BILL NUMBER: SB 2199 AMENDED BILL TEXT AMENDED IN ASSEMBLY JULY 6, 1998 AMENDED IN SENATE APRIL 28, 1998 AMENDED IN SENATE APRIL 14, 1998 INTRODUCED BY Senator Lockyer (Principal coauthors: Senators Hughes, Thompson, and Vasconcellos) (Principal coauthor: AssemblyMember Cedillo)Members Cedillo and Woods) (Coauthors: Senators Alpert, Costa, Karnette,Lee,McPherson, Rainey, Rosenthal, Sher, Solis, and Watson) (Coauthors: Assembly Members Alquist, Aroner, Baca, Bordonaro, Brown, Davis, Granlund, Havice, Honda,Keeley, Kuehl, Murray, Ortiz, Perata, Strom-Martin,Keeley, Knox, Kuehl, Murray, Ortiz, Perata, Shelley, Strom-Martin, Sweeney, Thomson, Washington, Wildman, Woods, and Wright) FEBRUARY 20, 1998 An act to amend Sections 15610.07, 15610.10, 15610.17, 15610.30, 15610.55, 15610.57, 15630, 15633, 15640, 15650, 15658, and 15659 of, to add Section 15653.5 to, and to add Chapter 13.5 (commencing with Section 15760) to Part 3 of Division 9 of, the Welfare and Institutions Code, relating to adult abuse. LEGISLATIVE COUNSEL'S DIGEST SB 2199, as amended, Lockyer. Elder and dependent adult abuse. (1) Existing law, the Elder Abuse and Dependent Adult Civil Protection Act, sets forth provisions for the reporting of actual or suspected physical or other abuse, as defined, of an elder or dependent adult by specified persons and entities, including care custodians, and imposes various requirements on state and local agencies in processing, investigating, and reporting on these reports. This bill, among other things, would broaden and redefine "abuse," "adult protective services," "neglect," and "care custodian" for purposes of these provisions, would change references from "fiduciary abuse" to "financial abuse," and would revise provisions relating to the reporting of abuse by an adult protective services agency to a local law enforcement agency or the long-term care ombudsman program. (2) Existing law imposes specified requirements on a mandated reporter, as defined, with respect to the observation and reporting of physical abuse of an elder or dependent adult. Violation of these provisions is a misdemeanor. This bill would revise these provisions and would include abandonment, isolation, financial abuse, and neglect as reportable abuse for purposes of these requirements. By expanding the definition of a crime, this bill would impose a state-mandated local program. (3) Existing law authorizes adult protective services to include investigations, needs assessment, the use of a multidisciplinary personnel team in order to obtain information and records necessary for adult protective services, a system in which reporting can occur on a 24-hour basis, emergency shelter, and adult respite care. Existing law also specifies the members of the multidisciplinary personnel team. This bill would enact enhanced adult protective services provisions that would be implemented only to the extent funds for this enhancement are provided in the annual Budget Act. These provisions would require, rather than authorize, adult protective services to include the above protective actions, would add a public guardian to the members of the multidisciplinary personnel team, and would require each county to establish an emergency response adult protective services program containing specified requirements. The imposition of these new requirements on counties would create a state-mandated local program. (4) Existing law specifies that any personnel of a multidisciplinary team that receives specified information relating to elder or dependent adult abuse is under the same obligations and subject to the same confidentiality penalties as the person disclosing or providing that information. This bill would specify that these provisions are also applicable to any personnel of an agency that receives this information. (5) This bill would require the Director of Social Services to adopt regulations to implement the provisions of this bill no later than January 31, 2000, and would authorize the State Department of Social Services to implement these provisions through an all county letter or similar instructions from the Director of Social Services until that date. (6) The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement, including the creation of a State Mandates Claims Fund to pay the costs of mandates that do not exceed $1,000,000 statewide and other procedures for claims whose statewide costs exceed $1,000,000. This bill would provide that with regard to certain mandates no reimbursement is required by this act for a specified reason. With regard to any other mandates, this bill would provide that, if the Commission on State Mandates determines that the bill contains costs so mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above. Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. The Legislature finds and declares all of the following: (a) California's mandatory reporting laws, first enacted in 1982, have brought the tragedy of elder and dependent adult abuse to public attention. Annually, 225,000 incidents of adult abuse occur in California--an increase of over 1000 percent over the number of incidents in 1986-87. Twenty-three percent of the incidents involve physical abuse, 32 percent involve fiduciary abuse, 22 percent involve mental suffering, and 3.8 percent involve sexual abuse. In addition to the victimization by another person, in more than 50 percent of the incidents the elder or dependent adult is unable to meet their own needs due to frailty, untreated health conditions, mental or emotional problems, or family dysfunctions. (b) California counties lack the ability to respond to approximately 80 percent of the incidents. In 1996-97 the Adult Protective Services Program statewide was able to respond to fewer than 44,000 of the 225,000 incidents. (c) Staff assigned to Adult Protective Services programs statewide has decreased by 35 percent