BILL ANALYSIS                                                                                                                                                                                                    






                                  SENATE HUMAN
                               SERVICES COMMITTEE
                            Senator Carol Liu, Chair


          BILL NO:       AB 1763                                      
          A
          AUTHOR:        Lieu                                         
          B
          VERSION:       April 8, 2010
          HEARING DATE:  June 22, 2010                                
          1
          FISCAL:        Public Safety/Appropriations                 
          7
                                                                      
          6
          CONSULTANT:                                                 
          3
          Park
                                        

                                     SUBJECT
                                         
                          In-home supportive services

                                     SUMMARY  

          Requires counties, nonprofit consortia, and public  
          authorities to accept the criminal background clearance of  
          an in-home supportive services (IHSS) provider that was  
          deemed an eligible provider by another county, nonprofit  
          consortium, or public authority. Requires DOJ to process  
          requests for notifications of subsequent arrests, as  
          specified.

                                     ABSTRACT  

          Existing law:
          
          1.Establishes the IHSS program to provide personal services  
            and home care for eligible low-income aged, blind, and  
            disabled individuals to enable recipients to remain in  
            their own homes and avoid institutionalization. 

          2.Provides for the oversight of the IHSS program by  
            Department of Social Services (DSS) at the state level,  
                                                         Continued---



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            and county administration at the local level. Specifies  
            the responsibilities of DSS, the Department of Health  
            Care Services, and the counties for various quality  
            assurance activities, including activities to ensure  
            program integrity. Permits counties to contract with a  
            nonprofit consortium or establish a public authority to  
            perform various duties in the employment of persons  
            providing IHSS services. Directs the public authority or  
            nonprofit consortium to assist recipients in finding IHSS  
            providers through the establishment of a provider  
            registry.

          3.Establishes rules governing provider enrollment,  
            including the requirement that criminal background checks  
            must be completed for all IHSS providers, as specified,  
            as a condition of the provider's enrollment in the IHSS  
            program. Provides that criminal background checks shall  
            be conducted at the provider's expense. Authorizes DOJ to  
            assess a fee to cover the cost of furnishing criminal  
            history information.

          4.Prohibits persons who have been convicted of fraud  
            against a government health care or supportive services  
            program, child abuse, or elder abuse within the preceding  
            10 years from providing IHSS services. 

          5.Requires DSS to convene periodic meetings in which  
            supportive services recipients, providers, advocates,  
            IHSS provider representatives, organizations representing  
            recipients, counties, public authorities, nonprofit  
            consortia, and other interested stakeholders may receive  
            information and have the opportunity to provide input to  
            DSS regarding required quality assurance, program  
            integrity, and program consistency efforts.

          This bill:
          
          1.Requires a county, an IHSS nonprofit consortium, or  
            public authority, to accept a clearance of an individual  
            that has been deemed eligible to receive payment for  
            providing IHSS services from another county, nonprofit  
            consortium or public authority. 

          2.Requires DOJ to process a request from a county, an IHSS  
            nonprofit consortium, or a public authority to receive  




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            notifications of subsequent arrests for a provider whose  
            criminal record clearance was originally processed by  
            another county, nonprofit consortium, or public authority  
            only if:

             a.   The request is submitted by the county, nonprofit  
               consortium, or public authority that is to be  
               substituted to receive notification;

             b.   The request is for an individual whose original  
               clearance was obtained to enroll or continue to be  
               enrolled as a provider in the IHSS program; and,

             c.   The request meets the data and format requirements  
               of a written agreement between DSS and DOJ.

          3.Requires DSS, in consultation and coordination with  
            county welfare departments and other designated  
            stakeholders, and in accordance with statutorily required  
            periodic meetings with stakeholders, to establish  
            guidelines to provide counties with instructions to  
            consistently and accurately comply with the statutory  
            requirements for the IHSS program.

          4.Makes legislative findings and declarations, including:   
            that the IHSS program has undergone substantial changes  
            over the past five years, that mechanisms have been put  
            in place to improve IHSS program integrity, that it is  
            important that counties have sufficient direction from  
            the state to implement these changes consistently, and  
            that it is important to minimize the need for IHSS  
            providers and recipients to provide the same information  
            multiple times.




                                 FISCAL IMPACT  

          According to the Assembly Appropriations Committee  
          analysis, costs associated with DOJ processing the requests  
          and sending subsequent arrest notices to the new county  
          would be approximately $800,000 in the first year and  
          $700,000 per year thereafter.  The analysis notes that DOJ  
          has the authority to charge fees to cover the cost of the  




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          background check.  The analysis further notes that it is  
          presumed that a fee sufficient to cover the cost of the  
          bill would be charged to county welfare departments, and  
          that cost would be state-reimbursable (General Fund), as  
          this bill constitutes a new mandate for counties.

