Bill Text: CA SB1384 | 2015-2016 | Regular Session | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: California Partnership for Long-Term Care Program.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Passed) 2016-09-22 - Chaptered by Secretary of State. Chapter 487, Statutes of 2016. [SB1384 Detail]

Download: California-2015-SB1384-Amended.html

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BILL NUMBER: SB 1384	AMENDED
	BILL TEXT

	AMENDED IN SENATE  MARCH 29, 2016

INTRODUCED BY   Senator Liu

                        FEBRUARY 19, 2016

   An act to  amend, repeal, and add Section 8231 of the
Education Code, relating to child care.   amend Sections
22002, 22003, 22004, 22005, 22005.1, 22005.2, 22006, 22009, and
22010 of the Welfare and Institutions Code, relating to long-term
care. 



	LEGISLATIVE COUNSEL'S DIGEST


   SB 1384, as amended, Liu.  Child care and development
services: children of migrant agricultural worker families. 
 California Partnership for Long-Term Care Program.  
   Existing law establishes the California Partnership for Long-Term
Care Program administered by the State Department of Health Care
Services. The purpose of the program is to link private long-term
care insurance and health care service plan contracts that cover
long-term care with the In-Home Supportive Services program and
Medi-Cal and to provide Medi-Cal benefits to certain individuals who
have income and resources above the eligibility levels for receipt of
medical assistance, but who have purchased certified private
long-term care insurance policies. Existing law provides criteria for
certification of a long-term care insurance policy, including a
requirement that it provide protection against loss of benefits due
to inflation.  
   This bill would shift administrative responsibilities for the
program to the California Department of Aging, and would require the
department to adopt regulations requiring that a long-term care
insurance policy or health care service plan contract that includes
long-term care services include nursing and residential care facility
coverage only, home care and community-based care coverage only, or
comprehensive coverage. The bill would also require that a long-term
care insurance policy, as a condition of certification, include
specified protections against loss of benefits due to inflation.
 
   Existing law, for purposes of migrant child care and development
programs, defines a migrant agricultural worker family as a family
that has earned at least 50 percent of its total gross income from
employment in fishing, agriculture, or agriculturally related work
during the 12-month period immediately preceding the date of
application for child care and development services. Existing law
requires the children of these families to be enrolled in child
development programs on the basis of specified priorities, including
priority to children whose family moves from place to place.
 
   This bill, beginning July 1, 2017, would instead define "migrant
agricultural worker family" as a family with at least one parent who
has earned at least 50 percent of his or her income from employment
in fishing, agriculture, or agriculturally related work during the
12-month period immediately preceding the date of application for
child care and development services. The bill would require the
children of these families to be given priority for enrollment in
migrant child care and development programs a specified priority
order, with first priority going to those children in families that
move from place to place. 
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

   SECTION 1.    Section 22002 of the   Welfare
and Institutions Code  is amended to read: 
   22002.  The State Department of Health  Care  Services
shall seek any federal waivers and approvals necessary to accomplish
the purposes of this division.
   SEC. 2.    Section 22003 of the   Welfare
and Institutions Code   is amended to read: 
   22003.  (a) Individuals who participate in the program and have
resources above the eligibility levels for receipt of medical
assistance under Title XIX of the Social Security Act (Subchapter XIX
(commencing with Section 1396) of Chapter 7 of Title 42 of the
United States Code) shall be eligible to receive those in-home
supportive services benefits specified by the State Department of
Social Services, and those Medi-Cal benefits specified by the State
Department of Health  Care  Services, for which they would
otherwise be eligible, if, prior to becoming eligible for benefits,
they have purchased a long-term care insurance policy or a health
care service plan contract covering long-term care that has been
certified by the  State Department of Health Services
  California Department of Aging  pursuant to this
division.
   (b) Individuals may purchase approved and certified long-term care
insurance policies or health care service plan contracts which cover
long-term care services in amounts equal to the resources they wish
to protect, so long as the amount of insurance purchased exceeds the
minimum level set by the  State Department of Health Services
  California Department of Aging  pursuant to
Section 22009.
   (c) The resource protection provided by this division shall be
effective only for long-term care policies, and health care service
plan contracts that cover long-term care services, when the policy or
contract is delivered, issued for delivery, or renewed on July 1,
1993 and thereafter.
   SEC. 3.    Section 22004 of the   Welfare
and Institutions Code   is amended to read: 
   22004.  Notwithstanding other provisions of law, the resources, to
the extent described in subdivision (c), of an individual who
purchases an approved and certified long-term care insurance policy
or health care service plan contract which covers long-term care
services shall not be considered by:
   (a) The State Department of Health  Care  Services in
determining:
   (1) Medi-Cal eligibility.
   (2) The amount of any Medi-Cal payment.
   (3) The amount of any subsequent recovery by the state of payments
made for medical services.
   (b) The State Department of Social Services in determining:
   (1) Eligibility for in-home supportive services provided pursuant
to Article 7 (commencing with Section 12300) of Chapter 3 of Division
9.
   (2) The amount of any payment for in-home supportive services.
   (c) The resources not to be considered as provided by this section
shall be equal to, or in some proportion set by the State Department
of Health  Care  Services or State Department of Social
Services that is less than equal to, the amount of long-term care
insurance payments or benefits made as described in Section 22006.
   SEC. 4.    Section 22005 of the   Welfare
and Institutions Code   is amended to read: 
   22005.  The  State Department of Health Services 
 California Department of Aging  shall only certify a
long-term care insurance policy or a health care service plan
contract that meets the Medi-Cal asset protection requirements.
   SEC. 5.    Section 22005.1 of the   Welfare
and Institutions Code   is amended to read: 
   22005.1.  (a) The  State Department of Health Care
Services   California Department of Aging  shall
only certify a long-term care insurance policy that substantially
meets the requirements of Chapter 2.6 (commencing with Section 10230)
of Part 2 of Division 2 of the Insurance Code, except the
requirements of Sections 10232.1, 10232.2, 10232.8, 10232.9, and
10232.92 of the Insurance Code, and that provides all of the items
specified in subdivision (b). The  State Department of Health
Care Services   California Department of Aging 
shall only certify a health care service plan contract that has been
approved by the Department of Managed Health Care pursuant to Chapter
2.2 (commencing with Section 1340) of Division 2 of the Health and
Safety Code as providing substantially equivalent coverage to that
required by Chapter 2.6 (commencing with Section 10230) of Part 2 of
Division 2 of the Insurance Code, and that provides all of the items
specified in subdivision (b). Policies issued by organizations
subject to the Insurance Code and regulated by the Department of
Insurance shall also be approved by the Department of Insurance.
   (b) Only policies and contracts that provide all of the following
items shall be certified by the department:
   (1) Individual assessment and case management by a coordinating
entity designated and approved by the department.
   (2) Levels and durations of benefits that meet minimum standards
set by the  State Department of Health Care Services
  California Department of Aging  pursuant to
Section 22009.
   (3)  (A)    Protection against loss of benefits
due to  inflation.   inflation, which shall
include both of the   following:  
   (i) One option no less favorable than that required by Section
10237.1 of the Insurance Code.  
   (ii) One lower cost option, consistent with the requirements of
the federal Deficit Reduction Act of 2005 (Public Law 109-171). 

