State Long-Term Care Ombudsman program

In order to be eligible to receive an allotment under section 3058b of this title from funds appropriated under section 3058a of this title and made available to carry out this subpart, a State agency shall, in accordance with this section— The Office shall be headed by an individual, to be known as the State Long-Term Care Ombudsman, who shall be selected from among individuals with expertise and experience in the fields of long-term care and advocacy. The Ombudsman shall be responsible for the management, including the fiscal management, of the Office. The Ombudsman shall serve on a full-time basis, and shall, personally or through representatives of the Office— identify, investigate, and resolve complaints that— relate to action, inaction, or decisions, that may adversely affect the health, safety, welfare, or rights of the residents (including the welfare and rights of the residents with respect to the appointment and activities of guardians and representative payees), of— Except as provided in subparagraph (B), the State agency may establish and operate the Office, and carry out the program, directly, or by contract or other arrangement with any public agency or nonprofit private organization. The State agency may not enter into the contract or other arrangement described in subparagraph (A) with— In carrying out the duties of the Office, the Ombudsman may designate an entity as a local Ombudsman entity, and may designate an employee or volunteer to represent the entity. An individual so designated shall, in accordance with the policies and procedures established by the Office and the State agency— Entities eligible to be designated as local Ombudsman entities, and individuals eligible to be designated as representatives of such entities, shall— The State agency shall establish, in accordance with the Office, policies and procedures for monitoring local Ombudsman entities designated to carry out the duties of the Office. In a case in which the entities are grantees, or the representatives are employees, of area agencies on aging, the State agency shall develop the policies in consultation with the area agencies on aging. The policies shall provide for participation and comment by the agencies and for resolution of concerns with respect to case activity. The State agency shall develop the policies and procedures in accordance with all provisions of this part regarding confidentiality and conflict of interest. Nothing in this paragraph shall be construed as prohibiting the program from providing and financially supporting recognition for an individual designated under subparagraph (A) as a volunteer to represent the Ombudsman program, or from reimbursing or otherwise providing financial support to such an individual for any costs, such as transportation costs, incurred by the individual in serving as such volunteer. The State shall ensure that representatives of the Office shall have— appropriate access to review all files, records, and other information concerning a resident, if— access to the files, records, and information as is necessary to investigate a complaint if— The State agency shall establish procedures to ensure the access described in paragraph (1). For purposes of section 264(c) of the Health Insurance Portability and Accountability Act of 1996 (including regulations issued under that section) (42 U.S.C. 1320d–2 note), the Ombudsman and a representative of the Office shall be considered a “health oversight agency,” so that release of residents’ individually identifiable health information to the Ombudsman or representative is not precluded in cases in which the requirements of clause (i) or (ii) of paragraph (1)(B), or the requirements of paragraph (1)(D), are otherwise met. The State agency shall establish a statewide uniform reporting system to— submit the data, on a regular basis, to— The State agency shall establish procedures for the disclosure by the Ombudsman or local Ombudsman entities of files, records, and other information maintained by the program, including records described in subsection (b)(1) or (c). The procedures described in paragraph (1) shall— prohibit the disclosure of the identity of any complainant or resident with respect to whom the Office maintains such files, records, or other information unless— In planning and operating the program, the State agency shall consider the views of area agencies on aging, older individuals, and providers of long-term care. The State agency shall— ensure that the Ombudsman— The State agency shall comply with subparagraph (B)(i) in a case in which the Office poses an organizational conflict of interest, including a situation in which the Office is placed in an organization that— The State agency may not operate the Office or carry out the program, directly, or by contract or other arrangement with any public agency or nonprofit private organization, in a case in which there is an organizational conflict of interest (within the meaning of subparagraph (A)) unless such conflict of interest has been— In a case in which a potential or actual organizational conflict of interest (within the meaning of subparagraph (A)) involving the Office is disclosed or reported to the Assistant Secretary by any person or entity, the Assistant Secretary shall require that the State agency, in accordance with the policies and procedures established by the State agency under subsection (a)(5)(D)(iii)— The State agency shall ensure that— adequate legal counsel is available, and is able, without conflict of interest, to— The State agency shall require the Office to— prepare an annual report— containing recommendations for— provide such information as the Office determines to be necessary to public and private agencies, legislators, and other persons, regarding— strengthen and update procedures for the training of the representatives of the Office, including unpaid volunteers, based on model standards established by the Director of the Office of Long-Term Care Ombudsman Programs, in consultation with representatives of citizen groups, long-term care providers, and the Office, that— specify the content of the training, including training relating to— prohibit any representative of the Office (other than the Ombudsman) from carrying out any activity described in subparagraphs (A) through (G) of subsection (a)(3) unless the representative— coordinate ombudsman services with the protection and advocacy systems for individuals with developmental disabilities and mental illnesses established under— The State shall ensure that no representative of the Office will be liable under State law for the good faith performance of official duties. The State shall—