BILL ANALYSIS                                                                                                                                                                                                    Ó






                                  SENATE HUMAN
                               SERVICES COMMITTEE
                            Senator Carol Liu, Chair


          BILL NO:       AB 40                                       
          A
          AUTHOR:        Yamada                                      
          B
          VERSION:       March 21, 2011
          HEARING DATE:  June 14, 2011                               
          4
          REFERRAL:      Banking & Financial Institutions; 
          Appropriations 0
                                                                     
          CONSULTANT:                                                
          Park
                                        

                                     SUBJECT
                                         
                             Elder abuse reporting

                                     SUMMARY  

          Requires mandated reporters of elder or dependent adult 
          abuse to report suspected or known instances of elder or 
          dependent adult abuse, which is believed to have occurred 
          in a long-term care facility, to both the Long-Term Care 
          Ombudsman (LTCO) and local law enforcement.  Also requires 
          mandated reporters of suspected financial abuse of an elder 
          or dependent adult to report known or suspected instances 
          of financial abuse against an individual living in a 
          long-term care facility, to both the LTCO and local law 
          enforcement.  Current law requires mandated reporters of 
          elder and dependent adult abuse to report to either the 
          LTCO or local law enforcement.

                                     ABSTRACT  

          Existing law:
          1.Under the Elder and Dependent Adult Civil Protection Act 
            (EADACPA), requires any mandated reporter Ýdefined as 
            any person who has assumed the care or custody of an 
            elder or dependent adult (compensated or not), including 
            administrators, supervisors, or licensed staff of a 
                                                         Continued---



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            public or private facility that provides care to elder 
            or dependent adults, elder or dependent adult care 
            custodian, health practitioner, clergy member, employee 
            of county adult protective services, or a local law 
            enforcement agency] who, within the scope of his or her 
            employment or professional capacity, observes or has 
            knowledge of physical abuse, abandonment, abduction, 
            isolation, financial abuse, or neglect, or is told by an 
            elder or dependent adult, as defined, that he or she has 
            experienced abuse above, or reasonably suspects abuse, 
            to report the known or suspected abuse, to appropriate 
            parties, as specified below.

             a.   For abuse that has occurred in a long-term care 
               facility, except a state developmental center or 
               state mental health hospital, requires the mandated 
               reporter to make a report to the local ombudsperson 
               or the local law enforcement agency.
             b.   For suspected or alleged abuse occurring in a 
               state mental hospital or state developmental center, 
               requires the report to be made to the Department of 
               Mental Health or the Department of Developmental 
               Services, or to the local law enforcement agency.
             c.   For abuse that occurs any place other than what is 
               described above, requires the report to be made to 
               the adult protective services agency or the local law 
               enforcement agency.

          1.Requires the local ombudsperson or the local law 
            enforcement agency to, as soon as practicable, except 
            immediately in the case of an emergency, report known or 
            suspected abuse to the appropriate state departments 
            (Department of Public Health, Department of Social 
            Services, and the Department of Aging) with regulatory 
            oversight for the type of long-term care facility, as 
            specified.  Also requires the local ombudsperson or 
            local law enforcement agency to make reports to the 
            Bureau of Medi-Cal Fraud and Elder Abuse any case of 
            known or suspected criminal authority, and all cases of 
            known or suspected physical abuse and financial abuse to 
            the local district attorney's office in the county where 
            the abuse occurred.

          2.Separately, requires any mandated reporter of suspected 
            financial abuse of an elder or dependent adult, defined 




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            as all officers and employees of financial institutions, 
            under prescribed circumstances, to report known or 
            suspected instance of financial abuse, as defined, to 
            the local adult protective services agency or local law 
            enforcement agency.  If the mandated reporter knows that 
            the elder or dependent adult resides in a long-term care 
            facility, as defined, requires the report to be made to 
            the local ombudsman or local law enforcement agency.  
            Sunsets these particular provisions on January 1, 2013.

          3.Provides for exceptions to reporting, when specified 
            conditions have been met, and provides for civil or 
            criminal penalties for failure to report.

