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AB-1137 The California Department of Aging.(2019-2020)

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Date Published: 04/22/2019 09:00 PM
AB1137:v98#DOCUMENT

Amended  IN  Assembly  April 22, 2019

CALIFORNIA LEGISLATURE— 2019–2020 REGULAR SESSION

Assembly Bill
No. 1137


Introduced by Assembly Member Nazarian

February 21, 2019


An act to amend Section 9100 of Sections 9100, 9531, 9541, 9542, and 9547 of, and to repeal Chapter 9 (commencing with Section 9590) of Division 8.5 of, the Welfare and Institutions Code, relating to aging.


LEGISLATIVE COUNSEL'S DIGEST


AB 1137, as amended, Nazarian. The California Department of Aging.
Existing law, the Mello-Granlund Older Californians Act, establishes the California Department of Aging in the California Health and Human Services Agency, and sets forth its mission 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 to develop minimum standards for service delivery, and requires those standards to ensure that a system meets specified requirements, including that it has cost containment and fiscal incentives consistent with the delivery of appropriate services at the appropriate level.
This bill would delete that cost containment and fiscal incentives requirement.
The act establishes the Community-Based Services Network, administered by the department, which requires the department to enter into contracts with local area agencies on aging to carry out the requirements of various community-based services programs, including Alzheimer’s day care resource centers, the Brown Bag Program, the Foster Grandparent Program, the Linkages Program, the Respite Program, and the Senior Companion Program.
This bill would additionally require the department to provide the area agencies on aging with flexibility to develop and manage programs based on need, including the block granting of funds to administer the above programs. The bill would also recast and revise the parameters of specified community-based services programs.
Existing law, the Senior Center Bond Act of 1984, provided for the sale of general obligation bonds, the proceeds of which were to be used, upon appropriation by the Legislature, to make awards to private nonprofit agencies for the purpose of acquiring, renovating, constructing, and purchasing of equipment for senior centers, funding startup costs of programs, or program expansion of senior center programs.
This bill would repeal those provisions.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

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


SECTION 1.

 Section 9100 of the Welfare and Institutions Code is amended to read:

9100.
 (a) There is in the California Health and Human Services Agency, the California Department of Aging.
(b) The department’s mission is 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.
(c) (1) In fulfilling its mission, the department shall develop minimum standards for service delivery to ensure that its programs meet consumer needs, operate in a cost-effective manner, and preserve the independence and dignity of aging Californians. In accomplishing its mission, the department shall consider available data and population trends in developing programs and policies, collaborate with area agencies on aging, the commission, and other state and local agencies, and consider the views of advocates, consumers and their families, and service providers.
(2) The department shall report the Elder Economic Security Standard Index data for each service area in its state plan and use it as a reference when making decisions about allocating its existing resources, but only if the Elder Economic Security Standard Index is updated and made available to the department, and if the available public data used to calculate each Elder Economic Security Standard Index data element is calculated and updated for each California county and made available to the department in a format that displays each county’s specific data.
(d) The minimum standards for the department’s programs shall ensure that the system meets all of the following requirements:
(1) Has the flexibility to respond to the needs of individuals and their families and caregivers.
(2) Provides for consumer choice and self-determination.
(3) Enables consumers to be involved in designing and monitoring the system.
(4) Is equally accessible to diverse populations regardless of income, and is consistent with state and federal law.
(5) Has consistent statewide policy, with local control and implementation.
(6) Includes preventive services and home- and community-based support.

SEC. 2.

 Section 9531 of the Welfare and Institutions Code is amended to read:

9531.
 (a) This chapter establishes the Community-Based Services Network.
(b) It is the intent of the Legislature that a Community-Based Services Network be initiated by the department in order to do all of the following:
(1) Locally integrate the state-funded community-based services programs, specified in this division, for older individuals and functionally impaired adults. adults with functional impairments.
(2) Provide increased local flexibility in setting priorities for the services contained within the six state General Fund programs specified in Sections 9542 to 9547, inclusive.
(3) Contract responsibility for local management of the state-funded community-based services programs specified in Chapter 7.5 (commencing with Section 9540) to participating area agencies on aging.
(c) Each participating area agency on aging shall ensure the continuation of the funding match currently required for the community-based services programs specified in Chapter 7.5 (commencing with Section 9540). The match may consist of either cash or in-kind services.
(d) Each participating area agency on aging shall have responsibility for local program management of the community-based services programs specified in Chapter 7.5 (commencing with Section 9540).
(e) The California Department of Aging shall provide area agencies on aging the flexibility to develop and manage programs based on local need, which includes providing the block granting of funds for the following programs specified under Chapter 7.5 (commencing with Section 9540):
(1) The Alzheimer’s Day Care-Resource Center Program.
(2) The Brown Bag Program.
(3) The Foster Grandparent Program.
(4) The Linkages Program.
(5) The Respite Program.
(6) The Senior Companion Program.

