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AB-2377 Adult residential facilities: closures and resident transfers.(2019-2020)

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Date Published: 03/12/2020 09:00 PM
AB2377:v98#DOCUMENT

Amended  IN  Assembly  March 12, 2020

CALIFORNIA LEGISLATURE— 2019–2020 REGULAR SESSION

Assembly Bill
No. 2377


Introduced by Assembly Member Chiu

February 18, 2020


An act to amend Section 11839.3 of the Health and Safety Code, relating to alcohol and drug programs. add Section 1562.2 to the Health and Safety Code, relating to health and care facilities.


LEGISLATIVE COUNSEL'S DIGEST


AB 2377, as amended, Chiu. Narcotic treatment programs. Adult residential facilities: closures and resident transfers.
Existing law, the California Community Care Facilities Act, provides for the licensing and regulation by the State Department of Social Services of community care facilities. Under existing law, community care facilities include, among others, various types of adult residential facilities. Existing regulations of the department define an “adult residential facility” as a facility of any capacity that provides 24-hour-a-day nonmedical care and supervision to persons 18 to 59 years of age, inclusive, and, under specified conditions, to persons 60 years of age and older. Under existing law, a violation of the act is a misdemeanor.
Existing law separately licenses and regulates residential care facilities for the elderly (RCFE), which provide housing and other specified services for persons 60 years of age and older. Among other things, existing law requires an RCFE, prior to transferring a resident to another facility or to an independent living arrangement as a result of the forfeiture of a license or change in use of the facility, to take all reasonable steps to transfer affected residents safely, and minimize possible trauma by taking specified actions relating to resident notification and transfer and relocation planning, as prescribed, including providing written notice to the resident or the resident’s responsible person 60 days prior to the eviction. Among other provisions, existing law requires an RCFE, if 7 or more residents of the facility will be transferred as a result of the forfeiture of a license or the change in the use of a facility, to submit a proposed closure plan for the affected residents to the department for review, and requires the department to approve or disapprove the plan. Existing law requires an RCFE to refund to a resident any paid preadmission fees, according to a prescribed schedule. Existing law imposes civil penalties for a violation of these requirements by an RCFE, of $100 per violation per day.
This bill would establish similar procedures and requirements for an adult residential facility transferring a resident of the facility to another facility or to an independent living arrangement as a result of the forfeiture of a license or a closure of the facility for another reason. The bill would define an adult residential facilities for these purposes to include a facility of any capacity that provides 24-hour-a-day nonmedical care and supervision to persons 18 to 59 years of age, inclusive. Because a violation of the bill’s requirements by an adult residential facility would be a misdemeanor, the bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.

Existing law requires the State Department of Health Care Services to license narcotic treatment programs to use narcotic replacement therapy in the treatment of addicted persons and makes legislative findings in support of coordinated narcotic treatment programs in this regard.

This bill would make technical, nonsubstantive changes to those provisions.

Vote: MAJORITY   Appropriation: NO   Fiscal Committee: NOYES   Local Program: NOYES  

The people of the State of California do enact as follows:


SECTION 1.

 Section 1562.2 is added to the Health and Safety Code, to read:

1562.2.
 (a) For purposes of this section “adult residential facility” means a facility of any capacity that provides 24-hour-a-day nonmedical care and supervision to persons 18 to 59 years of age, inclusive.
(b) A licensee of an adult residential facility shall, prior to transferring a resident of the facility to another facility or to an independent living arrangement as a result of the forfeiture of a license, as described in subdivision (a), (b), or (f) of Section 1520, or a closure of the facility for another reason, take all reasonable steps to transfer affected residents safely and to minimize possible transfer trauma, and shall, at a minimum, do all of the following:
(1) Prepare, for each resident, a relocation evaluation of the needs of that resident, which shall include both of the following:
(A) Recommendations on the type of facility that would meet the needs of the resident based on the current service plan.
(B) A list of facilities, within a 60-mile radius of the resident’s current facility, that meet the resident’s present needs.
(2) Provide each resident or the resident’s responsible person with a written notice no later than 60 days before the intended eviction. The notice shall include all of the following:
(A) The reason for the eviction, with specific facts to permit a determination of the date, place, witnesses, and circumstances concerning the reasons.
(B) A copy of the resident’s current service plan.
(C) The relocation evaluation.
(D) A list of referral agencies.
(3) Discuss the relocation evaluation with the resident and their legal representative within 30 days of issuing the notice of eviction.
(4) Submit a written report of any eviction to the licensing agency within five days.
(5) Upon issuing the written notice of eviction, a licensee shall not accept new residents or enter into new admission agreements.
(6) (A)   For paid preadmission fees in excess of five hundred dollars ($500), the resident is entitled to a refund in accordance with all of the following:
(i) A 100-percent refund if preadmission fees were paid within six months of notice of eviction.
(ii) A 75-percent refund if preadmission fees were paid more than six months but not more than 12 months before notice of eviction.
(iii) A 50-percent refund if preadmission fees were paid more than 12 months but not more than 18 months before notice of eviction.
(iv) A 25-percent refund if preadmission fees were paid more than 18 months but less than 25 months before notice of eviction.
(B) No preadmission refund is required if preadmission fees were paid 25 months or more before the notice of eviction.
(C) The preadmission refund required by this paragraph shall be paid within 15 days of issuing the eviction notice. In lieu of the refund, the resident may request that the licensee provide a credit toward the resident’s monthly fee obligation in an amount equal to the preadmission fee refund due.
(7) If the resident gives notice five days before leaving the facility, the licensee shall refund to the resident or their legal representative a proportional per diem amount of any prepaid monthly fees at the time the resident leaves the facility and the unit is vacated. Otherwise the licensee shall pay the refund within seven days from the date that the resident leaves the facility and the unit is vacated.
(8) Within 10 days of all residents having left the facility, the licensee, based on information provided by the resident or the resident’s legal representative, shall submit a final list of names and new locations of all residents to the department.
(c) If seven or more residents of an adult residential facility will be transferred as a result of the forfeiture of a license or change in the use of the facility pursuant to subdivision (a), the licensee shall submit a proposed closure plan to the department for approval. The department shall approve or disapprove the closure plan, and monitor its implementation, in accordance with the following requirements:
(1) Upon submission of the closure plan, the licensee shall be prohibited from accepting new residents and entering into new admission agreements for new residents.
(2) The closure plan shall meet the requirements described in subdivision (a), and describe the staff available to assist in the transfers. The department’s review shall include a determination as to whether the licensee’s closure plan contains a relocation evaluation for each resident.
(3) Within 15 working days of receipt, the department shall approve or disapprove the closure plan prepared pursuant to this subdivision, and, if the department approves the plan, it shall become effective upon the date the department grants its written approval of the plan.
(4) If the department disapproves a closure plan, the licensee may resubmit an amended plan, which the department shall promptly either approve or disapprove, within 10 working days of receipt by the department of the amended plan. If the department fails to approve a closure plan, it shall inform the licensee, in writing, of the reasons for the disapproval of the plan.
(5) If the department fails to take action within 20 working days of receipt of either the original or the amended closure plan, the plan, or amended plan, as the case may be, shall be deemed approved.
(6) Until the department has approved a licensee’s closure plan, the facility shall not issue a notice of transfer or require any resident to transfer.
(d) (1) If a licensee fails to comply with the requirements of this section, or if the director determines that it is necessary to protect the residents of a facility from physical or mental abuse, abandonment, or any other substantial threat to health or safety, the department shall take any necessary action to minimize trauma for the residents, including caring for the residents through the use of a temporary manager or receiver as provided for in Sections 1546.1 and 1546.2 when the director determines the immediate relocation of the residents is not feasible based on transfer trauma or other considerations such as the unavailability of alternative placements. The department shall contact any local agency that may have assessment, placement, protective, or advocacy responsibility for the residents, and shall work together with those agencies to locate alternative placement sites, contact relatives or other persons responsible for the care of these residents, provide onsite evaluation of the residents, and assist in the transfer of the residents.
(2) The participation of the department and local agencies in the relocation of residents from an adult residential facility does not relieve the licensee of any responsibility under this section. A licensee that fails to comply with the requirements of this section shall be required to reimburse the department and local agencies for the cost of providing the relocation services or the costs incurred in caring for the residents through the use of a temporary manager or receiver as provided for in Sections 1546.1 and 1546.2. If the licensee fails to provide the relocation services required in this section, then the department may request that the Attorney General’s office, the city attorney’s office, or the local district attorney’s office seek injunctive relief and damages in the same manner as provided for in Chapter 5 (commencing with Section 17200) of Part 2 of Division 7 of the Business and Professions Code, including restitution to the department of any costs incurred in caring for the residents through the use of a temporary manager or receiver as provided for in Sections 1546.1 and 1546.2.
(e) A licensee who fails to comply with the requirements of this section shall be liable for the imposition of civil penalties in the amount of one hundred dollars ($100) per violation per day for each day that the licensee is in violation of this section, until the violation has been corrected. The civil penalties shall be issued immediately following the written notice of violation. However, if the violation does not present an immediate or substantial threat to the health or safety of residents and the licensee corrects the violation within three days after receiving the notice of violation, the licensee shall not be liable for payment of any civil penalties pursuant to this subdivision related to the corrected violation.
(f) On and after January 1, 2021, a licensee who fails to comply with this section and abandons the facility and the residents in care resulting in an immediate and substantial threat to the health and safety of the abandoned residents, in addition to forfeiture of the license pursuant to Section 1524, shall be excluded from licensure in facilities licensed by the department without the right to petition for reinstatement.
(g) A resident of an adult residential facility covered under this section may bring a civil action against any person, firm, partnership, or corporation who owns, operates, establishes, manages, conducts, or maintains an adult residential facility who violates the rights of a resident, as set forth in this section. Any person, firm, partnership, or corporation who owns, operates, establishes, manages, conducts, or maintains an adult residential facility who violates this section shall be responsible for the acts of the facility’s employees and shall be liable for costs and attorney’s fees. The adult residential facility may also be enjoined from permitting the violation to continue. The remedies specified in this section are in addition to any other remedy provided by law.