          4.Provides for cross reporting between licensing entities, 
            county adult protective services, and ombudsmen, as 
            specified.  Specifically requires local law enforcement 
            to cross report to the local ombudsman for cases in a 
            long-term care facility.
                
           5.Establishes the Long-Term Care Ombudsman program, by the 
            Older Americans Act (OAA) and places it within the 
            California Department of Aging (CDA) by the Older 
            Californians Act (OCA) in order to encourage community 
            contact and involvement with elderly patients or 
            residents of long-term care facilities or residential 
            facilities through the use of volunteers and volunteer 
            programs.  Federal law generally prohibits ombudsman from 
            making a disclosure of personal information pertaining to 
            an ombudsman program client, unless the client provides 
            written consent.

          This bill:

          1.Requires mandated reporters to report physical abuse 
            which occurs within a long-term care facility, and 
            financial abuse of a resident of a long-term care 
            facility, to both the LTCO and local law enforcement.  
            Current law provides for a mandate to report to the 
            Long-Term Care Ombudsman or local law enforcement. 

          2.Clarifies that anyone who is not a mandated reporter who 
            knows, or reasonably suspects, that an elder or dependent 
            adult has been the victim of abuse can report that abuse 
            to both the long-term care ombudsman and local law 




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            enforcement agency, or either.

          3.Makes other technical changes.


                                  FISCAL IMPACT  

          According to the Assembly Appropriations Committee, costs 
          associated to the ombudsman receiving additional complaints 
          would be minor and absorbable within existing resources, 
          while minor nonreimbursable costs would accrue to local 
          government for additional enforcement, offset to some 
          extent by additional fine revenues.


                            BACKGROUND AND DISCUSSION  

          Author's statement
          The author states that the State Long-term Care Ombudsman 
          program operates under two conflicting mandates: federal 
          law prohibits any disclosure of personal information 
          pertaining to an ombudsman program client, unless the 
          client provides written consent; while state law mandates 
          cross reporting of abuse reports with local law 
          enforcement, in order to assure resolution.  The author 
          asserts that this conflict is causing criminal abuse and 
          neglect to occur, because ombudsman employees and 
          volunteers are unable to share the contents of their 
          reports with law enforcement.  The author highlights that 
          the consent issue is exacerbated by the high number of 
          long-term care facility residents-up to 65 percent, who 
          have diminished capacity and are unable to provide consent.

          Ombudsman and elder and dependent adult abuse reporting
          The state's Long-Term Care Ombudsman program is 
          administered through the California Department of Aging and 
          35 local programs contracted through the network of local 
          area agencies on aging (AAA).  The program utilizes 
          approximately 950 volunteers and 155 paid full-time and 
          part-time staff to serve as resident/patient advocates of 
          residents in over 9,000 long-term care facilities.  
          Volunteers initially receive a minimum of 36 hours of 
          training to carry-out their duties.  According to the CDA 
          website, the primary responsibility of the program is to 
          investigate and endeavor to resolve complaints            




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          made by, or on behalf of, individual residents in long-term 
          care facilities.  The goal of the program is to advocate 
          for the rights of all residents of long-term care 
          facilities. 

          In April 2010, Disability Rights California, Investigations 
          Unit, issued a report that documented several problems with 
          elder and dependent adult abuse reporting and investigation 
          in nursing homes, which are one type of long-term care 
          facility.  Of the findings, the report stated that reports 
          of criminal abuse are frequently made to the long-term care 
          ombudsman and are never referred to law enforcement, and 
          criminal investigations are not thorough and produce 
          insufficient evidence for prosecution.  In several of its 
          case studies, it appeared that physical evidence was not 
          gathered in a timely way, which weakened evidence 
          sufficient for prosecution.