   (B) The insurer or producer shall, at the time of application,
provide to the consumer an illustration comparing the premium rate
and benefits of each option over time. 
   (4) A periodic record issued to the insured including an
explanation of insurance payments or benefits paid that count toward
Medi-Cal asset protection under this division.
   (5) Compliance with any other requirements imposed by regulations
adopted by the State Department of Health Care  Services or
  Services, the California Department of Aging, or 
the State Department of Social Services and consistent with the
purposes of this division.
   SEC. 6.    Section 22005.2 of the  Welfare
and Institutions Code   is amended to read: 
   22005.2.  Each organization issuing policies certified by the
 State Department of Health Services  
California Department of Aging  under this division shall each
year contribute to a fund to be used for common educational and
marketing expenses for reaching the target population designated by
the California Partnership for Long-Term Care. The amount of each
participating issuer's required annual contribution shall be
determined by the department and shall not be less than twenty
thousand dollars ($20,000).
   SEC. 7.    Section 22006 of the   Welfare
and Institutions Code   is amended to read: 
   22006.  The State Department of Health  Care  Services,
in determining eligibility for Medi-Cal, and the State Department of
Social Services, in determining eligibility for in-home supportive
services, shall exclude resources up to, or equal to, the amount of
insurance payments or benefits paid by approved and certified
long-term care insurance policies or health care service plan
contracts which cover long-term care services to the extent that the
benefits paid are for all of the following:
   (a) In-home supportive services benefits specified in regulations
adopted by the State Department of Social Services pursuant to
Section 22009, or those services that Medi-Cal approves or benefits
that Medi-Cal provides as specified in regulations adopted by the
State Department of Health  Care  Services pursuant to
Section 22009.
   (b) Services delivered to insured individuals  at home or
 in a community setting as part of an individual assessment and
case management program provided by coordinating entities designated
and approved by the  State Department of Health Services.
  California Department of Aging. 
   (c) Services the insured individual receives after meeting the
disability criteria for eligibility for long-term care benefits
established by the State Department of Health  Care 
Services.
   SEC. 8.    Section 22009 of the   Welfare
and Institutions Code   is amended to read: 
   22009.  (a) The  State Department of Health Services
  California Department of Aging  shall adopt
regulations to implement this division, including, but not limited
to, regulations  which   that  establish:
   (1) The population and age groups that are eligible to participate
in the program.
   (2) The minimum level of long-term care insurance or long-term
care coverage included in health care service plan contracts that
must be purchased to meet the requirement of subdivision (b) of
Section 22003.
   (3)  (A)    The amount and types of services
that a long-term care insurance policy or health care service plan
contract  which   that  includes long-term
care services must cover to meet the requirements of this division.
 The types of policies or plans   shall include nursing
and residential care facility coverage only, home care and
community-based care coverage only, and comprehensive coverage. 

