BILL NUMBER: SB 816 CHAPTERED
BILL TEXT
CHAPTER 289
FILED WITH SECRETARY OF STATE SEPTEMBER 9, 2013
APPROVED BY GOVERNOR SEPTEMBER 9, 2013
PASSED THE SENATE MAY 2, 2013
PASSED THE ASSEMBLY AUGUST 22, 2013
INTRODUCED BY Committee on Health (Senators Hernandez (Chair),
Anderson, Beall, DeSaulnier, Monning, Nielsen, Pavley, and Wolk)
MARCH 11, 2013
An act to amend Sections 1339.40 and 1339.43 of the Health and
Safety Code, and to amend Section 4512 of the Welfare and
Institutions Code, relating to health and human services.
LEGISLATIVE COUNSEL'S DIGEST
SB 816, Committee on Health. Hospice facilities: developmental
disabilities: intellectual disability.
(1) Existing law provides for the licensure and regulation of
health facilities, including hospice facilities, by the State
Department of Public Health. A violation of those provisions is a
crime. Existing law requires a freestanding hospice facility to meet
specified requirements relating to the physical environment of the
facility until the Office of Statewide Health Planning and
Development, in consultation with the Office of the State Fire
Marshal, develops and adopts building standards for hospice
facilities.
This bill would instead require the Office of the State Fire
Marshal to develop and adopt the building standards for hospice
facilities in consultation with the Office of Statewide Health
Planning and Development and would make other technical changes.
(2) Existing law, the Lanterman Developmental Disabilities
Services Act, requires the State Department of Developmental Services
to contract with regional centers to provide services and supports
to individuals with developmental disabilities, defined to include
mental retardation and disabling conditions related to, or requiring
treatment similar to, mental retardation.
This bill would revise this definition of developmental
disabilities to instead include intellectual disability and disabling
conditions closely related to, or requiring treatment similar to,
intellectual disability.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 1339.40 of the Health and Safety Code is
amended to read:
1339.40. For the purposes of this article, the following
definitions apply:
(a) "Bereavement services" has the same meaning as defined in
subdivision (a) of Section 1746.
(b) "Hospice care" means a specialized form of interdisciplinary
health care that is designed to provide palliative care, alleviate
the physical, emotional, social, and spiritual discomforts of an
individual who is experiencing the last phases of life due to the
existence of a terminal disease, and provide supportive care to the
primary caregiver and the family of the hospice patient, and that
meets all of the following criteria:
(1) Considers the patient and the patient's family, in addition to
the patient, as the unit of care.
(2) Utilizes an interdisciplinary team to assess the physical,
medical, psychological, social, and spiritual needs of the patient
and the patient's family.
(3) Requires the interdisciplinary team to develop an overall plan
of care and to provide coordinated care that emphasizes supportive
services, including, but not limited to, home care, pain control, and
limited inpatient services. Limited inpatient services are intended
to ensure both continuity of care and appropriateness of services for
those patients who cannot be managed at home because of acute
complications or the temporary absence of a capable primary
caregiver.
(4) Provides for the palliative medical treatment of pain and
other symptoms associated with a terminal disease, but does not
provide for efforts to cure the disease.
(5) Provides for bereavement services following death to assist
the family in coping with social and emotional needs associated with
the death of the patient.
(6) Actively utilizes volunteers in the delivery of hospice
services.
(7) To the extent appropriate, based on the medical needs of the
patient, provides services in the patient's home or primary place of
residence.
(c) "Hospice facility" means a health facility as defined in
subdivision (n) of Section 1250.
(d) "Inpatient hospice care" means hospice care that is provided
to patients in a hospice facility, including routine, continuous and
inpatient care directly as specified in Section 418.110 of Title 42
of the Code of Federal Regulations, and may include short-term
inpatient respite care as specified in Section 418.108 of Title 42 of
the Code of Federal Regulations.
(e) "Interdisciplinary team" has the same meaning as defined in
subdivision (g) of Section 1746.
(f) "Medical direction" has the same meaning as defined in
subdivision (h) of Section 1746.
(g) "Palliative care" has the same meaning as defined in
subdivision (j) of Section 1746.
(h) "Plan of care" has the same meaning as defined in subdivision
(l) of Section 1746.
(i) "Skilled nursing services" has the same meaning as defined in
subdivision (n) of Section 1746.
(j) "Social services/counseling services" has the same meaning as
defined in subdivision (o) of Section 1746.
(k) "Terminal disease" or "terminal illness" has the same meaning
as defined in subdivision (p) of Section 1746.