          In November 2009, the California State Senate Office of 
          Oversight and Outcomes (SOOO), a non-partisan team from the 
          office of the Senate President pro Tempore that 
          investigates and measures government performance, issued a 
          report entitled, California's Elder Abuse Investigators: 
          Ombudsmen Shackled by Conflicting Laws and Duties, 
          highlighting the role of the ombudsman in investigating 
          instances of abuse and its inherent limitations, due to 
          consent requirements for ombudsman under federal law, among 
          other factors.  The report noted:
           
                       Over three decades, the state has strayed far 
               from the original intent of the federal
               program.  The Older Americans Act envisioned ombudsmen 
               as advocates for the elderly
               in nursing homes, listening to their concerns and 
               working with administrators to improve
               living conditions.  Like all the states, California 
               established its own ombudsman program
               with the help of federal funding.
                       In the 1980s, the state made ombudsmen key 
               players in another new initiative
               - requiring health care professionals and others who 
               work in facilities to report
               suspected abuse and neglect.  Ombudsmen became legally 
               responsible for receiving and
               investigating these mandated reports.  But there was a 




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               hitch: they were also bound by a
               requirement in the federal law to obtain consent from 
               long-term care residents before
               releasing their names or forwarding their complaints 
               to other agencies.
                       The conflict put ombudsmen in the difficult 
               position of knowing about abuse or neglect,
               but being forced by federal law to remain silent.  The 
               state long-term care ombudsman's
               office found that three-quarters of residents who made 
               abuse and neglect complaints 
               refused to consent to release of their identities.  
               California is one of only four states that 
               put ombudsmen in this bind.  The rest rely instead on 
               Adult Protective Services, state 
               agencies that license long-term care facilities, or 
               others not constrained by the consent
               requirement in the Older Americans Act. ÝEmphasis 
               added.]

          Additionally, the report noted several other problems that 
          hindered prompt and thorough reporting of abuse and 
          neglect.  Among them: 

                       While some local programs ban volunteers from 
               doing these complex 
               investigations, others rely on them, raising questions 
               about whether they are 
               qualified or prepared to handle such high-stakes 
               cases.  Volunteers themselves 
               report feeling overwhelmed.  They also feel torn by 
               their dual roles.  They work 
               with facilities to correct the everyday problems faced 
               by residents.  Yet they must 
               act as adversaries of those facilities in abuse and 
               neglect investigations.
                       Until last month, the state ombudsman 
               interpreted federal law to require consent 
               from witnesses, including the alleged abuser, before 
               ombudsmen could forward 
               full reports to outside agencies.  This interpretation 
               put California at odds with 
               other states and went beyond what the federal 
               government itself says the law 
               requires.  It further handcuffed local programs 




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               charged with handling serious 
               abuse and neglect complaints.  The state still has not 
               revised its erroneous view 
               that witnesses have the right to block the forwarding 
               of full reports, but as a result 
               of this investigation, that interpretation is under 
               review. 
                       In the absence of regulations or other 
               guidance, local ombudsman programs have 
               widely varying understandings of the state office's 
               requirements.  Many fail to get 
               consent at all, even from the long-term care resident. 
                Some intentionally ignore 
               consent requirements when they consider the case too 
               serious.  Others, including 
               volunteers, simply don't know the rules.  The state 
               ombudsman says the office 
               failed to follow its own five year plan and state law 
               requiring regulations because 
               the department lacks a regulation writer.  The office 
               submitted regulations ten 
               years ago, but the Office of Administrative Law found 
               them deficient, and they 
               were never revised.

          In its review of other states, the SOOO report stated that, 
          "California is almost alone among the states in depending 
          on ombudsmen to investigate mandated reports." Recent data 
          show that ombudsmen receive more than 50,000 complaints 
          statewide.  Between 6,400 and 7,100 involve abuse or 
          neglect.

          The Disability Rights California report made several 
          recommendations to improve abuse reporting and 
          investigation, including a recommendation to report to law 
          enforcement and the ombudsman.  The SOOO report also 
          recommended the Legislature consider dual reporting to 
          these two entities; however, this recommendation was in 
          addition to several alternative options, such as 
          centralized reporting, dual reporting to different 
          entities, prohibiting ombudsman volunteers from conducting 
          investigations, as well as other complementary (rather than 
          alternative) recommendations.

