BILL ANALYSIS                                                                                                                                                                                                    Ó




                   Senate Appropriations Committee Fiscal Summary
                            Senator Kevin de León, Chair


          AB 485 (Gomez) - In-home supportive services: Statewide  
          Authority.
          
          Amended: January 16, 2014       Policy Vote: HS 4-2; Health 7-0
          Urgency: No                     Mandate: No
          Hearing Date: January 21, 2014                          
          Consultant: Jolie Onodera       
          
          This bill meets the criteria for referral to the Suspense File.
          
          
          Bill Summary: AB 485 would require the California In-Home  
          Supportive Services (IHSS) Authority (Statewide Authority) to  
          assume employer responsibility for collective bargaining in all  
          58 counties effective January 1, 2015. This bill would remove  
          the provisions in existing law conditioning the transfer of  
          collective bargaining responsibility to the Statewide Authority  
          that is currently limited to only eight counties and contingent  
          upon each county's implementation of specified provisions of the  
          Coordinated Care Initiative (CCI), and would delink various  
          provisions of law currently contingent upon the continued  
          operation of the CCI.

          Fiscal Impact: 
              Potentially major ongoing costs (General Fund) in the tens  
              to low hundreds of millions of dollars to the extent the  
              provisions of this measure result in an increase in IHSS  
              provider wages and health benefits with the implementation  
              of the Statewide Authority in all 58 counties effective  
              January 1, 2015. As only those wage and benefit increases  
              that are locally negotiated or imposed before the Statewide  
              Authority assumes employer responsibility result in an  
              adjustment to the County IHSS Maintenance of Effort (MOE),  
              any increases negotiated by the Statewide Authority would  
              not require a county share of costs. The nonfederal share of  
              costs would be fully funded by the state, resulting in major  
              ongoing costs to the General Fund. 
              Annual costs in the range of $6.9 million (50 percent  
              General Fund, 50 percent federal funds) to the Department of  
              Human Resources (CalHR) to implement and operate a  
              collective bargaining platform on behalf of the Statewide  
              Authority expanded to cover all 58 counties effective  








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              January 1, 2015. 
              Additional one-time significant costs (General Fund) to  
              CalHR for limited-term staff and overtime required to  
              support the workload imposed under the accelerated  
              implementation date mandated in this measure.
              To the extent the CCI would have otherwise become  
              inoperative at some future date due to an estimate by the  
              Director of Finance that the CCI would not generate net  
              General Fund savings, as specified, the annual costs noted  
              above would continue to be incurred. The counties' share of  
              cost limited by the County IHSS MOE would not revert to the  
              original cost-sharing formula, and CalHR/DSS costs would  
              continue to support the activities of the Statewide  
              Authority. 

          Background: The IHSS program provides in-home custodial care to  
          aged, blind, and disabled individuals who meet specified  
          eligibility criteria. Eligible IHSS recipients receive such  
          services as housecleaning, meal preparation, laundry, grocery  
          shopping, personal care services, accompaniment to medical  
          appointments, and protective supervision. IHSS providers are  
          organized into 56 bargaining units, totaling approximately  
          380.000 employees located within 58 counties. The administration  
          of IHSS is a complex partnership that includes the IHSS  
          recipients, the DSS, the Department of Health Care Services  
          (DHCS), counties, public authorities, program advocates,  
          providers, and employee unions. Currently, the employers'  
          interests for collective bargaining purposes under the IHSS  
          program are represented either by each county's public authority  
          or by the county itself.

          The 2012-13 Budget included changes to authorize a demonstration  
          project in eight counties that integrates the delivery of  
          medical services, long-term services and supports (including  
          IHSS), and behavioral health services through Medi-Cal managed  
          care plans. As part of this demonstration project, SB 1036  
          (Committee on Budget and Fiscal Review) Chapter 45/2012, also  
          established a Statewide Authority for specified purposes of  
          collective bargaining as IHSS became a benefit provided through  
          managed care in those counties in the CCI.   

          With delays in the implementation of the CCI, due in part to  
          delayed approval from the federal Centers for Medicaid and  
          Medicare Services (CMS), the state has delayed the  








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          implementation of the CCI by more than a year to no sooner than  
          April 1, 2014. 

          Proposed Law: This bill would delink the statewide bargaining  
          provision of IHSS providers and associated creation of the  
          Statewide Authority from other provisions and timelines of the  
          CCI. Specifically, this bill:

          1) Eliminates the requirement to delete authority for the  
          Statewide Authority and related requirements if the CCI becomes  
          inoperative.

          2) Removes the requirement to link the establishment of the  
          statewide employee organization to a county's implementation of  
          the CCI, and makes related language changes in numerous places  
          in the statute.