(l) "Volunteer services" has the same meaning as defined in
subdivision (q) of Section 1746.
SEC. 2. Section 1339.43 of the Health and Safety Code is amended
to read:
1339.43. (a) A hospice facility shall provide a home-like
environment that is comfortable and accommodating to both the patient
and patient's visitors.
(b) Building standards for hospice facilities adopted pursuant to
this chapter relating to fire and panic safety, and other regulations
for hospice facilities adopted pursuant to this chapter, shall apply
uniformly throughout the state. No city, county, city and county,
including a charter city or charter county, or fire protection
district shall adopt or enforce any ordinance or local rule or
regulation relating to fire and panic safety in buildings or
structures subject to this section that is inconsistent with the
rules and regulations for hospice facilities adopted pursuant to this
chapter.
(c) The hospice facility shall meet the fire protection standards
set forth in the federal Medicare conditions of participation (42
C.F.R. Part 418 et seq.).
(d) A hospice facility may operate as a freestanding health
facility.
(1) Until the Office of the State Fire Marshal, in consultation
with the Office of Statewide Health Planning and Development,
develops and adopts building standards for hospice facilities, a
freestanding hospice facility shall meet applicable building
standards and requirements relating to the physical environment of
the facility as specified in Section 418.110 of Title 42 of the Code
of Federal Regulations. The building standards developed shall, at a
minimum, maintain the requirements specified in that section.
(2) A freestanding hospice facility shall be under the
jurisdiction of the local building department. As part of the license
application, the prospective licensee shall submit evidence of
compliance with applicable building standards for hospice facilities.
(3) The physical environment of the hospice facility shall be
adequate to provide the level of care and service required by the
residents of the facility as determined by the department.
(e) A hospice facility may be located within the physical plant of
another health facility.
(1) Notwithstanding subdivision (d) and paragraphs (8) and (9) of
subdivision (b) of Section 129725, a hospice facility located within
the physical plant of another licensed health facility that is under
the jurisdiction of the Office of Statewide Health Planning and
Development, shall meet the building standards for that category of
health facility within which the hospice facility is located, and
plans shall be submitted to the office for review of any new
construction or renovation of these hospice facilities. As part of
the license application, the prospective licensee shall submit
evidence of compliance with the building codes enforced by the Office
of Statewide Health Planning and Development.
(2) The physical environment of the facility shall be adequate to
provide the level of care and service required by the residents of
the facility as determined by the department.
(3) In the event the space used by the hospice facility reverts
back to the facility with which the hospice facility shared the
space, the building standards applicable to the former shared space,
as identified by date of enactment of the standards, shall not change
due solely to the reversion.
(4) A hospice facility that provides inpatient hospice care and is
located within, adjacent to or physically connected to another
health facility shall provide all of the following:
(A) A designated nursing station.
(B) Adequate space for the preparation of drugs with lockable,
secure storage that is accessible only by authorized personnel.
(C) Signage that shall clearly demarcate the hospice facility area
from the facility with which the hospice facility shares space.
(D) Doors for every exit and entrance to the hospice facility.
(E) Contiguous beds within the designated area set aside for the
hospice facility.
(f) If a freestanding hospice facility is located on the site of
or is physically connected to a health facility that is under the
jurisdiction of the Office of Statewide Health Planning and
Development or both, the hospice facility shall submit plans for any
new construction or renovation of the hospice facility to the office
for plan review and approval. The Office of Statewide Health Planning
and Development shall review the hospice facility plans to identify
any impacts to the health facility under the office's jurisdiction
that may compromise the health facility's continued compliance with
applicable laws and regulations.
SEC. 3. Section 4512 of the Welfare and Institutions Code is
amended to read:
4512. As used in this division:
(a) "Developmental disability" means a disability that originates
before an individual attains 18 years of age; continues, or can be
expected to continue, indefinitely; and constitutes a substantial
disability for that individual. As defined by the Director of
Developmental Services, in consultation with the Superintendent of
Public Instruction, this term shall include intellectual disability,
cerebral palsy, epilepsy, and autism. This term shall also include
disabling conditions found to be closely related to intellectual
disability or to require treatment similar to that required for
individuals with an intellectual disability, but shall not include
other handicapping conditions that are solely physical in nature.
(b) "Services and supports for persons with developmental
disabilities" means specialized services and supports or special
adaptations of generic services and supports directed toward the
alleviation of a developmental disability or toward the social,
personal, physical, or economic habilitation or rehabilitation of an
individual with a developmental disability, or toward the achievement
and maintenance of independent, productive, normal lives. The
determination of which services and supports are necessary for each
consumer shall be made through the individual program plan process.
