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Adult and Senior Care Updates - August 2003

This is our third Adult and Senior Care Update for 2003. It also marks the tenth year of our efforts to keep 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 those in your organization and others interested in adult and senior care issues.

CHANGES TO BACKGROUND CHECK PROCEDURES

Several important changes were made to the background check process, and emergency regulations implementing changes became effective on July 16, 2003. For example:

  • Before being allowed in a licensed facility, all individuals who submit their fingerprints on or after July 16, 2003, must have a Department of Justice (DOJ) notice indicating that the individual has no criminal history, or an approved criminal record exemption from this Department. You are required to maintain documentation of the DOJ notice or the exemption in your facility records, and to make them available for review by your licensing analyst.
  • When the Department orders that an individual be removed from a facility based on the background check, you are now required to send written confirmation to the licensing agency that the individual has been removed. Forms for this confirmation will be attached to the Department's order for removal. Failure to comply with the order to remove the individual is grounds for license revocation.
  • Individuals with either a clearance or an exemption must report any subsequent arrest, conviction, and probation or parole violation to the Department within 48 hours.
  • Criteria for reviewing criminal record exemptions are being included in regulations to ensure consistency. Requirements for considering an exemption will include:
    1. An exemption request will be denied if an individual fails to disclose or misrepresents his/her criminal history.
    2. Exemptions for violent felony convictions will not be granted.
    3. The number of convictions allowed has been reduced and the time required after the conviction or completion of supervised probation has been increased.

You are encouraged to review the regulations at the licensing website at www.ccld.ca.gov . If you have any questions, please contact your local licensing office.

CRIMINAL RECORD CLEARANCE LISTING

Department of Justice (DOJ) clearances can now be viewed on the Community Care Licensing Division's website. To coincide with the new regulations requiring individuals to obtain a DOJ clearance prior to employment added a new feature on our website which allows viewing of DOJ clearances. This site allows licensees to verify their prospective employee's DOJ clearance, thereby allowing them to begin work. The site can be accessed by visiting www.ccld.ca.gov and selecting the first button entitled DOJ Clearance Listing. Important Information About The Site

  • The list will be updated daily.
  • An individual's clearance information remains on the list for thirty days.
  • It lists DOJ clearances only - but this is all that is required for an individual to start working.
  • Federal Bureau of Investigation clearances are NOT posted on this site.
  • Child Abuse Central Index clearances are NOT posted on this site.
  • Fingerprint clearance delays are NOT posted on this site.
  • Rejections by DOJ are NOT posted on this site.
  • CDSS clearances granted after Department review, are NOT posted on this site.

REGULATIONS UPDATE

The following regulation packages are in process for adult and senior care facilities. If you have questions about any of the proposed regulations, please contact Carole Jacobi, Chief of the Policy Development Bureau, at (916) 322-5502. For copies of the proposed regulations or more information about hearing schedules, contact the Department's Office of Regulations Development at (916) 657-2586 or visit their website at www.dss.cahwnet.gov/ord/default.htm .

Administrator Certification Program Regulations: Amendments to existing Administrator Certification Program regulations for Residential Care Facilities for the Elderly and Adult Residential Facilities are being developed to streamline the process. The following highlights outline what these regulations are intended to accomplish.

  • Prohibit individuals who develop, research, review, approve training materials and/or provide training on such materials from receiving continuing education credit. This is to prevent potential conflict of interest issues.
  • Eliminate the formal hearing process to reduce expenditures. Formal hearings will be replaced with an informal administrative appeal.
  • Clarify the process necessary to submit continuing education hours provided by accredited educational institutions or vendors approved by other state agencies. Many administrators do not review course material carefully to ensure that the content is within the Core of Knowledge. As a result many hours of education are often unacceptable toward completing educational requirements. These regulations will clarify that administrators are responsible for review of course content before completing a course, and that a description of the course must be submitted to the Department at the time of recertification.
  • Requires vendors to disclose any current or past community care facility licenses held and whether or not there have been any administrative actions taken against those licenses.

Health Related Conditions in Residential Care Facilities for the Elderly: We are drafting regulations to revise the requirements for accepting or retaining individuals with health-related conditions. The revised regulations will eliminate the requirement for approval from the licensing agency prior to providing care. The criteria for the care of the health-related condition that licensees will be required to meet will be in the regulations. These regulations have gone through the internal process. These regulations will be filed as emergency which means that they go into effect upon approval by the Office of Administrative Law. As with all regulations filed on an emergency basis, the public hearing will be held thereafter and revisions to the regulations made as necessary in response to public testimony.

Fire and Life Safety Emergency Regulations: These regulations will require all residential facilities, adult day programs, and child care facilities to have smoke detectors and fire extinguishers; will set standards for emergency drills; and will address other fire and life safety issues. The State Fire Marshal's (SFM) review of the regulations has been completed. Based on this review, revisions to the regulations will be needed. Approval of these regulations by the SFM is required before they can be submitted to the Office of Administrative Law. The regulations will then be filed as emergency regulations which means that once approved by the Office of Administrative Law, they will become effective immediately. The public hearing will be held thereafter and necessary revisions based on public testimony will be made.

