CALIFORNIA CODE OF REGULATIONS - State of California

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Page 661 TITLE 22. DIVISION 5 — LICENSING & CERTIFICATION OF HEALTH FACILITIES § 77117 These agreements and/or contracts shall be readily available for inspection and review by the Department. The agreements and/or contracts shall include, but not be limited to, a description of the services to be provided, the financial arrangements, the methods by which the services are to be provided, and the conditions upon which the agreement or contract can be terminated. (c) The governing body shall be responsible and accountable for all services provided by agreements and/or contracts. NOTE: Authority cited: Sections 208(a) and 1275, Health and Safety Code. Reference: Section 1275.1, Health and Safety Code. § 77111. Nondiscrimination Policies. (a) No facility that receives any financial assistance from the State of California shall discriminate against or deny admission to any person, otherwise qualified, based on sex, age, race, color, religion, ancestry or national origin, or physical or mental handicap. Facility policies shall so state and apply to the appointment of the treatment staff, hiring of facility employees and the admission, housing and treatment of patients. While a facility may not discriminate against any group identified in this section, the facility may not admit a minor for whom it cannot provide protection from adult patients, appropriate treatment and educational services when applicable. No facility may admit a minor into the same treatment ward with adults as defined in Section 5751.7, Welfare and Institutions Code. (b) Any bona fide nonprofit religious, fraternal or charitable organization, which can demonstrate to the satisfaction of the Department that its primary or substantial purpose is not to evade this section, may establish admission policies limiting or giving preference to its own members or adherents. Such policies shall not be construed as a violation of (a) above. Any admission of nonmembers or nonadherents shall be subject to (a) above. (c) Facilities shall comply with the Americans with Disabilities Act (ADA), Public Law 101–336 of 1990 (42 U.S.C. §12101 et seq.) which guarantees equal opportunity for persons with disabilities. NOTE: Authority cited: Section 1275, Health and Safety Code. Reference: Sections 1270 and 1275.1, Health and Safety Code; and Section 5751.7, Welfare and Institutions Code. § 77113. Admission Policies. (a) Each facility shall have and implement written admission and discharge policies encompassing which licensed health professionals may admit patients, the types of diagnoses for which patients may be admitted, limitations imposed by law or licensure, staffing limitations, rules governing emergency admissions, policies concerning advance deposits, rates of charge for care, charges for extra services, limitations of services, termination of services, refund policies, insurance agreements and other financial considerations, discharge of patients and other relevant functions. These policies shall be made available to patients or their agents upon admission and upon request, and shall be made available to the public upon request. (1) Only persons diagnosed with major mental disorders are to be treated in psychiatric health facilities. (2) Psychiatric health facilities shall not admit and treat patients with the primary diagnosis of an eating disorder as defined in Section 1254.5(b) of the California Health and Safety Code. (3) Psychiatric health facilities shall not admit and treat patients when the primary diagnosis is chemical dependency, chemical intoxication or chemical withdrawal. (4) Individuals with major mental disorders shall not be admitted to a psychiatric health facility if their treatment requires medical interventions beyond the level appropriate to a psychiatric health facility, including: (A) detoxification from substance abuse, (B) treatment for substance induced delirium. (b) A facility shall accept and retain only those patients for whom it can provide adequate care, including but not limited to the provisions of Section 77135. (c) A minor shall not be detained in a facility against the will of his or her parent or legal guardian. In those cases where law permits minors to contract for or consent to the type of medical care provided by the facility, without the consent of their parent or guardian, they shall not be detained in the facility against their will. This provision shall not be construed to preclude or prohibit attempts to persuade patients to remain in the facility in their own interest, nor the temporary detention of patients for the protection of themselves or others under the provisions of the Lanterman–Petris–Short Act (Welfare and Institutions Code, Section 5000 et seq.), if the facility has been designated by the county as a treatment facility pursuant to said act, nor to prohibit minors legally capable of contracting for or consenting to medical care from assuming responsibility for their discharge. (d) Within 24 hours after admission or immediately