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AB-1382 Master Plan for Aging.(2019-2020)

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Date Published: 09/12/2019 09:00 PM
AB1382:v96#DOCUMENT

Enrolled  September 12, 2019
Passed  IN  Senate  September 09, 2019
Passed  IN  Assembly  May 23, 2019
Amended  IN  Assembly  April 22, 2019
Amended  IN  Assembly  April 01, 2019

CALIFORNIA LEGISLATURE— 2019–2020 REGULAR SESSION

Assembly Bill
No. 1382


Introduced by Assembly Member Aguiar-Curry
(Coauthor: Assembly Member Nazarian)
(Coauthor: Senator Caballero)

February 22, 2019


An act relating to public social services.


LEGISLATIVE COUNSEL'S DIGEST


AB 1382, Aguiar-Curry. Master Plan for Aging.
Existing law, including, among others, the Mello-Granlund Older Californians Act, provides programs and strategies to support the state’s older population. These programs include the Aging and Disability Resource Connection program, established to provide information to consumers and their families on available long-term services and supports (LTSS) programs and to assist older adults, caregivers, and persons with disabilities in accessing LTSS programs at the local level.
This bill would require the state to adopt a Master Plan for Aging, emphasizing workforce priorities. The bill would require the Master Plan for Aging to prioritize specified issues related to preparing and supporting the state’s paid paraprofessionals and professionals, as well as unpaid family caregivers. These issues would include, but not be limited to, (1) addressing the need for a well-trained and culturally competent paid paraprofessional and professional health care and long-term care workforce, and (2) developing recommendations regarding the need for high-quality, affordable, and accessible respite services throughout the state for unpaid family caregivers. The bill would require the Master Plan for Aging to include an implementation plan specifying the goals, objectives, and timelines for meeting the requirements set forth in those provisions. The bill would make findings and declarations relating to the objectives of the master plan.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

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


SECTION 1.

