Amended in Senate August 4, 2014

Amended in Assembly May 23, 2014

Amended in Assembly April 8, 2014

Amended in Assembly March 20, 2014

California Legislature—2013–14 Regular Session

Assembly Bill No. 1744

Introduced by Assembly Member Brown

(Principal coauthor: Assembly Member Atkins)

(Coauthors: Assembly Members Cooley, Levine, Waldron, and Yamada)

February 14, 2014

An act to add begin insert and repeal end insert Section 9104 to the Welfare and Institutions Code, relating to aging.

LEGISLATIVE COUNSEL’S DIGEST

AB 1744, as amended, Brown. California Department of Aging.

The Mello-Granlund Older Californians Act creates the California Department of Aging to provide leadership to the area agencies on aging in developing systems of home- and community-based services that maintain individuals in their own homes or least restrictive homelike environments. Existing law requires the department, in accomplishing its mission, to consider available data and population trends in developing programs and policies, collaborate with area agencies on aging, the California Commission on Aging, and other state and local agencies.

This bill begin insert , until January 1, 2018, end insert would require the department begin delete , upon securing $200,000 in nonstate funds from private sources for purposes of implementing the bill, end delete to convene a blue-ribbon begin delete panel, end delete begin insert task force end insert comprised of at least 13 members, as specified, to make legislative recommendations to improve services for unpaid and family caregivers in California, as provided. begin insert The bill would condition this requirement upon the receipt of $200,000 in nonstate funds from private sources for purposes of implementing the bill. end insert The bill would require the begin delete committee end delete begin insert task force end insert to prepare a report of its findings and recommendations and provide it to the Legislature on or before July 1, 2016. The bill would make related findings and declarations.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

SECTION 1.  

This act shall be known, and may be cited, as the
California Caregiver Act of 2014.

SEC. 2.  

The Legislature finds and declares all of the following:

(a) A caregiver can be any relative, partner, friend, or neighbor
who has a significant relationship with, and who provides a broad
range of assistance to, an older person or an adult with a chronic
or disabling condition.

(b) At present, there is no complete inventory of caregiving
programs available to Californians performing unpaid caregiving
services for an aging or disabled family member, friend, or
neighbor.

(c) Rising demand and shrinking families to provide caregiving
support suggest that California needs a comprehensive person-
and family-centered policy for long-term services and supports
systems that would better serve the needs of older persons with
disabilities, support family and friends in their caregiving roles,
and promote greater efficiencies in public spending.

(d) California ranked begin delete 30th end delete begin insert 24th end insert out of 50 states and the District
of Columbia on the begin delete 2011 end delete State Long-Term Services and Supports
Scorecard sponsored by the SCAN Foundation, American
Association of Retired Persons (AARP), and the Commonwealth
Fund.

(e) Family support is a key driver in remaining in one’s home
and community, but it comes at substantial costs to the caregivers,
their families, and to society. If family caregivers were no longer
available, the economic cost to California’s health care and
long-term services and supports systems would increase
astronomically.

begin delete

(f) In 2009, approximately

end delete

begin insert (f) end insert begin insert   end insert begin insert Approximately end insert 4 million family caregivers in California
begin delete provided end delete begin insert provide end insert care to an adult with limitations in daily activities
at any given point in time, and over 5.8 million begin delete provided end delete begin insert provide end insert
care at some time during the begin delete year. end delete

begin delete (g) end delete begin delete   end delete begin delete In 2009, end delete begin insert year. In addition, end insert California’s family caregivers
begin delete provided end delete begin insert provide end insert an estimated 3,850,000,000 hours of unpaid labor
caring for their loved ones. The estimated economic value of their
unpaid contributions begin delete was end delete begin insert is end insert approximately $47 billion.

begin delete

(h) In 2009, 59 percent

end delete

begin insert (g) end insert begin insert   end insert begin insert Fifty-nine percent end insert of all family caregivers begin delete were end delete begin insert are end insert employed
full or part time. Family caregivers typically spend 20 hours a
week caring for a family member who needs help with bathing,
dressing, and other kinds of personal care, as well as household
tasks such as shopping and managing finances.

