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Adult and Senior Care Update - December 2005
COMMUNITY CARE LICENSING ADULT & SENIOR CARE UPDATE
Happy Holidays! This is our fourth and final Adult and Senior Care Update for 2005. It also marks the end of our twelfth year keeping the residential care community informed about licensing programs and services. The Updates continue to be an important method for sharing information. We appreciate your support in sharing these Updates with members in your organization and others interested in adult and senior care issues.
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES DIRECTOR RETIRES
Director Dennis J. Boyle retired from the California Department of Social Services (CDSS) and public service all together at the end of November. In his memo announcing his retirement, he stated "It is with very mixed emotion that I tell you that I have decided to retire from public service at the end of November and rejoin my wife, my bird, and my cat at home." He went on to say that CDSS employees should be proud of their service to California and to the nation. Dennis' more than 30 years of experience in social services will be missed. Please join us in wishing Dennis well in his retirement and future endeavors. Chief Deputy Director, Robert Sertich, will serve as Acting Director of CDSS for the month of December.
CLIFF ALLENBY INTERIM DIRECTOR
With the retirement of Dennis, Cliff Allenby has been appointed the Interim Director for CDSS. Cliff, who is a graduate of California State University, Humboldt, will officially become the Director of CDSS on January 2, 2006. Cliff is a veteran of State service. Cliff was appointed to his current position, Director of Developmental Services (DDS) by Governor Gray Davis in November 1997. Previous appointments include: Interim Director for the Department of General Services (DGS); Chief Legislative Representative for Los Angeles County; Secretary of the (then) Health and Welfare Agency. Cliff shares the Governor's commitment to protecting California's children, strengthening our families and encouraging every individual to become independent. Please join us in welcoming Cliff to his new position!
NEW FEE STRUCTURE AUTHORIZED
The Budget Act for 2004-2005 authorized changes to the Community Care Licensing Division (CCLD) fee structure. These changes include the authorization to charge new fees. A portion of the CCLD program budget is now funded through the collection of these fees. The new fee authority is contained in Senate Bill 1104, Chapter 229, Statutes of 2004 and affects all facility categories. This legislation required CCLD to increase existing fees and charge new fees for the purpose of financing licensing activities. New fees authorized include: change in location fees; corporate status change fees; capacity change fees; orientation fees; probation monitoring fees; late (annual payment) fees; plan of correction fees; and payment processing (bounced check, credit and debit) fees. All CCLD regulations have been amended to reflect the new fee structure. The regulations became effective June 15, 2005.
If you have questions about the regulations, please contact our Policy Development Bureau at (916) 324-4312. For copies of the regulations, visit the Office of Regulation Development website at www.dss.cahwnet.gov/getinfo/pdf/f020502r.PDF. Please note that depending on the version of software you are currently using, it might be necessary to press your control key to activate the hyperlinks found throughout this document.
RCFE DEMENTIA REGULATONS QUESTIONS AND ANSWERS
The CCLD Policy Development Bureau has developed a Dementia Questions and Answers Guide that addresses common questions received about the dementia regulations for Residential Care Facilities for the Elderly that became effective on July 3, 2004. This Guide, which provides a reference tool for some of the most frequently asked questions from licensing field staff, licensees and other interested individuals, has been put on the CCLD website for public access. These questions have been grouped by topic and a Table of Contents has been included for ease of use. The website is located at http://ccl.dss.cahwnet.gov/Res/pdf/DementiaQARCFE.pdf.
NEW SUPPLEMENTAL SECURITY INCOME RATES EFFECTIVE JANUARY 1, 2006
The new Supplemental Security Income (SSI) rate for Non-Medical Out-of-Home Care (NMOHC) will become effective January 1, 2006. The new rate reflects a 4.10% federal cost of living increase to the SSI portion of the benefit. There is no cost of living increase to the State Supplementary Payment portion of the benefit. Attached are two charts which display the new non-medical out-of-home care rates effective January 1, 2006. SSI recipients who live in community care facilities receive the NMOHC rate. SSI recipients in other payment categories, who do not reside in licensed community care facilities, will not receive this rate increase until April 1, 2006. Another set of charts is attached which reflect the rate increases effective April 1, 2006. There is no increase to the NMOHC SSI rate on April 1, 2006. If you have questions regarding the new rates, please contact Dawn Devore of the Adult Programs Operations Bureau at (916) 229-4588.
COMMUNITY CARE LICENSING DIVISION INFORMATION RELEASES
CCLD recognizes the importance of communicating new information regarding licensing policies and procedures to licensing staff, facility licensees and other interested parties in a timely and efficient manner. Compliance with regulatory requirements is dependent upon everyone involved with licensed facilities being informed about changes in the licensing program. Therefore, CCLD is pleased to announce the introduction of CCLD Information Releases. We currently have three releases on the CCLD website.
As new policies are developed or existing ones are revised, CCLD will produce Information Releases. For ease of reference, each release is assigned a control number. They are distributed to CCLD staff and also posted at http://ccl.dss.cahwnet.gov/CommunityC_2284.htm on the CCLD website for public access.
Keeping current with licensing requirements is an important part of the operation of any licensed facility. Licensees are encouraged to check the links referred to above as well as the main CCLD website at www.ccld.ca.gov on a regular basis for updated information on the licensing program.