SEC. 3.

 Section 9541 of the Welfare and Institutions Code is amended to read:

9541.
 (a) The Legislature finds and declares that the purpose of the Health Insurance Counseling and Advocacy Program is to provide Medicare beneficiaries and those imminent of becoming eligible for Medicare with counseling and advocacy as to Medicare, private health insurance, and related health care coverage plans, on a statewide basis, and preserving service integrity.
(1) Lack of health insurance literacy skills can lead to misinformation or mismatched insurance needs.
(2) As health care options become increasingly complex, the Health Insurance Counseling and Advocacy Program plays a vital role in clarifying all aspects of the Medicare program to the beneficiary served.
(b) The department shall be responsible for, but not limited to, doing both of the following:
(1) To act as a clearinghouse for information and materials relating to Medicare, managed care, health and long-term care related life and disability insurance, and related health care coverage plans.
(2) To develop additional information and materials relating to Medicare, managed care, and health and long-term care related life and disability insurance, and related health care coverage plans, as necessary.
(c) Notwithstanding the terms and conditions of the contracts, direct services contractors shall be responsible for, but not limited to, all of the following:
(1) Advising, educating, and empowering Medicare beneficiaries to make informed choices among the array of options to best fit their needs.

(1)

(2) Community education to the public on Medicare, long-term care planning, private health and long-term care insurance, managed care, and related health care coverage plans.

(2)

(3) Counseling and informal advocacy with respect to Medicare, long-term care planning, private health and long-term care insurance, managed care, and related health care coverage plans.

(3)

(4) Referral services for legal representation or legal representation with respect to Medicare appeals, Medicare related managed care appeals, and life and disability insurance problems. Legal services provided under this program shall be subject to the understanding that the legal representation and legal advocacy shall not include the filing of lawsuits against private insurers or managed health care plans. In the event that legal services are contracted for by the agency separately from counseling and education services, a formal system of coordination and referral from counseling services to legal services shall be established and maintained.

(4)

(5) Educational services supporting long-term care educational activities aimed at the general public, employers, employee groups, senior older adult organizations, and other groups expressing interest in long-term care planning issues.

(5)

(6) Educational services emphasizing the importance of long-term care planning, promotion of self-reliance and independence, and options for long-term care.

(6)

(7) To the extent possible, support additional emphasis on community educational activities that would provide for announcements on television and in other media describing the limited nature of Medicare, the need for long-term care planning, the function of long-term care insurance, and the availability of counseling and educational literature on those subjects.

(7)

(8) Recruitment, training, coordination, and registration, with the department, of health insurance counselors, including a large contingent of volunteer counselors designed to expand services as broadly as possible.

(8)

(9) A systematic means of capturing and reporting all required community-based services program data, as specified by the department.
(d) Participants who volunteer their time for the health insurance counseling and advocacy program may be reimbursed for expenses incurred, as specified by the department.
(e) The department, the Department of Managed Health Care, and the Department of Insurance shall jointly develop interagency procedures for referring and investigating suspected instances of misrepresentation in advertising or sales of services provided by Medicare, managed health care plans, and life and disability insurers and agents.
(f) (1) No health insurance counselor shall provide counseling services under this chapter, unless he or she the health insurance counselor is registered with the department.
(2) No registered volunteer health insurance counselor shall be liable for his or her a negligent act or omission in providing counseling services under this chapter. No immunity shall apply to health insurance counselors for any grossly negligent act or omission or intentional misconduct.
(3) No registered volunteer health insurance counselor shall be liable to any insurance agent, broker, employee thereof, or similarly situated person, for defamation, trade libel, slander, or similar actions based on statements made by the counselor when providing counseling, unless a statement was made with actual malice.
(4) Prior to providing any counseling services, health insurance counselors shall disclose, in writing, to recipients of counseling services pursuant to this chapter that the counselors are acting in good faith to provide information about health insurance policies and benefits on a volunteer basis, but that the information shall not be construed to be legal advice, and that the counselors are, generally, not liable unless their acts and omissions are grossly negligent or there is intentional misconduct on the part of the counselor.
(5) The department shall not register any applicant under this section unless he or she the applicant has completed satisfactorily training which is approved by the department, and which shall consist of not less than 24 hours of training that shall include, but is not limited to, all of the following subjects:
(A) Medicare.
(B) Life and disability insurance.
(C) Managed care.
(D) Retirement benefits and principles of long-term care planning.
(E) Counseling skills.
(F) Any other subject or subjects determined by the department to be necessary to the provision of counseling services under this chapter.
(6) The department shall not register any applicant under this section unless he or she the applicant has completed all training requirements and has served an internship of cocounseling of not less than 10 hours with an experienced counselor and is determined by the local program manager to be capable of discharging the responsibilities of a counselor. An applicant shall sign a conflict of interest and confidentiality agreement, as specified by the department.
(7) A counselor shall not continue to provide health insurance counseling services unless he or she the counselor has received continuing education and training, in a manner prescribed by the department, on Medicare, managed care, life and disability insurance, and other subjects during each calendar year.

