1. Enhancing Collaborations Between Long-Term Care Ombudsmen and Legal Services Programs

2. LTC Ombudsman Program Empowers residents Addresses complaints
Advocates for improvements in the long-term care system

3. 53 State Ombudsman Programs
State Units on Aging & Disability
Other State Agencies
Legal Services Programs
Other nonprofit organizations
575 Local Ombudsman Entities
Area Agencies on Aging
1200+ Local Program Staff
8200+ Certified Volunteers

4. 2013 Ombudsman Activities 190,000+ complaints
24,000 resident and family council meetings
5400 trainings for facility staff
129,000 consultations to facilities
335,000 consultations to individuals
…plus…
Individual and community education
Public comments on laws and regulations
Legislative testimony
Working groups, committees

5. State and Local Coordination with others responsible for the health, safety, well-being or rights of residents:
AAA Programs
Aging & Disability Resource Centers
Adult Protective Services
Protection & Advocacy Programs
Licensing & Certification
Medicaid Fraud Control Units
Law Enforcement
Courts
Victims Assistance Programs
Legal Services Developers
Legal Assistance Programs

6. Legal Services Providers
Title III-B, Section 321 of the Older Americans Act
Provides legal assistance to older individuals with economic or social needs
Approximately 1000 OAA-funded legal services providers nationwide

7. Examples of Legal Services Provided by Title III-B Service Providers:
Accessing public benefits
Draft advance directive, designate surrogate decision-makers
Guardianship issues, including representation for older persons facing guardianship actions
Accessing housing options
Facing foreclosure or eviction proceedings
Protecting the rights of individuals transferring from long-term care facilities to HCBS
Assistance for victims of elder abuse and financial exploitation

8. Legal Services Corporation – Legal Aid
Funded by Congress to provide access to legal assistance to people living in households with annual income at or below 125% of the federal poverty guidelines
Issues include:
Family law
Housing and Foreclosure
Consumer issues
Employment and income maintenance
Helping Military families
Responding to disasters

9. LTCO Collaboration w/ Title III-B Legal Services Providers
Collaborative Efforts
Case referral*
Provision of legal services to LTCOPs through contract
Development of consumer information
Comments on proposed regulations
Legal advice, counsel, opinions to LTCOPs
Technical assistance between the programs
Training
Policy analysis
Issues for case referral include: Involuntary discharge; guardianship; other surrogate decision-making issues; Medicaid and other program eligibility issues; access to medically necessary services or supports; subpoenas; …

10. Barriers/Challenges to Collaboration
Confidentiality restrictions
Limited resources
Program priorities do not align
Time constraints
Lack of MOUs cause challenges in coordination
Lack of LTCO access to a III-B service provider contracting with their agency

11. Recommendations
Create opportunities for cross-training at the state and national levels through conference, webinars, conference calls to increase exposure and recognition of programs
Develop MOU to detail roles and responsibilities of entities when working on cases, sharing of information, establishing referral processes, exploring avenues for cross-training
Promote regular meetings to discuss cases and issues, and how they can more effectively collaborate
Seek out opportunities to work together on systemic issues through joint participation on legislative coalitions, training conferences, Olmstead Councils
Coordinate legislative agendas or priorities to identify common areas of interest or concern

12. Examples of Issue Support
Clients with Diminished Capacity
Guardianship
Powers of Attorney
Transfer/Discharge
Access to Benefits – Medicaid, SSI
Therapy (Jimmo)
Getting Durable Medical Equipment – power wheelchairs
Transitions to HCBS
Concerns about Abuse, Neglect, Exploitation

13. Examples of Ombudsman Program Support
Technical Assistance
Legal Advice
Subpoenas
Legal Representation
Public Policy Systemic Advocacy – Legislation, Regulations, Working Groups/Task Forces
Training

14. The National Long-Term Care Ombudsman Resource Center (NORC)