DISASTER PREPAREDNESS FOR COMMUNITY CARE FACILITIES
Hurricanes Katrina and Rita left tremendous suffering, loss and devastation in their wake in Louisiana, Mississippi and Texas. Our hearts go out to all those affected. While it is important that we comfort and assist those in need, these tragedies also remind us of the importance of disaster preparedness.
CCLD encourages all community care facilities to review their disaster plans and conduct disaster training and drills on a regular basis. Licensees should also be aware that emergency services may not be able to reach them immediately, particularly after a large disaster. Facilities should have the means and capacity to be self-reliant for at least 72 hours following a disaster. This means that each facility should have a three day supply of food and water, toiletries and medications for all clients and staff. Licensees may also want to consider developing a Disaster Preparedness Health Passport for each client. This is a document that contains a client's medical history, pharmacy information and numbers to call in cases of emergency. Attached is a sample copy of a Disaster Preparedness Health Passport.
The CCLD "Disaster Preparedness for Community Care Facilities" self-assessment guide provides information that you can use to assist you in making preparations for disasters. You can obtain copies of this guide at http://ccl.dss.cahwnet.gov/Res/pdf/DisasterGuide.pdf.
ADULT CARE PROGRAM STAFF CHANGES
The Adult Care Program is pleased to announce the appointment of Patrick Smith as Regional Manager of the Sierra-Cascade Adult Care Licensing Office. Prior to his appointment, Patrick was a Licensing Program Manager for seven years. Patrick assumed his new position on November 1, 2005.
CALIFORNIA DEPARTMENT OF HEALTH SERVICES ISSUES 2005-06 INFLUENZA RECOMMENDATIONS
The California Department of Health Services (DHS) has issued its 2005-06 recommendations for controlling outbreaks of influenza (commonly known as "the flu") in California long-term care facilities. About 2,000 Californians die each year from the flu. While most young, healthy people recover completely from the flu within one or two weeks, older people and those with certain chronic illnesses are much more likely to develop serious medical problems or die as a result of contracting the flu. The flu virus can spread rapidly in environments such as licensed residential community care facilities where people live close to each other. Licensees should contact their local health department immediately if they suspect an outbreak of the flu in their facility.
Vaccination is the best way to reduce illness and deaths from the flu. All facility staff and clients/residents of residential community care facilities should be vaccinated against the flu each autumn, beginning in October. In the healthcare field, a new federal rule requires nursing homes serving Medicare and Medi-Cal patients to provide immunizations against the flu and pneumonia to all patients if they want to continue in those programs. While this rule DOES NOT apply to licensed residential community care facilities, it illustrates just how important it is for clients/residents-particularly those who are frail and elderly-to be vaccinated against the flu.
This year, the DHS flu recommendations have been adapted for use by licensed residential community care facilities. This simplified version of the recommendations can be accessed at http://ccl.dss.cahwnet.gov/res/pdf/FluAdapted.pdf. The full text of the DHS flu recommendations, which references nursing homes, can be accessed at the DHS web site at www.dhs.ca.gov/ps/dcdc/disb/disbindex.htm under Disease Investigations Section ("Control of Influenza in Long-Term Healthcare Facilities, 2005-6"). Among other things, the recommendations emphasize common-sense approaches to controlling the spread of the flu, such as practicing "cough etiquette" (e.g., covering the nose or mouth with tissues or a mask when coughing or sneezing) and frequent handwashing. Because flu outbreaks in facilities have the potential to be deadly, licensees are encouraged to implement the adapted version of the flu recommendations to the fullest extent possible.
Finally, licensees are reminded that DHS has also developed guidelines for controlling outbreaks of acute viral gastroenteritis (commonly known as "the stomach flu"). These guidelines have also been adapted for use by licensed residential community care facilities and can be accessed at http://ccld.ca.gov/res/pdf/StomachFlu.pdf. The full text of the DHS stomach flu recommendations can be accessed at the DHS web site at www.dhs.ca.gov/ps/dcdc/disb/pdf/Gastroenteritis%20Outbreaks%20Report.pdf under Disease Investigations Section ("Control of Viral Gastroenteritis Outbreaks in California Long Term Care Facilities").
RESIDENTIAL CARE STATISTICS
All of the statistics for licensed Adult and Senior Care facilities are now available online. When you visit the CCLD home page, click on the link on the left side of the page that is titled, "Licensing Overview". After clicking on "Licensing Overview," click on "Basic Statistics About Licensed Facilities." Then click on the first bullet that says, "Number of State Licensed Facilities, by County." Scroll to the end of the document for the statewide totals. Further breakouts by category and location are still available. Please direct your requests to Sarah Fernandes, Central Operations Branch, at (916) 327-2406. Directories can also be obtained from your local licensing office. Please see the attached lists for phone numbers and locations of Adult and Senior Care Program offices.
SUMMARY
If you have questions about items included in this Update or suggestions for future topics, please contact Barbara Rooney, Acting Chief of the Technical Assistance and Policy Branch at (916) 324-4312. Also, please visit our website at www.ccld.ca.gov to obtain copies of Updates, office locations, provider letters, regulations, or to learn more about licensing services.
Sincerely,
Original Signed by Jo Frederick
JO FREDERICK
Deputy Director
Community Care Licensing Division
Enclosures