NADDP Participant Guide Module 7: Policy & Compliance
| Module 7: Policy and Compliance in Aging & Adult Services: Federal, State, and Local Perspectives |
| Description: This section provides a foundational overview of the legal and regulatory frameworks that shape aging and adult services across government levels. Participants will explore how federal statutes and policies are implemented through state and local systems. |
Learning Objectives:
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| Reading and Activities: 2 to 5 hours
Coaching: 2 hours |
| Segment # 1 Federal Policy and Compliance Standards for Delivering Aging and Adult Services
Reading and Activities: up to 2 hours Coaching: 1 hour |
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| Learning Objective | The director will be oriented to federal policy, compliance regarding the delivery of Aging and Adult Services.
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| Content | Overview
In the United States, services for older adults and adults with disabilities are delivered through a decentralized network shaped by federal, state, and local governance. Aging and disability services are frequently co-located within agency structures because the populations they serve share overlapping needs, challenges, and support systems. Older adults and individuals with disabilities may benefit from long-term services and supports (LTSS), such as accessible housing, transportation, personal care, and case management. Co-location enables agencies to streamline service delivery, reduce duplication, and adopt person-centered approaches that reflect the reality that many individuals age with disabilities or acquire them later in life. For various reasons, such as societal narratives, including ageism, ableism, and disability discrimination, aging and disability services are often viewed as a private family matter and/or a personal health/medical issue rather than a public responsibility. This has contributed to a slow pace of political momentum and public investment. Population Overview: Older Adults - As individuals age, they may encounter unique challenges, such as new or changing chronic health conditions, mobility limitations, social isolation, reduced income, or cognitive changes. Aging services are designed to help maintain independence, support caregivers, prevent abuse or neglect, and bridge gaps in housing, transportation, nutrition, and healthcare. These services also recognize that the aging experience isn’t one-size-fits-all. Older adults represent a diverse population shaped by culture, race, gender identity, economic status, and trauma history. Responsive services help promote equity, prevent marginalization, and ensure that people can age with autonomy and respect. Robert N. Butler, MD, founded the National Institute on Aging in 1974. In a landmark research study at the NIH, he and his colleagues demonstrated that cognitive decline is not an inevitable part of aging, and they worked to reduce the stigma surrounding the aging process. “In America, childhood is romanticized, youth is idolized, middle age does the work, wields the power, and pays the bills, and old age, its days empty of purpose, gets little or nothing of what it has already done. The old are in the way.”
People living with Disabilities - Historically, ableism and disability discrimination have been rooted in the medical model of disability, which conceptualizes disability as a defect or pathology within the individual. The model assumes that disability must be treated, corrected, or cured to restore functioning, and it reinforces the notion that people with disabilities are fundamentally different from those without. Such perspectives have shaped institutional policies, clinical practices, and public attitudes, often resulting in exclusionary systems that prioritize exclusion over inclusion. Review:
Federal Frameworks Supporting Aging and Disability Services Programs that provide services to older adults and individuals with disabilities are governed by a range of federal laws and regulations. While most are administered through the U.S. Department of Health and Human Services (HHS)—primarily via the Administration for Community Living (ACL), Centers for Medicare & Medicaid Services (CMS), and the Office for Civil Rights (OCR)—additional oversight and enforcement responsibilities fall under agencies such as the U.S. Department of Justice (DOJ) and the U.S. Equal Employment Opportunity Commission (EEOC) and others. Americans with Disabilities Act (ADA): signed into law in 1990, it is a landmark civil rights statute that prohibits discrimination against individuals with disabilities in nearly every aspect of public life. The ADA made it illegal to discriminate against individuals with disabilities in areas such as employment, education, transportation, public accommodations, telecommunications, and access to government services. The ADA applies to older adults because many experience changes in their abilities and needs, including physical and cognitive impairments that may qualify as disabilities under the ADA. It is important to note that age alone is not considered a disability. The ACL houses the Administration on Disabilities and the Office of Independent Living programs. The federal DOJ's Civil Rights Division and Disability Rights Section enforce the ADA. The Age Discrimination Act of 1974: The Civil Rights Act of 1964 laid the foundation for anti-discrimination protections in federally funded programs, targeting race, color, and national origin; however, it did not include age as a protected category. Congress passed the Age Discrimination Act of 1975, which prohibits age-based discrimination in any program or activity receiving federal financial assistance. Agencies must ensure that older adults have access to federally supported programs without unjustified age-based restrictions. The EEOC and DOJ collaborate to enforce anti-discrimination laws in the Age Discrimination Act. The Civil Rights Act of 1964: The law prohibits discrimination based on race, color, national origin, religion, and sex across multiple sectors—including education, employment, public accommodations, and federally funded programs. For aging and human services, Title VI of the Act ensures that individuals cannot be excluded from participation in, denied the benefits of, or subjected to discrimination under any program receiving federal financial assistance based on race, color, or national origin. The EEOC and DOJ collaborate to enforce the anti-discrimination provisions of the Civil Rights Act. The Civil Rights Act:
The Elder Justice Act (EJA) was enacted in 2010, as part of the Affordable Care Act, and it is the first comprehensive federal legislation to address the abuse, neglect, and exploitation of older adults and adults with disabilities. It authorized federal support for Adult Protective Services (APS). It established a framework for funding, but Congress did not allocate appropriations between 2010 and 2019. Fiscal year 2020 was the first wave of discretionary funding appropriated to the EJA and issued to States for the APS programs through the Coronavirus Response and Relief Supplemental Appropriations Act and subsequently the American Rescue Plan Act (ARPA). These appropriations were emergency-based and time-limited, not part of a permanent funding mechanism. APS programs have not received sustained or formula-based funding that was established under the EJA. The ACL is the federal home of the EJA, and there is a collaborative partnership with the DOJ for the Elder Justice Coordinating Council. The DOJ prosecutes elder abuse and financial exploitation, coordinates victim support, and develops public awareness and outreach.
Medicare and Medicaid: created by the Social Security Amendments of 1965, signed into law by President Lyndon B. Johnson on July 30, 1965. This landmark legislation added Titles XVIII (Medicare) and XIX (Medicaid) to the Social Security Act, establishing two foundational pillars of the national healthcare system. Medicare and Medicaid are overseen by the U.S. Department of Health and Human Services, in the Centers for Medicare and Medicaid Services (CMS).
The Older Americans Act (OAA) is the first federal initiative to provide comprehensive services for older adults. In 1965, older adults in the United States were facing widespread challenges that revealed deep gaps in public support, and these conditions helped catalyze the passage of the Older Americans Act (OAA). At the time, poverty among older adults was alarmingly high—nearly 1 in 3 lived below the poverty line. Many lacked access to adequate nutrition, housing, transportation, and healthcare. Social Security existed, but Medicare and Medicaid had just been signed into law that same year, and there were few coordinated community-based services to help older adults remain independent. Isolation, neglect, and institutionalization were common, especially for those without family support. The OAA:
The OAA is subject to reauthorization allocation every 5 years. OAA Services are federally funded through discretionary appropriations and administered through a network of state and local agencies for adults aged 60 and older. For fiscal year 2025, Congress approved approximately $1.1 billion in OAA formula grants, maintaining funding at FY2024 levels. Dr. Ethel Percy Andrus, the founder of AARP, played a pivotal role in the passage of the Older Americans Act (OAA) by mobilizing one of the first large-scale grassroots advocacy campaigns focused on aging policy. Review:
The Olmstead v. L.C. Decision: In 1999, the Supreme Court ruled that unjustified institutionalization of people with disabilities is a form of discrimination under Title II of the Americans with Disabilities Act (ADA). The case was based on two women who were kept in a psychiatric institution, in contrast with a medical health care professional’s statement that they could live in the community with support. The Olmstead decision involved one type of institution, a psychiatric hospital. However, in subsequent rulings, the courts clarified that Olmstead applied to all state and Medicaid-funded institutions, including nursing facilities. The Olmstead decision applied to individuals living in the community who were at risk of institutionalization. The DOJ civil rights division focuses on the legal enforcement of the Olmstead decision through the ADA. The HHS, Office for Civil Rights supports promoting community living and enforcing civil rights. According to the CDC, in 1999, at the time of the Olmstead decision, approximately 1.6 million people resided in nursing homes, and about 90% of the residents were aged 65 and older.