since 1990 in California. (d) Forty-five percent of the California counties no longer provide case management services in Adult Protective Services. Fifty percent of the counties do not provide counseling. Fifty percent do not provide a 24-hour hotline, money management, or tangible services critical to ongoing safety and protection of the elders and dependent adults. (e) Fewer than 20 percent of the counties respond to all Adult Protective Service reports. Counties must triage calls and are unable to respond to many serious types of abuse. (f) To remedy situations of immediate danger to vulnerable elders and dependent adults, it is urgent that California establishes and funds a comprehensive adult protective services program statewide to maintain the safety of elders and dependent adults in the home and in the community . SEC. 2. Section 15610.07 of the Welfare and Institutions Code is amended to read: 15610.07. "Abuse of an elder or a dependent adult" means either of the following: (a) Physical abuse, neglect, financial abuse, abandonment, isolation, abduction, or other treatment with resulting physical harm or pain or mental suffering. (b) The deprivation by a care custodian of goods or services that are necessary to avoid physical harm or mental suffering. SEC. 3. Section 15610.10 of the Welfare and Institutions Code is amended to read: 15610.10. "Adult protective services" means those preventive and remedial activities performed on behalf of elders and dependent adults who are unable to protect their own interests, harmed or threatened with harm, caused physical or mental injury due to the action or inaction of another person or their own action as a result of ignorance, illiteracy, incompetence, mental limitation, substance abuse, or poor health, lacking in adequate food, shelter, or clothing, exploited of their income and resources, or deprived of entitlement due them. SEC. 4. Section 15610.17 of the Welfare and Institutions Code is amended to read: 15610.17. "Care custodian" means an administrator or an employee of any of the following public or private facilities or agencies, or persons providing care or services for elders or dependent adults, including members of the support staff and maintenance staff: (a) Twenty-four-hour health facilities, as defined in Sections 1250, 1250.2, and 1250.3 of the Health and Safety Code. (b) Clinics. (c) Home health agencies. (d) Agencies providing publicly funded in-home supportive services, nutrition services, or other home and community-based support services. (e) Adult day health care centers and adult day care. (f) Secondary schools that serve 18- to 22-year-old dependent adults and postsecondary educational institutions that serve dependent adults or elders. (g) Independent living centers. (h) Camps. (i) Alzheimer's Disease day care resource centers. (j) Community care facilities, as defined in Section 1502 of the Health and Safety Code, and residential care facilities for the elderly, as defined in Section 1569.2 of the Health and Safety Code. (k) Respite care facilities. (l) Foster homes. (m) Vocational rehabilitation facilities and work activity centers. (n) Designated area agencies on aging. (o) Regional centers for persons with developmental disabilities. (p) State Department of Social Services and State Department of Health Services licensing divisions. (q) County welfare departments. (r) Offices of patients' rights advocates and clients' rights advocates, including attorneys. (s) The office of the long-term care ombudsman. (t) Offices of public conservators, public guardians, and court investigators. (u) Any protection or advocacy agency or entity that is designated by the Governor to fulfill the requirements and assurances of the following: (1) The federal Developmental Disability Assistance and Bill of Rights Act, as amended, contained in Chapter 75 (commencing with Section 6000) of Title 42 of the United States Code, for protection and advocacy of the rights of persons with developmental disabilities. (2) The Protection and Advocacy for the Mentally Ill Individuals Act of 1986, as amended, contained in Chapter 114 (commencing with Section 10801) of Title 42 of the United States Code, for the protection and advocacy of the rights of persons with mental illnesses. (v) Any other protective, public, sectarian, mental health, or private assistance or advocacy agency or person providing health services or social services to elders or dependent adults. SEC. 5. Section 15610.30 of the Welfare and Institutions Code is amended to read: 15610.30. (a) "Financial abuse" means a situation in which one or both of the following apply: (1) A person, including, but not limited to, one who has the care or custody of, or who stands in a position of trust to, an elder or a dependent adult, takes, secretes, or appropriates their money or property, to any wrongful use, or with the intent to defraud. (2) A situation in which all of the following conditions are satisfied: (A) An elder (who would be a dependent adult if he or she were between the ages of 18 and 64) or dependent adult or his or her representative requests that a third party transfer to the elder or dependent adult or to his or her representative, or to a court appointed receiver, property that meets all of the following criteria: (i) The third party holds or has control of the property. (ii) The property belongs to, or is held in express trust, constructive trust or resulting trust for, the elder or dependent adult. (iii) The ownership or control of the property was acquired in whole or in part by the third party or someone acting in concert with the third party from the elder or dependent adult at a time when the elder or dependent adult was a dependent adult or was a person who would have been a dependent adult if he or she had then been between the ages of 18 and 64. (B) Despite the request for the transfer of