BILL ANALYSIS                                                                                                                                                                                                    






                                  SENATE HUMAN
                               SERVICES COMMITTEE
                            Senator Carol Liu, Chair


          BILL NO:       SB 886                                       
          S
          AUTHOR:        Florez                                       
          B
          VERSION:       March 16, 2010
          HEARING DATE:  March 23, 2010                               
          8
          FISCAL:        Appropriations                               
          8
                                                                      
          6
          CONSULTANT:                                                
          Hailey
                                        

                                     SUBJECT
                                         
               In-home supportive services providers: electronic  
                                  timekeeping


                                     SUMMARY  

          Authorizes counties to use electronic timekeeping in record  
          keeping to verify tasks and hours completed by persons  
          providing in-home supportive services (IHSS).


                                     ABSTRACT  

           Current law  :
          1.  Establishes the IHSS program to provide domestic  
          services to persons of low income, who are aged or who have  
          a disability, to enable them to live safely in their homes.

          2.  Directs the State Department of Social Services (DSS)  
          to establish and implement hourly task guidelines as well  
          as a standard tool for consistently and accurately  
          assessing service needs and authorizing service hours to  
          meet those needs.

                                                         Continued---



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          3.  Provides for ensuring the quality and integrity of the  
          IHSS program through requirements for signed timesheets,  
          verification of receipt of supportive services, a criminal  
          records clearance for providers of services, a standardized  
          curriculum for county social workers in order to prevent  
          fraud, home visits by county social workers, a provider  
          enrollment form signed under penalty of perjury, and data  
          sharing between counties and the state to prevent fraud.

          4.  Allows eligible persons to receive home medical care  
          services or other home- and community based Medi-Cal  
          program services.

           This bill  :
          1.  Allows counties to use electronic timekeeping, as  
          defined, for providers of IHSS services to report their  
          payroll timesheets.

          2.  Requires that this electronic timekeeping includes  
          telephone-based interactive voice response or Web-based  
          technology that both identifies a provider and accurately  
          records the time of the provider's visit to the recipient  
          of services.

          3.  Defines "recipient" as the recipient of IHSS services,  
          of home medical care services, or of other home- and  
          community-based Medi-Cal program services.

          4.  Allows a person who provides services to a recipient,  
          as defined, to use electronic timekeeping to verify hours  
          of work completed.


                                  FISCAL IMPACT  

          Unknown.


                            BACKGROUND AND DISCUSSION  

          Twice each month under current law and practice, more than  
          400,000 paper time cards from IHSS providers are submitted  
          and manually entered by county workers across California.   
          The cards require the signature of both IHSS recipient and  
          provider, and they reflect the hours worked in a two-week  




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          period.  According to testimony provided to the Human  
          Services Committee in 2009 by representatives of DSS and of  
          county welfare departments, time cards are sometimes  
          illegible or inaccurate, are returned to the IHSS provider  
          and recipient, and are redone.

          The Alameda County Social Services Agency testified to the  
          committee last year that it would like to test electronic  
          timekeeping in the IHSS program; the Agency testified that  
          it uses electronic timekeeping for other social services  
          programs and finds the process to be more accurate, more  
          efficient, and less costly than paper timesheets.

          This bill would allow counties to use electronic timesheets  
          in the IHSS program.

           Alameda County's Experience
           Alameda County reports that it uses electronic reporting  
          and timekeeping in its foster care tracking system, its  
          customer automated response system, its adult and aging  
          automated response system.  The county reports a reduction  
          in incorrect payments in foster care, since adopting the  
          electronic system, and virtually 100 percent on-time  
          processing.  It also reports lower costs for reducing the  
          amount of paperwork required of county workers, freeing  
          them to provide professional services to foster families  
          and to CalWORKs recipients.  

          Alameda County believes that if it were allowed to use  
          electronic timekeeping for the IHSS program, it would  
          eliminate many problems stemming from timesheets arriving  
          unsigned, being filled out incorrectly, or not adding up  
          correctly.  These problems take staff time to correct and  
          can result in delayed payment of providers.  

          The county has several program-integrity assurances in its  
          proposal:
                 Each provider has a unique pin number mailed to him  
               or her each pay period.
                 Clients call in when the services begin and call in  
               when the services are completed.
                 Voice prompts require that the timesheet be signed  
               before entering service-hour information.
                 Signed timesheets could be required to be mailed  
               into the county for reference if any problem develops.  




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                In July, 2011, the timesheet could also have a  
               fingerprint of client and caregiver.
                 Providers and clients would be able to update or  
               correct the amount of time worked up to the closing of  
               the pay period if someone has forgotten to call in at  
               the appropriate times.
                 Audits would be an integral feature of the process.

           CMIPS II
           The current paper timesheet and in-county processing goes  
          by the name of the Case Management, Information and  
          Payrolling System, or CMIPS (pronounced "SEE-mips").  For  
          several years, DSS has had a contract with a vendor to  
          develop a statewide centralized paper-processing system,  
          referred to as CMIPS II (pronounced "SEE-mips TWO").  Once  
          it is operational, the timesheets will be scanned and sent  
          from throughout the state to a central location for  
          processing.  DSS is scheduled to test CMIPS II beginning in  
          September of this year, have five counties begin a pilot in  
          January of 2011, and operate the program statewide by  
          December of 2011.

          The author may want to consider amending the bill to allow  
          counties that adopt electronic timekeeping to opt out of  
          CMIPS II.

           Arguments in support
           The Alameda County Board of Supervisors believes that this  
          bill will allow the use of technology that will improve  
          accuracy, lower costs, and reduce the number of errors, all  
          of which will allow county staff to spend more of their  
          time performing customer service or program auditing.


                              COMMENTS AND QUESTIONS
           
          The Committee may wish to ask the author to comment on the  
          bill's cost, cost neutrality, or estimated savings.


                                    POSITIONS  

          Support:       Alameda County Board of Supervisors

          Oppose:   None received




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