BILL ANALYSIS Ó
SENATE COMMITTEE ON APPROPRIATIONS
Senator Ricardo Lara, Chair
2015 - 2016 Regular Session
AB 97 (Weber) - In-home supportive services: provider wages
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|Version: March 26, 2015 |Policy Vote: HUMAN S. 5 - 0 |
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|Urgency: No |Mandate: No |
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|Hearing Date: July 6, 2015 |Consultant: Jolie Onodera |
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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
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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
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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
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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.
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