SEC. 4.

 Section 9542 of the Welfare and Institutions Code is amended to read:

9542.
 (a) The Legislature finds and declares that the purpose of the Alzheimer’s Day Care-Resource Center Program is to provide access to specialized day care resource centers for individuals with Alzheimer’s disease and other dementia-related disorders and support to their families and caregivers.
(b) The following definitions shall govern the construction of this section:
(1) “Participant” means an individual with Alzheimer’s disease or a disease of a related type, particularly the participant in the moderate to severe stages, whose care needs and behavioral problems may make it difficult for the individual to participate in existing care programs.
(2) “Other dementia-related disorders” means those irreversible brain disorders that result in the symptoms described in paragraph (3). This shall include, but is not limited to, multi-infarct dementia and Parkinson’s disease.
(3) “Care needs” or “behavioral problems” means the manifestations of symptoms that may include, but need not be limited to, memory loss, aphasia (communication disorder), becoming lost or disoriented, confusion and agitation, with the potential for combativeness, difficulty completing familiar tasks, decreased or poor judgment, withdrawal from social activities or work, and incontinence.
(4) “Alzheimer’s day care resource center” means a center developed pursuant to this section to provide a program of specialized day care for participants with dementia. dementia and their families and caregivers.
(c) The department shall adopt policies and guidelines to carry out the purposes of this section, and the adoption thereof shall not be subject to Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.
(d) In order to be eligible to receive funds under this section, a direct services contract applicant shall do all of the following:
(1) Provide a program and services to meet the special care needs of, and address the behavioral problems of, participants.
(2) Provide adequate and appropriate staffing to meet the nursing, psychosocial, and recreational needs of participants. Staffing shall include, but need not be limited to, social workers, volunteers, and other professionals.
(3) Provide physical facilities that include the safeguards necessary to protect the participants’ safety.
(4) Provide a program for assisting individuals who cannot afford the entire cost of the program. This may include, but need not be limited to, utilizing additional funding sources to provide supplemental aid and allowing family members to participate as volunteers at the applicant’s facility.
(5) Utilize volunteers and volunteer aides and provide adequate training for those volunteers.
(6) Provide a match of not less than 25 percent of the direct services contract amount consisting of cash or in-kind contributions, identify other potential sources of funding for the applicant’s facility, and outline plans to seek additional funding to remain solvent.
(7) Maintain Provide counseling and maintain family and caregiver support groups.
(8) Encourage family members and caregivers to provide transportation to and from the applicant’s facility for participants.
(9) Concentrate on the care needs and behavior management of participants in the moderate to severe ranges of disability.
(10) Provide or arrange for a noon meal to participants. participants, with guidance from registered dieticians.
(11) Provide access and referrals to health services for participants, such as blood pressure checks, medication management, eye exams, physicals, and other health services.
(12) Provide appropriate recreational activities for participants.
(13) Provide care coordination for participants and their families, as well as training and support groups.

(11)

(14) Serve as model centers available to other service providers for onsite training in the care of these patients.

(12)

