the adverse effects of psychotropic drugs for use in
controlling the behavior of persons with dementia.
   (8) Nonpharmacologic, person-centered approaches to dementia care.

   (9) Resident admission, retention, and assessment procedures.
   (10) Residents' rights, and the importance of initial and ongoing
training for all staff to ensure residents' rights are fully
respected and implemented.
   (c) Successful completion of the certification program shall be
demonstrated by passing a written test and submitting a fee of one
hundred dollars ($100) to the department for the issuance of a
certificate of completion.
   (d) The department shall establish by regulation the program
content, the testing instrument, process for approving certification
programs, and criteria to be used for authorizing individuals or
organizations to conduct certification programs. These regulations
shall be developed with the participation of provider organizations
and other stakeholder groups. The department shall review the test
annually and update it as necessary to reflect changes in law and
regulations.
   (e) This section shall apply to all applications for licensure
unless the applicant provides evidence that he or she has a current
license for another residential care facility for the elderly which
was initially licensed prior to July 1, 1989, or has successfully
completed an approved certification program within the prior five
years.
   (f) If the applicant is a firm, partnership, association, or
corporation, the chief executive officer, or other person serving in
a like capacity, or the designated administrator of the facility
shall provide evidence of successfully completing an approved
certification program.
   (g) This section shall become operative on January 1, 2016.

   SEC. 3.   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. 4.   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  ensure that residents
receive   assist residents with accessing  home
health or hospice  services sufficient in scope and hours
  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 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 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 100 hours of coursework, which shall include at least 60
hours of in-person 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) 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, as required by
Section 1569.626.
   (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 resident's rights are fully
respected and implemented.
   (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 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 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 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  60   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 1569.625 of the Health and
Safety Code is amended to read:
   1569.625.  (a) The Legislature finds that the quality of services
provided to residents of residential care facilities for the elderly
is dependent upon the training and skills of staff. It is the intent
of the Legislature in enacting this section to ensure that
direct-care staff have the knowledge and proficiency to carry out the
tasks of their jobs.
   (b) The department shall adopt regulations to require staff
members of residential care facilities for the elderly who assist
residents with personal activities of daily living to receive
appropriate training. This training shall consist of 10 hours of
training within the first four weeks of employment and four hours
annually thereafter. This training shall be administered on the job,
or in a classroom setting, or any combination of the two. The
department shall establish, in consultation with provider
organizations, the subject matter required for this training.
   (c) The training shall include, but not be limited to, the
following:
   (1) Physical limitations and needs of the elderly.
   (2) Importance and techniques for personal care services.
   (3) Residents' rights.
   (4) Policies and procedures regarding medications.
   (5) Psychosocial needs of the elderly.
   (d) 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 1569.625 is added to the Health
and Safety Code, to read:
   1569.625.  (a) The Legislature finds that the quality of services
provided to residents of residential care facilities for the elderly
is dependent upon the training and skills of staff.
   (b) The current training requirements for staff of residential
care facilities for the elderly are insufficient to meet the range of
care needs of the residents of those facilities. It is the intent of
the Legislature in enacting this section to ensure that direct care
staff have the knowledge and proficiency to carry out the tasks of
their jobs.
   (c) The department shall adopt regulations to require staff
members of residential care facilities for the elderly who assist
residents with personal activities of daily living to receive
appropriate training. This training shall consist of 40 hours of
training within the first four weeks of employment, at least 24 hours
of which shall be completed prior to providing direct care to
residents, and 20 hours annually thereafter. This training shall be
administered on the job, or in a classroom setting, or any
combination of the two. The department shall establish the subject
matter required for this training. 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, as defined in Section 1771.
   (d) The training shall include, but not be limited to, the
following:
   (1) Physical limitations and needs of the elderly.
   (2) Importance and techniques for personal care services.
   (3) Residents' rights.
   (4) Policies and procedures regarding medications.
   (5) Use, misuse, and interaction of drugs commonly used by the
elderly, and the adverse effects of psychotropic drugs for use in
controlling the behavior of persons with dementia.
   (6) The special needs of persons with Alzheimer's disease and
dementia, including nonpharmacologic person-centered approaches to
dementia care.
   (7) Psychosocial needs of the elderly.
   (8) This subdivision shall not apply to certified nurse
assistants, certified pursuant to Section 1337.2, except that
certified nurse assistants with valid certification shall receive
eight hours of training prior to providing direct care to residents,
on resident characteristics, resident records, and facility practices
and procedures.
   (e) This section shall become operative on January 1, 2016.
 
  SEC. 9.    Section 1569.626 of the Health and
Safety Code is amended to read:
   1569.626.  All residential care facilities for the elderly that
advertise or promote special care, special programming, or a special
environment for persons with dementia, in addition to complying with
the training requirements described in Section 1569.625, shall meet
the following training requirements for all direct care staff:
   (a) Six hours of resident care orientation within the first four
weeks of employment. All six hours shall be devoted to the care of
persons with dementia. 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.
   (b) Eight hours of in-service training per year on the subject of
serving residents with dementia. This training shall be developed in
consultation with individuals or organizations with specific
expertise in dementia care or by an outside source with expertise in
dementia care. In formulating and providing this training, reference
may be made to written materials and literature on dementia and the
care and treatment of persons with dementia. This training
requirement may be satisfied in one day or over a period of time.
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 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. 10.    Section 1569.626 is added to the
Health and Safety Code, to read:
   1569.626.  All residential care facilities for the elderly that
advertise or promote special care, special programming, or a special
environment for persons with dementia, in addition to complying with
the training requirements described in Section 1569.625, shall meet
the following training requirements for all direct care staff:
   (a) Fifteen hours of resident care orientation prior to providing
direct care to residents. All 15 hours shall be devoted to the care
of persons with dementia. 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.
   (b) Twelve hours of in-service training per year on the subject of
providing care and supervision to residents with dementia. This
training shall be developed in consultation with individuals or
organizations with specific expertise in dementia care or by an
outside source with expertise in dementia care. In formulating and
providing this training, reference may be made to written materials
and literature on dementia and the care and treatment of persons with
dementia. 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. 11.  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. 12.   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  32   24 
hours of initial training. This training shall consist of  12
  16  hours of hands-on shadowing training, which
shall be completed prior to assisting with the self-administration of
medications, and  20   eight  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  16   10
 hours of initial training. This training shall consist of
 eight   six  hours of hands-on shadowing
training, which shall be completed prior to assisting with the
self-administration of medications, and  eight  
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,
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. 13.   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
that serve residents with postural supports,  as described in
Section 87608 of Title 22 of the California Code of Regulations, or
 restricted health conditions or health services, 
as described in Section 87612 of Title 22 of the California Code of
Regulations,  or who receive hospice services  , as
described in Section 87633 of Title 22 of the California Code of
Regulations, in addition to complying with   shall
include, as a component of  the training requirements 
specified  in  Section   Sections 1569.23,
1569.616, and  1569.625, shall meet  the
following training requirements for all direct care staff:
   (1)  Fifteen   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) Twelve hours   Two two-hour trainings
 thereafter of in-service training  per year 
 every six months  on the subject of serving those
residents.  This training shall be in   addition to the
trainings specified in Sections 1569.23, 1569.616, and 1569.625.

   (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) 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. 

   (c) 
    (d)  This section shall become operative on January 1,
2016.
   SEC. 14.   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.
                                                           
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