programs are housed within the SUA and utilize volunteers. A more in-depth examination of the variations and commonalities of the programs follows.

The Office of the State LTC Ombudsman is most often housed within the SUA (Table 2.1); this is the case in 42 states. The SUAs in these states themselves vary in their organizational placement. Half (21) are independent, single-purpose agencies that report directly to the governor. The other half are part of larger “umbrella” agencies, in which several other agencies report to a head office that in turn reports to the governor; in 9 of these states, the umbrella agency includes the agency responsible for licensing or certifying LTC facilities. Of the 10 state ombudsman programs that are not housed in a SUA, 3 reside in independent state-run ombudsman agencies and 7 reside completely outside state government (5 in legal services agencies, 2 in nonprofit citizen advocacy agencies).

Seventeen states operate their ombudsman program from a centralized office (some have regional offices). Thirty-five states have developed distinct local programs (sometimes referred to as “substate” programs). In FY 1993, 467 such local programs were in operation within these 35 states (Table 2.1). A variety of local organizations, most frequently AAAs, sponsor these programs. Of these 35 states, 12 place local programs only within AAAs, 2 house their local programs solely within nonprofit citizen advocacy agencies, 1 uses only legal service agencies, and 1 relies on state regional service agencies. The remaining 19 states employ a variety of AAAs, nonprofit agencies, and legal service agencies to house local programs.

How the program actually operates in a given state can be described as centralized, decentralized, or a combination of the two (Table 2.1). In 17 states the program is centralized, and the state ombudsman directly employs and supervises all paid and volunteer staff. Twenty-seven programs are considered decentralized; the state ombudsman has established local programs, which employ and supervise paid staff and volunteers. The remaining 8 states use a combination of these two approaches: part of the state is served by local programs and the rest of the state is directly served by state ombudsman staff.