Amended in Senate January 26, 2016

Amended in Senate January 4, 2016

Senate BillNo. 547


Introduced by Senator Liu

(Principal coauthor: Assembly Member Brown)

February 26, 2015


An act to add Division 121 (commencing with Section 152000) to the Health and Safety Code, relating to aging.

LEGISLATIVE COUNSEL’S DIGEST

SB 547, as amended, Liu. Aging and long-term care services, supports, and program coordination.

Existing law establishes the California Health and Human Services Agency consisting of the Departments of Aging, Child Support services, Community Services and Development, Developmental Services, Health Care Services, Managed Health Care, Public Health, Rehabilitation, Social Services, and State Hospitals.

Existing law sets forth legislative findings and declarations regarding long-term care services, including that consumers of those services experience great differences in service levels, eligibility criteria, and service availability that often result in inappropriate and expensive care that is not responsive to individual needs. Those findings and declarations also state that the laws governing long-term care facilities have established an uncoordinated array of long-term care services that are funded and administered by a state structure that lacks necessary integration and focus.

This bill, among other things, would create the Statewide Aging and Long-Term Care Services Coordinating Council, chaired by the Secretary of California Health and Human Services, and would consist of the heads, or their designated representative, of specified departments and offices. The secretary would have specified responsibilities, including, but not limited to, leading the council in the developmentbegin delete and implementationend delete of a state aging and long-term care services strategic plan to address how the state will meet the needs of the aging population in the years 2020, 2025, and 2030.begin delete The bill would also require the secretary to enter into a contract with the Regents of the University of California so that the council may either partner with the University of California, San Francisco, to operate, revise, and manage the CalQualityCare.org Internet Web site or acquire the rights to operate the CalQualityCare.org Internet Web site to function as a consumer-oriented portal that provides specified aging and long-term care information on a statewide basis.end deletebegin insert The bill would require the strategic plan to be submitted to the Secretary of the Senate, end insertbegin insertthe Chief Clerk of the Assembly, and end insertbegin insertthe chairs of specified policy and fiscal committees of the Legislature by July 1, 2018.end insert

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

P2    1begin insert

begin insertSECTION 1.end insert  

end insert
begin insert

The Legislature finds and declares all of the
2following:

end insert
begin insert

3(a) The California Health and Human Services Agency consists
4of the following departments: the California Department of Aging,
5the Department of Community Services and Development, the State
6Department of Developmental Services, the State Department of
7Health Care Services, the Department of Managed Health Care,
8the State Department of Public Health, the Department of
9Rehabilitation, the State Department of Social Services, and the
10State Department of State Hospitals.

end insert
begin insert

11(b) The agency also includes the Emergency Medical Services
12Authority, the Office of Health Information Integrity, the Office of
13Patient Advocate, the Office of Statewide Health Planning and
14Development, the Office of Systems Integration, the Office of Law
15Enforcement Support, and the State Council on Developmental
16Disabilities.

end insert
begin insert

17(c) California baby boomers are turning 65 years of age at the
18highest rate in the nation, and over 20 percent of California’s
19population will be 65 years of age or older by 2030.

end insert
begin insert

P3    1(d) Among persons 65 years of age and older, an estimated 70
2percent will use long-term services and supports (LTSS).

end insert
begin insert

3(e) Persons who are 85 years of age or older are the fastest
4growing segment of the United States population, and they are
5four times more likely to need LTSS than persons who are 65 years
6of age or older, but younger than 85 years of age.

end insert
begin insert

7(f) People are living longer, and the aging population is
8increasingly diverse.

end insert
begin insert

9(g) A report by the Senate Select Committee on Aging and Long
10Term Care on January 2015, called, “A Shattered System:
11Reforming Long-Term Care in California. Envisioning and
12Implementing an IDEAL Long-Term Care System in California,”
13found that the state’s system of 112 aging long-term care programs
14administered by 20 agencies and departments is almost impossible
15for consumers to navigate.

end insert
begin insert

16(h) Other deficiencies of the system include the lack of
17person-centered care, poor transitions from hospital to home or
18to other institutions, limited access to a range of services that
19enable aging in place, deficiency of services and supports in rural
20areas, limited cultural competency, skilled workforce shortages
21across a range of disciplines, the lack of uniform data, the lack of
22a universal assessment tool, and limited caregiver supports.

end insert
23

begin deleteSECTION 1.end delete
24begin insertSEC. 2.end insert  

Division 121 (commencing with Section 152000) is
25added to the Health and Safety Code, to read:

26 

27Division 121.  Aging and Long-Term Care
28Services, Supports, and Program Coordination

29

 

begin delete
30

152000.  

