BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                            



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                                    THIRD READING


          Bill No:  SB 609
          Author:   Wolk (D)
          Amended:  4/11/13
          Vote:     21

           
           SENATE HUMAN SERVICES COMMITTEE  :  6-0, 4/9/13
          AYES:  Yee, Berryhill, Emmerson, Evans, Liu, Wright

           SENATE APPROPRIATIONS COMMITTEE  :  6-0, 4/22/13
          AYES:  De León, Walters, Gaines, Lara, Padilla, Steinberg
          NO VOTE RECORDED:  Hill


           SUBJECT  :    Office of the State Long-Term Care Ombudsman

           SOURCE  :     Author


           DIGEST  :    This bill creates the Long-Term Ombudsman Program  
          Improvement Act Account, and requires the Office of the State  
          Long-Term Care Ombudsman (Office) to deposit specified funds  
          into the account.  Requires those funds to be used for the  
          purpose of supporting the operations and programs of the Office.

           ANALYSIS  :    

          Existing Federal Law:

          1. Establishes, within the Older Americans Act, the Office of  
             the Long-Term Care Ombudsman Program and requires states to  
             establish and operate an Office of the State Long-Term Care  
             Ombudsman Program. 
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          2. Requires states to ensure that representatives of the Office  
             shall have access to long-term care facilities and residents,  
             appropriate access to review the medical and social records  
             of a resident, as specified, and access to specified records  
             of patients and the facility. 

          3. Requires states to prohibit willful interference with the  
             functions of the Office, to prohibit retaliation and  
             reprisals by a long-term care facility, and to provide for  
             appropriate sanctions with respect to the interference,  
             retaliation, and reprisals.

          Existing State Law:

          1. Establishes, within the Department of Aging (CDA), the Office  
             of the State Long-Term Care Ombudsman to protect and advocate  
             for the rights and health and safety for long-term care  
             facility residents. 

          2. Requires the Ombudsman, either personally or through  
             representatives, to identify, investigate, and resolve  
             complaints that may adversely affect the health, safety,  
             welfare, or rights of residents of long term care facilities.

          3. Requires the Office to solicit and receive funds, gifts, and  
             contributions to support the operations and programs of the  
             Office.  Permits the Office to form a foundation eligible to  
             receive tax-deductive contributions for this purpose. 

          4. Provides that any person who willfully interferes with any  
             lawful action of the Office shall be subject to a civil  
             penalty of no more than $1,000 to be assessed by the Director  
             of the Agency on Aging upon the request of the Office. 

          5. Provides that funds designated as continuously appropriated  
             without regard to fiscal years may not be encumbered by the  
             Legislature, unless the Legislature by statute specifies that  
             the funds shall be encumbered for appropriation. 

          6. Establishes the Special Deposit Fund as a trust fund in the  
             State Treasury to provide a depository for money received in  
             trust for specific purposes by a department for which no  
             other fund has been created to receive those funds.  Permits  

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             a department to establish accounts through a request of the  
             Department of Finance (DOF) and, upon DOF approval, the State  
             Controller's Office. 

          This bill:

          1. Establishes in statute the Long-Term Care Ombudsman Program  
             Improvement Act Account (Account), and upon appropriation,  
             requires those funds to be used for the purpose of supporting  
             the operations and programs of the Office.
          2. Requires the Ombudsman to deposit solicited funds, gifts and  
             contributions into the Account.

          3. Increases civil penalties for willful interference with any  
             lawful action of the Office to $2,500 and provides that  
             penalties shall be assessed per incident.

          4. Provides that, if the penalty is not paid within 30 days of  
             the assessment, the director of the CDA shall initiate an  
             action to collect the penalties in the local jurisdiction.

          5. Establishes the Access to Facilities Account, created within  
             the Special Deposit Fund and provides that civil penalties  
             collected by the CDA shall be deposited into this account.

          6. Provides that funds in the Access to Facilities Account shall  
             be available, upon appropriation, to the Office and no less  
             than 75% of the penalties collected shall be dedicated to  
             fund the direct travel costs associated with local Ombudsmen  
             visits or training of local Ombudsmen throughout the state.

           Background
           
           Office of the State Ombudsman  .  The state's Long-Term Care  
          Ombudsman program is administered through the CDA and 35 local  
          programs contracted through the network of local area agencies  
          on aging.  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 Web site, the primary responsibility of the program is to  
          investigate and endeavor to resolve complaints made by, or on  
          behalf of, individual residents in long-term care facilities.   

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          The goal of the program is to advocate for the rights of all  
          residents of long-term care facilities. 

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No


          According to the Senate Appropriations Committee:


           Minor projected annual revenue increases, based on recent  
            administrative penalties issues (General Fund).  In 2012, the  
            CDA issued two such civil penalties.

           Minor ongoing expenditures for state Long-Term Care Ombudsman  
            activities and for local ombudsman activities (General Fund).
           

          SUPPORT  :   (Verified  4/23/13)

          Alliance on Aging Long-Term Care Ombudsman Program for Monterrey  
          County
          California Advocates for Nursing Home Reform 
          California Catholic Conference, Inc.
          California Commission on Aging
          California Long Term-Care Ombudsman Association
          California Senior Legislature
          Consumer Federation of California
          Council on Aging-Orange County
          Humboldt-Del Norte Long Term Care Ombudsman Program
          Long Term Care Services of Ventura County
          Older Women's League of California
          Ombudsman Services of Northern California-Shasta Region 
          Ombudsman Services of San Mateo County, Inc.
          Ventura County Board of Supervisor

           
          ARGUMENTS IN SUPPORT  :    According to the author's office, the  
          State Long-Term Care Ombudsman reports recent incidences where  
          local offices have approached long term care facilities and were  
          refused entry into the facility despite state law requiring  
          facilities to grant unhindered access.  In response, the  
          Ombudsman requested the CDA to initiate actions against those  
          facilities.  One facility paid the penalty of $1,000 but another  

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          facility has ignored the fine forcing the Ombudsman to initiate  
          a claim in small claims court.  Because the Ombudsman did not  
          have an account set up to receive the funds, nor authority to  
          expend the funds, the fines reverted to the General Fund.  

          The author's office further states that the current penalty of  
          $1,000 has been in place for 30 years and is an insufficient  
          deterrent against violations.  By increasing the penalty to  
          $2,500 and establishing it for each incident of willful  
          interference, the Ombudsman will have a stronger tool to ensure  
          local Ombudsmen legal access to residents and facilities.  The  
          author's office states that any penalties collected would fund  
          more outreach to facilities by local Ombudsmen and training for  
          volunteers to perform site visits. 


          Several local ombudsman programs state that, for years, some  
          facilities have refused to allow Ombudsman representatives to  
          enter facilities without an escort, in violation of state and  
          federal law.

          JL:d  4/24/13   Senate Floor Analyses 

                           SUPPORT/OPPOSITION:  SEE ABOVE

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