USING SYSTEMS ADVOCACY TO IMPROVE THE OMBUDSMAN PROGRAM Karen Jones, NALLTCO Co-Chair Cindy Englert, NALLTCO Co-Chair Louise Ryan, Ombudsman Specialist, ACL/AoA

Who is Joining Us Today? Local Ombudsman Representative (volunteer or paid staff) Employee of the State Ombudsman State Ombudsman Other?

Older Americans Act – Systems Advocacy What is systems advocacy? Role of State and Local Ombudsman programs State Ombudsman - recommend changes to laws, regulations, and policies as the Office determines to be appropriate; and Provide leadership to statewide systems advocacy efforts of the Office … including coordination of systems advocacy efforts carried out by representatives of the Office. Local - duties of the representatives of the Office are to “review, and if necessary, comment on … government policies and actions Louise: A State’s policies and procedures must assure that the Office of the State Long-Term Care Ombudsman (the Office) has sufficient authority to carry out its responsibility to, among other things, recommend changes to laws, regulations, and policies as the Office determines to be appropriate. (Older Americans Act Section 712(h)(2); 45 CFR 1324.11(e)(5); emphasis added) - Recommending changes in laws, regulations, policies, and actions as the Office determines to be appropriate is specifically a function and responsibility of the Ombudsman. (OAA Section 712(a)(3)(G); 45 CFR 1324.13(a)(7)(ii)) - The Ombudsman must fulfill other functions related to systems advocacy, including “leadership to statewide systems advocacy efforts of the Office … including coordination of systems advocacy efforts carried out by representatives of the Office.” (45 CFR 1324.13(a)(7)(iv)). We note that the Rule does not prohibit the Ombudsman from delegating some systems advocacy activities to representatives of the Office. In fact, among the duties of the representatives of the Office are to “review, and if necessary, comment on … government policies and actions.” (OAA Section 712(a)(5)(B)(v)(I); 45 CFR 1324.19(a)(5)(i); emphasis added). This means that the Ombudsman (consistent with Ombudsman program policy and procedures) can specify under what circumstances it may be necessary for a representative of the Office to comment on government policies and actions.

Advocacy – external and internal Advocacy strategies… May be internal to your agency May be administrative advocacy May be legislative advocacy Advocating for program resources may involve all of the above Louise

Unified Statewide Program The Ombudsman, as head of the Office, shall have responsibility for the leadership and management of the Office in coordination with the State agency, and, where applicable, any other agency carrying out the Ombudsman program… This is a group effort! 45 CFR 1324.11(2)(e )(5) Policies and procedures related to systems advocacy must assure that the Office is required and has sufficient authority to carry out its responsibility to analyze, comment on, and monitor the development and implementation of Federal, State, and local laws, regulations, and other government policies and actions that pertain to long-term care facilities and services and to the health, safety, welfare, and rights of residents, and to recommend any changes in such laws, regulations, and policies as the Office determines to be appropriate.

Self-care is not selfish. You cannot serve from an empty vessel. Eleanor Brown

How could your residents thrive if you had more resources for your Ombudsman program? How could your staff and volunteers thrive if you had more resources for your Ombudsman program?

Building Your Dream Ombudsman Program Work in small groups 2 – 3 people 10 minutes to complete your dream Use federal Ombudsman requirements (see handout)

Building Your Dream Money is not an issue – you can have as much as you need. If you spend it all, you get more. Local, state and federal politicians are helpful and willing to write AND pass any laws you need You have to comply with Federal Ombudsman requirements

Share Your Dream How many staff would you add? What would your office look like? What technology would you and your Ombudsman use?

Share Your Dream How many facility visits would you make? How would you educate residents and the community about long term care issues? How would you structure your program management? What else?

How Do You Achieve Your Dream? The California Experience 2007/08 – All state funds cut 2013 Federal sequestration – budget cuts Tons of staff positions and office hours cut Volunteer numbers down (no one to support them) Facility visits and complaints down and all other services too

Ombudsman Advocacy to the Rescue! We significantly increased the effectiveness of the State Local Ombudsman Association We passed legislation to be sure the State Ombudsman was allowed to take positions on funding or laws without permission from the Governor’s office We used legislative advocacy to restore state funding

Turning Your Dreams to Reality Build your state Ombudsman association, if applicable and work with your state Ombudsman Protection Strength in numbers Staffing to achieve goals Get to know your state legislative process Get to know your legislators

Turning Your Dreams to Reality Learn where you can find bill information Under the direction of the state Ombudsman comment on bills – let legislators know how bills will affect facility residents Get to know current laws

Turning Your Dreams to Reality Talk with legislators – they have staff who will help you Be a resource to legislators They need your help too

Create Your Message Be sure you have a message to share Check the dark side View your message from all sides Most IMPORTANT RULE!!!!! NEVER EVER GIVE A POLITICIAN A PROBLEM WITHOUT ALSO GIVING THEM A SOLUTION. YOU WILL NOT LIKE THEIR SOLUTION.

Get Help NALLTCO State Ombudsman CLTCOA Consumer Voice Aging Associations AARP Advocacy Associations/Agencies

When You Get Back to Your Office… My first step is______________ I am going to do these three things to make it happen_________ ________ _________ I am going to reach out for help if I need it

Questions?