The Legislature finds and declares all of the following:

31(a) The California Health and Human Services Agency consists
32of the following departments: the California Department of Aging,
33the Department of Community Services and Development, the
34State Department of Developmental Services, the State Department
35of Health Care Services, the Department of Managed Health Care,
36the State Department of Public Health, the Department of
37Rehabilitation, the State Department of Social Services, and the
38State Department of State Hospitals.

39(b) The agency also includes the Emergency Medical Services
40Authority, the Office of Health Information Integrity, the Office
P4    1of Patient Advocate, the Office of Statewide Health Planning and
2Development, the Office of Systems Integration, the Office of Law
3Enforcement Support, and the State Council on Developmental
4Disabilities.

5(c) California baby boomers are turning 65 years of age at the
6highest rate in the nation, and over 20 percent of California’s
7population will be 65 years of age or older by 2030.

8(d) Among persons 65 years of age and older, an estimated 70
9percent will use long-term services and supports (LTSS).

10(e) Persons 85 years of age and older are the fastest growing
11segment of the United States population, and they are four times
12more likely to need LTSS than persons between 65 and 84 years
13of age.

14(f) People are living longer, and the aging population is
15increasingly diverse.

16(g) A report by the Senate Select Committee on Aging and Long
17Term Care on January 2015, called, “A Shattered System:
18Reforming Long-Term Care in California. Envisioning and
19Implementing an IDEAL Long-Term Care System in California,”
20found that the state’s system of 112 aging long-term care programs
21administered by 20 agencies and departments is almost impossible
22for consumers to navigate.

23(h) Other deficiencies of the system include no person-centered
24care, poor transitions from hospital to home or to other institutions,
25limited access to a range of services that enable aging in place,
26deficiency of services and supports in rural areas, limited cultural
27competency, skilled workforce shortages across a range of
28disciplines, no uniform data, no universal assessment tool, and
29limited caregiver supports.

30(i) Also, the End of Life Option Act authorizes an adult, who
31meets certain qualifications and who has been determined by his
32or her attending physician to be suffering from a terminal disease,
33to make a request for a drug for the purpose of ending his or her
34life. Paragraph (5) of subdivision (i) of Section 443.1 states that
35an individual choosing the end-of-life option is required to be
36informed of “feasible alternatives or additional treatment
37opportunities, including, but not limited to, comfort care, hospice
38care, palliative care, and pain control.” Better systemwide
39coordination of aging and long-term care services and supports is
40needed to ensure access to services and information, so individuals
P5    1can plan for, access, and make informed decisions on end-of-life
2options.

end delete
3

begin delete152001.end delete
4begin insert152000.end insert  

The Secretary of California Health and Human
5Services shall be responsible for all of the following:

6(a) Inter- and intra-agency coordination of state aging and
7long-term care services, supports, and programs.

8(b) Ensuring efficient and effective use of state funds.

9(c) Maximizing the drawdown, and the efficient and effective
10use of federal funds.

11

begin delete152002.end delete
12begin insert152001.end insert  

There is hereby created a Statewide Aging and
13Long-Term Care Services Coordinating Council, chaired by the
14Secretary of California Health and Human Services, and consisting
15of the heads, or their designated representative, of all of the
16following:

17(a) The California Department of Aging.

18(b) The Department of Community Services and Development.

19(c) The Department of Consumer Affairs.

20(d) The Department of Food and Agriculture.

21(e) The Department of Human Resources.

22(f) The Department of Insurance.

23(g) The Department of Justice.

24(h) The Department of Motor Vehicles.

25(i) The Department of Rehabilitation.

26(j) The Department of Transportation.

27(k) The Department of Veterans Affairs.

28(l) The Emergency Medical Services Authority.

29(m) The Employment Development Department.

30(n) The Office of Health Information Integrity.

31(o) The Office of Law Enforcement Support.

32(p) The Office of Patient Advocate.

33(q) The Office of Statewide Health Planning and Development.

34(r) The Office of Systems Integration.

35(s) The State Department of Developmental Services.

36(t) The State Department of Health Care Services.

37(u) The State Department of Public Health.

38(v) The State Department of Social Services.

P6    1

begin delete152003.end delete
2begin insert152002.end insert  

(a) The secretary shall lead the council in the
3developmentbegin delete and implementationend delete of a state aging and long-term
4care services strategic plan to address how the state will meet the
5needs of the aging population in the years 2020, 2025, and 2030.
6The strategic plan shall incorporate clear benchmarks and timelines
7for achieving the goals set forth in the strategic planbegin delete and be updated
8every five years.end delete
begin insert and a cost and benefit analend insertbegin insertysis for each goal or
9recommendation included in the plan.end insert
In developing the strategic
10plan, the council shall consult with all of the following:

11(1) Experts, researchers, practitioners, service providers, and
12facility operators in the field of aging and long-term care.