          Other groups have also weighed in.  Some recommend dual 




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          reporting to the licensing agency and local law 
          enforcement.  Yet others, such as Developmental 
          Disabilities Area Board 10, are proponents of a centralized 
          reporting entity, such as a licensing agency or adult 
          protective services, which could disseminate information as 
          needed. ÝSee arguments section.]
           
          Reporting and cross-reporting
          Mandated reporters must report to a different entity 
          depending on the setting.  For long-term care facilities, 
          current law requires reporting to the ombudsman OR to local 
          law enforcement.  If the setting is a state mental hospital 
          or developmental center, the report must be made directly 
          to the state department in charge of the institution or 
          local law enforcement.  Outside these facilities, the 
          report must be made to adult protective services or local 
          law enforcement. 

          With cross reporting for a long-term care facility, local 
          law enforcement and the ombudsman must report to the state 
          licensing entity or entities, and the Bureau of Medi-Cal 
          Fraud and Elder Abuse, and to the local district attorney's 
          office in some cases.  Local law enforcement must also 
          cross report to the local ombudsman for cases in a 
          long-term care facility, and to county adult protective 
          services in cases outside of a long-term care facility.  
          County adult protective services must cross-report criminal 
          activity to local law enforcement and any other public 
          agency with responsibility for such an investigation.  
          County adult protective services must also cross-report to 
          the local ombudsman and local law enforcement for suspected 
          abuse occurring in a long-term care facility.  County adult 
          protective services, like local law enforcement and the 
          ombudsman, are also required to cross report to the 
          licensing agency for alleged abuse in a long-term care 
          facility.  According to the State Long-Term Care Ombudsman, 
          local ombudsmen do not always receive cross-reports from 
          law enforcement.

          Each of these entities has separate statutory authority for 
          investigations; however, a measure passed last year (SB 
          110, Liu, Chapter 617, Statutes of 2010) stated that law 
          enforcement agencies must retain exclusive responsibility 
          for criminal investigations.





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          Related legislation
          SB 718 (Vargas) of 2011 allows mandated reporters of elder 
          and dependent adult abuse to make reports through the 
          Internet, as specified.  Pending in Assembly for referral.
          SB 33 (Simitian) of 2011 deletes the January 1, 2013, 
          sunset date on the Elder and Dependent Adult Financial 
          Abuse Reporting Act, originally enacted in 2005.  Referred 
          to the Assembly Aging and Long-Term Care and Public Safety 
          committees.
          
          AB 367 (Smyth) of 2011 allows mandated and non-mandated 
          reporters of elder and dependent adult abuse to report 
          suspected elder and dependent adult abuse occurring within 
          a community to any adult protective services agency or law 
          enforcement agency, regardless of whether the agency lacks 
          geographical or subject matter jurisdiction or obligation 
          to receive the report.  Pending in Assembly Aging and 
          Long-Term Care committee as a two-year bill.

          AB 518 (Wagner) of 2011 is nearly identical to SB 33 
          (Simitian).  Pending in Senate Banking and Financial 
          Institutions Committee.

          Prior legislation
          AB 1765 (Blakeslee) of 2008 was identical to this measure.  
          Hearing cancelled at author's request.

          AB 2100 (Wolk), Chapter 481, Statutes of 2008, requires the 
          local ombudsperson or local law enforcement to whom a case 
          of abuse against an elder or dependent adult has been 
          reported, in addition to existing reporting requirements, 
          to report all cases of known or suspected physical abuse 
          and financial abuse to the local district attorney's office 
          in the county where the abuse occurred. ÝThis is an example 
          of another conflicting mandate for ombudsmen, when consent 
          cannot be obtained.]

          Arguments in support
          The Arc of California writes that current law effectively 
          defeats much of the purpose of mandating reports of abuse 
          of people with disabilities and elders in long-term care 
          facilities because it allows mandated reporters to report 
          exclusively to the LTCO who have no law enforcement powers 
          and are prohibited by federal law from reporting these 
          crimes to the police.




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          The Contra Costa Area Agency on Aging writes that AB 40 
          would strengthen reporting requirements so that the crime 
          of elder abuse can be investigated and prosecuted more 
          expeditiously and effectively.

