Long Term Care Insurance Task Force
- About the Long Term Care Insurance Task Force
- Task Force Members
- Meeting Dates and Materials
- Public Participation / Questionnaires
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, Chapter 746, Statutes of 2019) 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.
The Task Force has recommend several options for establishing a statewide long-term care insurance program and commented on the respective degrees of feasibility of those options in a report submitted to the commissioner, the Governor, and the Legislature on December 23, 2022, entitled the AB 567 Oliver Wyman Feasibility Report.
To ensure an adequate benefit within a solvent program, the options in the Feasibility Report will undergo financial analysis by Oliver Wyman and CDI. Their findings will be included in an Actuarial Report, which, if approved by the Task Force, will be submitted to the Legislature no later than January 1, 2024.
During the formation of the above reports, the Task Force has also taken into consideration the work performed and the findings from the Department of Health Care Services (DHCS) Long Term Services and Supports Feasibility Report.
- AB 567 Oliver Wyman Feasibility Report
- AB 567 Oliver Wyman Actuarial Report - in progress
Task Force Members
- Aron Alexander is Regional Vice President for Atria Senior Living, one of the largest senior living providers in North America, providing independent living, assisted living, and supportive living and memory care. Prior to Atria, Alexander worked for the Boys & Girls Clubs of America in the Director of Programs and Fundraising Director positions. She is a Certified Director of Assisted Living, Certified Administrator for Residential Care Facilities for the Elderly (RCFE), is a member of the California Assisted Living Association (CALA) as well as a former active member of the Chambers of Commerce and Rotary Clubs in Northern California. Alexander serves on the Task Force as a representative of residential care facilities for the elderly, appointed by Insurance Commissioner Ricardo Lara.
- Jamala Arland, FSA, MAAA, CFA is Vice President of Long-Term Care Insurance (LTCI) In-force 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 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.
- Dean Chalios is President and Chief Executive Officer of the California Association for Health Services at Home (CAHSAH). In that capacity, he is responsible for overall policy development, management, and operations of the largest state home care association in the nation. He has been an association executive and health care policy advocate for over 20 years having held senior positions with the California Medical Association and the California Dental Association and has also served on the staff of the California State Assembly and the United States Senate. Chalios serves on the Task Force as a representative of hospice and palliative care providers, appointed by Insurance Commissioner Ricardo Lara.
- Anastasia Dodson is Deputy Director for the Office of Medicare Innovation and Integration at the California Department of Health Care Services. 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 Michelle Baass.
- Joe Garbanzos is 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.
- Lydia Missaelides is interim Executive Director of California Association for Adult Day Services (CAADS) and Executive Director for the Alliance for Leadership and Education. Missaelides has 35 years of experience working in the field of aging and disability and long term care services and supports public policy and program development with a focus on adult day services, care coordination, and Medicaid managed care. She was a member of the Governor’s Master Plan for Aging Subcommittee on Long Term Services and Supports, as well as a current member of the California Health and Human Services Agency Secretary’s Olmstead Committee, the California Collaborative for Long Term Services and Supports, and the California Aging and Disability Alliance. Missaelides serves on the Task Force as a representative of adult day service providers, 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.
- Parag Shah is Vice President & Senior Actuary of Product Design for Pacific Life Insurance Company. In this capacity he oversees a team of product managers responsible for the development of new life insurance solutions. Mr. Shah also is responsible for Pacific Life’s LTC solutions portfolio. Mr. Shah started his career with Lincoln Financial Group in 1995. During his 14 years with Lincoln, Parag worked in a variety of roles from product development to mergers and acquisitions in a variety of locations from Fort Wayne, Indiana to London, England. He joined Pacific Life in March 2009. He is a Fellow of the Society of Actuaries (FSA) and a Member of the American Academy of Actuaries (MAAA). Shah serves on the Task Force as a certified actuary with expertise in long-term care insurance, appointed by Governor Gavin Newsom.
- Sarah Steenhausen serves as Deputy Director of the Division of Aging Policy, Research and Equity. In this role, she collaborates with state departments and stakeholders in developing policy and research impacting older adults and family caregivers in areas related to long-term services and supports, health, housing, equity, inclusion, and isolation prevention, among others. Previously, Sarah served as Director of Policy and Advocacy at The SCAN Foundation where she focused on advancing policy solutions to improve the system of care serving older adults and their family caregivers. Steenhausen serves on the Task Force as the designee for Director Susan DeMarois.
- 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.