The Supreme Court’s ruling reinforced the responsibility of states to offer home- and community-based services (HCBS) through the Medicaid Waiver process as a viable option for individuals who want to remain in their homes. Services such as in-home care, adult day programs, case management, caregiver support, and accessible transportation aren't just helpful—they have become integral to a civil rights framework. The ruling also catalyzed the growth of Medicaid HCBS waivers and bolstered programs funded under the Older Americans Act (OAA). Review: Guardianship/Conservatorship and Public Administration: There is no federal department or program that oversees public administrator, guardian, and conservatorship programs. The States have jurisdiction over guardianship and conservatorship matters, as these areas fall under family and probate law, which are traditionally managed at the state level. However, the federal government does influence conservatorship and guardianship practices through constitutional protections (like due process), oversight of federal benefits (e.g., Social Security). Currently, a proposed federal law, the Guardianship Bill of Rights Act (S. 1148), was introduced in 2023. And, if passed, would:
While not a law, The Uniform Guardianship, Conservatorship, and Other Protective Arrangements Act (UGCOPAA) is a model law for states to use to support consistency with guardianship/conservatorship procedures. It was developed by the Uniform Law Commission (ULC), a membership of practicing legal professionals, staff, and professors appointed by state governments to research, draft, and promote the enactment of uniform state laws. The UGCOPAA was updated in 2020 to modernize and standardize state guardianship and conservatorship proceedings. Each state has the autonomy to decide whether to enact, modify, or retain its existing laws. Some of the highlights are:
Looking Ahead: There may be significant changes to the federal administrative structure of older adult and disability services in the near future. The Federal Fiscal Year 2026 Budget Request includes a proposal to transfer programs from the Department of Health and Human Services’ (HHS) Administration for Community Living (ACL) to a newly created Administration for Children, Families, and Communities (ACFC). The operational and oversight implications of this potential reorganization are still under review. Note: This training focuses on regulatory frameworks and compliance obligations; however, it is essential to acknowledge the variability in funding streams and allocation mechanisms that impact the delivery and scope of AAS programs across jurisdictions. Please refer to the Fiscal training for further details about funding. |
| Coaching Session | The coach will engage in a discussion with the Director about the importance of the Director’s role and responsibilities in developing an understanding of the network of federal policies.
Based on the responses to these questions, the coach should work with the Director to identify activities and/or opportunities to build knowledge, skills, and experience, and develop an action plan to review progress with the coach at the next coaching session. Coach ends the session by looking at the next module LOs and activities, and makes a plan with the Director on activities to complete before the next session. |
| Activities | Federal Knowledge Check:
Multiple choice answers, check all that apply:
Multiple Choice answers: only one answer.
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| Materials | Medicare and Medicaid Act (1965) | National Archives
Older Americans Act: Summary in Brief | Congress.gov | Library of Congress Americans with Disabilities Act of 1990, As Amended | ADA.gov The Elder Justice Act: Background and Issues for Congress Guardianship Conservatorship and Other Protective Arrangements Act - Uniform Law Commission |
| Prep for Next Segment | Discuss Federal laws, comparing and contrasting their roots and structures.
Review Learning Objectives |
| Segment # 2 – Alignment of California Departments and Programs with Federal Regulations and Policies for Aging and Adult Services
Reading and Activities: 3-5 hours Coaching: 2-3 hours |
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| Learning Objectives |
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| Content | The system of services for older adults is a multi-agency, community-based network designed to support aging with dignity, independence, and access to care. It weaves together federal, state, and local programs—each with distinct roles but often working in tandem.
The California Health & Human Services Agency (CalHHS) serves as the state’s central hub for health, social services, aging, public health, and behavioral health policy. Under its leadership are 12 core departments that work together to deliver coordinated, person-centered services to Californians across all stages of life. CalHHS also leads major initiatives like the Master Plan for Aging, the Master Plan for Developmental Services, and the CARE Act, coordinating across departments such as the:
The following sections provide an overview and highlight the central state departments with the aging and disability programs and services. This is not an exhaustive list; additional programs and departments not included may also be involved in these services. The Superior Court is California’s trial court system, with one court in each of the state’s 58 counties. These courts have general jurisdiction, meaning they handle nearly every type of legal matter unless it's assigned to another court. Specific to aging and disability services, the Superior Courts manage Probate cases, which include wills, estates, guardianships, and conservatorships. ---------------------------------------- State Overview: California Department of Aging (CDA) Administers services from the federal Older Americans Act (OAA), the Mello-Granlund Older Californians Act (OCA), and in conjunction with the California Department of Health Care Services (CDHCS) for Medi-Cal (Medicaid) services. OAA and OCA programs are designed to provide early interventions, supporting older adults before they may need a higher level of care through Medi-Cal. Both the OAA and OCA programs and services are provided through 33 local Area Agencies on Aging (AAAs). The services provided
Each AAA is responsible for a specific geographic Planning Service Area (PSA). Some AAAs are within the county service structure, for example, as part of a county's human or social services agencies. However, some are separate non-profit organizations. AAAs are intended to be the hub for aging and adult services, and have a “No Wrong Door” philosophy. The provision of Information & Referral (I&R) services by the AAAs is required as part of the OAA to guide older adults, people with disabilities, caregivers, family members, and the community in navigating services with personalized guidance to community-based supports. Some AAAs have expanded I&R functions through Aging and Disability Resource Connections (ADRCs) to streamline access to long-term services and supports (LTSS). The I&R and ARDC services can also make referrals to Medi-Cal-funded Home and Community-Based Services (HCBS). These programs offer person-centered care, independence, and dignity, while aligning with federal Medicaid regulations and the principles of the Olmstead decision, which affirms the right to community-based living. Services are designed to prevent unnecessary institutionalization, promote autonomy, and offer cost-effective alternatives to nursing home care. Some examples of California HCBS programs include:
Review:
------------------------------------------------------------------------------------------ The California Department of Social Services (CDSS) Sets policy, guides counties, and oversees service delivery through county social services offices for
Adult Protective Services (APS) – Program Overview APS is a state-supervised, county-managed program that is mandated to operate a 24/7 hotline to receive and respond to known or suspected reports of Elder and Dependent Adult abuse, neglect, and financial exploitation. The Elder and Dependent Adult Civil Protection Act, as well as additional sections for APS and Home Safe, are codified in the California Welfare and Institutions Code. Operational requirements are outlined in the Division 33 APS Manual of Policy and Procedures (MPP) provided by CDSS. APS best practices for consistency were developed by county APS committees and are housed on the CWDA website. County APS social workers make home visits, complete assessments for risk and safety, develop service plans, conduct investigations and determine findings, may collaborate with law enforcement, healthcare providers, and support systems, and provide referrals to services and supports. Per State regulations, APS is not intended to provide long-term service or interfere with lifestyle choices of the population. APS services are voluntary and are provided in the county where the individual resides. Elders and Dependent Adults referred to APS have the right to self-determination and can decline or cancel services at any time. There are no income or benefit eligibility requirements for APS.
