BILL ANALYSIS                                                                                                                                                                                                    






                                  SENATE HUMAN
                               SERVICES COMMITTEE
                            Senator Carol Liu, Chair


          BILL NO:       AB 2114                                      
          A
          AUTHOR:        Beall                                        
          B
          VERSION:       April 22, 2010
          HEARING DATE:  June 22, 2010                                
          2
          FISCAL:        Appropriations                               
          1
                                                                      
          1
          CONSULTANT:                                                 
          4
          Park
                                        

                                     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.

                                     ABSTRACT  

          Existing federal 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, under the federal OAA, the Senior Community  
            Service Employment Program, to provide low-income seniors  
            with useful work experience at community service  
                                                         Continued---



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            agencies, and increase economic self-sufficiency and  
            placement into unsubsidized employment.

          3.Requires the Secretary of the Department of Health and  
            Human Services to update, at least annually, the poverty  
            guidelines, which shall be used as an eligibility  
            criterion for federal programs, as specified.
          
          Existing state law:
          
          1.Establishes the Older Californians Act, which provides  
            state-funded programs and services for older adults and  
            people with disabilities.

          2.Establishes CDA as the state unit on aging to administer  
            a broad range of home and community-based programs and  
            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.  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.

          3.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.  Requires each AAA to create a plan that considers  
            available data and population trends, assesses the needs  
            for services reflective of the community needs,  
            identifies sources of funding for those services, and  
            develops and implements a plan for the delivery of those  
            services based on the community's needs. 

          4.Requires AAAs, in fulfilling their mission, to 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, and those in  
            danger of losing their independence.

          5.Requires CDA to develop a state plan on aging according  




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            to federal law, which requires a state plan to be  
            submitted to the federal Administration on Aging every  
            four years, based upon the local area plans.

          This bill:

          1.Defines the Elder Index as an index, available on the  
            Internet, 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.   
            Specifies that it is updated by the University of  
            California, Los Angeles Center for Health Policy  
            Research, using publicly available data sources on the  
            costs to live in each county of the state.

          2.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 CDA.

          3.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 (PSA) and  
            identify which elders are living at or below the elder  
            index, if the elder index is updated and made available  
            to the AAA.

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



          5.Establishes, through the provisions above, the Elder  
            Economic Dignity Act of 2010, and specifies that nothing  
            in the act 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.

                                  FISCAL IMPACT  

          According to the Assembly Appropriations Committee, no  




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          direct fiscal impact to CDA to administer the elder index  
          if the data and analysis is provided by the UCLA Center for  
          Health Policy Research. The analysis also notes unknown,  
          likely minor administrative savings to AAAs to the extent  
          that use of the elder index reduces duplicative planning  
          efforts and increases the reliability of quantitative  
          analyses of local information.


                            BACKGROUND AND DISCUSSION  

          Author's statement
          The author states that California's elder population is  
          underestimated and poorly planned for largely because  
          federal law requires the state to measure senior economic  
          health using an old and inaccurate tool (the federal  
          poverty level, or FPL).  The author notes that the FPL is a  
          50-year-old measure based solely on the cost of food, and  
          does not account for California's wide range in cost of  
          living-from lower-cost Modoc County to higher-cost Los  
          Angeles.  The author states that, as a result of using FPL,  
          agencies perform costly and inefficient research to  
          determine the true cost of living in their geographic area,  
          with no consistent standard across the state.

          The author asserts that the elder index reflects whether a  
          senior owns or rents his or her home and the cost of  
          transportation, health care, and out-of-pocket expenses.   
          Because it is calculated for each county in California, the  
          author believes the elder index presents a more accurate  
          picture of a California senior's basic needs.  The author  
          believes that because the federal government has not  
          replaced the FPL, important programs suffer from  
          inaccuracies, which lead to inefficient allocation of very  
          scarce public dollars.  The author notes that, while the  
          federal movement to update the FPL with a supplemental  
          index is underway, California will benefit from using the  
          elder index.  The author notes that New York City  
          implemented a new poverty measure in 2008.

          Federal poverty guidelines and the elder index
          Policymakers typically measure poverty and determine  
          benefits eligibility by using the federal poverty  
          guidelines (FPG), a 1963 measure based solely on the cost  
          of an economy food diet.  Although the FPG (sometimes  




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          loosely referred to as FPL) 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 or a low-cost region.