                            BACKGROUND AND DISCUSSION  

          Author's statement
          The author states that, under ABx4 19 (Evans), Chapter 17,  
          Statutes of 2009, 4th Extraordinary Session, providers who  
          have previously cleared a background check and who provide  
          services in multiple counties must bear the cost of a new  
          criminal background check in each county. The author states  
          that this bill is needed to eliminate redundant background  
          check requirements on IHSS workers who provide services in  
          more than one county or whose recipient moves from one  
          county to another. The author believes that multiple  
          background checks are duplicative, unnecessary, and impose  
          an extreme hardship on already low-income workers. The  
          author believes that the bill will help resolve the problem  
          of providers being required to pay for more than one  
          criminal background check, while complying with the  
          requirement of ABx4 19 (Evans).

          The IHSS program
          The IHSS program provides in-home care to persons who  
          cannot safely remain in their homes without assistance.   
          Under the program, about 376,000 in-home care workers  
          provide services to more than 430,000 low-income elderly  
          and disabled persons.  IHSS services include, but are not  
          limited to, housecleaning, meal preparation, laundry,  
          grocery shopping, personal care services (such as bowel and  
          bladder care, bathing, grooming and paramedical services),  
          accompaniment to medical appointments, and protective  
          supervision for people with mental impairments.  The  
          program is credited with allowing many individuals to  
          remain in their own homes rather than being placed in more  
          costly nursing home care.

          Generally, for almost all IHSS recipients, 50 percent of  
          program costs are paid by the federal government (through  
          the Medicaid program), about 32.5 percent by the state, and  
          17.5 percent by the county.  (The American Recovery and  
          Reinvestment Act of 2009 temporarily increased the federal  




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          share of IHSS program costs from 50 percent to 61.6 percent  
          through December 2010.)  Administration costs are shared 50  
          percent by the federal government, 35 percent by the state,  
          and 15 percent by the counties.  

          Legislative history on criminal background checks
          According to committee analyses of prior bills dealing with  
          criminal background checks for IHSS workers, the principal  
          controversy has involved assessing the responsibility for  
          paying for the cost of fee charged by the Department of  
          Justice for its provision of            criminal history  
          information.  
           
          In July 2009, ABX4 19 (Evans), Chapter 17, Statutes of  
          2009, 4th Extraordinary Session, was enacted in conjunction  
          with the 2009-10 Budget Act.  Among its provisions, ABX4 19  
          requires criminal background checks to be completed for all  
          IHSS providers. The measure also specified that that  
          criminal background checks were to be conducted at the  
          provider's expense. The statute required new IHSS provider  
          applicant rules to go into effect by October 1, 2009. These  
          rules required providers to sign enrollment forms under  
          penalty of perjury, be fingerprinted and obtain background  
          checks, and participate in a program orientation. For  
          anyone who was already a provider on October 1, 2009, the  
          deadline to meet new requirements was July 1, 2010. (DSS  
          moved the initial deadline from October 1 to November 1,  
          2009, and required providers who were already on a registry  
          by November 1 to initiate the new enrollment process by  
          June 30 and complete it by December 31, 2010.) Providers  
          who were found to have been convicted of fraud against a  
          government health care or supportive services program,  
          child abuse, or elder abuse within the preceding 10 years,  
          through the background check, would be denied enrollment.   

          The Assembly Budget Committee and the Senate Budget  
          Subcommittee on Health and Human Services held a series of  
          hearings on issues surrounding the implementation ABx4 19,  
          including the provider enrollment process, as it pertained  
          to both prospective and existing providers. As of June 16,  
          2010, DSS reported that, as of the prior week,  
          approximately 330,000 IHSS providers have begun or  
          completed the new enrollment process. DSS estimates that  
          about 20,000 or six percent of existing providers haven't  
          yet begun the process. According to one source, an  




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          estimated 1,718 providers provide services in more than one  
          county. DSS does not track how often a provider moves from  
          one county to another.   

          Criminal background clearance
          According to the County Welfare Directors Association,  
          currently a county (or other authorized entity) that  
          requests a criminal background check (criminal offender  
          record information) on an individual also has the right to  
          ask for notification if the person is subsequently  
          arrested, so the criminal background check can be re-opened  
          if a crime is alter committed. Current law prohibits  
          persons convicted of specified crimes from being paid as  
          providers, and counties are responsible for tracking  
          whether a subsequent arrest results in a disqualifying  
          conviction, upon which a provider would be disenrolled from  
          the program. CWDA indicates that the Case Management  
          Information and Payrolling System, or "CMIPS" computer  
          system, used by every county IHSS program to track case  
          information and process payments, has a field that  
          indicates a person has passed the criminal background  
          check.  

