BILL ANALYSIS
ACR 151
Page 1
ASSEMBLY THIRD READING
ACR 151 (Ma)
As Amended May 12, 2010
Majority vote
HUMAN SERVICES 4-2
-----------------------------------------------------------------
|Ayes:|Beall, Ammiano, Swanson, | | |
| |Portantino | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Tom Berryhill, Logue | | |
| | | | |
-----------------------------------------------------------------
SUMMARY : Declares the intent of the Legislature to ensure the
preservation of home care and personal services to seniors and
people with disabilities through the In-Home Supportive Services
(IHSS) program. Specifically, this resolution makes the
following legislative findings:
1)For over a quarter century, California has provided home care
and personal assistance services to qualifying residents
through a unique, consumer-directed fiscally sound program
called IHSS.
2)The IHSS program was signed into law by Governor Ronald Reagan
in 1973 to avoid their unnecessary institutionalization and
assist IHSS recipients to live independently in the community.
3)California's IHSS program has become nationally recognized as
the preferred way to provide long-term care assistance and is
being replicated in other states.
4)IHSS is a prime example of the home-based, long-term care
solutions that were the focus of President George W. Bush's
2001 "New Freedom Initiative."
5)February 2010 data from the California IHSS Management
Statistics Summary show that the IHSS program serves nearly
450,000 residents who qualify for services because of
functional limitations and financial need.
6)The average per capita cost of IHSS is one-fifth of the
ACR 151
Page 2
average per capita cost to taxpayers of nursing homes.
7)The IHSS program is acknowledged as the reason California has
a relatively low number of people in nursing homes and other
institutions.
8)The IHSS program is key to fulfilling the civil rights of
Californians with disabilities to live in the most integrated
settings, as affirmed by the Americans with Disabilities Act
and the 1999 Supreme Court decision in Olmstead .
9)Nearly 370,000 IHSS providers deliver the home care services
and support to make it possible for California seniors and
people with disabilities to remain living independently in
their homes.
10)Numerous national organizations join together annually to
declare the month of November as National Home Care Month to
recognize, honor, and support the valuable contributions of
home care workers.
11)The work of IHSS providers is essential to the independence
of seniors and people with disabilities and deserves the
respect and appreciation of all Californians.
FISCAL EFFECT : None
COMMENTS :
The IHSS Program helps pay for services so that the elderly,
disabled, or blind individuals can remain in their own homes and
avoid institutionalization. More than 370,000 caregivers
provide services under the IHSS program to a projected 450,000
recipients.
The growth--that is, the success--of the IHSS program has led to
budget actions and budget proposals to control costs by cutting
provider wages, limiting access to services within the program,
narrowing eligibility for the program, and even elimination of
the entire program. Recent budget actions have reduced the
state's participation in provider wages and benefits, denied all
services based on Functional Index (FI) scores, and reduced
services based on Functional Ranks. These actions have been
enjoined as a result of litigation.
ACR 151
Page 3
The Governor's January budget proposal for Fiscal Year 2010-11
would eliminate IHSS eligibility for all but the most severely
impaired individuals, resulting in an 87% reduction in the
caseload. The LAO has noted that reducing the IHSS caseload by
87% would have other impacts, including the loss of over 310,000
jobs, thereby increasing the state's unemployment from a
projected 12% to as high as 13.2%, and further stressing the
state's unemployment insurance fund.
The Governor's January proposed budget also includes a trigger
provision that would eliminate the entire IHSS program effective
October 1, 2010 if the state does not receive $6.9 billion in
additional federal funds for a range of programs. In a January
2010 report, entitled Considering the State Costs and Benefits:
In-Home Supporive Services Program , the LAO considered the net
fiscal impact of eliminating the IHSS program and concluded
that elimination of the program would result in a net cost to
the state General Fund if more than 32% of recipients entered a
skilled nursing facility as a result. A subsequentlly conducted
analysis suggests that the breakeven point may be even lower,
resulting in net costs to the state if only 22% of IHSS
recipients moved to nursing homes in the absence of IHSS
services. Howes, C., Costs and Benefits of In-Home Supportive
Services for the Elderly and Persons with Disabilities: A
California Case Study , Institute for Women's Policy Research and
PHI (May 3, 2010), http://www.iwpr.org/pdf/E512HowesCBA.pdf .
This resolution recognizes the value of the IHSS program, not
only in terms of its cost effectiveness but also in its
importance in human terms to the lives of hundreds of thousands
of California's seniors and people with disabilities.
Analysis Prepared by : Eric Gelber / HUM. S. / (916) 319-2089
FN: 0004313