          The elder index is based on the actual cost in each county  
          of the basic expenses needed by older adults to age  
          independently with dignity in their own homes.  Those with  
          incomes below the elder index are considered economically  
          insecure.  The elder index methodology was developed by the  
          Gerontology Institute at UMass-Boston and Wider  
          Opportunities for Women, and refined and adapted to  
          California by the UCLA Center for Health Policy Research.   
          It uses national and state data sources, including the U.S.  
          Census Bureau and the U.S. Department of Housing and Urban  
          Development.

          According to the elder index, in California, the FPG covers  
          less than half of the basic costs experienced by older  
          adults.  According to a brief published by UCLA Center for  
          Health Policy Research, in collaboration with the Insight  
          Center, 495,000 older Californians living alone in 2007  
          could not make ends meet - lacking sufficient income to pay  
          for a minimum level of housing, food, health care,  
          transportation and other basic expenses.  The elder index  
          and related research show that, in addition to urban and  
          coastal areas, older adults in rural counties face  
          significant economic 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), while San Francisco County has the next highest  
          percentage, with 61.3 percent of older adults living alone  
          with incomes below the elder index.
          
          Local and state plans on aging 
          California has 33 AAAs that provide a wide range of  
          services designed to keep older adults and adults with  
          disabilities independent and living in their own homes and  
          communities.  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  




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          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 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.

          Programs and services administered by CDA and the AAAs do  
          not require means-testing for eligibility; however, the OAA  
          requires preference to 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.



          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.  




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           The program provides a variety of supportive services to  
          the individual such as personal and job-related counseling,  
          job training, and job referral.  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  
          excluded, and other factors may affect an individual's  
          eligibility.  The SCSEP is available through 17 of the 33  
          AAAs and eight national organizations.
           
           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 adults.  Supporters state that the elder index  
          provides a more accurate and localized measurement tool to  
          determine the cost of meeting basic needs and maintaining  
          independence in the community.  By institutionalizing this  
          tool, supporters believe that AB 2114 will empower  
          policymakers to allocate limited resources more  
          effectively, and prepare for the needs of seniors and aging  
          baby boomers. Supporters believe that the elder index will  
          also help adults of any age make informed decisions about  
          when and where to retire, how much to save, and whether to  
          continue to work after retirement.
          
          Arguments in opposition
          The California Department of Aging (CDA) writes that  
          legislation is not required to meet the stated objectives  
          of the bill, as CDA and AAAs can already use the elder  
          index for planning purposes.  CDA also believes that the  
          requirement for AAAs to use the elder index to track SCSEP  
          participants' progress is duplicative of existing measures  
          established by the federal Department of Labor.  CDA also  
          writes that the bill may dramatically increase the number  
          of clients eligible for referral to programs, given the  
          significant discrepancy between the proportion of older  
          Californians determined to be in economic need when using  
          the elder index (50 percent) versus those determined to be  
          in economic need when using the federal poverty thresholds  
          (nine percent).  CDA states that the bill does not ensure  
          that individuals would be eligible to receive these  
          services under federal statutory eligibility criteria or  




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          that existing programs would be able to serve additional  
          clients, and could create unrealistic service expectations.  
           CDA believes that the appropriate discussion for  
          implementing the elder index is at the federal level, where  
          there is already movement toward using a supplemental  
          poverty measure.  CDA writes that postponing state  
          implementation until federal measures change would  
          alleviate potential confusion arising from having different  
          poverty measures at the state an d federal level.

          Related/prior legislation
          AB 324 (Beall) of 2009 was substantially similar to this  
          bill in requiring CDA and AAAs to utilize the elder index  
          in their service planning.  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.

                                   PRIOR VOTES
           
          Assembly Floor:   51 - 20
          Assembly Appropriations: 12 - 5
          Assembly Aging and
                Long-Term Care:      4 - 1
                                         
                                    COMMENTS
           
          1.Minor and technical amendments.

            a) Page 2, line 12: insert "biennially" after "updated"





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                 5        9009.   "Elder Economic Security Standard  
               Index" means an
                6    index, available on the Internet, that  
               quantifies the costs that elders
                7    face in meeting their basic needs, including,  
               but not limited to,
                8    food, shelter, health care, transportation,  
               utilities, and essential
                9    household items, in the private market. It is   
               derived by applying  
               10     the existing publicly available methodology,  
               developed byWider  
               11     Opportunities forWomen and the Gerontology  
               Institute at the  
               12     University of Massachusetts, Boston, to   updated  
               biennially by the University
               13    of California, Los Angeles Center for Health  
               Policy Research,
               14    using publicly available data sources on the  
               costs to live in each
               15    county of the state.