EJA Focus Area CDSS Action California Code Reference APS Program Oversight Provides training, policy guidance, and technical support to counties WIC §§ 15750–15768; MPP Division 33 Mandated Reporting Enforces elder abuse reporting with standardized procedures and forms WIC §§ 15630–15661; SOC 341 and SOC 342 forms Cross Reporting Interagency Collaboration Participates in the CA Elder & Disability Justice Coordinating Council; Requires Multi-disciplinary teams WIC MPP Division 33 AB 135 Public Awareness & Training Statewide mandated reporter training, Older Americans Month, and World Elder Abuse Awareness Events, and promotes culturally responsive service models. CDSS APS policy memos & outreach initiative Data & Systems Improvement; National Adult Maltreatment Reporting System (NAMRS) Supports counties in data reporting SOC 242 reporting protocols APS Federal - Rule (Regulations) CDSS will update state regulations to match the federal rule. Issued in 2024, States have until 2028 to comply. While the EJA is the primary federal regulation with which APS is aligned, there are other federal regulations that APS supports.
Framework APS Alignment Older Americans Act (OAA) APS supports OAA goals by protecting older adults from abuse, neglect, and exploitation, primarily through coordination with Area Agencies on Aging (AAAs) and legal services under Title III-B. Older Californians Act (OCA) APS is a core component of California’s aging services network, advancing OCA priorities in the areas of elder justice, safety, and dignity. Medicaid/Medi-Cal APS often coordinates with Medi-Cal-funded services (e.g., IHSS, HCBS) to stabilize clients and prevent unnecessary institutionalization. APS referrals may trigger Medi-Cal eligibility or service adjustments. Americans with Disabilities Act (ADA) APS must ensure equal access to services, provide reasonable accommodations, and avoid discriminatory practices, especially for clients with cognitive, sensory, or mobility impairments. Olmstead v. L.C. APS helps uphold the Olmstead mandate by intervening early to prevent institutionalization and supporting clients in the least restrictive, community-based settings. Civil Rights Protections APS must comply with Title VI of the Civil Rights Act, Section 504 of the Rehabilitation Act, and ADA Title II—ensuring nondiscrimination, language access, and culturally competent services. -------------------------------------------------------------------------- In-Home Supportive Services (IHSS) – Program Overview Federal law requires all state Medicaid programs to cover nursing facility care under Title XIX of the Social Security Act as a mandatory benefit. With approval from the federal government for Medicaid state plans, states have the option to utilize Medicaid waivers, such as the Home and Community-Based Services (HCBS) waiver. These services support compliance with the ADA by preventing unnecessary institutionalization and the Olmstead decisions to provide services in the least restrictive setting. In California, the state’s Medicaid program is called Medi-Cal. The In-Home Supportive Services (IHSS) program is a Medi-Cal HCBS program and is part of the Medi-Cal State plan that supports eligible individuals to receive care in their own homes. IHSS is available to Medi-Cal eligible aged, blind, or disabled individuals who require in-home care to avoid institutionalization. IHSS is county-operated and state-supervised by the California Department of Social Services (CDSS) and the California Department of Health Care Services (DHCS). IHSS regulations are codified in the California Welfare and Institutions Code, and CDSS provides operational requirements in the Division 30 IHSS Manual of Policy and Procedures (MPP). County IHSS employees/social workers conduct home visits or virtual visits (in some cases) to the applicant or the person receiving IHSS services, referred to as the recipient. The visit includes the completion of a state-developed assessment for applicants and an annual reassessment for recipients to determine the levels of care needed and the time required per car activity, as well as a biopsychosocial history. Based on the assessments and state requirements, the social worker determines the number of hours of care a person is eligible to receive. The social worker authorizes the services by entering the information in the IHSS statewide Case Management Information and Payroll System (CMIPS II). After the social workers have completed the assessments and authorized the hours of care, the recipient can begin or continue receiving care from their chosen caregiver. The recipient can hire and fire their caregiver, and they also sign the caregiver's timesheets. The State issues payments directly to the caregivers.
Framework IHSS Alignment Medicaid (Title XIX) IHSS is a Medi-Cal benefit that delivers personal care and related services to help individuals avoid institutionalization. It’s part of California’s Home and Community-Based Services (HCBS) strategy. Older Americans Act (OAA) While not funded by OAA, IHSS complements OAA goals by supporting aging in place, reducing institutional reliance, and often coordinating with Area Agencies on Aging (AAAs). Older Californians Act (OCA) Advances OCA priorities by enabling older adults to remain safely at home with dignity, autonomy, and access to essential services. Americans with Disabilities Act (ADA) Upholds ADA principles by ensuring services are delivered in the most integrated setting, with reasonable accommodations and equal access. Olmstead v. L.C. Directly supports the Olmstead mandate by offering a least restrictive alternative to institutional care, promoting community integration. Elder Justice Act (EJA) Helps prevent neglect, abuse, and exploitation by stabilizing in-home care and reducing isolation for vulnerable older adults. Civil Rights Protections IHSS must comply with Title VI of the Civil Rights Act, Section 504 of the Rehabilitation Act, and ADA Title II, ensuring nondiscrimination, language access, and program accessibility. ------------------------------------------------------------------ The California Superior Courts: Superior courts have trial jurisdiction over all criminal and civil cases. Special departments of the courts handle family, probate, mental health, juvenile, small claims, and traffic cases. There is a Superior Court in each county in California. The Public Administrator, Public Guardian, Public Conservator (PA/PG/PC) – Program Overview The PAPGPC programs operate at the county level, not under the direct oversight of a state department. The roles are embedded within county governments, often under departments of health, behavioral health, or social services. Their legal authority stems from the California Probate Code and the Lanterman-Petris-Short (LPS) Act, which delegates conservatorship responsibilities to counties in collaboration with local courts. PAPGPC programs do not receive dedicated state funding. Their operations are sustained through county budgets, federal reimbursements, and limited grants. While a state department does not oversee PAPGPC programs, they are still guided by state law, court supervision, and a strong professional network. Counties remain accountable to their Boards of Supervisors and the judicial system, ensuring that services are delivered ethically, legally, and with respect for individual dignity. The PAPGPC programs can only act on behalf of an individual if appointed by the California Superior Court, which has determined that there is no other party willing or able to act as the administrator, guardian, or conservator. In some counties, the PAPGPC may conduct preliminary investigations to determine if a conservatorship is necessary without a formal court appointment. These reviews may be coordinated with Adult Protective Services (APS) or other county agencies, such as Behavioral Health. When the Superior Court appoints the public PA, PG, or PC, they are appointing the county designee or designees who hold the official titles as the County Public Administrator, Guardian, and Conservator. In some counties, the Director of Aging Adults Services may oversee some or all of the PA, PG, and PC programs, and may hold the title, or there may be a high-level manager or executive who holds the title. Each county has the autonomy to organize these functions independently. As a result, some counties operate a single, unified office that manages all three roles, while others distribute the responsibilities across multiple departments or agencies.
