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SB-280 Older adults and persons with disabilities: fall prevention. (2019-2020)

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Date Published: 06/13/2019 09:00 PM
SB280:v96#DOCUMENT

Revised  June 26, 2019
Amended  IN  Assembly  June 13, 2019
Amended  IN  Senate  April 10, 2019
Amended  IN  Senate  March 27, 2019

CALIFORNIA LEGISLATURE— 2019–2020 REGULAR SESSION

Senate Bill
No. 280


Introduced by Senator Jackson
(Coauthor: Assembly Member Lackey)

February 13, 2019


An act to add Section 17922.15 to the Health and Safety Code, and to repeal Article 2 (commencing with Section 9115) of Chapter 2 of, to repeal Chapter 4.5 (commencing with Section 9450) of, and to repeal and add Article 3 (commencing with Section 9675) of Chapter 10.5 of, Division 8.5 of the Welfare and Institutions Code, relating to older adults.


LEGISLATIVE COUNSEL'S DIGEST


SB 280, as amended, Jackson. Older adults and persons with disabilities: fall prevention.
(1) Existing law, the Mello-Granlund Older Californians Act, finds and declares that one in 3 Americans over 65 years of age suffers a fall each year, often in the home, which can cause serious injury and depression. The act establishes the California Department of Aging, and sets forth its duties and powers, including, among other things, entering into a contract for the development of information and materials to educate Californians on the concept of “aging in place” and the benefits of home modification.
Existing law also establishes the Senior Housing Information and Support Center within the department for the purpose of providing information and training relating to available innovative resources and senior services, and housing options and home modification alternatives designed to support independent living or living with family.
This bill would repeal those provisions relating to the department’s provision of information on housing and home modifications for seniors.
Existing law establishes the Program for Injury Prevention in the Home Environment, under which the department, through the Senior Housing and Information Support Center, is required to award grants to eligible local level entities for injury prevention information and educational programs and services.
This bill would repeal those provisions and would instead establish the Dignity at Home and Fall Prevention Program, which would require the department to provide grants to area agencies on aging for injury prevention information, education, and services for the purpose of enabling older adults and persons with disabilities to live independently in the home environment for as long as possible, as specified. The bill would require the department, in consultation with specified experts knowledgeable in injury prevention for older adults and persons with disabilities, to develop a grant application process, specific performance measures on which grant recipients would be required to report, and training materials for the implementation of these provisions. The bill would require the application process to include the submission of a plan that includes, among other things, the projected number of clients to be served and the array of services to be provided. The bill would provide that funding of these grants is subject to the appropriation of funds by the Legislature in the Budget Act or another statute.
(2) Existing law, the California Building Standards Law, provides for the adoption of building standards by state agencies by requiring all state agencies that adopt or propose adoption of any building standard to submit the building standard to the California Building Standards Commission for approval and adoption. Existing law requires the commission to publish, or cause to be published, editions of the code in its entirety once every 3 years. Existing law, the State Housing Law, requires the Department of Housing and Community Development to propose the adoption, amendment, or repeal of building standards to the California Building Standards Commission.
This bill would, at the next triennial building standards rulemaking cycle that commences on or after January 1, 2020, require the Department of Housing and Community Development to investigate possible changes to the building standards in the California Residential Code for adoption by the California Building Standards Commission to facilitate aging in place, as specified.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

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


SECTION 1.

 The Legislature finds and declares all of the following:
(a) According to the Public Policy Institute of California, by 2030, the California population of persons 65 years of age and older will increase by more than four million.
(b) Most older adults prefer to remain in their own homes as long as possible, but many are forced into skilled nursing, assisted living, or other congregate living options because their homes are no longer physically safe for them to live in.
(c) Falls are the leading cause of both fatal and nonfatal injuries for Californians 65 years of age and older.
(d) In 2014, there were 208,564 Californians 65 years of age and older treated in emergency departments for fall-related injuries and 74,954 were hospitalized as a result of an unintentional fall injury.
(e) In 2013, 1,733 Californians died as a result of a fall injury.
(f) Many of those fall patients will use Medicare, Medicaid, or both, to pay their medical expenses, including the charges for skilled nursing or rehabilitation facilities, costing the federal and state governments large amounts of money.
(g) The federal Centers for Disease Control and Prevention states that there are proven interventions that can reduce falls and help older adults live better and longer.
(h) The federal Centers for Medicare and Medicaid Services’ evidence-based review of multifactorial fall preventions prevention programs concluded that the incidence of falls was reduced by a minimum of 11 percent with a potential of a 23-percent reduction when falls prevention strategies are implemented.
(i) In many cases, the retrofit of homes to add fall prevention features to an existing house can be quite expensive and beyond the means of senior residents.

SEC. 2.

 Section 17922.15 is added to the Health and Safety Code, to read:

17922.15.
 (a) At the next triennial building standards rulemaking cycle that commences on or after January 1, 2020, the Department of Housing and Community Development shall investigate possible changes to the building standards in the California Residential Code (Part 2.5 of Title 24 of the California Code of Regulations) that promote aging-in-place design and are limited to all of the following:
(1) The location of doorbells, light switches, and heating, ventilation, and air-conditioning (HVAC) controls that are reachable by those with mobility impairments.
(2) The installation of support backing for the later installation of grab bars in one or more bathrooms.
(3) The provision of a 32-inch clearance in the width opening for one bathroom door and one bedroom door on the ground floor. floor, or, in the case of a two- or three-story single-family dwelling, on the second or third floor of the dwelling if a bathroom or bedroom is not located on the ground floor.
(b) If the department determines that one or more of the changes described in subdivision (a) can be incorporated into the California Residential Code without significantly increasing the cost of construction, the department may propose building standards to that effect for consideration by the California Building Standards Commission. The department shall include in any proposed building standard, regarding the 32-inch clearance width for a bathroom and bedroom door described in paragraph (3) of subdivision (a), a finding whether a delay of 18 months in the effective date of that proposed building standard is warranted to provide adequate time for industry to incorporate this change into standard designs.