(15) Maintain a systematic means of capturing and reporting all required community-based services program data.
(e) To the extent possible within their resources, direct services contract applicants are encouraged to:
(1) Establish contact with local educational programs, such as nursing and gerontology nursing, gerontology, and social work programs, to provide onsite training to students.
(2) Provide services to assist family members, including counseling and referrals to other resources.
(3) Involve the center in community outreach activities and provide educational and informational materials to the community.
(f) A direct services contractor shall be licensed as an adult day program, as defined in paragraph (2) of subdivision (a) of Section 1502 of the Health and Safety Code, or as an adult day health care center, as defined in subdivision (b) of Section 1570.7 of the Health and Safety Code, and shall be subject to the requirements of this division, including this chapter, for purposes of operating an Alzheimer’s day care resource center. If the direct services contractor surrenders its adult day program or adult day health care center license, or if the license has been terminated as a result of noncompliance with applicable licensure or certification standards, these actions shall also serve to terminate the direct services contractor’s Alzheimer’s day care resource center contract.
(g) An Alzheimer’s day care resource center that was not licensed as an adult day program or adult day health care center prior to January 1, 2005, shall be required to be so licensed by January 1, 2008. A direct services program that qualifies to operate as an Alzheimer’s day care resource center after January 1, 2005, shall be required to be licensed as an adult day program or adult day health care center.
(h) Nothing in this chapter shall be construed to prevent existing adult day care services, including adult day health care centers, from developing a specialized program under this chapter. The applicants shall meet all of the requirements for direct services contractors in this chapter and satisfactorily demonstrate that the direct services contract funding award shall be used to develop a distinct specialized program for this target population.

SEC. 5.

 Section 9547 of the Welfare and Institutions Code is amended to read:

9547.
 (a) The purpose of the Senior Companion Program shall be to provide personally meaningful volunteer community service opportunities to low-income older individuals older adults who are low income for the benefit of adults who need assistance in their with activities of daily living. It is the purpose of this chapter to enable older individuals to provide care and support on a person-to-person basis to adults with special needs, such as the frail elderly, physically impaired adults and those adults who are mentally or neurologically impaired, older adults at risk of institutionalization, in accordance with the National and Community Service Trust Act of 1993 (42 U.S.C. Sec. 12651, et seq.).
(b) For the purposes of this chapter “senior companion volunteer” means an older individual who is 60 years of age or older, has an insufficient who is low income, as determined in accordance with Part 1208 of Title 45 of the Code of Federal Regulations, and provides at least four hours a day, five days a week, of senior companion services under this chapter.
(c) Requirements of direct service contractors:
(1) Be a city, county, city and county, or department of the state, or any suitable private, nonprofit organization, that demonstrates the ability to provide the specified services in a variety of settings, including, but not limited to, in residential, nonresidential, institutional and in-home settings.
(2) Demonstrate the ability to recruit, select, train, and assign staff and volunteers.
(3) Provide volunteer participants with the same benefits, transportation, stipends, and income exemptions as provided to the senior companion volunteers funded through the Corporation for National Service.
(4) Provide or arrange for meals, transportation, and supervision for volunteers.
(5) Provide benefits and meaningful volunteer service opportunities to low-income individuals 60 years of age or older.
(6) Serve adults who are frail and have have severe functional impairments.
(7) Provide services to, but not limited to, all of the following:

(A)Older individuals who were either formerly active and are now bedfast, too frail, or too ill to be transported to special programs.

(B)Physically impaired older individuals who cannot leave their homes due to the extent of their disabilities.

(C)Individuals who, due to functional impairments, fear of a fast-moving society, and the possibility of bodily harm, are afraid to go out.

(D)Physically impaired individuals who are capable of interacting in activities for the physically impaired, but because of their limitations have been overprotected by their guardians.

(E)Physically or mentally impaired older individuals who have become so depressed that they have withdrawn from all social interaction and are confined as a result of psychological problems.

(F)Physically impaired individuals who are eager to be enrolled in day care programs, but have to stay on waiting lists until there is an opening.

(A) Older adults who have severe functional or cognitive limitations that result in an individual’s inability to leave the home.
(B) Individuals with mental or neurological impairments who are capable of participating in activities, but have been denied access to those activities.
(C) Older adults who have withdrawn from all social interaction.
(D) Adults with physical disabilities who wish to participate in home- and community-based services programs, but who remain on waiting lists until there is an opening.
(8) Maintain a systematic means of capturing and reporting all required community-based services program data.
(d) In addition to the opportunity to help other adults who have special needs, such as the frail elderly, physically impaired adults and those adults who are mentally or neurologically impaired, at-risk older adults, senior companion volunteers shall receive all of the following:
(1) Expenses for transportation to and from their homes and the place where they render their services or transportation in buses or in other transportation made available to them.
(2) One free meal during each day in which the senior companion renders services.
(3) Accident insurance, an annual physical examination, and a nontaxable hourly stipend.
(e) Senior companions funded under this chapter shall not be assigned to individuals already receiving in-home supportive services.
(f) This section shall be implemented only to the extent that funds are appropriated for its purposes in the annual Budget Act or in another statute.

SEC. 6.

 Chapter 9 (commencing with Section 9590) of Division 8.5 of the Welfare and Institutions Code is repealed.