100145-100147

HEALTH AND SAFETY CODE
SECTION 100145-100147




100145.  The Legislature finds and declares that for older persons
and persons with disabilities all of the following apply:
   (a) Long-term care consumers experience great differences in
service levels, eligibility criteria and service availability that
often results in inappropriate and expensive care that is not
responsive to individual needs.
   (b) Individuals requiring long-term care services are most often
the best judges of their own needs. Consequently, they should share
the responsibility for designing the overall long-term care delivery
system.
   (c) The laws governing long-term care facilities have established
an uncoordinated array of long-term care services that are funded and
administered by a state structure that lacks necessary integration
and focus.
   (d) Article 4.05 (commencing with Section 14139.05) of Chapter 7
of Part 3 of Division 9 of the Welfare and Institutions Code sets
forth the state's public policy strategy to address this problem
through an approach that provides the opportunity for a community to
design and implement a coordinated services delivery system with the
involvement of long-term care consumers in the decisionmaking
process.
   (e) The Long-Term Care Integration Pilot Projects were developed
to test models for service integration, with the goal of providing a
continuum of social and health services that foster independence and
self-reliance, maintain individual dignity, and allow consumers of
long-term care services to remain an integral part of their family
and community life.
   (f) The adoption of the Mello-Granlund Older Californians Act
(Division 8.5 (commencing with Section 9000) of the Welfare and
Institutions Code) sought to improve the integration of available
services at the local level and enhance the development of systems of
home and community-based services.
   (g) Obstacles currently preventing the integration of long-term
care programs and oversight at the state level include all of the
following: inflexible and inconsistent funding sources, economic
incentives that encourage the placement of consumers in the highest
levels of care, lack of coordination between aging, health, and
social service departments at the state level, and inflexible state
and federal regulations.
   (h) It is both necessary and urgent to restructure long-term care
programs and oversight at the state level so that duplicative and
confusing eligibility criteria, assessments, intake forms, and
service limitations will not continue to inhibit consumer
satisfaction, impede improvements in consumer health status, and
perpetuate the ineffective use of state resources.




100147.  For purposes of this chapter, the following definitions
shall apply:
   (a) "Long-term care" means a coordinated continuum of preventive,
diagnostic, therapeutic, rehabilitative, supportive, and maintenance
services that address the health, social and personal needs of older
individuals and functionally-impaired adults who have restricted
self-care capabilities. Long-term care may include licensed nursing
facilities, adult residential care facilities, residential care
facilities for the elderly, and home and community-based services.
   (b) "Systems of home and community based services" means an
integrated continuum of service options available locally to older
individuals and functionally-impaired adults through programs
administered by the state for persons who seek to maximize self-care
and independent living in the home or home-like environment.