The Honorable Mariko Yamada, Chair
Assembly Aging & Long-Term Care Committee
1020 N Street, Room 360-A
Sacramento, CA 95814

RE: SB 345 (Wolk) Support

Dear Assembly Member Yamada,

I am writing on behalf of the Committee for an Independent State Ombudsman Office (CISO) to express our strong support for SB 345, which would establish a more independent and improved state long term care ombudsman office.

CISO is a grassroots committee made up of local long term care ombudsman programs, housed in non-profit organizations, and sympathetic advocates. Having witnessed for years, the utter silence and lack of action on the part of the state long term care ombudsman to address and seek remedy for very serious issues that affect vulnerable seniors in long term care facilities, we are seeking legislative action that would establish and ensure, through state law and in compliance with federal law, the independence and autonomy of the state long term care ombudsman office.

In order to understand why this is absolutely essential, we need to see the long term care ombudsman office through the lens of the historical setting and sheer tragedy that created it.

In 1971 a consumer watchdog, named Ralph Nader, petitioned President Nixon regarding a horrific nationwide problem involving elderly residents in nursing homes. Residents were being neglected and abused, and dying painful excruciating deaths. He recounted horrifying accounts where, due to lack of regulation and enforcement, 100% of the residents in two nursing homes died excruciatingly painful, agonizing deaths as a result of fire and e-coli. From these heartbreaking accounts of horrendous pain and suffering, the concept of a watchdog for this vulnerable population was born, and the word “ombudsman” was selected because it is the only word in our language that encompasses the whole spirit and letter of exactly the type of watchdog that would be required.

In 1978 the long term care ombudsman office was created. Its duties, responsibilities, and mandates, were written and clearly spelled out in federal law. Those mandates state that the Ombudsman program must have the ability to speak freely on behalf of care facility residents, and take positions on legislation without interference from licensing or other agencies. In each state the office for this watchdog would be formally known as the Office of the State Long Term Care Ombudsman (OSLTCO).

In California, the OSLTCO is located within the Department of Aging and answers to the Director of the Department of Aging and the Director of the Health and Human Services agency. The Health and Human Services agency also houses the Department of Public Health which licenses skilled nursing facilities and the Department of Social Services which licenses residential care facilities for the elderly. A conflict of interest (as determined by the Federal Older American’s Act) currently exists where the Ombudsman is in a shared agency with programs that license long term care facilities.

As a result, over the years, the State Ombudsman has not taken positions on legislation that affect care facility residents and local Ombudsman programs. This includes efforts to cut funding to the local Ombudsman programs and efforts to stop the overmedication of care facility residents. In both of these examples, the State Ombudsman was not able to provide public testimony or take a public position because its “sister” agencies (Department of Public Health) and the Governor’s office were not supportive of the State Ombudsman’s position. This failure to take action resulted in drastically cutting services to this vulnerable population, dangerous understaffing at the local Ombudsman programs, and the continued drugging of care facility residents.

In addition to its failure to speak up for residents, the state ombudsman office has a history of obstructing local ombudsman programs from addressing abuse and neglect of residents. These problems are well documented in the California Senate Office on Oversight and Outcomes 2009 report, California’s Elder Abuse Investigators: Ombudsmen Shackled by Conflicting Laws and Duties.

As amended, SB 345 would address the lack of independence and advocacy by codifying key advocacy duties established in the federal Older American’s Act, requiring the state ombudsman office to establish an annual advocacy plan in coordination with local ombudsman programs, directing the state ombudsman office to establish a consumer-friendly website, and creating a new process for selecting the state ombudsman.

The Committee for an Independent State Ombudsman Office strongly urges the Assembly Aging and Long- Term Care Committee to vote “yes” on SB 345 as amended.

Sincerely,

Sylvia Taylor-Stein
CISO Team Leader

Cc: Senator Lois Wolk
Members of the Senate Human Services Committee
CISO Committee & Advisors:

Clift Wilson, Manager, Program Services, Ombudsman & HICAP Services of Northern California
Eric M. Carlson, Directing Attorney, National Senior Citizens Law Center
Joan Parks, Administrator, Ombudsman & HICAP Services of Northern California
Karen Jones, Ombudsman Program Coord., Long Term Care Ombudsman Svcs., San Luis Obispo Cty.
Kathleen Johnson, Executive Director, Advocacy Inc., Santa Cruz County
Linda Robinson, Ombudsman Program Coordinator, Advocacy Inc., Santa Cruz County
Michael Connors, Advocate, California Advocates for Nursing Home Reform
Molly Davies, Vice President, WISE & Healthy Aging, Los Angeles
Nina Weiler Harwell, PhD, Associate State Director-Advocacy, AARP
Shirley Krohn, California Senior Legislature
Sylvia Taylor Stein, Executive Director, Long Term Care Services of Ventura County, Inc.,

I want to update you on our advocacy efforts to create a stronger and more effective state ombudsman office in California. The Bill SB345, author Senator Lois Wolk, sponsor CISO, was passed by the Senate Health and Human Services Committee and the Senate Appropriations Committee, and passed out of the Senate with a 26/9 vote in favor. It has been amended with the additional Older American Act Language. It is now in the Assembly and should be scheduled for hearing soon before the Assembly Aging and Long Term Care Committee. SB345 is a much needed bill as it aligns state and federal law, and utilizing the current federal law that governs the state ombudsman office, it helps ensure a much improved state ombudsman office. I also want to add that the cost of this bill is not impactful as it is underwritten by the over $1,000,000 of federal funds that currently flow into the state office every year.

