Bill Text: CA AB2813 | 2021-2022 | Regular Session | Introduced
Bill Title: Long-Term Services and Supports Benefit Program.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2022-03-17 - Referred to Coms. on AGING & L.T.C. and HUM. S. [AB2813 Detail]
Download: California-2021-AB2813-Introduced.html
CALIFORNIA LEGISLATURE—
2021–2022 REGULAR SESSION
Assembly Bill
No. 2813
| Introduced by Assembly Member Santiago |
February 18, 2022 |
An act to add Article 5 (commencing with Section 9130) to Chapter 2 of Division 8.5 of the Welfare and Institutions Code, relating to long-term services and supports.
LEGISLATIVE COUNSEL'S DIGEST
AB 2813, as introduced, Santiago.
Long-Term Services and Supports Benefit Program.
Existing law, the Mello-Granlund Older Californians Act, establishes the California Department of Aging in the California Health and Human Services Agency, and sets forth its mission to provide leadership to the area agencies on aging in developing systems of home- and community-based services that maintain individuals in their own homes or least restrictive homelike environments. Existing law establishes an Aging and Disability Resource Connection (ADRC) program, administered by the department, to provide information to consumers and their families on available long-term services and supports (LTSS) programs and to assist older adults, caregivers, and persons with disabilities in accessing LTSS programs at the local level. Existing law requires the ADRC program to provide services within the geographic area served and provide information to the public about the services provided by the
program. Existing law makes the operation of these provisions contingent upon the appropriation of funds for that purpose.
This bill would require the department, upon appropriation, in conjunction with an unspecified board operating under the auspices of the State Treasurer, to establish and administer a Long-Term Services and Supports Benefits Program with the purpose of providing supportive care to aging Californians and those with physical disabilities. The bill would establish the Long-Term Services and Supports Benefit Program Fund and would require the department and the board to administer the program using proceeds from the fund. The bill would require an individual to have paid into the fund for an unspecified number of years to be eligible to receive benefits pursuant to the program. The bill would authorize the maximum amount of benefit available to an eligible individual to exceed the amount the individual contributed into the fund. The bill would
authorize eligible individuals to use the benefits pursuant to the program for specified services, including in-home support services support for an individual in need of assistance for at least 2 activities of daily living. The bill would require the department to ensure that all vendors and providers of services pursuant to the program have not taken any actions to actively discourage their employees’ membership in labor organizations or collective bargaining.
The bill would make related findings and declarations.
Digest Key
Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NOBill Text
The people of the State of California do enact as follows:
SECTION 1.
(a) The Legislature finds and declares all of the following:(1) Almost 8,000,000 Californians are either older adults or individuals with physical and mental disabilities. These individuals include adults with developmental disabilities, individuals with traumatic injuries or acquired disabilities, and individuals over 65 years of age with functional impairments due to age.
(2) This population is expected to grow significantly over the next decade due to demographic shifts, increased longevity, and a corresponding increase in disability. It will also be much more racially and ethnically diverse. In addition, more older adults are likely to live
alone.
(3) As a result, these individuals will need more and better access to long-term services and supports. Based on data from the 2015 American Community Survey, over 1,000,000 Californians will need long-term services and supports by 2030. Of those, 55 percent will be over 65 years of age.
(4) The current private long-term services and supports market is broken. Over the last 20 years, the number of companies offering these products has shrunk from over 100 to less than 12. This leaves families to rely on their own resources. Paying out-of-pocket for long-term services and supports is highly expensive and creates a significant long-term financial and social burden for families.
(5) According to the AARP/SCAN 2020 LTSS Scorecard, only 4.2 percent of Californians over 40 years of age have purchased long-term care
insurance. The cost of private pay nursing home care is 232 percent of the annual median income of 65 years of age or older California households. The lowest cost care option, utilizing a minimal number of hours of daily in-home care, is 71 percent of the annual median income of older California households.
(6) When costs are high for people who pay privately and do not have long-term care insurance, they will more quickly deplete their life savings and turn to the public safety net. If that safety net is inadequate, people may rely so heavily on family caregivers that those caregivers damage their own health and well-being and long-term earnings due to cutting back on work hours or dropping out of the workforce altogether.
