BILL ANALYSIS �
AB 1703
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Date of Hearing: March 25, 2014
ASSEMBLY COMMITTEE ON HUMAN SERVICES
Mark Stone, Chair
AB 1703 (Hall) - As Introduced: February 13, 2014
SUBJECT : In-Home Supportive Services (IHSS)
SUMMARY : Adds to the list of authorized IHSS services
assistance in reading and completing financial and other
documents for a blind or visually impaired IHSS recipient.
EXISTING LAW
1)Establishes the IHSS program to provide home care and
supportive services to low-income aged, blind, or disabled
persons in their homes who are unable to provide or care for
themselves and who cannot live safely in their homes without
assistance. (WIC 12300(a))
2)Defines supportive services to include domestic services,
personal care services, protective supervision, paramedical
services, and other services as described. (WIC 12300(b))
3)Permits certain IHSS recipients with high care needs, as
specified, to receive up to 283 hours of IHSS services per
month. (WIC 12303.4(b))
4)Requires county welfare agencies (CWAs) to provide eligible
visually impaired or blind IHSS recipients information and
referral services to non-profit services that provide reading
services. (WIC 12304.6)
5)Provides recipients the right to hire, fire, and supervise the
work of any IHSS provider providing services to them. (WIC
12301.6(c))
6)Requires an IHSS provider to undergo a criminal background
check conducted by the Department of Justice. (WIC 12305.86)
FISCAL EFFECT : Unknown.
COMMENTS :
Background on IHSS : The IHSS program is a Medi-Cal benefit,
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providing personal care services to over 460,000 qualified
low-income individuals who are aged, blind, or disabled. The
purpose of the IHSS program is to provide eligible individuals
with an array of personal care and domestic aide services to
allow them to remain in their homes, as opposed to receiving
care in an institutional facility, such as an adult care home or
nursing home. According to the Department of Social Services,
there are approximately 464,402 IHSS recipients, 10,153, or two
percent of whom are visually impaired or blind.
The IHSS program is administered by CWAs, in coordination with
DSS, whose social workers determine IHSS eligibility and perform
case management after conducting a standardized in-home
assessment of an individual's ability to perform activities of
daily living. Based upon the assessment, IHSS providers are
authorized to provide an array of daily supportive services,
including "paramedical services," which medical services that
are to be rendered under the direction of a licensed health care
professional. Based on authorized hours and services, IHSS
recipients are responsible for hiring, firing, and directing
their IHSS provider(s). About 70% of IHSS recipients receive
their care from a family member or relative provider. In order
to become an IHSS provider, an individual must undergo a
criminal background check, attend a provider orientation, and
meet other requirements.
Limited availability and access to written information for the
blind and visually impaired : Considered a low incidence
disability under federal and state law, persons who are blind or
visually impaired face a number of challenges in obtaining,
navigating and acquiring information. Due to their visual
impairment, many require either access to audio reading
technology or braille services in order to conduct daily tasks,
such as shopping, reading and understanding instructions,
overseeing their own personal finances, and otherwise living
self-sufficiently. Unfortunately, the types of services and
methods available to the visually impaired to help them access
and understand written information are limited, especially for
those who do not have the resources to afford them.
Adding to these challenges is the significant decline in the use
of braille and the costs associated with accessing written
information in braille. According to the National Braille
Press, only 12% of legally blind individuals can read braille,
in contrast to 50% of blind individuals who could do so in the
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1960s. The costs can be substantial. For example, academic
textbooks in braille can cost over $1,000 and can be significant
in size.
Although more affordable than braille, electronic means of
acquiring information is also costly for the blind or visually
impaired. Many look to digital audio files, reading software
such as text-to-speech programs, and audio files, however,
availability of this technology is limited, as well.
For visually impaired individuals, lacking the means and
resources to acquire evolving technology that can help them read
written information can result in limited access to information
considered necessary to conduct day-to-day tasks. This
especially rings true for IHSS recipients who are blind or
visually impaired due to their lack of income and the
limitations on their IHSS providers to provide them reading
assistance.
