initial rcfe administrator certification · family councils ab 1572 also created a law granting...

Initial RCFE Administrator Certification

Part 9 of 10

Assisted Living Education 1


This Course Material has been copyrighted © 2009 byAssisted Living Education

All rights reserved. No part of this coursematerial/content may be reproduced or utilized in anyform, by any means, electronic or mechanical, includingphotocopying, recording, emailing, or any informationstorage and retrieval system, without permission inwriting from Assisted Living Education.

Assisted Living Education has attempted to offer usefulinformation and assessment tools that have beenaccepted and used by professionals within this industry,including the California Department of Social Services.Nevertheless, changes in health/medical care and healthcare regulations may change the application of sometechniques and perceptions in this course material.Assisted Living Education thereby disclaims any liabilityfor loss, injury or damage incurred as a consequence,either directly or indirectly, from the use and applicationof any of the contents of this course material.

Online Class RulesSome required rules for this online classare:

• You can always navigate back to a prior slide forreview.

• There is a 20 question test that you must pass inorder to complete this section of the onlineCertification course. You must score at least70%, which is 14 or more correct answers, topass the test.

• If you do not pass, you will be directed to retakethe test.


DSS Training Requirements

Per DSS requirements, this 2 hoursegment of the 20 hour online RCFE InitialCertification Program will focus on:

Resident and Family Councils Conservatorships, etc.


Definitions

“DSS” = Department of Social Services“AB” = Assembly Bill“SB” = Senate Bill“LPA” = Licensing Program Analyst“RCFE” = Residential Care Facility for theElderly“AD” = Alzheimer’s disease


Sources

Many sources were consulted to create this coursecontent. They include:

• California Department of Social Services• The Judicial Council and the Administrative

Office of the Courts (AOC)• Courts.ca.gov



Course Objectives

• Define purpose and regulations for ResidentCouncils

• Define purpose and regulations for FamilyCouncils

• Discuss the differences betweenconservatorships, guardianships, etc.

Resident Councils

Resident Council regulations can be foundin both Title 22, Section 87221 and theHealth and Safety Codes 1569.157 and1569.158.

The regulations changed effective January1, 2016 by the passage of Assembly Bill1572.


Resident CouncilsWhat is a Resident Council anyway?

This is a group of residents that meet to discuss thestatus, policies, dining services, activity program, etc.of the facility.

In a large facility, this group could be very formal andorganized, with a President, Secretary, etc. andmeeting minutes.

In a small facility, this meeting may not occur due tothe likelihood that the residents have dementia.


Resident Councils

Per Title 22, Section 87221, the purpose ofthe Resident Council is……

“The purpose of such an organization shall be to workwith the administration in improving the quality of lifefor all residents by enriching the activity program andto discuss the services offered by the facility and makerecommendations regarding identified problems.”


Resident Councils

Hmmmm….that sounds daunting. A groupof residents together coming up with waysyou can make the facility better….

We need a pool!We want filetmignon every night!


Resident Councils

Let’s think about this. What is your purpose as anAdministrator or facility owner? To make the residentsas happy as possible, right? So how do you makethem happy if you don’t know WHAT makes themhappy?

You should listen to, and possibly embrace, thechanges they are asking for – if they are happier, youwill be happier!!


Resident CouncilsTitle 22, Section 87221 Regulations:“The facility shall permit the formation of a residentcouncil by interested residents, provide space andpost notice for meetings, and provide assistance inattending meetings for those residents who requestit……”

• Encourage the residents to form a Council;• Designate a private, quiet space for them to meet;• Advertise the meeting to all residents; and• Escort residents to the meeting, if needed.


Resident CouncilsTitle 22, Section 87221 Regulations:“In order to permit a free exchange of ideas, at leastpart of each meeting shall be allowed to be conductedwithout the presence of any facility personnel.Residents shall be encouraged, but shall not becompelled to attend.”

• No facility staff are allowed to attend the meetingunless you are invited!

• Encourage the residents to attend.


Resident CouncilsAssembly Bill 1572 went into effect January 1, 2015:

This law grants Resident Councils additional rights,adds requirements for licensees, and limitsmembership of a Resident Council to RCFE residents,except at the invitation of the Resident Council.Family members, resident representatives, advocates,long-term care ombudsman program representatives,facility staff or others may participate in ResidentCouncil meetings and activities at the invitation of theResident Council.