The PA, PG, and PC programs and case activities are held to a high legal and ethical standard. The official designated as the Public Administrator, Guardian, Conservator, and the Deputies take an oath of office and are sworn to protect, at all times and under all circumstances, the position of trust vested in their office. In addition, they must obtain certification and maintain continuing education to uphold certification from the California Association of Public Administrators, Public Guardians, and Public Conservators (CAPAPGPC). Public Administration/Administrator (PA) is a court-appointed role to manage the estates of individuals who die without a will, an executor, or when no other can act. Duties include searching for relatives, supporting, and coordinating the management/distribution of the estate. The role includes searching and securing assets, arranging burials, paying debts, and distributing inheritance. Terminology for Public Guardian and Public Conservator roles can vary across California counties. In some counties, the terms are used interchangeably to refer broadly to conservatorship responsibilities. The roles are detailed separately in this section to show the distinctions. The Public Guardian (PG) is court-appointed as the substitute decision maker in probate conservatorships for adults who cannot care for themselves or manage finances due to conditions like dementia (Probate Code §1800 et seq.). And who may be victims of abuse, including financial exploitation, such as scams by known and unknown persons, including those who may be acting in a position of power, such as a trustee or a power of attorney. The Public Conservator (PC) is court-appointed as the substitute decision-maker for LPS conservatorships for individuals with serious mental illness who are gravely disabled and require involuntary psychiatric treatment (WIC §5350 et seq.). The Superior Court (which may have a separate Mental Health Court or LPS calendar) may appoint the Public Conservator in an LPS conservatorship. While PAPGPC programs do not have formal oversight from federal or state departments, they do align with federal and state requirements:
Framework PA/PG/PC Alignment Older Americans Act (OAA) Supports elder protection and fiduciary intervention when no family is available; often collaborates with APS and AAAs Older Californians Act (OCA) Advances in safety, dignity, and autonomy for older adults through court oversight and fiduciary safeguards Americans with Disabilities Act (ADA) Requires accommodations, accessible proceedings, and exploration of less restrictive alternatives to conservatorship Olmstead v. L.C. Reinforces the right to live in the least restrictive setting; conservatorship must not result in unnecessary institutionalization Elder Justice Act (EJA) Aligns with EJA goals by intervening in cases of elder abuse, financial exploitation, and neglect Medi-Cal Coordinates eligibility, long-term care access, and HCBS for conservatees ensures continuity of care Civil Rights Protections Upholds due process, equal access, and nondiscrimination under the ADA, California Constitution, and federal law Civil Rights in Practice
Review:
---------------------------------------------------------------------------------- The CDSS Housing and Homelessness Division – California’s housing landscape is a complex weave of state and federal initiatives, each with a unique role in promoting housing stability. The federal Department of Housing and Urban Development (HUD) maintains regional and field offices across the country, including in California. These offices are part of HUD’s federal structure and serve as local hubs for implementing and overseeing housing programs. HUD and California’s Department of Housing and Community Development (HCD) provide funding and oversight for large-scale housing programs, such as Section 8, emergency housing grants, and capital development. While multiple programs support housing stability across California, two of the state's housing and homelessness programs, Home Safe and the Housing and Disability Advocacy Program (HDAP), highlighted below, are designed to fill gaps in services from federal programs. These programs do not receive or provide HUD funds and are overseen by the CDSS Housing and Homelessness Division, and are county-administered These programs intentionally align with HUD’s eligibility definitions and housing-first principles. Their focus is on individuals experiencing or at risk of homelessness due to disability, aging, or crisis. Counties use HDAP to offer wraparound services, like disability advocacy and housing navigation, while Home Safe prevents homelessness through financial assistance and eviction interventions for Adult Protective Services (APS) clients. Even though these are state-funded and initiated programs, both operate within a broader legal environment shaped by several federal and state legal acts. California law requires that all state-funded homelessness programs follow the Housing First model—an approach that also reflects federal priority. HomeSafe and the Housing and Disability Advocacy (HDAP) Program Overview The Home Safe Program is a California initiative that helps prevent homelessness among elders and dependent adults who are involved with or eligible for Adult Protective Services (APS). Launched in 2018, it provides flexible, housing-related support—like rent assistance, eviction prevention, and deep cleaning—to stabilize living situations for individuals at risk due to abuse, neglect, or exploitation. Home Safe operates across all 58 counties and 23 tribal communities, tailoring services to local needs while prioritizing safety, dignity, and housing stability. The Housing and Disability Advocacy Program (HDAP): provides services and financial help for people who are experiencing homelessness or at risk of homelessness and who are likely eligible for disability benefits. Each county has staff, case managers, and/or other partners that connect homeless individuals to housing and help them with applications and appeals for disability benefits, such as:
HDAP aims to stabilize housing while helping participants secure long-term income, with services tailored by counties and tribal agencies across the state. Home Safe & HDAP Alignment with Federal Regulations Frameworks Framework Home Safe Alignment HDAP Alignment Older Americans Act (OAA) Supports elder safety, housing stability, and APS coordination—especially for those at risk of abuse or neglect Addresses homelessness and disability among older adults, often intersecting with OAA Title III services Older Californians Act (OCA) Directly supports OCA goals by preventing homelessness among APS-involved older adults Advances OCA priorities through housing access and disability advocacy for vulnerable Californians Medi-Cal Coordinates with APS and Medi-Cal HCBS to prevent institutionalization Helps clients apply for SSI/SSDI, which can trigger Medi-Cal eligibility; supports HCBS goals Americans with Disabilities Act (ADA) Promotes housing access and reasonable accommodations for older adults with disabilities Requires accessible services and supports disability rights in housing and benefits navigation Olmstead v. L.C. Prevents unnecessary institutionalization by stabilizing housing for at-risk adults Enables people with disabilities to remain in the community with housing and wraparound supports Elder Justice Act (EJA) Addresses financial exploitation, neglect, and abuse through APS collaboration Supports legal advocacy and housing stability for disabled adults vulnerable to abuse or neglect U.S. Department of Housing & Urban Development (HUD) Aligns with HUD’s Housing First model and uses HUD definitions of homelessness (WIC § 15770) Uses HUD’s chronic homelessness criteria; supports rapid rehousing and permanent housing navigation ------------------------------------------------------------------------------------- The California Health & Human Services Agency (CalHHS): The CalHHS oversees several departments and initiatives that at the county level are grouped into various departments. The DDS and DOR are two departments that have overlapping populations, protections, and needs for supportive services with APS and IHSS. While they may not be a formal part of a county's Aging and Adult Services department or the director's role, it is critical to understand how they may interact with various programs. Additionally, the CalHHS oversees two initiatives, the Master Plan for Aging and the Master Plan for Developmental Services. Department of Developmental Services (DDS):Is the state agency that is responsible for coordinating services and supports for individuals with intellectual and developmental disabilities, and oversees a network of 21 regional centers. Its mission is to ensure that Californians with disabilities can live inclusive, self-directed lives in their communities. DDS administers the Lanterman Developmental Disabilities Services Act, Welfare & Institutions Code §§ 4500–4905, which guarantees lifelong, person-centered services for individuals with developmental disabilities. And established the right to services through Regional Centers and emphasizes person-centered planning and community inclusion. Department of Rehabilitation (DOR): Is the state’s lead agency for vocational rehabilitation and independent living services for people with disabilities. Its mission is to promote employment, equality, and community integration through tailored supports and advocacy. The Master Plan for Developmental Services (MPDS) Released in March 2025, the MPDS, led by the CalHHS, was created in partnership with the Department of Developmental Services (DDS), the Department of Rehabilitation (DOR), and stakeholder committees. It is a strategic roadmap for modernizing and strengthening support for individuals with developmental disabilities. It was developed through a community-driven process to respond to changing demographics, historic funding investments, and calls for equity and accountability. It builds on the promise of the Lanterman Act, ensuring lifelong, person-centered services. California serves over 400,000 individuals through its developmental services system, many of whom face barriers in housing, employment, and access to care. The MPDS explicitly seeks to bridge systems across CalHHS, encompassing education, housing, transportation, and healthcare. While the MPDS doesn’t directly implement OAA or EJA, it complements them by improving service navigation and safety for individuals with developmental disabilities, many of whom are also older adults or dependent adults. The California Master Plan for Aging (MPA) The MPA is a strategic plan designed for counties to replicate to prepare for the increasing aging population. It is not a federal or state regulation; it is a model framework to address gaps in aging services. It outlines five bold goals and 23 strategies to ensure older adults, people with disabilities, and caregivers can live with dignity, independence, and equity by 2030. The MPA was intentionally designed to align with federal and state frameworks. MPA and MPDS Alignment with Federal Regulations Frameworks Framework MPA Alignment Older Americans Act (OAA) Supports Title III & V goals: nutrition, caregiving, equity, and employment Older Californians Act (OCA) Advances in local planning, transportation, and access through AAAs Medi-Cal / Cal AIM Expands HCBS, Enhanced Care Management, and Community Supports Americans with Disabilities Act (ADA) Promotes accessibility, universal design, and digital inclusion Olmstead v. L.C. Prioritizes aging in place and the least restrictive settings Elder Justice Act (EJA) Strengthens APS, legal protections, and elder abuse prevention efforts |
| Coaching Session | The coach will engage in a discussion with the Director about the Director’s role and responsibilities in developing an understanding of the network of Statewide policies related to the Federal frameworks.
