SB 547 Senate Bill

BILL NUMBER: SB 547	AMENDED
	BILL TEXT

	AMENDED IN SENATE  JANUARY 26, 2016
	AMENDED IN SENATE  JANUARY 4, 2016

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 development  and implementation  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.  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.   The bill would
require the strategic plan to be submitted to the Secretary of the
Senate,   the Chief Clerk of the Assembly, and  
the chairs of specified policy and fiscal committees of the
Legislature by July 1, 2018. 
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

   SECTION 1.    The Legislature finds and declares all
of the following:  
   (a) The California Health and Human Services Agency consists of
the following departments: the California Department of Aging, the
Department of Community Services and Development, the State
Department of Developmental Services, the State Department of Health
Care Services, the Department of Managed Health Care, the State
Department of Public Health, the Department of Rehabilitation, the
State Department of Social Services, and the State Department of
State Hospitals.  
   (b) The agency also includes the Emergency Medical Services
Authority, the Office of Health Information Integrity, the Office of
Patient Advocate, the Office of Statewide Health Planning and
Development, the Office of Systems Integration, the Office of Law
Enforcement Support, and the State Council on Developmental
Disabilities.  
   (c) California baby boomers are turning 65 years of age at the
highest rate in the nation, and over 20 percent of California's
population will be 65 years of age or older by 2030.  
   (d) Among persons 65 years of age and older, an estimated 70
percent will use long-term services and supports (LTSS).  
   (e) Persons who are 85 years of age or older are the fastest
growing segment of the United States population, and they are four
times more likely to need LTSS than persons who are 65 years of age
or older, but younger than 85 years of age.  
   (f) People are living longer, and the aging population is
increasingly diverse.  
   (g) A report by the Senate Select Committee on Aging and Long Term
Care on January 2015, called, "A Shattered System: Reforming
Long-Term Care in California. Envisioning and Implementing an IDEAL
Long-Term Care System in California," found that the state's system
of 112 aging long-term care programs administered by 20 agencies and
departments is almost impossible for consumers to navigate. 

   (h) Other deficiencies of the system include the lack of
person-centered care, poor transitions from hospital to home or to
other institutions, limited access to a range of services that enable
aging in place, deficiency of services and supports in rural areas,
limited cultural competency, skilled workforce shortages across a
range of disciplines, the lack of uniform data, the lack of a
universal assessment tool, and limited caregiver supports. 
   SECTION 1.   SEC. 2.   Division 121
(commencing with Section 152000) is added to the Health and Safety
Code, to read:

      DIVISION 121.  Aging and Long-Term Care Services, Supports, and
Program Coordination


