BILL ANALYSIS Ó
SB 547
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SENATE THIRD READING
SB
547 (Liu)
As Amended August 1, 2016
Majority vote
SENATE VOTE: 35-4
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|Committee |Votes|Ayes |Noes |
| | | | |
| | | | |
| | | | |
|----------------+-----+----------------------+--------------------|
|Aging |6-0 |Brown, Hadley, Dahle, | |
| | |Gray, Levine, Lopez | |
| | | | |
|----------------+-----+----------------------+--------------------|
|Appropriations |19-1 |Gonzalez, Bloom, |Bigelow |
| | |Bonilla, Bonta, | |
| | |Calderon, Chang, | |
| | |Daly, Eggman, | |
| | |Gallagher, | |
| | | | |
| | | | |
| | |Eduardo Garcia, | |
| | |Holden, Jones, | |
| | |Obernolte, Quirk, | |
| | |Santiago, Wagner, | |
| | |Weber, Wood, McCarty | |
| | | | |
SB 547
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| | | | |
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SUMMARY: This bill creates the Statewide Aging and Long-Term
Care Services and Coordinating Council (Council), chaired by the
Secretary of the California Health and Human Services Agency
(CHHS) and requires the Council to develop a state aging and
long-term care services strategic plan to address how in 2020,
2025, and 2030 California will meet the needs of the aging
population. Specifically, this bill:
1)Requires the Secretary of CHHS (Secretary) to be responsible
for the inter- and intra-agency coordination of state aging
and long-term care services, supports, and programs, to ensure
the efficient and effective use of state funds, and maximize
the drawdown, and efficient and effective use of federal
funds.
2)Creates a Statewide Aging and Long-Term Care Services and
Coordinating Council (Council), chaired by the Secretary and
consisting of the heads, or designees, representing 22 state
departments.
3)Requires the Council to develop a state aging and long-term
care services strategic plan to address how in 2020, 2025, and
2030, California will meet the needs of the aging population.
4)Requires the strategic plan to incorporate clear benchmarks
and timelines for achieving the goals set forth in the
strategic plan, and include a cost benefit analysis for each
goal or recommendation included in the plan.
5)Requires consultation with specified experts, practitioners,
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service providers, advocates and stakeholders in developing
the strategic plan, and requires the findings and
recommendations of the California Task Force on Family Care
Giving be incorporated in the strategic plan.
6)Requires the strategic plan to address all of the following:
a) Integration and coordination of services that support
independent living, aging in place, social and civic
engagement, and preventative care;
b) Long-term care financing;
c) Managed care expansion and continuum of care;
d) Advanced planning for end-of-life care;
e) Elder justice;
f) Care guidelines for Alzheimer's disease, dementia,
Amyotrophic Lateral Sclerosis, and other debilitating
diseases;
g) Caregiver support;
h) Data collection, consolidation, uniformity, analysis,
and access;
i) Affordable housing;
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j) Mobility;
k) Workforce;
l) The alignment of state programs with the Federal
Administration for Community Living (ACL); and,
m) The potential for integration and coordination of aging
and long-term care services with services and supports for
people with disabilities.
7)Requires the Council to examine model programs and consider
how to scale up local, regional, and state-level best
practices and innovations to overcome long-term care services
delivery.
8)Requires the strategic plan to be submitted to the specified
committees of the Legislature by July 1, 2018.
FISCAL EFFECT: According to the Assembly Appropriations
Committee:
1)One-time costs, potentially in the hundreds of thousands, in
staff or contract costs to convene the council and produce a
strategic plan that includes goals, timelines, and
cost-benefit analyses (General Fund (GF), or potentially
private or in-kind funds). Staff time from a number of
departments and agencies will be required as well; however, no
significant increased staffing appears necessary (various
funds). The cost will vary based on the robustness of the
effort.
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2)The creation of a legislatively mandated strategic plan may
result in unknown cost pressure (potentially
GF/federal/special funds) if various improvements to the
long-term care system are recommended as goals in the plan.
Improvements could also result in cost avoidance by increasing
efficiency and effectiveness of aging services and long-term
care services and supports. The magnitude of any such costs,
and net effect on costs, are unknown.
COMMENTS:
Author's statement. According to the author, "California's
population of residents 65 years old and older will grow from
about 13 percent of the population to almost 20 percent of the
population by 2030. The state is not prepared for this 'silver
tsunami.' ?California's aging and long term care "system" of
services and supports is fragmented to the point of being almost
impossible for consumers, caregivers, and providers to navigate.
There are 112 aging and long term care programs spread over 20
state agencies and departments and very little coordination
among them. ?California must begin now to organize our services
and supports delivery system and plan our investments in long
term care to maximize returns in the form of improved quality of
life and cost savings to consumers and taxpayers before we are
faced with an overwhelming crisis."
Senate Select Committee on Aging and Long Term Care report. The
Senate Select Committee on Aging and Long Term Care's 2014
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report, A Shattered System: Reforming Long Term Care in
California (report) was the result of a comprehensive effort in
2014 to identify the structural, policy, and administrative
changes necessary to realize an ideal long-term care delivery
system and develop recommendations and a strategy to achieve
that vision. The report found that California's fragmented
organizational structure leaves the state with a leadership
vacuum that complicates any effort to undertake comprehensive
Long Term Care reform. Among state agencies there is no
distinct leader who is responsible for establishing and
implementing a vision for comprehensive LTC service delivery.
Instead, the current structure offers a piecemeal approach to
system change; there is no overarching plan for creating an
integrated system.
The Little Hoover Commission in its 2011 report, A Long-Term
Strategy for Long-Term Care, found California's long-term care
system broken. The state has no reliable means of gauging what
clients need, what benefits they receive, which services are
used by whom, how much each service costs the state, and which
programs work the best and are the most cost-effective in
keeping people in their homes. There is virtually no
coordination or communication between programs and staff
responsible for long-term care services. There is no integrated
management or coordination of financing, service delivery or
assessment of long-term care client needs or of providers.
These fundamental structural flaws leave the system unable to
effectively or efficiently deal with current needs and make it
woefully unprepared for the "silver tsunami" of seniors who will
lack services in the years to come. Furthermore, California
lacks a single leader within the Health and Human Services
Agency accountable for managing and modernizing long-term care
in the state, which creates significant challenges to any
attempt to systematically harness the dozens of long-term care
programs and the many billions of dollars spent on them.
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Analysis Prepared by:
Barry Brewer / AGING & L.T.C. / (916) 319-3990
FN:
0004051