BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 2114
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          Date of Hearing:   April 6, 2010

                   ASSEMBLY COMMITTEE ON AGING AND LONG-TERM CARE
                                Mariko Yamada, Chair
                    AB 2114 (Beall) - As Amended:  March 18, 2010
           
          SUBJECT  :   Aging: Elder Economic Security Standard Index.

           SUMMARY  :   Requires the California Department of Aging (CDA) and  
          Area Agencies on Aging (AAAs) to utilize the Elder Economic  
          Security Standard Index (Elder Index) in their service planning.  
           Specifically,  this bill  :  

          1)Defines the Elder Index as an index that quantifies the costs  
            that elders face in meeting their basic needs, including, but  
            not limited to, food, shelter, health care, transportation,  
            utilities, and essential household items, in the private  
            market.  

          2)Specifies that the Elder Index is derived by applying the  
            existing publicly available methodology, developed by Wider  
            Opportunities for Women and the Gerontology Institute at the  
            University of Massachusetts, Boston, to publicly available  
            data sources on the cost to live in each county of the state.

          3)Requires CDA to report the Elder Index data for each service  
            area in its State Plan if the Elder Index is updated and made  
            available to the department.

          4)Requires each Area Plan developed by an AAA to use the Elder  
            Index and 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 Elder Index if the Elder Index is  
            updated and made available to the AAA.

          5)Requires AAAs to use the Elder Index to track the progress of  
            participants in the state-administered Senior and Community  
            Service Employment Program (SCSEP) if the Elder Index is  
            updated and made available to the AAA.

          6)Specifies that nothing in this bill shall be construed to  
            mandate changes in the current funding allocations to AAAs or,  
            based on the use of the Elder Index, affect means-tested  
            programs administered through the Mello-Granlund Older  
            Californians Act.








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           EXISTING LAW  

          1)Establishes the federal Older Americans Act (OAA) 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 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  
            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 OAA, 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  








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            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.

          10)Establishes the Federal Poverty Guideline (FPG) 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.

           FISCAL EFFECT  :   Unknown.

           COMMENTS  :   
          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 OAA,  
          the Older Californians Act, local entities, and grants.  

           Planning for Aging Services
           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.   








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          When approved, CDA receives federal funds to administer the  
          State Plan.  Beyond the minimum required information,  
          California's 2009-2013 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 2009-2013 State Plan on Aging states that the number of  
          older Californians at both ends of the income scale is growing,  
          creating two very different groups: persons with annual incomes  
          over $50,000 (45 percent) and persons with incomes below $15,000  
          (16 percent), with a diverse middle class in between. The  
          highest proportion of older adults with income below 200 percent  
          of the FPG is in Imperial County, followed by several counties  
          in Northern California and the Central Valley, where  
          approximately 40 percent of the older population is in this  
          income group. Eleven percent of the population age 65 and over  
          has income below the FPG, and another 21 percent has income  
          between 100-199 percent of the FPG.  Persons in this latter  
          group have income too high to make them eligible for many public  
          assistance programs, yet often do not have resources sufficient  
          to meet their most basic needs.

          Recent research from the University of California, Los Angeles  
          and the Insight Center for Community Economic Development has  
          shown that 495,000 older Californians living alone in 2007 could  
          not make ends meet - lacking sufficient income to pay for even a  
          minimum level of housing, food, health care, transportation and  
          other basic expenses.  

          Senior Community Service Employment Program
           According to the CDA web site, The SCSEP provides part-time  
          work-based training opportunities at local community service  
          agencies for older workers who have poor employment prospects  
          and assists with the transition of individuals to private or  
          other employment opportunities in the community. The program  
          provides a variety of supportive services to the individual such  
          as personal and job-related counseling, job training, and job  
          referral.

          The work-based training is an integral part of the program.  
          Individuals may receive job-related training prior to, and as  
          preparation for their community service assignment, and train  








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          for an average 20 hours per week. After a prescribed period of  
          on-the-job training, individuals are either transitioned into  
          unsubsidized employment or rotated to other training positions  
          in the community to further upgrade their skills and assist in  
          finding unsubsidized employment.


          Individuals who participate in the program must be residents of  
          California, be at least 55 years of age, and have an income that  
          does not exceed 125 percent of the federal poverty level.   
          ($1,083 per month/$13,000 annual). Some income sources may be  
          excludable, and other factors may effect an individual's  
          eligibility. 


          The SCSEP is available through 17 of the 33 AAAs and eight  
          national organizations.  While this bill requires AAAs to use  
          the Elder Index to track participant progress and outcomes, it  
          does not change eligibility requirements for the SCSEP.  In  
          addition, the requirement for using the Elder Index to track  
          progress only applies to the AAA-administered SCSEPs and not to  
          those programs operated by the national organizations.  

           Poverty Guidelines and the Elder Index
          Since 1965, there have been two slightly different versions of  
          the federal poverty measure - the FPG and the federal poverty  
          thresholds.  The poverty thresholds are the original version of  
          the federal poverty measure and are updated by the Census Bureau  
          each year.  The thresholds are used primarily for statistical  
          purposes.  The FPG are issued each year in the Federal Register  
          and are a simplification of the poverty thresholds.  They are  
          used for administrative purposes, including determining  
          financial eligibility for certain federal programs.  The FPG are  
          sometimes loosely referred to as the federal poverty level.