begin delete

(i)

end delete

begin insert (h) end insert  Nationally, 46 percent of family caregivers begin delete performed end delete
begin insert perform end insert medical or nursing tasks for care recipients with multiple
chronic physical and cognitive conditions. More than three-quarters
of family caregivers who begin delete provided end delete begin insert provide end insert medical or nursing
tasks begin delete were end delete begin insert are end insert managing medications, including administering
intravenous fluids and begin delete injections. end delete

begin delete (j) end delete begin delete   end delete begin delete Almost one-half end delete begin insert injections. Nearly half end insert of family caregivers
begin delete were end delete begin insert are end insert administering five to nine prescription medications a day,
and one in five begin delete was end delete begin insert is end insert helping with 10 or more prescription
medications a day. Yet begin delete , 61 percent of these end delete begin insert most end insert caregivers
begin delete reported end delete begin insert report end insert that they trained themselves to perform medication
management.

begin delete

(k)

end delete

begin insert (i) end insert  Only 31 percent of caregivers begin delete reported end delete begin insert report end insert being visited
at home by a health care professional. begin delete In addition, 27 end delete begin insert Twenty-seven end insert
percent of caregivers report that they have no additional assistance
from a family member, health care professional, or home health
aide.

begin delete

(l)

end delete

begin insert ( end insert begin insert j) end insert  Nationally, more than 8 in 10 caregivers are over 50 years
of age. Family caregivers are aging and are increasingly from
diverse social, racial, ethnic, and political backgrounds. begin insert As the
baby boomers age into their 80s, the decline in the caregiver
support ratio is projected to shift from a slow decline to a free fall
in California. end insert

begin delete

(m)

end delete

begin insert (k) end insert  For many families in the midst of caregiving, there is deep
worry and concern about the quality of care and quality of begin delete life. end delete

begin delete (n) end delete begin delete   end delete begin delete Families end delete begin insert life. They end insert do not know who to call or where to go
to get the right kind of affordable help when they need it.

begin delete

(o) In just 13 years, as the baby boomers age into their 80s, the
decline in the caregiver support ratio is projected to shift from a
slow decline to a free fall in California.

end delete begin delete

(p)

end delete

begin insert (l) end insert  To avoid bankrupting our health and social service systems
serving the elderly and persons with disabilities, it is imperative
that California prepare by identifying strategies that will promote
appropriate, person-centered services for families struggling with
providing care to a family member.

begin delete

(q)

end delete

begin insert (m) end insert  It is in the interest of the state to better serve the
approximately 4,000,000 families statewide who are currently
struggling to care for an aging or disabled family member, many
of whom are also in the workforce.

begin delete

(r)

end delete

begin insert (n) end insert  There is an immense need for caregiving resources and
services. As California’s population begin delete ages end delete begin insert ages, end insert and as California
becomes increasingly diverse, it is begin delete also end delete in the interest of the state
to adequately serve the following emerging caregiver populations:

(1) Caregivers from the Black, Latino, Asian American, and
Pacific Islander communities.

(2) Families of individuals with developmental disabilities.

(3) Persons who cannot access or are not eligible for existing
caregiver support programs.

(4) Non-English speakers, and ethnically and racially diverse
populations that need caregiving programs to be provided in a
culturally and linguistically appropriate manner.

(5) Those in the lesbian, gay, bisexual, and transgender
community.

(6) Rural residents.

SEC. 3.  

Section 9104 is added to the Welfare and Institutions
Code, to read:

9104.  

(a) The department shall begin delete , upon securing two hundred
thousand dollars ($200,000) of nonstate funds from private sources
for the purpose of implementing this section, convene a blue-ribbon
panel on family caregiving and long-term services and supports.
The panel end delete begin insert convene a blue-ribbon task force on unpaid family
caregiving upon receipt of two hundred thousand dollars
($200,000) of nonstate funds from private sources for purposes of
implementing this section. The department shall use the private
funds solely for the planning, operation, assessment, and final
recommendations of the task force. end insert

begin insert (b) end insert begin insert   end insert begin insert The task force end insert shall be begin delete jointly end delete chaired by the director of the
department or his or her designee and begin insert shall be vice-cha end insert begin insert ired by end insert a
representative elected by the members of the begin delete panel end delete begin insert task force end insert .

begin delete

(b)

end delete

begin insert ( end insert begin insert c) end insert  The begin delete panel end delete begin insert task force end insert shall be comprised of at least 13
members, each of whom shall begin delete be representative of end delete begin insert have experience
in end insert one or more of the following categories:

(1) A person with experience in the field of academic research
on caregiving.

(2) A family caregiver for an adult with a chronic or disabling
condition.

(3) A representative of the mental health community.

(4) A representative of the California caregiver resource centers.

(5) A representative of the begin delete national end delete begin insert California end insert Alzheimer’s
Association.

