BILL ANALYSIS Ó
AB 2301
Page 1
Date of Hearing: April 19, 2016
ASSEMBLY COMMITTEE ON AGING AND LONG-TERM CARE
Cheryl Brown, Chair
AB 2301
(Chu) - As Amended April 13, 2016
SUBJECT: Residential care facilities for the elderly: elder
abuse.
SUMMARY: Requires the California Health & Human Services Agency
to file a report to the Legislature regarding the manner in
which each county in the state invests in and conducts services
that train and equip law enforcement officers to identify and
investigate instances of elder abuse in long-term care and
assisted living facilities within their jurisdictions.
Specifically, this bill:
1)Requires the Health & Human Services Agency to file a report
on or before January 1, 2020, to the Legislature regarding the
manner in which each county in the state invests in and
conducts services that train and equip law enforcement
officers to identify and investigate instances of elder abuse
in long-term care and assisted living facilities within their
jurisdictions.
2)Requires the report to include, but not be limited to,
information for each county regarding:
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a. the size and scope of the county's long-term care
ombudsman program;
b. whether or not the county sheriff's department maintains
an elder abuse task force or a resource officer trained and
equipped to investigate elder abuse cases;
c. whether the sheriff's department coordinates with the
county long-term care ombudsman on elder abuse
investigations;
d. the way in which these programs are funded;
e. how proactive the county's programs are at engaging with
long-term care facilities and conducting services,
including, but not limited to, routine check-ins with
facility managers and residents; and,
f. whether or not the county's elder abuse task force or
designated resource officer, if any, has contact
information available to long-term care facilities and
their residents.
1)Requires the report to be submitted in compliance with Section
9795 of the Government Code.
2)Repeals these provisions on January 1, 2024 pursuant to
Section 9795 of the Government Code.
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EXISTING LAW:
1)Establishes the Elder Abuse and Dependent Adult Civil
Protection Act (EADACPA) to protect elder and dependent adults
from abuse and exploitation.
2)Recognizes that elders and dependent adults may have
disabilities and cognitive impairments, such as Alzheimer's
disease and other dementia disorders, which often leave them
incapable of seeking help and protection from others.
3)Recognizes that elders and dependent adults suffer physical
impairments and poor health, conditions that place them in a
dependent and vulnerable position, and that cases of elder and
dependent adult abuse are seldom prosecuted as criminal
matters, and that few civil cases are brought in connection
with this abuse due to problems of proof, court delays, and
the lack of incentives to prosecute these suits.
4)Requires a mandated reporter who, within the scope of his or
her employment or professional capacity, has knowledge of
physical abuse, abandonment, abduction, isolation, financial
abuse, or neglect, or is told by an elder or dependent adult,
that he or she has experienced abuse, to report the known or
suspected abuse, to appropriate parties.
5)Creates the Long-Term Care Ombudsman program under the Older
Americans Act (OAA) and places it within the California
Department of Aging (CDA) under 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 and generally prohibits an
ombudsman from making a disclosure of personal information
pertaining to an ombudsman program client, unless the client
provides written consent.
6)Requires the local ombudsperson or the local law enforcement
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agency to report suspected abuse to the state Departments of
Public Health, Social Services, and 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
activity, 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.
7)Establishes the licensing framework administered by California
Department of Social Services (DSS) for residential care
facilities for the elderly, facilities that provide personal
care and supervision, protective supervision or health related
services for persons 60 years of age or older who voluntarily
choose to reside in that facility.
8)Defines a resident's rights living in an RCFE to promote for
individual choice, autonomy to make decisions, and to be
protected from physical or mental abuse, neglect, and
endangerment.
FISCAL EFFECT: Unknown
COMMENTS: According to the Administration on Aging, in the
United States, the 2010 Census recorded the greatest number and
proportion of people age 65 and older in all of decennial census
history: 40.3 million, or 13% of the total population - the
"Boomer Generation" effect. By 2050, people age 65 and older
are expected to comprise 20% of the total U.S. population, with
the largest proportion in California. The fastest growing
segment of American's population consists of those 85 and up.
In 2010, there were 5.8 million people aged 85 or older. By
2050, it is projected that there will be 19 million people aged
85 or older.
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The most recent major studies on the incidence of elder abuse
reported that nearly 10% of study participants experienced abuse
in the prior year. Despite the accessibility of Adult
Protective Services (APS), as well as mandatory reporting laws
for elder abuse in most states, experts agree that a substantial
number of cases of abuse and neglect go unreported and untreated
each year. One study estimated that only 1 in 14 cases of elder
abuse ever comes to the attention of authorities. Elders who
experienced abuse, even modest abuse, had a 300% higher risk of
death when compared to those who had not been abused. Elder
abuse occurs in community settings, such as private homes, as
well as institutional settings like nursing homes and other
types of long term care facilities. Abuse can also occur
perpetrated by family members, most often adult children,
spouses, partners, and others.
Author's statement: According to the author, this bill is
needed to "study the ways that addressing elder abuse and
providing resources and accountability in elder care facilities
and RCFEs differ from county to county." In addition, "the
diminished funding for Adult Protective Services and the Long
Term Care Ombudsman has exasperated discrepancies between
counties in their ability to properly address elder abuse cases.
