2005 California Welfare and Institutions Code Sections 14550-14555 Article 3. Services and Standards

14550.  Adult day health care centers shall offer, and shall provide
directly on the premises, at least the following services:
   (a) Rehabilitation services, including the following:
   (1) Occupational therapy as an adjunct to treatment designed to
restore impaired function of patients with physical or mental
limitations.
   (2) Physical therapy appropriate to meet the needs of the patient.
   (3) Speech therapy for participants with speech or language
disorders.
   (b) Medical services supervised by either the participant's
personal physician or a staff physician, or both, which emphasize
prevention treatment, rehabilitation, and continuity of care and also
provide for maintenance of adequate medical records.  To the extent
otherwise permitted by law, medical services may be provided by nurse
practitioners, as defined in Section 2835 of the Business and
Professions Code, operating within the existing scope of practice, or
under standardized procedures pursuant to Section 2725 of the
Business and Professions Code, or by registered nurses practicing
under standardized procedures pursuant to Section 2725 of the
Business and Professions Code.
   (c) Nursing services, including the following:
   (1) Nursing services rendered by a professional nursing staff, who
periodically evaluate the particular nursing needs of each
participant and provide the care and treatment that is indicated.
   (2) Self-care services oriented toward activities of daily living
and personal hygiene, such as toileting, bathing, and grooming.
   (d) Nutrition services, including the following:
   (1) The program shall provide a minimum of one meal per day which
is of suitable quality and quantity as to supply at least one-third
of the daily nutritional requirement.  Additionally, special diets
and supplemental feedings shall be available if indicated.
   (2) Dietary counseling and nutrition education for the participant
and his or her family shall be a required adjunct of such service.
Dietary counseling and nutrition education may be provided by a
professional registered nurse, unless the participant is receiving a
special diet prescribed by a physician, or a nurse determines that
the services of a registered dietician are necessary.
   (e) Psychiatric or psychological services which include
consultation and individual assessment by a psychiatrist, clinical
psychologist, or a psychiatric social worker, when indicated, and
group or individual treatment for persons with diagnosed mental,
emotional, or behavioral problems.
   (f) Social work services to participants and their families to
help with personal, family, and adjustment problems that interfere
with the effectiveness of treatment.
   (g) Planned recreational and social activities suited to the needs
of the participants and designed to encourage physical exercise, to
prevent deterioration, and to stimulate social interaction.
   (h) Transportation service for participants, when needed, to and
from their homes utilizing specially equipped vehicles to accommodate
participants with severe physical disabilities that limit their
mobility.
   (i) Written procedures for dealing with emergency situations.
These written procedures shall include either of the following:
   (1) The use of a local 911 emergency response system.
   (2) All of the following elements:
   (A) The name and telephone number of a physician on call.
   (B) Written arrangements with a nearby hospital for inpatient and
emergency room service.
   (C) Provision for ambulance transportation.
14551.  The following additional services may also be provided:
   (a) Podiatric services provided or arranged for, or under
direction of, the supervising physician.
   (b) Optometric screening and advice for low-vision cases by a
licensed ophthalmologist or optometrist.
   (c) Dental screening for the purpose of apprising the participant
of the necessity of regular or emergency dental care.
   (d) Such other services within the concept and objectives of adult
day health care as may be approved by the department.
14552.  In order to obtain certification as a provider of adult day
health care under this chapter and Chapter 7 (commencing with Section
14000), the following standards shall be met:
   (a) The provider shall have met all other requirements of
licensure as an adult day health care center pursuant to Chapter 3.3
(commencing with Section 1570) of Division 2 of the Health and Safety
Code.
   (b) The provider shall comply with requirements of this chapter
regarding program and scope of services.
   (c) The provider shall have appropriate licensed personnel.
   (d) The provider shall employ required personnel for furnishing of
required services pursuant to Section 14550 consistent with commonly
accepted professional standards.