Based on the responses to these questions, the coach should work with the Director to identify activities and/or opportunities that will develop and build skills, knowledge, and foster engagement with partners. Coach ends the session by looking at the next module LOs and activities, and makes a plan with the Director on activities to complete before the next session. |
| Activities | Understanding the Issues: Aging, Disability, and Poverty activities:
Identifying Resources Activities:
Least Restrictive Settings and Discrimination:
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| Materials | What is the difference between the Lanterman Petris Short Act (LPS), a type of conservatorship, and the Lanterman Act regarding services for people with disabilities?
Frank D. Lanterman was a California State Assemblymember who served from 1951 to 1978 and co-authored both laws. But there is a distinct difference between the two laws that bear his name:
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| Prep for next Segment | Review the LOS for the following segments. |
| Segment 3: Alignment of County and Local Aging & Adult Services Programs with California State Laws and Regulatory Frameworks | |
| Learning Objectives |
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| Content |
Operate under a compliance framework governed by the California Department of Aging (CDA). These agencies are guided by the federal Older Americans Act (OAA), the state’s Older Californians Act (OCA), and regulatory standards codified in Title 22 of the California Code of Regulations. Each AAA is required to submit a CDA-approved Area Plan that outlines how it will equitably deliver aging services—such as nutrition, transportation, legal assistance, and case management—within its designated Planning and Service Area (PSA). Area Agencies on Aging (AAAs) – State Compliance Snapshot Legal & Regulatory Foundations Source AAA Alignment Older Americans Act (OAA, Title III & VII) Establishes AAAs as the local entities responsible for planning, coordinating, and delivering aging services in designated Planning and Service Areas (PSAs). California Welfare & Institutions Code (WIC §§ 9100–9200) Codifies the Older Californians Act (OCA) and defines the role of AAAs in advancing elder independence, dignity, and community-based care. California Department of Aging (CDA) Serves as the single state agency overseeing AAAs; issues Area Plan guidance, fiscal rules, and program standards. Area Plan (4-Year Strategic Plan) Each AAA must submit a CDA-approved Area Plan outlining local goals, service priorities, and equity strategies. Title 22, California Code of Regulations Provides detailed rules for AAA operations, including procurement, monitoring, fiscal reporting, and service delivery. Government Code §§ 11135–11139.5 Requires AAAs to comply with civil rights laws, including those related to nondiscrimination, language access, and disability accommodations. Key Compliance Features
The California Welfare and Institutions Code (WIC) sections that apply to the Older Americans Act (OAA) and are primarily found in Division 8.5, known as the Mello-Granlund Older Californians Act. Topic WIC Section Range Relevance General Provisions §§ 9000–9023 Establishes the Mello-Granlund Older Californians Act and its alignment with the OAA California Department of Aging §§ 9100–9114 Defines CDA’s duties, including administering OAA programs and coordinating Area Agencies on Aging Civil Rights & Equity § 9103.1 Ensures equal access to OAA services regardless of disability, language, or identity California Commission on Aging §§ 9200–9205 Advisory body supporting CDA and aging policy development Area Agencies on Aging §§ 9400–9404 Governance and responsibilities of local AAAs under CDA oversight Home-Delivered Meals Act §§ 9500–9501 Nutrition services aligned with OAA Title III-C Community-Based Services Network §§ 9530–9538 Supports aging in place and local service coordination Multipurpose Senior Services Program (MSSP) §§ 9560–9568 Medi-Cal waiver program for frail older adults Aging Information & Education §§ 9630–9631 Outreach and public awareness initiatives Senior Wellness & Injury Prevention §§ 9650–9681 Health promotion and safety programs for older adults CDA Website: 2025-2029 Older Americans Act State Plan Planning: Area Agencies on Aging Guidance and Requirements
Governed by a detailed set of compliance requirements issued by the California Department of Social Services (CDSS) in Division 33 of the APS Manual of Policies and Procedures (MPP) and the California Welfare and Institutions Code. Adult Protective Services (APS) – State Compliance Snapshot State Legal & Regulatory Foundations Source APS Alignment Welfare & Institutions Code (WIC §§ 15750–15766) Establishes APS as a county-operated, state-supervised program to protect elders and dependent adults from abuse, neglect, and exploitation. CDSS Manual of Policies & Procedures (MPP Division 33) Provides operational standards for APS, including eligibility, timelines, documentation, and service planning. California Department of Social Services (CDSS) Serves as the single state agency overseeing APS statewide; issues All County Letters (ACLs), fiscal guidance, and policy updates. CWDA APS Consistency Guidelines Promotes statewide consistency in investigations, findings, and documentation through the application of best practices and the use of training tools. Government Code §§ 11135–11139.5 Requires APS to comply with civil rights laws, including those related to nondiscrimination, language access, and disability accommodations. Probate Code § 2250 Guides APS in initiating temporary conservatorships when clients lack capacity and are at imminent risk, ensuring due process and judicial oversight. Key Compliance Features
APS California Legal Codes Role / Topic Legal Code Relevant Sections Scope of Authority APS WIC §§ 15600-15675 The Elder Abuse and Dependent Adult Civil Protection Act General WIC §§15700-15705.40 Protective Placements and Custody of Endangered Adults APS WIC §§ 15750-15768 Adult Protective Services APS WIC §§ 15770-15771 Home Safe Law Enforcement Penal Code §§ 368 -368.7 Crimes Against Elders, Dependent Adults, and Persons with Disabilities CDSS Division 33 APS Manual of Policies and Procedures APS Publication 470- Know Your Rights --------------------------------------------------------------------------
Operates under a comprehensive compliance framework overseen by the California Department of Social Services (CDSS) and DHCS, the Division 30 of the IHSS Manual of Policies and Procedures (MPP), and Welfare & Institutions Code In Home Supportive Services (IHSS) – State Compliance Snapshot CDSS and DHCS partner for IHSS compliance, with DHCS responsible for Medicaid compliance and CDSS for program administration. State Legal & Regulatory Foundations Source IHSS Alignment Welfare & Institutions Code (WIC §§ 12300–12330) Establishes IHSS as a Medi-Cal benefit that provides in-home care to eligible aged, blind, and disabled individuals to prevent institutionalization. California Department of Social Services (CDSS) Serves as the single state agency overseeing IHSS statewide; issues All County Letters (ACLs), regulations, and fiscal guidance. Manual of Policies & Procedures (MPP Division 30) Defines eligibility, assessment protocols, Functional Index Rankings, Hourly Task Guidelines (HTGs), and service authorization standards. County IHSS Programs Administer IHSS locally, conduct assessments, authorize hours, and ensure compliance with state rules and timelines. Electronic Visit Verification (EVV) Required under federal law and implemented by CDSS to ensure accurate timekeeping and reduce fraud. Government Code §§ 11135–11139.5 Requires IHSS to comply with civil rights laws, including those related to nondiscrimination, language access, and accommodations for individuals with disabilities. The IHSS program must meet federal Medicaid standards for service authorization, documentation, and fraud prevention. DHCS ensures that services provided to older adults and people with disabilities meet all federal Medicaid requirements. IHSS Oversight Functions & Medicaid Compliance Alignment (DHCS) Oversight Function Description Federal Medicaid Rule State Implementation Program Integrity Prevents fraud, ensures services are delivered as authorized 42 CFR § 455 (Program Integrity Requirements) CDSS Program Integrity Units; SOC 2245 reports Quality Assurance Verifies that service assessments and authorizations match client needs 42 CFR § 431.10 (State Medicaid Agency Oversight) SOC 824 QA reports; WIC § 12305.71 Quality Improvement Uses QA findings to improve accuracy, safety, and client outcomes CMS State Plan requirements: Continuous Monitoring County QI action plans; CDSS technical guidance State Legal Codes for the IHSS program: Role / Topic Legal Code Relevant Sections Scope of Authority IHSS WIC §§ 12000-12351 State Supplementary Program for Aged, Blind, and Disabled IHSS WIC §§ 12300-12318 In Home Supportive Services program, IHSS WIC § 12301.6 Public Authority DHCS WIC §§14000-14199.67 Basic Health Care DHCS WIC §§14131-14138 Medi-Cal Benefits Program CDSS Website: In-Home Supportive Services CDSS Division 30 IHSS Manual of Policies and Procedures Program Integrity, QA/QI webpage: Fraud Prevention and Program Integrity Publication 13- Know Your Rights ---------------------------------------------------
