SECTIONS 9250-9256 - California Statutes

WELFARE AND INSTITUTIONS CODE

SECTION 9250-9256

9250. (a) The Legislature finds and declares all of the following:
(1) Our delivery of long-term care needs to be vastly improved in
order to coordinate services that are appropriate to each individual'
s functional needs and financial situation. Care services should be
holistic and address the needs of the entire person, including the
person's mental, physical, social, and emotional needs.
(2) The coming age wave will bankrupt California if we maintain
the current uncoordinated system of long-term care.
(3) The new generation of aging Californians will desire, expect,
and demand a much more responsive, coherent, and human-dignified
system of care services.
(4) Multiple funding streams and varied eligibility criteria have
created "silos" of services, making it difficult for consumers to
move with ease from one service or program to another.
(5) Separate funding streams and uncoordinated services for older
adults and adults with disabilities have created barriers in services
for these populations. Adults with disabilities often receive
long-term care services designed to support and protect the
institutionalized older population. Instead, services need to be
individualized to empower older adults and persons with disabilities
to live in the community.
(6) Historically, two delivery systems, referred to as the medical
model and the social model of care, have evolved with little or no
coordination between the two.
(7) A high percentage of consumers enter the long-term care system
after a hospitalization. Assistance and support following
hospitalization would reduce the number of nursing home placements.
(8) The Legislature affirms the notion that individuals should be
able to receive care in the least restrictive environment.
(9) Skilled nursing facilities account for 5 percent of the
long-term care caseload and 52 percent of the long-term care
expenditures. Home and community-based services account for 78
percent of the long-term care caseload, and 13 percent of long-term
care expenditures. It is, therefore, more cost-effective to connect
consumers with services in the community than to continue to place
individuals in institutions.
(10) A number of counties and programs have developed and
implemented innovative Internet-based information systems. Some of
these systems are designed to help consumers access information
regarding long-term care services, and others are designed to help
providers track client information.
(11) The California Health and Human Services Agency is developing
the "CalCareNet" Web site, which is designed to help the consumer
find state-licensed providers of health services, social services,
mental health services, alcohol and other drug services, and
disability services, and also to find state-licensed care facilities.
(b) It the intent of the Legislature to enact legislation to do
all of the following:
(1) Ensure that each consumer is able to connect with the
appropriate services necessary to meet individual needs.
(2) Better coordinate long-term care delivery, recognizing the
elements that are already in place, and expand the availability of
long-term care.
(3) Deliver long-term care services in the most cost-effective
manner.
(4) Access multiple public and private funding streams, without
supplanting existing funding for programs and services.

9251. For purposes of this chapter, the following definitions
apply:
(a) The term "long-term care" refers to a wide range of supportive
and health and social services for older adults and adults with
disabilities. Long-term care differs from other types of care in that
the goal of long-term care is not to cure illnesses, but to allow
individuals to attain and maintain optimal levels of functioning in
their homes or in their communities. The provision of long-term
services involves a continuum of health and social services in a
variety of home- and community-based settings.
(b) The term "care navigation" describes any of the following
services, performed in multiple settings, including, but not limited
to, area agencies on aging, hospitals, caregiver resource centers,
independent living centers, and senior centers:
(1) Consumer information delivered over the Internet, by
telephone, including a statewide information hotline, or in person.
(2) Referral to programs or services delivered over the Internet,
by telephone, including a statewide information telephone hotline, or
in person.
(3) Short-term assistance for the consumer or caregiver, provided
by persons qualified to work with the consumer to define needs, to
refer the consumer to services that are free of charge or that may be
purchased by the consumer, and to develop a plan of coordinated
care.
(4) Recognition of the need for ongoing assistance, with the
ability to link consumers to ongoing assistance, care coordination,
services coordination, or case management.
(c) (1) The term "care navigator" describes an individual who
provides care navigation to older persons or persons with
disabilities in need of long-term care services, or to caregivers.
Care navigators consider an individual's medical and functional
needs, financial resources, and social support, in order to partner
with the individual and, together, determine which services offered
in the community are most appropriate for the consumer. The
intervention with the consumer may be limited, depending on the
consumer's needs.
(2) Care navigation may be performed within existing programs and
at multiple points of entry, including, but not limited to, area
agencies on aging, independent living centers, county welfare
departments, hospitals, caregiver resource centers, and senior
centers.
(d) The term "CalCareNet" describes a self-directed statewide,
Internet-based application using the State of California Internet
portal to link local Internet information systems. The CalCareNet Web
site is designed to help the consumer find state-licensed providers
of health services, social services, mental health services, alcohol
and other drug services, and disability services, and also to find
state-licensed care facilities. The purpose of CalCareNet is to
enable the consumer to better navigate the long-term care system.

9252. Implementation of this chapter shall be grounded on the
following principles:
(a) Services shall be provided in the least restrictive, most
home-based environment compatible with the health condition, mental
status, and long-term needs of each consumer.
(b) Services shall be accessible through multiple points of entry
into a continuum of long-term care services that meet a wide range of
needs of the aging population and for persons with disabilities.
(c) Home- and community-based long-term care services shall be
readily accessible from the hospital.
(d) Home- and community-based long-term care services that meet a
wide range of consumer needs shall be available.

