Today's Law As Amended

PDF |Add To My Favorites |Track Bill | print page

SB-512 Long-term services and supports.(2019-2020)



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 health care 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 health care 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. (1999) 527 U.S. 581.
(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. (1999) 527 U.S. 581, 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.

SEC. 2.

 Chapter 12.5 (commencing with Section 9800) is added to Division 8.5 of the Welfare and Institutions Code, to read:

CHAPTER  12.5. Long-Term Services and Supports
9800.
 (a) There is hereby created in state government the California Long-Term Services and Supports Benefits Board (LTSS Board), which shall consist of the following nine members:
(1) The Treasurer, who shall serve as the chair.
(2) The Secretary of California Health and Human Services, who shall serve as the vice chair.
(3) The Director of Finance, or the director’s designee.
(4) The Controller, or the controller’s designee.
(5) An individual with expertise in the provision and financing of long-term services and supports who shall be appointed by the Senate Committee on Rules.
(6) An individual with expertise in the provision and financing of long-term services and supports who shall be appointed by the Speaker of the Assembly.
(7) The following individuals, who shall be appointed by the Governor:
(A) A person who is 60 years of age or older and who is a consumer of long-term services and supports.
(B) A person who has lived with a disability, a chronic condition, or both, for a majority of their life and who is a consumer of long-term services and supports.
(C) A person who serves as an unpaid family caregiver to an older adult or individual with a disability.
(b) (1) The LTSS Board shall manage and invest revenue deposited in the California Long-Term Services and Supports Benefits Trust Fund (LTSS Trust), which is hereby created in the State Treasury. Moneys in the fund shall be available, upon appropriation by the Legislature, to finance long-term services and supports for eligible older adults and individuals with physical and mental disabilities in California.
(2) After sufficient funds are deposited in the LTSS Trust to be self-sustaining, all costs of administration shall be paid out of funds in the LTSS Trust.
9805.
 (a) There is hereby created within state government the California Long-Term Services and Supports Advisory Committee, which shall consist of nine members that have experience in aging and disability services. The appointments shall be made as follows:
(1) At least one member of the advisory committee shall be each of the following:
(A) A provider of long-term services and supports.
(B) A consumer of publicly financed long-term services and supports.
(C) A representative of a labor union that is the designated representative of in-home supportive services providers.
(D) An advocate for older adults.
(E) An advocate for persons with physical and mental disabilities who rely upon long-term services and supports.
(F) A family caregiver.
(2) Three members each shall be appointed by the Senate Committee on Rules, the Speaker of the Assembly, and the Governor.
(b) The advisory committee shall provide ongoing advice and recommendations to the LTSS Board.
(c) This section shall remain in effect only until January 1, 2025, and as of that date is repealed.