Each year the California Collaborative provides input to the State Legislature as well as state and federal agencies and officials, in support of effective policies for long term services and supports. These are some of our recent recommendations.
Letter to DHCS requesting that, while they are in the process of both re-procuring Medi-Cal health plans and making benefit changes that necessitate contract updates under the CalAIM process, they include emergency planning and services as part of these initiatives, as well as requiring health plans to play a role in member-focused emergency preparedness. Inclusion of these initiatives will help to fulfill the state’s mandate to plan for the needs of older adults and people with disabilities through the Master Plan for Aging.
A summary of member budget and policy priorities, supported by the California Collaborative. Please note that this document is updated on a regular basis. The most current version can be found here.
These recommendations were developed by the California Collaborative for Long Term Services and Supports (CCLTSS) CCI workgroup and include thoughtful policy and financing recommendations that will improve care for members, deliver on the promise of the CCI, and build a more sustainable program. The recommendations have been shared with the Department of Health Care Services, Department of Finance, and members of the Legislature.
This letter was sent to Jennifer Kent, Director of the Department of Health Care Services to recommend that DHCS consider including LTSS representation on the Behavioral Health Stakeholder Advisory Committee.
This letter was submitted to the Office of Governor Gavin Newsom thanking him for his commitment to a Master Plan for Aging.
This letter states concerns by the CCLTSS on the Log-In process, privacy issues, and resources to save prescription entries applicable to the new Medicare Plan Finder. CCLTSS requests resolution to these concerns by providing special access to SHIP/HICAP counselors to process plan comparison searches without going through the myMedicare.gov process, and to monitor the fall enrollment roll-out closely for issues facing the counselors during this fall enrollment period.
This letter requests that the CalQualityCare.org website be moved to the Office of the Patient Advocate and be funded through the OPA trust fund. This can be accomplished by either a Jr. budget bill this summer or administrative action.
This bill directs the Department of Health Care Services (DHCS) to significantly increase the available participant slots in the Assisted Living Waiver (ALW) and expand the availability of the ALW beyond the current 15 counties. This bill also directs the DHCS to modify its reimbursement rates to account for regional differences in the costs of providing care.
This letter is a request to postpone action on the White House OMB proposal to change the inflation measure used to update the official federal poverty level (FPL) due to its severe impact on older adults and those with disabilities.
This bill requires that the California Department of Aging, in partnership with other specified departments and in consultation with stakeholders, develop a plan and strategy for a phased statewide implementation of the No Wrong Door system on or before July 2, 2020.
This bill requires that the state adopt a Master Plan for Aging, emphasizing workforce priorities. The bill requires the Master Plan for Aging to prioritize specified issues related to preparing and supporting the state’s paid paraprofessionals and professionals, as well as unpaid family caregivers.
This bill establishes the Master Plan for Aging Housing Task Force to make recommendations for legislation that will help increase the supply of accessible and affordable housing for older adults and reduce barriers to providing health care and social services.
This $36.118 million Budget Request sponsored by Assemblymember Kalra is for the expansion of the Assisted Living Waiver program slots statewide, which will result in an estimated net savings of $44.601 million to the state.
This bill directs the Department of Health Care Services (DHCS) to significantly increase the available participant slots in the Assisted Living Waiver (ALW) and expand the availability of the ALW beyond the current 15 counties.
Collaborative Support Letter – CAADS’ Request for Medi-Cal Reimbursement Rate Increase for CBAS Program
The California Association for Adult Day Services (CAADS) request for restoration of the 10% cut to the current Medi-Cal fee-for-service published rate for the Community-Based Adult Services (CBAS) program to prevent potential closures of CBAS centers (per AB 97, Chapter 3, Statutes of 2011). Also includes CAADS’ request for a 15% cost-of-living increase to the published Medi-Cal rate to adjust for more than 10 years of cost increases.
