BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1044
                                                                  Page  1

          Date of Hearing:   May 20, 2009 

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Kevin De Leon, Chair

                     AB 1044 (Jones) - As Amended:  May 5, 2009  

          Policy Committee:                              Aging & LTC Vote:  
          4-2
                        Health                                    13-6 

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              

           SUMMARY  

          This bill transfers the oversight and regulation of continuing  
          care retirement communities (CCRC) from the California  
          Department of Social Services (DSS) to the California Department  
          of Insurance (CDI). Specifically, this bill: 

          1)Requires CDI to be vested with all the duties, powers,  
            purposes, functions, responsibilities, and jurisdiction of DSS  
            over CCRC, except for oversight and regulation of programs and  
            services provided directly to residents of the CCRC.

          2)Requires CDI to review the requirements of the CCRC body of  
            law and make recommendations to the Legislature to improve the  
            oversight and regulation of the financial management of CCRC  
            to protect consumers who enter into continuing care contracts.  


          3)Requires the Continuing Care Provider Fee Fund to consist of  
            two accounts: (a) the Insurance Account and (b) DSS Account  
            and requires 95% of fees received to be deposited in the  
            Insurance Account and 5% in the DSS Account.  

           FISCAL EFFECT  

          Annual increased fee-supported special fund costs of $1 million  
          to CDI to provide a higher level of oversight with respect to  
          financial surveillance, legal analysis, information technology,  
          and overhead. Actual costs may be lower to the extent CDI is  
          able to provide new regulatory infrastructure and scrutiny of  
          the CCRC industry in the early years following enactment of this  








                                                                  AB 1044
                                                                  Page  2

          legislation and permanent workload is less. 

           COMMENTS  

           1)Rationale  . This bill transfers the oversight of CCRC from DSS  
            to CDI. The author indicates continuing care contracts should  
            be regulated more like insurance products due to transactions  
            between an individual and the CCRC provider in which the  
            business sells a future benefit in terms of housing, health  
            care, and other services to support aging residents, in return  
            for one-time and recurring fees. 

           2)Background  . CCRC provide a long-term continuing care contract  
            that supports independent living, residential care/assisted  
            living services, and skilled nursing care, usually in one  
            location, and usually for a resident's lifetime. California  
            currently has 79 CCRC serving approximately 20,000 adults over  
            60 years of age. According to DSS, there are 15 CCRC which  
            serve lower income residents, but statewide, the growth has  
            been in the higher cost CCRC. Most CCRC require a substantial  
            entrance fee (from a low of $100,000 to over $1 million) to be  
            paid by the applicant upon admission in addition to on-going  
            fees. CCRC provide three levels of care: independent living,  
            assisted living, and skilled nursing. The author contends that  
            financial oversight differs considerably from the bulk of the  
            regulation that DSS is engaged in, and financial analysis is  
            not a typical role for state social services agencies to play.  
             This bill increases the oversight and financial scrutiny of a  
            growing industry serving wealthy Californians. 


           Analysis Prepared by  :    Mary Ader / APPR. / (916) 319-2081