- Brandi Wolf is the Policy and Research Director for the Service Employees International Union (SEIU) Local 2015, representing over 400,000 long term care workers in California, including homecare providers and nursing home workers across the state. She was appointed by the California Health and Human Services Secretary, Dr. Mark Gahly, to the Stakeholder Advisory Committee for the California Master Plan for Aging. Prior to joining the SEIU team in 2011, Wolf worked for three years as a Legislative Aide in the office of State Senator Curren D. Price, Jr. (D-Los Angeles) where she handled legislative issues relating to Health & Human Services, Business & Professions and the State budget. Wolf serves on the Task Force as a representative of an employee organization that represents long-term care workers, appointed by the Speaker of the Assembly.
Meeting Dates and Materials
Meetings of the Task Force are held on the third Thursday of certain months. The following list comprises all scheduled meetings and may be updated at any time.
- Quarterly Task Force Meetings
- Meeting #20: June 15, 2023 - Preliminary actuarial analysis and potential Program design changes
- Meeting #21: July 13, 2023 - Potential Program design changes questionnaire discussion
- Meeting #22: September 21, 2023 - Presentation of draft Actuarial Report
- Meeting #23: December 14, 2023 - Presentation of final Actuarial Report
- Actuarial Sub-committee Meetings
- Meeting #19: March 9, 2023 - Overview of actuarial sub-committee's work and approach
- Subcommittee Meeting #1: February 27, 2023 at 10:00 AM - Actuarial sub-committee scope, approach, and workplan
- Meeting #18: December 15, 2022 at 1:00 p.m. (PST) - Presentation of Final Feasibility Report
- Meeting #17: November 18, 2022 at 1:00 p.m. (PST) - Discussion of Draft Feasibility Report
- Meeting #16: October 6, 2022 at 2:00 p.m. (PST) - Presentation of Draft Feasibility Report
- Meeting #15: August 4, 2022 at 2:00 p.m. (PST) - Program Interdependencies Questionnaire Discussion
- Meeting #14: July 21, 2022 at 1:00 p.m. (PST) - Program Interdependencies
- Meeting #13: June 30, 2022 at 1:00 p.m. (PST) - Access and Regulation Questionnaire Discussion
- Meeting #12: June 16, 2022 at 1:00 p.m. (PST) - Access and Regulation
- Meeting #11: May 5, 2022 at 2:00 p.m. (PST) - Workforce Questionnaire Discussion
- Meeting #10: April 21, 2022 at 1:00 p.m. (PST) - Workforce
- Meeting #9: March 10, 2022 at 2:30 p.m. (PST) - Financing Questionnaire Discussion
- Meeting #8: February 17, 2022 at 1:00 p.m. (PST) - Financing
- Meeting #7: February 16, 2022 at 1:00 p.m. (PST) - Administration and services Questionnaire Discussion
- Meeting #6: January 27, 2022 at 1:00 p.m. (PST) - Benefits and Services
- Meeting #5: December 16, 2021 - Interaction/Coordination and Administration
- Meeting #4: October 21, 2021 - Interaction/Coordination
- Meeting #3: August 19, 2021
- Meeting #2: June 4, 2021
- Meeting #1: March 9, 2021
Public Participation / Questionnaires
Members of the public are encouraged to provide their views and opinions by completing the various Questionnaires prepared for each of the Task Force meetings. Please select this link to visit our Questionnaires page.
If you have questions, would like to sign up to receive meeting notices via email, or would like to submit general comments on the work of the Task Force, please email: CDIBoards@insurance.ca.gov.
- Bipartisan Solutions to Improve the Availability of Long-term Care
- California Department of Aging: Master Plan for Aging
- California Department of Health Care Services (DHCS) Long Term Services and Supports Feasibility Study Final Report
- Caregiver Resources Centers
- Caregiving Choices: Series on Advancing Transformation in Long-Term Services and Supports (LTSS)
- DHCS Financing Reform Proposals That Involve Public Programs - American Academy of Actuaries
- Essential Criteria for Long-term Care Financing Reform Proposals - American Academy of Actuaries
- Family Caregiving and LTSS Survey (AARP)
- Learning from New State Initiatives in Financing Long-Term Services and Supports
- Lives & Livelihoods: California's Private Homecare Industry in Crisis (UCLA Labor Center)
- Long-term Care Discussion Group
- Medi-Cal Working Disabled Program
- New Approaches to Long-term Care Access for Middle-Income Households - AARP Institute
- National Academy of Social Insurance: Designing Universal Long-Term Services and Supports Programs: Lessons from Germany and Other Countries
- Regulatory Options for Long-term Care Insurance Innovation - American Academy of Actuaries
- Value in LTC Insurance Policies - Anthem Public Policy Institute