TABLE 5.2 Structure of the Office of the State LTC Ombudsman and Elements of the Host Agency(s) for the State and Local Entities

Exemplary Practices

Essential Practices

Unacceptable Practices

The committee recognizes that its Recommendation 4.1 calls for an essential practice that will have a major impact on the majority of state ombudsman programs. Presently, in a majority of states, the state ombudsman is not housed in a totally independent state agency or contracted out to an independent nonprofit agency. The committee’s recommended exemplary practice for structure therefore calls for a thoughtful extended transition to new organizational “homes” for parts or all of the ombudsman program. An exemplary transition will examine the current structure of the Office, determine the components housed in regulatory or provider settings, determine the alternative settings for housing those program elements, and develop a plan for transition that maximizes the existing strengths of the program and builds toward the other essential and exemplary practices.

The Office of the State LTC Ombudsman is placed in a totally independent state agency, solely or primarily focused on LTC issues or it is contracted out to an independent nonprofit agency. This conclusion is based on the committee’s overall study and the current effectiveness of programs. Consistent with Recomendation 4.1, “totally independent” means that the agency is not responsible for regulating, providing, managing, determining eligibility for, or paying for LTC services or protective services.

State or local ombudsmen operate in an agency with many prohibited ties to regulatory or provider agencies.

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