BILL ANALYSIS                                                                                                                                                                                                    Ó






                                  SENATE HUMAN
                               SERVICES COMMITTEE
                            Senator Carol Liu, Chair


          BILL NO:       SB 529                                      
          S
          AUTHOR:        Correa                                      
          B
          VERSION:       January 4, 2012
          HEARING DATE:  January 10, 2012                            
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          FISCAL:        Appropriations                              
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          CONSULTANT:    Sara Rogers
                                        

                                     SUBJECT
                                         
          Seniors: community-based services: long-term care strategic 
                                      plan

                                     SUMMARY  

          Requires the California Department of Aging (CDA) in 
          consultation with the California Commission on Aging 
          (CCoA), the area agencies on aging (AAA) and the Office of 
          the State Long-Term Care Ombudsman to develop a long-term 
          care strategic plan to provide guidance for community based 
          programs that serve seniors.  This bill would require the 
          department to submit the plan to the Legislature by July 1, 
          2013.

                                     ABSTRACT  

          Current Law
             1.   Through federal law, enacts the Older Americans Act 
               of 1965, administered at the state level by CDA which 
               contracts with a network of 33 Area Agencies on Aging 
               intended to coordinate and directly manage various 
               state and federal services for older Californians.


             2.   Enacts the Mello-Granlund Older Californians Act 
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               establishing the CDA, appointing it with various 
               duties, including the development of the federally 
               mandated State Plan on Aging.


             3.   Enacts the Burton Act of 1973 establishing the 
               California Commission on Aging consisting of 25 
               volunteer commissioners appointed to three-year terms 
               by the Governor (19 positions), the Speaker of the 
               Assembly (3 positions), and the Senate Rules Committee 
               (3 positions).  Further establishes legislative intent 
               that the CCoA be the coordinating agency of all 
               programs for the aging in this state, except those 
               programs designated elsewhere by the Governor or 
               Legislature.


             4.   Establishes the Olmstead Advisory Committee in 
               response to the U.S. Supreme Court's Olmstead v. L.C. 
               decision which determined that states are obliged by 
               the Americans with Disabilities Act (ADA) to provide 
               community-based services for persons with disabilities 
               who would otherwise be entitled to institutional 
               services.  A responsibility of the Committee is to 
               develop a state Olmstead Plan prescribing actions the 
               state may take in order to comply with the Olmstead 
               decision.


             5.   Enacts various institutional and community based 
               programs and services for older Californians 
               administered by various state agencies, including In 
               Home Supportive Services under the Department of 
               Social Services, Multipurpose Senior Services Program 
               under CDA, Medi-Cal and numerous Medicaid waiver 
               programs under the Department of Health Care Services 
               (DHCS), Adult Protective Services under both the 
               Department of Social Services and CDA, Linkages 
               administered by CDA, nutrition services under CDA and 
               the AAA's, Caregiver Resource Centers under the 
               Department of Mental Health and others.


             6.   Requires the California Health and Human Services 
               Agency (CHHS) to prepare a Long Range Strategic Plan 




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               on Aging by July of 2003, and consult or seek the 
               advice of CCoA in the development of this strategic 
               plan.  Existing statute provided an appropriation to 
               the University of California to undertake a survey of 
               existing resources and gaps in California's long term 
               care system and to establish a longitudinal database 
               to inform the report.  As mandated, CHHS prepared a 
               258-page report in 2003 entitled "Strategic Plan for 
               An Aging California Population."



          This bill
             1.   Requires the California Department of Aging in 
               consultation with the California Commission on Aging, 
               the area agencies on aging and the Office of the State 
               Long-Term Care Ombudsman to develop a long-term care 
               strategic plan to provide guidance for community based 
               programs that serve seniors.  This bill would require 
               the department to submit the plan to the Legislature 
               by July 1, 2013.


             2.   Requires the strategic plan address the following:
                  a.        Goals for the state's long-term care 
                    system, and statutory and program changes 
                    required to meet those goals including the 
                    establishment of a community based pilot project.
                  b.        Selection of a single agency to manage 
                    the process of guiding future decisions regarding 
                    long-term care including appropriate staffing and 
                    timelines.
                  c.        Services and supports enabling 
                    individuals with advanced age or disabilities to 
                    remain in their communities avoiding unnecessary 
                    institutionalization.
                  d.        Identification of short term, medium 
                    range and long term programs recommended in the 
                    November 2009 final report "Home and 
                    Community-Based Long-Term Care: Recommendations 
                    to Improve Access for Californians" prepared for 
                    CHHS and California Community Choices.
                  e.        The feasibility of enacting a bond 
                    measure to provide limited term funding to 
                    restore programs that have faced budget 




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                    reductions but provide a foundation for long-term 
                    care cost savings.
                  f.        Makes requirement inoperative on January 
                    1, 2017, pursuant to Section 10231.5 of the 
                    Government code.