          Proponents argue that policymakers struggle to create effective  
          policies to promote economic security and eradicate poverty  
          because they do not have an accurate picture of what it really  
          takes to make ends meet in today's economy.  Policymakers  
          typically measure poverty and determine benefits eligibility by  
          using the FPG, a 1963 measure based solely on the cost of a  
          bare-bones food diet.  Although the FPG is updated annually  
          using the Consumer Price Index, the current FPG is the same  
          dollar amount ($10,830 for an individual living alone) whether  
          one lives in a high cost market like urban Los Angeles, or a low  








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          cost region like rural Arkansas.

          In response to the shortcomings of the FPG, The Insight Center  
          for Community Economic Development led the effort to create the  
          California Elder Index which sets a new benchmark of income  
          adequacy for older adults.  According to proponents, it provides  
          the true cost of meeting basic needs and maintaining  
          independence in the community.  The Elder Index methodology uses  
          national and state data sources, including the U.S. Census  
          Bureau and the U.S. Department of Housing and Urban Development,  
          and reveals that in California, the FPG covers less than half of  
          the basic costs experienced by older adults.  

          While California's most expensive counties to live in tend to be  
          urban and coastal, the Elder Index and related research show  
          that older adults in rural counties face significant challenges  
          as well.  For example, Imperial County has the highest  
          percentage of single older adults with incomes below the Elder  
          Index benchmark (67.1 percent).  San Francisco County has the  
          next highest percentage with 61.3 percent of older adults living  
          alone with incomes below the Elder Index.

           Impact of using the Elder Index on Program Eligibility and  
          Funding 
           Programs and services administered by CDA and the AAAs do not  
          require means-testing for eligibility, however, the OAA 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 AAAs track data, including poverty data,  
          on the number of older adults and people with disabilities  
          within a given PSA, but enrollment in programs is not restricted  
          to those who fall below a certain threshold, with the exception  
          of programs that use Medi-Cal funds.  This bill will not change  
          eligibility for any of the programs administered by CDA or the  
          AAAs.




           Arguments in Support
           The California Association of Area Agencies on Aging, AARP,  
          Aging Services of California, the Older Women's League of  
          California, and a host of other organizations, contend that the  
          Elder Index sets a new benchmark of income adequacy for older  








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          adults.  It provides the true cost of meeting basic needs and  
          maintaining independence in the community.  By  
          institutionalizing this tool, AB 2114 will empower policymakers  
          to allocate limited resources more effectively, and prepare for  
          the needs of seniors and aging baby boomers.

          According to the author, the state is not well-prepared for the  
          senior tsunami of baby boomers that are now retiring. In fact,  
          California is home to one of the highest number of seniors in  
          the nation at almost 6.5 million-that is almost 20 percent of  
          the state's population. .  Planning better for our seniors is  
          one of the most significant and responsible improvements we can  
          make to ensure the dignity of our parents.  Utilizing the Elder  
          Index in our planning documents will ensure that our measurement  
          of their needs will be accurate and consistent across the state.

           Related Legislation
           AB 324 (Beall) was substantially similar to this bill and  
          required CDA and AAAs to utilize the Elder Index in their  
          service planning.  AB 324 was vetoed by the Governor.  The  
          Governor's veto message stated:

          "While I appreciate the author and sponsors' interest in better  
          refining their
           planning and service levels for the seniors in their  
          communities, this bill is
           unnecessary.  Local agencies can already use the specific index  
          defined by
           this bill in their planning efforts.  Furthermore, this bill  
          would create
           General Fund cost pressures at a time when there is no ability  
          to increase
           service levels."

          REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          Insight Center for Community Economic Development - Sponsor

          AARP
          Aging Services of California
          Aging Services Collaborative of Santa Clara County
          At Your Home Familycare
          California Advocates for Nursing Home Reform (CANHR)








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          California Association of Area Agencies on Aging (C4A)
          California Commission on the Status of Women
          California Communities United Institute
          California Health Collaborative
          California Senior Leaders Alliance
          California Senior Legislature
          California Women's Agenda
          Catholic Charities of California United
          Catholic Charities of Santa Clara County
          Center for Technology and Aging
          Chicano Federation of San Diego County, Inc.
          Community Living Campaign
          Congress of California Seniors
          Contra Costa County Board of Supervisors
          County Welfare Directors Association (CWDA)
          ElderHelp of San Diego
          Experience Corps San Francisco
          Gray Panthers Sacramento
          Human Investment Project Housing
          In-Home Supportive Services Consortium of San Francisco
          Islamic Shura Council of Southern California
          JERICHO, A Voice for Justice
          Jewish Family Services of Los Angeles
          Lavender Seniors of the East Bay
          Meals-on-Wheels Greater San Diego, Inc.
          National Association of Social Workers - California Chapter
          National Senior Citizens Law Center
          Neighborhood House Association
          ONEgeneration
          Openhouse
          Older Women's League of California (OWL-CA)
          Partners in Care Foundation
          Professional Fiduciary Association of California (PFAC)
          Rehabilitation Services of Northern California (RSNC)
          San Diego East County Action Network
          San Francisco Gray Panthers
          Senior Community Centers of San Diego
          Seniors Council
          Senior Services Coalition of Alameda 
          South Asian Network, Inc.
          St. Mary's Center
          St. Paul's Senior Home & Services
          The Health Trust
          UC Berkeley's Center on Aging
          Wider Opportunities for Women








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          Women's Foundation of California
          Women's Initiative

          36 individuals

           Opposition 
           
          None on file.
           
          Analysis Prepared by :    Allison Ruff / AGING & L.T.C. / (916)  
          319-3990