BILL ANALYSIS
SENATE HUMAN
SERVICES COMMITTEE
Senator Carol Liu, Chair
BILL NO: AB 2374
A
AUTHOR: Nestande
B
VERSION: April 5, 2010
HEARING DATE: June 22, 2010
2
FISCAL: Appropriations
3
7
CONSULTANT:
4
Hailey
SUBJECT
In-home supportive services: pilot project
SUMMARY
Changes the starting date and the number of counties
participating in a pilot project for severely impaired
recipients of in-home supportive services.
ABSTRACT
Current law
1) Establishes the county-administered in-home supportive
services (IHSS) program to provide personal care and
domestic services to eligible aged, blind, and disabled
persons to enable them to live safely in their own homes.
2) Requires each county to ensure that IHSS services are
provided to all eligible recipients in accordance with the
county plan.
3) Permits IHSS services to be provided through the
Continued---
STAFF ANALYSIS OF ASSEMBLY BILL 2374 (Nestande) Page
2
employment of individual providers, through a contract
between the county and an entity for the provision of
services, through the creation by the county of a public
authority, or through a contract between the county and a
nonprofit consortium.
3) Requires a pilot project in five counties to commence
January 1, 2009, wherein severely impaired recipients of
IHSS services will choose between receiving services
through a public authority or a contracting agency, which
can be nonprofit or proprietary.
4) Defines a "non-severely impaired" recipient to mean a
person who is assessed to need fewer than 20 hours of IHSS
services per week.
This bill
1) Requires the pilot project to begin on January 1, 2011,
and authorizes the pilot project to include no more than
five counties.
FISCAL IMPACT
According to the Assembly Appropriations Committee, the
original pilot project is estimated to cost approximately
$350,000 General Fund per year. Absent this extension, it
is likely that those funds would remain in the General
Fund.
BACKGROUND AND DISCUSSION
IHSS delivery modes
Counties deliver IHSS services in one or a
combination of three service delivery modes. First,
the 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
STAFF ANALYSIS OF ASSEMBLY BILL 2374 (Nestande) Page
3
consortium.
A handful of 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 can select from
among the caregivers employed by the home care agency.
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 were to 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 of the legislation was
to enable recipients, particularly those with severe
impairments who may be less able to direct their services,
to have an alternative in which the contractor takes
responsibility for hiring, scheduling, and supplying
back-up workers when needed.
This bill 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.
Assembly votes
Floor 74-1
Appropriations15-0
Human Services 5-0
POSITIONS
Support: Addus Healthcare
County Welfare Directors Association
STAFF ANALYSIS OF ASSEMBLY BILL 2374 (Nestande) Page
4
Oppose: None received
-- END --