property, the third party without good cause either continues to hold the property or fails to take reasonable steps to make the property readily available to the elder or dependent adult, to his or her representative or to a court appointed receiver. (C) The third party committed acts described in this paragraph in bad faith. A third party shall be deemed to have acted in bad faith if the third party either knew or should have known that the elder or dependent adult had the right to have the property transferred or made readily available. For purposes of this subdivision, a third party should have known of this right if, on the basis of the information received by the elder or dependent adult, or the elder or dependent adult's representative, it is obvious to a reasonable person that the elder or dependent adult had this right. (b) For the purpose of this section, the term "third party" means a person who holds or has control of property that belongs to or is held in express trust, constructive trust or resulting trust for an elder or dependent adult. (c) For the purposes of this section, the term "representative" means an elder or dependent adult's conservator of the estate, or attorney-in-fact acting within the authority of the power of attorney. SEC. 6. Section 15610.55 of the Welfare and Institutions Code is amended to read: 15610.55. (a) "Multidisciplinary personnel team" means any team of two or more persons who are trained in the prevention, identification, and treatment of abuse of elderly or dependent persons and who are qualified to provide a broad range of services related to abuse of elderly or dependent persons, as defined in Section 15753.5. (b) A multidisciplinary personnel team may include, but is not limited to, all of the following: (1) Psychiatrists, psychologists, or other trained counseling personnel. (2) Police officers or other law enforcement agents. (3) Medical personnel with sufficient training to provide health services. (4) Social workers with experience or training in prevention of abuse of elderly or dependent persons. (5) Public guardians. SEC. 7. Section 15610.57 of the Welfare and Institutions Code is amended to read: 15610.57. (a) "Neglect" means either of the following: (1) The negligent failure of any person having the care or custody of an elder or a dependent adult to exercise that degree of care that a reasonable person in a like position would exercise. (2) The negligent failure of the person themselves to exercise that degree of care that a reasonable person in a like position would exercise. (b) Neglect includes, but is not limited to, all of the following: (1) Failure to assist in personal hygiene, or in the provision of food, clothing, or shelter. (2) Failure to provide medical care for physical and mental health needs. No person shall be deemed neglected or abused for the sole reason that he or she voluntarily relies on treatment by spiritual means through prayer alone in lieu of medical treatment. (3) Failure to protect from health and safety hazards. (4) Failure to prevent malnutrition or dehydration. (5) Failure of a person to provide the needs specified in paragraphs (1) to (4), inclusive, for themselves due to ignorance, illiteracy, incompetence, mental limitation, substance abuse, or poor health. SEC. 8. Section 15630 of the Welfare and Institutions Code is amended to read: 15630. (a) Any elder or dependent adult care custodian, health practitioner, or employee of a county adult protective services agency or a local law enforcement agency is a mandated reporter. (b) (1) Any mandated reporter, who, in his or her professional capacity, or within the scope of his or her employment, has observed or has knowledge of an incident that reasonably appears to be physical abuse, abandonment, isolation, financial abuse, or neglect, or is told by an elder or dependent adult that he or she has experienced behavior constituting physical abuse, abandonment, isolation, financial abuse, or neglect, or reasonably suspects abuse shall report the known or suspected instance of abuse by telephone immediately or as soon as practically possible, and by written report sent within two working days, as follows: (A) If the abuse has occurred in a long-term care facility, except a state mental health hospital or a state developmental center, the report shall be made to the local ombudsman or the local law enforcement agency. Except in an emergency, the local ombudsman shall report any case of known or suspected criminal activity to both the State Department of Health Services and the Bureau of Medi-Cal Fraud as soon as is practical. (B) If the suspected or alleged abuse occurred in a state mental health hospital or a state developmental center, the report shall be made to designated investigators of the State Department of Mental Health or the State Department of Developmental Services or to the local law enforcement agency. Except in an emergency, the local ombudsman shall report any case of known or suspected criminal activity to both the State Department of Health Services and the Bureau of Medi-Cal Fraud as soon as is practical. (C) If the abuse has occurred any place other than one described in subparagraph (A), the report shall be made to the adult protective services agency or the local law enforcement agency. (2) (A) A mandated reporter shall not be required to report, as a suspected incident of abuse, as defined in Section 15610.07, an incident where all of the following conditions exist:(A)(i) The mandated reporter has been told by an elder or dependent adult that he or she has experienced behavior constituting physical abuse, abandonment, isolation, financial abuse, or neglect.(B) There is no(ii) The mandated reporter is not aware of any independent evidence that corroborates the statement that the abuse has occurred.