          Developmental Disabilities Area Board 10 writes (support, 
          if amended) that, while it appreciates the intent of the 
          bill to improve upon the reporting and investigation of 
          abuse allegations, the Board does not believe it will do so 
          as currently written. The Board suggests, instead, that all 
          such reports be made to adult protective services, instead 
          of local law enforcement and the ombudsman, citing the 
          limited knowledge of investigatory techniques of the 
          ombudsman. 

          The California Advocates for Nursing Home Reform (CANHR) 
          states that a recent joint hearing of the Assembly 
          Committees on Public Safety and Aging and Long-Term Care 
          made it clear that having a choice of agencies to report to 
          has resulted in situations where notification about 
          criminal activity does not reach law enforcement. CANHR 
          believes that this bill would be a major advancement to 
          California's mandated reporting law. 
          The Los Angeles County District Attorney (LADA) writes that 
          if an ombudsperson does not recognize the criminal 
          implications of a consumer complaint or fails to report to 
          the district attorney, a perpetrator can escape prosecution 
          for crimes of violence or financial crimes against elderly 
          or dependent adults. The LADA states that this allows 
          individuals to victimize others, and nothing will appear on 
          the criminal background check. 
          
          Arguments in opposition
          The California Association of Health Facilities (CAHF) 
          writes that it is concerned that over-reporting may 
          overwhelm scarce facility and/or community resources.  CAHF 
          further argues that the California Department of Public 
          Health's failure to issue regulations defining specific 
          portions of the reporting statute, including what 
          constitutes "alleged or suspected" abuse and 
          "resident-to-resident" abuse has led to over reporting of 
          incidents by mandated reporters in long-term care settings. 
          CAHF supports Senate Office of Oversight and Outcome's 
          recommendation of reporting to a single entity, either 




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          adult protective services or the licensing agency, which 
          would triage reports and refer to the ombudsman or law 
          enforcement. CAHF also supports dual reporting to law 
          enforcement and the licensing entity. The latter option, 
          CAHF believes, would align state law with federal changes 
          made through the Patient Protection and Affordable Care 
          Act. 

          The California Association of Marriage and Family 
          Therapists (CAMFT) writes that mandating that reports be 
                                                                                     made not only to the ombudsperson, but also law 
          enforcement, is duplicative and inefficient in a time when 
          county and community departments are overburdened and 
          spread thin. CAMFT contends that making these reports can 
          become onerous for mandated reporters who may be on hold 
          for long periods of time -- times that have grown with 
          budget cuts. CAMFT believes that, for the mandated reporter 
          who is a therapist with a full client load, attempting to 
          make the call, as soon as practically possible as the law 
          requires, becomes an impossible chore  often with only ten 
          minutes available time between clients. CAMFT believes that 
          the report should be required to be made solely to the 
          local law enforcement agency (who is required under current 
          law to then share the information with the ombudsperson). 

          The California Bankers Association (CBA) states that the 
          bill creates a duplicative, unnecessary new compliance 
          burden on financial institutions. CBA points out that local 
          ombudsmen have limited power to investigate elder financial 
          abuse, and they already receive the report of suspected 
          abuse. CBA also asserts that financial institutions will be 
          forced to modify their existing employee training programs, 
          as their current practice is to make one report to law 
          enforcement, and retrain hundreds of thousands of bank 
          employees on this new compliance obligation.
          
          Concerns
          CALA, the California Assisted Living Association, expresses 
          concerns that AB 40 would have the effect of criminalizing 
          common dementia-related behaviors. CALA writes that, under 
          this bill, a care provider who witnesses an 82-year-old 
          assisted living resident with advanced Alzheimer's disease 
          push another resident would be required to contact the 
          police, and such behaviors should be managed from a 
          caregiving perspective that involves the provider. CALA 




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          suggests that instead of requiring identical reports to be 
          made to multiple government entities for review, serious 
          consideration should be given to requiring reports to go to 
          a central reporting entity that can summon law enforcement 
          when appropriate, such as a state licensing entity or adult 
          protective services.  
                                  PRIOR VOTES
           
          Assembly Floor:     58 - 18
          Assembly Appropriations:17 - 0
          Assembly Public Safety:  6 - 0
          Assembly Aging & LTC:  4 - 2 


                               QUESTIONS & COMMENTS
           
          1.Double-referred.  This bill has been double-referred to 
            this committee and the Banking and Financial Institutions 
            committee.