          3) Eliminates the requirement to revert a county's IHSS County  
          MOE share of cost to the original cost-sharing formula if the  
          CCI is not implemented or becomes inoperative.

          4) Deletes the requirement that the establishment of the  
          Statewide Authority be tied to the completed enrollment of  
          beneficiaries into the CCI and the notification of such by the  
          Director of the DHCS.

          5) Sets January 1, 2015, as the date that the Statewide  
          Authority assumes responsibility for statewide collective  
          bargaining.

          6) Eliminates language that renders inoperative the requirement  
          to count a county's
          IHSS MOE in lieu of a county's share of cost of negotiated wage  
          and benefit increases, as specified.

          7) Changes the required date for plans to establish an MOU with  
          county public authorities that transfers bargaining  
          responsibility to the Statewide Authority from the  
          implementation of the CCI in each county to January 1, 2015.

          8) Deletes statute that would eliminate the Statewide Authority  
          and return the role of employer of record to the counties should  
          the CCI become inoperative.









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          9) Eliminates from the list of code sections that shall be  
          deleted if the CCI becomes inoperative those sections that  
          establish the IHSS Employer-Employee Relations Act, establish  
          and define the duties of the Statewide Authority, establish the  
          IHSS Fund, require all counties to have a County IHSS MOE, and  
          require counties to pay the County IHSS MOE instead of paying  
          the nonfederal share of IHSS costs, as specified.

          Prior Legislation: SB 1036 (Committee on Budget and Fiscal  
          Review) Chapter 45/2012 established the Statewide Authority,  
          incorporated IHSS into the CCI, and established a statewide  
          bargaining process to be implemented as each county implemented  
          the CCI. The statute anticipated that as soon as March 1, 2013,  
          the pilot would begin in the demonstration counties and provided  
          that once IHSS was an established Medi-Cal benefit through  
          managed care plans, collective bargaining would be transferred  
          to the Statewide Authority. This bill also required all  
          counties, commencing July 1, 2012, to have a County IHSS MOE,  
          which required counties to pay the County IHSS MOE instead of  
          paying the nonfederal share of IHSS costs, as specified. 

          Staff Comments: Accelerating and expanding the implementation of  
          statewide bargaining to all 58 counties could result in  
          potentially major ongoing costs (General Fund) in the tens to  
          low hundreds of millions of dollars to the extent the provisions  
          of this measure result in an increase in IHSS provider wages and  
          health benefits with the implementation of the Statewide  
          Authority effective January 1, 2015. As only those wage and  
          benefit increases that are locally negotiated or imposed before  
          the Statewide Authority assumes employer responsibility result  
          in an adjustment to the County IHSS Maintenance of Effort (MOE),  
          any increases negotiated by the Statewide Authority would not  
          require a county share of costs. The nonfederal share of costs  
          would be fully funded by the state, resulting in major ongoing  
          costs to the General Fund. 

          Under current law, the Statewide Authority becomes the  
          bargaining entity for IHSS providers only in the eight counties  
          participating in the CCI demonstration, and only upon the  
          Director of the DHCS' determination that enrollment into managed  
          care plans has been completed for the Med-Cal beneficiaries in  
          that county. Because existing law restricts the transfer to  
          statewide bargaining to the eight CCI demonstration counties  
          upon complete Medi-Cal enrollment to managed care, this bill  








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          potentially accelerates the implementation date for those eight  
          counties, and expands statewide bargaining to the remaining 50  
          counties. The 2014-15 Governor's Budget projects enrollment to  
          commence in April 2014 in five of the eight counties (Orange,  
          Riverside, San Bernardino, San Diego, and San Mateo). Enrollment  
          of the remaining three counties (Los Angeles, Alameda, and Santa  
          Clara) is projected to commence in July 2014.

          CalHR has indicated the provisions of this measure will result  
          in annual costs in the range of $6.9 million to implement and  
          operate a collective bargaining platform on behalf of the  
          Statewide Authority expanded to cover all 58 counties effective  
          January 1, 2015. In addition, CalHR will incur one-time  
          significant costs for limited-term staff and overtime required  
          to support the workload imposed under the accelerated  
          implementation date mandated in this measure.

          To the extent the CCI would have otherwise become inoperative at  
          some future date due to an estimate by the Director of Finance  
          that the CCI would not generate net General Fund savings, as  
          specified, the annual costs noted above would continue to be  
          incurred. The counties' share of cost limited by the County IHSS  
          MOE would not revert to the original cost-sharing formula, and  
          CalHR/DSS costs would continue to support the activities of the  
          Statewide Authority.