State Legal & Regulatory Foundations Source PA/PG/PC Alignment Probate Code §§ 1800–2955 Governs Probate Conservatorships and Public Administrator duties, including appointment, powers, and fiduciary responsibilities. Welfare & Institutions Code (WIC §§ 5350–5372) Establishes Lanterman-Petris-Short (LPS) Conservatorships for individuals with serious mental illness who are gravely disabled. California Department of Health Care Services (DHCS) Oversees LPS conservatorship coordination with behavioral health systems and Medi-Cal-funded services. California Department of Social Services (CDSS) Provides guidance on APS referrals, IHSS coordination, and Medi-Cal eligibility for conservatees. California Association of PA/PG/PC (CAPAPGPC) Sets certification standards, training requirements, and best practices for county PA/PG/PC staff. Government Code §§ 11135–11139.5 Requires compliance with civil rights laws, including nondiscrimination, language access, and disability accommodations. Judicial Council of California Issues court rules, conservatorship handbooks, and oversight guidance for court-appointed fiduciaries. Key Compliance Features
PAPGPC State Legal Codes: Welfare & Institutions Code (WIC): Primarily governs LPS conservatorships and mental health-related duties. Probate Code: Covers probate conservatorships, guardianships, and estate administration. Terminology for Public Guardian and Public Conservator roles can vary across California counties. In some counties, the terms are used interchangeably to refer broadly to conservatorship responsibilities. The roles are detailed separately in this section to show the distinctions Role / Topic Legal Code Relevant Sections Scope of Authority County Gov Code §§ 27430-27436 County BOS may appoint the office of the Public Guardian and Administrator Public Guardian Probate Code §§ 810–812 Defines lack of capacity—decision-making deficits linked to functional impairments Public Guardian Probate Code § 2356.5 Dementia powers—permits locked placement and psychotropic medication with court approval Public Guardian Probate Code §§1400-3925 Guardianship, Conservatorship and other Protective Proceedings Public Conservator WIC (LPS Act) §§ 5000–5550 LPS Conservatorships for individuals with serious mental illness Public Conservator WIC §§ 5150-5349.10 Involuntary Mental Health or Substance Abuse Treatment County Behavioral Health Dept. WIC §§5970-5987 Community Assistance, Recovery, and Empowerment (CARE) Act. Public Conservator Probate Code §§ 7000–12591 Administration of Estates of Decedents when no executor or heir is available Public Conservator Government Code §§ 27440–27444 County-level authority and duties for managing decedents’ estates Conservatorships Overview: Conservatorships are legal arrangements designed to support individuals who are unable to manage their personal care, finances, or mental health needs. While these arrangements can provide critical protection, they also involve significant shifts in autonomy and must be approached with care, collaboration, and a commitment to least restrictive alternatives. LPS Conservatorships: LPS conservatorships are reserved for individuals with serious mental illness who are deemed gravely disabled and unable to care for themselves. These cases typically begin with multiple psychiatric hospitalizations and are initiated by county mental health professionals. The Public Guardian plays a central role in investigating and petitioning for conservatorship when no suitable private party is available. Once established, the Superior Court’s probate division oversees the conservatorship, which may include placement in locked facilities and involuntary treatment. LPS conservatorships are time-limited (usually one year) and must be renewed through judicial review. They intersect closely with county behavioral health departments, psychiatric hospitals, and legal advocates. Probate Conservatorships: Probate conservatorships support adults who cannot manage their personal care or finances due to age, injury, dementia, or disability. These conservatorships may be initiated by family members, professionals, or the Public Guardian, and can involve one or both types of authority: conservator of the person and/or conservator of the estate. The Superior Court appoints and monitors conservators, while agencies like the Area Agencies on Aging, Adult Protective Services (APS), In-Home Supportive Services (IHSS), Regional Centers, and Independent Living Centers often provide assessments, referrals, and ongoing support. Probate conservatorships are ongoing and reviewed periodically to ensure continued necessity and compliance. Limited Conservatorships: Limited conservatorships are tailored for adults with developmental disabilities, such as autism or intellectual disability. These arrangements aim to preserve as much independence as possible, granting only the powers necessary to support the individual’s well-being. Regional Centers play a key role in assessing capacity and recommending appropriate supports. The Superior Court grants limited powers—such as medical consent or educational decision-making—based on individualized needs. The Public Guardian is rarely involved unless no other suitable conservator is available. For all conservatorship types, the Superior Court ensures due process and legal oversight, while the Public Guardian serves as a safety net for LPS and Probate conservatorships. Least restrictive alternatives, such as supported decision-making, powers of attorney, and professional fiduciaries are can often meet an individual’s needs without removing their rights. The Community Assistance, Recovery, and Empowerment (CARE) Act: Signed into law in 2022, the CARE Act is designed to support individuals living with untreated schizophrenia spectrum and other serious mental health conditions, especially those at risk of homelessness, hospitalization, or incarceration. It is intended to be a diversion to an LPS conservatorship, and is considered a least restrictive alternative The CARE Act creates an early intervention pathway through civil court to connect people with coordinated mental health care, housing, and support before more restrictive measures like conservatorship are considered. Counties are responsible for ensuring services are delivered and the court monitors compliance and can hold systems accountable. The CARE Act is built around self-determination, choice, and recovery, recognizing that people thrive when supported in their communities, not institutionalized against their will. Although it may resemble aspects of LPS and Probate conservatorships, and involve responsibilities typically associated with the Public Guardian, the CARE Act is distinct in its approach and is primarily administered by county behavioral health departments. Resources: Public Administration: Guide to property after someone dies | California Courts | Self Help Guide Probate and LPS: Handbook for Conservators LPS Conservatorship: LPS Conservatorship: Guide to LPS Conservatorship - NAMI Westside Los Angeles Probate Conservatorship: Conservatorship | Superior Court of California - County of San Diego Rights for Individuals in Mental Health Facilities National Center for State Courts: Effectively managing guardianships & conservatorships | National Center for State Courts Care Act: CARE Act - California Health and Human Services CARE Court: A New Framework for Community Assistance, Recovery, and Empowerment—FAQ CARE Act | California Courts | Self Help Guide ------------------------------------------------------ CDSS Civil Rights: Division 21 Ensures that civil rights are upheld in every aspect of public social service delivery. When applying for or receiving services for state-administered programs, Division 21 guarantees that they are treated with fairness, dignity, and respect, regardless of their race, language, disability, age, gender identity, or other protected characteristics. This division is California’s way of implementing and enforcing key federal civil rights laws, including:
Through Division 21, counties and service providers are required to:
Applicants and recipients are informed of their rights through resources like PUB 13, a statewide brochure that outlines protections and complaint procedures, and PUB 470 for APS. If someone believes they’ve been discriminated against, Division 21 provides a clear pathway for filing a complaint and seeking a resolution. Division 21: Civil Rights Compliance – Manual of Policies and Procedures |
| Coaching | The coach will engage with the Director in a discussion about the Director’s role and responsibilities in developing an understanding of the County Aging & Adult Services Programs with California State Laws, Regulations, and Policies