          2.Dual reporting for telephone versus written report 
            unclear.  The bill currently requires mandated reporters 
            to make reports to both local law enforcement and the 
            ombudsman.  It is unclear whether the mandated reporter 
            must make two telephone calls immediately, followed by 
            two written reports within two working days, or one 
            telephone call, followed by two written reports within 
            two working days.  The former would allow for dual 
            immediate notification, while the latter would still 
            cause the mandated reporter to choose the entity to whom 
            to make the immediate telephone report.

          3.Interaction between ombudsman and law enforcement is 
            lacking.  The bill requires dual reports to be made; yet, 
            the bill does not provide for any interaction between 
            ombudsman and law enforcement, which appears to be 
            necessary as the ombudsman is considered the residents' 
            advocate.  When law enforcement is called 100 percent of 
            the time, such interaction with the local ombudsman can 
            be considered paramount in cases involving residents who 
            have dementia.  Additionally, both local law enforcement 
            and local ombudsmen have many tasks and few resources.  
            The scope of their duties allows them to play different 
            roles and fulfill different functions in dealing with a 
            suspected or known case of abuse.  Interaction and 




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            coordination between the two parties can reduce confusion 
            and duplication of effort.  In child welfare services, 
            such responses to abuse are coordinated between county 
            child welfare departments, local law enforcement, and 
            licensing agencies.

          4.With greater coordination, dual may be reporting 
            unnecessary.  Statute requires local law enforcement to 
            cross-report to the ombudsman when suspected or known 
            abuse occurs in a long-term care facility.  If 
            coordination between local law enforcement and the 
            ombudsman is also required, a single report to law 
            enforcement may suffice, as both parties would have 
            access to the same information, while alleviating 
            mandated reporters from making two phone calls, followed 
            by two reports.

          5.Recommended amendments.  Staff recommends the following 
            amendments to streamline reporting to a single entity and 
            facilitate a coordinated response.

              a.   Page 2-3:
                1        SECTION 1.   Section 15630 of the Welfare and 
               Institutions
                2    Code is amended to read:
                3        15630.   (a)  Any person who has assumed 
               full or intermittent
                4    responsibility for the care or custody of an 
               elder or dependent
                5    adult, whether or not he or she receives 
               compensation, including
                6    administrators, supervisors, and any licensed 
               staff of a public or
                7    private facility that provides care or services 
               for elder or dependent
                8    adults, or any elder or dependent adult care 
               custodian, health
                9    practitioner, clergy member, or employee of a 
               county adult
               10    protective services agency or a local law 
               enforcement agency, is
               11    a mandated reporter.
               12       (b)  (1)  Any mandated reporter who, in his 
               or her professional
               13    capacity, or within the scope of his or her 




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               employment, has
               14    observed or has knowledge of an incident that 
               reasonably appears
               15    to be physical abuse, as defined in Section 
               15610.63, abandonment,
               16    abduction, isolation, financial abuse, or 
               neglect, or is told by an
                1    elder or dependent adult that he or she has 
               experienced behavior,
                2    including an act or omission, constituting 
               physical abuse, as defined
                3    in Section 15610.63, abandonment, abduction, 
               isolation, financial
                4    abuse, or neglect, or reasonably suspects that 
               abuse, shall report
                5    the known or suspected instance of abuse by 
               telephone immediately
                6    or as soon as practicably possible, and by 
               written report sent within
                7    two working days, as follows:
                8       (A)  If the abuse has occurred in a long-term 
               care facility, except
                9    a state mental health hospital or a state 
               developmental center, the
               10    report shall be made to   both the local    
               ombudsperson     ombudsman   
               11      and   the local law enforcement agency  , and may be 
               also made to the local ombudsman  .
               12       The local  ombudsperson   ombudsman  and the 
               local law
               13    enforcement agency shall, as soon as 
               practicable, except in the
               14    case of an emergency or pursuant to a report 
               required to be made
               15    pursuant to clause (v), in which case these 
               actions shall be taken
               16    immediately, do all of the following:
               17       (i)  Report to the State Department of Public 
               Health any case of
               18    known or suspected abuse occurring in a 
               long-term health care
               19    facility, as defined in subdivision (a) of 
               Section 1418 of the Health
               20    and Safety Code.
               21       (ii)  Report to the State Department of 




