BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  SB 345
                                                                  Page  1

          Date of Hearing:   August 8, 2012

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Felipe Fuentes, Chair

                     SB 345 (Wolk) - As Amended:  June 28, 2012 

          Policy Committee:                             Aging and 
          Long-Term CareVote:                           6-0

          Urgency:     No                   State Mandated Local Program: 
          No     Reimbursable:              No

           SUMMARY  

          This bill modifies and clarifies numerous provisions governing 
          the duties of the State Office of the Long-Term Care (LTC) 
          Ombudsman (Office), in order to better align with federal law 
          and improve the ability of the Office to advocate on behalf of 
          LTC residents, including:

          1)Enumerating duties of the State LTC ombudsman to conform with 
            federal law, including ensuring residents have timely access 
            to services to the extent resources allow, providing 
            assistance to local ombudsman programs, analyzing and 
            commenting on legislation and other policy without 
            interference from the administration, and other duties.

          2)Requiring the Office to establish and post specified 
            information to an Internet web site. 

          3)Requiring the Office to prepare and disseminate an annual 
            advocacy report.

          4)Requiring, instead of authorizing, the Office to hire outside 
            counsel in the case of a conflict of interest generated by 
            representation by the Attorney General. 

          5)Recasting a current-law requirement establishing a 
            (now-defunct) advisory council to the Office to grant 
            additional flexibility with respect to the size of the council 
            and the nominating process for members.  

          6)Requiring the Department of Aging and other state departments 
            and programs that have roles in funding, regulating, 








                                                                  SB 345
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            monitoring, or serving LTC residents, including law 
            enforcement agencies, to cooperate with and meet with the 
            Office periodically and as needed to address concerns or 
            questions involving the care of LTC residents. 

          7)Clarifying that representatives of the State LTC Ombudsman are 
            allowed to enter LTC facilities unhindered under specified 
            circumstances. 

          8)Enacting other conforming, clarifying, and technical changes. 
           
           FISCAL EFFECT  

          1)Minor costs, not likely to exceed $50,000 annually, may be 
            incurred by the Office to comply with certain new requirements 
            of this bill that are not required by federal law, including 
            maintenance of an internet Web site, preparation of an annual 
            advocacy report, requirement to hire outside counsel in the 
            case of a conflict of interest generated by representation by 
            the Attorney General, and reconstitution of an advisory 
            council.  These costs are expected to be absorbable within 
            existing federal fund resources.  

          2)The State LTC Ombudsman indicates many other listed duties 
            that conform to federal law are currently being performed by 
            the office and will not result in increased costs. 

           COMMENTS  

           1)Rationale  .  According to the author, this bill furthers and 
            reinforces the State Ombudsman's independence from the 
            California Department of Aging, in order to enhance the 
            Ombudsman's advocacy for protection of residents.  The 
            author's goal is to ensure that LTC residents have an 
            independent voice at the state level who can advocate for 
            systemic change to better protect their rights, safety, and 
            welfare.  

            In addition, the author indicates conformity with federal law 
            will provide state-level accountability for the State 
            Ombudsman's efforts. Although many duties enumerated in this 
            bill are already required by federal law, the author believes 
            enacting them in state law will remove any questions about the 
            State Ombudsman's role as an advocate for LTC residents.









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           2)Background  .  The Older Americans Act mandates that state 
            long-term care ombudsman programs provide systems-level 
            advocacy, including "recommending any changes in laws, 
            regulations, policies, and actions that will further promote 
            the interests, well-being and rights of residents."  National 
            studies have documented that ombudsman programs in many states 
            have encountered barriers to effective advocacy, including 
            political interference, limiting the program's ability to 
            effect change on behalf of residents.  California's Office of 
            the LTC Ombudsman is located in the Department of Aging, and 
            in the past has been required to obtain permission from the 
            administration to perform certain advocacy duties required by 
            federal law.

            Several provisions in this bill, including the requirement for 
            an annual advocacy plan, were provided as options to 
            strengthen the LTC Ombudsman's advocacy role, in a program 
            review conducted by the Senate Office of Research at the 
            author's request.  This bill follows policy options outlined 
            in the SOR review to increase the ability of, and the 
            expectations for, the Office to advocate independently.  
            According to SOR and the author, this change would allow for 
            more effective protection of LTC residents while maximizing 
            administrative efficiency by maintaining the Office in the 
            Department of Aging.  
           
            3)Related Legislation  .  AB 2276 (Campos) appropriated  $1.6 
            million for the 2012-13 fiscal year, and $1.6 million for the 
            2013-14 fiscal year, from the State Health Facilities Citation 
            Penalties Account to the California Department of Aging to 
            fund local ombudsman programs.  AB 2276 was held on the 
            Suspense File of this committee.

           
          Analysis Prepared by  :    Lisa Murawski / APPR. / (916) 319-2081