(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).