Amended in Senate August 19, 2014

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 and repeal 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, until January 1, 2018, would require the department to convene a blue-ribbon task force comprised of at least 13 members, as specified, to make legislative recommendations to improve services for unpaid and family caregivers in California, begin delete as provided. The bill would condition this requirement upon the receipt of $200,000 in end delete begin insert if the department receives sufficient end insert nonstate funds from private sources begin delete for purposes of implementing end delete begin insert to implement end insert the bill. The bill would require the task force to prepare a report of its findings and recommendations and provide it to the Legislature on or before July 1, begin delete 2016 end delete begin insert 2017 end insert . 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:

begin delete

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 24th out of 50 states and the District of
Columbia on the 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.

(f) Approximately 4 million family caregivers in California
provide care to an adult with limitations in daily activities at any
given point in time, and over 5.8 million provide care at some time
during the year. In addition, California’s family caregivers provide
an estimated 3,850,000,000 hours of unpaid labor caring for their
loved ones. The estimated economic value of their unpaid
contributions is approximately $47 billion.

(g) Fifty-nine percent of all family caregivers are 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.

(h) Nationally, 46 percent of family caregivers perform medical
or nursing tasks for care recipients with multiple chronic physical
and cognitive conditions. More than three-quarters of family
caregivers who provide medical or nursing tasks are managing
medications, including administering intravenous fluids and
injections. Nearly half of family caregivers are administering five
to nine prescription medications a day, and one in five is helping
with 10 or more prescription medications a day. Yet most
caregivers report that they trained themselves to perform
medication management.

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

(j) 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. 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.

(k) For many families in the midst of caregiving, there is deep
worry and concern about the quality of care and quality of life.
They do not know who to call or where to go to get the right kind
of affordable help when they need it.

(l) 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.

(m) 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.

(n) There is an immense need for caregiving resources and
services. As California’s population ages, and as California
becomes increasingly diverse, it is 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.

end delete

begin delete SEC. 3. end delete
begin insert SECTION 1. end insert   

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

9104.  

(a) The department shall convene a blue-ribbon task
force on unpaid family caregiving upon receipt of begin delete two hundred
thousand dollars ($200,000) of end delete begin insert sufficient end insert nonstate funds begin insert , as
determined by the department, end insert from private sources begin delete for purposes
of implementing end delete begin insert to implement end insert this section. The department shall
use the private funds solely for the planning, operation, assessment,
and final recommendations of the task force.

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

(c) The task force shall be comprised of at least 13 members,
each of whom shall have experience in 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 California end delete Alzheimer’s begin delete Association end delete
begin insert Disease community end insert .

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

begin delete

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

end delete begin delete

(8)

end delete

begin insert (7) end insert  A representative of an organization that provides services
to caregivers.

begin delete

(9)

end delete

begin insert ( end insert begin insert 8) end insert  A representative of begin delete AARP California end delete begin insert a nonprofit
organization representing senior citizens end insert .

begin delete

(10)

end delete

begin insert (9) end insert  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.

begin delete

(11)

end delete

begin insert (1 end insert begin insert 0) end insert  An adult with a chronic or disabling condition who receives
care from an unpaid caregiver or family member.

begin delete

(12)

end delete

begin insert (11) end insert  A director or designated representative of an area agency
on aging.

(d) The blue-ribbon task force 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.

begin insert

(8) Assess information referral and resource sharing systems
used by family caregivers by doing all of the following:

end insert begin insert

(A) Compiling an inventory of the resources available to family
caregivers.

end insert begin insert

(B) Determining access barriers in the current system.

end insert begin insert

(C) Considering the cultural and linguistic factors that impact
caregivers and care recipients who are from diverse populations.

end insert begin insert

(D) Comparing consistency of access across the counties.

end insert begin delete

(8)

end delete

begin insert (9) end insert  Identify best practices both in California and in other states.

begin delete

(9)

end delete

begin insert (10) end insert  Explore expanding those best practices in caregiving
programs to populations that are not currently targeted.

begin delete

(10)

end delete

begin insert (11) end insert  Make specific recommendations that address, at a
minimum, each of the following:

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

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

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

begin delete

(11)

end delete

begin insert (12) end insert  Prepare and provide to the Legislature a report of its
findings and recommendations on or before July 1, begin delete 2016 end delete begin insert 2017 end insert .

(e) (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 task force shall meet on a bimonthly basis.

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

(4) All meetings of the task force 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).

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

(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.