BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 2920
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          Date of Hearing:   April 25, 2006

                   ASSEMBLY COMMITTEE ON AGING AND LONG-TERM CARE
                                  Patty Berg, Chair
                     AB 2920 (Leno) - As Amended:  April 18, 2006
              As Proposed to be Amended Legislative Council RN 06 09994
           
          SUBJECT  :   California Department of Aging: Seniors

           SUMMARY  :   This bill requires the California Department of Aging  
          (CDA) to ensure that all programs administered by CDA and the  
          Area Agencies on Aging (AAAs) account for the needs of lesbian,  
          gay, bisexual, and transgender (LGBT) elders.  Specifically,  
           this bill  :  

          1)Makes findings and declarations including the following:
             a)   Recent studies have shown that lifelong experiences of  
               marginalization place LGBT seniors at high risk for  
               isolation, poverty, homelessness, and premature  
               institutionalization;
             b)   Many LGBT seniors avoid accessing elder programs and  
               services, even when their health and safety and security  
               depend on it;
             c)   LGBT seniors often lack social and family support  
               networks available to non-LGBT seniors;
             d)   LGBT seniors are denied many vital financial benefits  
               provided to heterosexual married couples including Social  
               Security benefits and equal long-term care insurance  
               protections;
             e)   The number of people 65 years of age and older in  
               California is expected to double to 6.5 million by the year  
               2020, thereby increasing the number of LBGT seniors who are  
               receiving inadequate services;
             f)   Ensuring that the needs of LGBT seniors as well as other  
               underrepresented groups are adequately assessed during the  
               planning and development of programs and services will  
               increase access to the programs administered by CDA and the  
               AAAs; and, 
             g)   California leads the nation in the protections it  
               affords to LGBT persons.  Including the needs of LGBT  
               seniors and other underrepresented groups in the needs  
               assessment and Area Plan process will help the state to be  
               a model for change in other states and at the federal  
               level.









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          2)Specifies that CDA shall ensure that programs and services  
            provided through the Older Americans Act and the Older  
            Californians Act in each planning and service area are  
            available to all older adults regardless of physical or mental  
            disabilities, language barriers, cultural or social isolation,  
            including that caused by actual or perceived racial and ethnic  
            status, ancestry, national origin, religion, sex, gender  
            identity, marital status, familial status, sexual orientation,  
            or by any other basis set forth in Section 12921 of the  
            Government Code, or by association with a person or persons  
            with one or more of these actual or perceived characteristics,  
            that restrict an individual's ability to perform normal daily  
            tasks or that threaten his or her capacity to live  
            independently.

          3)Specifies that CDA shall require each AAA to include the needs  
            of LGBT seniors in their needs assessments and Area Plans.

          4)Requires CDA to provide technical assistance to the AAAs for  
            the training of program staff, volunteers, and contractors  
            regarding the unique needs of LGBT seniors.

           EXISTING LAW  

          1)Establishes the federal Older Americans Act (Chapter 35 of  
            Title 42 of the United States Code) which provides a national  
            network of state units on aging and AAAs to deliver home and  
            community-based programs for older adults.  Programs include  
            nutrition, transportation, information and assistance, elder  
            abuse prevention, and caregiver support.

          2)Establishes the Older Californians Act (Welfare and  
            Institutions Code, Division 8.5) which provides state-funded  
            programs and services for older adults and people with  
            disabilities.  

          3)Establishes CDA as the state unit on aging to administer a  
            broad range of home and community-based programs.  The  
            department's mission is to provide leadership to the AAAs in  
            developing systems of home and community-based services that  
            maintain individuals in their own homes or least restrictive  
            homelike environments.

          4)Requires CDA to develop minimum standards for service delivery  
            to ensure that programs meet consumer needs, operate in a  








                                                                  AB 2920
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            cost-effective manner, and preserve the independence and  
            dignity of aging Californians.

          5)Establishes the AAAs as the entities that provide for and/or  
            deliver services under the Older Americans Act, the Older  
            Californians Act, and other funding sources at the local  
            level.  

          6)Requires AAAs to conduct regular needs assessments in their  
            planning and service area to document the service needs of  
            older adults and adults with disabilities.  

          7)Requires each AAA to develop and submit to CDA an Area Plan  
            every four years.  Each plan must include the available data  
            and population trends, assess the community's need for  
            services, identify sources of funding for those services, and  
            develop and implement a plan for the delivery of those  
            services based on the community's needs. 

          8)Specifies that in fulfilling their mission, AAAs shall build  
            upon the resources unique to each community and be guided by a  
            description of a community-based system that includes the  
            assurance that all services are readily accessible to all  
            older adults, involves a collaborative decision making  
            process, and offers special help or targeted resources for the  
            most vulnerable older individuals, those in danger of losing  
            their independence.

          9)Requires CDA to develop a State Plan on Aging every four years  
            based upon the local area plans.  The State Plan is submitted  
            to the Administration on Aging at the federal level.

