BILL ANALYSIS                                                                                                                                                                                                    






              SENATE HEALTH AND HUMAN SERVICES
                     COMMITTEE ANALYSIS
            Senator Diane E. Watson, Chairperson


BILL NO:       AB 2800
AUTHOR:        GRANLUND
AMENDED:       June 26, 1996 in Senate
HEARING DATE: JULY 03, 1996
FISCAL:        APPROPRIATIONS

CONSULTANT:
Robinson
                              

                           SUBJECT
                              
                           Aging

                            INTENT

This bill seeks to develop minimum standards for service  
delivery to ensure that the system meets consumer needs,  
operates in a cost-effective manner, and preserves the  
independence and dignity of aging Californians.

                           ABSTRACT

Current law:

   Establishes the Older Californians Act (OCA) which is  
     administered by the California Commission on Aging  
     (CCA) and the California Department of Aging; and

   Provides for CDA to improve and enhance the coordination  
     and development of home and community based services  
     for the frail elderly and functionally impaired  
     adults.

This bill deletes inoperative and outdated sections and  
makes the following changes:

    Establishes and defines the policy of ohome and  
     community-based serviceso

   The bill emphasizes the need and establishes the  
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     statewide goal to strengthen and expand home and  
     community-based services, which maintain individuals  
     in their own homes or least restrictive homelike  
     environments.


    Places the California Department of Agingos (CDA)  
     Mission Statement in Law

   The mission statement contains language requiring CDA to  
     provide ongoing oversight, monitoring and service  
     quality evaluation to ensure that providers are  
     meeting minimum standards of service provision.  As a  
     result, a clear, appropriate role for CDA as explained  
     through the mission statement, will assist providers  
     to better understand CDAos responsibilities.  The  
     mission statement provides for consumer choice,  
     accessibility to diverse populations, involving  
     consumers in designing and monitoring, and having  
     statewide consistency with local control and  
     implementation.

    Establishes a preamble for the Older Californians Act

   The insertion of the preamble is necessary in order to  
     establish the Stateos updated commitment to older  
     individuals.  The intent of the preamble is to  
     establish in law, State policy regarding services for  
     older individuals.

    Emphasizes the transfer of program management to the  
     local Area Agencies on  Aging (AAA)

   This bill transfers daily management of the current  
     State fund programs to Area Agencies on Aging, while  
     maintaining within CDA the necessary State oversight.   
     Language allows maximum flexibility of management of  
     the programs by the Area Agencies.  Local management  
     of the programs is expected to enhance development of  
     home and community-based services.

   Language is added to clearly establish the role of CDA  
     as standard-setting, training, certification,  
     technical assistance and auditing.

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   Transfer of program management to Area Agencies on Aging  
     will also include the following:

        Area Agencies on Aging will act as sole program  
          managers (either directly or through contracts),  
          except Multipurpose Senior Services Program which  
          operates on a federal waiver and Adult Day Health  
          Care which CDA performs under contract with the  
          Department of Health Services.

        Language to ensure that the changes to the Act are  
          implemented in a manner that is compatible with  
          the Long-Term Care Integration Pilot Project; and

        A plan is required to be developed by CDA to  
          expand, over time, General Fund programs in parts  
          of the State not now covered.


    Clarifies management/transition of Health Insurance  
     Counseling and Advocacy Program (HICAP) and  
     community-based services

   Transfers current HICAP provisions to AAAs for daily  
     contract management.  New language will be included  
     that explains the transitioning process of the HICAP  
     to Area Agencies and standards required for management  
     of the program.
   Language is also added to the Act which will transition  
     management of State fund programs to AAAs over a two  
     year (maximum) period of time.  The two year  
     transition will allow for development of program  
     expertise and reprocurement responsibilities.  As with  
     the HICAP, specific statewide standards for operation  
     of these programs are maintained and specified.

    Clarifies management issues relating to the Ombudsman  
     Program

   Clarifies that confidential information held by local  
     ombudsman programs can be shared with law enforcement  
     agencies and released pursuant to court order.  In  
     addition, the language will specify that release of  
     such information must be accomplished in a manner  
     consistent with Federal laws and regulations.
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    Calls for coordination of Health and Welfare Agency  
     (HWA) departments in  providing integration of services

   This measure is modified to require the HWA Secretary to  
     convene periodic meetings on matters of  
     interdepartmental coordination.  This modification is  
     intended to place authority at appropriate levels to  
     deal with larger HWA issues, many of which overlap  
     departmental responsibilities.

    Establishes a matching special fund for major outreach  
     programs (e.g., medication management, prevention of  
     elder abuse, a statewide information referral number  
     and informational outreach on ombudsman and other  
     senior services.

     This bill establishes an Aging Information and  
     Education Fund for the purpose of developing public  
     awareness projects.  Foundation, privately-donated and  
     one-time only State and Federal funds will be used to  
     promote public awareness of issues of importance to  
     Californiaos older individuals, their families and  
     caregivers.

                        FISCAL IMPACT

Undetermined.  There should be no direct fiscal effect.

















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                  BACKGROUND AND DISCUSSION

The Older Californians Act specifies most of the programs  
which provide services for senior citizens.  It also is the  
method by which the Older Americans Act is administered in  
California.  Since the Older Californians Act was first  
established in 1965, there have been numerous amendments to  
the Act required by changes in both state and federal law.

It is estimated that California has over 4.6 million  
persons who are 60 years of age and over, and that this  
population will expand to 5.2 million by the year 2000.   
Services to frail elderly and functionally impaired adults  
in California include an array of social and other  
supportive services that are administered through a wide  
variety of programs.  Some of these programs include  
Alzheimeros Day Care Resource centers, Adult Day Health  
Care, Long-Term Care Ombudsman, Health Insurance Counseling  
and Advocacy, and congregate and home-delivered nutrition.

Senate Bill 1895(Mello) is the companion bill to AB 2800.   
Each bill contains ocontingency languageo specifying that  
it will only become operative if the other bill is enacted.

The current language in AB 2800 was developed by CDA.  It  
was recently released to the public after approval from the  
Governoros Office.  The department, both authors, and the  
affected groups realize that there is inadequate time to  
seek public input before the policy deadline.  Therefore,  
both authors have agreed to seek to pass their respective  
bills from the policy committees (to meet the deadline)  
with the commitment to return them to the policy committee  
after Appropriations in August.

Understanding that the oaging services networko will have  
concerns with some provisions of the bill and seek to make  
changes to the document, open meetings have
been scheduled with the concerned groups on July 11th and  
July 17th.  The meetings have been scheduled jointly by the  
Senate Subcommittee on Aging and the Assembly Health  
Committee.  Written notification of the meetings has been  
sent to over 600 groups and individuals.  After receiving  
both verbal and written testimony from the network as well  
as a summary of written comments received by CDA, the two  
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authors will attempt to complete a consensus recodification  
of the Act.  This collaborative effort represents a  
milestone in the move towards a comprehensive integrated  
community based system of care for this stateos frail older  
population.

There is one basic consensus, unless there is agreement  
between the authors, the chairs of the policy committees,  
and the Governoros Office, the bills will not proceed.




































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                        PRIOR ACTIONS

Assembly Floor:               Passed         (58-6)
Assembly Appropriations:           Do Pass   (16-0)
Assembly Health:                             Do Pass to  
Consent Calendar    (16-0)

                          POSITIONS

Support:       California Association of Area Agencies on  
Aging California
                    Commission on Aging
               California Senior Legislature
               Triple-A Council of California

Oppose:   None reported.



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