BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



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          |SENATE RULES COMMITTEE            |                   AB 324|
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                                 THIRD READING


          Bill No:  AB 324
          Author:   Beall (D), et al
          Amended:  9/1/09 in Senate
          Vote:     21

           
           SENATE HUMAN SERVICES COMMITTEE  :  4-1, 6/23/09
          AYES:  Liu, Maldonado, Alquist, Yee
          NOES:  Runner

           SENATE APPROPRIATIONS COMMITTEE  :  8-5, 8/27/09
          AYES:  Kehoe, Corbett, Hancock, Leno, Oropeza, Price, Wolk,  
            Yee
          NOES:  Cox, Denham, Runner, Walters, Wyland

           ASSEMBLY FLOOR  :  53-21, 6/3/09 - See last page for vote


           SUBJECT  :    Aging:  Elder Economic Security Standard Index

           SOURCE  :     California Senior Legislature
                      Catholic Charities of California
                      Insight Center for Community Economic  
          Development
                      National Association of Social Workers,  
          California Chapter
                      The Womens Foundation of California


           DIGEST  :    This bill requires area agencies on aging to  
          utilize the Elder Index in it four-year plans, and requires  
          the Department of Aging to include the Elder Index in the  
          four-year State Plan and review area agencies on aging area  
                                                           CONTINUED





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          plans for inclusion of the Elder Index.

           ANALYSIS  :    

          Existing law:

          1. Establishes the federal Older Americans Act which  
             provides a national network of state units on aging and  
             area agencies on aging to deliver home and  
             community-based programs for older adults, including  
             nutrition, transportation, information and assistance,  
             elder abuse prevention, and caregiver support.

          2. Establishes the Older Californians Act which provides  
             state-funded programs and services for older adults and  
             people with disabilities.

          3. Establishes the Department of Aging (CDA) as the state  
             unit on aging to administer a broad range of home and  
             community-based programs and to provide leadership to  
             the area agencies on aging 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 cost-effective manner, and preserve the  
             independence and dignity of aging Californians.

          5. Establishes the area agencies on aging as the entities  
             that provide for and deliver services under the Older  
             Americans Act, the Older Californians Act, and other  
             funding sources at the local level.

          6. Requires area agencies on aging 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 area agency to develop and submit to CDA  
             an area plan every four years that must include the  
             available data and population trends, assess the  
             community's need for services, identify sources of  







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             funding for those services, and develop and implement a  
             plan for the delivery of those services based on the  
             community's needs.

          8. Defines "greatest economic need" as need resulting from  
             an income level at or below the poverty threshold  
             established by the Bureau of the Census (Section 9014 of  
             the Welfare and Institutions Code), directs CDA to:

             A.    Provide an annual update for each service planning  
                area of changes in population characteristics  
                including persons over 60 years of age of greatest  
                economic need.

             B.    Ensure that new funds provided to service and  
                planning areas be expended on persons with the  
                greatest economic need.
              
             C.    Ensure that funding decisions to reach parity  
                among the service and planning areas will be based in  
                part on targeting services to those of greatest  
                economic need.  (WIC Sections 9111 and 9112)

          9. Specifies that in fulfilling their mission, area  
             agencies 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.

          10.Establishes the linkages program to provide  
             comprehensive case management to help frail elderly and  
             adults with disabilities remain in their homes: it is  
             designed to serve individuals who are not eligible for  
             other care management programs, and there are no income  
             criteria for clients, but they must have some difficulty  
             with completing their daily activities to qualify for  
             the program.

          11.Requires CDA to develop a state plan on aging every four  
             years based upon the local area plans and to submit the  







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             plan to the federal administration on aging.

          12.Establishes the federal poverty guideline, issued each  
             year in the Federal Register by the Department of Health  
             and Human Services, for use in determining financial  
             eligibility for certain federal programs.
           
           This bill:

          1. Defines "elder economic security standard index (EESSI)"  
             as an index developed by the Wider Opportunities for  
             Women and Gerontology Institute at the University of  
             Massachusetts, Boston, which uses publicly available  
             data to quantify the costs in the private market of  
             basic needs for elders, including, but not limited to,  
             food, shelter, health care, transportation, utilities,  
             and essential household items.

          2. Requires CDA to report elder index data for each service  
             area in its state plan.

          3. Requires each plan utilize the EESSI, specify the costs  
             of meeting basic needs for elders in each planning and  
             service area, and identify which elders are living at or  
             below the EESSI.  The requirements of this paragraph  
             shall be implemented only upon receipt by the area  
             agencies on aging of the updated EESSI.

          4. Requests that the University of California (UC) take the  
             necessary actions to update the EESSI and provide it to  
             area agencies on aging for purposes of developing the  
             area plans.

          5. Establishes the California EESSI Fund, to be composed of  
             private donations, which upon appropriation by the  
             Legislature will be used by the department for its  
             administrative costs and for allocation to the UC for  
             purposes of updating the EESSI, as specified. 

