BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 1744
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          ASSEMBLY THIRD READING
          AB 1744 (Brown)
          As Amended  May 23, 2014
          Majority vote 

           AGING               7-0         APPROPRIATIONS      14-3        
           
           ----------------------------------------------------------------- 
          |Ayes:|Yamada, Wagner, Brown,    |Ayes:|Gatto, Bocanegra,         |
          |     |Daly, Gray, Grove, Levine |     |Bradford,                 |
          |     |                          |     |Ian Calderon, Campos,     |
          |     |                          |     |Eggman, Gomez, Holden,    |
          |     |                          |     |Linder, Pan, Quirk,       |
          |     |                          |     |Ridley-Thomas, Wagner,    |
          |     |                          |     |Weber                     |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |     |                          |Nays:|Bigelow, Donnelly, Jones  |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 

           SUMMARY  :  Establishes the California Caregiver Act of 2014.   
          Specifically,  this bill  :  

           1) Makes legislative findings and declarations regarding  
             demographics and experiences of family and "informal"  
             (unpaid) caregivers.  

          2)Directs the California Department of Aging (CDA), upon  
            securing $200,000 from private sources for the purpose of  
            implementing this activity, to convene a blue-ribbon panel on  
            family caregiving, chaired by the Director of CDA (or his or  
            her designee) made up of 13 individuals to:  

              a)   Review current policies and practices of state, local  
               and community programs available to caregivers of adults  
               with chronic disabling conditions, and consider how the  
               needs of family caregivers should be assessed and addressed  
               so that they may avoid overburdening themselves, and remain  
               in their caregiving role.

             b)   Consider other state plans, including State Olmstead  
               Plan, the Long-Range Strategic Plan on Aging, the State  
               Plan for Alzheimer's disease, and the State Plan on Aging,  








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               and compile and inventory resources available to family  
               caregivers.

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

             d)   Consider cultural and linguistic factors that impact  
               caregivers and care recipients who are from diverse  
               backgrounds.

             e)   Consult with a broad range of stakeholders, including  
               but not limited to people diagnosed with Alzheimer's,  
               adults with disabling and 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.

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

            g)   Identify best practice in other states.

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

             i)   Develop at least three legislative recommendations to  
               improve the provisions of services for unpaid and family  
               caregivers in California to address the following:

               i)     Community-based support for California's diverse  
                 populations of caregivers for adults with chronic or  
                 disabling conditions;

               ii)    Choices for care and residence for persons with  
                 Alzheimer's disease and their families; and

               iii)  The family caregiving "competencies" of health care  
               professionals.  

            j)   Prepare a report to the legislature on or before July  
            2016 in digital format.








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             k)   Provide ongoing advice and assistance to the department  
               and the legislature as to the needs of unpaid and relative  
               caregivers.

          3)Members will serve without compensation but shall receive  
            reimbursement for travel and other expenses incurred in the  
            performance of their official duties, and meet publicly  
            every-other month.
           
          EXISTING LAW  :

          1)Establishes the Older Californians Act (OCA) and assures older  
            adults have equal access to programs and services provided  
            through the OCA regardless of physical or mental disabilities,  
            language barriers, cultural or social isolation, including  
            that caused by actual or perceived racial and ethnic status,  
            including, but not limited to, African American, Hispanic,  
            American Indian, and Asian American, ancestry, national  
            origin, religion, sex, gender identity, marital status,  
            familial status, sexual orientation, or by association with a  
            person or persons with one or more of these actual or  
            perceived characteristics, that restrict an individual's  
            ability to perform normal daily tasks or that threaten his or  
            her capacity to live independently.

          2)Establishes CDA 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.  

          3)Establishes 33 area agencies on aging to receive federal,  
            state, and local funds to contract with local organizations  
            for service to seniors.  There are 33 area agencies on aging  
            designated by the CDA as the local Planning Services Agencies.  
             

          4)Establishes the Title IIIE program, also known as the National  
            Family Caregiver Support Program (NFCSP), established in 2000,  
            to coordinate local community-service systems for assisting  
            caregivers of seniors.  Services are available to family and  
            other unpaid caregivers supporting older individuals, as well  
            as grandparents and older relatives caring for children.  Each  
            Area Agency on Aging (AAA) is responsible for determining the  








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            array of services, including caregiver information, assistance  
            in gaining access to services, counseling and training  
            support, temporary respite, and limited supplemental services  
            to complement the care provided by caregivers.  Services are  
            provided directly by AAA staff, or through partnerships with  
            other public or private agencies.  

          5)Establishes Caregiver Resource Centers to deliver services to  
            and advocate for caregivers of cognitively impaired adults, by  
            offering specialized information on chronic and disabling  
            conditions and diseases, aging, caregiving issues, community  
            resources and family consultation.  Professional staff work  
            with families and caregivers to provide support, alleviate  
            stress, examine options, and enable them to make decisions  
            related to the care, respite, and counseling in legal and  
            financial aid.  

           FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee: 

          1)One-time costs to CDA to support the study and report in the  
            low hundreds of thousands of dollars (private funding).  

           COMMENTS  :  Families are the major provider of long-term care,  
          but research has shown that caregiving exacts a heavy emotional,  
          physical and financial toll.  Many caregivers who work and  
          provide care experience conflicts between their  
          responsibilities.  Almost half of all caregivers are over age  
          50, making them more vulnerable to a decline in their own  
          health, and one-third describe their own health as fair to poor.  
           Women make up the majority of the unpaid caregiver workforce,  
          often interrupting work careers to take on the burden of caring  
          for a relative.  Caregiving women face uncertain economic  
          futures due to breaks from employment and the corresponding  
          reductions to retirement plans and the social security system.  

          At a joint hearing of the Assembly Aging and Long-Term Care and  
          the Human Services Committees in 2011, testimony about  
          caregiving in California revealed that while some people receive  
          care from paid caregivers, most rely on unpaid assistance from  
          families, friends and neighbors.  The National Alliance on  
          Caregiving and AARP report entitled: "Caregiving in the United  
          States, 2009," estimates 31.2% of households in the United  
          States had at least one person who served as an unpaid family  








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          caregiver during the course of the year.  The same report  
          estimates the number of caregivers in California at any given  
          time at 4.0 million, with an estimated 5.88 million people  
          serving as caregivers during the course of a year.  The  
          estimated value of unpaid care in California is $47 billion,  
          accounting for over 3.8 billion hours of care at $12.17, the  
          average caregiver wage in 2009.  On the personal side, long-term  
          caregiving has significant financial consequences for  
          caregivers, particularly for women.  Informal caregivers  
          personally lose about $659,139 over a lifetime:  $25,494 in  
          social security benefits; $67,202 in pension benefits; and  
          $566,443 in forgone wages.  Caregivers face the loss of income  
          of the care recipient, loss of their own income if they reduce  
          their work hours or leave their jobs, loss of employer-based  
          medical benefits, shrinking of savings to pay caregiving costs,  
          and a threat to their retirement income due to fewer  
          contributions to pensions and other retirement vehicles.  
           

          Analysis Prepared by  :    Robert MacLaughlin / AGING & L.T.C. /  
          (916) 319-3990


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