Amended in Senate March 29, 2016

Senate Bill No. 1384

Introduced by Senator Liu

February 19, 2016

An act to begin delete amend, repeal, and add Section 8231 of the Education Code, relating to child care. end delete begin insert 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. end insert

LEGISLATIVE COUNSEL’S DIGEST

SB 1384, as amended, Liu. begin delete Child care and development services: children of migrant agricultural worker families. end delete begin insert California Partnership for Long-Term Care Program. end insert

begin insert

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.

end insert begin insert

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.

end insert begin delete

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.

end delete begin delete

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.

end delete

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

begin insert

begin insert SECTION 1. end insert   

end insert

begin insert Section 22002 of the end insert begin insert Welfare and Institutions
Code end insert begin insert is amended to read: end insert

22002.  

The State Department of Health begin insert Care end insert Services shall
seek any federal waivers and approvals necessary to accomplish
the purposes of this division.

begin insert

begin insert SEC. 2. end insert   

end insert

begin insert Section 22003 of the end insert begin insert Welfare and Institutions Code end insert begin insert is
amended to read: end insert

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 begin insert Care end insert 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 begin delete State Department of Health Services end delete begin insert California
Department of Aging end insert 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 begin delete State Department of Health
Services end delete begin insert California Department of Aging end insert 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.

begin insert

begin insert SEC. 3. end insert   

end insert

begin insert Section 22004 of the end insert begin insert Welfare and Institutions Code end insert begin insert is
amended to read: end insert

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 begin insert Care end insert 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 begin insert Care end insert 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.

begin insert

begin insert SEC. 4. end insert   

end insert

begin insert Section 22005 of the end insert begin insert Welfare and Institutions Code end insert begin insert is
amended to read: end insert

22005.  

The begin delete State Department of Health Services end delete begin insert California
Department of Aging end insert shall only certify a long-term care insurance
policy or a health care service plan contract that meets the Medi-Cal
asset protection requirements.

begin insert

begin insert SEC. 5. end insert   

end insert

begin insert Section 22005.1 of the end insert begin insert Welfare and Institutions Code end insert

begin insert is amended to read: end insert

22005.1.  

(a) The begin delete State Department of Health Care Services end delete
begin insert California Department of Aging end insert 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 begin delete State Department of Health Care Services end delete begin insert California
Department of Aging end insert 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 begin delete State Department of Health Care Services end delete
begin insert California Department of Aging end insert pursuant to Section 22009.

(3)  begin insert (A) end insert begin insert   end insert Protection against loss of benefits due to begin delete inflation. end delete

begin insert inflation, which shall include both of the following: end insert

begin insert

(i) One option no less favorable than that required by Section
10237.1 of the Insurance Code.

end insert begin insert

(ii) One lower cost option, consistent with the requirements of
the federal Deficit Reduction Act of 2005 (Public Law 109-171).

end insert begin insert

(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.

end insert

(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
begin delete Services or end delete begin insert Services, the California Department of Aging, or end insert the
State Department of Social Services and consistent with the
purposes of this division.

begin insert

begin insert SEC. 6. end insert   

end insert

begin insert Section 22005.2 of the end insert begin insert Welfare and Institutions Code end insert

begin insert is amended to read: end insert

22005.2.  

Each organization issuing policies certified by the
begin delete State Department of Health Services end delete begin insert California Department of
Aging end insert 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).

begin insert

begin insert SEC. 7. end insert   

end insert

begin insert Section 22006 of the end insert begin insert Welfare and Institutions Code end insert begin insert is
amended to read: end insert

22006.  

The State Department of Health begin insert Care end insert 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 begin insert Care end insert Services pursuant to Section
22009.

(b) Services delivered to insured individuals begin insert at home or end insert in a
community setting as part of an individual assessment and case
management program provided by coordinating entities designated
and approved by the begin delete State Department of Health Services. end delete

begin insert California Department of Aging. end insert

(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 begin insert Care end insert Services.

begin insert

begin insert SEC. 8. end insert   

end insert

begin insert Section 22009 of the end insert begin insert Welfare and Institutions Code end insert begin insert is
amended to read: end insert

22009.  

(a) The begin delete State Department of Health Services end delete begin insert California
Department of Aging end insert shall adopt regulations to implement this
division, including, but not limited to, regulations begin delete which end delete begin insert that end insert
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)  begin insert (A) end insert begin insert   end insert The amount and types of services that a long-term care
insurance policy or health care service plan contract begin delete which end delete begin insert that end insert
includes long-term care services must cover to meet the
requirements of this division. begin insert 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. end insert

begin insert

(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.

end insert

(4) Which coordinating entities are designated and approved to
deliver individual assessment and case management services to
individuals begin insert at home or end insert in a community setting, as required by
subdivision (b) of Section 22006.

begin insert

(b) The State Department of Health Care Services shall also
adopt regulations to implement this division, including, but not
limited to, regulations that establish:

end insert begin delete

(5)

end delete

begin insert (1) end insert  The disability criteria for eligibility for long-term care
benefits as required by subdivision (c) of Section 22006.

begin delete

(6)

end delete

begin insert (2) end insert  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.

begin delete

(b)

end delete

begin insert (c) end insert  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.

begin delete

(c)

end delete

begin insert (d) end insert  The State Department of Health begin insert Care end insert 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.

begin delete

(d)

end delete

begin insert (e) end insert   begin insert (1) end insert begin insert   end insert 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.

begin delete

Notwithstanding

end delete

begin insert (2) end insert begin insert   end insert begin insert Notwithstanding end insert 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.

begin insert

begin insert SEC. 9. end insert   

end insert

begin insert Section 22010 of the end insert begin insert Welfare and Institutions Code end insert begin insert is
amended to read: end insert

22010.  

(a) In implementing this division, the begin delete State Department
of Health Services end delete begin insert California Department of Aging end insert 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.

begin delete

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.

end delete