BILL ANALYSIS
SENATE HUMAN
SERVICES COMMITTEE
Senator Carol Liu, Chair
BILL NO: SB 142
S
AUTHOR: Maldonado
B
VERSION: To be amended
HEARING DATE: April 28, 2009
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FISCAL: To Appropriations
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CONSULTANT:
Hailey
SUBJECT
In-home supportive services: provider timesheets authorized
tasks
SUMMARY
Note: the author intends to replace the language of SB 142,
as amended April 2, 2009, with a new proposal. That new
proposal is reflected in this analysis.
Requires the Department of Social Services (DSS) to devise
a method to ensure that an IHSS provider receives a list of
approved tasks before working for an IHSS consumer.
ABSTRACT
Current law
1. Establishes the in-home supportive services program
(IHSS) to assist qualifying aged, blind, and disabled
individuals to remain safely in their homes.
2. Requires the Department of Social Services (DSS) to
establish statewide hourly task guidelines for the chores
Continued---
STAFF ANALYSIS OF SENATE BILL 142 (Maldonado) Page
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and services provided through IHSS and to provide a
standardized tool for consistent and accurate assessment of
a client's service needs.
3. Requires county social services staff to do an
assessment, at least annually, of the needs of each IHSS
recipient and to authorize that certain tasks and services
be provided to that recipient by a provider of his or her
choosing.
4. Allows recipients of IHSS to select their own provider
or providers.
5. Requires recipients and providers of IHSS to sign a
timesheet every fourteen days showing the number of hours
per day of services received, and to submit that timesheet
to the county for payment for services rendered.
This bill
1. Requires the Department of Social Services, along with
the appropriate stakeholders, to devise a method ensuring
the IHSS provider gets a list of approved duties before
working for the IHSS recipient.
2. Requires DSS to work with appropriate stakeholders in
devising this method.
3. Requires that the process be implemented by December
31, 2011.
FISCAL IMPACT
Unknown.
BACKGROUND AND DISCUSSION
Need for the bill
The author believes that there is a need to continue the
professionalization of the IHSS program, a process
significantly boosted by statutory changes that established
quality assurance activities (Chapter 229, Statutes of
2004, SB 1104, Committee on Budget and Fiscal Review).
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One of the centerpieces of the quality assurance program is
a statewide standard for the various services available
through IHSS: "time for task" guidelines are now in place
and are used by social workers in calculating the amount of
time that a provider is available to work for an IHSS
recipient. A provider is not paid for more hours of
service than are authorized for a recipient by the county
social worker during the assessment.
However, an IHSS recipient is not obliged to give his or
her service provider a copy of the assessment or a list of
the approved tasks on that assessment. The provider knows
the maximum hours of service for which he or she will be
paid, and the provider receives direction from the client
as to what to do.
The author believes that if the provider knows what tasks
have been approved for the client, the provider will
provide those services needed and will submit a time sheet
that covers only the time used to provide those services.
The result will be a closer match between services
authorized and services provided.
Oversight hearing discussion of this issue: pros and cons
At a recent oversight hearing on IHSS conducted by the
Senate Human Services Committee, several witnesses
discussed the advantages and disadvantages of having
providers know which chores, tasks, and services the county
has authorized for a particular individual.
Representatives of providers in general testified that
sharing this information is a good idea and would add to
the program's integrity. Representatives from the
Legislative Analyst's Office (LAO) also discussed their
recommendation that such a change be enacted into law.
Representatives of IHSS clients either raised
implementation questions or opposed the idea. Those
raising implementation questions had two main concerns.
First, they argued that any disclosure process would need
to protect the client's privacy. For example, witnesses
did not want personal identifying information such as
social security numbers and personal information such as
medical diagnoses shared with providers. Second, clients
with more than one provider would need ways to control the
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information given each service provider.
Those opposing the idea outright noted that there is
generally at least one year between assessments, so the
list of authorized tasks may be out of date before another
assessment is completed. IHSS clients often have
complicated medical problems, multiple disabilities, or
changing symptoms. The current system allows the client to
be in control of using IHSS to address his or her needs at
the time the services are provided.
Witnesses also spoke of the positive aspect of IHSS being a
virtual block grant for services needed to assist an
individual to remain safely at home - again, with the
client in control of how his or her budget for services is
utilized.
QUESTIONS AND COMMENTS
1. Sufficient time for the public to review the bill's new
content?
Given testimony received on this issue at the committee's
oversight hearing of IHSS - and the potential for
opposition as well as support - should the bill be held in
committee to allow sufficient time for it to be in print
before all testimony is heard and a vote taken?
POSITIONS
Support: None received: bill to be amended in
committee April 28, 2009
Oppose: None received: bill to be amended in committee
April 28, 2009
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