          6. Requires the Director of the Department of Finance (DOF)  
             to determine, in writing, whether sufficient funds are  
             available for the costs of updating the EESSI, as  
             specified. The area agencies on aging would not be  
             required to develop the specified plan requirements if  







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             the UC declines to update the EESSI.

          7. Repeals the provisions of this bill on the date that the  
             Director of DOF determines that sufficient moneys from  
             private donations are not available in the fund for  
             expenditure for purposes of updating the EESSI.

          8. Specifies nothing in the bill shall be construed, based  
             on the use of the EESSI, to affect means-tested programs  
             administered through the Mello-Granlund Older  
             Californians Act.

          9. Specifies that this bill shall not be construed to  
             mandate changes in the current funding allocations to  
             area agencies.

           Background  

          While programs and services administered by CDA and the  
          area agencies on aging do not require means-testing for  
          eligibility, the federal Older Americans Act requires that  
          preference be given to older adults with the greatest  
          economic or social needs, with particular attention given  
          to low-income minority individuals.  To meet the federal  
          requirements, CDA and area agencies track data, including  
          poverty data, on the number of older adults and people with  
          disabilities within a given area.  One effect of this bill  
          would be to increase the number of persons whom the  
          department and area agencies plan for and track and to  
          increase the number of persons who would be considered a  
          priority for receiving services.
           
          University of California, Los Angeles (UCLA) has calculated  
          county-by-county indices for California using 2007 data  .   
          The Center for Health Policy Research at UCLA, has  
          calculated the elder index for each California county,  
          using 2007 data, and center staff have put the results on  
          line:  
          http://www.healthpolicy.ucla.edu/elder_index08feb.html.   
          For purposes of comparison, the biggest differences are  
          within counties when comparing persons who have a mortgage  
          payment or are renters with those who do not rather than  
          between and among counties.  For example, here are the  
          elder indices for Los Angeles, San Francisco, San Luis  







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          Obispo, and Santa Clara counties, counties that members of  
          the Senate Human Services Committee represent.  Again,  
          according to UCLA, these figures are an estimate of the  
          "basic income needed to make ends meet for retired persons  
          ages 65 and older."

          Elder index per year by county:

           County         Single w/o mortgage           Single w/  
          mortgage       Single renter
           Los Angeles     $16,355         $30,591      $22,827
          San Francisco   $17,586         $37,893      $27,435
          San Luis Obispo $17,587         $30,588      $22,380
          Santa Clara     $17,632         $37,641      $25,391

          Note:  Los Angeles data excludes City of Los Angeles 
          Source:  UCLA Center for Health Policy Research

          For couples in San Francisco, San Luis Obispo, and Santa  
          Clara counties, add $10,000 to each column; for couples in  
          Los Angeles County, add $8,000 to each figure.

           FISCAL EFFECT :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No

          According to the Senate Appropriations Committee:

                          Fiscal Impact (in thousands)

           Major Provisions          2009-10            2010-11     
           2011-12   Fund  

          CDA EESSI implementation        $30      $60        
          $60Private
          and annual calculation

          CDA administration      unknown, but potentially in  
          theGeneral/
                                  hundreds of thousands;  
          eventuallyPrivate
                                  offset by private donations

          Cost pressure on state means             unknown, but  
          potentially in the      General/







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          tested programs         millions of dollars annuallyFederal

           SUPPORT  :   (Verified  9/1/09)

          California Senior Legislature (co-source)
          Catholic Charities of California (co-source)
          Insight Center for Community Economic Development  
          (co-source)
          National Association of Social Workers, California Chapter  
          (co-source)
          The Women's Foundation of California (co-source)
          AAA Advisory Council - PSA 19
          Aging Services of California 
          Alameda County Community Food Bank 
          American Association of Retired Persons 
          Area 4 Agency on Aging 
          Asian & Pacific Islander, Older Adults Task Force 
          Asian Pacific American Legal Center of Southern California 
          Asian Pacific Health Care Venture, Inc. 
          Asian Resources 
          Ben Eden Housing 
          Berkeley City Council District 7 
          Blackbaud 
          California Advocates For Nursing Home Reform 
          California Alliance for Retired Americans 
          California Association of Area Agencies on Aging 
          California Association of Public Authorities for In-Home  
            Supportive Services 
          California Church Impact 
          California Commission on Aging 
          California Commission on the Status of Women 
          California Senior Leaders' Alliance, University of  
          California Berkeley 
          Cambrian Center 
          Central California Asian Pacific Women 
          Chinatown Service Center 
          Christian Church Homes 
          Citizens for Choice 
          City and County of San Francisco
          City of Carson 
          Community Living Campaign 
          Congress of California Seniors 
          Consumer Action 
          Contra Costa County Advisory Council on Aging 







