RCFE vs ARF in California, and "Residential Assisted Living"

The statute defines an RCFE as "a housing arrangement chosen voluntarily by persons 60 years of age or over, or their authorized representative" ^[1]. The next sentence covers younger residents: "Persons under 60 years of age with compatible needs may be allowed to be admitted or retained in a residential care facility for the elderly as specified in Section 1569.316." ^[1]

What § 1569.316 says. Subdivision (b): "In determining a person’s compatibility, the licensee shall consider criteria that includes, but is not limited to, both of the following: (1) The extent to which the person’s personal and health care needs can be adequately met in the residential care facility for the elderly. (2) The existence of a past history of violence or mental illness that would create a risk for the person or other residents of that facility." ^[2] The section has no minimum age and no share of younger residents.

What the regulation adds. Title 22 § 87101(r)(5) defines an RCFE as a housing arrangement "where 75 percent of the residents are sixty years of age or older and where varying levels of care and supervision are provided" ^[3]. It adds: "Any younger residents must have needs compatible with other residents." ^[3] The 75 percent figure is not in the statute. If a younger resident would change your mix, ask your licensing office how it reads the two texts together.

Two versions of the definition. Section 1569.2 prints the definition twice. Subdivision (o) "shall be operative only until the enactment of legislation implementing the three levels of care in residential care facilities for the elderly pursuant to Section 1569.70." Subdivision (p) "shall become operative upon the enactment of legislation implementing the three levels of care in residential care facilities for the elderly pursuant to Section 1569.70." Both carry the same under-60 sentence ^[1].

Section 1562.3 refers to "adult residential facilities, as defined in paragraph (1) of subdivision (a) of Section 1502" ^[11]. That paragraph reads: "“Residential facility” means any family home, group care facility, or similar facility determined by the department, for 24-hour nonmedical care of persons in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of the individual." ^[4] It names no age.

The age line is in Title 22. Section 80001(a)(5) says an ARF "provides 24-hour-a-day nonmedical care and supervision to the following: (A) persons 18 years of age through 59 years of age; and (B) persons 60 years of age and older only in accordance with Section 85068.4." ^[5]

The rule for residents 60 and older. Section 85068.4(b): "The licensee may admit or retain persons who are 60 years of age or older whose needs are compatible with those of other clients if they require the same level of care and supervision as the other clients in the facility and the licensee is able to meet their needs." ^[6] Subdivision (c) goes on: "When a licensee admits or retains any person 60 years of age or older, the licensee shall ensure that all of the following information is contained in the person's file: (1) Completed Functional Capabilities Assessment, required by Section 80069.2. (2) Completed Needs and Services Plan, required by Section 85068.2." ^[6] The list has more items after those two.

CDSS's own summary: ARFs serve "clients ages 18-59 or any person 60 years of age or older under specified requirements" ^[7].

Status: CDSS's facility-type lists show no license by that name.

• The adult list names eight types, from Adult Residential Facilities to Residential Care Facilities for the Chronically Ill ^[8].
• The senior list names two: Continuing Care Retirement Community and Residential Care Facility for the Elderly ^[9].
• The Centralized Applications Bureau takes applications for ten types, and none is called residential assisted living ^[7].

On these licensing pages, CDSS uses "assisted living" only as a common name for an RCFE: "Residential Care Facility for the Elderly are often referred to as assisted living facilities, or board and care homes." ^[7] If a listing or a seller uses the phrase for a California home, ask which CDSS license the home holds.

RCFE. Section 1569.616(a)(1): "An administrator of a residential care facility for the elderly shall successfully complete a department-approved administrator certification training program pursuant to subdivision (c) prior to employment." ^[10] Under (c)(1), the program "shall require a minimum of 80 hours of coursework, which shall include at least 60 hours of instruction conducive to learning, in which participants are able to simultaneously interact with each other, as well as with the instructor" ^[10]. Subdivision (b) covers "Individuals seeking exemptions under paragraph (2) of subdivision (a)", such as an administrator "who holds a valid license as a nursing home administrator" ^[10].