(C)(iii) The elder or dependent adult has been diagnosed with a mental illness, defect, dementia, or incapacity, or is the subject of a court-ordered conservatorship because of a mental illness, defect, dementia, or incapacity.(D)(iv) The mandated reporter reasonably believes that the abuse did not occur. (B) This paragraph shall not be construed to impose upon mandated reporters a duty to investigate a known or suspected incident of abuse. (3) (A) In a long-term care facility, a mandated reporter shall not be required to report as a suspected incident of abuse, as defined in Section 15610.07, an incident where all of the following conditions exist: (i) The mandated reporter is aware that there is a proper plan of care. (ii) The mandated reporter is aware that the plan of care was properly provided or executed. (iii) A physical, mental, or medical injury occurred as a result of care provided pursuant to clause (i) or (ii). (iv) The mandated reporter reasonably believes that the injury was not the result of abuse. (B) This paragraph shall not be construed to require a mandated reporter to seek, nor to preclude a mandated reporter from seeking, information regarding a known or suspected incident of abuse prior to reporting. This paragraph shall apply only to those categories of mandated reporters that the State Department of Health Services determines, upon approval by the Bureau of Medi-Cal Fraud and the state long-term care ombudsman, have access to plans of care and have the training and experience necessary to determine whether the conditions specified in this section have been met. (c) (1) Any mandated reporter who has knowledge of, or reasonably suspects that, types of elder or dependent adult abuse for which reports are not mandated have been inflicted upon an elder or dependent adult or that his or her emotional well-being is endangered in any other way, may report the known or suspected instance of abuse. (2) If the suspected or alleged abuse occurred in a long-term care facility other than a state mental health hospital or a state developmental center, the report may be made to the long-term care ombudsman program. (3) If the suspected or alleged abuse occurred in a state mental health hospital or a state developmental center, the report may be made to the designated investigator of the State Department of Mental Health or the State Department of Developmental Services, or to a local law enforcement agency or to the local ombudsman. (4) If the suspected or alleged abuse occurred in a place other than a place described in paragraph (1) or (2), the report may be made to the county adult protective services agency. (5) If the conduct involves criminal activity not covered in subdivision (b), it may be immediately reported to the appropriate law enforcement agency. (d) When two or more mandated reporters are present and jointly have knowledge or reasonably suspect that types of abuse of an elder or a dependent adult for which a report is mandated have occurred, and when there is agreement among them, the telephone report may be made by a member of the team selected by mutual agreement, and a single report may be made and signed by the selected member of the reporting team. Any member who has knowledge that the member designated to report has failed to do so shall thereafter make the report. (e) A telephone report of a known or suspected instance of elder or dependent adult abuse shall include the name of the person making the report, the name and age of the elder or dependent adult, the present location of the elder or dependent adult, the names and addresses of family members or any other person responsible for the elder or dependent adult's care, if known, the nature and extent of the elder or dependent adult's condition, the date of the incident, and any other information, including information that led that person to suspect elder or dependent adult abuse, requested by the agency receiving the report. (f) The reporting duties under this section are individual, and no supervisor or administrator shall impede or inhibit the reporting duties, and no person making the report shall be subject to any sanction for making the report. However, internal procedures to facilitate reporting, ensure confidentiality, and apprise supervisors and administrators of reports may be established, provided they are not inconsistent with this chapter. (g) (1) Whenever this section requires a county adult protective services agency to report to a law enforcement agency, the law enforcement agency shall, immediately upon request, provide a copy of its investigative report concerning the reported matter to that county adult protective services agency. (2) Whenever this section requires a law enforcement agency to report to a county adult protective services agency, the county adult protective services agency shall, immediately upon request, provide a copy of its investigative report concerning the reported matter to that law enforcement agency. (3) The requirement to disclose investigative reports pursuant to this subdivision shall not include the disclosure of social services records or case files that are confidential, nor shall this subdivision be construed to allow disclosure of any reports or records if the disclosure would be prohibited by any other provision of state or federal law. (h) Failure to report physical abuse, abandonment, isolation, financial abuse, or neglect of an elder or dependent adult, in violation of this section, is a misdemeanor, punishable by not more that six months in the county jail or by a fine of not more than one thousand dollars ($1,000), or by both that fine and imprisonment. SEC. 9. Section 15633 of the Welfare and Institutions Code is amended to read: 15633. (a) The reports made pursuant to Sections 15630 and 15631 shall be confidential and may be disclosed only as provided in subdivision (b). Any violation of the confidentiality required by this chapter is a misdemeanor