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Elder Rights: LTC Ombudsman

Legislation & Regulations

The Long-Term Care Ombudsman Program was incorporated into the Older Americans Act in 1978, with enactment of the requirement that every state to have an Ombudsman Program and the statutory definition of ombudsman functions and responsibilities. OAA Amendments in subsequent years expanded and strengthened the program:

1981 Expanded ombudsman coverage to include board and care homes. The name was changed from Nursing Home Ombudsman to Long-Term Care Ombudsman to reflect this change.
1987 Required states to provide for ombudsman access to residents and residents’ records; immunity to ombudsmen for the good faith performance of their duties and prohibitions against willful interference with the official duties of an ombudsman and/or retaliation against an ombudsman, resident or other individual for assisting representatives of the program in the performance of their duties.
1992 Strengthened the program and transferred it to a new title in the Act., Title VII, Vulnerable Elder Rights Protection Activities, which also included Programs for Prevention of Elder Abuse, Neglect and Exploitation, the State Elder Rights and Legal Assistance Development Program and an Outreach, Counseling and Assistance Program. (which was subsequently deleted).
2000 Retained and updated ombudsman provisions in Titles II, III and VII.

Ombudsman provisions are in the following sections of the Older Americans Act:

Title I, Section 102, Definitions

  • (13) Definition of abuse
  • (18) Definition of “board and care facility”
  • (22) Definition of “elder abuse”
  • (23) Definition of “elder abuse, neglect, and exploitation”
  • (24) Definition of “exploitation”
  • (33) Definition of “long-term care facility”

(Other definitions also have relevance, but these are the primary ones.)

Title II, Administration on Aging

  • Section 201(d): Office and Director of Long-Term Care Ombudsman Programs in the Administration on Aging and Director’s Functions
  • Section 202(a)(18): The National Ombudsman Resource Center– Functions, Required Funding Level
  • Section 207(b)(1): The AoA National Ombudsman Report

Title III, Grants for State and Community Programs on Aging

  • Section 301 (c): Assistant Secretary shall provide technical assistance and training to state and local long-term care ombudsmen.
  • Section 304(d)(1)(B): “Such amount” (of specified funds for supportive services under Sec. 321, Part B) “as the State agency determines to be adequate for conducting an effective ombudsman program…shall be available for conducting such program.” (Note: This is the Title III funding that a state may take “off the top” before Title III funds are distributed to the area agencies on aging under the intrastate funding formula. This is the source of most federal funding for state ombudsman programs.)
  • Section 306(a)(9): The area agency plan shall provide that, in carrying out the ombudsman program, the agency “will expend not less than the total amount of funds appropriated under the Act and expended by the agency in fiscal year 2000….”
  • Section 307(a)(9): The state “plan shall provide assurances that the State agency will carry out, through the Office of the State Long-Term Care Ombudsman, a State Long-Term Care Ombudsman program in accordance with section 712 and this title, and will expend for such purpose an amount that is not less than an amount expended by the State agency with funds received under this title for fiscal year 2000, and an amount that is not less than the amount expended by the State agency with funds received under title VII for fiscal year 2000.”
  • Section 321(a)(10): Authorizes as a state supportive service “service of an ombudsman at the State level to receive, investigate, and act on complaints by older individuals who are residents of long-term care facilities and to advocate for the well-being of such individuals.”
  • Section 321(d): Non-supplantation provision for funding of Title III-B programs

Title IV -- Training, Research, and Discretionary Projects and Programs

  • Section 421: Authorizes between three and ten state grants to demonstrate and evaluate cooperative projects between the state ombudsman program, legal assistance agencies and the state protection and advocacy systems for individuals with developmental disabilities and mental illness and requires the Assistant Secretary to prepare and submit to Congress a report on the results of the evaluation.

Title VII – Allotments for Vulnerable Elder Rights Protection Activities

  • Chapter 1 - General State Provisions
    • Sections 701-705 cover Title VII establishment; authorization, allotment and reallotment of funding; state and area agency eligibility requirements; and additional state plan requirements, including that states will establish programs in accordance with the requirements of the Title VII chapters in (705[a][1]), a non-supplantation of funding clause for each of the Title VII chapters (705[a][4]) and an assurance that states will place no additional restrictions on the eligibility of entities for designation as local ombudsman entities (705[a][5]).
  • Chapter 2 – Ombudsman Programs
    • Section 711 – Definitions (of “office,” “ombudsman,” “local ombudsman entity,” “program,” “representative” and “resident”)
    • Section 712 – State Long-Term Care Ombudsman Program
    • Section 713 – Regulations pertaining to conflict of interest
    • Sections 762-764 – Administration, Technical Assistance and Audits (of Title VII programs)
  • Older Americans Act Ombudsman Provisions, by Topic
    [Word - 146 KB] [PDF - 324 KB]
  • Proposed regulations were published in the Nov. 15, 1994 Federal Register but were never issued in final.
    [Word - 192 KB] [PDF - 247 KB]


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