CALA members are committed to a responsive and vibrant resident experience. With this in mind, CALA regularly collaborates with legislators, regulators, issue experts, and other stakeholders to establish new policies, revise out-of-date laws, and bring clarity to existing rules governing care and services in Assisted Living, Memory Care, and Continuing Care Retirement Communities. The following are a few of CALA’s efforts impacting the resident experience and the strength of these models of care.
Emergency Preparedness Enhanced
Disaster plans have long been required. Now, they’re being strengthened. AB 3098 (Chapter 348, Statutes of 2018), authored by Assemblymember Laura Friedman (D-Glendale) and sponsored by CALA, takes effect January 1, 2019. The goal is to strengthen emergency preparedness across the state and clarify applicability to RCFEs and CCRCs alike.
Assisted Living Waiver Program Renewal
Although Governor Brown vetoed AB 2233 (Kalra), which would have expanded the availability of the program, the bill helped keep the issue alive and moving forward throughout the year and a new bill has been introduced for 2019 by Assemblymember Kalra. CALA was also successful in advocating for changes to the waiver renewal that will be effective from March 1, 2019 through the end of February 2024.
State Oversight Supported
Annual licensing inspections have been a long-standing CALA priority. Thanks to CALA’s advocacy, the leadership of Assemblymember Ian Calderon, strong legislative support, and acknowledgement by Governor Jerry Brown, California is now increasing the number of inspections each year and will reach annual inspections by 2019.
CALA was instrumental in overhauling the outdated civil penalty system over the past three years. Updates to the level of fines, addition of appropriate due process, and stronger transparency were achieved in legislation over this three-year period:
- AB 2231 Civil Penalties (2015)
- AB 1387 Appeal Process (2015)
- AB 2236 New Civil Penalty Structure (2014)
CALA has also supported a host of reforms at the Department of Social Services (DSS) that are strengthening oversight, increasing departmental efficiency and responsiveness, and providing additional transparency. CALA even supported an increase in licensing fees to realize these goals.
Administrator Certification Program Strengthened
As sponsor of AB 1570 (Chapter 698, Statutes of 2014) and supporter of SB 911 (Chapter 705, Statutes of 2014), CALA fought for a doubling of the training hours required to become certified as an administrator, as well as an increase in the length of the administrator exam and the integrity of the exam questions themselves. Certified administrators are responsible for managing the community, and a strong certification foundation is key to their success. These bills represent a significant step forward.
Dementia Care Training Increased – Again!
CALA joined with the Alzheimer’s Association last year to increase dementia care staff training and expand the training to all Residential Care Facilities for the Elderly (RCFEs), not just those that advertise dementia care. AB 1570 (Chapter 698, Statutes of 2014) was a follow-up to AB 1753 (Chapter 434, Statutes of 2000) the two groups passed in 2000 to establish new dementia care training and disclosure requirements. AB 1753 was one of the first in the nation to focus on the special training needs related to care for people with dementia.
Caregiver Training Dramatically Increased
CALA partnered with stakeholders to quadruple the training required to be an RCFE caregiver. AB 1570 (Chapter 698, Statutes of 2014)) and SB 911 (Chapter 705, Statutes of 2014) ensure that caregivers have the knowledge necessary to meet the needs of today’s residents.
Barriers to Hospice Care Removed
CALA successfully advocated for a change in law to allow a resident who is using hospice services to move into and remain in an RCFE when appropriate planning and communication takes place. Prior to AB 1961 (Chapter 109, Statutes of 2002), seniors were forced to move to a nursing home or other setting in order to receive hospice care. Today, seniors have the choice of remaining in their community—their home—while receiving hospice services.
In addition, AB 1166 (Chapter 312, Statutes of 2003) allowed communities to call the hospice agency instead of 9-1-1 for residents receiving hospice care. This avoids unwanted transfers to the hospital at the end of life and helps ensure that residents’ wishes are honored.
Consumer Disclosure Promoted
CALA has worked with a variety of stakeholders over the years to ensure that residents and families receive advance notice of changing rates (SB 1662 (Chapter 401, Statues of 2004)), history of rate increases (AB 2370 (Chapter 478, Statutes of 2008)), special services available (SB 540 (Chapter 322, Statutes of 2003)), and detailed information in admission agreements (SB 211, Chapter 409, Statutes of 2003)), in order to promote well-informed decisions.
Medication Management Training Strengthened – Again!
CALA helped enact legislation that significantly increases the training required for staff members who assist residents with medications. Most recently, SB 911 (Chapter 705, Statutes of 2014) increases the requirement for communities of all sizes. In 2006, CALA co-sponsored AB 2609 (Chapter 615, Statutes of 2006) with the Alzheimer’s Association to strengthen training for Assisted Living caregivers who assist residents with medication. The additional training hours, specialized topics, exam component, and professional consultation significantly raised the bar for medication management in RCFEs.
Institutionalization of Residents with Mobility Challenges Prevented
CALA led the fight to preserve access and prevent institutionalization for those who simply need a hand getting out of bed. Before CALA’s intervention, an unintended consequence of an unrelated code change mistakenly classified seniors who need any assistance getting out of bed as “bedridden” instead of “non-ambulatory.” This inaccurate label was leading fire inspectors to deny fire clearances, which led to eviction notices. Working closely with the Office of the State Fire Marshal, Alzheimer’s Association, and other stakeholders, CALA sponsored AB 762 (Chapter 471, Statutes of 2009), which clarified that residents who need assistance transferring are considered “non-ambulatory” for fire clearance purposes.