punishable by not more than six months in the county jail, by a fine of five hundred dollars ($500), or by both that fine and imprisonment. (b) Reports of suspected elder or dependent adult abuse and information contained therein may be disclosed only to the following: (1) Persons or agencies to whom disclosure of information or the identity of the reporting party is permitted under Section 15633.5. (2) (A) Persons who are trained and qualified to serve on multidisciplinary personnel teams may disclose to one another information and records that are relevant to the prevention, identification, or treatment of abuse of elderly or dependent persons. (B) Except as provided in subparagraph (A), any personnel of the multidisciplinary team or agency that receives information pursuant to this chapter, shall be under the same obligations and subject to the same confidentiality penalties as the person disclosing or providing that information. The information obtained shall be maintained in a manner that ensures the maximum protection of privacy and confidentiality rights. (c) This section shall not be construed to allow disclosure of any reports or records relevant to the reports of elder or dependent adult abuse if the disclosure would be prohibited by any other provisions of state or federal law applicable to the reports or records relevant to the reports of the abuse. SEC. 9.5. Section 15640 of the Welfare and Institutions Code is amended to read: 15640. (a) (1) An adult protective services agency shall immediately, or as soon as practically possible, report by telephone to the law enforcement agency having jurisdiction over the case any known or suspected instance of criminal activity, and to any public agency given responsibility for investigation in that jurisdiction of cases of elder and dependent adult abuse, every known or suspected instance of abuse pursuant to Section 15630 of an elder or dependent adult. A county adult protective services agency shall also send a written report thereof within two working days of receiving the information concerning the incident to each agency to which it is required to make a telephone report under this subdivision. Prior to making any cross-report of allegations of financial abuse to law enforcement agencies, an adult protective services agency shall first determine whether there is reasonable suspicion of any criminal activity. (2) If an adult protective services agency receives a report of abuse alleged to have occurred in a long-term care facility, that adult protective services agency shall immediately inform the person making the report that he or she is required to make the report to the long-term care ombudsman program or to a local law enforcement agency. The adult protective services agency shall not accept the report by telephone but shall forward any written report received to the long-term care ombudsman. (b) If an adult protective services agency or local law enforcement agency or ombudsman program receiving a report of known or suspected elder or dependent adult abuse determines, pursuant to its investigation, that the abuse is being committed by a health practitioner licensed under Division 2 (commencing with Section 500) of the Business and Professions Code, or any related initiative act, or by a person purporting to be a licensee, the adult protective services agency or local law enforcement agency or ombudsman program shall immediately, or as soon as practically possible, report this information to the appropriate licensing agency. The licensing agency shall investigate the report in light of the potential for physical harm. The transmittal of information to the appropriate licensing agency shall not relieve the adult protective services agency or local law enforcement agency or ombudsman program of the responsibility to continue its own investigation as required under applicable provisions of law. The information reported pursuant to this paragraph shall remain confidential and shall not be disclosed. (c) A local law enforcement agency shall immediately, or as soon as practically possible, report by telephone to the long-term care ombudsman program when the abuse is alleged to have occurred in a long-term care facility or to the county adult protective services agency when it is alleged to have occurred anywhere else, and to the agency given responsibility for the investigation of cases of elder and dependent adult abuse every known or suspected instance of abuse of an elder or dependent adult. A local law enforcement agency shall also send a written report thereof within two working days of receiving the information concerning the incident to any agency to which it is required to make a telephone report under this subdivision. (d) A long-term care ombudsman coordinator may report the instance of abuse to the county adult protective services agency or to the local law enforcement agency for assistance in the investigation of the abuse if the victim gives his or her consent. A long-term care ombudsman program and the Licensing and Certification Division of the State Department of Health Services shall immediately report by telephone and in writing within two working days to the bureau any instance of neglect occurring in a health care facility, that has seriously harmed any patient or reasonably appears to present a serious threat to the health or physical well-being of a patient in that facility. If a victim or potential victim of the neglect withholds consent to being identified in that report, the report shall contain circumstantial information about the neglect but shall not identify that victim or potential victim and the bureau and the reporting agency shall maintain the confidentiality of the report until the report becomes a matter of public record. (e) When a county adult protective services agency, a long-term care ombudsman program, or a local law