BILL NUMBER: AB 16	INTRODUCED
	BILL TEXT


INTRODUCED BY   Assembly Member Honda

                        DECEMBER 7, 1998

   An act to amend Section 12301.6 of, and to add Section 12301.8 to,
the Welfare and Institutions Code, relating to public social
services.



	LEGISLATIVE COUNSEL'S DIGEST


   AB 16, as introduced, Honda.  In-home supportive services.
   Existing law provides for the county-administered In-Home
Supportive Services (IHSS) program, under which qualified aged,
blind, and disabled persons are provided with services in order to
permit them to remain in their own homes and avoid
institutionalization.
   Existing law permits services to be provided under the IHSS
program either through the employment of individual providers, a
contract between the county and an entity for the provision of
services, the creation by the county of a public authority, or a
contract between the county and a nonprofit consortium.
   Existing law provides that when any increase in provider wages or
benefits is negotiated or agreed to by a public authority or
nonprofit consortium, the county shall use county-only funds to fund
both the county's share and the state's share, including employment
taxes, of any increase in IHSS costs, unless otherwise provided for
by law.
   This bill would delete this provision, and would, instead, provide
that the annual costs for any public authority or nonprofit
consortium shall be shared by the state and county according to
provisions of existing law.
   The bill would also authorize counties to designate funds to be
used to increase provider wages and benefits for the provision of
IHSS services through a nonprofit consortium or public authority or
through a 3-year contract with various providers, and would provide
for the reimbursement of any county that designates an amount at
least equal to the reduction in the county's share of cost that
results from federal financial participation in services provided to
medically needy aged, blind, and disabled persons, for the cost of
the increase in wages and benefits that exceeds the reduction in the
county share of cost.
   Vote:  majority.  Appropriation:  no.  Fiscal committee:  yes.
State-mandated local program:  no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:


  SECTION 1.  The Legislature finds and declares all of the
following:
   (a) The In-Home Supportive Services (IHSS) program was developed
to permit the aged and persons with disabilities to live safely in
their own homes and to avoid more costly institutionalization.
   (b) Commencing in 1992, many services that had been provided
through the IHSS program were able to be provided to certain
recipients through the adoption of the personal care option
provisions in the Medi-Cal program.
   (c) By 1998, this conversion resulted in savings to the General
Fund of almost one billion dollars ($1,000,000,000).
   (d) The original intent was to use this savings to enhance the
program, including improving the wages and benefits of IHSS program
personnel pursuant to Section 12301.6 of the Welfare and Institutions
Code.
   (e) Most IHSS personnel are paid at the minimum wage, with no
additional benefits.
   (f) Due to the recession and resulting decreases in revenues, this
savings was used to prevent program reductions.
   (g) In addition, counties lost revenue from the recession and from
the property tax transfer.
   (h) The state's economy has now improved, and there is additional
revenue available.  There are also additional savings available
through the IHSS program by transferring the aged, blind, and
disabled medically needy recipients to the personal care option
program.
   (i) Therefore, in order to improve the quality of IHSS personnel
and their working conditions, and in order to reduce turnover in IHSS
personnel, it is the intent of the Legislature to reinvest a portion
of these savings in the program, specifically for wage and benefit
increases, and to provide county relief by providing funds for the
county share of cost.
  SEC. 2.  Section 12301.6 of the Welfare and Institutions Code is
amended to read:
   12301.6.  (a) Notwithstanding Sections 12302 and 12302.1, a county
board of supervisors may, at its option, elect to do either of the
following:
   (1) Contract with a nonprofit consortium to provide for the
delivery of in-home supportive services.
   (2) Establish, by ordinance, a public authority to provide for the
delivery of in-home supportive services.
   (b) (1) To the extent that a county elects to establish a public
authority pursuant to paragraph (2) of subdivision (a), the enabling
ordinance shall specify the membership of the governing body of the
public authority, the qualifications for individual members, the
manner of appointment, selection, or removal of members, how long
they shall serve, and other matters as the board of supervisors deems
necessary for the operation of the public authority.
   (2) A public authority established pursuant to paragraph (2) of
subdivision (a) shall be both of the following:
   (A) An entity separate from the county, and shall be required to
file the statement required by Section 53051 of the Government Code.