It is time California long term care residents and disabled persons had the advocate at the state level that was envisioned when this program was created back in 1978.

I have attached the CISO letter of support for your review, and the roster of committee members for the Aging and Long Term Care Committee. Please help us give the elderly and disabled a stronger voice at the state level by faxinga letter of support to Chairman Yamada, and the Aging and Long Term Care Committee members by March 5, 2012. Please copy us on your letter.

Thank you so very much!

Sincerely,

Sylvia Taylor-Stein
Committee for an Independent State Ombudsman Office (CISO)

I want to let you know that SB 345, for which the Committee for an Independents State Office (CISO) is the sponsor, is scheduled for hearing January 10th at 1:30 PM before the Senate Committee for Health and Human Services.

I have attached the fact sheet for your review. Factsheet (75)

I have also attached CISO’s support letter of the bill.Support Letter (59)

As the CA Dept of Aging will be auditing our local ombudsman program next week, I am unable to attend the hearing, but two members of our CISO committee will be speaking on behalf of the bill.

SB 345 has gone through many revisions since we started back in February of 2009, and there have been many rewrites, but the most significant revision which was the cornerstone of the bill involves the outsourcing of the state ombudsman office to a private entity. We were forced to eliminate that section as the CA constitution prohibits the elimination of civil servant positions as a result of outsourcing to a private entity, and the bill, in its original form, would have eliminated about 8 civil servant positions.

The bill is not where we started, but the revised bill, SB 345, when enacted, will be a good first step toward strengthening the state ombudsman office in that it will mandate stronger advocacy and accountability from that office.

I wanted to share this with all of you as many of you have been on this long journey with us for the past three years, and we very much appreciate all your encouragement and support.

I also want to wish each of you a very Happy and Healthy New Year, and thank you for being such an integral part of our community and our team.

Warmest regards,

Sylvia

Sylvia Taylor Stein

Team Leader

Committee for and Independent State Office (CISO)

What started out as a very bad situation in FL, with Brian being fired for doing his job as an ombudsman, could end up creating the independent state ombudsman office there. Brian will keep us updated on their progress in Fl.

This could be very good for our efforts here in CA.
Source: orlandosentinel.com

TALLAHASSEE — A senator who oversees Florida’s seniors wants to see the state’s nursing home watchdog given more independence following Gov. Rick Scott ‘s decision to fire the long-term care ombudsman and complaints that he was “muzzling” the office.

Read more >

I have attached Senator Lois Wolk’s bill which was just put in final form yesterday. Amendments to Senate Bill No. 345

Federal law expressly prohibits the state long-term care ombudsman office from being operated by any state agency that is responsible for licensing or certifying long-term care facilities. This conflict exists in California.  It has precluded local programs from having a strong, advocacy driven state ombudsman. If you recall, during the past two years when our Ombudsman Funding Workgroup worked countless hours on funding legislation, the Office of the State Long-Term Care Ombudsman (OSLTCO) was silent. They could not participate in hearings, they could not offer us any support. This is minor compared to the thirty years we have experienced without an office of long-term care advocacy for the residents in our facilities! There has not been one press conference or press release from the OSLTCO, when systems failed, when deplorable conditions were uncovered, when systemic issues needed to be addressed. Silence has prevailed.

We are asking you for your support. We need letters by Friday afternoon to members of the Senate Human Services Committee

Support Letter for SB 34 (DOWNLOAD AND PRINT)

and participation at the hearing, scheduled for Tuesday, April 26th at 1:30 PM in Room 3191.

I have attached a Fact Sheet, Senate Bill 345 and a sample support letter. We realize this is very short notice and appreciate anything you can do to help with this much needed legislation.

Please send letters of support to the offices of the following members on the Human Services Committee.

Human Services Committee Fax Numbers

Senator Liu (Chair): (916) 324-7543

Senator Emmerson (Vice Chair): (916) 327-2187

Senator Berryhill: (916) 327-3523

Senator Hancock: (916) 327-1997

Senator Strickland: (916) 324-7544

Senator Wright: (916) 445-3712

Senator Yee: (916) 327-2186

Thank you for all your support.

Sylvia Taylor-Stein (Team Leader CISO)