The Budget Request by the Senior Services Coalition of Alameda County and sponsored by Assemblymember Chu to appropriate $45.092 million from the General Fund to increase California’s investment in aging services in order to build local assistance capacity in Older Californians Act programs administered in the California Department of Aging (CDA). This will assist seniors to stay connected with their communities, and to help them to comply with care plans and avoid institutionalization.
This bill transfers responsibility for the licensing of PACE programs and expansions from the Department of Public Health (DPH) to the Department of Health Care Services (DHCS), which handles all other PACE-related functions, thereby streamlining the approval process and avoiding delay of access to PACE services.
This bill would stop seniors and adults with disabilities from yo-yoing or flipping between free and share of cost Medi-Cal. Currently, this happens because the Medi-Cal income counting rules deduct an individual’s out-of-pocket payment of the Medicare Part B premium from their income, but stop deducting that payment when it comes from the state as a benefit of free Medi-Cal.
The California Long-Term Care Ombudsman Association’s request of $5.2 million in general funds would enable local programs to conduct vital quarterly unannounced visits to over 8,500 long-term care facilities and investigate and resolve an additional 8,000 complaints per year.
This bill updates and expands the home upkeep allowance, which helps ensure seniors and adults with disabilities who have a short-term nursing facility stay do not lose their home or belongings. Currently, an individual who resides in a nursing home should have access to the home upkeep allowance, which allows that individual to keep money for up to 6 months to pay for rent or mortgage so they don’t lose their housing while in a nursing home.
This bill raises the Medi-Cal income eligibility limit for seniors and adults with disabilities to 138% of the federal poverty level. This bill resolves an unfair situation in which seniors and adults with disabilities are subject to a lower income eligibility limit than others in the Medi-Cal population.
This bill increases and simplifies the asset eligibility limit for Medi-Cal and eliminates those limits for the Medicare Savings Programs, which makes Medicare more affordable. This bill is needed because the current asset rules are so low that they affect seniors’ financial stability and perpetuate racial inequity within the Medi-Cal program.
This bill will create the California Care Corps. The California Care Corps is an incredible solution at some of the most looming cost and moral pressures of the State of California – the care for our growing senior population.
This letter was submitted to the office of Senator Hannah-Beth Jackson to express support for the concept of appointing an Aging Czar and Aging Task Force to work with representatives from state departments and stakeholders to develop a Master Plan for aging.
At the request of the Department of Health Care Services for stakeholder input, the California Collaborative submitted recommendations for program improvements to Cal MediConnect in anticipation of a 3-year financial alignment demonstration renewal.
The Governor’s January 2019-20 budget proposal makes much-needed investments in California’s communities. Yet, more is required to address the long-term care needs of older adults and persons with disabilities to ensure their highest quality of life and quality of care. The Collaborative looks forward to working with the Governor to make his commitment a reality.
In a letter to California Senate President pro Tempore Toni Atkins and Assembly Speaker Anthony Rendon in December 2018, the Collaborative laid out its
in 2019. Noting that aging and disability programs span a wide array of state departments, programs and services, the Collaborative urged the Legislature not to pit these programs against one another in budget deliberations, but rather to take a holistic and comprehensive look at how to advance all of the systems of care that provide crucial services to California’s older adults and individuals with disabilities.
This letter was submitted to U.S. Senators Dianne Feinstein and Kamala Harris in December 2018 in support of federal legislation S. 3679 (Casey, D-PA), the Readiness for Elders and Americans with Disabilities Inclusion (READI) Act. The READI Act would establish a National Commission on Disability Rights and Disasters to study the needs of older adults, individuals with disabilities and others, and make recommendations for addressing their needs in disaster situations.
The California Collaborative strongly opposed proposed rulemaking by the U.S. Department of Homeland Security on Inadmissibility on Public Charge grounds. These proposed changes would cause serious harm to older immigrants, immigrants with disabilities, their families, localities, states and healthcare providers and facilities. The Collaborative submitted these comments thru www.regulations.gov on December 10, 2018.
