The SB-910 Long Range Strategic Plan For Aging

Prepared for

Secretary Grantland Johnson,
California Health and Human Services Agency
May 22, 2003
Prepared by
Commission Commission on Aging
Nancy Dolton, Chair, Pacific Grove
Jorge Lambrinos, Vice Chair, Los Angeles
Sally Acosta, Los Angeles
Ernest "Chuck" Ayala, San Francisco
Shirley A. Bierly, San Francisco
Mary Dennison, Eureka
Jerry Edwards, Pasadena
Celia J. Esquivel, Sacramento
Helen Karr, Pacifica
Roberta King, Ukiah
Henry "Hank" Lacayo, Newbury Park
Charles Latimer, San Diego
Barbara Lundeen, Fresno
Betty Polston, Tarzana
Jon Pynoos, Beverly Hills
Brenda Ross, Laguna Woods
Marvin Schachter, Pasadena
Andrew E. Scharlach, Berkeley
Joanna Selby, Albany
Carolyn Tate, Lakewood
Robert Weber, Novato
Dan Western, Sacramento
Leah Wyman, Long Beach

Staff

Ray Mastalish, Executive Director
Carla Hett Smith, Program Analyst

I. Introduction and Purpose

The California Commission on Aging (CCoA), under the Older Californians Act, is to act as "the principal advocate in the state on behalf of older individuals, including, but not limited to, advisory participation in the consideration of all legislation and regulations made by state and federal departments and agencies relating to programs and services that affect older individuals." As such, it is the principal advisory body to the Governor, State Legislature, and State, Federal and local departments and agencies on issues that ensure a quality of life for older Californians so they may live with dignity in their chosen environment.

A. Mandate
SB 910 (Vasconcellos) of the 1999-2000 Legislative Session requires, among other things, that the California Health and Human Services Agency (HHSA) prepare a Long Range Strategic Plan on Aging by July of 2003, and consult or seek the advice of CCoA in the development of this strategic plan.

B. Commission Strategy

1. Public Discussions
   Preparing the Commission to provide this advice to HHSA on a Long Range Strategic Plan on Aging, a series of field meetings called "public discussions" were convened around the state. In April, 2002, a public discussion in Eureka focused on rural aging issues; a June discussion in Ontario focused on senior health issues; a September discussion in Fresno focused on senior transportation issues; a December discussion in Los Angeles focused on senior housing; and a February, 2003 discussion in Marin County highlighted planning/systems design for home and community based services for seniors and adults with disabilities.

   Input in the public discussions came from a variety of sources including: State legislative staff, local government representatives, area agency on aging directors, area agency advisory council members, physicians, university researchers, local and state aging and disability advocates, issue specific state advocates (housing and transportation), seniors and disabled adult consumers, and aging and disabled services providers.

2. Statements of Findings
   Four 'Statements of Findings' were developed as a result of CCoA's public discussions and research into the particular issues of senior health, transportation, housing, and planning/systems design.

3. Statewide Invitational Forum
   These Statements of Findings served as the basis for discussions with state leadership from departments and agencies responsible for programs and services for seniors and adults with disabilities during the Commission's April 1-2, 2003, "Planning for an Aging California: An Invitational Forum." The forum was attended by over 125 leaders in the field of aging in California.

4. Statement of Recommendations
   This document, CCoA's 'Statement of Recommendations' captures the dialogue that occurred on April 1-2 and combines it with the conclusions reached in the 'Statement of Findings' for succinct input in each issue area. These recommendations will be submitted to Secretary Grantland Johnson, HHSA, as CCoA's formal input into the SB 910 long range strategic plan for aging. CCoA will also submit these recommendations to the Governor and State Legislature.

C. Learning from Past/Current Efforts to Build for the Future
This Statement of Recommendations, while written for the specific pupose of input into the SB 910 long range strategic plan for aging, exists parallel with other efforts and plans relating to aging issues. The most significant of these is the current state Olmstead Plan crafted through the efforts of the Health and Human Services Agency Long Term Care Council. The Commission recognizes that the successful implementation of a Long Range Strategic Plan on Aging is contingent on continued efforts of the Long Term Care Council and others in the implementation of the recommendations common to both of these significant plans.