 The Legislature finds and declares the following:
(a) The Public Policy Institute of California estimates that by the year 2030, California’s population of people 65 years of age and over will increase by four million people and become more racially and economically diverse.
(b) The aging of California’s population will impact all areas of the service delivery system, including, but not limited to, increasing the demand for long-term services and supports (LTSS), housing, transportation, dental care, healthcare, and behavioral health services.
(c) Ensuring a well-trained, culturally competent workforce is critical to meeting the needs of California’s aging population. Yet, the supply of trained paraprofessionals and professionals cannot keep pace with population demand now, let alone in the future. It is estimated that an additional 600,000 home care providers will be needed by 2030 to meet the needs of aging Californians.
(d) This workforce is composed of the following three categories:
(1) Paid paraprofessionals.
(A) Home care workers provide critical personal care services that help individuals remain safely and with dignity in their own homes. Home care workers may be employed through public programs such as the In-Home Supportive Services (IHSS) program, or in the private market.
(B) The IHSS program, established in 1974, is a Medi-Cal funded program for eligible low-income seniors and persons with disabilities. The IHSS program currently has a workforce of over 500,000 home care providers caring for 593,000 recipients across the state.
(C) Approximately 113,000 home care workers are employed by private agencies throughout the state.
(D) Low wages and meager benefits result in low workforce retention rates in home care. Treatment of home care workers under federal and state law has historically reflected stereotypical assumptions about the nature of this work-, specifically that employment within a household is not “real” work. An example of this inequity is the “family employment exception” in the federal Internal Revenue Code.
(E) Improving the wages and benefits of home care workers improves the economic well-being of workers and their families, substantially reduces industry turnover, and improves access to reliable and quality services. To ensure that workers get paid a living wage with health benefits and retirement security, the state must create an independent, sustainable financing mechanism.
(2) Paid health care professionals.
(A) Less than 5 percent of today’s health professions workforce is certified in geriatrics.
(B) The American Geriatrics Society estimates the nation will need to train approximately 6,250 additional geriatricians by 2030 to meet population needs.
(3) Unpaid family caregivers.
(A) Family caregivers have emerged as the backbone of the LTSS system, by providing unreimbursed care and support to aging family and friends in the home and community settings.
(B) The AARP Public Policy Institute reports that in 2015, over four million family caregivers in California provided approximately $57 billion worth of unpaid care. Nationally, other data shows that nearly two-thirds of older adults with LTSS needs receive all help from unpaid family caregivers.
(C) Despite their critical role, family caregivers continue to face daunting challenges in navigating the service delivery system, balancing employment and caregiving responsibilities, and financing their loved ones’ care needs.
(D) As reported by the California Task Force on Family Caregiving, the financial burden of caregiving is significant, with caregivers often losing income from taking time off from employment or entirely leaving paid employment prematurely. Few caregivers know of California’s family leave benefits that can provide much needed benefits to eligible workers.
(E) “Respite care” is broadly defined as support services that provide caregivers with a break from caregiving, and are provided to meet the caregiver’s needs. These respite services can positively impact both the caregivers’ and family members’ health and well-being.
(F) Respite care is one of the most sought-out services for caregivers in the state, and is particularly important to caregivers who live with the person they care for, are attending to a person with Alzheimer’s disease, or are caring for someone with a mental health issue or other condition that requires a significant level of care.
(G) Multiple organizations in the state are knowledgeable about distributing respite care services, including California caregiver resource centers (CRCs), area agencies on aging, and regional centers.
(H) The state should elevate policies that support unpaid family caregivers, better serve the needs of older adults, and promote greater efficiencies in public spending.
(I) The final report of the California Task Force on Family Caregiving outlines a range of recommendations to meet the needs of family caregivers now and into the future, including the following: supporting the financial well-being of caregivers; standardizing caregiver assessments; enhancing access to information, education, and training; increasing access to affordable caregiver services and supports; integrating family caregivers into the healthcare process; increasing funding for CRCs; and creating a statewide advisory council on caregiving.
(J) The challenges facing California’s family caregivers reflect issues plaguing the broader service delivery system. A 2015 report by the Senate Select Committee on Aging and Long-Term Care, entitled “A Shattered System: Reforming Long-Term Care in California,” identified a number of system challenges including fragmentation, lack of access to services, workforce challenges and cultural competency, and a crumbling infrastructure.
(K) The aging of California’s population demands a thoughtful, deliberative approach to meeting the needs of older adults, people with disabilities, and family caregivers.
(e) It is, therefore, the intent of the Legislature to enact legislation to establish a Master Plan for Aging that provides a comprehensive strategy for issues affecting California’s aging population, including health care, LTSS, financing, and service delivery. It is the further intent of the Legislature that the range of issues addressed in the legislation include recommendations regarding preparing and supporting California’s paid paraprofessional and professional workforce, as well as the unpaid family caregiver workforce.

SEC. 2.

 (a) The state shall develop a Master Plan for Aging, emphasizing workforce priorities, as provided in this section. The Master Plan for Aging shall prioritize the following issues related to preparing and supporting California’s paid paraprofessionals, professionals, and unpaid family caregivers:
(1) Addressing the need for a well-trained and culturally competent paid paraprofessional and professional health care and long-term care workforce, including both of the following:
(A) Recommendations to improve the wages and benefits of home care workers through the creation of an independent, sustainable financing mechanism.
(B) Recommendations for widespread training and the adoption of existing competencies in geriatrics, palliative, and hospice care for all health care professionals, including educational curricula incorporating geriatric-related competencies and specialized training for primary care providers to manage care for the state’s aging population.
(2) Meeting the needs of California’s unpaid family caregivers, including both of the following:
(A) The development of recommendations regarding the need for high-quality, affordable, and accessible respite services throughout California.
(B) Incorporation of recommendations outlined by the California Task Force for Family Caregiving to better support family caregivers now and into the future.
(b) The Master Plan for Aging shall include an implementation plan specifying the goals, objectives, and timelines for meeting the requirements set forth in subdivision (a).