9253. By June 1, 2003, pursuant to the California long-term care
plan developed pursuant to Section 96 of Assembly Bill 442 of the
2001-02 Regular Session, the Long-Term Care Council shall assess the
current availability of home- and community-based services, identify
gaps in service availability, and evaluate changes that could be made
to enable consumers to be served in the most integrated setting
possible.

9253.5. (a) The Legislature finds and declares all of the
following:
(1) Providers of long-term care programs, including, but not
limited to, programs of all-inclusive care for the elderly, skilled
nursing facilities, adult day care, adult day services, Alzheimer's
day care centers, and multipurpose senior services programs, are
regulated by numerous state and local agencies.
(2) Overlapping and duplicative oversight of long-term care
programs often results in conflicting interpretations of statutes and
regulations. Also, oversight by multiple agencies creates an
operational burden that ultimately deprives residents or clients of
valuable staff time.
(3) The State Auditor has completed an audit investigation of the
duplicative overlapping regulatory oversight of long-term care
programs.
(b) By March 1, 2005, the California Health and Human Services
Agency shall determine the appropriate single entity to provide
oversight of the waiver standards for adult day health care centers.
(c) The State Department of Health Services shall determine a
percentage of the number of oversight reviews it conducts of the
Multipurpose Senior Services Program (MSSP) utilization surveys that
are conducted by the California Department of Aging. The percentage
of surveys reviewed shall be sufficient to ensure effective
oversight, but small enough to avoid unnecessary duplication of
effort.

9254. (a) By January 1, 2005, the agency, with recommendations from
the Long-Term Care Council, shall set standards for CalCareNet, with
the goal of creating an Internet site that links to counties and
planning service areas, and that provides information on long-term
care services that are available to the consumer. The agency shall
recommend guidelines for local Internet information systems, allowing
for flexibility in design and structure. The local entities with
existing systems are encouraged to maintain existing systems,
assuming CalCareNet guidelines are met.
(b) State funds shall not be appropriated for purposes of this
section. The agency is not required to undertake any new task
described in this section unless it receives federal or private funds
for that purpose.
(c) Information shared between, and tracked by, providers through
CalCareNet may in no way violate Section 15633, pertaining to client
confidentiality, or any other statute requiring that client
information be kept confidential, unless otherwise exempted by law.
(d) In crafting its guidelines for the local-level information
systems, the Long-Term Care Council shall seek input from interested
stakeholders, including, but not limited to, all of the following:
(1) Consumers.
(2) Consumer advocacy organizations.
(3) Area agencies on aging.
(4) Senior legal services.
(5) The California Commission on Aging.
(6) Caregiver resource centers.
(7) Veterans' services.
(8) Senior centers.
(9) PACE (Program for All Inclusive Care for the Elderly).
(10) The Senior Care Action Network (SCAN).
(11) The Multipurpose Senior Services Program (MSSP) services.
(12) Ombudspersons.
(13) County-level programs, including, but not limited to, In-Home
Supportive Services (IHSS), county welfare departments, public
health departments, and adult protective services agencies.
(14) Programs for persons with disabilities, including, but not
limited to, independent living centers.
(15) Other social service programs, including, but not limited to,
employment development programs.
(e) By January 1, 2004, the agency shall link the CalCareNet Web
site to local Internet information systems. The agency shall permit
counties and planning service areas to design local information
systems, contingent upon the availability of funding and resources
for these purposes.

9255. (a) By January 1, 2004, the agency, based on recommendations
from the Long-Term Care Council, shall recommend to the Legislature
standards for care navigation, including suggestions for connecting
consumers from the acute care system, to and through the long-term
care system.
(b) In its recommendations to the Legislature, the agency shall
address care navigator educational and training requirements, the
care navigator location within the long-term care continuum,
licensure and oversight requirements, and potential funding impact.
In its recommendations, the agency shall discuss the need for
waivers, enhancing access to home- and community-based services for
private payers, connecting the acute care system with the long-term
care system, and obtaining private and public funding. The agency
shall also discuss means for the cooperative participation of
insurance companies, physicians, hospitals, assisted living
facilities, home health agencies, and skilled nursing facilities.
(c) In crafting its recommendations to the agency, the Long-Term
Care Council shall seek input from interested stakeholders,
including, but not limited to, those stakeholders described in
subdivision (d) of Section 9254.
(d) Care navigation must be consistent with the goal of developing
a program that is based on the existing state and local systems, to
ensure that consumers are connected to the necessary care and
services.
(e) State funds shall not be appropriated for the purpose of
implementing this section. The agency is not required to undertake
any new task specified in this section unless it receives federal or
private funds for that purpose.

9256. The implementation of a care navigation program, as described
in Section 9255, shall be subject to the enactment of legislation
requiring implementation.