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Adult and Senior Care Updates - November 2002
This is our final Adult and Senior Care Update for 2002. It also marks the ninth 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.
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) 323-4312. 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.
New Staff Training Requirements in Residential Care Facilities for the Elderly (RCFEs): These new employee staff training requirements for RCFEs became effective August 31, 2002. The regulations implement Section 1569.625 of the Health and Safety Code regarding new staff training in Residential Care Facilities for the Elderly. The regulations now require staff to receive ten hours of training within the first four weeks of employment and four hours annually thereafter.
Incidental Medical Services Regulations: Incidental Medical Services (IMS) regulations became effective September 9, 2002. These regulations govern acceptable health-related conditions in adult community care facilities. The revised IMS regulation package provides clarification on delayed-egress devices and training requirements for facility staff who provide care to clients with restricted health conditions.
Reformatted Regulations for Residential Care Facilities for the Elderly: We are reformatting the RCFE regulations into a more user-friendly format. The sequence of the regulation sections is being changed to reflect the six new comprehensive visit guidelines used by the Senior Care Program Licensing Program Analysts when they conduct facility visits. No content of the RCFE regulations is being changed. Some regulation sections are being renumbered to align with the new sequence of the sections. Since no content is being changed, there will be no public hearing. I will keep you informed of the progress of this project.
Automated External Defibrillators (AEDs): AEDs are devices that deliver an electric shock to the heart during cardiac arrest and have been proven to save lives. New AED regulations became effective on September 8, 2002. These regulations are specific to adult programs, Residential Care Facilities for the Elderly, and Residential Care Facilities for the Chronically Ill. The new regulation section specific to AEDs requires notification to the licensing agency when an AED is in the facility and will be used, and a requirement that the use of the AED must be reported to licensing as a reportable incident. There are also additional requirements regarding training and use of the equipment. The use of AEDs is not required in any facility.
Dementia Regulations for Residential Care Facilities for the Elderly: We are drafting regulations to 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 added 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 references to these items in their plan of operation. The public hearings for these regulations are tentatively scheduled for mid-January 2003 in two locations, Monterey Park and Sacramento.
Hospice Regulations for Adult Residential Facilities: Regulations governing Adult Residential Facilities are being updated to reflect previous legislation that permits licensees to request a waiver from the Department to allow a client who has been diagnosed as terminally ill by his or her physician to remain in the facility and receive hospice services. These regulations do not permit an individual already receiving hospice care services to be admitted into a facility. We expect these regulations to go to public hearing in January 2003. The recent legislation allowing individuals receiving hospice care to be admitted to a facility was specific only to Residential Care Facilities for the Elderly.
Adult Day Care / Adult Day Support Center: The consolidation of the Adult Day Care and Adult Day Support Center regulations is complete. The revised regulations are more user-friendly, as they are now freestanding and no longer require use in combination with the General Licensing Requirements. However, changes to the Criminal Record Clearance sections (82019 and 82019.1) of the new regulations have delayed finalizing this consolidated package. The changes to the Criminal Record Sections will require a 15-day renotice. I will keep you posted in future updates on the progress of this package.
Secured Perimeters in Adult Day Care Facilities and Adult Day Support Centers: New regulations 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. This option is limited to use in facilities where there is documentation from the physician that the client has dementia. Residential Care Facilities for the Elderly and Adult Residential Facilities are currently allowed to use secured perimeter fencing or delayed-egress devices.
RCFE RESIDENTS AND TELECOMMUNICATIONS DEVICE NOTIFICATION
Section 87568 (b) of the Residential Care Facilities for the Elderly regulations requires licensees to complete and maintain in the resident's file a Telecommunications Device Notification form (LIC 9158). This form is for each resident whose pre-admission appraisal or medical assessment indicates that the individual is deaf, hearing impaired, or otherwise disabled. The LIC 9158 has been revised to instruct the resident/authorized representative to contact the California Telephone Access Program at 1-800-806-1191 and ask for assistance in obtaining this equipment and service. LIC 9158 can be printed from the Department's web site at www.ccld.ca.gov.
ANNUAL LICENSE FEE RENEWALS
All license fee renewal notices are mailed out each year to every facility 120 days prior to their annual renewal date. This is intended to allow licensees ample time to submit their annual fee. If you do not receive your renewal notice or have questions about payment, please contact your assigned Licensing Program Analyst. CCLD does not contact licensees via telephone to submit their fees.
NEW SSI/SSP PAYMENT RATES
New SSI/SSP rates, which become effective January 1, 2003, reflect a 1.40% federal cost of living increase. An additional cost of living increase to the SSI/SSP rates will become effective June 1, 2003. The June rates reflect the 1.40% federal cost of living increase from January 1, 2003 and an additional 3.74% state cost of living increase. The enclosed chart displays the new non-medical out-of-home care rates. If you have questions regarding the new rates, please contact Terrie Marks of the Adult Programs Management Bureau at (916) 229-4041.
EATING DISORDERS
Health and Safety Code Section 1254.5 requires that the treatment of eating disorders such as anorexia nervosa and bulimia be provided in acute psychiatric hospitals or in any other licensed health facility designated by the State Department of Health Services (DHS). Community Care Licensing is not authorized to license such facilities. Individuals interested in providing treatment for eating disorders should contact the appropriate DHS Licensing and Certification field operations office.
RCFE RESIDENTS AND ADVANCE HEALTH CARE DIRECTIVES
In an article on this topic in our last quarterly update, we discovered an error in the link for Publication 325, "Your Right To Make Decisions About Medical Treatment." You may download Publication 325 from the following corrected link: www.dss.cahwnet.gov/forms/english/pub325.pdf.
This publication can also be ordered by sending a written request to: CDSS Warehouse, P.O. Box 980788, West Sacramento, California 95691. You may fax your request to (916) 371-3518.
NEW CONTINUING CARE CONTRACTS BRANCH CHIEF
I am pleased to announce Mr. Ben Partington as our new Chief of the Continuing Care Contracts Branch. The Department's Continuing Care Contracts Branch (CCCB) has the responsibility for overseeing continuing care contract providers. CCCB reviews and approves applications to operate a Continuing Care Retirement Community (CCRC), monitors the ongoing financial condition of all CCRC providers and also monitors their ability to fulfill the long-term contractual obligations to senior residents. Mr. Partington transitioned into his new role effective November 1, 2002, and has worked for the Community Care Licensing Division for over 18 years. He has managed the Division's adult and children's policy sections and has extensive experience in senior care issues. His most recent assignment was managing the Division's Technical Assistance Bureau, which provides technical assistance and training to care providers and licensing staff. Please join me in welcoming Ben to his new assignment!
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. 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, office locations, provider letters, regulations, or to learn more about licensing services.
.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
Enclosures