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               Social Services any case
               22    of known or suspected abuse occurring in a 
               residential care facility
               23    for the elderly, as defined in Section 1569.2 of 
               the Health and
               24    Safety Code, or in an adult day care facility, 
               as defined in paragraph
               25    (2) of subdivision (a) of Section 1502.
               26       (iii)  Report to the State Department of 
               Public Health and the
               27    California Department of Aging any case of known 
               or suspected
               28    abuse occurring in an adult day health care 
               center, as defined in
               29    subdivision (b) of Section 1570.7 of the Health 
               and Safety Code.
               30       (iv)  Report to the Bureau of Medi-Cal Fraud 
               and Elder Abuse
               31    any case of known or suspected criminal 
               activity.
               32       (v)  Report all cases of known or suspected 
               physical abuse and
               33    financial abuse to the local district attorney's 
               office in the county
               34    where the abuse occurred.


              b.   Page 8-9:

                27       (d)  (1)  Any mandated reporter of suspected 
               financial abuse of
               28    an elder or dependent adult who has direct 
               contact with the elder
               29    or dependent adult or who reviews or approves 
               the elder or
               30    dependent adult's financial documents, records, 
               or transactions,
               31    in connection with providing financial services 
               with respect to an
               32    elder or dependent adult, and who, within the 
               scope of his or her
               33    employment or professional practice, has 
               observed or has
               34    knowledge of an incident, that is directly 
               related to the transaction




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               35    or matter that is within that scope of 
               employment or professional
               36    practice, that reasonably appears to be 
               financial abuse, or who
               37    reasonably suspects that abuse, based solely on 
               the information
               38    before him or her at the time of reviewing or 
               approving the
               39    document, record, or transaction in the case of 
               mandated reporters
               40    who do not have direct contact with the elder or 
               dependent adult,
                1    shall report the known or suspected instance of 
               financial abuse by
                2    telephone immediately, or as soon as practicably 
               possible, and by
                3    written report sent within two working days to 
               the local adult
                4    protective services agency or the local law 
               enforcement agency.
                5       (2)  When two or more mandated reporters 
               jointly have
                6    knowledge or reasonably suspect that financial 
               abuse of an elder
                7    or a dependent adult for which the report is 
               mandated has occurred,
                8    and when there is an agreement among them, the 
               telephone report
                9    may be made by a member of the reporting team 
               who is selected
               10    by mutual agreement.  A single report may be 
               made and signed by
               11    the selected member of the reporting team.  Any 
               member of the
               12    team who has knowledge that the member 
               designated to report has
               13    failed to do so shall thereafter make that 
               report.
               14       (3)  If the mandated reporter knows that the 
               elder or dependent
               15    adult resides in a long-term care facility, as 
               defined in Section
               16    15610.47, the report shall be made to the   local 
               ombudsman   or     and   
               17    local law enforcement agency  , and may also be 




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               made to the local ombudsman .


              c.   Add section that amends WIC 15640:

                 15640.   


                (a) (1) An adult protective services agency shall 
               immediately, or as soon as practically possible, 
               report by telephone to the law enforcement agency 
               having jurisdiction over the case any known or 
               suspected instance of criminal activity, and to any 
               public agency given responsibility for investigation 
               in that jurisdiction of cases of elder and dependent 
               adult abuse, every known or suspected instance of 
               abuse pursuant to Section 15630 or 15630.1 of an elder 
               or dependent adult. A county adult protective services 
               agency shall also send a written report thereof within 
               two working days of receiving the information 
               concerning the incident to each agency to which it is 
               required to make a telephone report under this 
               subdivision.  Prior to making any cross-report of 
               allegations of financial abuse to law enforcement 
               agencies, an adult protective services agency shall 
               first determine whether there is reasonable suspicion 
               of any criminal activity.

