BILL ANALYSIS Ó SENATE COMMITTEE ON APPROPRIATIONS Senator Ricardo Lara, Chair 2015 - 2016 Regular Session AB 97 (Weber) - In-home supportive services: provider wages ----------------------------------------------------------------- | | | | | | ----------------------------------------------------------------- |--------------------------------+--------------------------------| | | | |Version: March 26, 2015 |Policy Vote: HUMAN S. 5 - 0 | | | | |--------------------------------+--------------------------------| | | | |Urgency: No |Mandate: No | | | | |--------------------------------+--------------------------------| | | | |Hearing Date: July 6, 2015 |Consultant: Jolie Onodera | | | | ----------------------------------------------------------------- This bill meets the criteria for referral to the Suspense File. Bill Summary: AB 97 would require the Case Management Information and Payrolling System (CMIPS II) for the In-Home Supportive Services (IHSS) program to be reprogrammed to enable managed health care plans to pay a provider for additional services authorized for IHSS recipients in participating counties of the Coordinated Care Initiative (CCI), as specified. Fiscal Impact: One-time costs of $6 million ($3 million General Fund) for reprogramming of CMIPS II and ongoing costs of $1 million ($0.5 million General Fund). Potential increase in county administrative costs (Federal Fund/General Fund) to enter data from two payroll systems into the CMIPS II database in order to differentiate between authorized hours for IHSS and by managed health care plans. AB 97 (Weber) Page 1 of ? Potential increase in IHSS program costs (General Fund) for overtime and related activities, to the extent issuing a single payroll check to providers for both IHSS authorized hours and hours authorized by managed health care plans triggers the requirements under the federal Fair Labor Standards Act (FLSA) and the federal rule is upheld. Background: Existing law provides that the Department of Social Services (DSS) is responsible for procuring and implementing a new Case Management Information and Payrolling System (CMIPS II) for IHSS and establishes minimum functionalities that are required to be provided by the system including payroll and management information, the ability to calculate wage and benefit deductions, and coordinate benefits information and processing with the California Medicaid Management Information System. Existing law declares the intent of the Legislature that managed care health plans may authorize personal care services and related domestic services in addition to the hours authorized under IHSS, which managed care health plans shall be responsible for paying at no share of cost to the county. Legislative intent additionally states that the Department of Health Care Services, in consultation with DSS, shall be required to develop policies and procedures for these additional benefits, which managed care health plans may authorize. (Welfare and Institutions Code § 14186(b)(6)(B).) Proposed Law: This bill requires CMIPS II to be programmed to enable the system to do all of the following: Receive payments from managed care health plans for the additional personal care service hours and related domestic service hours authorized by the managed care health plan. Issue a single payroll check to providers that covers both the hours authorized under IHSS and the hours authorized by the managed care health plan, as specified. Differentiate between IHSS authorized hours and the hours AB 97 (Weber) Page 2 of ? authorized by the managed care health plan for purposes of federal reimbursement and to enable managed care health plans to track the effect of providing the additional benefits. Related Legislation: The 2015-16 Budget Conference Committee took an action to include a similar proposal. This provision was not included, however, in the final budget bill, AB 93 (Committee on Budget and Fiscal Review) Chapter 10/2015 or the human services budget trailer bill, SB 79 (Committee on Budget and Fiscal Review) Chapter 20/2015, signed by the Governor. Staff Comments: The DSS has indicated one-time costs of $6 million ($3 million General Fund) for the reprogramming of CMIPS II as specified in this measure and ongoing costs of $1 million ($0.5 million General Fund). In order to differentiate between the number of authorized hours for IHSS and authorized by managed health care plans as required under the provisions of this measure, county social workers could incur additional workload to enter data from two payroll systems into the CMIPS II database. The magnitude of the increase in IHSS administrative costs would be dependent on the additional time required to input the required information and the number of cases impacted, which is unknown at this time. SB 1036 (Chapter 45/2012) altered the historical county contribution of IHSS funding by enacting a county IHSS maintenance of effort (MOE), which replaced the county contribution of 17.5 percent with a requirement that counties generally maintain their Fiscal Year (FY) 2011-12 expenditure level for IHSS program costs as of FY 2012-13, to be adjusted annually for inflation beginning in FY 2014-15. As a result, all increases in the non-federal share of IHSS costs above the county IHSS MOE are now borne by the General Fund. Additionally, the provisions of this measure could potentially result in a significant increase in future IHSS program costs (Federal Fund/General Fund) for overtime and related activities, to the extent issuing a single payroll check to providers for both IHSS authorized hours and hours authorized by managed health care plans triggers the requirements under the federal AB 97 (Weber) Page 3 of ? FLSA, assuming the federal rule is upheld. In the absence of data regarding the number of recipients eligible to receive additional hours in the pilot counties and the applicable number of authorized hours, the magnitude of this impact cannot be determined at this time. -- END --