II. Statements of Recommendations

A. Senior Related Transportation Issues

1. Driving and Pedestrian Safety
   
   
   • Short Term Recommendation
     Initiate development of a comprehensive statewide strategic initiative on traffic safety among older adults by acting on the seven recommendations of the California Task Force on Older Adults and Traffic Safety. These are:
     • Institutionalize a statewide system for the prevention of traffic-related injuries among older adults.
     • Institutionalize effective and equitable driver assessment and licensing practices within the California Department of Motor Vehicles (DMV).
     • Facilitate older adult risk identification and risk reduction practices.
     • Improve the ability of health care and service providers to assess traffic safety risk and minimize the impact of health impairments on safe mobility.
     • Establish roadway infrastructure and land use practices that promote safety.
     • Promote safer motor vehicle designs.
     • Expand the existing research and knowledge base about older adult traffic safety.
   • Long Term Recommendation
     • Periodically review the progress of efforts to implement a comprehensive statewide strategic initiative on traffic safety among older adults and make adjustments to state legislation, regulations, programs, and funding as needed.
       
       
2. Public Transportation
   
   
   • Short Term Recommendation
     Encourage a system of public transportation services that meets the diverse needs of older adults, including community-based services that fill the gaps left by conventional public transportation and ADA paratransit by:
     • Providing assistance to help develop community-based transportation services in the form of training, favorable insurance regulations (including workers compensation coverage for volunteers), and access to funding;
     • Including training and information about alternative mobility options in all relevant DMV publications and state approved and provided mature driver education programs (in appropriate languages and cultures, formats and through channels that will reach older adults);
     • Modifying the farebox recovery and unmet transit need provisions of the Transportation Development Act to encourage increased levels of transit service, including innovative service methods, in low-density and rural areas where transit service is currently lacking or inadequate; and
     • Directing Regional Transportation Planning Agencies to include pedestrian improvements that enhance access to transit in their definition of an "unmet transit need" when considering requests for Streets and Roads funding under Article 8 of the Transpor-tation Development Act.
     • Making improvements to the usability of public transportation systems through minimizing the need for transfers between systems, and making necessary transfers as easy and seamless as possible.
   • Long Term Recommendation
     Strengthen efforts to promote coordination of public transportation systems to make them more attractive and usable by all riders, including older adults, by:
     • Establishing coordinated fare policies and fare payment mechanisms;
     • Providing information about the full range of public transportation services in easy-to-use formats, through a wide variety of channels of communication (including channels targeted specifically to older adults who have to curtail their driving);
     • Providing training for older people to help them become more comfortable using transit and to transit drivers and other transit agency staff to help them become more attuned to the needs of older riders;
     • Identifying design features of transit vehicles and facilities, beyond those required by the Americans with Disabilities Act, that will help older riders, and encourage their implementation by transit opera-tors; and
     • P roviding funding incentives for coordinated service.
       
       
3. Transportation and Health and Human Services
   
   
   • Short Term Recommendation
     Convene a Mobility Summit, with sponsorship by the Health and Human Services Agency, the Business, Transportation, and Housing Agency, and the California Commission on Aging, that will:
     • Assess the adequacy of current arrangements by departments of the Health and Human Services Agency for ensuring access to state-supported health and human services and identify ways to im-prove those arrangements;
     • Identify ways that health and human service providers and local public transportation providers can work cooperatively and share the cost of improved access to services;
     • Determine how state legislation and regulations concerning transportation, including but not limited to the Transportation Development Act and the Social Service Transportation Improvement Act, promote or impede coordinated access to health and human services.
     • Recommend changes to state legislation or regulations needed to create an effective mechanism for Long Term implementation of coordinated human service and public transportation, and to overcome existing barriers to coordination.
   • Long Term Recommendation
     Establish an ongoing interdepartmental Mobility Task Force with duties and powers to implement the program recommended by the Mobility Summit.
     
