CHAPTER 8.7. Adult Day Health Care Programs
Heading of Chapter 8.7 renumbered from Chapter 8.5 (as added by Stats. 1977, Ch. 1066) by Stats. 1978, Ch. 429.
§§ 14520–14590 · 46 sections
ARTICLE 1. General Provisions §§ 14520–14522.4 · 6 sections
- § 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…
- § 14521.1 If 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…
- § 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…
- § 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…
- § 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…
ARTICLE 2. Eligibility, Participation, and Discharge §§ 14525–14530 · 10 sections
- § 14525 Any adult eligible for benefits under Chapter 7 (commencing with Section 14000) shall be eligible for adult day health care services if that person meets all…
- § 14525.1 (a) Except as provided in subdivisions (b) and (c), any adult eligible for benefits under Chapter 7 (commencing with Section 14000) shall be eligible for adult…
- § 14526 Participation in an adult day health care program shall require prior authorization by the department. The authorization request shall be initiated by the…
- § 14526.1 (a) Initial and subsequent treatment authorization requests may be granted for up to six calendar months. (b) Treatment authorization requests shall be…
- § 14526.2 (a) Initial and subsequent treatment authorization requests may be granted for up to six calendar months, initial and subsequent treatment authorization…
- § 14527 Participation in an adult day health care program shall be voluntary. The participant may end the participation at any time. However, an adult day health…
- § 14528 Before acceptance into the program, all adult day health providers shall conduct a multidisciplinary assessment directed towards ascertaining the individual’s…
- § 14528.1 (a) The personal health care provider, as defined in Section 14552.3, shall have and retain responsibility for the participant’s medical care. (b) If the…
- § 14529 (a) The multidisciplinary health team conducting an assessment shall consist of at least the individual’s personal physician or a staff physician, or both, a…
- § 14530 (a) Individual plans of care shall be submitted to the department. Services for each participant shall be provided as specified in the individual plan of care…
ARTICLE 3. Services and Standards §§ 14550–14555 · 11 sections
- § 14550 Adult day health care centers shall offer, and shall provide directly on the premises, at least the following services: (a) Rehabilitation services, including…
- § 14550.5 Adult day health care centers shall offer, and provide directly on the premises, in accordance with the participant’s individual plan of care, and subject to…
- § 14550.6 Adult day health care centers shall offer, and provide directly on the premises, in accordance with the participant’s individual plan of care, and subject to…
- § 14551 The following additional services may also be provided: (a) Podiatric services provided or arranged for, or under direction of, the supervising physician. (b)…
- § 14552 In order to obtain certification as a provider of adult day health care under this chapter and Chapter 7 (commencing with Section 14000), the following…
- § 14552.2 (a) “Program plan” means a written description of the adult day health care center’s philosophy, objectives, and processes for providing required services to…
- § 14552.5 Pursuant to Section 14043.46, the department may implement a one-year moratorium on the certification and enrollment into the Medi-Cal program of new adult day…
- § 14553 An adult day health care provider shall establish written policies and procedures, which shall have prior approval of the department, unless otherwise…
- § 14553.1 The adult day health care center’s policies and procedures shall include provisions for the following: (a) Designating the staff who will serve in the required…
- § 14554 The adult day health care provider shall maintain a complete standard medical record for each participant, including records of treatment rendered by a…
- § 14555 Each adult day health care provider shall establish a grievance procedure under which participants may submit their grievances. Such procedure shall be…
ARTICLE 4. Administration §§ 14570–14577 · 12 sections
- § 14570 (a) The department shall adopt all necessary rules and regulations providing for quality of care and payment for services rendered under this chapter pursuant…
- § 14571 The department, in consultation with the California Association for Adult Day Services, shall develop a rate methodology. The methodology shall take into…
- § 14571.1 The Legislature finds and declares all of the following: (a) Adult day health care is a necessary component in achieving an integrated home- and…
- § 14571.2 (a) Subject to the provisions of this section, the department shall establish, effective August 1, 2012, a reimbursement methodology and a reimbursement limit…
- § 14571.5 Federally qualified health centers shall be reimbursed on a prospective payment system rate basis pursuant to Section 14132.100 for the provision of adult day…
- § 14572 (a) No Medi-Cal reimbursement shall be made for a service rendered by an adult day health care provider that does not have a license as an adult day health…
- § 14573 (a) Initial Medi-Cal certification for adult day health care providers shall expire 12 months from the date of issuance. The director shall specify any date he…
- § 14574 (a) The director shall terminate the Medi-Cal certification of any adult day health care provider at any time if he or she finds the provider is not in…
- § 14574.1 (a) Every adult day health care center shall be periodically inspected and evaluated for quality of care by a representative or representatives designated by…
- § 14575 Each adult day health care provider shall maintain a uniform accounting and reporting system as developed by the department, in consultation with the provider.…
- § 14576 Each adult day health care provider shall furnish to the department, unless otherwise specified by the interagency agreement entered into pursuant to Section…
- § 14577 All subcontracts for services reimbursable under this chapter shall be entered into pursuant to regulations of the department. All subcontracts shall be in…
ARTICLE 5. Conflict of Interest §§ 14585–14588 · 4 sections
- § 14585 For purposes of this article, “state officer or employee” means a Member of Congress representing the State of California; a Member of the Legislature; a…
- § 14586 No Medi-Cal certification for an adult day health center shall be approved or renewed pursuant to this chapter if a state officer or employee, or the spouse or…
- § 14587 No Medi-Cal certification for an adult day health center shall be approved or renewed if any state officer or employee has a direct financial interest in such…
- § 14588 No Medi-Cal certification for an adult day health center shall be approved or renewed if a state officer or employee, or the spouse or a minor child of a state…
ARTICLE 6. Cessation of Adult Day Health Care and Assistance with Transition from Adult Day Health Care Services to Other Services §§ 14589–14590 · 3 sections
- § 14589 (a) The Legislature finds and declares the following: (1) During times of economic crisis, it is crucial to find areas within the program where efficiencies…
- § 14589.5 (a) Notwithstanding any other provision of law related to the Medi-Cal program or to adult day health care, adult day health care is excluded from coverage…
- § 14590 (a) As a result of the enactment of this article to eliminate adult day health care as an optional benefit under the Medi-Cal program, the department shall…