           DOJ indicates that when it receives a request for a  
          criminal background check (or criminal offender record  
          information), it provides notice of criminal offender  
          record information or notice of no criminal offender record  
          information. DOJ does not provide a "clearance" per se. A  
          dual notification option can be instigated when the initial  
          criminal offender record information search request is  
          received, and the fingerprint is present when the initial  
          response and subsequent arrest notifications are sent. With  
          a transfer process, a piece of paper with a name and other  
          numeric identifiers is provided to DOJ to modify the  
          information in the automated criminal history system. The  
          modification changes the subsequent arrest notification,  
          replacing one receiving entity with another. It is  
          important to note that this is a replacement, rather than  
          add-on, process. DOJ estimates that the cost of  
          transferring, i.e., replacing one entity with another in  
          the criminal history system, is currently more costly ($39)  
          than processing the initial request for criminal offender  
          record information ($32). 

          Cost of a criminal background check




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          The DOJ charges $32 for its process. The cost for the  
          fingerprint image depends on the vendor and ranges from $10  
          to $25. 

          Related/prior legislation
          ABX4 19 (Evans), Chapter 17, Statutes of 2009, 4th  
          Extraordinary Session, was a budget trailer bill  
          enacted in conjunction with the 2009-10 Budget Act.  
          Among its other provisions, ABX4 19 required criminal  
          background checks to be completed for all IHSS  
          providers as a condition of being placed or maintained  
          on a county's IHSS provider registry. 

          SB 868 (Ridley-Thomas), Chapter 447, Statutes of 2007,  
          clarified that public authorities and non-profit consortia  
          are authorized to require a criminal background check of     
             persons applying to be on the IHSS registry, and  
          prohibited the charging of a fee to those persons required  
          to submit to a criminal background check.

          Arguments in support
          The United Domestic Workers of America/AFSCME state that  
          criminal offender record information records cannot be  
          shared between counties due to privacy statutes that govern  
          sharing and dissemination of DOJ criminal history records.  
          UDW/AFSCME believe that the unintended consequences are  
          that IHSS providers who work in more than one county are  
          required to bear the cost of undergoing and submitting  
          multiple fingerprints and criminal record background  
          checks. 

          Service Employees International Union writes that the  
          measure will ease an administrative burden on counties and  
          county social workers and reduce redundant background check  
          requirements on IHSS workers who provide services in more  
          than one county or who move from one county to another. The  
          California Association of Area Agencies on Aging writes  
          that this measure gives the IHSS worker employment  
          flexibility in the workplace and lessens the financial  
          burden on the worker.

          Aging Services of California writes that multiple criminal  
          background checks are not only excessive and unnecessary,  
          they impose an extreme hardship on already low-income  
          workers. Aging Services believes that with the state's  




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          financial picture growing increasingly uncertain, it is  
          critical to make every effort to preserve and secure home  
          and community-based services.

          In a letter supporting this bill in concept, the County  
          Welfare Directors Association of California (CWDA) writes  
          that the 2009-10 budget agreement enacting provider  
          enrollment requirements was silent on whether a provider  
          who moves from one county to another must undergo an  
          entirely new criminal background check. CWDA states that  
          allowing a person who is cleared in one county to transfer  
          that clearance to a new county, without requiring an  
          entirely new background check and incurring a second set of  
          fees, makes sense, and points out that there is a parallel  
          in the foster care licensing statutes, which explicitly  
          provide that a foster parent or approved relative may  
          transfer their criminal background clearance from one  
          county to another. CWDA further points out that the foster  
          care statutes also authorize a county to request to receive  
          notification when a person who was cleared in another  
          county is subsequently arrested. CWDA states it will  
          continue to work with the author on the implementation  
          issues of such transfers.  

                                         
                                  PRIOR VOTES
           
          Assembly Floor:     54 - 22
          Assembly Appropriations:12 - 5
          Assembly Human Services:   4 - 0

                                     COMMENTS
           
          1.Urgency. This is an urgency measure and requires a  
            two-thirds vote by both houses.

          2.Double-referral. This bill is double-referred. Any  
            amendments agreed to in this committee will be adopted in  
            Senate Public Safety Committee.