     
4. Planning and Design
   
   
   • Short Term Recommendation
     Promote safer pedestrian environments by:
     • Implementing the recommendations of the Task Force on Older Adults and Traffic Safety to establish roadway infrastructure and land use practices that promote safety; and
     • Refining initiatives aimed at encouraging smart growth so that they explicitly recognize the mobility concerns of older adults.
   • Long Term Recommendation
     Identify programs within the Department of Housing and Community De-velopment, the Housing Financing Agency, the State Treasurer, the Health and Human Services Agency, and other state departments with the ability to provide incentives for the creation of walkable and transit-friendly communities, and modify programs or policies as needed to provide these incentives. Within the Health and Human Services Agency, require local service providers to consider in their decision making process about locating services and facilities the availability and cost of public transportation and paratransit that clients and customers can use to access those services and facilities.

B. Senior Related Housing Issues

1. Affordability - Preserve and increase the supply of affordable housing.
   
   
   • Increase housing options funded by the Low-Income Housing Tax Credit (LIHTC) Program.
     
     

• Short Term Recommendations
  Work with State officials to support efforts to keep the LIHTC that is jeopardized by proposed changes in the federal tax structure.
• Long Term Recommendations
  California Housing Finance Agency (CalHFA) to increase the range of hous-ing options available for seniors by giving housing designed for older adults (e.g., supportive housing, housing linked to services, and/or assisted living projects) a higher priority in their allocation system.
  
  

• Create a State Housing Trust Fund for affordable housing.
  
  
  • Long Term Recommendations
    Determine an appropriate revenue source and create a State Housing Trust Fund as an ongoing and dedicated source of funding for affordable housing that includes earmarked funds to help finance a range of supportive housing options for the elderly.
• Strengthen the utilization of Proposition 46 funding for senior housing.
  • Short Term Recommendations
    HCD should add "frail elderly," "at-risk elderly" and/or "very low income elderly" as qualifying population groups under the Special Needs Category of the Multi-Family Housing Program funding distribution formula.
    
    
• Preserve Section 8 housing and other government financed af-fordable housing.
  
  
  • Short Term Recommendations
    • Encourage California’s Congressional Delegation to advocate for continued funding commitments to the Section 8 program, including project-based Section 8, as well as vouchers.
    • Increase CalHFA and the Department of Housing and Community Development (HCD) efforts to prevent transference of expiring Section 8 and other government-financed projects to market rate status.
    • Improve HCD's process of notifying local communities of at-risk properties so localities can have sufficient time to develop plans to preserve their affordable housing stock.
  • Long Term Recommendations
    • Encourage HCD to develop and disseminate information on suc-cessful strategies and mechanisms that local governments can utilize to preserve affordable housing.
    • Require increased notice from owners who choose to opt-out of Section 8 projects in order to give the State and tenants more time to respond.
    • Provide Short Term subsidized rent to tenants living in buildings that are converting to market rent in order to give tenants sufficient time to relocate to other affordable housing.
      
      
• Support Section 202 housing production.
  
  
  • Short Term Recommendations
    Encourage California's Congressional Delegation to advocate for continued funding commitments to the federal Section 202 senior housing program.
    
    
• Enforce the Housing Element in local general plans.
  
  
  • Long Term Recommendations
    • Tighten the Housing Element law to insure that all local governments submit their housing plans and that they address the issue of senior housing.
    • Develop expertise within California Department of Aging (CDA) and/or local Area Agencies on Aging (AAA) to participate in the Housing Element process.
    • Create a mechanism to involve the CDA in the approval process of the Housing Element in regards to senior housing.
      
      
• Adequacy - Prevent substandard housing from disrupting the possibility of aging in place.
  • Enhance the ability of home environments to enable aging in place.
    
