The Legislature hereby finds and declares that there exists
a pattern of overutilization of long-term institutional care for
elderly persons or adults with disabilities, and that there is an
urgent need to establish and to continue a community-based system of
quality adult day health care which will enable elderly persons or
adults with disabilities to maintain maximum independence. While
recognizing that there continues to be a substantial need for
facilities providing custodial care, overreliance on this type of
care has proven to be a costly panacea in both financial and human
terms, often traumatic, and destructive of continuing family
relationships and the capacity for independent living.
It is, therefore, the intent of the Legislature in enacting this
chapter and related provisions to provide for the development of
policies and programs that will accomplish the following:
(a) Ensure that elderly persons and adults with disabilities are
not institutionalized inappropriately or prematurely.
(b) Provide a viable alternative to institutionalization for those
elderly persons and adults with disabilities who are capable of
living at home with the aid of appropriate health care or
rehabilitative and social services.
(c) Establish adult day health centers in the community for this
purpose, that will be easily accessible to all participants,
including economically disadvantaged elderly persons and adults with
disabilities, and that will provide outpatient health,
rehabilitative, and social services necessary to permit the
participants to maintain personal independence and lead meaningful
(d) Include the services of adult day health centers as a benefit
under the Medi-Cal Act, that shall be an initial and integral part in
the development of an overall plan for a coordinated, comprehensive
continuum of optional long-term care services based upon appropriate
(e) Establish a rural alternative adult day health care program
designed to meet the special needs and requirements of rural areas to
enable the implementation of subdivisions (a) through (d),
inclusive, for all Californians in need of those services.
(f) Ensure that all laws, regulations, and procedures governing
adult day health care be enforced equitably regardless of
organizational sponsorship and that all program flexibility
provisions be administered equitably.
As used in this chapter and in any regulations promulgated
(a) "Adult day health care" means an organized day program of
therapeutic, social, and skilled nursing health activities and
services provided pursuant to this chapter to elderly persons or
adults with disabilities with functional impairments, either physical
or mental, for the purpose of restoring or maintaining optimal
capacity for self-care. Provided on a short-term basis, adult day
health care serves as a transition from a health facility or home
health program to personal independence. Provided on a long-term
basis, it serves as an alternative to institutionalization in a
long-term health care facility when 24-hour skilled nursing care is
not medically necessary or viewed as desirable by the recipient or
his or her family.
(b) "Adult day health center" or "adult day health care center"
means a licensed facility that provides adult day health care.
(c) "Core staff" includes the positions of program director,
registered nurse, social worker, activity director, and program aide.
(d) "Department" or "state department" means the State Department
of Public Health.
(e) "Director" means the State Public Health Officer.
(f) "Elderly" or "older person" means a person 55 years of age or
older, but also includes other adults who are chronically ill or
impaired and who would benefit from adult day health care.
(g) "Extended hours" means those hours of operation prior to or
following the adult day health care program hours of service, as
designated by the adult day health care center in its plan of
operation, during which the adult day health care center may operate
an adult day program, or an Alzheimer's day care resource center, or
(h) "Hours of service" means the program hours defined and posted
by the adult day health care center for the provision of adult day
health care services, pursuant to Section 14550 of the Welfare and
Institutions Code, which shall be no less than four hours, excluding
(i) "Individual plan of care" means a plan designed to provide
recipients of adult day health care with appropriate treatment in
accordance with the assessed needs of each individual.
(j) "License" means a basic permit to operate an adult day health
care center. With respect to a health facility licensed pursuant to
Chapter 2 (commencing with Section 1250), "license" means a special
permit, as defined by Section 1251.5, empowering the health facility
to provide adult day health care services.
(k) "Long-term absence" or "long-term vacancy" means an absence or
vacancy lasting, or likely to last, more than one month. An adult
day health care center's policies and procedures shall be specific
regarding coverage in the situation for long-term absences or
(l) "Maintenance program" means procedures and exercises that are
provided to a participant, pursuant to Section 1580, in order to
generally maintain existing function. These procedures and exercises
are planned by a licensed or certified therapist and are provided by
a person who has been trained by a licensed or certified therapist
and who is directly supervised by a nurse or by a licensed or
(m) "Program director" shall be a person with both of the
(1) One of the following backgrounds:
(A) A person with a bachelor's degree and a minimum of two years
of experience in a management, supervisory, or administrative
(B) A person with a master's degree and a minimum of one year of
experience in a management, supervisory, or administrative position.
(C) A registered nurse with a minimum of two years experience in a
management, supervisory, or administrative position.
(2) Appropriate skills, knowledge, and abilities related to the
health, and mental, cognitive, and social needs of the participant
group being served by the adult day health center.
(n) "Restorative therapy" means physical, occupational, and speech
therapy, and psychiatric and psychological services that are planned
and provided by a licensed or certified therapist. The therapy and
services may also be provided by an assistant or aide under the
appropriate supervision of a licensed therapist, as determined by the
licensed therapist. The therapy and services are provided to restore
function, when there is an expectation that the condition will
improve significantly in a reasonable period of time, as determined
by the multidisciplinary assessment team.
(o) "Short-term absence" or "short-term vacancy" means an absence
or vacancy lasting one month or less, and includes sick leave and
vacations. An adult day health care center shall ensure that
appropriate staff is designated to serve in these positions during
the short-term absence or vacancy and that the center's policies and
procedures are specific regarding coverage of short-term absences or
(p) "Social worker" shall be a person who meets one of the
(1) The person holds a master's degree in social work from an
accredited school of social work.
(2) The person holds a master's degree in psychology, gerontology,
or counseling from an accredited school and has one year of
experience providing social services in one or more of the fields of
aging, health, or long-term care services.
(3) The person is licensed by the California Board of Behavioral
(4) The person holds a bachelor's degree in social work from an
accredited school with two years of experience providing social
services in one or more of the fields of aging, health, or long-term
In the event of conflict between the provisions of this
chapter and the provisions of Chapter 1 (commencing with Section
1200), Chapter 2 (commencing with Section 1250), or Chapter 3
(commencing with Section 1500) of this division, this chapter shall
be deemed controlling. Except as provided in Section 1507, no
facility which provides a specialized program of both medical and
nonmedical care for the elderly or adults with disabilities on an
outpatient basis shall be licensed as a health facility, clinic, or
community care facility under this division, but shall be subject to
licensure exclusively in accordance with the provisions of this
Review of the need and desirability of proposals for adult day
health centers shall be governed by the provisions of this chapter
and shall not be subject to review under Part 1.5 (commencing with
Section 437) of Division 1.