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CA Department of Insurance
CA Department of Insurance
CA Department of Insurance

Long Term Care Insurance Task Force

Background

Recent public opinion research indicates that Californians, regardless of political party or income level, are worried about the costs of growing older. Two-thirds of respondents in the research said that they are apprehensive about being able to afford long-term care. Sixty-three percent of respondents worry as much about paying for long-term care as they do for their future health care.

A majority of respondents could not afford more than three months of nursing home care at an average cost of six thousand dollars ($6,000) per month in California. About four in 10 respondents could not afford a single month of care at that rate. Among Latino voters, 88 percent said they do not have long-term care insurance or are not sure whether they are covered for supportive services like in-home care. Concerns about paying for long-term care cut across all income levels and all partisan affiliations.

About the Long Term Care Insurance Task Force

The passage of AB 567 (Calderon) established the Long Term Care Insurance Task Force (Task Force) in the California Department of Insurance to explore the feasibility of developing and implementing a culturally competent statewide insurance program for long-term care services and supports.

The objectives of the Task Force include all of the following:

  • Explore how a statewide long-term care insurance program could be designed and implemented to expand the options for people who are interested in insuring themselves against the risk of costs associated with functional or cognitive disability, and require long-term care, services, and supports.
  • Explore options for the design of the program, including eligibility, enrollment, benefits, financing, administration, and interaction with the Medi-Cal program and other publicly funded resources. In exploring these options, the task force shall consider all of the following:
    • Whether and how a long-term care insurance program could be included as a benefit in the state disability insurance program structure, possibly through a nominal increase in the payroll tax, and whether the program could be structured in the same manner as Paid Family Leave benefits.
    • Allowing for enrollment in the program of working adults who would make voluntary premium contributions either directly or through payroll deductions through their employer.
    • To the extent feasible, requiring a mandatory enrollment with a voluntary opt-out option.
    • Giving working adults the opportunity to plan for future long-term care needs by providing a basic insurance benefit to those who meet work requirements and have developed functional or equivalent cognitive limitations.
    • Helping individuals with functional or cognitive limitations remain in their communities by purchasing nonmedical services and supports, including home health care and adult daycare.
    • Helping offset the costs incurred by adults with chronic and disabling conditions. The program need not be designed to cover the entire cost associated with an individual’s long-term care needs.
  • Evaluate how benefits under the program would be coordinated with existing private health care coverage benefits.
  • Evaluate the demands on the long-term care workforce as the need for long-term care in California grows, and how the long-term care workforce can be prepared to meet those demands.
  • Consider the establishment of a joint public and private system to make long-term care accessible to as many individuals within California as possible.
  • Make recommendations related to key regulatory provisions necessary for the public to access existing long-term care insurance programs and participate in future long-term care insurance programs, whether those programs are recommended by the task force or otherwise.

Reports


The Task Force shall recommend options for establishing a statewide long-term care insurance program and comment on the respective degrees of feasibility of those options in a report submitted to the commissioner, the Governor, and the Legislature on or before January 1, 2023. The report submitted to the Legislature shall be submitted in accordance with Section 9795 of the Government Code.

After the completion of the Feasibility Report, and to ensure an adequate benefit within a solvent program, the department will, no later than January 1, 2024, produce an actuarial report of the recommendations made by the Task Force. The report shall be shared with and approved by the members of the Task Force. If approved the report shall be submitted to the Legislature.