(7) At least 90 percent of older adults receiving help with daily activities receive some informal care, and about two-thirds receive only informal care.
AARP’s cost of caregiving research showed that on average, family caregivers pay nearly $7,000 out of pocket each year to assist their older loved ones. Nationally, family caregivers, who are the backbone of our LTSS system, are overwhelmingly women (86 percent), most are people of color (59 percent), and about one-quarter are immigrants. These caregivers usually work without any compensation and almost one-half of informal caregivers said they have things they cannot handle or do not have enough time for themselves. This impacts their ability to participate in the workforce and save for retirement, and ultimately contributes to the “feminization” of poverty. Nearly two-thirds of individuals 65 years of age and over living in poverty are women. The failure to address this will literally increase poverty for the next generation.
(8) Younger people with disabilities, with or without families, bear the significant burden of paying out-of-pocket
for long-term services and supports when they do not qualify for Medi-Cal. Younger people with disabilities find it difficult to save for their retirement, or even contemplate retirement, due to the need to continually pay for the long-term services and supports they need to maintain health, independence, and function.
(9) Long-term services and supports help individuals maintain their dignity, autonomy, individuality, privacy and sense of safety, security, and order. Most individuals prefer to remain in their homes for as long as possible, particularly in light of the COVID-19 pandemic.
(10) Long-term services and supports include a broad range of services that enable older adults and individuals with physical and mental disabilities to live independently in their communities. They include personal care services, assistance with health needs, assistance with activities of daily
living such as bathing, dressing, toileting, and cooking, adult day services, transportation, social services, in-home support care, assisted living, home modifications, assistive technology, nutrition assistance, person-centered care coordination, supportive services, and nursing facility services.
(11) Long-term services and supports are not adequately covered by Medicare. The Medi-Cal program covers some long-term care services and supports, but because “spending down” to become eligible for Medi-Cal is the primary means by which older adults and individuals with disabilities currently receive access to paid long-term services and supports, the shifting demographics will create significant budget pressures for the Medi-Cal program, including the In-Home Supportive Services (IHSS) program.
(12) This crisis worsens every day. It is one that can no longer be ignored. It is
bankrupting families and steadily increasing the burden on all taxpayers. The solution must be the creation of, and funding for, a long-term services and support benefit. This will require placing shared funding responsibilities on all Californians, both those that ultimately will use the benefit and through other dedicated sources of funding that are outside of the Medicaid program or the state General Fund.
(b) It is the intent of the Legislature to create a cash or reimbursement form of benefit for those individuals that participate through the payments set forth in this act.
SEC. 2.
Article 5 (commencing with Section 9130) is added to Chapter 2 of Division 8.5 of the Welfare and Institutions Code, to read:Article 5. Long-Term Services and Supports Benefit Program
9130.
(a) The department, in conjunction with an unspecified board operating under the auspices of the State Treasurer, shall establish and administer a Long-Term Services and Supports Benefits Program with the purpose of providing supportive care to aging Californians and those with physical disabilities.(b) The Long-Term Services and Supports Benefit Program Fund is hereby established. The department and the board shall administer the program using proceeds from the Long-Term Services and Supports Benefit Program Fund.
9131.
(a) An individual shall have paid into the fund for ____ years to be eligible to receive benefits pursuant to this article.(b) The maximum amount of benefits available to an eligible individual may exceed the amount the individual contributed into the fund.
(c) Eligibility for the program shall be based only on the contribution from earnings, a vesting period, and the need for assistance with activities of daily living.
9132.
Eligible individuals may use benefits received pursuant to the program for any of the following services:(a) In-home support services and support for an individual in need of assistance for at least two activities of daily living.
(b) Costs incurred for skilled nursing care, participation in adult day or day Programs of All-Inclusive Care for the Elderly (PACE), residential care facilities for the elderly, and adult residential care facilities.
(c) Costs incurred to delay or eliminate the need for more expensive skilled medical care, including, but not limited to, employing a family caregiver to provide the services, home modifications,
personal care services, meal delivery, transportation, durable medical equipment, and assistive technology.
(d) Other services and costs deemed appropriate by the department.
