Introduction

Family Councils: Avenues for Change

The Law

California’s Family Council bill, Health & Safety Code §1418.4, went into effect on January 1, 1989, and was amended by SB 1551 (Dunn), which was signed by the Governor and became effective January 1, 2000. California’s family council law now provides the following:

• Defines "Family Council" as a meeting of family members, friends or repesentatives of two or more residents to confer in private without facility staff.
• No facility may prohibit the formation of a family council when requested by a member of the resident’s family or the resident’s representative.

Family Council Rights:

• The family council shall be allowed to meet in a common meeting room of the facility at least once a month during mutually agreed upon hours.
• Facilities shall in no way limit the right of residents, family members and family council members to meet independently with outside persons or with facility personnel.
• Staff or visitors may attend family council meetings at the group’s invitation.

Facility Obligations to Family Council:

• The facility shall provide a designated staff person who shall be responsible for providing assistance and responding to written requests that result from family council meetings.
• The facility shall consider the views and act upon the grievances and recommendations of a family council concerning proposed policy and operational decisions affecting resident care and life in the facility.
• The facility shall respond in writing to written requests or concerns of the family council within 10 days.
• Family councils shall be provided adequate space on a prominent bulletin board or other posting area for the display of notices, minutes, newsletters, or other information pertaining to the operation or interest of the family council.
• When a family council exists, the facility shall include notice of the meetings in quarterly mailings and shall inform family members, friends and representatives of new residents of the time,place and date of the meetings.

Penalties for Interference:

• No facility shall willfully interfere with the formation, maintenance or promotion of a family council. "Willful interference" includes discrimination, retaliation or the willful scheduling of facility events in conflict with a previously scheduled family council meeting.
• Violation of these laws can result in a citation and penalty up to $1,000. California’s new family council provisions are based on the federal OBRA regulations, found at 42 CFr §483.15(c). These state and federal laws give families and friends of residents a unique opportunity to effect change.

What are Family Councils?

Family Councils are not merely "gripe" sessions. While the primary purpose of a family council is for families, as a group, to influence the quality of care for the residents, they also offer a forum to enhance communications with the facility staff and offer peer support for the relatives and friends of residents.

Whatever affects the residents’ lives is a proper concern of the family council, whether it’s the atmosphere of the facility, the role of the medical director, the day–to–day care or the activity program.

An effective family council will provide an opportunity for the members to meet without facility staff (and thus, without fear of retaliation), share concerns, and submit the group’s concerns in writing to the administrator. The council should request that appropriate action be taken and follow up the request to ensure that such action was taken.

Working Together for Prevention of Problems

Too often, nursing home and residents’ representatives attempt to resolve resident problems individually rather than working to prevent the problems in the first place. Too often, this one–to–one approach, because of fear of retaliation, prevents residents and their representatives from lodging legitimate complaints and asserting their rights.