            b) Page 4, line 13: strike comma and insert "to"; page 4,  
            line 14: strike "which elders are" and insert "the number  
            or percent of elders who are"

               12       (2)  Each plan shall use the Elder Economic  
               Security Standard
               13    Index  ,  to specify the costs of meeting basic  
               needs for elders in each
               14    planning and service area, and identify  which  
               elders are  the number or percent of elders who are  
               living at
               15    or below the Elder Economic Security Standard  
               Index. The
               16    requirements of this paragraph shall be  
               implemented only if the
               17    Elder Economic Security Standard Index is  
               updated and made
               18    available to the area agencies on aging.

            c) Page 5, line 27: strike "and"

               25       (h)  The area agencies on aging shall use the  




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               Elder Economic
               26    Security Standard Index to track the progress of  
               participants in the
               27    state-administered Senior  and  Community Service  
               Employment
               28    Program. The requirements of this subdivision  
               shall only be
               29    implemented if the Elder Economic Security  
               Standard Index is
               30    updated and made available to the area agencies  
               on aging.


          2.Senior Community Service Employment Program.  While this  
            bill requires AAAs to use the elder index to track  
            participant progress and outcomes in the SCSEP, it does  
            not require programs operated by national organizations  
            to do so for SCSEP.

                                    POSITIONS  

          Support:  AARP California (co-sponsor)
                    California Senior Leaders Alliance (co-sponsor)
                    Catholic Charities of CA United (co-sponsor)
                    Insight Center (co-sponsor)
                    Jewish Family Services of Los Angeles  
                    (co-sponsor)
                    National Association of Social Workers  
                    (co-sponsor)
                    Women's Foundation of CA (co-sponsor)
                    Aging Services Collaborative of Santa Clara  
                    County
                    Aging Services of California
                    Amador County Commission on Aging
                    At Your Home FamilyCare
                    California Advocates for Nursing Home Reform
                    California Alliance for Retired Americans
                    California Association of Area Agencies on Aging
                    California Association of Public Authorities for  
                    IHSS
                    California Commission on Aging
                    California Commission on the Status of Women
                    California Communities United Institute
                    California Health Collaborative
                    California Senior Leaders




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                    California Senior Legislature
                    California Women's Agenda
                    Catholic Charities of California United
                    Center for Technology and Aging
                    Chicano Federation of San Diego County, Inc.
                    City and County of San Francisco
                    Commission on Aging
                    Community Living Campaign
                    Contra Costa County, Board of Supervisors
                    County Welfare Directors Association
                    County of Santa Clara, Board of Supervisors
                    ElderHelp of San Diego
                    Gray Panthers Sacramento
                    Health Trust
                    HIP Housing
                    In-Home Supportive Services Consortium of San  
                    Francisco
                    Institute for Health and Aging, University of  
                    California, San Francisco
                    Islamic Shura Council of Southern California
                    Jericho
                    Lavender Seniors of the East Bay
                    Los Angeles Area Chamber of Commerce
                    Meals-on-Wheels Greater San Diego, Inc.
                    Multi-Purpose Senior Services Program Association
                    National Senior Citizens Law Center
                    Neighborhood House Association
                    Older Women's League of California
                    On Lok Inc.
                    ONEgeneration
                    Openhouse
                    Partners in Care Foundation
                    Professional Fiduciary Association of California
                    Rehabilitation Services of Northern California
                    San Diego East County Action Network
                    San Francisco Gray Panthers
                    Santa Clara County, Board of Supervisors
                    SCAN Healthplan
                    Senior Community Centers
                    Senior Services Coalition of Alameda County
                    Seniors Council (Area Agency on Aging of Santa  
                                                        Cruz and San Benito      Counties)
                    South Asian Network
                    St. Mary's Center
                    St. Paul's Senior Homes & Services




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                    State of California, California Senior  
                    Legislature
                    State of California, Commission on the Status of  
                    Women
                    U.C. Berkeley Center on Aging
                    Wider Opportunities for Women
                    Women's Foundation of California
                     36 individuals 

          Oppose:California Department of Aging


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