    
    • Short Term Recommendations
      HCD to identify the need for additional funding for basic home improve-ments to improve health and safety in the State’s Consolidated Housing Plan.
    • Long Term Recommendations
      • Expand the current State funding sources for home improvements including the creation of a revolving and self-sustaining loan pro-gram.
      • Work with the private sector on initiatives that support home repair for older adults.
      • Encourage the Area Agencies on Aging to work with appropriate entities in their communities to apply for CalHome funds and provide outreach in conjunction with the entity administering these programs to assure seniors are accessing this program.
      • Encourage the Area Agencies on Aging to work with appropriate entities in their communities to strengthen the inspection and maintenance of quality housing available to seniors.
        
• Accessibility - Eliminate physical barriers which prevent housing from being accessible to those with disabilities.
  
  
  • Help low - and moderate-income older persons access home modification information and funding.
    
    
    • Short Term Recommendations
      • CDA should preserve the core functions of the Senior Housing In-formation and Support Center (SHISC) and insure that its materials are made available to the public.
      • CDA should assign staff to handle housing modification issues, coor-dinate its programs with other State housing agencies, and be aware of other senior organizations’ housing efforts.
      • HCD should highlight the need for additional funding for home modification in the State’s Consolidated Housing Plan.
      • Utilize materials created by the SHISC and others, to educate consumers (elders and families) about home modification’s potential to increase safety and independence, and how to obtain assistance from existing home modification programs.
    • Long Term Recommendations
      • Expand the current State funding sources for home modification in-cluding the creation of a revolving and self-sustaining loan program.
      • Provide additional resources for the provision of home modification through programs such as Medi-Cal and/or Medi-Cal waivers in order to reduce accidents and save long term care costs and meet the objective of the State Olmstead Plan.
      • Work with the private sector on initiatives that train builders and re-modelers to provide home modification.
        
        
  • Improve linkages to better provide home modification services.
    
    
    • Long Term Recommendations
      • Train community service providers to better assess the home envi-ronment and to identify modification needs; also provide training in Fair Housing Laws to improve their ability to advocate with landlords for improvements in housing settings.
      • Create a consortium of those involved in home modification and ac-cessibility concerns including CDA and HCD to coordinate efforts, avoid duplication, create efficiencies, distribute information, and ex-pand their scope.
      • Infuse home modification into the local long term care integration planning efforts.
      • Encourage the Area Agencies on Aging to work with appropriate entities in their communities to apply for CalHome funds and provide outreach in conjunction with the entity administering these programs to assure seniors are accessing this program.
        
        
  • Encourage creation of visitability and universal design require-ments.
    
    
    • Short Term Recommendations
      HCD to rapidly complete its responsibilities to develop model mandatory visitability and universal design ordinances that localities can adopt.
    • Long Term Recommendations
      • Support adoption of mandatory universal design guidelines and ordinances by local governments.
      • Educate housing construction industry (including mobile home build-ers) of importance of universal design and visitability standards in order to meet the needs of an aging population; additionally, edu-cate builders about local accessibility requirements where adopted.
      • Provide incentives and/or requirements for builders and developers to adopt visitability and universal design concepts in housing funded by the State.
        
        
• Appropriateness - Create a "continuum of housing" which will of-fer seniors a range of housing options that include supportive physical features and linkages to services in a variety of settings.
  
  
  • Create and replicate new models of elderly housing that integrate housing and supportive services.
    
    
    • Short Term Recommendations
      The State should identify exemplary models of integrative housing and best practices for replication by localities; in addition, begin to explore new models for efficient integration of services with housing.
    • Long Term Recommendations
      • Cluster services in housing sites and naturally occurring retirement communities (NORCs), including mobile home communities, in order to increase efficiency.
      • In their competitive ranking of applications for senior housing, Cal-HFA and HCD should encourage the development of partnerships between developers, community based service providers, and health care providers.
      • Fill in the continuum of housing by encouraging the development of housing options such as small group homes for persons with Alz-heimer’s disease and ECHO housing.
      • Increase flexibility in the use of funds at the State and local levels to allow the adoption of models of housing that incorporate both public (e.g., senior centers, day care centers, classrooms) and commercial spaces (e.g., restaurants, stores).
      • Utilize the State Plan on Aging and Area Plans on Aging to encourage integrated housing models.
      • Endorse the concept of aging in place within government-sponsored senior housing and change regulations to allow necessary design features as well as support increased provision of services and care.
      • Where efforts are undertaken to develop Smart Growth Communities (housing combined with commercial areas in proximity to public transportation) work with appropriate agencies to incorporate senior housing, apartment set-asides for seniors, and/or appropriate services for seniors, and assure accessibility standards are implemented.
        