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Task Force Members

  • Dr. Lucy Andrews is Director of Nursing and CEO for At Your Service Nursing and Home Care. Dr. Andrews presently serves as Board Chair for the California Association for Health Services at Home (CAHSAH) and is the former Vice Chair of the National Association for Home Care and Hospice in Washington, DC. She is also a recipient of the Lois Lillick Award, which honors advocacy and expertise in the home care industry. Dr. Andrews serves on the Task Force as a representative of hospice and palliative care providers, appointed by Insurance Commissioner Ricardo Lara.
  • Jamala Arland, FSA, MAAA, CFA is Vice President of Long-Term Care Insurance (LTCI) Inforce at Genworth, with responsibilities for the largest private LTCI inforce block, covering more than one million Americans and 120,000 Californians. Prior to joining Genworth, she worked at Ernst & Young in New York City. She is a Fellow in the Society of Actuaries (SOA), a Member of the American Academy of Actuaries (AAA), and a Charterholder of the CFA Institute. Arland served as 2020 Chair of the SOA’s Long-Term Care Section, 2021 Chair of the AAA’s Long-Term Care Reform Subcommittee, and 2021 Chair of the SOA’s Diversity Equity and Inclusion Committee. She is also a past Vice President of the International Association of Black Actuaries (IABA). Arland serves on the Task Force as a representative from the long-term care insurance industry, appointed by the Senate Committee on Rules.
  • Susan Bernard (Chair) is Deputy Commissioner of the Financial Surveillance Branch in the California Department of Insurance. Bernard is a Certified Financial Examiner (CFE), a Certified Information Systems Auditor (CISA) and an Automated Examination Specialist (AES). She participates in several NAIC Working Groups and Task Forces and is currently the Chair of the Financial Condition Examiners Handbook Technical Group and the Electronic Workpaper Working Group. Bernard serves on the Task Force as the designee for Insurance Commissioner Ricardo Lara.
  • Grace Cheng Braun, MSPH is President and CEO of WISE & Healthy Aging, which administers the City & County of Los Angeles’ Long-Term Care Ombudsman Program (the largest Ombudsman program in the state, and second in the nation) and Elder Abuse Prevention Services. The community-based, nonprofit social services organization also operates two adult day care centers and other care coordination and enrichment programming for older adults and caregivers of the elderly in Los Angeles. She is also a member of the Steering Committee of both the Los Angeles Alliance for Community Health and Aging (LAACHA) and the Westside Older Adult Services Network, which promotes health and service equity in the Los Angeles community. Cheng Braun serves on the Task Force as a representative of adult day services providers, appointed by Insurance Commissioner Ricardo Lara.
  • Anastasia Dodson is Associate Director at the California Department of Health Care Services where where she leads special projects and initiatives on behalf of the Director.  Dodson has been part of the DHCS leadership team for several key efforts, including the Coordinated Care Initiative, the Affordable Care Act, the Medi-Cal 2020 waiver, Medi-Cal palliative care services, the Governor’s Master Plan for Aging, COVID response, the CalAIM Initiative, and the 2020 Long-Term Services and Supports Feasibility Study prepared by Milliman. Her state government experience also includes the California Department of Finance, County Welfare Directors Association of California, and California State Senate Budget Committee. Dodson serves on the Task Force as the designee for Director Will Lightbourne.
  • Joe Garbanzos as the State President for AARP California. In this role, Garbanzos chairs the Executive Council, a diverse group of statewide volunteer professionals who provide advice and counsel to advance AARP’s social impact agenda in California. He also serves as the volunteer leader for AAPI outreach, the Chair of the Education Committee for the California Telehealth Coalition, co-lead for AARP’s livable communities work in San Diego County, and chair of the new High-Speed Internet Advisory Committee. Previously, Garbanzos was the CEO/Executive Director at Samahan Health Centers, a Federally Qualified Health Center in San Diego, and served as a health care consultant in launching the Affordable Care Act in California and the implementation of Coordinated Care Initiative in San Diego County. Garbanzos serves on the Task Force as a representative of a senior/consumer organization, appointed by Governor Gavin Newsom.
  • Eileen Kunz is Chief of Government Affairs and Compliance for On Lok Senior Health Services.  On Lok is a family of non-profit organizations with the common mission of empowering older adults to age with dignity and independence.  Kunz joined On Lok in 1986 as On Lok prepared to launch the national PACE (Program of All-Inclusive Care for the Elderly) replication effort and was instrumental in the formation of the National PACE Association.  She is a member of the CalPACE Board of Directors, the California Disability and Aging Community Living Advisory Committee (formerly the California Olmstead Advisory Committee), and the San Francisco Long-Term Care Coordinating Council. Kunz serves on the Task Force as a representative of a long-term care provider association, appointed by Governor Gavin Newsom.
