BILL ANALYSIS                                                                                                                                                                                                    



                                                          AB 16
                                                          Page  1

Date of Hearing:   March 23, 1999

              ASSEMBLY COMMITTEE ON HUMAN SERVICES 
                       Dion Aroner, Chair
            AB 16 (Honda) - As Amended: March 18, 1999
  
SUBJECT  :   In-home supportive services

  SUMMARY  :   Changes the state's share of cost for In Home  
Supportive Services (IHSS) in counties with a public authority  
or nonprofit consortium.  Specifically,  this bill  : 

1)Requires the state to share in the cost of services provided  
  by a public authority or nonprofit consortium at the same rate  
  as it pays for other forms of IHSS delivery.

2)Specifies that for the 1999-2000 fiscal year and all future  
  fiscal years, a county that:

   a)   increases wages and benefits for public authority,  
     nonprofit consortium, and contract employees, and 
   b)   spends at least the amount it accrues in savings due to  
     the receipt of federal funding for IHSS share-of-cost  
     recipients 

  shall be reimbursed by the state for the remainder of the cost  
  of increased wages and benefits.

3)Exempts the wage increases necessary to meet federal or state  
  minimum wage requirements.

  EXISTING LAW  :

1)Establishes the IHSS program within the Department of Social  
  Services (DSS) to provide personal care services and domestic  
  assistance to eligible aged, blind, and disabled individuals  
  who would otherwise be unable to remain safely in their homes.  
   Provides services with no cost to SSI/SSP recipients.   
  Requires those with higher incomes to pay a share of the cost.  


2)Authorizes counties to deliver IHSS through any of the  
  following modes of delivery, or a combination of these:  

   a)   individual providers (IPs) hired by the recipient;








                                                          AB 16
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   b)   private agencies under contract with the county; or
   c)   county social service staff.

3)Authorizes counties that use the IP mode to establish a public  
  authority or nonprofit consortium to administer the program  
  and requires them to:

   a)   operate a registry of IPs;
   b)   screen potential IPs;
   c)   provide for training of IPs and recipients; and
   d)   perform any other necessary functions.

4)Establishes the public authority or nonprofit consortium as  
  the employer of record for the purpose of collective  
  bargaining by individual providers. 

5)Funds approximately 60 percent of the IHSS caseload through  
  the personal care option of the federal Medicaid program and  
  requires non-federal costs to be shared by the state and  
  county at a ratio of 65/35.

6)Specifies that any cost due to increased provider wages or  
  benefits negotiated by a county and a public authority or  
  nonprofit consortium shall be paid by the county, without any  
  state share, unless otherwise provided for in the annual  
  Budget Act.

  FISCAL EFFECT  :   unknown

  COMMENTS :  

1)This bill is sponsored by IHSS Agenda '99, a coalition of 38  
  organizations representing seniors, disabled persons, and  
  labor organizations.  The Coalition has met annually for the  
  last three years in order to identify common goals for  
  improving the IHSS program.

2)Public authorities have been established in San Mateo,  
  Alameda, San Francisco, Contra Costa, and Los Angeles  
  counties.  A public authority is under consideration by  
  Sacramento County, pending further information regarding how  
  it will be funded.  The Service Employees International Union  
  represents IHSS individual providers in the public authority  
  counties.









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3)Federal funds pay for only a portion of the IHSS program  
  because federal law prohibits the use of Medicaid funds to pay  
  providers who are family members.  Prior to last year the  
  state also chose not to use Medicaid funds to pay for  
  "share-of-cost" recipients - those whose income is above the  
  SSI/SSP level and pay out-of-pocket for a portion of their  
  services.  Last year, in the annual Budget Act, the  
  Legislature and Governor agreed to begin paying for the latter  
  group with Medicaid funds.  This moved approximately 15,600  
  IHSS cases from state and county-only funding to 50 percent  
  federal funding, resulting in savings for both the state and  
  counties.









































                                                          AB 16
                                                          Page  4

  REGISTERED SUPPORT / OPPOSITION  :   

  Support  

Addus Health Care (Clovis)
Adult and Aging Commission
Alzheimer's Association
American River College (Sacramento)
Bay Area and Western Paralyzed Veterans of America
Board of Supervisors of Santa Clara County
California Coalition of United Cerebral Palsy Associations
California Council of the Blind
California Retired Teachers Association
California State Association of Counties
California State Association of Counties
Congress of California Seniors 
Contra Costa County Developmental Disabilities Council
County of Contra Costa
County of Sacramento Board of Supervisors
County of Santa Clara Board of Supervisors
Family Service Agency of San Mateo County
Foundation of Resources for Equality and Employment for the  
Disabled
Foundation of Resources for Equality and Employment of the  
Disabled
IHSS Public Authority (San Francisco)
IHSS Recipients & Providers Sharing (IRAPS)
Jay Nolan Community Services
LACES
Los Angeles Coalition for IHSS Reform
Older Womens League of California
Organization of Area Boards on Developmental Disabilities
Resources for Independent Living, Inc.
SEIU Local 415
SEIU Local 535
SEIU Local 616 Service Employees International Union 
Senior Gleaners, Inc.
Senior Outreach Services of Contra Costa
The ARC San Francisco
World Institute on Disability



  Opposition 









                                                          AB 16
                                                          Page  5

None in file
  
Analysis Prepared by  :    Sherry Novick / HUM. S. / (916)319-2247