State Long-Term Care Ombudsman Program
July 1, 2015
On behalf of the Long Term Care Ombudsman Program staff and volunteers, all of the residents we serve, and their families who care about them, we thank the Governor for initiating a Special Session Proclamation on Health Care. The Governor’s proclamation calls for legislation that will:
“Improve the health of Californians.”
- Complaints identified and investigated by Ombudsmen are often the precursors of severe cases of abuse and neglect and point to systemic problems in long term care facilities. Residents may develop painful and costly conditions such as pressure ulcers if care is inadequate, urinary tract infections if water is unavailable or out of reach, or malnourishment if food is not served in a timely and appropriate manner.
- Ombudsmen are trained to recognize abuse that providers, family, and facility staff many overlook.
“Reduce the cost of providing health care services.”
- Long-Term Care Ombudsmen saves the State money by detecting and resolving complaints before they escalate into regulatory violations and crimes requiring the involvement of higher cost agencies such as law enforcement and licensing agencies or causing serious harm to facility residents requiring costly medical services thru the Medi-Cal program
- The Program detects health care issues such as overmedication/inappropriate sedation of residents, insufficient staffing, negligent care, insufficient food supply and unhygienic living conditions that would otherwise lead to poor health outcomes and costly hospitalizations.
- The Program is well positioned to report Medicare and Medi-Cal fraud to the appropriate authorities, further reducing the cost associated with providing health care services.
- Additionally, the Long Term Care Ombudsman Program helps the State of California meet it’s commitment to Olmstead by identifying residents who may be safely transitioned into more appropriate (and less costly) community care, and help guide the resident and their family through those transitions.
“Improve the efficiency and efficacy of the health care system.”
- Beyond the cost savings incurred by California’s Health Care System as a result of the preventative presence of Ombudsmen, the Long Term Care Ombudsman Program is also a highly efficient use of State funding. The Long Term Care Ombudsman Program relies on relatively few paid staff compared to our Licensing and Certification and Community Care Licensing counterparts. Instead, the Program relies on highly trained, skilled, and committed certified volunteers to provide an astonishing 127,556 hours of oversight, the equivalent of 63 full-time paid staff (2013 data). These volunteers are the eyes, ears, and heart of our hard working and efficient program.
- By providing front-line oversight Ombudsmen allow State inspectors in the Department of Public Health (Licensing and Certification) and the Department of Social Services (Community Care Licensing) to focus on larger and more complex investigations enabling a more efficient use of limited State resources.
- Ombudsmen also regularly assist and support law enforcement and the courts when complaints reach the criminal level, by providing background and evidence as appropriate.
- With recent state reforms through the Coordinated Care Initiative, skilled nursing care in California is now a Medi-Cal managed care benefit. By providing oversight within long term care facilities, Ombudsmen provide a valuable service to managed care organizations (MCOs) which are accountable for the quality and costs of services provided to their members.
- The oversight provided by Ombudsmen give MCOs the information they need to make important decisions about which facilities to include in their network and to care for their members.
We request an allocation that conforms to the unanimous and bipartisan actions of the 2015-16 Budget Conference Committee which recommended an additional $5 million in General Fund support for the Long Term Care Ombudsman Program, which was then passed by both houses of the Legislature. While the program is grateful for the $1 million General Fund allocation from the Governor, we request that the Legislature’s intent be fully actualized and sustained through an on-going $4 million allocation from the new MCO tax made to the Department of Health Care Services for the Long Term Care Ombudsman, beginning when those revenues take effect.
California’s frail and dependent adults in long term care facilities need an adequate program of oversight and protection with a stable funding base into the future when the aging population will more than double. The Long Term Care Ombudsman Program stands ready to serve California’s aging population and meet the Health Care Standards set forth in the Governor’s Proclamation.
Please join the Senate and Assembly leadership and vote to fund the State Long-Term Care Ombudsman Program
Sincerely,
Leza Coleman
Executive Director- California Long-Term Care Ombudsman Association
3950 Industrial Blvd., Ste. 500
West Sacramento, CA 95691
Office: (916) 375-3313
Fax: (916) 376-8795
www.CLTCOA.org
