Section 1507 Of Article 1. General Provisions From California Health And Safety Code >> Division 2. >> Chapter 3. >> Article 1.
1507
. (a) Notwithstanding any other provision of law, incidental
medical services may be provided in a community care facility. If the
medical services constitute a substantial component of the services
provided by the community care facility as defined by the director in
regulations, the medical services component shall be approved as set
forth in Chapter 1 (commencing with Section 1200) or Chapter 2
(commencing with Section 1250).
(b) Notwithstanding any other provision of law, if the
requirements of subdivision (c) are met, the department shall permit
incidental medical services to be provided in community care
facilities for adults by facility staff who are not licensed health
care professionals but who are trained by a licensed health care
professional and supervised according to the client's individualized
health care plan prepared pursuant to subdivision (c). Incidental
medical services provided by trained facility staff for the following
conditions shall be limited as follows:
(1) Colostomy and ileostomy: changing bags and cleaning stoma.
(2) Urinary catheter: emptying bags in day care facilities;
emptying and changing bags in residential facilities.
(3) Gastrostomy: feeding, hydration, cleaning stoma, and adding
medication per physician's or nurse practitioner's orders for the
routine medication of patients with chronic, stable conditions.
(c) Facility staff may provide incidental medical services if the
following conditions have been met:
(1) For regional center clients the following shall apply:
(A) An individualized health care plan, which may be part of a
client's individual program plan, shall be prepared for each client
by a health care team that shall include the client or his or her
designee if the client is not able to participate in planning his or
her health care, the client's primary care physician or nurse
practitioner or other health care professional designated by the
physician or nurse practitioner, the licensee or licensee's designee,
any involved social worker or regional center worker, and any health
care professional designated to monitor the client's individualized
health care plan.
(B) The client's individualized health care plan shall be
reassessed at least every 12 months or more frequently as determined
by the client's physician or nurse practitioner during the time the
client receives incidental medical services in the facility.
(C) The client's regional center, primary care physician or nurse
practitioner, or other health care professional designated by the
physician or nurse practitioner shall identify the health care
professional who shall be responsible for training facility staff in
the provision of incidental medical services.
(D) Facility staff shall be trained by the identified health care
professional practicing within his or her scope of practice who shall
monitor, according to the individualized health care plan, the staff'
s ability to provide incidental medical services and who shall
review, correct, or update facility staff training as the health care
professional deems necessary.
(E) The regional center or placing agency shall evaluate, monitor,
and have responsibility for oversight of the incidental medical
services provided in the facility by facility staff. However, nothing
in this section shall preclude the department from taking an
administrative action against a licensee or facility staff member for
failure or refusal to carry out, or negligence in carrying out, his
or her duties in providing these incidental medical services.
(2) For persons who are not regional center clients, the following
shall apply:
(A) An individualized health care plan shall be prepared that
includes the physician's or nurse practitioner's order for services
to be provided during the time the client is in the day care
facility. The plan shall be prepared by a team that includes the
client or his or her designee if the client is not able to
participate in planning his or her care, the client's social worker,
conservator, or legal guardian, as appropriate, a licensed health
care professional, and the licensee or the licensee's designee.
(B) The client's individualized health care plan shall be
reassessed at least every 12 months or more frequently as determined
by the client's physician or nurse practitioner during the time the
client receives incidental medical services in the facility.
(C) A licensed health care professional practicing within his or
her scope of practice shall train the staff of the facility on
procedures for caring for clients who require incidental medical
services and shall periodically review, correct, or update facility
staff training as the health care professional deems necessary.
(d) Facilities providing incidental medical services shall remain
in substantial compliance with all other applicable regulations of
the department.
(e) The department shall adopt emergency regulations for community
care facilities for adults by February 1, 1997, to do all of the
following:
(1) Specify incidental medical services that may be provided.
These incidental medical services shall include, but need not be
limited to, any of the following: gastrostomy, colostomy, ileostomy,
and urinary catheters.
(2) Specify the conditions under which incidental medical services
may be provided.
(3) Specify the medical services that, due to the level of care
required, are prohibited services.
(f) The department shall consult with the State Department of
Developmental Services, the State Department of Health Care Services,
the Association of Regional Center Agencies, and provider
associations in the development of the regulations required by
subdivision (e).