(6) A representative of an organization that provides
community-based adult services.

(7) A representative of an organization that provides an adult
day program.

(8) A representative of an organization that provides services
to caregivers.

(9) A representative of begin delete an unpaid or family caregiver consumer
organization end delete begin insert AARP California end insert .

(10) A representative with expertise in and knowledge of the
specific needs of culturally and linguistically diverse caregivers
and the unique challenges of delivering services to family
caregivers who face cultural or linguistic barriers.

(11) An adult with a chronic or disabling condition who receives
care from an unpaid caregiver or family member.

(12) A director or designated representative of an area agency
on aging.

begin delete

(c)

end delete

begin insert (d) end insert  The blue-ribbon begin delete panel end delete begin insert task force end insert shall do all of the following:

(1) Review the current policies and practices of state, local, and
community programs available to caregivers of adults with chronic
or disabling conditions, and consider how the needs of family
caregivers should be assessed and addressed so that they can
continue in their caregiving role without being overburdened.

(2) Consider the recommendations of other state plans,
including, but not limited to, the Olmstead Plan, the Long-Range
Strategic Plan on Aging, the State Plan for Alzheimer’s Disease,
and the State Plan on Aging.

(3) Compile an inventory of the resources available to family
caregivers.

(4) Determine gaps in services to family caregivers and identify
barriers to participation in current programs.

(5) Consider cultural and linguistic factors that impact caregivers
and care recipients who are from diverse populations.

(6) Consult with a broad range of stakeholders, including, but
not limited to, people diagnosed with Alzheimer’s disease, adults
with disabling or chronic conditions, family caregivers,
community-based and institutional providers, caregiving
researchers and academicians, formal caregivers, the Caregiver
Resource Centers, the California Commission on Aging, and other
state entities.

(7) Solicit testimony on the needs of family caregivers, including
the designation of caregivers, training, respite services, medical
leave policies, delegation of tasks to nonmedical aides, and other
policies.

(8) Identify best practices both in California and in other states.

(9) Explore expanding those best practices in caregiving
programs to populations that are not currently targeted.

begin delete

(10) Develop at least three legislative recommendations to
improve the provision of services for unpaid and family caregivers
in California. These recommendations shall address all of the
following:

(A) Community-based support for California’s diverse
population of caregivers for adults with chronic or disabling
conditions.

(B) Choices for care and residence for persons with Alzheimer’s
disease and their families.

(C) The family caregiving competence of health care
professionals.

end delete begin insert

(10) Make specific recommendations that address, at a
minimum, each of the following:

end insert begin insert

(A) The development of a one-stop information hub Web site or
portal that contains a list of current resources and supports
available in a family caregiver’s community, or the contact
information of a person or organization who can help a family
caregiver navigate these support services.

end insert begin insert

(B) The enhancement of outreach and education efforts by area
agencies on aging and family resource centers to ensure that
information is provided to family caregivers at the time they need
it most.

end insert begin insert

(C) The development of a caregiver screening and assessment
tool that will help identify which services and supports a family
caregiver needs.

end insert

(11) Prepare and provide to the Legislature a report of its
findings and recommendations on or before July 1, 2016.

begin delete

(d)

end delete

begin insert (e) end insert  (1) Members shall serve without compensation, but shall
receive reimbursement for travel and other necessary expenses
actually incurred in the performance of their official duties.

(2) The begin delete panel end delete begin insert task force end insert shall meet on a bimonthly basis.

begin insert

(3) Members of the task force shall be appointed to serve for
the duration of the task force.

end insert begin delete

(3)

end delete

begin insert (4) end insert  All meetings of the begin delete panel end delete begin insert task force end insert shall be open to the
public and adequate notice shall be provided in accordance with
the Bagley-Keene Open Meeting Act (Article 9 (commencing with
Section 11120) of Chapter 1 of Part 1 of Division 3 of Title 2 of
the Government Code).

begin delete

(e) (1) The requirement for submitting a report imposed under
paragraph (11) of subdivision (c) is inoperative on July 1, 2020,
pursuant to Section 10231.5 of the Government Code.

end delete begin delete

(2)

end delete

begin insert (f) end insert  A report to be submitted pursuant to paragraph (11) of
subdivision begin delete (c) end delete begin insert (d) end insert shall be submitted in compliance with Section
9795 of the Government Code.

begin insert

(g) This section shall remain in effect only until January 1, 2018,
and as of that date is repealed, unless a later enacted statute, that
is enacted before January 1, 2018, deletes or extends that date.

end insert