CCLTSS Nominations to RAISE Family Caregivers Advisory Council
The California Collaborative nominated two of our members to serve on the national RAISE Family Caregivers Advisory Council. Our nominations of
of the California Association of Caregiver Resource Centers and
of SEIU Local 2015 were submitted to the Administration on Community Living on December 1, 2018.
This letter was submitted to Governor Brown in September 2018 urging him to sign SB 398, legislation remove the sunset date on the California Traumatic Brain Injury (TBI) program and bring the program’s policies and provisions up-to-date. (The Governor signed this legislation on 9/14/18.)
This letter was submitted to Governor Brown in September 2018 urging him to sign AB 2233, legislation which would require the Department of Health Care Services to request renewal of the Assisted Living Waiver, increasing the number of slots available for assisted living and making improvements to the program. (The Governor
this legislation on 9/29/18.)
This letter was submitted to Governor Brown in September 2018 urging him to sign AB 2132, legislation which would authorize cities and counties to waive or reduce building permit fees for older adults to make home modifications to help them live at home despite a disability. (The Governor signed this legislation on 9/14/18.)
This letter was written to the Assembly Appropriations Committee in August 2014 withdrawing the Collaborative’s opposition to SB 1004 regarding Mental Health Services Act funding, due to new amendments to the bill which removed the discriminatory impact on older adults.
This letter was written to Department of Health Care Services Deputy Director for Health Care Delivery Systems Sarah Brooks in August 2018, requesting that DHCS correct an oversight in not appointing any long-term services and supports providers to the state’s new Care Coordination Assessment Advisory Committee. DHCS subsequently denied this request.
This letter was written to Centers for Medicare and Medicaid Services Administrator Seema Verma in August 2018, supporting the California Department of Health Care Services’ request to extend the Cal MediConnect dual demonstration project thru December 31, 2020.
This letter was written to Centers for Medicare and Medicaid Services Administrator Seema Verma in August 2018, opposing proposed rule CMS-2413-P. This rule would alter how states make payments for employee benefits such as health care coverage or authorized union dues, a policy which would have severe negative consequences for California’s 400,000 home health workers.
This letter was written to the Assembly Appropriations Committee in July 2018 in support of legislation which would fund supportive services for the Veterans Housing and Homelessness Prevention and No Place Like Home programs, by allowing Californians to purchase a specialized license plate.
This letter was written to the Senate Appropriations Committee in July 2018, urging passage of legislation which would require the Department of Health Care Services to request renewal of the Assisted Living Waiver, increasing the number of slots available for assisted living and making improvements to the program.
This letter was written to Senate President pro Tempore Toni Atkins in July 2018, urging the Senate to adopt legislation which would authorize cities and counties to waive or reduce building permit fees for older adults to make home modifications to help them live at home despite a disability.
This letter was submitted to the Assembly Appropriations Committee in July 2018, opposing legislation which set new priorities for Mental Health Services Act Prevention and Early Intervention Funding which would have the impact of disadvantaging older adults. Opposition to this bill was subsequently withdrawn on August 14, 2018 due to amendments, see revised position letter above.
This letter was submitted to the Assembly Appropriations Committee in June 2018 in support of legislation to remove the sunset date on the California Traumatic Brain Injury (TBI) program and bring the program’s policies and provisions up-to-date.
This letter was submitted to the Senate Appropriations Committee in June 2018 in support of legislation to reauthorize the California Alzheimer’s Disease and Related Dementia Research Voluntary Tax Contribution Fund until 2025 and to modernize the provisions of the fund to ensure its effectiveness. (The Governor signed this legislation on 9/7/18.)
This letter was written to all of the members of the California Congressional delegation, requesting their sponsorship and support for the EMPOWER Care Act, legislation to extend and improve the recently expired Money Follows the Person demonstration program, which helps seniors and people with disabilities transition out of nursing homes and other institutional settings and move back to the community.
Written to the members of the Legislature’s Budget Conference Committee in May of 2018, this letter urged adoption of seven key budget items that would provide funding for critical long-term services and supports for California seniors and people with disabilities.