before admission, every patient shall have a complete history and physical examination unless a history and physical examination has been completed within the previous 30 days and is determined by the attending physician to be current. (e) No inpatient shall be transferred or discharged for purposes of effecting a transfer, from a facility to another facility, unless arrangements have been made in advance for admission to such health facility and the person legally responsible for the patient has been notified or, in the case of an emergency, documented attempts to contact such person have been made and a responsible person cannot be reached. A transfer or discharge shall not be carried out if in the opinion of the clinical director such transfer or discharge would be contraindicated, unless there exists no legal basis to do so. This section shall not be construed to prohibit the transfer or discharge of a patient pursuant to court orders. (f) There shall be a method of prompt and accurate identification of each patient admitted to the facility. NOTE: Authority cited: Section 1275, Health and Safety Code; and Section 4080(f)(1), Welfare and Institutions Code. Reference: Section 1275.1, Health and Safety Code; and Section 4080(f)(1), Welfare and Institutions Code. § 77115. Written Administrative Policies. (a) Written administrative policies and procedures for services provided shall be developed and implemented by appropriate staff members. These policies and procedures shall be reviewed and approved at least annually by the clinical director and administrator. (b) The facility shall have policies and procedures for the provision of first aid and life saving measures that shall be implemented in emergency situations. (c) The facility shall have a policy which shall ensure the obtaining of the patient’s written consent prior to photographing that patient. (d) Each facility shall adopt and implement written policies and procedures to properly manage outbreaks or prevalence of infectious and communicable disease whether or not such disease is required to be reported by Title 17, California Administrative Code, Section 2500. NOTE: Authority cited: Sections 208(a) and 1275, Health and Safety Code. Reference: Section 1275.1, Health and Safety Code. § 77117. Personnel Policies. (a) Each facility shall adopt and implement written personnel policies concerning qualifications, responsibilities and conditions of employment for each classification employed which shall be available to all personnel. Such policies shall include but not be limited to: (1) Hours of work. (2) A plan for orientation for all new staff members that shall ensure that all new staff providing program services shall receive at least 20 hours of orientation and training within 60 days of employment. Staff attendance shall be documented. Initial training shall include, but not be limited to, the following: (A) Orientation to all policies, procedures and objectives of the facility.
§ 77119 CALIFORNIA CODE OF REGULATIONS Page 662 (B) Orientation to special needs of the mentally disordered. (C) Orientation to overall concepts of programs to meet the special needs of the mentally disordered. (D) Orientation and training in specific program techniques being used in the facility to meet the identified program needs of the patients. (3) A plan for at least annual evaluation of employee performance. (4) A plan to conduct a background investigation, including previous employment and criminal background information, on prospective employees. (b) The facility shall provide for a continuing inservice education program designed to improve patient care and employee efficiency. This training shall include, but not be limited to, suicide prevention techniques, management of assaultive behavior techniques and cardiopulmonary resuscitation (CPR). All staff members shall attend and attendance shall be documented. Continuing inservice education shall be provided by the facility or obtained by the staff at an annual rate of 48–hours for full time staff. Part time staff accrual rates shall be prorated to be consistent with their part–time status. (c) Personnel policies shall require that employees and other persons working in or for the facility familiarize themselves with these regulations and such other regulations as are applicable to their duties. (d) The facility shall recruit qualified personnel. Mental health workers shall work under the direct supervision of qualified mental health professionals. (e) If language or communication barriers exist between facility staff and patients, arrangements shall be made for interpreters or for the use of other means to ensure adequate communications between patients and personnel. (f) All personnel shall wash their hands before and after coming in direct contact with any linen or food. NOTE: Authority cited: Section 1275, Health and Safety Code. Reference: Section 1275.1, Health and Safety Code. § 77119. Employee Personnel Records. (a) All facilities shall maintain personnel records of all employees. Such records shall be retained for at least three years