OFFICE OF THE STATE LONG-TERM CARE OMBUDSMAN PROGRAM Virginia Moore-Bell, Director

Program Description The Older Americans Act (OAA) establishes the Long-Term Care Ombudsman Program as a person-centered consumer protection service. The word ombudsman (om-budz-man) is of Swedish origin and means one who speaks on behalf of another. Ombudsmen resolve problems and advocate for the rights of individuals in order to maximize the independence, well-being, and health of individuals residing in: *Nursing facilities *Assisted living *Board and care *Other similar adult care facilities

Authority to Operate the Ombudsman Program Federal Law Section 712 of the Older Americans Act of 1965, as amended, requires each State Agency on Aging, in its State Plan, to provide assurances that it will carry out its statutory responsibilities under this Section. Although the statue permits certain contractor organizations and other agencies to perform specific aspects of the long-term care ombudsman program, the Office of the State Long-Term Care Ombudsman Program remains responsible for the performance of activities under Section 712 of the Act.

Authority to Operate the Ombudsman Program (con’t) State Law Alabama Act 85-657, the Long-Term Residential Health Care Recipient Ombudsman Act of 1985, authorizes the State Long-Term Care Ombudsman and the Alabama Department of Senior Services to investigate complaints concerning health care and other providers and institutions that threatens patients or residents of health care, domiciliary, and residential facilities. The Act further requires the appointment, training, and certification of at least one local ombudsman representative by each Area Agency on Aging. *The state law has been revised for consistency with the Final Rule, to delete and/or revise obsolete language, and will be presented to the legislature for approval.

Historical Overview LTC Ombudsman Program Origins: *1970s – Ombudsman Program was created as part of President Nixon’s initiative to improve conditions and respond to widespread reports of resident abuse in the nation’s nursing facilities. *1980s – Ombudsman Program expanded to board and care and similar adult care facilities (widely interpreted to include assisted living). *1992 – Ombudsman Program became part of Title VII of OAA. *2000 – Assisted Living expressly added to the definition of “long-term care facility” in OAA. *2016 – Older Americans Act reauthorized and Final Regulations effective. Since inception: *Envisioned as an autonomous entity able to represent consumer interests.

Historical Overview (con’t) State unit on aging is required to establish the Office of the State Long-term Care Ombudsman Program to carry out the following activities: Promote the development of citizen organizations and train volunteers; Identify significant problems by establishing a statewide reporting system for complaints, and work to investigate and resolve these problems. Monitor the development and implementation of federal, state, and local long-term care laws and policies; Gain access to long-term care facilities and to resident records;

Historical Overview (con’t) Protect the confidentiality of resident records, complainants’ identities, and ombudsman files; Provide immunity to ombudsmen for the good faith performance of their duties; and Ensure prohibitions against willful interference with the official duties of an ombudsman and/or retaliation against an ombudsman, resident, or other individual for assisting the Program in the performance of its duties.

Program Structure and Function Organization Location and Criteria for Designating State Ombudsman The Alabama Department of Senior Services established and operates directly the Office of the State Long-Term Care Ombudsman Program. The State Ombudsman shall be appointed by the Alabama Department of Senior Services and shall report to the Commissioner. Ala. Code 22-5A-2 (1975). In appointing a State Ombudsman, the Alabama Department of Senior Services shall determine that no conflict of interest exists that might preclude the ability or willingness of the State Ombudsman to vigorously and impartially investigate and resolve complaints and to promote quality care. Ala. Code 22-5A-3 (1975). The State Ombudsman shall certify to the Alabama Department of Senior Services that he/she has no association with any healthcare facility or provider for reward or profits. Ala. Code 22-5A-3.

Office of the State Long-Term Care Ombudsman Program Staffing At a minimum, the Office of the State Long-Term Care Ombudsman Program shall have a full-time Ombudsman whose credentials are approved and who is officially appointed or designated as the State Long-Term Care Ombudsman. Alabama’s thirteen Area Agencies on Aging administer the program on the local level through the local ombudsman representatives. All local ombudsmen certified pursuant to Alabama Act 85-657 shall be considered as a representative of the Office unless they have been decertified in accordance with Section 4(6) of Act 85-657. The State Ombudsman, staff of the program, and all persons in the position significantly to control or influence the program shall be free of all financial and other affiliations and ties to long-term care facilities and associations that might compromise the program’s efforts to vigorously and impartially investigate and resolve complaints.

Ombudsman Roles Companion - the friendly visiting function is often an important and necessary step in getting to know residents and establishing trust. Advocate - the ombudsman advocates for residents of long-term care facilities, or their friends or families, who work to protect the health, safety, welfare, and rights of residents. Educator - the ombudsman works to educate residents, families, friends or potential consumers about their rights and responsibilities in a facility. Mediator - the ombudsman may serve as a mediator between resident and staff, resident and community or local government agency, resident and other residents or resident and family. Broker - the broker’s role is essentially that of a referral agent. When an ombudsman investigates a problem and finds that another agency could better resolve it or is essential to the process, a referral should be made.

Ombudsman Responsibilities Ombudsman responsibilities outlined in Title VII of the Older American Act include: Identify, investigate and resolve complaints made by or on behalf of residents; Provide information to residents about long-term care services; Represent the interests of residents before governmental agencies and seek administrative, legal and other remedies to protect residents; Analyze, comment on and recommend changes in laws and regulations pertaining to the health, safety, welfare and rights of residents;

Ombudsman Responsibilities (con’t) Educate and inform consumers and the general public regarding issues and concerns related to long-term care and facilitate public comment on laws, regulations, policies and actions; Educate and inform residents, staff, and the general public regarding Gateway to Community Living and conduct baseline and follow-up Quality of Life (QoL) surveys. Promote the development of citizen organizations to participate in the program; Provide technical support for the development of resident and family councils to protect the well-being and rights of residents; and Advocate for changes to improve residents’ quality of life and care.

The Ombudsman Program is available to … Residents of any long-term care facility; Friends and relatives of persons who live in long-term care facilities; Long-term care facility staff members and administrators with resident-related concerns; Individuals and families who are considering nursing home placement as a long-term care option; The community-at-large; and Other interested groups concerned about the welfare of residents of long-term care facilities.

Contact Information To contact the Office of the State Long-Term Care Ombudsman Program: Virginia Moore-Bell, Director 201 Monroe Street RSA Tower, Suite 350 P.O. Box 301851 Montgomery, Alabama 36130-1851 Office: (334) 242-5753; 1-877-425-2243 Fax: (334) 353-1596 E-mail: virginia.bell@adss.alabama.gov Website: www.AlabamaAgeline.gov To contact the Local Ombudsman Representative for your region - 1-800-Ageline (243-5463)