           FISCAL EFFECT  :   Unknown.

           COMMENTS  :   This bill ensures that the needs of LGBT seniors are  
          addressed in the planning and development of programs and  
          services administered by CDA and the AAAs.  

          California has 33 AAAs that provide a wide range of services  
          designed to keep older adults and adults with disabilities  
          independent and in their own homes and communities for as long  
          as possible.  AAAs serve as the focal point for local aging  
          issues and concerns.  The services are funded through the Older  
          Americans Act, the Older Californians Act, local entities, and  
          grants.  








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          To ensure that programs and services funded by the AAA  
          adequately serve the older adults within each community, AAAs  
          are required to conduct a needs assessment every four years to  
          document the service needs of community residents and any gaps  
          in the service network.  The needs assessment process typically  
          includes a community-wide survey, community meetings, and  
          information received from stakeholders and key informants.   
          California Code of Regulations (Title 22, Division 1.8, Chapter  
          3, Article 3) requires that each needs assessment include all of  
          the following:  the target populations, the types of existing  
          and potential needs of older individuals in the community, the  
          services or resources that currently are available, as well as  
          any constraints (waiting lists, geographic limitations,  
          quality), an estimate of unmet needs or barriers to access,  
          demographic information, and data from other agencies. The  
          information received through the needs assessment process guides  
          the AAA in identifying the service priorities for the Area Plan.  
           

          Every four years, CDA is required by federal law to submit a  
          State Plan on Aging to the federal Administration on Aging.   
          When approved, CDA receives federal funds to administer the  
          State Plan.  Beyond the minimum required information,  
          California's 2005-2009 State Plan on Aging addresses key  
          socio-demographic factors that will shape funding needs and  
          priorities, unmet needs and promising practices identified by  
          CDA and the AAAs, and CDA's objectives in working with the AAAs  
          to provide cost-effective, high quality services to California's  
          Older adults and their informal caregivers.  

          The 2005-2009 State Plan on Aging includes a summary of AAA  
          needs assessment findings.  Statewide, AAAs have indicate that  
          older adults often do not know how to secure available services  
          and that information on what services exist and how to access  
          them is one of the most pressing needs.  The promising practices  
          to expand outreach and information identified in the State Plan  
          on Aging includes establishing many more activities targeting  
          diverse cultural and ethnic groups, which in some areas included  
          creating neighborhood partnerships with African American, Asian  
          Pacific Islander, and LGBT groups.

          In addition, the State Plan on Aging includes in its priorities  
          for 2005-2009 the facilitation of diversity training for CDA  
          staff and external stakeholders to promote cultural competence  








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          and sensitivity in providing services so that ethnic and  
          cultural differences are not a barrier to accessing services.   
          The technical assistance requirement included in this bill could  
          potentially be included in this priority area.

          Recent studies have called attention to the lack of culturally  
          competent services for LGBT seniors.  In areas ranging from  
          housing and health care to relationship and asset protection,  
          these individuals are vulnerable to multiple forms of  
          discrimination and often have limited legal, medical, and social  
          resources.  A number of the unique problems faced by LGBT  
          seniors are caused by the fact that they often do not have the  
          same family support systems as heterosexual individuals.  

          Because LGBT seniors may be more likely to age alone and without  
          children, they are especially dependent on public and private  
          services for the elderly.  However, fears of homophobia or  
          transphobia often prevent LGBT seniors from accessing adequate  
          health care, affordable housing, and other social services that  
          they need. 

          According to the author, having to rely on the healthcare  
          system, a nursing home facility, or any other social institution  
          understandably provokes anxiety and fear in aging LGBT  
          Californians.  Many avoid accessing services altogether, even  
          when their health, safety, and security depend on it.  Due to  
          discriminatory marriage laws, LGBT seniors also face barriers to  
          protecting their relationships and assets later in life.

          AB 2920 would greatly strengthen the state's ability to respond  
          to the needs of this population by including LGBT elders in the  
          planning and development of services administered by the AAAs  
          and CDA.

          Proponents argue that there is a clear need for public policy  
          measures to better protect LGBT seniors who constitute an  
          underserved population at high risk for health disparities,  
          isolation, poverty, homelessness and premature isolation.  By  
          including LGBT seniors in the needs assessment and Area Plan  
          process, CDA and the AAAs can ensure that they are responding to  
          the needs of all older adults and adults with disabilities in  
          each community.

          While the Committee received letters of opposition from two  
          organizations, neither letter included information regarding the  








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          basis of the organization's opposition to the bill.  


           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          American Society on Aging (ASA)
          Gay and Lesbian Alliance of the Central Coast (GALA)
          Lambda Letters Project
          Lavender Seniors of the East Bay
          National Association of Social Workers, California Chapter
          National Center for Lesbian Rights
          San Francisco Aids Foundation
          Spectrum Center

           Opposition 
           
          California Family Alliance
          California Family Council
           
          Analysis Prepared by  :    Allison Ruff / AGING & L.T.C. / (916)  
          319-3946