Previous legislation : AB 1703 is a reintroduction of AB 238
(Beall) from 2007, which was passed by the Legislature but
vetoed by then Governor Schwarzenegger.
According to a Department of Finance's Bill Analysis of AB 238,
in addition to their fiscal mandate concerns, it noted that the
bill "has the potential to create a fiduciary relationship
between the provider and IHSS consumer, potentially increasing
the risk for financial fraud. In addition, there currently is
no requirement that IHSS providers be literate in English."
The author's response was noted in the Senate Human Services
Committee's April 10, 2007 analysis of AB 238:
In response to these concerns, the author indicates that
consumers who need reading assistance would be responsible
for considering a provider's capacity to provide the
service when selecting a provider. Further, consumers are
responsible for and use their own judgment when making a
request of an IHSS provider for reading assistance with
financial and other sensitive personal information. In
addition, the author points out that there are no specific
statewide provider qualifications for any existing covered
services.
Stating his reasoning for his veto, the Governor wrote:
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I strongly support the In-Home Supportive Services (IHSS)
program which provides services to low-income aged, blind
or disabled persons so they can remain safely in homes. My
Administration has worked hard to secure more than 1.7
billion in federal funds to protect these important
services. However, I cannot support expanding the
program's scope to include reading services. This
expansion would add more than one million dollars in new
costs at a time of ongoing budget challenges. We must
balance our need for important program services with our
fiscal reality.
For these reasons, I am returning AB 238 without my
signature.
Need for the bill : Writing in support as the sponsor of this
bill, the California Council of the Blind writes:
"Without access to the many types of written documents,
including financial documents, notices from public
programs, and more, it is almost impossible to effectively
handle many of the important decisions that a person faces
in his/her daily lives. Yet, that is exactly the problem
that many low-income persons who are blind or visually
impaired or that have other severe print disabilities face.
"These individuals cannot, by themselves, access their
daily mail and other written materials that they receive.
Moreover, because they are on fixed incomes, they do not
have the excess income necessary to hire someone to perform
the services of reading their mail and completing documents
for them.
"For more than 40 years, the In-Home Supportive Services
(IHSS) program has provided services to low-income seniors
and persons with disabilities in order to enable these
persons to remain in their own homes and avoid
institutionalization. However, although access to written
information is very likely the greatest impediment to the
ability of persons who are blind or visually impaired to
live independently, the reading and completion of documents
is not a service covered under the IHSS program."
Also writing in support as a co-sponsor, the California
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Association of Public Authorities states:
"Under current law, county welfare departments are required
to provide visually impaired IHSS consumers with
information about and referrals to community public and
nonprofit entities that provide reading services (Welfare
and Institutions Code �12304.6). The current referral
system is inadequate to protect persons with visual
impairments who could obtain reading assistance sooner from
an IHSS provider than from a friend or alternative public
or private program. These consumers may suffer severe
negative consequences such as termination of financial and
medical benefits if important deadlines to file documents
and medical verifications are not met. In addition,
consequences of not paying bills promptly can include not
only additional financial hardships, but loss of essential
utility services.
"Reading services are critical for consumers who need to
know about notices that may affect their IHSS services, or
medical bills, or the terms of prescription medications.
Without assistance, those with visual impairments may be
unaware of critical information and developments affecting
their health and well-being for days or weeks until they
find a friend, relative or alternative program to read the
documents to them."
REGISTERED SUPPORT / OPPOSITION :
Support
California Council of the Blind - Sponsor
California Association of Public Authorities (CAPA) - co-
sponsor
American Federation of State, County and Municipal Employees
(AFSCME)
SEIU California
United Domestic Workers of America
Opposition
None on file.
Analysis Prepared by : Chris Reefe / HUM. S. / (916) 319-2089
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