   (B) A corporate public body, exercising public and essential
governmental functions and that has all powers necessary or
convenient to carry out the delivery of in-home supportive services,
including the power to contract for services pursuant to Sections
12302 and 12302.1 and that makes or provides for direct payment to a
provider chosen by the recipient for the purchase of services
pursuant to Sections 12302 and 12302.2.  Employees of the public
authority shall not be employees of the county for any purpose.
   (3) (A) As an alternative, the enabling ordinance may designate
the board of supervisors as the governing body of the public
authority.
   (B) Any enabling ordinance that designates the board of
supervisors as the governing body of the public authority shall also
specify that no fewer than 50 percent of the membership of the
advisory committee shall be individuals who are current or past users
of personal assistance services paid for through public or private
funds or recipients of services under this article.
   (C) If the enabling ordinance designates the board of supervisors
as the governing body of the public authority, it shall also require
the appointment of an advisory committee of not more than 11
individuals who shall be designated in accordance with subparagraph
(B).
   (D) Prior to making designations of committee members pursuant to
subparagraph (C), or governing body members in accordance with
paragraph (4), the board of supervisors shall solicit recommendations
of qualified members of either the governing body of the public
authority or of any advisory committee through a fair and open
process that includes the provision of reasonable, written notice to,
and a reasonable response time by, members of the general public and
interested persons and organizations.
   (4) If the enabling ordinance does not designate the board of
supervisors as the governing body of the public authority, the
enabling ordinance shall require the membership of the governing body
to meet the requirements of subparagraph (B) of paragraph (3).
   (c) (1) Any public authority created pursuant to this section
shall be deemed to be the employer of in-home supportive services
personnel referred to recipients under paragraph (3) of subdivision
(d) within the meaning of Chapter 10 (commencing with Section 3500)
of Division 4 of Title 1 of the Government Code.  Recipients shall
retain the right to hire, fire, and supervise the work of any in-home
supportive services personnel providing services to them.
   (2) (A) Any nonprofit consortium contracting with a county
pursuant to this section shall be deemed to be the employer of
in-home supportive services personnel referred to recipients pursuant
to paragraph (3) of subdivision (d) for the purposes of collective
bargaining over wages, hours, and other terms and conditions of
employment.
   (B) Recipients shall retain the right to hire, fire, and supervise
the work of any in-home supportive services personnel providing
services for them.
   (3)  When any increase in provider wages or benefits is
negotiated or agreed to by a   (A) The annual cost for
any  public authority or nonprofit consortium  under
this section, then the county shall use county-only funds to fund
both the county share and the state share, including employment
taxes, of any increase in the cost of the program, unless otherwise
provided for in the annual Budget Act or appropriated by statute.  No
  created pursuant to this section shall be shared by
the state and the counties as prescribed in Section 12306.  

   (B) No  increase in wages or benefits negotiated or agreed to
pursuant to this section shall take effect unless and until, prior
to its implementation, the department has obtained the approval of
the State Department of Health Services for the increase pursuant to
a determination that it is consistent with federal law and to ensure
federal financial participation for the services under Title XIX of
the federal Social Security Act.
   (d) A public authority established pursuant to this section or a
nonprofit consortium contracting with a county pursuant to this
section, when providing for the delivery of services under this
article by contract in accordance with Sections 12302 and 12302.1 or
by direct payment to a provider chosen by a recipient in accordance
with Sections 12302 and 12302.2, shall comply with and be subject to,
all statutory and regulatory provisions applicable to the respective
delivery mode.
   (e) Any nonprofit consortium contracting with a county pursuant to
this section or any public authority established pursuant to this
section shall provide for all of the following functions under this
article, but shall not be limited to those functions:
   (1) The provision of assistance to recipients in finding in-home
supportive services personnel through the establishment of a
registry.
   (2) Investigation of the qualifications and background of
potential personnel.
   (3) Establishment of a referral system under which in-home
supportive services personnel shall be referred to recipients.
   (4) Providing for training for providers and recipients.
   (5) Performing any other functions related to the delivery of
in-home supportive services.
   (6) Ensuring that the requirements of the personal care option
pursuant to Subchapter 19 (commencing with Section 1396) of Chapter 7
of Title 42 of the United States Code are met.
   (f) (1) Any nonprofit consortium contracting with a county
pursuant to this section or any public authority created pursuant to
this section shall be deemed not to be the employer of in-home
supportive services personnel referred to recipients under this
section for purposes of liability due to the negligence or
intentional torts of the in-home supportive services personnel.
   (2) In no case shall a nonprofit consortium contracting with a
county pursuant to this section or any public authority created
pursuant to this section be held liable for action or omission of any
in-home supportive services personnel whom the nonprofit consortium
or public authority did not list on its registry or otherwise refer
to a recipient.
   (3) Counties and the state shall be immune from any liability
resulting from their implementation of this section in the
administration of the In-Home Supportive Services program.  Any
obligation of the public authority or consortium pursuant to this
section, whether statutory, contractual, or otherwise, shall be the
obligation solely of the public authority or nonprofit consortium,
and shall not be the obligation of the county or state.
   (g) Any nonprofit consortium contracting with a county pursuant to
this section shall ensure that it has a governing body that complies
with the requirements of subparagraph (B) of paragraph (3) of
subdivision (b) or an advisory committee that complies with
subparagraphs (B) and (C) of paragraph (3) of subdivision (b).
   (h) Recipients of services under this section may elect in-home
supportive services personnel who are not referred to them by the
public authority or nonprofit consortium.  Those personnel shall be
referred to the public authority or nonprofit consortium for the
purposes of wages, benefits, and other terms and conditions of
employment.
   (i) Nothing in this section shall be construed to affect the state'
s responsibility with respect to the state payroll system,
unemployment insurance, or workers' compensation and other provisions
of Section 12302.2 for providers of in-home supportive services.
Any county that elects to provide in-home supportive services
pursuant to this section shall be responsible for any increased costs
to the in-home supportive services case management, information, and
payrolling system attributable to that election.  The department
shall collaborate with any county that elects to provide in-home
supportive services pursuant to this section prior to implementing
the amount of financial obligation for which the county shall be
responsible.
   (j) To the extent permitted by federal law, personal care option
funds, obtained pursuant to Subchapter 19 (commencing with Section
1396) of Chapter 7 of Title 42 of the United States Code, along with
matching funds using the state and county sharing ratio established
in subdivision (c) of Section 12306, or any other funds that are
obtained pursuant to Subchapter 19 (commencing with Section 1396) of
Chapter 7 of Title 42 of the United States Code, may be used to
establish and operate an entity authorized by this section.
   (k) Notwithstanding any other provision of law, the county, in
exercising its option to establish a public authority, shall not be
subject to competitive bidding requirements.  However, contracts
entered into by either the county, a public authority, or a nonprofit
consortium pursuant to this section shall be subject to competitive
bidding as otherwise required by law.
   (l) (1) The department may adopt regulations implementing this
section as emergency regulations in accordance with Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 3 of Title 2 of
the Government Code.  For the purposes of the Administrative
Procedures Act, the adoption of the regulations shall be deemed an
emergency and necessary for the immediate preservation of the public
peace, health and safety, or general welfare.  Notwithstanding
Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3
of Title 2 of the Government Code, these emergency regulations shall
not be subject to the review and approval of the Office of
Administrative Law.
   (2) Notwithstanding subdivision (h) of Section 11364.1 and Section
11349.6 of the Government Code, the department shall transmit these
regulations directly to the Secretary of State for filing.  The
regulations shall become effective immediately upon filing by the
Secretary of State.
   (3) Except as otherwise provided for by Section 10554, the Office
of Administrative Law shall provide for the printing and publication
of these regulations in the California Code of Regulations.
Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1
of Division 3 of Title 2 of the Government Code, these regulations
shall not be repealed by the Office of Administrative Law and shall
remain in effect until revised or repealed by the department.
   (m) (1) In the event that a county elects to form a nonprofit
consortium or public authority pursuant to subdivision (a) before the
State Department of Health Services has obtained all necessary
federal approvals pursuant to paragraph (3) of subdivision (j) of
Section 14132.95, all of the following shall apply:
   (A) Subdivision (c) shall apply only to those matters that do not
require federal approval.
   (B) The second sentence of subdivision (g) shall not be operative.