                                  FISCAL IMPACT  

          This bill has not been analyzed by a fiscal committee.

                            BACKGROUND AND DISCUSSION  

          Purpose of the bill
          According to the author, the purpose of SB 529 is to make 
          long-term care more efficient through appropriate planning 
          and coordination of services.  The California Senior 
          Legislature argues that long range planning and 
          coordination of service is needed now more than ever.

          The author points to a November 2009 report published by 
          the California Community Choices Advisory Committee 
          entitled, "Home and Community-Based Long-Term Care: 
          Recommendations to Improve Access for California," stating 
          the report found that California lacks a long-term care 
          strategic plan that sets priorities for services.
           
          California Department of Aging State Plan
          Federal law requires the California Department of Aging to 
          submit a State Plan to the federal Administration on Aging 
          (AoA), which approves the plan as a condition of releasing 
          federal funds (matched with state and local funds) to the 
          State of California to administer the State Plan.  The 
          State Plan is required to include California's goals and 
          objectives for the planning period, statewide program 
          objectives to comply with the Older Americans Act, a 
          resource allocation plan for disbursing Title III federal 
          funds, and other information.  California's plan goes 
          beyond the federally required information to additionally 
          address key socio-demographic factors that will shape 
          funding needs; priorities, unmet needs and promising 
          practices identified by CDA and the Area Agencies on Aging 
          (AAA); and the Department's objectives in working with the 
          AAAs and others to provide cost-effective, high quality 
          services to California's older adults, adults with 
          disabilities, and their caregivers.




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          Olmstead Plan
          Pursuant to the U.S. Supreme Court's Olmstead v. L.C. 
          decision which determined that states are obligated under 
          the Americans with Disabilities Act (ADA) to provide 
          community-based services for persons with disabilities who 
          would otherwise be entitled to institutional services, the 
          California legislature passed AB 442 (Statutes of 2002) 
          requiring the California Health and Human Services Agency 
          to develop a report prescribing actions the state may take 
          in order to comply with the Olmstead decision. California's 
          plan includes recommendations for system change and 
          improvement.  The plan was informed by more than 73 
          stakeholder groups which participated in 38 meetings held 
          between September 2002 and January 2003.  In May of 2003, 
          the California Health and Human Services Agency published, 
          "California Olmstead Plan."  The document emphasizes the 
          importance of regularly updating the plan.
          
          Strategic Plan for an Aging California Population
          SB 910 (Statutes of 1999) required the California Health 
          and Human Services Agency to prepare a Long Range Strategic 
          Plan on Aging by July of 2003 and to consult with the CCoA 
          in its development.  The legislation appropriated funding 
          to the University of California to support the plan 
          development by providing information and analysis.  Over an 
          eleven-month period, the Plan Development Task Team and 
          other experts developed 589 policy and action 
          recommendations listed in a 258 page report in 2003 
          entitled "Strategic Plan for An Aging California 
          Population."

          California Community Choices Advisory Committee report
          The California Community Choices project is a five-year 
          grant funded by the Centers for Medicare and Medicaid 
          Services to support the development of home and 
          community-based long-term care services through the 
          establishment of Aging and Disability Resource Connection 
          (ADRC) programs, in coordination with CDA.  This project 
          also included a financing study published in November of 
          2009 entitled "Home and Community-Based Long-Term Care: 
          Recommendations to Improve Access for California" which 
          examined the laws, regulations, policies and payment 
          methodologies related to long-term care financing in 
          California.  Among other findings, the report recommends 




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          that California develop a strategic plan that describes 
          priority populations, and describes the mission, values and 
          goals for its long-term living services and supports 
          program.

          Related/prior legislation
          SB 910, (Statutes of 1999, Chapter 948)  required, among 
          other things, that the California Health and Human Services 
          Agency (HHSA) prepare a Long Range Strategic Plan on Aging 
          by July of 2003, and consult or seek the advice of CCoA in 
          the development of this strategic plan.

          AB 442, (Statutes of 2002, Chapter 1162) required the 
          California Health and Human Services Agency to develop a 
          comprehensive plan describing the actions which California 
          can take to improve its long term care system so that its 
          residents have available an array of community care options 
          that allow them to avoid unnecessary institutionalization 
          pursuant to the Olmstead U.S. Supreme Court decision.


                              COMMENTS AND QUESTIONS

           Duplicative mandate.  Previous statutes have required the 
          California Health and Human Services Agency to prepare a 
          long-term strategic plan on Aging as well as a plan to meet 
          Olmstead requirements, both of which have been fulfilled.  
          Additionally, federal law requires a State Plan on Aging as 
          a condition of receipt of federal funds.  Would the author 
          consider amending the bill to request for an update of 
          previously published plans?  
                                   POSITIONS 

          Support:       California Senior Legislature (sponsor)

          Oppose:   None received




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