BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 753|
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CONSENT
Bill No: AB 753
Author: Lowenthal (D)
Amended: 6/18/13 in Senate
Vote: 27 - Urgency
SENATE HEALTH COMMITTEE : 9-0, 7/3/13
AYES: Hernandez, Anderson, Beall, De León, DeSaulnier, Monning,
Nielsen, Pavley, Wolk
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
ASSEMBLY FLOOR : 70-0, 5/16/13 - See last page for vote
SUBJECT : Cognitively impaired adults: caregiver resource
centers
SOURCE : Association of California Caregiver Resource Centers
DIGEST : This bill repeals and recasts statutes related to the
system of caregiver resource centers to conform with the
transfer of the program from the former Department of Mental
Health (DMH) to the Department of Health Care Services (DHCS).
ANALYSIS :
Existing law:
1.Establishes the Comprehensive Act for Families and Caregivers
of Brain-Impaired Adults, previously administered by the
former DMH, to contract with a Statewide Resources Consultant
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to coordinate a statewide system of caregiver resource centers
(CRCs) to serve caregivers of adults with Alzheimer's disease,
stroke, Parkinson's, traumatic brain injury, and other
adult-onset cognitive disorders.
2.Transfers the CRC program from DMH to DHCS, due to the
elimination of DMH in the 2012 Budget.
This bill:
1. Repeals existing law governing CRCs under the jurisdiction
of DMH and enacts the Comprehensive Act for Families and
Caregivers of Cognitively Impaired Adults.
2. Makes a number of legislative findings and declarations
regarding the value and role of CRCs and expresses intent to
support family caregivers taking care of adults living with
cognitive impairment by funding and implementing the
California CRCs.
3. Establishes various definitions for purposes of this bill,
including that "caregiver" means any unpaid family member or
individual who assumes responsibility for the care of a
person whose cognitive impairment has occurred after 18 years
of age. Defines "respite care" as substitute care or
supervision in support of the caregiver for the purposes of
providing relief from the stresses of providing constant care
and so as to enable the caregiver to pursue a normal routine
and responsibilities. Specifies that "respite care" may be
provided in the home or in an out-of-home setting, such as
day care centers or short-term placements in inpatient
facilities.
4. Requires the Director of the DHCS to take the following
actions with respect to CRCs:
A. Maintain or enter into contracts directly with CRCs to
provide direct services to caregivers throughout the state
in the existing geographic service areas; and
B. Maintain or require CRCs to maintain a CRC Operations
Manual that defines CRC services and procedures and
identifies CRC duties and responsibilities.
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1. Permits the Director of DHCS to enter into any contracts
under this bill on a bid or non-bid basis and exempts such
contracts from existing law related to public contracting
code.
2. Requires agencies designated as CRCs by the Director of DHCS
to include in their governing or advisory boards, or both,
persons who represent the ethnic and socioeconomic character
of the area served and the client groups served in the
geographic area. Specifies the criteria that must be used in
selecting CRCs.
3. Requires CRCs to deliver services to, and advocate for,
caregivers of cognitively-impaired adults in accordance with
the CRC Operations Manual and specifies the range of services
CRCs must provide.
4. Requires that each of the services provided to be determined
by local needs and resources.
5. Provides that persons receiving services pursuant to this
bill may be required to contribute to the cost of services
depending upon their ability to pay, but not to exceed the
actual cost.
6. Requires each CRC to submit progress reports with specified
information on its activities to the Director of DHCS.
Comments
CRCs . According to the Senate Health Committee analysis, the
CRC system was created pursuant to AB 2913 (Agnos, Chapter 1658,
Statutes of 1984) to provide a single point of entry to
long-term care services available to caregiving families in 11
major geographic regions throughout California. The CRC system
was the first of its kind in the nation and was looked to as a
model for the development of similar services now available in
all 50 states. CRCs were legislatively mandated to assist
families who provide care for loved ones with Alzheimer's
disease, stroke, Parkinson's, Huntington's disease, Traumatic
Brain Injury, Multiple Sclerosis and other brain disorders
acquired after the age of 18. Unlike most publicly supported
services and programs, CRC services are not intended to address
the needs of the disabled family member who is being cared for
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directly -- but instead directed to the caregiver.