   (C) The nonprofit consortium or public authority shall not provide
services other than those specified in paragraphs (1), (2), (3),
(4), and (5) of subdivision (d).
   (2) Paragraph (1) shall become inoperative when the State
Department of Health Services has obtained all necessary federal
approvals pursuant to paragraph (3) of subdivision (j) of Section
14132.95.
   (n) (1) One year after the effective date of the first approval by
the department granted to the first public authority, the Bureau of
State Audits shall commission a study to review the performance of
that public authority.
   (2) The study shall be submitted to the Legislature and the
Governor not later than two years after the effective date of the
approval specified in subdivision (a).  The study shall give special
attention to the health and welfare of the recipients under the
public authority, including the degree to which all required services
have been delivered, out-of-home placement rates, prompt response to
recipient complaints, and any other issue the director deems
relevant.
   (3) The report shall make recommendations to the Legislature and
the Governor for any changes to this section that will further ensure
the well-being of recipients and the most efficient delivery of
required services.
   (o) Commencing July 1, 1997, the department shall provide annual
reports to the appropriate fiscal and policy committees of the
Legislature on the efficacy of the implementation of this section,
and shall include an assessment of the quality of care provided
pursuant to this section.
  SEC. 3.  Section 12301.8 is added to the Welfare and Institutions
Code, to read:
   12301.8.  (a) A county may designate funds to be used to increase
provider wages and benefits for the provision of services pursuant to
Section 12301.6 or 12302.1.  For the 1999-00 fiscal year, and for
each fiscal year thereafter, any county that designates an amount at
least equal to the reduction in the county's share of cost that
results from federal financial participation in services provided to
medically needy aged, blind, and disabled persons after June 30,
1999, shall be reimbursed for the cost of the increase in wages and
benefits that exceeds the reduction in the county share of cost after
January 1, 2000.  This provision does not apply to any wage increase
necessary to meet federal or state minimum wage requirements.  This
subdivision applies solely to individual providers and contract
employees who provide services pursuant to Sections 12301.6 and
12302.1.
   (b) The department shall determine the reduction in the per capita
state share of cost, pursuant to subdivision (c) of Section 12301.6,
for services provided after June 30, 1999, to medically needy aged,
blind, and disabled persons that results from providing those
services under the personal care option pursuant to Section 14132.95.
  The department shall reimburse counties for the cost of increased
wages and benefits that exceed the amount of the reduction in the
county's share of cost as determined pursuant to subdivision (a),
provided that amount is not greater than the county's actual cost.
   (c) A county that provides services pursuant to Section 12302.1
shall only be reimbursed pursuant to subdivision (a) for the increase
in the rate of reimbursement negotiated after June 30, 1999, and for
the amount specifically designated for increases in wages and
benefits that is in addition to that necessary to meet federal and
state minimum wage requirements.