enforcement agency receives a report of abuse, neglect, or abandonment of an elder or dependent adult alleged to have occurred in a long-term care facility, that county adult protective services agency, long-term care ombudsman coordinator, or local law enforcement agency shall report the incident to the licensing agency by telephone as soon as possible. (f) County adult protective services agencies, long-term care ombudsman programs, and local law enforcement agencies shall report the results of their investigations of referrals or reports of abuse to the respective referring or reporting agencies. SEC. 10. Section 15650 of the Welfare and Institutions Code is amended to read: 15650. (a) Investigation of reports of known or suspected instances of abuse in long-term care facilities shall be the responsibility of the long-term care ombudsman program, for instances of physical and financial abuse, the local law enforcement agency, and for instances of potential criminal neglect in a long-term health care facility, the long-term care ombudsman program and the bureau. (b) Investigations of known or suspected instances of abuse outside of long-term care facilities shall be the responsibility of the county adult protective services agency and the local law enforcement agency unless another public agency is given responsibility for investigation in that jurisdiction. (c) The investigative responsibilities set forth in this section are in addition to, and not in derogation of or substitution for, the investigative and regulatory responsibilities of licensing agencies, such as the State Department of Social Services Community Care Licensing Division and the State Department of Health Services Licensing and Certification Division and their authorized representatives. (d) Other public agencies involved in the investigation of abuse or advocacy of respective client populations, or both, include, but shall not be limited to, the State Department of Mental Health and the State Department of Developmental Services. Other public agencies shall conduct or assist in, or both, the investigation of reports of abuse of elder and dependent adults within their jurisdiction in conjunction with county adult protective services, local ombudsman programs and local law enforcement agencies. (e) Each county adult protective services agency shall maintain an inventory of all public and private service agencies available to assist victims of abuse, as defined by Section 15610.07. This inventory shall be used to refer victims in the event that the county adult protective services agency cannot resolve the immediate needs of the victim, and to serve the victim on a long-term, followup basis. The intent of this section is to acknowledge that limited funds are available to resolve all suspected cases of abuse reported to a county adult protective services agency. (f) Each local ombudsman program shall maintain an inventory of all public and private agencies available to assist long-term care residents who are victims of abuse, as defined by Section 15610.07. This inventory shall be used to refer cases of abuse in the event that another agency has jurisdiction over the resident, the abuse is verified and further investigation is needed by a law enforcement or licensing agency, or the program does not have sufficient resources to provide immediate assistance. The intent of this section is to acknowledge that ombudsman responsibility in abuse cases is to receive reports, determine the validity of reports, refer verified abuse cases to appropriate agencies for further action as necessary, and follow up to complete the required report information. Other ombudsman services shall be provided to the resident, as appropriate. SEC. 11. Section 15653.5 is added to the Welfare and Institutions Code, to read: 15653.5. Training for determining when to refer a report of a known or suspected instance of abuse that occurred in a long-term care facility for potential criminal action shall be included in the training provided by the Bureau of Medi-Cal Fraud pursuant to subdivision (h) of Section 12528 of the Government Code. SEC. 11.5. Section 15658 of the Welfare and Institutions Code is amended to read: 15658. (a) (1) The written abuse reports required for the reporting of abuse, as defined in this chapter, shall be submitted on forms adopted by the State Department of Social Services after consultation with representatives of the various law enforcement agencies, the California Department of Aging, the State Department of Developmental Services, the State Department of Mental Health, the bureau, professional medical and nursing agencies, hospital associations and county welfare departments. These reporting forms shall be distributed by the county adult protective services agencies and the long-term care ombudsman programs. This reporting form may also be used for documenting the telephone report of a known or suspected instance of abuse of an elder or dependent adult by the county adult protective services agency, local ombudsman program, and local law enforcement agencies. (2) The forms required by this section shall contain the following items: (A) The name, address, telephone number, and occupation of the person reporting. (B) The name and address of the victim. (C) The date, time, and place of the incident. (D) Other details, including the reporter's observations and beliefs concerning the incident. (E) Any statement relating to the incident made by the victim. (F) The name of any individuals believed to have knowledge of the incident. (G) The name of the individuals believed to be responsible for the incident and their connection to the victim. (b) (1) Each county adult protective services agency shall report to the State Department of Social Services monthly on the reports received pursuant to this chapter. The reports shall be made on forms adopted by the