This letter was submitted to the Assembly Budget Subcommittee 1 and Senate Budget Subcommittee 3 in support of legislation and a related budget request to end the “senior penalty” penalizing older adults. The legislation would raise the Medi-Cal Aged and Disabled income limit to 138% of the federal poverty level in order to make Medi-Cal more accessible for low-income seniors.
The California Collaborative and Statewide Regional Coalitions developed an expanded budget agenda for Sacramento Advocacy Day on April 23, 2018, holding over 50 meetings with Legislative offices in support of investments in long-term services and supports, increasing economic security, and better protection and care for California seniors and people with disabilities.
Written to Assembly Budget Subcommittee 1 and Senate Budget Subcommittee 3, this letter expresses the Collaborative’s support for a proposal sponsored by 19 aging, disability, labor and provider organizations, to appropriate $3 million in funding to collect and analyze data on long-term services and supports (LTSS) needs and access to services by incorporating questions about LTSS into the California Health Interview Survey. Details about this proposal may be found
Written to Assembly Budget Subcommittee 1 and Senate Budget Subcommittee 3, this letter supports a $2.2 million investment of one-time General Funds to launch a statewide public awareness campaign about Alzheimer’s disease, to be implemented in partnership with the Area Agencies on Aging. The campaign is intended to address the fact that less than half of Californians living with Alzheimer’s and related dementias have been properly diagnosed and informed of their illness, delaying crucial opportunities to provide disease management and plan for appropriate services and supports. Details about this proposal are
Written to Assembly Budget Subcommittee 1 and Senate Budget Subcommittee 3, this letter supports a $7.299 million augmentation of funds to local Ombudsman programs to provide quarterly unannounced visits to nearly 9,000 additional long-term care facilities, investigation of 6,000 additional complaints, and resources to recruit, train, support and retain volunteers. Details of the proposal are found
Written to Assembly Budget Subcommittee 1 and Senate Budget Subcommittee 3, this letter expresses the Collaborative’s support for $12.5 million increase in funding to augment the Home-Delivered Nutrition Program and the Congregate Nutrition Program, administered thru Area Agencies on Aging. This funding will allow an additional 6% of at-risk seniors who are at greatest economic and social risk to receive meals and nutrition services, particularly those who are homebound, isolated, low-income, minority or living in rural areas. Details about this proposal are
This letter was written to Congresswoman Nancy Pelosi in support of HR 2575, the Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act, consumer protection legislation that simplifies the Medicare Part B enrollment process and helps new enrollees avoid incurring fees and penalties for late enrollment.
This letter was submitted to the Centers for Medicare and Medicaid Services in response to their Request for Information regarding a new direction for the Centers for Medicare & Medicaid Innovation.
This letter was written to the Department of Health Care Services in support of several proposals to restructure managed care rates for long term services and supports in order to increase access to home and community-based services.
The California Collaborative has joined the Western Center on Law and Poverty and other California health and social services agencies to voice strong opposition to the House Fiscal Year 2018 budget resolution passed by the House Budget Committee in July, which lays out a harsh economic vision for California and the nation. If approved, this resolution would set into motion a plan that would cause pain for millions of Californians, especially seniors, people with disabilities and other vulnerable Californians.
This letter was submitted to Governor Brown in September 2017 urging him to sign SB 3, legislation that would significantly increase California’s supply of affordable housing, building tens of thousands of affordable homes for the state’s most vulnerable citizens and consequently avoiding costs to the Medi-Cal program and the state budget for unnecessary and expensive institutional care.
This letter was submitted to Governor Brown in September 2017 urging him to sign SB 2, legislation that would create jobs and economic growth with substantial investments that create affordable and accessible housing, addressing the current housing crisis for seniors and people with disabilities and other low-income Californians.