  • Laurel Lucia is director of the Health Care program at the UC Berkeley Labor Center, where she has worked since 2009. Her research focuses on health coverage and cost trends in California, and policies to improve access to and affordability of health care for California workers and their families. She provides technical assistance to policymakers and stakeholders, and her work has been covered in the Los Angeles Times, the Atlantic, and National Public Radio. Previously, she worked on issues affecting long term care workers during her time as a researcher/policy analyst for the Service Employees International Union (SEIU). Lucia serves on the Task Force as a representative of a nongovernment health policy expert, appointed by Governor Gavin Newsom.
  • Kim McCoy Wade is the Director of the California Department of Aging.  She most recently served at the California Department of Social Services as the CalFresh & Nutrition Branch Chief, where she led the expansion of CalFresh food benefits to older adults and people with disabilities, as well as several data and technology initiatives, including the GetCalFresh mobile application.  She previously served as a consultant to multiple health and human services non-profits and as Executive Director of the California Association of Food Banks.  Earlier in her career, she worked in Washington, DC for the Children’s Defense Fund, Bread for the World, and Alliance for Justice.  She is an alumna of NYU School of Law, Carleton College, and the Jesuit Volunteer Corps.
  • Michael Mejia is Senior Vice President, Operations for Atria Senior Living where he leads Atria’s operations in the Western U.S. and currently oversees operations at 43 Atria communities in California, including 33 with memory care neighborhoods. He joined Atria in 1998 and since then has overseen operations in Texas and Kansas as Regional Vice President and served as Senior Vice President previously in the Central, Southeast, and Southwest divisions. He is also a member of the California Assisted Living Association (CALA) Board of Directors. Mejia serves on the Task Force as a representative of residential care facilities for the elderly, appointed by Insurance Commissioner Ricardo Lara.
  • Doug Moore is the Executive Director of the United Domestic Workers of America (UDW/AFSCME Local 3930) which represents more than 140,000 In-Home Supportive Services (IHSS) providers and family child care providers across California. Moore also serves as International Vice President of AFSCME. He was appointed by the State Assembly to the California Task Force on Family Caregiving in 2017. In 2019, he was appointed to the Governor’s Task Force on Alzheimer’s Prevention and Preparedness. Moore serves on the Task Force as a representative of independent providers of in-home personal care services, appointed by Insurance Commissioner Ricardo Lara.
  • Dr. Karl Steinberg has been a skilled nursing facility and hospice medical director in San Diego County for over 25 years and cares for patients in nursing homes, assisted living facilities, and small board-and-care facilities. He is President-Elect of AMDA – The Society for Post-Acute and Long-Term Care Medicine, a national organization representing physicians and medical directors working in various post-acute and long-term care settings, and is a delegate to the American Medical Association and the California Medical Association. Dr. Steinberg serves on the Task Force as a representative of long-term care health professionals, appointed by Insurance Commissioner Ricardo Lara.
  • Tiffany Whiten is Senior Government Advocate at SEIU California State Council where she oversees and coordinates state legislative and administrative policy development on many SEIU-California policy priorities, including assisted living, IHSS, nursing homes, adult day care, developmentally disabled, and other long-term care sectors as well as racial and social justice issues. She not only represents and advocates on behalf of long-term care providers, workers, and consumers, but is also a family caregiver to her mother with Alzheimer’s. Whiten’s previous roles include working as an Associate with Niemela Pappas and Associates, a Consultant for Senator Mark DeSaulnier, a Legislative Aide to Senate Majority Leader Ellen Corbett, and a Legislative Aide to Senate President pro Tempore Don Perata. Whiten serves on the Task Force as a representative of family caregivers, appointed by Insurance Commissioner Ricardo Lara.
  • TBD: A certified actuary with expertise in long-term care insurance, appointed by the Governor.
  • TBD: An employee representative organization that represents long-term care workers, appointed by the Speaker of the Assembly.

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Meeting Dates and Materials

Future Meetings

  • Meeting #4: October 21, 2021 - Interaction/Coordination
  • Meeting #5: December 16, 2021 - Administration
  • Meeting #6: February 17, 2022 - Financing
  • Meeting #7: April 21, 2022 - Workforce
  • Meeting #8: June 16, 2022 - Access
  • Meeting #9: September 15, 2022 - Draft Feasibility Report
  • Meeting #10: December 15, 2022 - Final Feasibility Report
  • Meeting #12: September 21, 2023 - Draft Actuarial Report
  • Meeting #13: December 21, 2023 - Final Actuarial Report

Past Meetings

Questions/Comments

If you have questions, would like to sign up to receive meeting notices via email, or would like to submit your comments on the work of the Task Force, please email: CDIBoards@insurance.ca.gov

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Resources

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