Dementia Regulations for Residential Care Facilities for the Elderly: These regulations address necessary safeguards for residents with dementia, while maximizing their independence. The regulations also implement the provisions of Assembly Bill 1753, (Chapter 434, Statutes of 2000). This statute adds training requirements for direct care staff working for licensees who advertise or promote specialized dementia care, programming, and/or environments. In addition, licensees of these facilities must include a brief narrative description about the special features of their facility in their plan of operation. Substantive changes are being made to the regulations as a result of the comments received from the public hearing. The regulations are presently under management review. It is anticipated that the regulations will go out for a 15-day renotice in October 2003.

Hospice Regulations for Adult Residential Facilities: This regulation package permits licensees to request a waiver from the Department to allow a client diagnosed with a terminal illness to receive hospice care services in an adult residential facility. This package was submitted to the Office of Administrative Law in July 2003. Due to some requested revisions, a 15-day renotice is necessary. These regulations are expected to become effective in early 2004.

Secured Perimeters in Adult Day Care Facilities and Adult Day Support Centers: These regulations will implement Section 1531.2 of the Health and Safety Code to permit licensees of Adult Day Programs to install secured perimeter fences or delayed egress devices of the time-delay type on exit doors. Residential Care Facilities for the Elderly and Adult Residential Facilities are currently allowed to use delayed-egress devices. The State Fire Marshal developed regulations to allow the use of secured perimeter fences and/or special egress control devices in facilities providing day care. These regulations were heard before the California Building Standards Commission on May 14, 2003, and were not approved. Based on comments from the hearing the regulations were revised. They were resubmitted and rejected by the Commission on July 16, 2003. The regulations are scheduled to be heard again in November 2003. I will keep you informed in future updates on the progress of this package.

RECORDKEEPING - U.S. DEPARTMENT OF LABOR FACT SHEET #21

The United States (U.S.) Department of Labor, Wage and Hour Division is responsible for the administration of the Fair Labor Standards Act (FLSA) in the area of wages and compensation. In a joint effort with the Wage and Hour Division, each of our updates feature one in a series of fact sheets providing general information on various topics. Enclosed is a fact sheet entitled Recordkeeping Requirements Under The Fair Labor Standards Act (FLSA) that provides a listing of the basic records that employers must maintain on all non-exempt employees. It is important to note that the FLSA does not require the use of particular forms, but does require that the records include certain identifying information about the employee and data about the hours worked and wages earned. Additional information can be obtained from the Department of Labor website at www.dol.gov or by calling their toll-free information service number, (866) 889-5627. Please review Fact Sheet # 21 at the following address: http://www.dol.gov/esa/regs/compliance/whd/whdfs21.htm . Please note there might be additional State requirements. For information on those requirements, please contact the Department of Industrial Relations at www.dir.ca.gov  or call (800) 963-9424 for employer consultation services.

UPDATE ON SSI/SSP PAYMENT RATES

An additional cost of living increase to the Supplemental Security Income/State Supplemental Payment (SSI/SSP) rate became effective on June 1, 2003. This increase reflects the 3.74 percent state cost of living increase. Retroactive SSP payment checks are expected to be issued in September and represent the payment differential for June, July, August, and September. For clients receiving one check, the amount of this check will be $108, representing the increase for that period. The October 1, 2003 checks are expected to reflect this increase. For clients whose admission agreement includes modification of their basic rate charge at the same time the SSI/SSP rate changes, the client is entitled to $12 which represents the $3 monthly Personal and Incidental Needs Allowance increase and the licensee is entitled to $96 which represents the Basic Services increase for four months (June through September). The new payment standard of $952 includes $110 for the client's personal and incidental needs allowance and $842 for room and board and care and supervision. If you have questions regarding the new rate, please contact Dawn Devore of the Adult Programs Management Bureau at (916) 229-4588.

LIABILITY INSURANCE

Some RCFE providers have reported that liability insurance companies are refusing to issue or renew policies if residents have Alzheimer's disease or receive hospice care. The provider associations (California Assisted Living Association (916) 448-1900, California Association of Homes and Services for the Aging (916) 392-5111, Community Residential Care Association of California (916) 455-0723, along with the California Hospice and Palliative Care Association (916) 441-3770 and the California Association for Health Services at Home (916) 443-8055) are conducting a survey of all licensed RCFEs to learn the full extent of this problem. We encourage you to return the survey if you haven't already. For more information, please call one of the associations listed above.

LICENSED RESIDENTIAL CARE STATISTICS

Enclosed are the most recent statistics on licensed Adult and Senior Care facilities and capacities. Further breakouts by category and location are available. Please direct your requests to Jeff Hiratsuka, Chief of the Central Operations Branch, at (916) 322-4875.

SUMMARY

If you have questions about items included in this Update or suggestions for future topics, please contact Cathleen McCoy, Chief of the Technical Assistance and Policy Branch, or me at (916) 657-2346. Also, please visit our website at www.ccld.ca.gov to obtain copies of Updates, adult and senior care licensing offices , provider letters, regulations, or to learn more about licensing services.

Sincerely,

DAVE DODDS
Deputy Director
Community Care Licensing Division