BILL ANALYSIS Ó AB 663 Page 1 ASSEMBLY THIRD READING AB 663 (Gomez) As Amended April 29, 2013 Majority vote HUMAN SERVICES 5-2 AGING 5-2 ----------------------------------------------------------------- |Ayes:|Stone, Ammiano, Ian |Ayes:|Yamada, Brown, Daly, | | |Calderon, Garcia, Hall | |Gray, Levine | | | | | | |-----+--------------------------+-----+--------------------------| |Nays:|Maienschein, Grove |Nays:|Wagner, Grove | | | | | | ----------------------------------------------------------------- APPROPRIATIONS 12-5 ----------------------------------------------------------------- |Ayes:|Gatto, Bocanegra, | | | | |Bradford, | | | | |Ian Calderon, Campos, | | | | |Eggman, Gomez, Hall, | | | | |Rendon, Pan, Quirk, Weber | | | | | | | | |-----+--------------------------+-----+--------------------------| |Nays:|Harkey, Bigelow, | | | | |Donnelly, Linder, Wagner | | | | | | | | ----------------------------------------------------------------- SUMMARY : Requires additional training for administrators of adult community care facilities. Specifically, this bill : 1)Requires administrators of adult residential facilities (ARF) and residential care facilities for the elderly (RCFE) to undergo additional training in cultural competency and sensitivity in aging lesbian, gay, bisexual, and transgender minority issues. 2)Requires the Long-Term Care (LTC) Ombudsman to undergo additional training in cultural competency and sensitivity in aging lesbian, gay, bisexual, and transgender minority issues. FISCAL EFFECT : According to the Assembly Appropriations AB 663 Page 2 Committee, because the bill does not require an increase in the overall number of hours of training, costs associated with this legislation should be minor and absorbable within existing resources. COMMENTS : Community Care Facilities Act (CCFA) : Established in 1973, the CCFA was adopted in response to the need to provide a system of nonmedical community care, to provide care and supervision services for persons with developmental and mental health needs, as well as socially dependent children and adults in California. Over the years, Community Care Facilities (CCFs) have evolved to become more sophisticated in the range of care they provide, which now includes providing care for persons with severe behavioral or emotional problems, serious mental or developmental disorders and significant medical needs. Under the CCFA, ARFs are generally considered facilities that provide residentially-based care for adults age 18-59, who are unable to provide for their own daily needs. ARFs typically provide residential care for adults with mental health needs or developmental disabilities that prevent them from living at home safely on their own. CCF administrators must undergo 35 hours of classroom instruction provided by a Department of Social Services (DSS)-approved certification program. The instruction is required to provide training on a uniform core of knowledge that is necessary to operate a CCF. According to DSS, as of February 6, 2013, there were 77,243 licensed CCFs in California with a capacity to serve 1,395,577 residents. Residential Care Facilities for the Elderly : It is the intent of the Legislature, in creating for RCFEs their own licensing category, to help provide a system of residential care to allow older persons to live as independently as possible while not forcing them to move between medical and nonmedical services. Commonly referred to as assisted living facilities, retirement homes and board and care homes, RCFEs are licensed facilities that provide services to individuals who are 60 years of age and over and persons under the age of 60 with compatible needs. AB 663 Page 3 RCFEs provide a wide array of care, which can include varying levels of personal care and protective supervision, based upon the needs of the resident. Much like CCF certification requirements, RCFE administrators must undergo a similar training, but with more hours. They are required to successfully complete 40 hours of classroom instruction provided by a DSS-approved certification program, which includes additional hours of instruction relating to serving clients with dementia. According to DSS, as of February 6, 2013, there are 7,613 licensed RCFEs in California with a capacity to serve 173,333 residents. Office of the Long-Term Care (LTC) Ombudsman : As established by the Mello-Granlund Older Californians Act, the LTC Ombudsman serves as an independent entity within the California Department of Aging. Its primary responsibilities are two-fold. First, it identifies, investigates and resolves complaints made by residents of RCFEs, nursing homes and assisted living facilities. Second, it plays an advocacy role in the development of policies, regulations and statute to improve California's system of care for older persons. Need for the bill : One of the most significant demographic changes occurring in the United States (US) today is the growth of our aging population. According to the US Census, in 2000, there were just over 41 million Americans over the age of 62, representing almost 15% of the country's population. In the 2010 Census, that number increased by more than 21% to nearly 50 million people who are 62 years of age and over. Americans aged 62 and over grew at a faster rate than any other age group in the country. Additionally, with advances in health care and medical treatment, life expectancy is increasing. It is estimated that by the year 2030, seniors will represent more than 20% of the nation's population and be made up of a greater proportion of seniors over the age of 85. This will result in longer periods of retirement for seniors, and increased reliance on housing, health care, and social services. Parallel to this increase in the nation's senior population, is AB 663 Page 4 the growth in the number of lesbian, gay, bisexual and transgender (LGBT) seniors. Although LGBT seniors and their heterosexual counterparts will experience similar issues associated with growing older, they encounter a different and unique set of challenges and circumstances that can serve as barriers to accessing needed services. In the 2004 report "Aging in Equity" by the Funders for Gay and Lesbian Issues, it notes: LGBT elders are? less likely to have children than their heterosexual counterparts. Since life partners and children play an important role in caregiving, many LGBT elders become reliant on formal caregiving services sooner than elders who can turn to family members and partners for informal support. The report goes on to say: LGBT couples face unequal treatment in hospital visitation, health decision making, nursing care policies, Medicaid regulations, Medicare and Social Security Coverage, pension and tax regulations, housing rights, and a host of other issues that fundamentally affect their financial security, health status, and quality of life. There are also numerous cultural and equity issues that have yet to percolate into the world of senior and aging care in California. Whereas there is greater tolerance and understanding of the LGBT community in younger generations, this acceptance and equity of treatment has yet to immerse itself into older generations, including seniors. Writing in support of the bill, the AARP states: The LGBT community has made incredible strides battling social discrimination. They shouldn't be forced back into hiding in the late stages of life. Increasing training in cultural competence regarding LGBT seniors is necessary to enable these individuals to live lives of dignity and autonomy. Analysis Prepared by : Chris Reefe / HUM. S. / (916) 319-2089 AB 663 Page 5 FN: 0000600