Based on the responses to these questions, the coach should work with the Director to identify activities and/or opportunities to develop and build skills, knowledge, and engage with partners. Coach ends the session by looking at the next module LOs and activities, and makes a plan with the Director on activities to complete before the next session. |
| Activities | Knowledge Check Questions:
Multiple Choice answers:
Multiple Choice Anseres
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| Materials | Summary of Legal Codes:
Adult Protective Services:
In Home Supportive Services:
Public Administrator/Guardian/Conservator:
DB101 California - In-Home Supportive Services (IHSS): IHSS Programs Medi-Cal In-Home Supportive Services (IHSS) Program IHSS_Program_Data-Dec2024.xlsx Medi-Cal In-Home Supportive Services (IHSS) Program IHSS_Program_Data-Dec2024.xlsx Least Restrictive Alternatives Trauma-Informed Supervisions Aging and bias (?) Disability Rights Independent Living Centers Reginal Centers |
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| Segment 4: Aging and Adult Services Program Overview, Data Reporting Training, and Professional Organizations
Reading and Activities: up to 2 -3 hours Coaching: 1 hour |
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| Content | Overview of AAA, APS, IHSS, and PAGC programs:
The CDA oversees the program compliance and coordination with the Area Agencies on Aging, as required to receive federal funding from the OAA. California is required to submit a State Plan on Aging to the federal Administration for Community Living every four years, outlining specific goals and priorities for programs funded under the Older Americans Act (OAA). In alignment with this, each Area Agency on Aging (AAA) must submit a comprehensive Area Plan every four years, with annual updates to reflect progress, changes, and emerging needs. CDA and AAA Data Reporting: AAAs are required to submit detailed client-level and service-level data to the California Aging Reporting System (CARS) every quarter to fulfill both state and federal reporting obligations. All data must conform to National Aging Program Information System (NAPIS) standards.
The California Department of Aging (CDA) reviews and validates the submitted data, and subsequently uploads the aggregated State Program Report to the federal Older Americans Act Performance System (OAAPS) for annual reporting. If an Area Agency on Aging (AAA) in California fails to comply with data reporting requirements or Area Plan submission and approval standards, the California Department of Aging (CDA) has several mechanisms to enforce accountability and ensure corrective action: 1. Conditional Approval or Rejection of Area Plan
2. Corrective Action Plans (CAPs)
3. Funding Withhold or Reallocation
4. Contractual Enforcement
5. Monitoring and Audits
------------------------------------------------------------- Overview of the local APS program 1. Eligibility & Jurisdiction
2. Timely Response to Reports
3. Investigation & Case Planning
4. Case Documentation & Records
5. Client Rights & Consent
6. Coordination with Other Entities
7. Data Collection & Reporting
8. Civil Rights & Non-Discrimination
APS Case Management System and Data Reporting Requirements: Adult Protective Services (APS) programs are county-administered and state-supervised. Counties support APS programs using 2011 Realignment funds, which come from local sales tax and vehicle license fees. Because realignment funds are locally controlled, counties have discretion over how much to allocate to APS versus other health and human services programs. In 2021, AB 135, a budget trailer bill, was passed for APS, creating allocation from the State general fund, which is essentially baseline funding. This is an important difference from other programs, because the APS program is not an entitlement program, meaning that individuals are not legally entitled to receive services like they are with IHSS and other programs, so the funding is different. Counties are mandated to operate APS programs per Welfare & Institutions Code §15751. However, counties have flexibility in how they structure and fund APS; based on local needs and resources, they cannot opt out of providing APS or contract it out. This leads to differences between counties in staffing levels and caseload ratios, the availability of multidisciplinary teams and wraparound services, investments in technology, training, and outreach, and capacity to respond to complex cases like self-neglect or financial exploitation. The status of APS and funding structure is a factor in variances across counties, and the state and the absence of an APS statewide case management system. Counties can choose their systems, either from vendor-supported systems or created by the county. There are no state funds specifically allocated for the APS case management systems; however, counties can use their realignment or AB 135 funds. Although some may view the lack of a single statewide platform as a challenge, it also offers strategic advantages that support innovation, responsiveness, and local control. For these reasons, data reporting for APS is not as robust as the IHSS program. Data Reporting: County APS programs are required to submit the SOC 242 – Adult Protective Services Monthly Statistical Report, which captures key information about APS activity. This includes the number and type of reports received, client demographics, investigation outcomes, risk factors, and service referrals. CDSS uses this data to:
To ensure consistency, counties follow standardized definitions and procedures, and CDSS provides training webinars and technical assistance. The data captured in the SOC 242 was adapted in 2019 to align with federal APS standards under the Administration for Community Living (ACL). Click Here to see APS Statewide SOC 242 report: CDSS SOC 242 Webpage: SOC 242 data is also available on the Statewide APS Data Dashboard and informs legislative reports and funding allocations. Compliance: To uphold its mission, the APS program is guided by state mandates, most notably the Welfare and Institutions Code (WIC) and the requirement to submit accurate, timely SOC 242 data to the California Department of Social Services (CDSS). SOC 242 captures the volume and nature of abuse investigations, risk factors, outcomes, and client demographics, and is used for multiple purposes, including legislative briefings, State budget allocations from AB 135, and recent funding allocations from COVID-19 and ARPA federal funds. Non-Compliance with WIC obligations or SOC 242 reporting standards can result in the CDSS initiating formal corrective action, including performance reviews, mandatory remediation plans, or funding restrictions. Monitoring audits may be triggered to assess the integrity of casework practices, data quality, and documentation systems. Adult Protective Services Training is Organized into Regional Training academies: Training Academy Region APSWI – SDSU Southern California ASTA – CSU Fresno Central and Bay Area California Northern California Training Academy – UC Davis Northern California --------------------- IHSS Structured overview of the local IHSS program
State law (AB 1682), passed in 1999, mandated that every California county establish a Public Authority or nonprofit consortium to serve as the employer of record for IHSS providers, but only for collective bargaining. Before the law, providers had no formal employer and provided care without the benefits, protections, or bargaining rights that other workers in public programs typically had. Additionally, recipients faced growing challenges in recruiting and retaining caregivers due to low wages, inconsistent training, and fragmented support. This structural change gave providers a formal voice through union representation, allowing them to negotiate for fair wages, health benefits, and working conditions. For many, it was the first time their caregiving labor was publicly acknowledged and protected in this way. Public Authorities are county-created entities, but they operate within a statewide framework. Their governance varies slightly by county—some have independent boards, while the Board of Supervisors directly oversees others with advisory input. Public Authorities' Role:
IHSS Case Management System and Data Reporting Requirements: IHSS is a Medi-Cal entitlement program, meaning eligible individuals have a legal right to receive services. Consequently, the state must ensure uniformity, accountability, and fiscal oversight across all 58 counties. IHSS involves paying over 700,000 providers and managing billions in payments annually. IHSS programs in all counties use the Case Management Information and Payrolling System (CMIPS II), which is mandated by Welfare & Institutions Code §12302.2 to centralize:
Data Reporting: CDSS automatically generates a Monthly IHSS Program Data Workbook and an IHSS Equity Data Workbook. Those two workbooks focus on service delivery, demographics, and equity indicators, which are pulled directly from CMIPS II. IHSS Program Data and Equity Data workbooks are posted monthly and include program information such as recipient/consumer, provider, county, and statewide data.