Resident CouncilsAB 1572 requires Licensees to:

1. Assist residents in establishing andmaintaining a single resident council (formerlyreferred to as resident-oriented facilitycouncil) at the request of two or moreresidents, instead of a majority of itsresidents;



2. Provide a written response within 14 calendar daysto written concerns or recommendations ofResident Councils regarding any action or inactiontaken in response to concerns orrecommendations;

3. Inform Resident Council members of their right tobe interviewed as part of the regulatory inspectionprocess; (This means by your LPA, etc.)



4. Promote established Resident Councils byproviding information on the Council to newresidents, as specified (see next slide);

5. Inform in writing new residents and residentrepresentatives, upon admission, of their rightto form a Resident Council when no Council iscurrently established (see next slide);



6. Upon request and with permission of theCouncil, share Resident Council contactinformation with the long-term careombudsman; and

7. Post the text of Health & Safety Code Section1569.157 with the heading “Rights of ResidentCouncils” in a prominent place at the facilityaccessible to residents, family members andresident representatives (see next slide).


Resident Councils

In regard to the posting of the “Rights of ResidentCouncils”, DSS states that they will bedeveloping and making available on their websitea PUB 747 form.

Until this is available, you will need to downloadthe verbiage from the Health and Safety Codes1569.157.


Resident Councils

For a facility with a licensed capacity of 16or more beds, this Bill also requires aLicensee to designate a staff person toassist with Resident Council meetings andnotifications, including, making a roomavailable for meetings and postinginformation in a central location readilyaccessible to residents, relatives andresident representatives.


Resident Councils

AB 1572 prohibits Licensees from:

1. Having policies limiting the rights of residents tomeet independently with outside persons orfacility personnel; or

2. Willfully interfering with the formation,maintenance, or promotion of a ResidentCouncil or its participation in the regulatoryinspection process.


Resident Councils

AB 1572 also states that a violation of anyprovision in this Section is considered a violationof Resident Rights and subjects the licensee to adaily civil penalty of $250 until the violation iscorrected and verified.

This includes:• Not posting the required H&S Code 1569.157;• Not posting the specific text of this Code


Family Councils

AB 1572 also created a law granting FamilyCouncils’ additional rights, adds requirements forlicensees, and specifies that facility personnel orvisitors may attend Family Council meetings onlyat the invitation of the Family Council.

The requirements are very similar to those for theResident Councils.


Family Councils

“Family Council” is defined by this Bill as:

a “meeting of family members, friends,representatives or agents as defined inSection14110.8 of the Welfare andInstitutions Code of two or more residents toconfer in private without facility staff.”


Family CouncilsAB 1572 requires Licensees to:

1. Provide a written response within 14 calendar days towritten concerns or recommendations of FamilyCouncils regarding any action or inaction taken inresponse to concerns or recommendations;

2. Promote established Family Councils and to providenotice of the Family Council and it meeting in routemailings to family members and residentrepresentatives and to inform family members andresident representatives of the existence of the familycouncil, as specified;


Family CouncilsAB 1572 requires Licensees to:

3. Inform in writing the resident’s family or residentrepresentative – who are identified on theAdmission Agreement or in the resident’s records –upon admission of a new resident, of their right toform a Family Council when no Council is currentlyestablished; and

4. Upon request and with the permission of theCouncil, to share Council contact information withthe long-term care ombudsman.


Family Councils

AB 1572 requires Licensees to:

Just like with Resident Councils, for a facility with alicensed capacity of 16 or more beds, this Bill alsorequires the Licensee to designate a staff personto provide assistance to the Family Council andresponse to written requests that result fromFamily Council meetings.


Family CouncilsAB 1571 prohibits Licensees from:

• Willfully interfering with the formation, maintenanceor promotion of a Family Council or its participationin the regulatory inspection process.

• A violation of any provision of this Section isconsidered a violation of Resident Rights andsubjects the Licensee to a daily civil penalty of $250until the violation is corrected and verified.


Family Councils

AB 1572 also states that a violation of anyprovision in Section 1569.158(a) through (i) isconsidered a violation of Resident Rights andsubjects the licensee to a daily civil penalty of$250 until the violation is corrected and verified.

This includes:• Not posting the required H&S Code 1569.157;• Not posting the specific text of this Code


Conservatorships


ConservatorshipWhat is a “conservatorship”?

According to courts.ca.gov:“A conservatorship is a court case where a judgeappoints a responsible person or organization (calledthe “conservator”) to care for another adult (called the“conservatee”) who cannot care for himself or herselfor manage his or her own finances.”

This person could be a spouse, relative, friend or aprivate professional conservator.


Conservatorship

If the conservator is a private professionalconservator, it is called a public guardian orpublic conservator.


Conservatorship

Why would someone need a conservatorship?

