BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 392
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          ASSEMBLY THIRD READING
          AB 392 (Feuer and Jones) 
          As Amended May 11, 2009
          2/3 vote.  Urgency 

           HEALTH              13-0        APPROPRIATIONS      16-0        
           
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          |Ayes:|Jones, Fletcher, Adams,   |Ayes:|De Leon, Nielsen,         |
          |     |De La Torre, De Leon,     |     |Ammiano,                  |
          |     |Gaines, Hall, Hayashi,    |     |Charles Calderon,         |
          |     |Hernandez, Bonnie         |     |Krekorian, Duvall,        |
          |     |Lowenthal, Hill, Salas,   |     |Fuentes, Monning, Harkey, |
          |     |Audra Strickland          |     |Miller, John A. Perez,    |
          |     |                          |     |Price, Skinner, Solorio,  |
          |     |                          |     |Audra Strickland,         |
          |     |                          |     |Torlakson                 |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Appropriates $1.6 million from the Federal Health  
          Facilities Citation Penalties Account (Federal Account) to  
          support local long-term care (LTC) ombudsman programs  
          administered by the California Department of Aging (CDA).   

           EXISTING LAW  :

          1)Authorizes the California State LTC Ombudsman Program under  
            the federal Older Americans Act and its State companion, the  
            Older Californians Act, to investigate and endeavor to resolve  
            complaints made by, or on behalf of, individual residents in  
            long-term care facilities.

          2)Establishes the State Health Facilities Citation Penalties  
            Account (State Account), into which monies derived from civil  
            penalties levied against long-term care facilities for  
            violations of state law are deposited.

          3)Establishes the Federal Account, into which monies derived  
            from civil penalties levied against long-term care facilities  
            for violations of federal law are deposited.

          4)Makes this bill an urgency statute that will take effect  
            immediately upon enactment.

           FISCAL EFFECT  :  According to the Assembly Appropriations  








                                                                  AB 392
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          Committee, a one-time $1.6 million (federal) appropriation to  
          CDA to partially backfill a $3.6 million line-item veto enacted  
          in the 2008-09 Budget Act.  This bill makes funds available for  
          expenditure through 2009-10. Any unspent funds at the end of  
          2009-10 revert to the original Federal Account. 

           COMMENTS  :   According to the author, in September of 2008,  
          Governor Schwarzenegger, through a line item veto, eliminated  
          all state funding for the LTC Ombudsman Program, approximately  
          $3.8 million, which represented about half of the local program  
          funding.  According to the sponsors of this bill, as of January  
          5, 2009, more than 80 staff ombudsman positions had been  
          eliminated due to the state funding cuts.  Advocates maintain  
          that the funding cuts are causing a devastating impact on LTC  
          ombudsman programs throughout California and are greatly  
          compromising their abilities to investigate complaints, monitor  
          facilities, and advocate on behalf of long-term care facility  
          residents, putting the most vulnerable segment of our population  
          at greater risk of abuse and neglect.  Supporters maintain that  
          ombudsman presence, advocacy, and intervention are crucial to  
          the safety and well-being of facility residents.  
           
          According to CDA's Web site, since its inception over thirty  
          years ago, the primary responsibility of the LTC Ombudsman  
          Program is to investigate and endeavor to resolve complaints  
          made by, or on behalf of, individual residents in long-term care  
          facilities.  These facilities include nursing homes, residential  
          care facilities for the elderly, and assisted-living facilities.  
           The LTC Ombudsman Program also investigates elder abuse  
          complaints in long-term care facilities and in residential care  
          facilities for the elderly.   

           The LTC Ombudsman Program is administered by CDA and is a  
          community-supported program that extensively utilizes  
          volunteers.  The paid staff of 35 local Ombudsman Program  
          Coordinators are responsible for recruiting, training, and  
          supervising nearly 1,200 volunteer state-certified ombudsman  
          representatives.  The LTC Ombudsman Program's goal to advocate  
          for the rights of all residents of long-term care facilities  
          takes two forms:  a) To receive and resolve individual  
          complaints and issues by, or on behalf of, these residents; and,  
          b) To pursue resident advocacy in the long-term care system, its  
          laws, policies, regulations, and administration through public  
          education and consensus building.  Residents or their family  
          members can file a complaint directly with the LTC Ombudsman or  








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          by calling the state administered CRISISline.  All long-term  
          care facilities are required to post, in a conspicuous location,  
          the phone number for the local ombudsman office and the  
          toll-free Statewide CRISISline number.  The CRISISline is  
          available 24 hours a day, 7 days a week to take calls and refer  
          complaints from residents.  

          According to the Department of Public Health, current state law  
          provides the authority to deposit monies colleted as a result of  
          state and federal civil penalties imposed against health  
          facilities for non-compliance with state and federal laws into  
          two accounts:  the State Account and the Federal Account.   
          Monies from these accounts are to be used, upon appropriation by  
          the Legislature, in accordance with state and federal law for  
          the protection of health or property of residents of long-term  
          health care facilities, including, but not limited to the  
          following:  a) relocation expenses incurred by the state, in the  
          event of a facility closure; b) maintenance of facility  
          operation pending correction of deficiencies or closure, such as  
          temporary management or receivership; c) reimbursing residents  
          for personal funds lost; and, d) costs associated with  
          informational meetings required under existing law.

          There is a $10 million cap on the allowable fund balance for the  
          State Account.  There is no cap on the fund balance for the  
          Federal Account.
           

          Analysis Prepared by  :    Deborah Kelch / HEALTH / (916) 319-2097  



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