IHSS Program Integrity data is reported separately through dedicated forms and statewide reports:
CDSS publishes statewide summaries of these reports via All County Information Notices (ACINs) such as:
Compliance and Consequences The IHSS program plays a critical role in enabling low-income older adults and individuals with disabilities to live safely at home. To maintain public trust, fiscal responsibility, and equitable access, the program is governed by strict federal and state standards for data accuracy, quality assurance, and fraud prevention. Counties and providers are expected to meet established benchmarks through timely data reporting, robust internal controls, and continuous program improvement. When these standards are not upheld, the California Department of Social Services (CDSS) initiates a tiered accountability response. At the administrative level, counties that fall short may be required to submit Corrective Action Plans, outlining concrete strategies to address deficiencies. These plans are closely monitored, with funding implications tied to compliance. In cases where serious or repeated violations occur, CDSS may suspend or reallocate funding to ensure the integrity of services. Provider-level noncompliance — including fraudulent billing, falsified documentation, or unauthorized care delivery — can result in suspension, termination, or exclusion from the IHSS network for a period of up to one year. Verified cases of fraud are also subject to criminal referral, with potential felony charges, financial restitution, and loss of program eligibility. Quality Assurance and Quality Improvement (QA/QI) protocols serve as both a frontline safeguard and a systemic learning mechanism. Counties must engage in ongoing QA/QI activities, including service verification, collecting consumer feedback, and resolving discrepancies. Failure to meet QA/QI obligations can trigger monitoring audits, funding holdbacks, and reputational risk. CDSS publishes annual performance reports on fraud prevention and QA/QI efforts across counties, offering transparency and comparative insights. These data points support policy refinement, equity tracking, and strategic investment, reinforcing the shared commitment to a responsive and accountable IHSS infrastructure. Review: California State Auditor Report (2021) IHSS Quality Assurance Monitoring IHSS Program Integrity and Fraud Prevention ------------------------- Training is required for county IHSS staff, particularly those involved in assessments, eligibility determinations, and service planning. The training provides structured learning modules to ensure consistency, legal compliance, and person-centered service delivery. CDSS hosts the webpage for the IHSS Training Academy -------------------------------- Structured overview of the PAPGPC programs The Public Guardian-Conservator has several key requirements and processes if Some individuals may need a protective intervention. However, a conservatorship is the most restrictive action and should be considered only as a last resort. Conservatorships have complex legal frameworks: Probate Conservatorship: May be initiated or established for individuals who require assistance with their financial and personal affairs due to disability or incapacity. This may include a person with dementia or other impairments.
Lanterman-Petris-Short (LPS) Conservatorship: This may be initiated for individuals diagnosed with severe behavioral health conditions, resulting in the person's inability to provide for their food, clothing, shelter, and financial management, and who are unwilling or unable to accept treatment. There must be no other alternative or less restrictive interventions available. Similar to the Probate conservatorship, evidence such as medical records, physician evaluations, and other assessments or evaluations must be submitted to the court.
Estate Administration: The Public Administrator is responsible for administering the estate of county residents who die without a will or family. This is a complex legal process, overseen by the Superior Court, which can appoint the Public Administrator to manage the assets/estate. This includes:
PAPGPC Case Management System and Data Reporting Requirements: Each county administers services independently, using its case management tools—ranging from customized software to spreadsheets—without statewide interoperability. There is no statutory requirement for counties to report caseloads, staffing levels, or service outcomes to the California Department of Social Services or any central body. There is no statutory mandate requiring counties to report PA/PG/PC data to the state in a centralized manner. However, counties must report:
Compliance: The Public Administrator, Public Guardian, and Public Conservator programs serve as fiduciaries and legal stewards for some of the state’s most vulnerable populations, including individuals with cognitive impairments, severe mental illness, and those who die without next of kin. Authority is codified in the California Probate Code and Welfare and Institutions Code (WIC), which collectively define the legal, ethical, and procedural standards for estate administration, conservatorship, and protective intervention. Noncompliance with these statutes, whether through delayed filings, mismanagement of assets, failure to protect conservatees, or procedural lapses in court-mandated duties, can result in the courts issuing sanctions, removing fiduciary authority, or appointing alternative conservators. Counties may face civil liability for breach of fiduciary duty, especially if harm results from neglect or administrative failure. In cases involving financial mismanagement or abuse, referrals may be made to the California Attorney General, County Counsel, or law enforcement for investigation and prosecution. However, sanctions and judicial interventions typically occur, as documented in individual probate or conservatorship case files, rather than in centralized audits or public dashboards. Training: The California State Association of Public Administrators, Public Guardians, and Public Conservators is a non-profit organization that provides certification and training, promotes collaboration, and advances legislative priorities. An individual may hire a professional fiduciary as a least restrictive alternative to a conservatorship, or they may be appointed as a conservator of a person's estate. Role of a Fiduciary - Professional Fiduciary Association of California ----------------------------------------------------------------- The California Welfare Directors Association (CWDA) is a non-profit organization that represents human/social services directors in all 58 counties. CWDA serves as an advocate and as a guide to inform policymakers and the public of the impacts of policies on individuals, communities, and county human services operations. Additionally, CWDA supports counties and other entities in developing best practices and streamlining service delivery. This is done by leading several policy and program committees. All committees have scheduled standing meetings every month, with a few exceptions. For Aging and Adults Services, CWDA supports Directors, and the APS and IHSS programs with the following committees: The Adult Services Committee guides policies and effective operations of the Adult Protective Services (APS) and In-Home Supportive Services (IHSS) programs. The committee collaborates with the California Department of Social Services (CDSS) and the California Department of Health Care Services (CDHCS) to ensure a consistent interpretation of laws and regulations regarding the IHSS and APS programs. The Adult committee meetings are typically attended by County Adult Services Directors or their designee. The Adult Services committee also has two subcommittees. In some counties, the APS and IHSS manager, or their designee, may oversee both programs and attend both subcommittee meetings.
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| Coaching Session | Discuss the difference in state oversight between AAA, APS, IHSS, and PAPGPC.
What are some challenges that are new to you about compliance with these programs? |
| Activities |
If you oversee one or more programs in the PA/PG/PC:
ASK: Does your cunty create or submit public reports such as an annual report to the County BOS or other stakeholders?
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| Materials | The California Association of Area Agencies on Aging (C4A)
National Adult Protective Services Association (NAPSA) |
| Prep for next segment | Review Learning Objectives |
| Segment 5 | ACLS, ACINS, ACWDLS, and CFLs- Oh My! Slide 24 |
| LO | The director will learn how to access information about state implementation requirements and compliance. |
| Content | CDSS Letters and Notices: How California Communicates Policy and Practice
The California Department of Social Services (CDSS) oversees a vast network of public benefit programs, including APS and IHSS, among other programs. To ensure counties, service providers, and stakeholders stay aligned with evolving laws, regulations, and best practices, CDSS issues a series of official communications known as Letters and Notices. These documents provide statewide guidance, translating legislation, budget changes, court decisions, and federal mandates into actionable instructions for county agencies and program administrators. There are several types:
Each letter is publicly posted on the CDSS Letters and Notices portal and organized by year and program area. Counties are expected to review, interpret, and implement the guidance locally—often incorporating it into staff training, eligibility procedures, and service delivery protocols. |
| Coaching Session | Review applicable program letters and notices.
Identify the differences between this program and others and discuss the pros and cons. |
| Activities | Knowledge Check: |
| Materials | |
| Prep |