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Adult and Senior Care Update - December 2004
COMMUNITY CARE LICENSING ADULT & SENIOR CARE UPDATE
This is our final Adult and Senior Care Update for 2004. It also marks the eleventh 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 members in your organization and others interested in adult and senior care issues.
GOVERNOR SCHWARZENEGGER APPOINTS NEW CALIFORNIA DEPARTMENT OF SOCIAL SERVICES DIRECTOR
Dennis Boyle is our new Director of the California Department of Social Services (CDSS). Mr. Boyle is a graduate of California Polytechnic University, San Luis Obispo, and earned a certificate in Total Quality Management from the University of California, Riverside. He has more than 30 years of experience in social services. He has served as Director of the Riverside County Department of Public Social Services for the past nine years. In that capacity, he oversaw all social service programs for the county's 1.6 million residents with a staff of nearly 3,000 and a budget of approximately $500 million. Governor Schwarzenegger states "Dennis is an individual with not only the experience, but also the compassion necessary to effectively serve the most vulnerable residents of our state." Dennis 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 Dennis to his new position!
NEW DEPUTY DIRECTOR FOR THE COMMUNITY CARE LICENSING DIVISION
"Seasons Greetings! I'm Jo Frederick, recently appointed as the new Deputy Director of the Community Care Licensing Division. My understanding of community care makes me appreciate that almost all Californians at some point in their lives will need the services that you provide. I am pleased to be working with such a dedicated and caring group, one that strives on a daily basis to build capacity, provide adequate resources, and help the Division oversee the care and safety of our most vulnerable friends, neighbors, and loved ones. I thought you might like to know a bit about my background too. I have over 25 years of senior level experience in human services, most recently as the Department's Deputy Director of Legislation, where I regularly worked on matters directly related to community care. I've worked in a variety of other legislative and policy areas as well; in my earlier days in a community based setting and later as Chief or Principal Consultant to Legislative Committees in both the California Senate and Assembly. I look forward to our collaboration in promoting the health, safety, and quality of life of each person in community care."
REGULATION PACKAGES
The following regulation packages for adult and senior care facilities are currently in process or completed. If you have questions about any of the proposed regulations, please contact our Policy Development Bureau, at (916) 324-4312. 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 . Please note that depending on the version of software that you are currently using, it might be necessary to press your control key to activate the hyperlinks found throughout this document.
Records Removal and Reproduction Regulations: These proposed regulations clarify and delineate the Department's authority to inspect, audit, and copy client or facility records upon demand during normal business hours; and to remove them if necessary for copying. They also contain safeguards to prohibit the removal of health-related records (unless duplicate information is available); establish standards for the removal and return of records; and cut across facility categories. The public hearing was held on June 16, 2004 in Sacramento. We recently completed our responses to the public testimony, and have determined that no substantive changes need to be made to the regulations. We anticipate that the proposed regulations will be submitted to the Office of Administrative Law in December 2004.
Category Consolidation for Adult Day Programs: We are consolidating the General Licensing Requirements, Adult Day Care and Adult Day Support Center Regulations into a single category called Adult Day Programs to comply with Senate Bill 1982, Chapter 773, Statutes of 2002. The regulations were submitted to the Office of Regulations Development on July 12, 2004. We will inform you in future updates about the date and location of the public hearing.
Age and Postural Support Exceptions for Adult Residential Facilities: These regulations will eliminate the need for a licensee to request an exception when a client reaches 60 years of age and for the use of a postural support. The criteria for retaining a resident who has reached the age of 60 will be based upon a percentage between the capacity and census of the facility. This regulation package will also remove those approval/exception requirements under specified conditions. The licensee will have to meet the same regulatory conditions required by the approval/exception process. The Notice of Anticipated Regulatory Activity was approved by the Office of Regulations Development on September 28, 2004. We will report in future updates about the progress of these regulations.
Dementia Regulations for Residential Care Facilities for the Elderly (RCFEs): These regulations, which became effective July 3, 2004, address necessary safeguards for residents with dementia, while maximizing their independence. Licensees of facilities that advertise of promote dementia special care, programming, and/or environments must include a brief narrative description about the special features of their facility in their plan of operation. In addition, new training requirements were added for direct care staff working for licensees who advertise or promote specialized dementia care, programming, and/or environments.
Section 87725.2 provided additional timelines, until October 31, 2004, for licensees who were already advertising or promoting dementia special care, programming, and/or environments as of July 3, 2004, and who would continue to do so. Since that timeline has since past, all licensees must now meet the requirements in Sections 87725 and 87725.1 if they advertise or promote dementia special care, programming, and/or environments. Section 87725(b) provides procedures for licensees who will discontinue advertising or promoting themselves as providing special care, programming, and/or environments for residents with dementia or related disorders. If you have questions about these new regulations please contact either your local licensing office or your licensing program analyst.