SEC. 2.

 No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.
SECTION 1.Section 11839.3 of the Health and Safety Code is amended to read:
11839.3.

(a)In addition to the duties authorized by other statutes, the department shall perform all of the following:

(1)License the establishment of narcotic treatment programs in this state to use narcotic replacement therapy in the treatment of addicted persons whose addiction was acquired or supported by the use of a narcotic drug or drugs, not in compliance with a physician and surgeon’s legal prescription, except that the Research Advisory Panel shall have authority to approve methadone or LAAM research programs. The department shall establish and enforce the criteria for the eligibility of patients to be included in the programs, program operation guidelines, such as dosage levels, recordkeeping and reporting, urinalysis requirements, take-home doses of controlled substances authorized for use pursuant to Section 11839.2, security against redistribution of the narcotic replacement drugs, and any other regulations that are necessary to protect the safety and well-being of the patient, the local community, and the public, and to carry out this chapter. A program may admit a patient to narcotic maintenance or narcotic detoxification treatment at the discretion of the medical director. The program shall assign a unique identifier to, and maintain an individual record for, each patient of the program. The arrest and conviction records and the records of pending charges against a person seeking admission to a narcotic treatment program shall be furnished to narcotic treatment program directors upon written request of the narcotic treatment program director provided the request is accompanied by a signed release from the person whose records are being requested.

