BILL ANALYSIS                                                                                                                                                                                                    






                                 SENATE HEALTH
                               COMMITTEE ANALYSIS
                        Senator Elaine K Alquist, Chair


          BILL NO:       AB 2555                                      
          A
          AUTHOR:        Feuer, Jones & Neilsen                       
          B
          AMENDED:       May 28, 2010
          HEARING DATE:  June 16, 2010                                
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          CONSULTANT:                                                 
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          Bain                                                        
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                                     SUBJECT
                                         
                       Ombudsman programs:  appropriation

                                     SUMMARY  

          Appropriates $1.6 million from the State Health Facilities  
          Citation Penalties Account (State Account) to the  
          California Department of Aging (CDA) for local ombudsman  
          programs.  Takes effect immediately as an urgency statute.

                             CHANGES TO EXISTING LAW  

          Existing law:
          Under existing law, long-term health care facilities are  
          defined to include skilled nursing facilities, intermediate  
          care facilities, congregate living facilities, nursing  
          facilities, and pediatric day health and respite  
          facilities.  Existing law requires the Department of Public  
          Health (DPH) to inspect and license health facilities.   
          Under existing law, the Long-Term Care, Health, Safety, and  
          Security Act of 1973, DPH can assess penalties for  
          violations of prescribed state and federal requirements.

          Money collected as a result of state and federal civil  
          penalties imposed under the existing state Long-Term Care,  
                                                         Continued---



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          Health, Safety, and Security Act of 1973, or federal law,  
          must be deposited into the State Health Facilities Citation  
          Penalties Account (State Account), which contains money  
          collected from violations of state law, or the Federal  
          Health Facilities Citation Penalties Account (Federal  
          Account), which contains money collected from violations of  
          federal law.

          Existing law establishes the California State Long-Term  
          Care Ombudsman Program within CDA, and requires the Office  
          of the state Long-Term Care Ombudsman to investigate and  
          seek to resolve complaints and concerns communicated by, or  
          on behalf of, patients, residents, or clients of any  
          long-term care (LTC) facility (nursing facility, skilled  
          nursing facility or residential care facilities for the  
          elderly).  Existing state law sets forth a distribution  
          formula by which CDA must allocate federal and state funds  
          for local ombudsman programs.
          This bill:
          This bill would appropriate $1.6 million from the State  
          Account to CDA for use in funding local ombudsman programs  
          under the existing distribution schedule.  This bill would  
          authorize these funds to be used for this purpose through  
          the end of the 2010-11 fiscal year, at which time remaining  
          unencumbered funds would be required to revert to the State  
          Account.  The provisions of this bill would take immediate  
          effect as an urgency statute.
                                         
                                 FISCAL IMPACT  

          According to the Assembly Appropriations Committee  
          analysis, AB 2555 would result in a one-time $1.6 million  
          special fund appropriation from the State Account to CDA to  
          support local ombudsman programs.  This bill makes funds  
          available for expenditure through 2010-11.  Any unspent  
          funds at the end of the 2010-11 revert to the original  
          State Account. 
                                         
                           BACKGROUND AND DISCUSSION  

          According to the author, this bill ensures that Long Term  
          Care Ombudsman programs continue to have adequate funding  
          for the 2010-11 fiscal year, by appropriating $1.6 million  
          from the  State  Account, which is funded with state civil  
          penalties issued against long-term health care facilities.   




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          Last year, the Governor signed into law AB 392 (Feuer &  
          Jones), which restored $1.6 million in funding for this  
          important program for the 2009-10 fiscal year using revenue  
          from the  Federal  Account.  The Federal Account is funded  
          with federal civil penalties issued against long-term  
          health care facilities.  The author states that funding  
          provided by AB 392 has nearly run out.

          The author argues local ombudsman programs protect  
          vulnerable residents of nursing homes and assisted living  
          facilities from abuse and neglect through unannounced  
          monitoring visits and investigations of thousands of abuse  
          cases reported to them each year.  In contrast to  
          government agencies, which may only review facilities  
          annually (or less), the author argues ombudsman programs  
          serve as the front line in the provision of immediate  
          investigative services for isolated and frail residents.   
          The author states there is no other program or agency that  
          duplicates this critical advocacy service, and these  
          cost-effective programs can significantly improve  
          residents' quality of life and quality of care.  Finally,  
          the author concludes that the use of penalty funds for  
          ombudsman programs has been approved by the federal Centers  
          for Medicare and Medicaid Services.