department. The information reported shall include, but shall not be limited to, the number of incidents of abuse, the number of persons abused, the type of abuse sustained, and the actions taken on the reports. For purposes of these reports, sexual abuse shall be reported separately from physical abuse. (2) The county's report to the department shall not include reports it receives from the long-term care ombudsman program pursuant to subdivision (c). (3) The department shall refer to the bureau monthly data summaries of the reports of elder and dependent adult abuse, neglect, abandonment, isolation, and financial abuse, and other abuse it receives from county adult protective services agencies. (c) Each long-term care ombudsman program shall report to the Office of the Long-Term Care Ombudsman of the California Department of Aging monthly on the reports it receives pursuant to this chapter with a copy sent to the county adult protective services agency. The office of the State Ombudsman shall submit a summarized quarterly report to the department based on the monthly reports submitted by local long-term care ombudsman programs. The reports shall be on forms adopted by the department and the office of the State Ombudsman. The information reported shall include, but shall not be limited to, the number of incidents of abuse, the numbers of persons abused, the type of abuse, and the actions taken on the reports. For purposes of these reports, sexual abuse shall be reported separately from physical abuse. SEC. 12. Section 15659 of the Welfare and Institutions Code is amended to read: 15659. (a) Any person who enters into employment on or after January 1, 1995, as a care custodian, health practitioner, or with an adult protective services agency or a local law enforcement agency, prior to commencing his or her employment and as a prerequisite to that employment shall sign a statement on a form, that shall be provided by the prospective employer, to the effect that he or she has knowledge of Section 15630 and will comply with its provisions. The signed statement shall be retained by the employer. (b) Agencies or facilities that employ persons required to make reports pursuant to Section 15630, who were employed prior to January 1, 1995, shall inform those persons of their responsibility to make reports by delivering to them a copy of the statement specified in subdivision (a). (c) The cost of printing, distribution, and filing of these statements shall be borne by the employer. (d) On and after January 1, 1995, when a person is issued a state license or certificate to engage in a profession or occupation the members of which are required to make a report pursuant to Section 15630, the state agency issuing the license or certificate shall send a statement substantially similar to the one contained in subdivision (a) to the person at the same time as it transmits the document indicating licensure or certification to the person. (e) As an alternative to the procedure required by subdivision (d), a state agency may cause the required statement to be printed on all application forms for a license or certificate printed on or after January 1, 1995. (f) The retention of statements required by subdivision (a), and the delivery of statements required by subdivision (b) shall be the full extent of the employer's duty pursuant to this section. The failure of any employee or other person associated with the employer to report abuse of elders or dependent adults pursuant to Section 15630 or otherwise meet the requirements of this chapter shall be the sole responsibility of that person. The employer or facility shall incur no civil or other liability for the failure of these persons to comply with the requirements of this chapter. SEC. 13. Chapter 13.5 (commencing with Section 15760) is added to Part 3 of Division 9 of the Welfare and Institutions Code, to read: CHAPTER 13.5. ENHANCED SERVICES 15760. Notwithstanding Section 15753, adult protective services shall include investigations, needs assessments, remedial, and preventative social work activities, and the necessary tangible resources such as food, transportation, emergency shelter, and in-home protective care, the use of multidisciplinary teams, and a system in which reporting or abuse can occur on a 24-hour basis. 15761. Notwithstanding Section 15753.5, "multidisciplinary personnel team" means any team of two or more persons who are trained in the prevention, identification, and treatment of abuse of elderly or dependent persons and who are qualified to provide a broad range of services related to abuse of elderly or dependent persons. The team may include, but is not limited to: (a) Psychiatrists, psychologists, or other trained counseling personnel. (b) Police officers or other law enforcement agents. (c) Medical personnel with sufficient training to provide health services. (d) Social workers with experience or training in prevention of abuse of elderly or dependent persons. (e) Public guardian. 15762. When an allegation of abuse of an elder or dependent adult is reported to a county designated adult protective service agency and an agency social worker has reason to believe an elder or dependent adult has suffered or is at substantial risk of abuse pursuant to Section 15630, the social worker shall attempt to obtain consent to enter and meet privately with the elder or dependent adult about whom the report was made in the residence or dwelling in which the elder or dependent adult resides without the presence of the person's caretaker, attendant, or family or household member, unless the person requests the presence of the attendant, caregiver, or family member, or refuses to meet with the social worker. 