1. They are unable to make decisions on theirown behalf because of dementia or they aremaking poor decisions;

2. They have no family to make decisions ontheir behalf;

3. No one in their family wants to makedecisions for them.


ConservatorshipsIn California, an elder law attorney accomplishes this by preparing, and filing with the court, the petition for conservatorship, along with the other required documentation.


Conservatorship

Generally, there are two kinds ofconservatorship:1. over the person (when an elder cannot

take care of their personal needs, such asfood, clothing and shelter); and

2. over the “estate” (when an elder cannotmake sound financial decisions or resistfraud or undue influence).


Conservatorship

The duties of a conservator of the person are to:

• Arrange for the conservatee’s care and protection; • Decide where the conservatee will live; • Make arrangements for the conservatee’s meals;• Health care;• Clothing;• Personal care; • Housekeeping;


ConservatorshipThe duties of a conservator of the person are to (cont’d):

• Transportation;• Shelter;• Recreation;• Well-being;• Get approval from the court for certain decisions about

the conservatee’s health care or living arrangement;and

• Report to the court on the conservatee’s currentstatus.


Conservatorship

The duties of a conservator of the estate are to:• Manage the conservatee’s finances. • Locate and take control of all assets. • Collect the conservatee’s income. • Make a budget to show what the conservatee can afford. • Pay the conservatee’s bills. • Responsibly invest the conservatee’s money. • Protect the conservatee’s assets. • Account to the court and to the conservatee for the

management of the conservatee’s assets.


Conservatorship

Once a conservatorship is established, the courtmonitors the conservator’s actions. Theconservator must file periodic accountings with thecourt, informing the judge of every penny that theconservatee received, and every penny that wasspent. The conservator will petition the court to beawarded reasonable fees for his or her work on thecase, and to be reimbursed for out of pocket costs,sometimes including attorney fees, that were paidfor the benefit of the conservatee.


Conservatorship

The Conservatee’s rights:

When a person becomes a conservatee, he orshe does not necessarily lose the right to takepart in important decisions affecting his or herproperty and way of life. All conservatees havethe right to be treated with understanding andrespect and to have their wishes considered.


Conservatorship

The Conservatee generally keeps the right to:

• Directly receive and control his or her salary• Make or change a will• Marry, unless a judge has determined he or she

does not have the capacity to do so• Receive personal mail• Receive visits from family and friends, unless a

judge has ordered restrictions on a person’s visits orother contact with the conservatee (see next slide)


Conservatorships

Assembly Bill 937 that was effective January1, 2014 states that a conservator CANNOTlimit their client’s right to receive visitors,telephone calls and personal mail, unlessspecifically limited by a court order.


Conservatorship


• Be represented by a lawyer• Ask a judge to change conservators• Ask a judge to end the conservatorship• Vote, unless a judge decides the conservatee is not

capable of exercising this right• Make his or her own medical decisions, unless a

judge has taken away that right and given it to theconservator


Conservatorship


• Enter into business transactions, to the extentreasonable to provide the necessaries of life to theconservatee or to his or her minor children

• Engage in other activities the court expressly allowshim or her to do, at the time of conservatorappointment, or a later time following a court hearingon a request for authority to engage in the activity


Conservatorship

Consenting to medical treatment:

In most cases, the conservator and theconservatee share the right to make decisionsabout the conservatee’s health care.

However, the conservator may not arrange fora particular treatment if the conservatee objectsto it.


Conservatorship

Exclusive authority:

If the conservator believes at some pointthat the conservatee has lost the ability tomake sound medical choices, a judge maytake away the conservatee’s right to makemedical treatment decisions and to give thatright to the conservator. This is calledexclusive authority.


Conservatorship

So as the Administrator of an RCFE, howdoes this affect me if a resident isconserved?

You treat the conservator just like a familymember or responsible party. For example,you would contact them if there is a changeof condition in the resident or a medicalemergency just like a family member.


Conservatorship

You will want to get a copy of theconservatorship documents from theconservator.

If the resident requires emergency care,send a copy of these documents with theresident to the hospital.


Conservatorship

Does the conservator have the right to tellyou or your staff not to call 911 if there is anemergency?

No – you must call 911 if there is anemergency.


Proceed to Test

You have completed the class presentation andnow you must take the 20 question Final Test.

You must score at least 70%, which is 14 or morecorrect answers, to pass the test. If you do notpass the test, you will be redirected to take thetest again.

Proceed to the next slide to begin your Final Test.

Good Luck!


Completion

Congratulations oncompleting this online classfor your RCFE AdministratorCertification.

You are now are now readyto proceed to Part 10 of 10.


initial rcfe administrator certification · family councils ab 1572 also created a law granting...

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