Despite this, there is little to no existing research on these
discrepancies, whether it is the result of funding, extent of
training, extent of coordination with facilities, and/or whether
the county has a designated law enforcement task force or
resource officer equipped to identify and address suspected
abuse."
California's Long-Term Care Ombudsman Program: The Long-Term
Care Ombudsman (LTCO) Program investigates complaints of elder
abuse in both long-term care facilities and residential care
facilities for the elderly. The LTCO also serves as a way for
residents to communicate on a confidential basis when other
concerns or needs arise.
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Funding for LTCO has suffered during the Great Recession in
California. Resources in 2016 stand at $7.29 million compared
to $11.2 million in FY 2007-08. During the intervening years
and in response to reduced funding, California's local LTCOs
were forced to reduce operating hours and scale back services.
Since the cuts to their budget, the local LTCOs have had to
greatly reduce the number of long-term care facilities they
visit quarterly. This depleted the LTCO capacity to regularly
visit facilities. Recent updates in funding have helped restore
that capacity.
Last year, additional resources of $1.4 million were allocated
to provide increased support for the LTCO. Local ombudsman
programs received $1 million from the state General Fund for the
first time since FY 2007-08. They also received an additional
$400,000 from the California Department of Public Health,
Licensing and Certification Program Fund, as a direct result of
an increase in the Skilled Nursing Facility Bed Fee. This
additional funding permitted the hiring for 27 additional
positions needed to work with facilities and respond to resident
complaints and substantially increased the amount of training
that took place for staff. The additional funding has directly
led to increased LTC Ombudsman visits to facilities and
assistance to residents, including a 27.3% increase in the
number of information and consultation sessions with individuals
where Ombudsman representatives provide information about
long-term care and answer questions about residents' rights and
other issues that residents, family members, and friends may be
concerned about. This interaction in turn often empowers
residents, families, and friends to resolve issues on their own.
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The added funds also led to a 13.9% increase in the number of
residential care facilities and a 6.2% increase in the number of
skilled nursing facilities receiving at least one visit each
quarter, not in response to a complaint. During these
unannounced, non-complaint related visits, Ombudsman
representatives meet with residents, inform residents of their
rights, and build relationships of trust.
Suggested Clarifying Amendments:
On page 2, line 5, insert "how" and delete "the manner in
which". On line 6 delete "conducts services that" and insert
"trains and equips."
On page 2, line 19, insert "frequently and which county" and
delete "proactive." On line 19 delete "at engaging" and insert
"able to engage". On line 20 delete "conducting services" and
insert "periodic visits to facilities" and delete "routine
check-ins with facility managers and residents."
On page 3, line 2, delete "has" and insert "makes"
Arguments in Support: The Coalition for Elder & Dependent Abuse
Rights (CEDAR) writes in support of a thorough study of law
enforcement policies and practices associated with reports of
abuse, citing difficulties from prior experience.
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Previous and Related Legislation:
SB 1166 (Mello) Chapter 1115, Statutes of 1989 enacted the
Residential Care Facilities for the Elderly Reform Act of 1989.
AB 40 (Yamada), Chapter 659, Statutes of 2012 required mandated
reporters to report physical abuse which occurs within a
long-term care facility, except a state mental hospital or state
developmental center, to local law enforcement by telephone
within two hours, with the required written follow-up report to
be sent to both the law enforcement agency and the LTCO within
24 hours, as well as to the appropriate licensing agency.
Defined those crimes that must be reported to law enforcement,
at a minimum, to include those defined in WIC 15610.63, which
include assault, battery, sexual assault, unreasonable physical
restraint, improper use of a physical or chemical restraint or
psychotropic drugs, as specified, and other related crimes.
AB 1623 (Atkins), Chapter 85, Statutes of 2014 authorized the
creation of Family Justice Centers (FJCs) and defines key
aspects of their operations under state law. FJCs are
multiagency, multidisciplinary service centers where public and
private agencies assign staff members to provide services to
victims of domestic violence, sexual assault, elder and
dependent adult abuse, or human trafficking in order to reduce
the number of places victims must go to for help and increase
access to services and support for them and their children.
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AB 2171 (Wieckowski), Chapter 702, Statutes of 2014 established
a bill of rights for residents of RCFEs in order to strengthen a
resident's right to make choices about his or her care,
treatment, and daily life in the facility, ensure that the
resident's choices are respected, and protect residents from
physical or mental abuse, neglect, restraint, exploitation, or
endangerment.
AB 2379 (Weber), Chapter 62, Statutes of 2014 adds child welfare
services personnel to the list of individuals who may be
included in multidisciplinary teams that are trained in the
prevention, identification, management, or treatment of abuse of
elderly or dependent adults.
REGISTERED SUPPORT / OPPOSITION:
Support
Coalition for Elder & Dependent Abuse Rights (CEDAR) - Sponsor
Arc and United Cerebral Palsy California Collaboration
Opposition
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None on file.
Analysis Prepared by:Gail Gronert / AGING & L.T.C. / (916)
319-3990