following termination of employment. (b) The record shall include the employee’s full name, Social Security number, the license of registration number, if any, brief resume of experience, employment classification, date of beginning employment and date of termination of employment. (c) Records of hours and dates worked by all employees during at least the most recent six–month period shall be kept on file at the place of employment. NOTE: Authority cited: Sections 208(a) and 1275, Health and Safety Code. Reference: Section 1275.1, Health and Safety Code. § 77121. Employee Health Examinations and Health Records. (a) A health examination, performed by a person lawfully authorized to perform such an examination shall be performed as a prerequisite for employment within six months prior to employment or within one week after employment. Written examination reports, signed by the person performing the examination, shall verify that employees are able to perform assigned duties and do not have any health condition that would create a hazard for the employee, fellow employees, patients or visitors. (b) The initial health examination shall include a tuberculosis screening test consisting of a purified protein derivative intermediate strength intradermal skin test and a chest X–ray if the skin test is positive. The facility shall establish a policy regarding subsequent health examinations and tuberculosis screening test based on an assessment of the following: (1) The risk of a previously infected person developing tuberculosis and then possibly infecting others. (2) The risk of a non–infected person becoming infected and developing a disease. (c) The facility shall develop policies which ensure that reasonable precautions are taken to prevent the spread of infectious disease between persons within the facility. (d) Employee health records shall be maintained by the facility and shall include the records of all required health examinations. Such records shall be kept a minimum of three years following terminations of employment. NOTE: Authority cited: Sections 208(a) and 1275, Health and Safety Code. Reference: Section 1275.1, Health and Safety Code. § 77123. Equipment and Supplies. Equipment and supplies adequate in quality and quantity shall be available as necessary to provide patient services related to the scope and nature of the services offered. NOTE: Authority cited: Sections 208(a) and 1275, Health and Safety Code. Reference: Section 1275.1, Health and Safety Code. § 77125. Advertising. (a) No facility shall make or disseminate any false or misleading statement, or advertise by any manner or means any false or misleading claims regarding services provided by the facility. (b) No facility shall allow false or misleading claims regarding services provided by the facility to be made by a third party or entity on behalf of the facility. (c) No facility shall allow the use of its name or logo to be used in advertising by third parties. NOTE: Authority cited: Section 1275, Health and Safety Code. Reference: Section 1275.1, Health and Safety Code. § 77127. Records and Reports. (a) Each facility shall maintain copies of the following applicable documents on file in the facility. (1) Articles of incorporation or partnership agreement. (2) Bylaws and rules and regulations of the governing body. (3) Bylaws and rules and regulations of all staff including medical, professional and other staff. (4) Minutes of the meetings of the governing body, medical and professional staff. (5) Reports of inspections by local, state and federal agencies. (6) All contracts, leases and other agreements required by these regulations. (7) Patient admission roster. (8) Reports of unusual occurrences for the preceding three years. (9) Personnel records, including credential files. (10) Policy manuals. (11) Procedure manuals. (12) Any other records deemed necessary by the Department for the direct enforcement of these regulations. (b) The records and reports specified above shall be made available for inspecting by any duly authorized officer, employee or agent of the Department. NOTE: Authority cited: Sections 208(a) and 1275, Health and Safety Code. Reference: Section 1275.1, Health and Safety Code. § 77129. Fire and Internal Disasters. (a) A written fire and internal disaster program, incorporating evacuation procedures, shall be developed with the assistance of local fire, safety and other appropriate experts. A copy of the program shall be available on the premises for review by the Department. (b) The written program shall be implemented in the event of a fire or internal disaster and shall include but not be limited to the following: (1) Plans for the assignment of personnel to specific tasks and responsibilities. (2) Instructions relating to the use of alarm systems and signals. (3) Information concerning methods of fire containment. (4) Systems for notification of appropriate persons. (5) Information concerning the location of fire fighting equipment. (6) Identification of evacuation routes and procedures.
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