          3.Provider serves clients in more than one county. The bill  
            does not yet address the circumstance of a provider who  
            has clients in more than one county and would, therefore,  
            also be required to undergo multiple background checks.  
            DOJ indicates that making a modification to the automated  




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            criminal history system, which changes the subsequent  
            arrest notification cycle from one response (receiving)  
            entity to another, is a replacement process, and not an  
            additional entity process. Thus, it cannot provide  
            multiple notices on a provider's subsequent arrest  
            notifications. DOJ does indicate, however, that a request  
            for dual notification can be made when the initial  
            criminal offender record information search request is  
            made. 

          4.Author's amendments. The author states that, currently,  
            counties and public authorities enroll IHSS providers and  
            enter a providers' eligibility status into CMIPS. The  
            author proposes the following amendments, which would  
            allow other counties in which the provider works or is  
            moving to access CMIPS to see if that individual is  
            eligible to be a provider.

             On page 7, beginning on line 19:
             
            (F) (i) A nonprofit consortium or a public authority  
            authorized to secure a criminal background check  
            clearance pursuant to this section shall accept a  
            clearance for an individual  who is not a registry  
            applicant  described in clause (i) of subparagraph (A) who  
            has been deemed eligible to receive payment for providing  
            services pursuant to this article from another nonprofit  
            consortium, public authority, or county with criminal  
            background check authority pursuant to either Section  
            12305.86 or this section.   The existence of a clearance  
            shall be determined by verification through the Case  
            Management Information and Payrolling System that another  
            county, nonprofit consortium, or public authority with  
            criminal background check authority pursuant to either  
            Section 12301.6 or this section has deemed the current  
            IHSS provider or prospective provider to be eligible to  
            receive payment for providing services pursuant to this  
            article.  
             
             On page 13, beginning on line 24
             
            (e) (1) A county authorized to secure a criminal  
            background check clearance pursuant to this section shall  
            accept a clearance for an individual described in  
            subdivision (a)  or (b)  who has been deemed eligible to  




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            receive payment for providing services pursuant to this  
            article from another county, nonprofit consortium, or  
            public authority with criminal background check authority  
            pursuant to either Section 12301.6 or this section.   The  
            existence of a clearance shall be determined by  
            verification through the Case Management Information and  
            Payrolling System that another county, nonprofit  
            consortium, or public authority with criminal background  
            check authority pursuant to either Section 12301.6 or  
            this section has deemed the current IHSS provider or  
            prospective provider to be eligible to receive payment  
            for providing services pursuant to this article.  
           
          5.Findings and declarations. Staff recommends the following  
            intent language in lieu of the findings and declarations  
            section.


                SECTION 1. The Legislature finds and declares all of  
               the following:


               (a) The In-Home Supportive Services (IHSS) program  
               provides people who are blind, disabled, or over 65  
               years of age with personal assistance and in-home  
               supportive services so they can live safely in their  
               homes and avoid unnecessary and expensive  
               institutional care.


               (b) IHSS is an entitlement program that is regulated  
               by state and federal laws and regulations. To be  
               eligible, consumers must be assessed and found to be  
               aged (65 years of age or older), blind, or disabled  
               (as determined by the Social Security Administration)  
               and are unable to remain safely in their own home  
               without assistance. Recipients must also be low  
               income, meeting the income requirements consistent  
               with eligibility for Medi-Cal.


               (c) Both federal and state laws require the IHSS  
               program to be administered in a manner that ensures  
               that services are comparable in amount, duration, and  
               scope in every county.




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               (d) IHSS is a complex program and has undergone  
               substantial changes over the past five years.  
               Mechanisms have been put in place to improve IHSS  
               program integrity with the enactment of the IHSS  
               Quality Assurance Initiative (Chapter 229, Statutes of  
               2004) and the antifraud initiative (Chapter 17,  
               Statutes of 2009).


               (e) It is important to ensure that counties have  
               sufficient direction from the state to implement these  
               changes consistently and to minimize the need for IHSS  
               providers and recipients to provide the same  
               information multiple times.

           
               SECTION 1.  It is the intent of the Legislature in  
               enacting this act to ensure a more efficient process  
               and eliminate unnecessary, duplicative criminal  
               background checks at the local level for the in-home  
               supportive services program.
          




                                    POSITIONS  
                                                                 
          Support:  United Domestic Workers of America/AFSCME  
          (co-sponsor)
                    Service Employees International Union  
                    (co-sponsor)
                    Aging Services of California
                    American Civil Liberties Union
                    California Alliance for Retired Americans
                    California Association of Area Agencies on Aging 
                    California Foundation for Independent Living  
                    Centers
                    County Welfare Directors Association of  
                    California

          Oppose:None received





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