SECTION 1.
(a) The Legislature finds and declares all of the following:(1) Almost 8,000,000 people who are either older adults or individuals with physical and mental disabilities currently live in California. This population is expected to grow significantly over the next decade, primarily due to the longer life expectancy we now enjoy and the growing number of people living longer with physical and mental disabilities. This population includes individuals with developmental disabilities who are aging out of their systems of care or do not have systems of care in place, but need supports; individuals with traumatic injuries or acquired
disabilities who are surviving prior life expectancies due to advances in medical care; and individuals over 65 years of age with functional impairments.
(2) California’s older adult population, in particular, is entering a period of unprecedented growth. By 2030, the population over 65 years of age will grow by 4,000,000 people as the Baby Boom generation reaches retirement age. The population of Californians 65 years of age and older is projected to triple by 2060 from the 2013 population.
(3) California’s older adult population will also be much more racially and ethnically diverse than ever before. In addition, more older adults are likely to live alone without family members to care for them as their need for long-term supports and services increase.
(4) Based on data from the 2015 American Community Survey, approximately 1,100,000 Californians need long-term services and supports, which includes people living in the community and in institutions. Of those, 45 percent are under 65 years of age and 55 percent are over 65 years of age.
(5) Long-term services and supports include a broad range of services and supports that enable older adults and individuals with physical and mental disabilities to live independently in their communities. They include, but are not limited to, personal care services, assistance with health maintenance, 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, assistive
technology, nutrition assistance, person-centered care coordination, and nursing facility services.
(6) Long-term services and supports are not adequately covered by Medicare, and most Californians cannot afford to purchase private long-term care insurance. Paying out-of-pocket for long-term services and supports for aging family members and family members with disabilities who are unable to maintain their health and independence without appropriate services and supports is highly expensive and creates a significant financial and social burden for families. Most caregiving is provided by family members, primarily women, without any compensation. 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.
(7) Family caregivers are significantly contributing to paying the cost of their loved one’s long-term care needs. In 2016, family caregivers spent an average of nearly $7,000 per year for out-of-pocket expenses, or about 20 percent of their income, when caring for a loved one. Hispanic and Latino and low-income family
caregivers spend even more — an average of 44 percent of their annual income. Unsurprisingly, these expenses can create a significant burden for family caregivers.
(8) Younger working 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. Like women who function as unpaid caregivers for their families, younger working people with disabilities find it difficult to save for 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) The most recent national estimates show that, for those over 65 years of age who need long-term services
and supports, the lifetime costs average about $260,000, while older adults’ median retirement savings are estimated at just $148,000.
(10) The most recent estimates show that, in 2017, the median annual cost of nursing home care in California was $116,000 for a private room and $97,000 for a shared room. These costs are as much as, or more than, double the median income of older households in California, which is $50,000 per year. The base price for assisted living was $51,000 per year. The median cost for a home health aide to provide care at home for 30 hours per week was $39,000 annually. Adult day services for five days per week cost $20,000 per year.
(11) By 2030, more than 1,000,000 older adults in California will require some assistance with self-care. 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 supports and services, these changes will create significant budget pressures for the Medi-Cal program, including the In-Home Supportive Services (IHSS) program, which pays for in-home care and services for low-income older adults and persons with physical and mental disabilities. The state will need additional resources, including a wider array of home- and community-based services, person-centered care coordination, nursing care facilities, adult day services, direct care workers, assistive technology, and healthcare professionals and peer-driven services, especially those who provide home- and community-based services.
(12) As California addresses the needs of the 8,000,000 older adults
and individuals with physical and mental disabilities who rely on effective programs, it must also address the workforce development and training needs of healthcare professionals and those direct care workers who deliver long-term services and supports to this growing population.
(13) As California seeks new options for funding long-term services and supports, it will continue its commitment to promote the ability of California’s older adults and individuals with physical and mental disabilities to live independently in their homes and their communities, consistent with the United States Supreme Court’s decision in Olmstead v. L.C. (1998) 525 U.S. 1062.
(b) It is the intent of the Legislature to, consistent with the principles of the United States Supreme Court’s decision in Olmstead
v. L.C. (1998) 525 U.S. 1062, advance its commitment to older adults and individuals with physical and mental disabilities by creating a funding stream and a program to provide for long-term services and supports for eligible Californians.