          Long-Term Care Ombudsman Programs
          According to CDA, the primary responsibility of the  
          ombudsman program is to investigate and endeavor to resolve  
          complaints made by, or on behalf of, individual residents  
          in LTC facilities.  CDA indicates the Office of the State  
          Long-Term Care Ombudsman develops policy and provides  
          oversight to the local Long-Term Care Ombudsman Programs,  
          confers with state licensing agencies regarding difficult  
          cases, meets with the CDA legal counsel to clarify laws and  
          develop plans for implementing them, defines program roles,  
          and provides ongoing statewide ombudsman training.   
          Residents or their family members can file a complaint  
          directly with the local Long-Term Care Ombudsman or by  
          calling a statewide toll-free telephone line. 

          CDA indicates the local Long-Term Care Ombudsman Program is  
          a community-supported program.  Volunteers are an integral  
          part of this program.  The Office of the State Long-Term  
          Care Ombudsman and its 35 local ombudsman program  
          coordinators are responsible for recruiting, training, and  




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          supervising the volunteer ombudsman representatives.

          Ombudsman budget
          The Governor's May Revise proposes $4.1 million in local  
          assistance funding for the Long-Term Care Ombudsman  
          Program.  As part of the May Revision, the Governor's  
          budget proposes to shift $680,000 in General Fund spending  
          from the Department of Public Health (DPH) to CDA.
           
           ---------------------------------------------------------- 
          |               |  2007/08  |2008/09 | 2009/10  |   May    |
          |               |           |        |          | Revision |
          |               |           |        |          | Proposal |
          |               |           |        |          | 2010/11  |
          |---------------+-----------+--------+----------+----------|
          |General Fund   | $3,822,000|      $0|        $0|  $680,000|
          |---------------+-----------+--------+----------+----------|
          |Federal Older  | $2,726,000|$2,726,0|$2,726,000|$2,726,000|
          |Americans Act  |           |      00|          |          |
          |Funds          |           |        |          |          |
          |---------------+-----------+--------+----------+----------|
          |Federal        | $1,442,000|$1,442,0|$3,042,000|  $762,000|
          |Account        |           |      00|          |          |
          |---------------+-----------+--------+----------+----------|
          |Total Funding  | $7,990,000|$4,168,0|$5,768,000|$4,168,000|
          |               |           |      00|          |          |
           ---------------------------------------------------------- 


          The Federal Account is not expected to be able to fund the  
          ombudsman program at budgeted levels in 2009-10.  As a  
          result, the Administration recently received increased  
          reimbursement authority which allows CDA to use up to  
          $700,000 in General Fund revenue from operational savings  
          within DPH to fund the anticipated Federal Account  
          shortfall in the current year.

          According to DPH, the estimated fund balance of the State  
          Account is projected to be $4.5 million at the end of  
          2009-2010 fiscal year.  Current law caps the balance in the  
          State Account, at any time, at $10 million.

          For the budget year, the Assembly Budget Committee adopted  
          placeholder trailer bill language to fund the ombudsman  
          program using revenue from a Quality Assurance Fee imposed  




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          on skilled nursing facilities.  The Senate Budget Committee  
          also adopted placeholder trailer bill language to send the  
          issue to the full Budget Conference Committee.

          State and federal penalty accounts
          Under existing law, funds in the State Account and the  
          Federal Account must be used, upon appropriation by the  
          Legislature, in accordance with state and federal law for  
          the protection of health or property of residents of LTC  
          facilities, including, but not limited to, the following:

           Relocation expenses incurred by DPH, in the event of a  
            facility closure;
           Maintenance of facility operation pending correction of  
            deficiencies or closure, such as temporary management or  
            receivership, in the event that the revenues of the  
            facility are insufficient;
           Reimbursing residents for personal funds lost; and,
           The costs associated with informational meetings required  
            if DPH proceeds with a receivership petition.
          
          Audit of Citation Penalty Accounts
          In January 2010, several legislators requested an audit of  
          the Federal and State Accounts maintained by DPH for the  
          protection of vulnerable nursing home residents.  That  
          audit was approved by the Joint Legislative Audit  
          Committee, and the results are expected this month.  The  
          audit is expected to review the revenues and expenditures  
          from the two accounts since 2003, as well as the reasons  
          DPH is not fully collecting the fines owed, in the hope  
          that the Legislature can determine the level of funds that  
          exist in the accounts and the ability of the accounts to  
          fund programs that protect nursing home residents,  
          including ombudsman programs.
          