CRC Funding. Individuals pay for CRC services on a sliding
scale basis. According the Senate Health Committee analysis,
funding for CRCs has been reduced by 74% since 2009 and went
from a high of $11.5 million in 2008 to $2.9 million today. As
a result of these budget reductions, all 11 CRCs maintain
waiting lists for various services; the CRC serving the Los
Angeles area has a waiting list of over 900 people for respite
services alone.
The Governor's 2012-13 Budget proposed to eliminate all funding
for CRCs. In rejecting this proposal, the Legislature noted
that CRCs are a valuable component of the state's overall safety
net that allows caregivers to continue providing long-term care
in homes, thereby enabling many disabled Californians to
continue living in the community rather than in nursing
facilities, hospitals, or institutionalized settings. According
to the Budget Committees, keeping people at home leads to
substantial savings for the state in reduced institutional care
costs. The Legislative Analyst's Office also commented that
eliminating funding for CRCs seemed at odds with the
Administration's efforts to provide better coordinated care for
seniors and persons with disabilities in order to reduce
fragmentation in the state's long-term care services continuum.
Prior Legislation
AB 1467 (Budget Committee, Chapter 23, Statutes of 2012)
transfers the CRC program from DMH to DHCS, due to the
elimination of DMH in the 2012 Budget.
AB 2913 (Agnos, Chapter 1658, Statutes of 1984) created the CRC
system.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
SUPPORT : (Verified 8/20/13)
Association of California Caregiver Resource Centers (source)
Alzheimer's Association
Association of California Caregiver Resource Centers
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California Association for Health Service at Home
California Association of Public Authorities
Caregiver Resource Center - Orange County
Coast Caregiver Resource Center
Del Mar Caregiver Resource Center
Del Oro Caregiver Resource Center
Family Caregiver Alliance
Inland Caregiver Resource Center
Los Angeles Caregiver Resource Center
Peninsula Stroke Association
Redwood Caregiver Resource Center
Southern Caregiver Resource Center
The Arc and United Cerebral Palsy California Collaboration
Traumatic Brain Injury Services of California
Valley Caregiver Resource Center
ARGUMENTS IN SUPPORT : The Association of California Caregiver
Resource Centers writes in support that dedicated families - not
institutions - provide most of the long-term care in the United
States to loved ones suffering from debilitation health
conditions, often at great physical, emotional and financial
sacrifice. For nearly three decades, the11 CRCs have supplied
information, education, respite and emotional support to
California families. The California Association for Health
Services at Home writes that such services play a vital role in
allowing families to keep their loved ones at home and in the
community. Sponsors are pleased to update the governing
statutes to be more reflective of the current practices of this
vital community-based program.
ASSEMBLY FLOOR : 70-0, 5/16/13
AYES: Achadjian, Alejo, Ammiano, Atkins, Bigelow, Bloom,
Blumenfield, Bocanegra, Bonilla, Bonta, Bradford, Brown, Ian
Calderon, Campos, Chau, Chávez, Chesbro, Conway, Cooley,
Dahle, Daly, Dickinson, Donnelly, Fong, Fox, Frazier, Garcia,
Gatto, Gomez, Gordon, Gorell, Gray, Hagman, Hall, Harkey,
Roger Hernández, Jones, Jones-Sawyer, Levine, Linder, Logue,
Lowenthal, Maienschein, Mansoor, Medina, Mitchell, Mullin,
Muratsuchi, Nazarian, Nestande, Olsen, Pan, Patterson, Perea,
V. Manuel Pérez, Quirk, Quirk-Silva, Rendon, Salas, Skinner,
Ting, Torres, Wagner, Waldron, Weber, Wieckowski, Wilk,
Williams, Yamada, John A. Pérez
NO VOTE RECORDED: Allen, Buchanan, Eggman, Beth Gaines, Grove,
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Holden, Melendez, Morrell, Stone, Vacancy
JL:nl 8/20/13 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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