ARF. Section 1562.3(b)(1): "An administrator of an adult residential facility, as defined in paragraph (1) of subdivision (a) of Section 1502, shall successfully complete a department-approved administrator certification training program pursuant to subdivision (c) prior to employment." ^[11] Under (c)(1), the program "shall require a minimum of 35 hours of instruction conducive to learning, in which participants are able to simultaneously interact with each other as well as with the instructor" ^[11]. On the exam, (c)(3) says: "Unless an extension is granted to the applicant by the department, an applicant for an administrator’s certificate shall, within 60 days of the applicant’s completion of instruction, pass the examination provided in this section." ^[11]

Approved courses. CDSS keeps separate lists, "RCFE 80-Hour Initial Certification Training Program Vendors" and "ARF 35-Hour Initial Certification Training Program Vendors", on its Approved Vendors page. It warns: "Courses that do not have DSS approval will not be accepted by the ACB." ^[12]

Fees. The Administrator Certification Bureau's administrator certification fees are $140 for the initial application and $100 for the exam, with no split by facility type ^[13].

Section 1520.5 is in the Community Care Facilities Act. Subdivision (a): "the department shall deny an application for a new residential facility license if the department determines that the location is in a proximity to an existing residential facility that would result in overconcentration." ^[14] Subdivision (b) defines overconcentration: "if a new license is issued, there will be residential facilities that are separated by a distance of 300 feet or less, as measured from any point upon the outside walls of the structures housing those facilities. Based on special local needs and conditions, the department may approve a separation distance of less than 300 feet with the approval of the city or county in which the proposed facility will be located." ^[14]

Subdivision (c): "At least 45 days prior to approving any application for a new residential facility, the department, or county licensing agency, shall notify, in writing, the planning agency of the city, if the facility is to be located in the city, or the planning agency of the county, if the facility is to be located in an unincorporated area, of the proposed location of the facility." ^[14] Subdivision (d): "Any city or county may request denial of the license applied for on the basis of overconcentration of residential facilities." ^[14]

Which homes it names. Subdivision (f): "Foster family homes and residential facilities for the elderly shall not be considered in determining overconcentration of residential facilities, and license applications for those facilities shall not be denied upon the basis of overconcentration." ^[14] For ARFs, § 1562.3 refers to them "as defined in paragraph (1) of subdivision (a) of Section 1502," which is the paragraph that defines "Residential facility" ^[4][11].

What CDSS's application steps say. At the application review step, CDSS lists an "Overconcentration Notice to the County Zoning Department and/or Planning Commission (ARFs, SRF, RCFECI applications only)", citing § 1520.5 ^[18]. Ask CDSS how the rule applies to your address before you sign for a property.

Welfare and Institutions Code § 4648(a)(3)(A): "A regional center may, pursuant to vendorization or a contract, purchase services or supports for a consumer from an individual or agency that the regional center and consumer or, if appropriate, the consumer’s parents, legal guardian, or conservator, or authorized representatives, determines will best accomplish all or part of that consumer’s program plan." ^[15]

On payment, (a)(3)(D): "A regional center may reimburse an individual or agency for services or supports provided to a regional center consumer if the individual or agency has a rate of payment for vendored or contracted services established by the department, pursuant to this division, and is providing services pursuant to an emergency vendorization or has completed the vendorization procedures or has entered into a contract with the regional center and continues to comply with the vendorization or contracting requirements." ^[15]

Section 4681.1(a): "The department shall adopt regulations that specify rates for community care facilities serving persons with developmental disabilities. The implementation of the regulations shall be contingent upon an appropriation in the annual Budget Act for this purpose." ^[16] Subdivision (b) says the rate cost model "shall take into account factors that include, but are not limited to, all of the following", and the first is "Facility size, as defined by the department on the basis of the number of facility beds licensed by the State Department of Social Services and vendorized by the regional center." ^[16]

Section 4648 speaks of "a regional center consumer" ^[15]. The text does not say every ARF resident is one.