BILL ANALYSIS �
AB 2276
Page 1
Date of Hearing: April 24, 2012
ASSEMBLY COMMITTEE ON HEALTH
William W. Monning, Chair
AB 2276 (Campos) - As Amended: April 17, 2012
SUBJECT : Office of the State Long-Term Care Ombudsman: funding.
SUMMARY : Appropriates $1.6 million for the fiscal year (FY)
2012-13 and appropriates $1.6 million for the FY 2013-14 from
the State Health Facilities Citation Penalties Account (State
Account) to the California Department of Aging (CDA) for use in
funding local ombudsman programs pursuant to the distribution
schedule in existing law.
EXISTING LAW :
1)Requires the Department of Public Health (DPH) to inspect and
license health facilities including long-term care (LTC)
facilities defined as skilled nursing facilities, intermediate
care facilities, congregate living facilities, nursing
facilities, and pediatric day health and respite facilities.
2)Authorizes DPH to assess penalties for violations of
prescribed state and federal requirements under the existing
Long-Term Care Health, Safety, and Security Act of 1973 (LTC
Security Act). Requires money collected as a result of state
and federal civil penalties imposed under the LTC Security Act
to be deposited into the State Account, which contains money
collected from violations of state law, or the Federal Health
Facilities Citation Penalties Account (Federal Account), which
contains money collected from violations of federal law.
3)Establishes the California State Long-Term Care Ombudsman
Program at 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 LTC facilities.
4)Establishes a distribution formula by which CDA must allocate
federal and state funds for local ombudsman programs.
5)Appropriates $1.6 million from the Federal Account to CDA to
fund local ombudsman programs for FY 2009-10 under the
existing distribution schedule, after which time remaining
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funds revert to the originating account.
FISCAL EFFECT : This bill has not yet been analyzed by a fiscal
Committee.
COMMENTS :
1)PURPOSE OF THIS BILL . According to the author, Governor
Arnold Schwarzenegger's reduction to the Long-Term Care
Ombudsman Program in 2008 has resulted in staff lay-offs and
has drastically reduced services. These reductions, the
author argues, have greatly compromised the Long-Term Care
Ombudsman Program's ability to investigate complaints from
residents and monitor LTC facilities, thus putting LTC
facility residents at significantly greater risk for abuse.
The author maintains that this bill protects vulnerable
nursing home residents and their families by restoring some of
the funding for the Long-Term Care Ombudsman Program that was
cut in recent years. The author asserts that this bill is a
win-win solution for both the Legislature and LTC facilities
by providing support to the program without cost to the
General Fund (GF).
2)BACKGROUND . The FY 2007-08 Budget Act appropriated $3.9
million from the GF in local assistance funding for the
Long-Term Care Ombudsman Program and for elder abuse
prevention. In September of 2008, Governor Arnold
Schwarzenegger, through a line-item veto, eliminated all state
funding for the Long-Term Care Ombudsman Program for FY
2008-09, and proposed no GF funding for local assistance in FY
2009-10. In his veto message, Governor Schwarzenegger cited
the need to control state spending. AB 392 (Feuer), Chapter
102, Statutes of 2009, restored funding to the Long-Term Care
Ombudsman Program by appropriating $1.6 million from the
Federal Account to CDA for local ombudsman programs.
3)LONG-TERM CARE OMBUDSMAN PROGRAMS . According to CDA, the
primary responsibility of the Long-Term Care Ombudsman Program
is to investigate and endeavor to resolve complaints made by,
or on behalf of, individual residents in LTC facilities. CDA
indicates that the Office of the 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
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program roles, and provides ongoing statewide ombudsman
training.
CDA indicates that the Long-Term Care Ombudsman Program 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 volunteer state-certified ombudsman
representatives. The Program's goal to advocate for the
rights of all residents of LTC 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 LTC 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 Long-Term Care Ombudsman or by
calling the state administered CRISISline. All LTC 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, seven days a week to take calls and refer
complaints from residents.
4)STATE AND FEDERAL PENALTY ACCOUNTS . Under existing law, funds
in the State Account and the Federal Account must be used,
upon appropriation by the Legislature, in accordance with
state and federal law for the protection of health or property
of residents of LTC facilities, including, but not limited to,
the following:
a) Relocation expenses incurred by DPH, in the event of a
facility closure;
b) Maintenance of facility operation pending correction of
deficiencies or closure, such as temporary management or
receivership, in the event that the revenues of the
facility are insufficient;
c) Reimbursing residents for personal funds lost; and,
d) The costs associated with informational meetings
required if DPH proceeds with a receivership petition.
Monetary awards presented under the Quality Awards Program for
nursing homes may also be paid from funds from the Federal
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Account. Additionally, money from the Federal Account in an
amount up to $130,000 and upon appropriation by the
Legislature, may be used in accordance with state and federal
law for the improvement of quality of care and quality of life
for long-term health care facilities residents.
In 2002, the Centers for Medicare and Medicaid Services (CMS)
issued guidance to states in regard to the proper use of civil
monetary penalty (CMP) funds. CMS stated that because CMP
funds collected by a state are state funds, the state may use
the money for any project that directly benefits facility
residents, including funding an increase in ombudsman
services.
According to DPH, the estimated fund balance of the State
Account is projected to be $10.047 million as of March 31,
2012, and the estimated balance of the Federal Account is
projected to be $1.485 million as of March 31, 2012. DPH
indicates no minimum fund balance is required for either
account.
5)SUPPORT . The California Advocates for Nursing Home Reform,
the Catholic Charities of California United, and the AARP, all
write in support that on any given day there are literally
tens of thousands of California citizens residing in nursing
homes throughout the state. The task of the ombudsman,
supporters maintain, is to be available to act as advocates
for each and every one of those residents. Supporters argue
that without adequate funding, it is virtually impossible to
carry out this charge. Supporters assert that this bill
offers a unique opportunity to restore $1.6 million of funding
over the next two years without a GF cost. According to
supporters, this is an opportunity that the state cannot pass
up to protect California's most vulnerable residents.
The Office of the State Long-Term Care Ombudsman and the
California Long-Term Ombudsman Association both write that,
while this short-term partial funding will not completely
address the Long-Term Care Ombudsman Program's resource
issues, it will help the Long-Term Care Ombudsman Program in
its advocacy work in protecting the health, safety, welfare
and rights of residents of LTC facilities.
6)PREVIOUS LEGISLATION .
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a) AB 2555 (Feuer) of 2010, would have appropriated $1.6
million from the State Account to CDA for local ombudsman
programs. AB 2555 was held in the Senate Appropriations
Committee.
b) AB 392 (Feuer), Chapter 102, Statutes of 2009,
appropriates $1.6 million from the Federal Account to CDA
for local ombudsman programs.
c) AB 935 (Feuer and Jones) of 2009, would have
appropriated $1.6 million from the Federal Account to CDA
for local ombudsman programs. AB 935 was held in Assembly
Appropriations.
REGISTERED SUPPORT / OPPOSITION :
Support
AARP
Alzheimer's Association
California Advocates for Nursing Home Reform
California Long-Term Care Ombudsman Association
Catholic Charities of California United
Office of the State Long-Term Care Ombudsman
Ombudsman & HICAP Services of Northern California
Opposition
None on file.
Analysis Prepared by : Tanya Robinson-Taylor / HEALTH / (916)
319-2097