(a) Every 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 established by Section 22000 of the Welfare and Institutions Code shall provide at least the following:
(1) Residential care facility.
(2) Assisted living facility.
(3) Home health care.
(4) Adult day care.
(5) Personal care.
(6) Homemaker services.
(7) Hospice services.
(8) Respite care.
(b) For purposes of this section, policy definitions of the benefits described in subdivision (a) may be no more restrictive than the following:
(1) “Residential care facility” means a facility that is licensed as a residential care facility for the elderly or a residential care facility as defined in the Health and Safety Code. Outside California, an eligible provider is a facility that meets licensure standards applicable to the facility, if any, and is engaged primarily in providing ongoing care and related services sufficient to support needs resulting from impairment in activities of daily living or impairment in cognitive ability and which also provides care and services on a 24-hour basis, has a trained and ready-to-respond employee on duty in the facility at all times to provide care and services, provides three meals per day and accommodates special dietary needs, has agreements to ensure that residents receive the medical care services of a physician or nurse in case of emergency, and has appropriate methods and procedures to provide necessary assistance to residents in the management of prescribed medications.
(2) “Assisted living facility” means a facility licensed as an assisted living facility as defined in the Health and Safety Code. Outside California, an eligible provider is a facility that meets licensure standards applicable to the facility, if any, and is engaged primarily in providing food and shelter and providing personal care services, or in administering medication by a person licensed or otherwise authorized to administer the medication.
(Added by Stats. 2016, Ch. 487, Sec. 2. (SB 1384) Effective January 1, 2017.)
Last modified: October 25, 2018