SEC. 3.

 Article 2 (commencing with Section 9115) of Chapter 2 of Division 8.5 of the Welfare and Institutions Code is repealed.

SEC. 4.

 Chapter 4.5 (commencing with Section 9450) of Division 8.5 of the Welfare and Institutions Code is repealed.

SEC. 5.

 Article 3 (commencing with Section 9675) of Chapter 10.5 of Division 8.5 of the Welfare and Institutions Code is repealed.

SEC. 6.

 Article 3 (commencing with Section 9675) is added to Chapter 10.5 of Division 8.5 of the Welfare and Institutions Code, to read:
Article  3. Dignity at Home and Fall Prevention Act

9675.
 This article shall be known and may be cited as the Dignity at Home and Fall Prevention Act.

9676.
 The Dignity at Home and Fall Prevention Program is hereby established. Under the program, the department shall provide grants to area agencies on aging for injury prevention information, education, and services pursuant to this article for the purpose of enabling older adults and persons with disabilities to live independently in the home environment for as long as possible.

9677.
 (a) A participating area agency on aging with grant funds provided pursuant to this article shall provide all of the following:
(1) Information and education on injury prevention to older adults and persons with disabilities living in the community.
(2) Referral-related resources and services in the community.
(3) Home environmental assessments and assessments of individual injury prevention needs, including instruction on behavioral, physical, and environmental aspects of injury prevention.
(b) In carrying out the responsibilities of a grant provided pursuant to this article, a participating area agency on aging shall partner with local public and private nonprofit agencies that are experienced in injury prevention services, including, but not limited to, medical providers and hospital systems, fire departments, independent living centers, and home modification providers.

9678.
 (a) The Dignity at Home and Fall Prevention Program shall include funding for injury prevention needs, including injury prevention equipment, services, materials, and labor costs for homeowners and renters meeting income requirements established pursuant to subdivision (c). A participating area agency on aging shall comply with all of the requirements of this section in implementing the program.
(b) Equipment and services covered under the program shall include, but not be limited to, all of the following:
(1) Grab bars, nonskid surfaces, toilet seat risers, shower seats, and transfer benches.
(2) Indoor and outdoor handrails and threshold modifications.
(3) Reconfiguration of furniture and other elements of the physical home environment to reduce hazards.
(4) Wearable medical alert devices.
(c) Eligibility for equipment and services, as described in this section, shall be limited to older adults and persons with disabilities who meet both of the following requirements:
(1) The older adult or person with a disability has an adjusted household income that does not exceed 80 percent of the area median income.
(2) The older adult or person with a disability has fallen, is at risk for falling, or is at risk for institutionalization, and is otherwise unable to afford the equipment or services to be provided by the program.
(d) All other potential funding sources for these equipment and services shall be exhausted before funds appropriated for purposes of this article may be used.

9679.
 The department, in consultation with experts knowledgeable in injury prevention for older adults and persons with disabilities, including, but not limited to, the Fall Prevention Center of Excellence at the University of Southern California, local fall prevention coalitions, and local public health agencies, shall develop and compile training materials and program standards for implementation of this article.

9680.
 (a) The director, in consultation with the entities described in Section 9679, shall establish an application process and a selection methodology for grants authorized pursuant to this article.
(b) The department, as part of the grant application process established pursuant to this section, shall require an applicant to submit a plan that details how the area agency on aging will provide injury prevention education, assessment services, equipment, and activities in an effective and cost-appropriate manner. The plan shall include, but not be limited to, all of the following information:
(1) The projected number of clients to be served.
(2) A description of the local population to be served.
(3) The geographic locations at which services will be provided.
(4) The array of services that will be offered.
(5) The ability of the area agency on aging to administer an effective service program.
(6) The ability of the area agency on aging to collaborate with local entities, including, but not limited to, public and private nonprofit agencies that are experienced in injury prevention services, home modification services, home safety services, and services for seniors and persons with disabilities, for purposes of program coordination.
(7) The ability of the area agency on aging to gather and utilize other resources to supplant funding provided by the department and whether any local funding match is available.
(c) The grant funding awarded to participating area agencies on aging pursuant to this article shall, to the extent provided in subdivision (b) of Section 9682, be sufficient to provide injury prevention education, assessment services, equipment, and activities necessary for injury prevention in the home.
(d) The director, in consultation with the entities described in Section 9679, shall identify specific performance measures for grant recipients to include in the report required by Section 9681. These performance measures shall include, but not be limited to, both of the following:
(1) The number of people served.
(2) The types of services received by program participants.

9681.
 An area agency on aging that receives a grant pursuant to this article shall submit a report to the department and to the appropriate fiscal and policy committees of each house of the Legislature that includes the specific performance measures identified by the department pursuant to subdivision (d) of Section 9680. The report shall also provide information on the administrative costs incurred by the agency in carrying out the program and any barriers to service that the agency encountered. A report submitted pursuant to this section shall comply with Section 9795 of the Government Code.

9682.
 (a) Funding of grants pursuant to this article shall be subject to the appropriation of funds by the Legislature in the Budget Act or another statute.
(b) Appropriations made pursuant to subdivision (a) shall be expended to fund grants to eligible area agencies on aging in an amount not to exceed one hundred fifty thousand dollars ($150,000) each.

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REVISIONS:
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