        
  • Create affordable assisted living facilities (ALFs).
    
    
    • Short Term Recommendations
      Encourage Department of Health Services (DHS) implementation of the Assisted Living Waiver Demonstration Program (AB 499).
    • Long Term Recommendations
      DHS to explore governmental funding sources such as Supplemental Secu-rity Income, Section 8 vouchers, and the Medicaid waiver program to pay for housing and services in ALFs.
      
      
• Oversight - Create an interagency coordinated structure (including aging services, transportation, social services, and health care, housing) and a process within the State government which assures that appropriate housing is created and maintained for seniors.
  
  
  • Increase coordination among government agencies (both hori-zontally and vertically) to more effectively address the need for affordable senior housing.
    
    
    • Long Term Recommendations
      • CDA should reflect housing in its planning process and be responsi-ble for advocating for and coordinating State activities to address senior housing needs with appropriate agencies.
      • Create a task force that includes CalHFA, HCD, CDA, and other ap-propriate agencies to set priorities and coordinate efforts to address senior housing needs.
      • Promote closer working relations among HCD, California Department of Transportation, CDA, and California Health and Human Services Agency in order to foster innovative housing developments.
      • Amend current State and local tax structure (which provides greater incentive for localities to promote commercial development over housing development) to provide tax benefits for increasing affordable housing development for seniors.

C. Senior Related Health Issues

Statement of Intent:
The following recommendations focus on three very important areas of senior healthcare this committee has addressed over the past eighteen months. How-ever, due to our burgeoning senior California population and the enormous number of interrelated health care issues, this Committee also supports the pres-ervation and strengthening of programs such as Medi-Cal, which can offer basic services such as dental care, psychiatric services, prescription drugs, and rehabili-tation therapies. Ultimately, this committee envisions a health care delivery system for seniors that provides for basic care along with other vital services.

1. Alcohol and Medication Misuse
   
   
   • Short Term Recommendations
     Provide effective and age appropriate screening and interventions in the area of alcohol and medication misuse in older adults through developing regulations that would:
     • Include appropriate screening forms and intervention strategies at: a) clinics and emergency rooms that treat older adults, and b) existing services e.g. Linkages, MSSP, PHCA, senior housing and senior centers.
     • Use licensure of alcohol and drug treatment professionals to ensure treatment consistent with the needs of older adults.
     • Strengthen public private partnerships such as public education campaigns regarding alcohol and medications misuse in pharmaceu-tical ads in the media.
   • Long Term Recommendations
     Increase services to the older adults population in need of treatment serv-ices by:
     • Revising licensing and certification requirements for health care professionals including physicians, social workers, nurses, and alco-hol and drug counselors to include training on older adults issues such as depression and suicide and the misuse of alcohol and medi-cations;
     • Requiring continuing education units related to alcohol, medications and older adults for key professional groups listed above;
     • Providing statewide training that will increase awareness and knowledge of older adults (and professionals serving older adults in aging programs) on their treatment and service needs related to alcohol and medication misuse; and
     • Encouraging California Department of Alcohol and Drug Programs to develop programs to meet the demands for aging baby boomers, looking at the Substance Abuse and Mental Health Services Administration alcohol, other drug and mental health block grant to target of funds for older adults programs.
       
       
2. Oral Health Care
   
   
   • Short Term Recommendations
     Improve and expand oral health screening and education through:
     • Collaboration between oral health provider partners and aging serv-ices and co-locating programs in senior centers, nutrition programs, senior housing, adult day care programs and other senior or health oriented programs such as PHCA; and
     • Promoting existing models and proposed models by the California Dental Association and the University of the Pacific, School of Den-tistry of education, outreach, and screening for older adults.
   • Long Term Recommendations
     Improve oral health care for older Californians, especially those who are homebound, in care facilities, disabled, or have special needs by:
     • Identifying and providing incentives for dentists to serve homebound and nursing home patients;
     • Removing disincentives to increase the number of dentists partici-pating in the state Denti-Cal program;
     • Expanding and creating more educational programs in California dental schools for Alternative Practicing Hygienists.
       
