BILL ANALYSIS Ó
SENATE COMMITTEE ON APPROPRIATIONS
Senator Ricardo Lara, Chair
2015 - 2016 Regular
SB 199 (Hall) - IHSS: reading and document completion services
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|Version: April 7, 2015 |Policy Vote: HUMAN S. 5 - 0 |
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|Urgency: No |Mandate: Yes |
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|Hearing Date: April 20, 2015 |Consultant: Jolie Onodera |
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This bill meets the criteria for referral to the Suspense File.
Bill
Summary: SB 199 would expand the scope of services available
under the In-Home Supportive Services (IHSS) program to include
assistance in reading and completing financial and other
documents, for up to two hours per month, for a recipient who is
blind, when that assistance is necessary for the recipient to
remain in his or her home, as specified. This bill provides that
provision of the service would be implemented on January 1,
2017, only to the extent that federal financial participation is
available and any necessary federal approvals have been
obtained.
Fiscal
Impact:
IHSS services to blind : Potential first-year costs (6
months) of up to $2.1 million (General Fund/Federal Fund),
and $3.9 million annually to fund additional authorized IHSS
provider hours for services to IHSS recipients who are
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blind. This estimate assumes approximately two percent of
the IHSS caseload, or 12,000 individuals, are legally blind
and would be authorized for an additional two hours per
month. Estimated costs do not reflect the potential impact
of the Fair Labor Standards Act (FLSA) overtime regulations
recently vacated by the court.
IHSS services to visually impaired or otherwise qualified :
Potential ongoing costs of about $14 million (General
Fund/Federal Fund) annually to fund additional authorized
IHSS provider hours to visually impaired or other qualified
individuals eligible for the service. This estimate assumes
approximately 30,000 additional IHSS recipients may qualify
for the service authorized for an additional three hours per
month.
IHSS Administration : Near-term potentially significant
county administrative costs (General Fund/Federal Fund) to
assess current IHSS recipients who are visually impaired or
otherwise eligible for this new service. Future ongoing
costs are estimated to decline once the existing caseload is
assessed.
Automation : Unknown but potentially significant one-time
costs (General Fund/Federal Fund) for necessary automation
changes to CMIPS II.
Minor one-time costs to DHCS to submit the request for
federal approval of this service.
Background: Existing law provides for the IHSS program, administered by
the Department of Social Services (DSS), through which qualified
aged, blind, or disabled individuals receive supportive services
enabling them to remain in their own homes. Existing law defines
the scope of supportive services under the IHSS program to
include heavy cleaning, personal care services, accompaniment by
a provider when needed during necessary travel to health-related
appointments or to alternative resource sites, yard hazard
abatement, protective supervision, teaching and demonstration
directed at reducing the need for other supportive services, and
paramedical services which make it possible for the recipient to
establish and maintain an independent living arrangement.
Under existing law, county welfare departments are required to
provide visually impaired applicants and recipients with
information on, and referral services to, entities that provide
reading services to visually impaired persons.
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Proposed
Law: This bill would expand the scope of services available under
the IHSS program to include assistance in reading and completing
financial and other documents, limited to up to two hours per
month for a recipient who is blind, when that assistance is
necessary for the recipient to remain in his or her home, or
abode of his or her own choosing, as defined by the DSS.
Additionally, this bill:
By January 1, 2017, requires the DHCS to seek all
federal approvals necessary to ensure that Medicaid funds
may be used in implementing the provisions of this measure.
Provides that the authorization to provide the specified
service becomes operative on January 1, 2017.
Specifies that provision of the service shall be
implemented only if, and to the extent that, federal
financial participation is available, and any necessary
federal approvals have been obtained.
Provides that the state and counties shall be immune
from any liability, including negligence or intentional
torts of providers, associated with the delivery of the
service, as specified.
Authorizes the DSS to implement the bill's provisions
through all-county letters until emergency regulations are
filed, as specified.
Requires the DSS to adopt emergency regulations on or
before January 1, 2018, and to adopt final regulations by
January 1, 2019.
Related
Legislation: AB 1703 (Hall) 2014 was substantially similar to this measure.
AB 1703 would have provided assistance in reading and completing
financial and other documents to an IHSS recipient who is blind
or visually impaired, or who has another disability that
significantly impairs his or her ability to read. This bill was
held on the Suspense File of this Committee.
AB 238 (Beall) 2007 was substantially similar to AB 1703 (Hall)
and was vetoed by the Governor with the following message:
I strongly support the In-Home Supportive Services program which
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provides services to low-income aged, blind or disabled persons
so they can remain safely in homes. My Administration has worked
hard to secure more than 1.7 billion in federal funds to protect
these important services. However, I cannot support expanding
the program's scope to include reading services. This expansion
would add more than one million dollars in new costs at a time
of ongoing budget challenges. We must balance our need for
important program services with our fiscal reality. For these
reasons, I am returning AB 238 without my signature.
Staff
Comments: By expanding the scope of authorized IHSS program services to
include assistance in reading and completing financial and other
documents, this bill will result in an ongoing increase in
authorized IHSS hours and costs for IHSS provider wages. 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 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.
The DSS has indicated two percent of the IHSS caseload is
legally blind, or about 12,000 individuals. Assuming the
necessary federal approvals have been obtained, costs to provide
the new service to 12,000 recipients at two hours per month
would result in annual costs of about $2.1 million (General
Fund/Federal) in FY 2016-17 and $3.9 million annually ongoing.
As drafted, this bill could potentially be interpreted to extend
eligibility for assistance in reading and completing financial
and other documents to all IHSS recipients, with the two-hour
limitation applicable only to IHSS recipients who are blind. As
a result, IHSS recipients who are visually impaired or assessed
to have another disability that significantly impairs their
ability to read could potentially be eligible for the new
service. It is estimated an additional 30,000 IHSS recipients
could qualify for this service under an assessment meeting this
standard. Assuming the 30,000 IHSS recipients are authorized for
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the new service at three hours per month would result in annual
costs of nearly $14 million (General Fund/Federal).
Staff notes the estimates above do not include the potential
impact of the changes to FLSA regulations recently vacated by
the court and on appeal by the federal Department of Labor. To
the extent the overtime provisions of the regulations are
implemented in the future, estimated costs would potentially be
greater.
To the extent a portion of the existing IHSS caseload would
request reassessment for potential eligibility for this service
upon enactment of this bill would result in a short-term
increase in county eligibility worker costs to reassess IHSS
recipients for this new service. The addition of this new
supportive service will also likely require automation changes
to existing systems which could result in potentially
significant one-time costs.
Recommended Amendments: To clarify that the new service may only
be provided to blind IHSS recipients, staff recommends the
following amendments to WIC § 12300(b):
(b) (1) Supportive services shall include domestic services and
services related to domestic services, heavy cleaning, personal
care services, accompaniment by a provider when needed during
necessary travel to health-related appointments or to
alternative resource sites, yard hazard abatement, protective
supervision, teaching and demonstration directed at reducing the
need for other supportive services, and paramedical services
that make it possible for the recipient to establish and
maintain an independent living arrangement. arrangement, and
assistance in reading and completing financial and other
documents, for up to two hours per month, for a recipient who is
blind, when that assistance is necessary for the recipient to
remain in his or her home, or abode of his or her own choosing,
as defined by the department .
(2) Supportive services shall also include assistance to a
recipient who is blind in reading and completing financial and
other documents, for up to two hours per month, when that
assistance is necessary for the recipient to remain in his or
her home, or abode of his or her choosing, as defined by the
department.
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