BILL ANALYSIS �
Senate Appropriations Committee Fiscal Summary
Senator Kevin de Le�n, Chair
AB 1703 (Hall) - IHSS: reading services.
Amended: May 23, 2014 Policy Vote: Human Services 4-0
Urgency: No Mandate: No
Hearing Date: August 4, 2014
Consultant: Jolie Onodera
This bill meets the criteria for referral to the Suspense File.
Bill Summary: AB 1703 would include assistance in reading and
completing financial and other documents which are essential to
activities of daily living (ADL) for a recipient of the In-Home
Supportive Services (IHSS) Program who is blind or visually
impaired, or who has another disability that significantly
impairs his or her ability to read.
Fiscal Impact:
Potentially major ongoing costs of about $18 million
(General Fund/Federal) to fund additional authorized IHSS
provider hours for reading assistance services to legally
blind, visually impaired, or other qualified individuals
eligible for the service. This cost assumes approximately
two percent of the IHSS caseload, or 10,000 individuals, who
are legally blind, as well as 30,000 additional IHSS
recipients who may qualify for the service are authorized
for an additional 3 hours per month.
Near-term potentially significant county administrative
costs (Federal/General Fund) to assess all current IHSS
recipients who are visually impaired, blind, or otherwise
disabled for eligibility for this new service. Future
ongoing costs are estimated to decline once the existing
caseload is assessed.
Unknown but potentially significant one-time costs for
automation changes.
Minor one-time costs to DHCS to submit the request for
federal approval of this service. To the extent federal
approval is not received, all costs would be borne by the
General Fund.
Background: Existing law provides for the In-Home Supportive
Services (IHSS) program through which qualified aged, blind, or
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disabled individuals receive supportive services enabling them
to remain in their own homes. Existing law defines the scope of
supportive services under the IHSS program to include heavy
cleaning, personal care services, accompaniment by a provider
when needed during necessary travel to health-related
appointments or to alternative resource sites, yard hazard
abatement, protective supervision, teaching and demonstration
directed at reducing the need for other supportive services, and
paramedical services which make it possible for the recipient to
establish and maintain an independent living arrangement.
Under existing law, county welfare departments are required to
provide visually impaired applicants and recipients with
information on, and referral services to, entities that provide
reading services to visually impaired persons.
Proposed Law: This bill would include assistance in reading and
completing financial and other documents which are essential to
ADL for a recipient of the IHSS Program who is blind or visually
impaired, or who has another disability that significantly
impairs his or her ability to read.
This bill requires the Director of Health Care Services (DHCS)
to seek any federal approvals necessary to ensure that Medicaid
funds may be used in implementing the provisions of this
measure.
Prior Legislation: AB 238 (Beall) 2007 was substantially similar
to this bill and was vetoed by the Governor with the following
message:
I strongly support the In-Home Supportive Services 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.
Staff Comments: By expanding the scope of authorized IHSS
program services to include assistance in reading and completing
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financial and other documents which are essential to ADL for a
recipient who is blind, visually impaired, or who has another
disability that significantly impairs his or her ability to
read, this bill will result in an increase in authorized IHSS
hours and costs for IHSS provider wages, including the provision
of overtime pay, if necessary.
The DSS has indicated two percent of the IHSS caseload is
legally blind, or about 10,000 individuals. This bill also
extends eligibility for assistance in reading and completing
financial and other documents to recipients who have "another
disability" that significantly impairs his or her ability to
read. It is estimated an additional 30,000 IHSS recipients could
qualify for this service under an assessment meeting this
standard. Assuming the 40,000 IHSS recipients are authorized for
the new reading service at three hours per month would result in
annual costs of nearly $18 million (General Fund/Federal Fund)
to fund additional IHSS provider hours for reading assistance
services. To the extent federal approval is not received for
this service under the IHSS program, all costs would be borne by
the General Fund.
To the extent a portion of the existing IHSS caseload would
request reassessment for potential eligibility for this service
upon enactment of this bill would result in a short-term
increase in county social worker costs to reassess IHSS
recipients for this new service.
The addition of this new supportive service will also likely
require automation changes to existing systems which could
result in potentially significant one-time costs.