The determination shall be made on the basis of the needs and
preferences of the consumer or, when appropriate, the consumer's
family, and shall include consideration of a range of service options
proposed by individual program plan participants, the effectiveness
of each option in meeting the goals stated in the individual program
plan, and the cost-effectiveness of each option. Services and
supports listed in the individual program plan may include, but are
not limited to, diagnosis, evaluation, treatment, personal care, day
care, domiciliary care, special living arrangements, physical,
occupational, and speech therapy, training, education, supported and
sheltered employment, mental health services, recreation, counseling
of the individual with a developmental disability and of his or her
family, protective and other social and sociolegal services,
information and referral services, follow-along services, adaptive
equipment and supplies, advocacy assistance, including self-advocacy
training, facilitation and peer advocates, assessment, assistance in
locating a home, child care, behavior training and behavior
modification programs, camping, community integration services,
community support, daily living skills training, emergency and crisis
intervention, facilitating circles of support, habilitation,
homemaker services, infant stimulation programs, paid roommates, paid
neighbors, respite, short-term out-of-home care, social skills
training, specialized medical and dental care, supported living
arrangements, technical and financial assistance, travel training,
training for parents of children with developmental disabilities,
training for parents with developmental disabilities, vouchers, and
transportation services necessary to ensure delivery of services to
persons with developmental disabilities. Nothing in this subdivision
is intended to expand or authorize a new or different service or
support for any consumer unless that service or support is contained
in his or her individual program plan.
(c) Notwithstanding subdivisions (a) and (b), for any organization
or agency receiving federal financial participation under the
federal Developmental Disabilities Assistance and Bill of Rights Act
of 2000, as amended, "developmental disability" and "services for
persons with developmental disabilities" mean the terms as defined in
the federal act to the extent required by federal law.
(d) "Consumer" means a person who has a disability that meets the
definition of developmental disability set forth in subdivision (a).
(e) "Natural supports" means personal associations and
relationships typically developed in the community that enhance the
quality and security of life for people, including, but not limited
to, family relationships, friendships reflecting the diversity of the
neighborhood and the community, associations with fellow students or
employees in regular classrooms and workplaces, and associations
developed through participation in clubs, organizations, and other
civic activities.
(f) "Circle of support" means a committed group of community
members, who may include family members, meeting regularly with an
individual with developmental disabilities in order to share
experiences, promote autonomy and community involvement, and assist
the individual in establishing and maintaining natural supports. A
circle of support generally includes a plurality of members who
neither provide nor receive services or supports for persons with
developmental disabilities and who do not receive payment for
participation in the circle of support.
(g) "Facilitation" means the use of modified or adapted materials,
special instructions, equipment, or personal assistance by an
individual, such as assistance with communications, that will enable
a consumer to understand and participate to the maximum extent
possible in the decisions and choices that effect his or her life.
(h) "Family support services" means services and supports that are
provided to a child with developmental disabilities or his or her
family and that contribute to the ability of the family to reside
together.
(i) "Voucher" means any authorized alternative form of service
delivery in which the consumer or family member is provided with a
payment, coupon, chit, or other form of authorization that enables
the consumer or family member to choose his or her own service
provider.
(j) "Planning team" means the individual with developmental
disabilities, the parents or legally appointed guardian of a minor
consumer or the legally appointed conservator of an adult consumer,
the authorized representative, including those appointed pursuant to
subdivision (d) of Section 4548 and subdivision (e) of Section 4705,
one or more regional center representatives, including the designated
regional center service coordinator pursuant to subdivision (b) of
Section 4640.7, any individual, including a service provider, invited
by the consumer, the parents or legally appointed guardian of a
minor consumer or the legally appointed conservator of an adult
consumer, or the authorized representative, including those appointed
pursuant to subdivision (d) of Section 4548 and subdivision (e) of
Section 4705, and including a minor's, dependent's, or ward's
court-appointed developmental services decisionmaker appointed
pursuant to Section 319, 361, or 726.
(k) "Stakeholder organizations" means statewide organizations
representing the interests of consumers, family members, service
providers, and statewide advocacy organizations.
(l) "Substantial disability" means the existence of significant
functional limitations in three or more of the following areas of
major life activity, as determined by a regional center, and as
appropriate to the age of the person:
(1) Self-care.
(2) Receptive and expressive language.
(3) Learning.
(4) Mobility.
(5) Self-direction.
(6) Capacity for independent living.
(7) Economic self-sufficiency.
Any reassessment of substantial disability for purposes of
continuing eligibility shall utilize the same criteria under which
the individual was originally made eligible.