13(2) Consumer advocates and stakeholders, including the
14Olmstead Advisory Committee, the California Commission on
15Aging,begin delete the area agencyend deletebegin insert area agenciesend insert on aging, the State Council
16on Developmental Disabilities, the California Foundation for
17Independent Living Centers, and the Milton Marks “Little Hoover”
18Commission on California State Government Organization and
19Economy.

20(3) Rural and urbanbegin delete communitiesend deletebegin insert communities,end insert in order to
21identify infrastructure capacity issues, the need for uniform access
22standards for home and community-based services, and
23mechanisms for supporting coordination of regional and local
24service access and delivery.

25(4) The California Task Force on Family Caregiving, the
26findings and recommendations of which shall be incorporated into
27the strategic plan.

28(b) Technical support for the development of the strategic plan
29shall be provided by the Office of Health Equity in the State
30Department of Public Health and by the California Department of
31Aging.

32(c) The strategic plan shall address all of the following:

33(1) Integration and coordination of services that support
34independent living, aging in place, social and civic engagement,
35and preventative care.

36(2) Long-term care financing.

37(3) Managed care expansion and continuum of care.

38(4) Advanced planning for end-of-life care.

39(5) Elder justice.

P7    1(6) Care guidelines for Alzheimer’s disease, dementia,
2Amyotrophic Lateral Sclerosis (ALS), and other debilitating
3diseases.

4(7) Caregiver support.

5(8) Data collection, consolidation, uniformity, analysis, and
6access.

7(9) Affordable housing.

8(10) Mobility.

9(11) Workforce.

10(12) The alignment of state programs with the federal
11Administration for Community Living.

12(13) The potential for integration and coordination of aging and
13long-term care services with services and supports for people with
14disabilities.

15(d) In developing the strategic plan, the council shall examine
16model programs in various cities, counties, and states. The strategic
17plan shall consider how to scale up local, regional, and state-level
18best practices and innovations designed to overcome the challenges
19related to long-term care services delivery.

20(e) Notwithstanding Section 10231.5 of the Government Code,
21the strategic plan shall be submitted to the Secretary of the Senate
22and the Chief Clerk of the Assembly, to the appropriate chairs of
23the policy committees of the Legislature with jurisdiction over any
24aging and long-term care related issues, and to the chairs of the
25fiscal committees of the Legislature by July 1,begin delete 2018, with updates
26submitted by July 1, 2023, and by July 1, 2028.end delete
begin insert 2018.end insert

begin delete

27(f) Notwithstanding Section 10231.5 of the Government Code,
28beginning on July 1, 2017, the secretary shall report on an annual
29basis to the appropriate policy committees of the Legislature with
30jurisdiction over any aging and long-term care related issues and
31to the fiscal committees of the Legislature regarding the current
32status of long-term care in the state, the level of state spending on
33long-term care programs, federal funding received, progress in
34developing and implementing the strategic plan as provided in this
35section, and the statewide Internet Web site portal as provided in
36Section 152004.

end delete
begin delete
37

152004.  

Notwithstanding Chapter 2 (commencing with Section
3810290) and Chapter 3 (commencing with Section 12100) of Part
392 of Division 2 of the Public Contract Code, the secretary shall
40enter into a contract with the Regents of the University of
P8    1California so that the council may either partner with the University
2of California, San Francisco, to operate, revise, and manage the
3CalQualityCare.org Internet Web site or acquire the rights to
4operate the CalQualityCare.org Internet Web site to function as a
5consumer oriented portal that provides all of the following
6information on a statewide basis:

7(a) Comprehensive, free, unbiased information on long-term
8care services and supports, including licensed skilled nursing
9facilities (freestanding and hospital-based), congregate living health
10facilities, hospice, home health, assisted living, continuing care
11retirement communities, adult day care, adult day health care, and
12intermediate care for the developmentally disabled (ICF/DD).

13(b) Depending on the availability and reliability of the data,
14information within all of the following domains shall be provided:

15(1) Provider characteristics, such as location, size, and
16ownership.

17(2) Ratings of skilled nursing facilities, home health, hospice,
18and ICF/DD.

19(3) Staffing, such as number and type.

20(4) Quality of the facility, such as deficiencies and complaints.

21(5) Quality of care, such as incidence of pressure ulcers and
22infections.

23(6) Cost and finances.

24(c) The CalQualityCare.org Internet Web site shall include
25information that assists the consumer to learn about options and
26how to make decisions on long-term care services and supports,
27advanced planning, and end-of-life options.

28(d) By July 1, 2018, the secretary shall expand the
29CalQualityCare.org Internet Web site to provide all of the
30following:

31(1) Information about long-term services and supports eligibility
32and how to access long-term care services and supports.

33(2) Internet links to reputable local resource portals, such as
34county long-term care services and supports Internet Web sites.

35(3) Internet links to reputable caregiver resources.

36(4) Information on additional licensed providers, such as
37nonmedical home care aides.

end delete


O

    97