CDSS WAREHOUSE NO LONGER PROVIDING LICENSING FORMS
CDSS warehouse is no longer providing copies of the licensing forms. Licensees are encouraged to download forms from the Internet at www.ccld.ca.gov . Licensees with no direct access to the Internet can obtain a master copy of the forms from their local licensing office or may choose to access our website via the Internet at public libraries, photocopy stores, local colleges, etc
NEW FORMS FOR RESIDENTIAL CARE FACILITIES FOR THE ELDERLY
The Physician's Report for Residential Care Facilities for the Elderly (LIC 602A) is being revised and should be online in the near future. The form provides the licensee with information in determining whether a resident is appropriate for placement or retention in their facility and what staffing needs the resident will require. The font will be at least 12 point for easier reading, definitions have been added and/or updated, and the form will now be consistent with the new dementia regulations approved in July 2004. If you have any questions about this form, please contact Debbie Fox in the Policy Development Bureau at (916) 322-3178.
The Admission Agreement (LIC 604A) has also been updated to incorporate changes from legislation that was chaptered over the past two years. The new form will also be online in the near future. The revised form outlines all of the new requirements, including but not limited to, a comprehensive description of any item or services the facility agrees to provide and what services are provided under a single fee. The form is also in at least 12 point font for easier reading. If you have any questions about this new form, please contact Barbara Baker in the Policy Development Bureau at (916) 322-9121.
SAFETY TIPS DURING THE HOLIDAY SEASON
Winter is rapidly approaching and so are the colder temperatures. It is important to maintain a comfortable temperature for residents as required by regulations. The facility shall be heated to a minimum of 68 degrees Fahrenheit. If you have residents who are using portable space heaters, you must ensure they are operated in a safe manner. They should have an automatic shut-off device in the event the heater is tipped over. Also, keep heaters away from clothing, window coverings, bed linens or any other types of flammable material. Remind residents to dress warmly and utilize extra layers of clothing and/or bed coverings when possible. You are also encouraged to visit the United States Fire Administration website and read their fact sheet on holiday fire prevention. The document is entitled Holiday Fire Prevention Fact Sheet . If you have additional fire safety questions, please contact your local fire inspection office. Make this holiday a warm, safe and enjoyable time for everyone!
DEPARTMENT OF HEALTH SERVICES ISSUES INFLUENZA GUIDELINES
Influenza outbreaks occur during the winter months, and as a result, about 2,000 Californians die each year. Influenza is a particularly serious problem in residential care facilities where residents are at high risk of developing serious complications or dying due to their age and/or health problems. Once the virus enters a residential care facility, it can spread rapidly and result in hospitalizations and deaths. The impact of influenza on long-term care facilities may be made worse this season by the vaccine shortage, although public health agencies are working to provide all high-risk individuals and their contacts vaccine. This makes it particularly important for the California Department of Health Services (CDHS) and local health departments to be immediately notified of outbreaks of respiratory illness in residential facilities. We can provide assistance in: 1) laboratory testing to determine the cause (outbreaks of respiratory illness may be caused by other pathogens); 2) taking measures to control the outbreak; and 3) obtaining influenza antiviral medications or vaccine.
Annual vaccination is the primary method for preventing influenza and its complications. Influenza vaccine is strongly recommended for BOTH residents and workers in residential care facilities. Residential care workers need to be vaccinated to decrease the risk of transmitting infection to others; vaccination also reduces lost work time. Please encourage your staff to get vaccinated against the flu. As vaccine becomes available, both residents of residential care and other chronic-care facilities and workers in those facilities should be vaccinated. FluMist ®, the nasal-spray flu vaccine, is an option for healthy individuals, ages 5 to 49 years of age, and may be used as a substitute for standard flu vaccine for workers in residential care facilities.
The annual guideline "Recommendations for the Prevention, Detection, and Control of Influenza in California Long-Term Care Facilities" is available at the California Department of Health Services, Division of Communicable Disease Control website at www.dhs.ca.gov/ps/dcdc/disb/disbindex.htm under Disease Investigations Section. For additional information please contact the new toll-free CDHS Flu Vaccine Information Line at (866) 470-3788.
NEW SOCIAL SECURITY INCOME/STATE SUPPLEMENTAL PAYMENT RATES
New Social Security Income (SSI)/State Supplemental Payment (SSP) rates, which become effective January 1, 2005, reflect a 2.70% federal cost of living increase to the SSI portion of the benefit. There will be no state cost of living increase until April 1, 2005. The enclosed chart displays the new non-medical out-of-home care rates. If you have questions regarding the new rates, please contact Dawn Devore of the Adult Programs Management Bureau at (916) 229-4588.
DEPARTMENT OF LABOR FACT SHEET #53
The United State 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, "The Health Care Industry and Hours Worked." 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 #53 at the following address: www.dol.gov/esa/regs/compliance/whd/whdfs53.pdf .
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." 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. Directories can also be obtained from your local licensing office. Please direct your requests to Sarah Fernandes, Central Operations Branch, at (916) 327-2406.
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, office locations , provider letters, regulations, or to learn more about licensing services.
Sincerely,
JO FREDERICK
Deputy Director
Community Care Licensing Division
Enclosures