   (B) Policies that provide only home care benefits shall include
coverage for electronic or other devices intended to assist in
monitoring the health and safety of an insured. 
   (4) Which coordinating entities are designated and approved to
deliver individual assessment and case management services to
individuals  at home or  in a community setting, as required
by subdivision (b) of Section 22006. 
   (b) The State Department of Health Care Services shall also adopt
regulations to implement this division, including, but not limited
to, regulations that establish:  
   (5) 
    (1)  The disability criteria for eligibility for
long-term care benefits as required by subdivision (c) of Section
22006. 
   (6) 
    (2)  The specific eligibility requirements for receipt
of the Medi-Cal benefits provided for by the program, and those
Medi-Cal benefits for which participants in the program shall be
eligible. 
   (b) 
    (c)  The State Department of Social Services shall also
adopt regulations to implement this division, including, but not
limited to, regulations that establish:
   (1) The specific eligibility requirements for in-home supportive
services benefits.
   (2) Those in-home supportive services benefits for which
participants in the program shall be eligible. 
   (c) 
    (d)  The State Department of Health  Care 
Services and the State Department of Social Services shall also
jointly adopt regulations that provide for the following:
   (1) Continuation of benefits pursuant to Section 22008.5.
   (2) The protection of a participant's resources pursuant to
Section 22004, and the ratio of resources to long-term care benefit
payments as described in subdivision (c) of Section 22004. 
   (d) 
    (e)   (1)    The departments shall
adopt emergency regulations pursuant to Chapter 3.5 (commencing with
Section 11340) of Part 1 of Division 3 of Title 2 of the Government
Code to implement this division. The adoption of regulations pursuant
to this section in order to implement this division shall be deemed
to be an emergency and necessary for the immediate preservation of
the public peace, health, or safety. 
    Notwithstanding 
    (2)     Notwithstanding Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 3 of Title 2 of
the Government Code, emergency regulations adopted pursuant to this
section shall not be subject to the review and approval of the Office
of Administrative Law. The regulations shall become effective
immediately upon filing with the Secretary of State. The regulations
shall not remain in effect more than 120 days unless the adopting
agency complies with all of the provisions of Chapter 3.5 (commencing
with Section 11340) as required by subdivision (c) of Section
11346.1 of the Government Code.
   SEC. 9.    Section 22010 of the   Welfare
and Institutions Code   is amended to read: 
   22010.  (a) In implementing this division, the  State
Department of Health Services   California Department of
Aging  may contract, on a bid or nonbid basis, with any
qualified individual, organization, or entity for services needed to
implement the project, and may negotiate contracts, on a nonbid
basis, with long-term care insurers, health care service plans, or
both, for the provision of coverage for long-term care services that
will meet the certification requirements set forth in Section 22005.1
and the other requirements of this division.
   (b) In order to achieve maximum cost savings, the Legislature
declares that an expedited process for issuing contracts pursuant to
this division is necessary. Therefore, contracts entered into on a
nonbid basis pursuant to this section shall be exempt from the
requirements of Chapter 1 (commencing with Section 10100) and Chapter
2 (commencing with Section 10290) of Part 2 of Division 2 of the
Public Contract Code. 
  SECTION 1.    Section 8231 of the Education Code
is amended to read:
   8231.  (a) For the purpose of this article, a "migrant
agricultural worker family" means a family that has earned at least
50 percent of its total gross income from employment in fishing,
agriculture, or agriculturally related work during the 12-month
period immediately preceding the date of application for child care
and development services.
   (b) (1) Children of migrant agricultural worker families shall be
enrolled in child development programs on the basis of the following
priorities:
   (A) The family moves from place to place.
   (B) The family has qualified under subparagraph (A) within the
past five years and is currently dependent for its income on
agricultural employment, but is currently settled near agricultural
areas.
   (C) The family resides in a rural agricultural area and is
dependent upon seasonal agricultural work.
   (2) Eligibility and priority for services for the federally funded
Migrant Child Development Program shall be in accordance with the
applicable federal regulations.
   (c) This section shall remain in effect only until July 1, 2017,
and as of that date is repealed, unless a later enacted statute, that
is enacted before July 1, 2017, deletes or extends that date.
 
  SEC. 2.    Section 8231 is added to the Education
Code, to read:
   8231.  (a) For the purpose of this chapter, a "migrant
agricultural worker family" means a family with at least one parent
who has earned at least 50 percent of his or her income from
employment in fishing, agriculture, or agriculturally related work
during the 12-month period immediately preceding the date of
application for child care and development services.
   (b) (1) For purposes of this article, priority for enrollment
shall be given to children of migrant agricultural worker families in
the following priority order:
   (A) The family moves from place to place.
   (B) The family has qualified under subparagraph (A) within the
past five years and is currently dependent for its income on
agricultural employment, but is currently settled near agricultural
areas.
   (C) The family resides in a rural agricultural area and is
dependent upon seasonal agricultural work.
   (2) Eligibility and priority for services for the federally funded
migrant child care and development program shall be in accordance
with the applicable federal regulations.
   (c) This section is operative on July 1, 2017.