               (2) If an adult protective services agency receives a 
               report of abuse alleged to have occurred in a 
               long-term care facility, that adult protective 
               services agency shall immediately inform the person 
               making the report that he or she is required to make 
               the report to   the long-term care ombudsman program or 
               to   a local law enforcement agency  , and may also make a 
               report to the local long-term care ombudsman program  .  
               The adult protective services agency shall not accept 
               the report by telephone but shall forward any written 
               report received to the long-term care ombudsman.

               (b) If an adult protective services agency or local 
               law enforcement agency or ombudsman program receiving 
               a report of known or suspected elder or dependent 
               adult abuse determines, pursuant to its investigation, 
               that the abuse is being committed by a health 




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               practitioner licensed under Division 2 (commencing 
               with Section 500) of the Business and Professions 
               Code, or any related initiative act, or by a person 
               purporting to be a licensee, the adult protective 
               services agency or local law enforcement agency or 
               ombudsman program shall immediately, or as soon as 
               practically possible, report this information to the 
               appropriate licensing agency.  The licensing agency 
               shall investigate the report in light of the potential 
               for physical harm.  The transmittal of information to 
               the appropriate licensing agency shall not relieve the 
               adult protective services agency or local law 
               enforcement agency or ombudsman program of the 
               responsibility to continue its own investigation as 
               required under applicable provisions of law.  The 
               information reported pursuant to this paragraph shall 
               remain confidential and shall not be disclosed.


               (c) A local law enforcement agency shall immediately, 
               or as soon as practically possible, report by 
               telephone to the long-term care ombudsman program when 
               the abuse is alleged to have occurred in a long-term 
               care facility or to the county adult protective 
               services agency when it is alleged to have occurred 
               anywhere else, and to the agency given responsibility 
               for the investigation of cases of elder and dependent 
               adult abuse every known or suspected instance of abuse 
               of an elder or dependent adult.  A local law 
               enforcement agency shall also send a written report 
               thereof within two working days of receiving the 
               information concerning the incident to any agency to 
               which it is required to make a telephone report under 
               this subdivision.


                (1) When a local law enforcement agency receives an 
               initial report of suspected abuse in a long-term care 
               facility, pursuant to 15630 or 15630.1, the local law 
               enforcement agency shall coordinate efforts with the 
               local ombudsman to provide the most immediate and 
               appropriate response warranted to investigate the 
               mandated report.  If the mandated report involves a 
               resident with dementia, or otherwise involves a 
               resident who does not have decision-making capacity, 




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               the local law enforcement agency shall work 
               collaboratively with the local ombudsman in the 
               response to the mandated report.  The State Long-Term 
               Care Ombudsman may develop protocols, in collaboration 
               with law enforcement entities, to implement this 
               section.


                                   POSITIONS  

          Support:  The Arc of California
                    Association of California Healthcare Districts
                    Board of Behavioral Sciences
                    California Advocates for Nursing Homes Reform
                    California Board of Behavioral Sciences 
                    California District Attorney's Association
                    California Long-Term Care Ombudsman Association
                    California Narcotic Officers' Association
                    California Police Chiefs Association
                    California Senior Legislature
                    Congress of California Seniors
                    Contra Costa County Advisory Council on Aging
                    Crime Victims United of California
                    Disability Rights California Developmental 
                    Disabilities Area Board 10
                                   (if amended)
                    Emergency Medical Services Association of 
                    California
                    Los Angeles County District Attorney's Offices
                    National Association of Social Workers, 
                    California Chapter
                    San Luis Obispo County Adult Abuse Council
                    1 individual

          Oppose:California Bankers Association
                    California Association of Health Facilities 
                    (unless amended)
                    California Association of Marriage and Family 
                    Therapists 
                                   (unless amended)

          Concerns: California Assisted Living Association 


                                   -- END --




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