   152000.  The Legislature finds and declares all of the following:
   (a) The California Health and Human Services Agency consists of
the following departments: the California Department of Aging, the
Department of Community Services and Development, the State
Department of Developmental Services, the State Department of Health
Care Services, the Department of Managed Health Care, the State
Department of Public Health, the Department of Rehabilitation, the
State Department of Social Services, and the State Department of
State Hospitals.
   (b) The agency also includes the Emergency Medical Services
Authority, the Office of Health Information Integrity, the Office of
Patient Advocate, the Office of Statewide Health Planning and
Development, the Office of Systems Integration, the Office of Law
Enforcement Support, and the State Council on Developmental
Disabilities.
   (c) California baby boomers are turning 65 years of age at the
highest rate in the nation, and over 20 percent of California's
population will be 65 years of age or older by 2030.
   (d) Among persons 65 years of age and older, an estimated 70
percent will use long-term services and supports (LTSS).
   (e) Persons 85 years of age and older are the fastest growing
segment of the United States population, and they are four times more
likely to need LTSS than persons between 65 and 84 years of age.
   (f) People are living longer, and the aging population is
increasingly diverse.
   (g) A report by the Senate Select Committee on Aging and Long Term
Care on January 2015, called, "A Shattered System: Reforming
Long-Term Care in California. Envisioning and Implementing an IDEAL
Long-Term Care System in California," found that the state's system
of 112 aging long-term care programs administered by 20 agencies and
departments is almost impossible for consumers to navigate.
   (h) Other deficiencies of the system include no person-centered
care, poor transitions from hospital to home or to other
institutions, limited access to a range of services that enable aging
in place, deficiency of services and supports in rural areas,
limited cultural competency, skilled workforce shortages across a
range of disciplines, no uniform data, no universal assessment tool,
and limited caregiver supports.
   (i) Also, the End of Life Option Act authorizes an adult, who
meets certain qualifications and who has been determined by his or
her attending physician to be suffering from a terminal disease, to
make a request for a drug for the purpose of ending his or her life.
Paragraph (5) of subdivision (i) of Section 443.1 states that an
individual choosing the end-of-life option is required to be informed
of "feasible alternatives or additional treatment opportunities,
including, but not limited to, comfort care, hospice care, palliative
care, and pain control." Better systemwide coordination of aging and
long-term care services and supports is needed to ensure access to
services and information, so individuals can plan for, access, and
make informed decisions on end-of-life options. 
    152001.   152000.   The Secretary of
California Health and Human Services shall be responsible for all of
the following:
   (a) Inter- and intra-agency coordination of state aging and
long-term care services, supports, and programs.
   (b) Ensuring efficient and effective use of state funds.
   (c) Maximizing the drawdown, and the efficient and effective use
of federal funds.
    152002.   152001.   There is hereby
created a Statewide Aging and Long-Term Care Services Coordinating
Council, chaired by the Secretary of California Health and Human
Services, and consisting of the heads, or their designated
representative, of all of the following:
   (a) The California Department of Aging.
   (b) The Department of Community Services and Development.
   (c) The Department of Consumer Affairs.
   (d) The Department of Food and Agriculture.
   (e) The Department of Human Resources.
   (f) The Department of Insurance.
   (g) The Department of Justice.
   (h) The Department of Motor Vehicles.
   (i) The Department of Rehabilitation.
   (j) The Department of Transportation.
   (k) The Department of Veterans Affairs.
   (l) The Emergency Medical Services Authority.
   (m) The Employment Development Department.
   (n) The Office of Health Information Integrity.
   (o) The Office of Law Enforcement Support.
   (p) The Office of Patient Advocate.
   (q) The Office of Statewide Health Planning and Development.
   (r) The Office of Systems Integration.
   (s) The State Department of Developmental Services.
   (t) The State Department of Health Care Services.
   (u) The State Department of Public Health.
   (v) The State Department of Social Services.
    152003.   152002.   (a) The secretary
shall lead the council in the development  and implementation
 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. The strategic plan
shall incorporate clear benchmarks and timelines for achieving the
goals set forth in the strategic plan  and be updated every
five years.   and a cost and benefit anal  
ysis for each goal or recommendation included in the plan.  In
developing the strategic plan, the council shall consult with all of
the following:
   (1) Experts, researchers, practitioners, service providers, and
facility operators in the field of aging and long-term care.
   (2) Consumer advocates and stakeholders, including the Olmstead
Advisory Committee, the California Commission on Aging,  the
area agency   area agencies  on aging, the State
Council on Developmental Disabilities, the California Foundation for
Independent Living Centers, and the Milton Marks "Little Hoover"
Commission on California State Government Organization and Economy.
   (3) Rural and urban  communities  
communities,  in order to identify infrastructure capacity
issues, the need for uniform access standards for home and
community-based services, and mechanisms for supporting coordination
of regional and local service access and delivery.
   (4) The California Task Force on Family Caregiving, the findings
and recommendations of which shall be incorporated into the strategic
plan.
   (b) Technical support for the development of the strategic plan
shall be provided by the Office of Health Equity in the State
Department of Public Health and by the California Department of
Aging.
   (c) The strategic plan shall address all of the following:
   (1) Integration and coordination of services that support
independent living, aging in place, social and civic engagement, and
preventative care.
   (2) Long-term care financing.
   (3) Managed care expansion and continuum of care.
   (4) Advanced planning for end-of-life care.
   (5) Elder justice.
   (6) Care guidelines for Alzheimer's disease, dementia, Amyotrophic
Lateral Sclerosis (ALS), and other debilitating diseases.
   (7) Caregiver support.
   (8) Data collection, consolidation, uniformity, analysis, and
access.
   (9) Affordable housing.
   (10) Mobility.
   (11) Workforce.
   (12) The alignment of state programs with the federal
Administration for Community Living.
   (13) The potential for integration and coordination of aging and
long-term care services with services and supports for people with
disabilities.
   (d) In developing the strategic plan, the council shall examine
model programs in various cities, counties, and states. The strategic
plan shall consider how to scale up local, regional, and state-level
best practices and innovations designed to overcome the challenges
related to long-term care services delivery.
   (e) Notwithstanding Section 10231.5 of the Government Code, the
strategic plan shall be submitted to the Secretary of the Senate and
the Chief Clerk of the Assembly, to the appropriate chairs of the
policy committees of the Legislature with jurisdiction over any aging
and long-term care related issues, and to the chairs of the fiscal
committees of the Legislature by July 1,  2018, with updates
submitted by July 1, 2023, and by July 1, 2028.   2018.
 
   (f) Notwithstanding Section 10231.5 of the Government Code,
beginning on July 1, 2017, the secretary shall report on an annual
basis to the appropriate policy committees of the Legislature with
jurisdiction over any aging and long-term care related issues and to
the fiscal committees of the Legislature regarding the current status
of long-term care in the state, the level of state spending on
long-term care programs, federal funding received, progress in
developing and implementing the strategic plan as provided in this
section, and the statewide Internet Web site portal as provided in
Section 152004.  
   152004.  Notwithstanding Chapter 2 (commencing with Section 10290)
and Chapter 3 (commencing with Section 12100) of Part 2 of Division
2 of the Public Contract Code, the secretary shall 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 all of the following information on a
statewide basis:
   (a) Comprehensive, free, unbiased information on long-term care
services and supports, including licensed skilled nursing facilities
(freestanding and hospital-based), congregate living health
facilities, hospice, home health, assisted living, continuing care
retirement communities, adult day care, adult day health care, and
intermediate care for the developmentally disabled (ICF/DD).
   (b) Depending on the availability and reliability of the data,
information within all of the following domains shall be provided:
   (1) Provider characteristics, such as location, size, and
ownership.
   (2) Ratings of skilled nursing facilities, home health, hospice,
and ICF/DD.
   (3) Staffing, such as number and type.
   (4) Quality of the facility, such as deficiencies and complaints.
   (5) Quality of care, such as incidence of pressure ulcers and
infections.
   (6) Cost and finances.
   (c) The CalQualityCare.org Internet Web site shall include
information that assists the consumer to learn about options and how
to make decisions on long-term care services and supports, advanced
planning, and end-of-life options.
   (d) By July 1, 2018, the secretary shall expand the
CalQualityCare.org Internet Web site to provide all of the following:

   (1) Information about long-term services and supports eligibility
and how to access long-term care services and supports.
   (2) Internet links to reputable local resource portals, such as
county long-term care services and supports Internet Web sites.
   (3) Internet links to reputable caregiver resources.
   (4) Information on additional licensed providers, such as
nonmedical home care aides.