       
3. Preventive Health Care for the Aging
   
   
   • Short Term Recommendations
     The PHCA should expand the number of older persons being served in ex-isting programs by finding ways to partner with the California University system, as well as other colleges and universities to utilize PHCA programs for training nurses, doctors, social workers, occupational, recreational, and physical therapists. This would add to the manpower of the program, would possibly be a source of revenue, and would provide valuable training for health care professionals in public and preventive health care.
     
     The PHCA Program has demonstrated that it closes the gaps in health care for seniors who have a provider but do not receive thorough health screenings or preventive education. The 65% who receive new diagnoses are a testament to PHCA's great value and need. Because this program has shown that it improves our seniors' health and quality of life and saves health care dollars, it is now time to find ways to expand this program to all counties in California.
   • Long Term Recommendations
     Incrementally expand the PHCA program statewide by introducing legisla-tion to:
     • Mandate the program statewide;
     • Establish an interdepartmental study group led by the Department of Health Services partnering with the California Conference of Local Health Officers, Chronic Disease Committee, Area Agencies on Aging, California Department of Aging and other state and county entities to study funding sources and incentives for county and area agency on aging participation in PHCA; and
     • Develop a long range plan with timelines for implementation as funding sources are identified or state funding becomes available.

D. Senior Related Planning/System Design Issues

Vision: California's older adult delivery system, which includes home and community based services as well as residential care, needs significant renovation to improve its structure and processes, and to achieve excellent consumer outcomes. To accomplish this goal, CCoA envisions a system that incorporates these essential building blocks of integrated service delivery: A far reaching delivery system that supports consumers in all areas of the state; broad and flexible benefits responsive to individual needs; care coordination at the consumer and administrative level; unified program administration; integrated financing mechanisms; and overarching quality systems.

1. Consumer-Focused System Design
   Rationale: Consumers have clearly expressed a desire to navigate and partici-pate in the older adult delivery system, with the support of professional expertise if needed. When consumers cannot contribute directly due to physical and/or cognitive limitations, this consideration should be extended to designated caregivers acting as proxies.
   
   
   • State and local agencies should revise current programmatic structures to maximize consumer participation and consumer-directed care to the extent possible.
     
     
     • Short Term Recommendations
       • Establish collaborative linkages among departments and programs to ensure that consumers connect with any service they need, regardless of what entity they encounter first.
       • Ensure culturally competent service delivery through training and education of agency staff and identify required service adaptations to serve the diverse needs of older adults in their communities.
       • Expand and improve user-friendliness of the CalCareNet web-based information and assistance (I&A) portal.
     • Long Term Recommendations
       • Promote ongoing consumer evaluation of older adult service delivery systems.
       • Support web-based Information and Assistance (I&A) development in all 33 Planning and Service Areas (PSAs), with links to programs administered outside of the California Health and Human Services Agency (CHHSA), such as employment information, transportation, housing, and volunteer clearinghouses in each community.
         
2. Integrated Information Systems
   Rationale: Collaborative efforts require an integrated information system to gather, coordinate and share the appropriate level of information among all stakeholders. Problems, such as incompatible systems, lack of a standardized data core across programs, and inaccurate data collection, have been cited as barriers. Essential elements include a consumer-friendly, web-accessible informa-tion and assistance portal; uniform assessment and monitoring tools among providers; and data storage/tracking in the same or compatible format used for reporting and program evaluation.
   
   
   • Develop a statewide, integrated consumer tracking system that follows the consumer regardless of county/PSA residency.
     