The California Collaborative joined 104 California organizations in this letter opposing HR 1628, sent to all members of the California Congressional delegation. HR 1628, the Graham-Cassidy-Heller-Johnson legislation, represents a disproportionate attack on California’s health care system, threatening the health coverage of millions of Californians and resulting in $58 billion dollars annual loss of funding to our state’s health care system by 2027.
This letter was submitted to Governor Brown in September 2017 urging him to sign AB 940, legislation that would require skilled nursing facilities discharging or evicting residents to provide notification to the local Long-Term Care Ombudsman Program, in order for them to furnish assistance with transition and making arrangements for alternative services.
This letter was submitted to the Senate Appropriations Committee in September 2017 in support of legislation to adjust the developmental disability provider rate to reflect local minimum wage ordinances, in order to stabilize crucial services to a high-needs population.
The California Collaborative joined 110 other California organizations in this letter of opposition to HR 620 sent to all members of the California Congressional delegation. HR 620 would weaken the Americans with Disabilities Act by removing incentives for businesses to comply with the law regarding accessibility of public accommodations and place excessive burdens on individuals with disabilities.
This letter was submitted to the Senate Appropriations Committee in April 2017 in Support of the Affordable Housing Bond Act of 2018, which would provide funding to backfill some of the recent state and federal cuts of $1.5 billion annually to California’s affordable housing.
This letter was submitted in April 2017 to the Senate Appropriations Committee in support of SB 2, legislation which would generate an estimated $500 million in state investment to build affordable housing for Californians in need, including seniors and people with disabilities.
This letter was submitted in April 2017 to the Assembly Revenue and Taxation Committee in support of AB 71, legislation to appropriate $300 million annually in state funds to build an estimated 3,000 affordable homes each year. This would provide an opportunity for low-income seniors and people with disabilities to live in the community.
This letter was submitted in April 2017 to the Senate Appropriations Committee in support of SB 177, legislation sponsored by the Association of California Caregiver Resource Centers to appropriate funds for the purpose of reinstating essential respite services to unpaid family caregivers.
This testimony was provided to the Assembly Health Committee in April 2017 in support of legislation sponsored by Disability Rights California. AB 286 would increase the Medi-Cal home upkeep allowance to assist people to keep their housing when they experience a health crisis.
This report submitted in February 2017 to the California Department of Health Care Services and the federal Centers for Medicare & Medicaid Services documented the feedback of Collaborative members regarding the Governor’s proposed changes to the CCI.
Submitted to the Legislature, state departments and agency officials, the Collaborative’s annual budget letter outlined CCLTSS support for several key long-term services and supports investments sponsored by member organizations.
This letter was submitted in August 2016 to Governor Jerry Brown, requesting his signature on SB 547 to authorize a stakeholder planning process to review California’s fragmented system of long-term services and supports serving seniors and people with disabilities, and to make recommendations to create a modern service delivery system that would better meet California’s needs in the 21st century.
In July 2016 the Collaborative responded to an invitation from the California Department of Health Care Services (DHCS) to provide input on a voluntary enrollment strategy for the Cal MediConnect program. Convening a workgroup of Collaborative members in partnership with health plans, CCLTSS developed eleven key recommendations for enrollment in the program and submitted them to DHCS and the Centers for Medicare & Medicaid Services. DHCS provided a detailed response to the recommendations, which can be found
This letter was submitted in June 2016 to the California Legislative Budget Conference Committee in support of Alzheimer’s disease detection and diagnosis, senior nutrition funding and training for Adult Protective Services.
In May 2016 the Collaborative wrote to Director Jennifer Kent outlining the problems in the long-term care insurance market, their impact on older adults and the Medi-Cal program, and requesting a meeting to discuss opportunities to address these issues by revitalizing the California Partnership for Long-Term Care program.
In March 2016 the Collaborative distributed this Op-ed piece to the Legislature and our networks, explaining the significance of California’s adoption of a Managed Care Organization tax to the sustainability of the Medi-Cal program and to California’s ability to provide services to 300,000 Californians with developmental disabilities.