BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



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          |SENATE RULES COMMITTEE            |                   AB 392|
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                                 THIRD READING


          Bill No:  AB 392
          Author:   Feuer (D), et al
          Amended:  5/11/09 in Assembly
          Vote:     27 - Urgency

           
           SENATE HEALTH COMMITTEE :  9-1, 6/10/09
          AYES:  Alquist, Strickland, Cedillo, Cox, DeSaulnier, Leno,  
            Maldonado, Negrete McLeod, Wolk
          NOES:  Aanestad
          NO VOTE RECORDED:  Pavley

           SENATE APPROPRIATIONS COMMITTEE  :  10-0, 7/13/09
          AYES:  Kehoe, Cox, Corbett, Denham, Leno, Price, Walters,  
            Wolk, Wyland, Yee
          NO VOTE RECORDED:  Hancock, Oropeza, Runner
           
          ASSEMBLY FLOOR  :  72-0, 5/14/09 - See last page for vote


           SUBJECT  :    Appropriation for local ombudsman programs

           SOURCE  :     AARP California
                      Bet Tzedek Legal Services
                      California Advocates for Nursing Home Reform
                      California Alliance for Retired Americans
                      Catholic Charities of California
                      California Commission on Aging 
                      Health Insurance Counseling and Advocacy  
          Program 
                        Services of Northern California
                      Ombudsman Services of Northern California

                                                           CONTINUED





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           DIGEST  :    This bill appropriates $1.6 million from the  
          Federal Health Facilities Citation Penalties Account to the  
          Department of Aging for local ombudsman programs.

           ANALYSIS  :    Under existing law, long-term health care  
          facilities are defined to include skilled nursing  
          facilities, intermediate care facilities, congregate living  
          facilities, nursing facilities, and pediatric day health  
          and respite facilities.  Existing law requires the  
          Department of Public Health (DPH) to inspect and license  
          health facilities.  Under existing law, the Long-Term Care,  
          Health, Safety, and Security Act of 1973, DPH can assess  
          penalties for violations of prescribed state and federal  
          requirements.

          Money collected as a result of state and federal civil  
          penalties imposed under the existing state Long-Term Care,  
          Health, Safety, and Security Act of 1973, or federal law,  
          must be deposited into the State Health Facilities Citation  
          Penalties Account, which contains money collected from  
          violations of state law, or the Federal Health Facilities  
          Citation Penalties Account, which contains money collected  
          from violations of federal law.

          Existing law establishes the California State Long-Term  
          Care Ombudsman Program within the Department of Aging  
          (CDA), and requires the Office of the State Long-Term Care  
          Ombudsman to investigate and seek to resolve complaints and  
          concerns communicated by, or on behalf of, patients,  
          residents, or clients of any long-term care facility  
          (nursing facility, skilled nursing facility or residential  
          care facilities for the elderly).  Existing state law sets  
          forth a distribution formula by which CDA must allocate  
          federal and state funds for local ombudsman programs.

          This bill appropriates $1.6 million from the Federal Health  
          Facilities Citation Penalties Account to CDA for use in  
          funding local ombudsman programs under the existing  
          distribution schedule.  This bill authorizes these funds to  
          be used for this purpose through the end of the 2009-10  
          fiscal year, at which time remaining funds would be  
          required to revert to the originating account.  








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           Background  

          According to CDA, the primary responsibility of the  
          ombudsman program is to investigate and endeavor to resolve  
          complaints made by, or on behalf of, individual residents  
          in long-term care facilities.  CDA indicates the Office of  
          the State Long-Term Care Ombudsman develops policy and  
          provides oversight to the local Long-Term Care Ombudsman  
          Programs, confers with state licensing agencies regarding  
          difficult cases, meets with CDA legal counsel to clarify  
          laws and develop plans for implementing them, defines  
          program roles, and provides ongoing statewide ombudsman  
          training.  Residents or their family members can file a  
          complaint directly with the local Long-Term Care Ombudsman  
          or by calling a statewide toll-free telephone line. 

          CDA indicates the local Long-Term Care Ombudsman Program is  
          a community-supported program.  Volunteers are an integral  
          part of this program.  The Office of the State Long-Term  
          Care Ombudsman and its 35 local ombudsman program  
          coordinators are responsible for recruiting, training, and  
          supervising the volunteer ombudsman representatives.
          In February 2009, CDA estimated as a result of the  
          Governor's budget veto, the number of paid staff in local  
          ombudsman programs will decline from 183 in 2007-08, to 117  
          in 2008-09, and 108 in 2009-10.  CDA estimates the number  
          of complaints received will fall from 53,443 in 2007-08, to  
          40,082 in 2008-09, and 37,410 in 2009-10, with the number  
          of complaints verified and closed also projected to  
          decline.  CDA currently projects the number of volunteers  
          will increase from 858 in 2007-08, to 950 in 2008-09, and  
          declining to 850 in 2009-10.  CDA estimates there will be  
          approximately 1,375 skilled nursing facilities and 8,050  
          residential care facilities for the elderly, with a  
          combined total of 296,000 beds, in California in 2009-10.

          The 2007-08 budget appropriated $3.9 million General Fund  
          in local assistance funding for the Ombudsman Program and  
          for Elder Abuse Prevention.  Governor Schwarzenegger  
          line-item vetoed all General Fund spending in 2008-09, and  
          proposed no General Fund funding for local assistance in  
          2009-10.  In his veto message, the Governor cited the need  
          to control state spending.  Total local assistance funding  
          for the local ombudsman programs in 2009-10 is $4.2 million  







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          ($2.7 million federal funds, $1.4 million special deposit  
          funds from the Federal Account, with no General Fund  
          funding).

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

          According to the Senate Appropriations Committee:

                          Fiscal Impact (in thousands)

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

            Appropriation to CDA           $1,600    $0        
            $0Special*

            * Federal Health Facilities Citation Penalties Account

           SUPPORT  :   (Verified  7/14/09)

          AARP California (co-source)
          Bet Tzedek Legal Services (co-source)
          California Advocates for Nursing Home Reform (co-source)
          California Alliance for Retired Americans (co-source)
          Catholic Charities of California (co-source)
          California Commission on Aging (co-source)
          Health Insurance Counseling and Advocacy Program Services  
            of Northern California (co-source)
          Ombudsman Services of Northern California (co-source)
          Aging Services of California
          Alzheimer's Association
          Alliance on Aging
          Catholic Charities Diocese of Stockton
          Congress of California Seniors
          Council on Aging-Orange County Ombudsman 
          Counties of Orange, San Bernardino, San Francisco, Santa  
            Clara, and Ventura
          Damar Construction Inc. 
          Long Term Care Services of Ventura County, Inc.
          Marin County Commission on Aging
          Regional Council of Rural Counties
          San Bernardino County Board of Supervisors
          St. John's Pleasant Valley Hospital 








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           ARGUMENTS IN SUPPORT  :    Supporters of this bill include  
          numerous individuals, senior organizations and  
          organizations serving seniors and residents of long-term  
          care facilities, which argue that last year's $3.8 million  
          state budget cut to California's local ombudsman programs  
          severely compromised the programs' ability to provide  
          services and has put long-term care residents at risk of  
          abuse and neglect.  Supporters state that residents and/or  
          their families are often hesitant to make complaints to the  
          appropriate regulatory agency fearing retaliation by the  
          facility staff.  Supporters further state that residents  
          depend on ombudsmen to provide a voice for them when their  
          rights have been violated, and that ombudsman presence,  
          advocacy, and intervention are crucial to the safety and  
          well-being of facility residents. 


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


          CTW:mw  7/15/09   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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