          Arguments in support
          Supporters of this bill include senior, and nursing home  
          advocacy groups, which argue this bill preserves critical  
          oversight services for long-term care facility residents by  
          appropriating $1.6 million from the State Account to help  
          fund long-term care ombudsman services to residents of  
          nursing homes and assisted living facilities. 
          Supporters argue it is urgent that these funds be  
          appropriated now to prevent further damage to long-term  
          care ombudsman services, and that ombudsmen staff and  




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          volunteers play a critical role in identifying,  
          investigating and reporting abuse and neglect.  Supporters  
          argue ombudsman programs' ability to respond was severely  
          compromised in 2008 when the Governor vetoed $3.8 million  
          in General Fund support for the local long-term care  
          ombudsman programs, representing about half of their  
          funding.  Supporters further state that, in 2009, the  
          Legislature passed AB 392, which appropriated $1.6 million  
          from the Federal Account to partially restore the funds  
          cut, and that this bill would continue the funding  
          established by AB 392 using funds in the State Account.   
          Finally, supporters argue there are sufficient funds in the  
          State Account for this bill, and that this bill is a  
          short-term measure that is desperately needed to keep the  
          long-term care ombudsman programs in operation until a  
          longer term funding source is established.

          Arguments in opposition
          Aging Services of California (ASC) writes in opposition  
          that, while they recognizes the need for and support a  
          robust, long-term care ombudsman program, this bill  
          continues to raid funds from penalty accounts needed to  
          protect the health and property of residents in problem  
          facilities.  ASC argues the state must meet its obligation  
          to long-term care residents through the usual appropriation  
          process for the ombudsman program.

          The California Association of Health Facilities (CAHF) and  
          Crestwood Behavioral Health, Inc. (Crestwood) also write in  
          opposition that money in the State Account should be  
          available by DPH to protect residents in problem  
          facilities, that this is not a sustainable source to fund  
          another agency's program, and that by funding ombudsman  
          programs through this source, the state is encouraging the  
          wrong behavior by giving the ombudsman program a stake in  
          making sure there is funding in the State Account to  
          support their program.  Both CAHF and Crestwood suggest  
          that, instead of the transfer of $1.6 million from the  
          State Account to the ombudsman program, proponents could  
          direct that any funds in excess of the $10 million cap on  
          the State Account go toward funding the ombudsman program.

          The California Department of Public Health (DPH) writes in  
          opposition this bill does not provide a solution to the  
          on-going problem of funding for the ombudsman program, and  




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          without a more comprehensive solution, this program is  
          likely to continue to face funding shortages in future  
          years.  DPH also argues these penalty accounts cannot  
          sustain a repeated diversion of funds and remain solvent  
          for its intended purposes.

          Related legislation
          AB 392 (Feuer), Chapter 102, Statutes of 2009, appropriated  
          $1.6 million from the Federal Account to CDA for local  
          ombudsman programs.  
          
          AB 935 (Feuer) would have required at least one-half of the  
          funds in the State Account and the Federal Account to be  
          used to fund local ombudsman programs using the funding  
          distribution schedule in existing law.  AB 935 was held on  
          the Assembly Appropriations suspense file.

                                  PRIOR ACTIONS

           Assembly Aging and Long Term Care: 4-0  
          Assembly Appropriations:                          17-0
          Assembly Floor:                           76-0

                                    POSITIONS

                                         
          Support:   AARP (co-sponsor)
                 Bet Tzedek Legal Services (co-sponsor)
                 California Advocates for Nursing Home Reform  
          (co-sponsor)
                            Ombudsman Services of Northern California  
          (co-sponsor)
                 Alzheimer's Association
                 Area 4 Agency on Aging
                 California Alliance for Retired Americans 
                 California Commission on Aging
                 California Senior Legislature
                 California State Association of Counties
                 Catholic Charities of California United
                 Congress of California Seniors
                 Council on Aging - Orange County     
                 County of Los Angeles Board of Supervisors
                 Long -Term Care Ombudsman Program for Santa Cruz and  
                 San Benito      
                   Counties




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                     Long Term Care Services of Ventura County
                            Ombudsman & HICAP Services of Northern  
          California 
                 Ombudsman Services of San Mateo County, Inc.
                 Ombudsman Services of Northern California - Shasta  
                 Region
                 The Arc of California 
                 Regional Council of Rural Counties
                 Senior Advocacy Services
                 Sonoma County Area Agency on Aging Advisory Council
                 Ventura County Board of Supervisors
                 WISE & Healthy Aging
                 Several individuals

          Oppose:    Aging Services of California
                 California Association of Health Facilities
                 California Department of Public Health
                 Crestwood Behavioral Health, Inc.
                 University of California, San Diego, Linguistics  
          Language Program



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