BILL ANALYSIS Ó
AB 485
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB 485 (Gomez)
As Amended February 18, 2014
Majority vote
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|ASSEMBLY: | |(May 30, 2013) |SENATE: |26-7 |(February 24, |
| | | | | |2014) |
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(vote not relevant)
Original Committee Reference: P.E., R. & S.S.
SUMMARY : Disconnects implementation of statewide collective
bargaining authority for the In-Home Support Services (IHSS)
program from the state's Coordinated Care Initiative (CCI) and
implements it separately under the new statewide California IHSS
Authority (Authority) beginning January 1, 2015.
The Senate amendments delete the Assembly version of this bill,
and instead:
1)Require the Authority to assume collective bargaining
responsibility for IHSS providers in all counties beginning
January 1, 2015, rather than in the eight counties
participating in the CCI demonstration project.
2)Make the Authority permanent by deleting statute making
statewide collective bargaining conditional upon
implementation of the CCI.
3)Delete statute authorizing the Director of Finance to halt
implementation of the CCI and therefore statewide collective
bargaining by the Authority if the director determines that
the CCI will not generate anticipated General Fund savings.
4)Make permanent through the separation of statewide collective
bargaining authority for IHSS:
a) The IHSS Maintenance of Effort (MOE) requirement for all
counties in lieu of their share of non-federal costs.
b) The existing requirement that each county's IHSS MOE
count toward its share of cost of negotiated wage and
AB 485
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benefit increases.
5)Eliminate from the list of codes that will become inoperative,
if the CCI is rendered inoperative because of a lack of
General Fund savings, various codes relating to the Statewide
Authority, including those that establish the IHSS
Employer-Employee Relations Act, establish and define the
duties of the Statewide Authority, and require all counties to
have a county IHSS MOE.
6)Make other technical and aligning changes to existing CCI
statutes to disconnect statewide IHSS collective bargaining
contingency language from the implementation of the CCI.
AS PASSED BY THE ASSEMBLY , this bill ratified the provisions of
a memorandum of understanding between the state and State
Bargaining Unit 16, Physicians, Dentists, and Podiatrists.
FISCAL EFFECT : According to the Senate Appropriations
Committee:
1)Potentially major ongoing costs (General Fund) in the tens to
low hundreds of millions of dollars to the extent the
provisions of this bill 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 MOE, any increases negotiated by the Statewide
Authority is not require a county share of costs. The
nonfederal share of costs will be fully funded by the state,
resulting in major ongoing costs to the General Fund.
2)Annual costs in the range of $6.9 million (50% General Fund,
50% 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 January 1, 2015.
3)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 bill.
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4)To the extent the CCI will have otherwise become inoperative
at some future date due to an estimate by the Director of
Finance that the CCI will 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 will not revert to the original
cost-sharing formula, and CalHR/DSS costs will continue to
support the activities of the Statewide Authority.
COMMENTS :
Background on IHSS : The IHSS program is a Medi-Cal benefit,
which provides services that enable the recipient to remain in
their home. The IHSS program provides personal care services to
approximately 420,000 qualified low-income individuals who are
aged, blind, or disabled.
County social workers determine IHSS eligibility and perform
case management after conducting a standardized in-home
assessment of an individual's ability to perform activities of
daily living. Based on authorized hours and services, IHSS
recipients are responsible for hiring, firing, and directing
their IHSS provider(s). In the majority of cases, recipients
choose a relative to provide care. Prior to July 1, 2012,
county public authorities or nonprofit consortia were designated
as "employers of record" for collective bargaining purposes on a
statewide basis, while the state administered payroll and
benefits. Pursuant to 2012-13 Budget trailer bill SB 1036
(Senate Budget and Fiscal Review Committee), Chapter 45,
Statutes of 2012, however, collective bargaining
responsibilities in the eight counties participating in the CCI
will start to shift to an IHSS Authority administered by the
state.
Background on the CCI : The Budget Act of 2012 enacted the CCI
(also called Cal MediConnect), a framework for integrating
delivery of medical, behavioral and long-term care services
through a single health plan for persons eligible for both
Medicare and Medi-Cal. The CCI is currently limited to the
following eight demonstration counties: Alameda, Los Angeles,
Orange, San Diego, San Mateo, Riverside, San Bernardino, and
Santa Clara. Approximately 65% of IHSS recipients reside in the
demonstration counties.
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Related to CCI, SB 1036 shifted collective bargaining
responsibilities from local county public authorities or
non-profit consortia in the demonstration counties to the new
Statewide Authority, with specified members and an advisory
committee. The bill also created an IHSS MOE funding
requirements for counties, which replaced the previously
existing county share of non-federal funding of 35%. Further,
the bill shifted collective bargaining responsibilities from
local county public authorities or non-profit consortia in the
demonstration counties to the new Statewide Authority, with
specified members and an advisory committee. Under SB 1036,
this shift occurs in each county once enrollment into managed
care pursuant to the CCI has been completed. The Department of
Health Care Services (DHCS) anticipates that this shift will
begin in April 2014.
Need for the bill : According to the author, this bill is
necessary to move to statewide collective bargaining for IHSS
providers despite delays in the implementation of the CCI.
While the statute creating the CCI anticipated roll-out within
eight demonstration counties no earlier than March 1, 2013,
various delays have pushed that date to no sooner than April 1,
2014. June 2013 budget trailer bill language already delinked
the integration of long-term services and supports into managed
care from the implementation of the integration of Medi-Cal and
Medicare financing. The author argues that it is necessary to
additionally sever the link between CCI implementation and the
creation of the IHSS Statewide Authority and transfer of
employer responsibility to that authority from local entities.
The bill's sponsor, the American Federation of State and County
Municipal Employees, notes that the implementation delays have
resulted in delays in the transfer of collective bargaining to
the state, and as a consequence some local bargaining units have
been met with delays or reluctance to engage in bargaining when
the transfer of responsibility is expected to be imminent. The
sponsor writes that several counties have proposed one-year
contract extensions, while others have opposed increases in IHSS
spending because it would permanently increase the county's IHSS
MOE.
Prior legislation :
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SB 94 (Senate Budget and Fiscal Review Committee), Chapter 37,
Statutes of 2013: Enacted changes to existing law regarding the
CCI and de-linked CCI components to allow the mandatory
enrollment of Medi-Cal and Medicare beneficiaries (dual
eligible) into Medi-Cal managed care, the integration of
long-term services and supports into managed care plans, and the
commencement of the IHSS Statewide Authority, to proceed
separately from the CCI Duals Demonstration Project.
SB 1036 (Senate Budget and Fiscal Review Committee), Chapter 45,
Statutes of 2012: The Human Services budget trailer bill that
contained the necessary statutory changes to implement the human
services provisions related to the integration of home and
community based and long-term care services, including IHSS,
into Medi-Cal managed care, as specified in the Budget Act of
2012.
SB 1008 (Senate Budget and Fiscal Review Committee), Chapter 33,
Statutes of 2012: Implements the Duals Demonstration Pilot
Projects, including integration of long-term services and
supports.
SB 208 (Steinberg), Chapter 714, Statutes of 2010: Implemented
several changes to the Medi-Cal Program as proposed in the
state's application to renew the state's Section 1115 Medicaid
Waiver. Also gave DHCS the authority to establish the dual
eligible beneficiary demonstration project to give those
eligible for Medicare and Medi-Cal a continuum of services and
maximize coordination of benefits.
Analysis Prepared by : Chris Reefe / HUM. S. / (916) 319-2089
FN: 0003045