SB 255

Bill Subjects

Abstract

Existing law establishes the California Partnership for Long-Term Care Program, which is 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 the Medi-Cal program and to provide Medi-Cal program 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 prescribes specified criteria for certification of a long-term care insurance policy under the program. Existing law requires a policy, certificate, or rider in which benefits are limited to the provision of all care settings, except nursing facility care, and that is offered under the California Partnership for Long-Term Care Program to be called a home care and community-based services policy, certificate, or rider. A long-term care policy, certificate, or rider that purports to provide benefits of home and community-based services under the California Partnership for Long-Term Care Program is required to provide specified minimum services, including assisted living facility services and residential care facility services. Existing law includes minimum policy definitions of those facilities. Existing law also requires 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, among other specified coverage categories, home care and community-based care coverage only. This bill would require a policy, certificate, or rider as described above to instead be called a home care, community-based services, and residential care facility only policy, certificate, or rider. The bill would delete assisted living facility services from the list of required minimum services to be provided, clarify that those required minimum services include care in a residential care facility, and delete the policy definitions. The bill also would make conforming name changes. This bill would declare that it is to take effect immediately as an urgency statute.