     
     • Short Term Recommendations
       • Appoint a lead agency to accept leadership for the successful imple-mentation of an integrated information system, building upon the existing work of the Long Term Care Council.
       • The Long Term Care Council should create a report showing the in-formation collection and reporting requirements for each state program serving older adults and recommend an appropriate uni-form substitute.
     • Long Term Recommendations
       • Standardize data collection using a minimum dataset on older adults and disabled consumers of all HHSA programs and coordinate efforts with counties/PSAs to ensure accurate data collection.
       • Renovate reporting requirements so data collection at the local level can serve both local and State needs.
       • Require ongoing research and evaluation using consumer/program data for all 58 counties.
         
         
3. Collaboration Between the State, Counties, and Local Providers.
   Rationale: Multiple funding streams, duplicative regulatory requirements, and complex bureaucratic structures grossly inhibit integrated systems development. All levels of government should work collaboratively to simplify administrative processes both within and among themselves, and develop a virtually seamless system of care to benefit consumers, family caregivers, and providers. Each entity must be willing to compromise and relinquish some turf to achieve the higher ideal of creating a consumer-friendly service delivery system.
   
   
   • Institute the necessary Executive Orders as well as legislative and regulatory directives to ensure compliance and bring about a coordinated and integrated service delivery system for older adults in California.
     
     
     • Short Term Recommendations
       • Charge and convey the proper authority to CDA as the lead state agency to serve as the focal point for coordination and integration activities at all levels in California.
       • Require formal collaboration across programmatic areas internal and external to HHSA in service delivery contracts and grants for older adults in California.
       • Task other consumer-related agencies, such as the Business, Trans-portation & Housing Agency, State Board of Education, State Controller’s Office, and the Department of Consumer Affairs, to de-velop an estimate of how the aging of the state will affect their service delivery, and propose actions for addressing the impact.
     • Long Term Recommendations
       • Draft legislation to create compatible operational requirements for the multiplicity of programs serving older adults in order to conduct evaluations across HHSA programs.
       • Develop a consolidated coordination/integration process for the statewide plans and the area plans.
         
         
4. Require Coordination and Integration of Aging and Disability Programs and Services.
   Rationale: The aging and disability networks both have constituencies that are consumers in the LTC service delivery system. Both constituencies would benefit from the elimination of institutional barriers to collaborative, community-based service delivery, such as disconnected information systems, rigid eligibility requirements, and individualized funding streams.
   
   
   • Enhance Collaboration Between Aging and Disability Networks.
     
     
     • Short Term Recommendations
       • Require that the Long Term Care Council, charged with the Olmstead planning process, establish a working-group composed of representatives from the aging and disability communities for the purposes of identifying and implementing the common recommendations among the Olmstead Planning process and the SB 910 Long Range Strategic Plan on Aging.
       • Charge the California Commission on Aging, working in tandem with a representative advocacy organization for the disability community, with the task of working collectively to advocate for the elimination of barriers to home community-based service access and delivery.
     • Long Term Recommendations
       Charge the workgroup with developing a series of action strategies to ensure compliance with principles espoused in the Olmstead Plan and the SB 910 Long Range Strategic Plan on Aging and promote the coordination/ integration of com-mon service areas.
       
       
5. Promote Community Level Action for Healthy Aging.
   Rationale: Fewer than 5% of older adults live in institutional settings. The other 95% live in some type of community arrangement and function on a broad continuum from exceptionally healthy in all aspects to subsisting in outright despair. A more holistic per-spective of older adults focuses on each persons’ strengths to compensate for any deficits he/she may experience. This view allows for each person to be a giver of service as well as a recipient, depending upon the individual’s capabilities and needs.
   
   
   • Promote aging as a continuum and a positive aspect of the life pro-cess.
     
     
     • Short Term Recommendations
       • Conduct a statewide survey of state agencies to identify programs and initiatives that promote healthy aging and good physical health as Californians age.
       • Identify "best practice" programs in community level action for replication throughout the state.
     • Long Term Recommendations
       • Develop K through 12 and college level gerontological curricula in accordance with SB 953 objectives.
       • Review licensing/continuing education criteria for human service and other service professions to ensure gerontological content.
       • Work with the entertainment sector to eliminate stereotyping and promote a positive view of aging.