15763. (a) Each county shall establish an emergency response adult protective services program that shall provide in-person response, 24 hours per day, seven days per week, to reports of abuse of an elder or a dependent adult, for the purpose of providing immediate intake or intervention, or both, to new reports involving immediate life threats and to crises in existing cases. The program shall include policies and procedures to accomplish all of the following: (1) Provision of case management services that include investigation of the protection issues, assessment of the person's concerns, needs, strengths, problems, and limitations, stabilization and linking with community services, and development of a service plan to alleviate identified problems utilizing counseling, monitoring, followup, and reassessment. (2) Provisions for emergency shelter or in-home protection to guarantee a safe place for the elder or dependent adult to stay until the dangers at home can be resolved. (3) Establishment of multidisciplinary teams to develop interagency treatment strategies, to ensure maximum coordination with existing community resources, to ensure maximum access on behalf of elders and dependent adults, and to avoid duplication of efforts. (b) A county shall respond immediately to any report of imminent danger to an elder or dependent adult residing in other than a long-term care facility, as defined in Section 9701 of the Health and Safety Code, or a residential facility, as defined in Section 1502 of the Health and Safety Code. For reports involving persons residing in a long-term care facility or a residential care facility, the county shall report to the local long-term care ombudsman program. Adult protective services staff shall consult, coordinate, and support efforts of the ombudsman program to protect vulnerable residents. The county shall respond to all other reports of danger to an elder or dependent adult in other than a long-term care facility or residential care facility within 10 calendar days or as soon as practically possible. (c) A county shall provide case management services to elders and dependent adults who are determined to be in need of adult protective services for the purpose of bringing about changes in the lives of victims and to provide a safety net to enable victims to protect themselves in the future. Case management services shall include the following, to the extent services are appropriate for the individual: (1) Investigation of the protection issues, including, but not limited to, social, medical, environmental, physical, emotional, and developmental. (2) Assessment of the person's concerns and needs on whom the report has been made and the concerns and needs of other members of the family and household. (3) Analysis of problems and strengths. (4) Establishment of a service plan for each person on whom the report has been made to alleviate the identified problems. (5) Client input and acceptance of proposed service plans. (6) Counseling for clients and significant others to alleviate the identified problems and to implement the service plan. (7) Stabilizing and linking with community services. (8) Monitoring and followup. (9) Reassessments, as appropriate. (d) To the extent resources are available, each county shall provide emergency shelter in the form of a safe haven or in-home protection for victims. Shelter and care appropriate to the needs of the victim shall be provided for frail and disabled victims who are in need of assistance with activities of daily living. (e) Each county shall designate an adult protective services agency to establish and maintain multidisciplinary teams including, but not limited to, adult protective services, law enforcement, home health care agencies, hospitals, adult protective services staff, the public guardian, private community service agencies, public health agencies, and mental health agencies for the purpose of providing interagency treatment strategies. (f) Each county shall provide tangible support services, to the extent resources are available, which may include, but not be limited to, emergency food, clothing, repair or replacement of essential appliances, plumbing and electrical repair, blankets, linens, and other household goods, advocacy with utility companies, and emergency response units. 15764. Notwithstanding Section 10101.1, a county shall have no share of any nonfederal expenditures above the required expenditures for this program in the 1996-97 fiscal year, provided that the county has maintained the level of county matching funds it provided for this program in the 1996-97 fiscal year. 15765. This chapter shall be implemented only to the extent funds are provided in the annual Budget Act. SEC. 14. (a) The Director of Social Services shall adopt regulations to implement the provisions of this act no later than January 31, 2000. (b) Notwithstanding any other provision of law, the State Department of Social Services may implement the provisions of this act through an all county letter or similar instructions from the Director of Social Services until January 31, 2000. SEC. 15. No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution for certain costs that may be incurred by a local agency or school district because in that regard this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution. However, notwithstanding Section 17610 of the Government Code, if the Commission on State Mandates determines that this act contains other costs mandated by the state, reimbursement to local agencies and school districts for those costs shall be made pursuant to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of the Government Code. If the statewide cost of the claim for reimbursement does not exceed one million dollars ($1,000,000), reimbursement shall be made from the State Mandates Claims Fund. Notwithstanding Section 17580 of the Government Code, unless otherwise specified, the provisions of this act shall become operative on the same date that the act takes effect pursuant to the California Constitution.