BILL ANALYSIS
AB 2374
Page 1
ASSEMBLY THIRD READING
AB 2374 (Nestande)
As Amended April 5, 2010
Majority vote
HUMAN SERVICES 5-0 APPROPRIATIONS 17-0
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|Ayes:|Beall, Tom Berryhill, |Ayes:|Fuentes, Conway, Ammiano, |
| |Hall, Logue, Swanson | |Bradford, Charles |
| | | |Calderon, Coto, Davis, |
| | | |Monning, Ruskin, Harkey, |
| | | |Miller, Nielsen, Norby, |
| | | |Skinner, Solorio, |
| | | |Torlakson, Torrico |
| | | | |
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SUMMARY : Changes from January 1, 2009 to January 1, 2011, the
start date for up to five consenting counties to establish pilot
projects offering In-Home Supportive Services (IHSS) recipients
a choice of having services provided by a contracting agency or
a public authority.
EXISTING LAW :
1)Establishes the IHSS program to provide personal services and
home care for eligible poor, aged, blind and disabled
individuals to enable recipients to remain in their own homes
and avoid institutionalization.
2)Requires each county to ensure that IHSS services are provided
to all eligible recipients in accordance with the county plan.
3)Provides that a county board of supervisors may provide for
the delivery of IHSS services by contracting with a nonprofit
consortium or establish by ordinance a public authority.
4)Allows a county to hire homemakers and other in-home
supportive personnel, or contract with a voluntary nonprofit
agency, a proprietary agency or an individual, or make direct
payment to a recipient for the purchase of services.
5)Requires that, commencing January 1, 2009, a pilot project be
established in five consenting counties that provides severely
AB 2374
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impaired recipients of IHSS who receive services through the
public authority with a choice of receiving services through
the public authority or receiving services through a voluntary
nonprofit or proprietary agency.
6)Defines "non-severely impaired" recipient to mean a person who
is assessed to need fewer than 20 hours of IHSS services per
week.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, the original pilot project is estimated to cost
approximately $350,000 General Fund (GF) per year. Absent this
extension, it is likely that those funds would remain in the GF.
COMMENTS : IHSS delivery modes : Counties deliver IHSS services
in one of three service delivery modes, or by a combination of
different modes. The vast majority of IHSS clients receive care
services from an individual provider . The client interviews,
hires, and fires a caregiver, who is not an employee of the
client, but serves as an independent contractor. This mode
offers maximum autonomy to the consumer, and relieves him or her
from employer tasks such as withholding taxes and providing
worker's compensation insurance. The employer of record is a
county-operated public authority or a non-profit consortium.
About six counties provide IHSS services through a contract with
a home care agency. The agency employs and supervises
caregivers who provide care to the clients in their home.
Clients have less autonomy in the selection of a caregiver in
this mode of services delivery. Finally, in the county
homemaker mode, counties employ their own care providers to
deliver services to clients. Since they are county employees,
the county is responsible for their work.
Prior legislation: AB 1674 (Jones), Chapter 319, Statutes of
2008, requires, starting January 1, 2009, the establishment of
pilot projects in five consenting counties to offer severely
impaired IHSS recipients a choice of having services provided by
a contracting nonprofit or proprietary agency or by an
individual provider through a public authority. The pilots
would expand consumer choices by allowing recipients to choose
whether to use a nonprofit or for-profit contractor, or the
existing system administered by public authorities. The purpose
is to enable recipients, particularly those with severe
impairments who are the least able to self-direct their
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services, to have an alternative in which the contractor takes
responsibility for hiring, scheduling, and supplying back-up
workers when needed.
As introduced, this bill would have expanded participation in
the pilot program to all IHSS recipients, rather than only
severely impaired recipients (i.e., those requiring 20 or more
hours of IHSS services per week). As amended, however, this
bill merely extends the start date of the pilot projects to
January 1, 2011, and requires the establishment of pilot
projects in "up to" five consenting counties, rather than in
five consenting counties, as stated in current law.
Analysis Prepared by : Eric Gelber / HUM. S. / (916) 319-2089
FN: 0004598