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          County Welfare Directors' Association 
          Davis Street Family Resource Center 
          East Bay Asian Local Development Corporation 
          East Bay Asian Local Development Corporation 
          East San Diego County Action Network 
          Ecumenical Peace Institute 
          Experience Corps 
          Family Bridges 
          Family Caregiver Alliance 
          Filipinos for Affirmative Action 
          Gray Panthers 
          Health Trust 
          J.L. Richard Terrace and Irene Cooper Terrace Senior  
          Housing 
          Japanese American Citizens League 
          Japanese American Community Senior Service 
          Jewish Community Relations Council 
          Jewish Family Service of Los Angeles 
          Keller Plaza Apartments 
          Korean Churches of Community Development 
          Lavender Seniors of the East Bay 
          LifeLong Medical Care 
          Little Tokyo Service Center, CDC 
          Live Oak Adult Day Services 
          Madera Coalition for Community Justice 
          Member San Francisco Mental Health Board (for  
            identification purposes only) 
          Monterey County Department of Social and Employment  
          Services 
          Old Lesbians Organizing for Change 
          Older Women's League of California 
          ONEgeneration 
          Organization of Farmworker Women Leaders in California 
          Partners in Care Foundation 
          Passages 
          Planned Parenthood of San Diego and Riverside Counties 
          Professional Fiduciary Association of California 
          Rebuilding Together Oakland 
          Retired Public Employees' Association 
          Richmond Commission on Aging 
          Sacramento County Mental Health Services Act Community  
            Services and Supports Older Adult Workgroup 
          Salud Para La Gente 
          San Diego East County Action Network 







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          San Francisco Advisory Council to Aging and Adult Services  
          Commission 
          San Francisco Black Leadership Forum 
          San Francisco Department on the Status of Women 
          San Francisco Mayor Gavin Newsom 
          San Francisco Mental Board 
          Satellite Housing, Inc. 
          Senior Community Centers 
          Senior Housing Solutions 
          Senior Peer Counseling 
          Senior Services Coalition 
          Senior Services Foundation 
          Seniors Council 
          St. Anthony Foundation 
          St. Mary's Center 
          St. Paul's Senior Homes and Services 
          The Berkeley Daily Planet 
          The Utility Reform Network 
          Time For Change Foundation 
          UCLA Center for Health Policy Research 
          United Methodist Women 
          United Way of the Bay Area 
          Visiting Angels, East Bay 
          Westlake Christian Terrace 
          Wider Opportunities for Women 
          WIN/California Women's Agenda 

           OPPOSITION  :    (Verified  9/1/09)

          Department of Aging (prior version)
          Department of Finance (prior version)

           ARGUMENTS IN SUPPORT  :    Supporters believe that the elder  
          economic security standard provides a framework to help  
          guide public, private, and elders' decisions.  Cost data  
          can be inserted into the model for specific geographic  
          areas to determine the minimum standard for that area.  In  
          this way, the tool may be adapted for individual planning  
          purposes and used as a targeted tool for state and local  
          policy makers, community agencies, and advocates.  In  
          addition, supporters believe that using the index in  
          preparing area agency plans will enable the state and  
          federal governments to have a more complete and accurate  
          picture of the numbers of elderly people who lack the basic  







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          income needed to make ends meet, and the extent of those  
          income shortfalls.

           ARGUMENTS IN OPPOSITION  :    CDA opposes the bill because it  
          states that it cannot absorb the cost of implementation.   
          CDA also points out that the bill could create unrealistic  
          service expectations at a time when there is little ability  
          to increase service levels.  
           

           ASSEMBLY FLOOR  : 
          AYES:  Adams, Ammiano, Arambula, Beall, Blumenfield,  
            Brownley, Buchanan, Caballero, Charles Calderon, Carter,  
            Chesbro, Coto, Davis, De La Torre, De Leon, Eng, Evans,  
            Feuer, Fong, Fuentes, Furutani, Galgiani, Gilmore, Hall,  
            Hayashi, Hernandez, Hill, Huber, Huffman, Jones,  
            Krekorian, Lieu, Bonnie Lowenthal, Ma, Mendoza, Monning,  
            Nava, Nestande, John A. Perez, V. Manuel Perez,  
            Portantino, Price, Ruskin, Salas, Saldana, Skinner,  
            Solorio, Swanson, Torlakson, Torres, Torrico, Tran, Bass
          NOES:  Anderson, Bill Berryhill, Tom Berryhill, Blakeslee,  
            DeVore, Duvall, Fletcher, Fuller, Gaines, Garrick,  
            Hagman, Harkey, Jeffries, Knight, Logue, Miller, Niello,  
            Nielsen, Smyth, Audra Strickland, Villines
          NO VOTE RECORDED:  Block, Conway, Cook, Emmerson, Silva,  
            Yamada

          CTW/JJA:mw  9/2/09   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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