SECTIONS 14520-14522.4 - California Statutes

WELFARE AND INSTITUTIONS CODE

SECTION 14520-14522.4

14520. This chapter shall be known and may be cited as the Adult
Day Health Medi-Cal Law.

14521. It is the intent of the Legislature in enacting this chapter
to establish adult day health care as a Medi-Cal benefit and allow
persons eligible to receive the benefits under Chapter 7 (commencing
with Section 14000) of this part, and who have medical or psychiatric
impairments, to receive adult day health care services. It is the
intent of the Legislature in authorizing this Medi-Cal benefit to
establish and continue a community-based system of quality adult day
health care services that will accomplish all of the following:
(a) Ensure that elderly persons and adults with disabilities will
not be institutionalized prematurely and inappropriately.
(b) Provide appropriate health and social services designed to
maintain elderly persons in their own communities.
(c) Establish adult day health care centers in locations easily
accessible to persons who are economically disadvantaged.
(d) Encourage the establishment of rural alternative adult day
health care centers that are designed to make adult day health care
accessible to elderly persons and adults with disabilities living in
rural areas.

14521.1. (a) Effective January 1, 2007, the department shall report
annually to the relevant policy and fiscal committees of the
Legislature, as part of the budget submitted by the Governor to the
Legislature each January, on the implementation of changes made to
the adult day health care program by the act adding this section,
including the impact of those changes on the number of centers and
participants.
(b) Where a conflict exists between existing regulations and adult
day health care laws in effect on and after January 1, 2007, the
department shall, until new regulations are adopted, issue guidance
to adult day health care providers through provider bulletins to
clarify the adult day health care laws and regulations that are in
effect.

14522. Unless the context otherwise requires, the definitions
contained in Part 7 (commencing with Section 14000) of this part and
in Chapter 3.5 (commencing with Section 1570) of Division 2 of the
Health and Safety Code shall govern the construction of this chapter.

14522.3. The following definitions shall apply for the purposes of
this chapter:
(a) "Activities of daily living" (ADL) means activities performed
by the participant for essential living purposes, including bathing,
dressing, self-feeding, toileting, ambulation, and transferring.
(b) "Instrumental activities of daily living" (IADL) means
functions or tasks of independent living, including hygiene,
medication management, transportation, money management, shopping,
meal preparation, laundry, accessing resources, and housework.
(c) "Personal health care provider" means the participant's
personal physician, physician's assistant, or nurse practitioner,
operating within his or her scope of practice.
(d) "Care coordination" means the process of obtaining information
from, or providing information to, the participant, the participant'
s family, the participant's primary health care provider, or social
services agencies to facilitate the delivery of services designed to
meet the needs of the participant, as identified by one or more
members of the multidisciplinary team.
(e) "Facilitated participation" means an interaction to support a
participant's involvement in a group or individual activity, whether
or not the participant takes active part in the activity itself.
(f) "Group work" means a social work service in which a variety of
therapeutic methods are applied within a small group setting to
promote participants' self-expression and positive adaptation to
their environment.
(g) "Professional nursing" means services provided by a registered
nurse or licensed vocational nurse functioning within his or her
scope of practice.
(h) "Psychosocial" means a participant's psychological status in
relation to the participant's social and physical environment.

14522.4. (a) The following definitions shall apply for the purposes
of this chapter:
(1) "Activities of daily living (ADL)" means activities performed
by the participant for essential living purposes, including bathing,
dressing, self-feeding, toileting, ambulation, and transferring.
(2) "Instrumental activities of daily living (IADL)" means
functions or tasks of independent living limited to hygiene and
medication management.
(3) "Personal health care provider" means the participant's
personal physician, physician's assistant, or nurse practitioner,
operating within his or her scope of practice.
(4) "Care coordination" means the process of obtaining information
from, or providing information to, the participant, the participant'
s family, the participant's personal health care provider, or social
services agencies to facilitate the delivery of services designed to
meet the needs of the participant, as identified by one or more
members of the multidisciplinary team.
(5) "Facilitated participation" means an interaction to support a
participant's involvement in a group or individual activity, whether
or not the participant takes active part in the activity itself.
(6) "Group work" means a social work service in which a variety of
therapeutic methods are applied within a small group setting to
promote participants' self-expression and positive adaptation to
their environment.
(7) "Professional nursing" means services provided by a registered
nurse or licensed vocational nurse functioning within his or her
scope of practice.
(8) "Psychosocial" means a participant's psychological status in
relation to the participant's social and physical environment.
(9) "Assistance" means verbal or physical prompting or aid,
including cueing, supervision, stand-by assistance, or hands-on
support to complete the task correctly.
(10) "Substantial human assistance" means direct, hands-on
assistance provided by a qualified caregiver, which entails
physically helping the participant perform the essential elements of
the ADLs and IADLs. It entails more than cueing, supervision, or
stand-by assistance to perform the ADLs and IADLs. It also includes
the performance of the entire ADL or IADL for participants totally
dependent on human assistance.
(11) "Cognitive impairment" means the loss or deterioration of
intellectual capacity characterized by impairments in short- or
long-term memory, language, concentration and attention, orientation
to people, place, or time, visual-spatial abilities or executive
functions, or both, including, but not limited to, judgment,
reasoning, or the ability to inhibit behaviors that interfere with
social, occupational, or everyday functioning due to conditions,
including, but not limited to, mild cognitive impairment, Alzheimer's
disease or other form of dementia, or brain injury.
(b) Upon the date of execution of the declaration described under
subdivision (g) of Section 14525.1, this section shall become
operative and Section 14522.3 shall become inoperative and on that
date is repealed.