   (e) The provider shall afford to each participant all rights,
including the right to be free from harm and abuse, identified in the
rules and regulations adopted pursuant to Section 1580 of the Health
and Safety Code.
   (f) A provider serving a substantial number of participants of a
particular racial or ethnic group, or participants whose primary
language is not English, shall employ staff who can meet the cultural
and linguistic needs of the participant population.
   (g) A provider shall have organizational and administrative
capacity to provide services under the provisions of this chapter.
14552.2.  (a) "Program plan" means a written description of the
adult day health care center's philosophy, objectives, and processes
for providing required services to the participant populations.
   (b) The program plan shall include any of the following elements,
as requested by the California Department of Aging, and shall be
submitted as required in Section 14574.1:
   (1) The total number of participants the center proposes to serve,
or currently serves, daily.
   (2) A profile of the participant population the center proposes to
serve, or currently serves, that includes a description of the
specific medical, social, and other needs of each population.
   (3) A description of the specific program elements and services
that addresses the medical, social, and other needs of each
participant population that the center proposes to serve, or
currently serves, as specified in paragraph (2).  "Program elements"
means the components of an adult day health care program, as
specified in Section 14550.
   (4) A description of the specialized professional and program
staff that will provide, or currently provide, the adult day health
care center's program services, as specified in paragraph (3), and
that staff's responsibilities.  The plan shall demonstrate that the
adult day health care center is organized and staffed to carry out
the requirements as specified in the regulations adopted pursuant to
Section 1580 of the Health and Safety Code.
   (5) An in-service training plan for each center staff member to
commence within the first six months of employment.  The training
plan shall address, at a minimum, the specific medical, social, and
other needs of each participant population the center proposes to
serve, as specified in paragraph (2).
   (6) A sample individual plan of care for each specialty population
the adult day health care center proposes to serve, or currently
serves, and a sample of a one-week schedule of daily program services
for each sample individual plan of care.  The individual plan of
care shall demonstrate the specific medical, social, and other needs
of each participant population the adult day health center proposes
to serve.
   (7) A plan for a behavior modification program if such a program
will be used as a basic intervention for meeting the needs of a
special population, such as persons with developmental disabilities
or persons with mental disabilities.
   (c) This section shall be implemented only to the extent funds are
made available for the purposes of this section in the annual Budget
Act or another statute.
   (d) The implementation of the program plan requirements does not
require adoption of regulations pursuant to the Administrative
Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1
of Division 3 of Title 2 of the Government Code).
14552.5.  Pursuant to Section 14043.46, the department may implement
a one-year moratorium on the certification and enrollment into the
Medi-Cal program of new adult day health care centers.
14553.  An adult day health care provider shall establish written
policies and procedures, which shall have prior approval of the
department, unless otherwise specified in an interagency agreement
entered into pursuant to Section 1572 of the Health and Safety Code,
for continuously reviewing the quality of care, performance of all
personnel, the utilization of services and facilities, and costs.
Information derived from the review shall be made available to the
department, unless otherwise specified in an interagency agreement
entered into pursuant to Section 1572 of the Health and Safety Code.
14554.  The adult day health care provider shall maintain a complete
standard medical record for each participant, including records of
treatment rendered by a subcontractor, according to specifications
established by the department and as may be further specified by the
California Department of Aging.
14555.  Each adult day health care provider shall establish a
grievance procedure under which participants may submit their
grievances.  Such procedure shall be approved by the department prior
to the approval of the certification.  The department shall
establish standards for such procedures to insure adequate
consideration and rectification of participant grievances.  A
provider shall make written findings of fact in the case of each
grievance processed, a copy of which shall be transmitted to the
participant.  If the Medi-Cal participant has an unresolved
grievance, the fair hearing provided in Chapter 7 (commencing with
Section 10950) of Part 2 of this division shall be available to
resolve all grievances regarding care and administration by the adult
day health care provider.  The findings and recommendations of the
department, based on the decision of the hearing officer, shall be
binding upon the adult day health care provider.