(2)Inspect narcotic treatment programs in this state and ensure that programs are operating in accordance with the law and regulations. The department shall have sole responsibility for compliance inspections of all programs in each county. Annual compliance inspections shall consist of an evaluation by onsite review of the operations and records of licensed narcotic treatment programs’ compliance with applicable state and federal laws and regulations and the evaluation of input from local law enforcement and local governments, regarding concerns about the narcotic treatment program. At the conclusion of each inspection visit, the department shall conduct an exit conference to explain the cited deficiencies to the program staff and to provide recommendations to ensure compliance with applicable laws and regulations. The department shall provide an inspection report to the licensee within 30 days of the completed onsite review describing the program deficiencies. A corrective action plan shall be required from the program within 30 days of receipt of the inspection report. All corrective actions contained in the plan shall be implemented within 30 days of receipt of approval by the department of the corrective action plan submitted by the narcotic treatment program. For programs found not to be in compliance, a subsequent inspection of the program shall be conducted within 30 days after the receipt of the corrective action plan in order to ensure that corrective action has been implemented satisfactorily. Subsequent inspections of the program shall be conducted to determine and ensure that the corrective action has been implemented satisfactorily. For purposes of this requirement, “compliance” shall mean to have not committed any of the grounds for suspension or revocation of a license provided for under subdivision (a) of Section 11839.9 or paragraph (2) of subdivision (b) of Section 11839.9. Inspection of narcotic treatment programs shall be based on objective criteria including, but not limited to, an evaluation of the programs’ adherence to all applicable laws and regulations and input from local law enforcement and local governments. This section does not preclude counties from monitoring their contract providers for compliance with contract requirements.

(3)Charge and collect licensure fees. In calculating the licensure fees, the department shall include staff salaries and benefits, related travel costs, and state operational and administrative costs. Fees shall be used to offset licensure and inspection costs, not to exceed actual costs.

(4)Study and evaluate, on an ongoing basis, narcotic treatment programs including, but not limited to, the adherence of the programs, to all applicable laws and regulations and the impact of the programs on the communities in which they are located.

(5)Provide advice, consultation, and technical assistance to narcotic treatment programs to ensure that the programs comply with all applicable laws and regulations and to minimize any negative impact that the programs may have on the communities in which they are located.

(6)In its discretion, to approve local agencies or bodies to assist it in carrying out this chapter provided that the department may not delegate responsibility for inspection or any other licensure activity without prior and specific statutory approval. However, the department shall evaluate recommendations made by county alcohol and drug program administrators regarding licensing activity in their respective counties.

(7)The director may grant exceptions to the regulations adopted under this chapter if the director determines that this action would improve treatment services or achieve greater protection to the health and safety of patients, the local community, or the general public. An exception shall not be granted if it is contrary to, or less stringent than, the federal laws and regulations that govern narcotic treatment programs.

(b)It is the intent of the Legislature in enacting this section, in order to protect the general public and local communities, that take-home doses of narcotic replacement therapy medications authorized for use pursuant to Section 11839.2 shall only be provided when the patient is clearly adhering to the requirements of the program, and if daily attendance at a clinic would be incompatible with gainful employment, education, responsible homemaking, retirement or medical disability, or if the program is closed on Sundays or holidays and providing a take-home dose is not contrary to federal laws and regulations governing narcotic treatment programs. The department shall define “satisfactory adherence” and shall ensure that patients not satisfactorily adhering to their programs shall not be provided take-home doses. A narcotic treatment program medical director shall determine whether or not to dilute take-home doses.

(c)There is established in the State Treasury the Narcotic Treatment Program Licensing Trust Fund. All licensure fees collected from the providers of narcotic treatment services shall be deposited in this fund. Except as otherwise provided in this section, if funds remain in this fund after appropriation by the Legislature and allocation for the costs associated with narcotic treatment licensure actions and inspection of narcotic treatment programs, a percentage of the excess funds shall be annually rebated to the licensees based on the percentage their licensing fee is of the total amount of fees collected by the department. A reserve equal to 10 percent of the total licensure fees collected during the preceding fiscal year may be held in each trust account to reimburse the department if the actual cost for the licensure and inspection exceed fees collected during a fiscal year.

(d)Notwithstanding any provision of this code or regulations to the contrary, the department shall have sole responsibility and authority for determining if a state narcotic treatment program license shall be granted and for administratively establishing the maximum treatment capacity of a license. However, the department shall not increase the capacity of a program unless it determines that the licensee is operating in full compliance with applicable laws and regulations.