BILL ANALYSIS                                                                                                                                                                                                    



                                                          AB 16
                                                          Page  1

ASSEMBLY THIRD READING
AB 16 (Honda)
As Amended May 28, 1999
Majority vote 

  HUMAN SERVICES      6-2         APPROPRIATIONS      13-7        
  
 ----------------------------------------------------------------- 
|Ayes:|Aroner, Ducheny, Dutra,   |Ayes:|Migden, Cedillo,          |
|     |Floyd, Shelley,           |     |Longville, Hertzberg,     |
|     |Strom-Martin              |     |Kuehl, Papan, Romero,     |
|     |                          |     |Jackson, Steinberg,       |
|     |                          |     |Thomson, Wiggins, Wright, |
|     |                          |     |Aroner                    |
|     |                          |     |                          |
|-----+--------------------------+-----+--------------------------|
|Nays:|Ashburn, Kaloogian        |Nays:|Brewer, Ashburn, Battin,  |
|     |                          |     |Ackerman, Maldonado,      |
|     |                          |     |Runner, Zettel            |
 ----------------------------------------------------------------- 

  SUMMARY  :  Changes the state's share of cost for In Home  
Supportive Services (IHSS). 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  
  it pays for other forms of IHSS delivery.

2)Requires the state, for the 1999-2000 fiscal year and all  
  future fiscal years, to reimburse counties that have public  
  authorities, nonprofit consortia, or contracts for the cost of  
  increased wages and benefits for IHSS workers, provided the  
  county spends at least the amount it accrues in savings during  
  that fiscal year due to the receipt of federal funding for  
  IHSS share-of-cost recipients.
 
  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.  









                                                          AB 16
                                                          Page  2


2)Authorizes counties to deliver IHSS through any of the  
  following modes of delivery:

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

   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 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  :  According to the Assembly Appropriations  
Committee, the General Fund cost could be up to $94 million, but  
could be less depending on the extent of wage and benefit  
increases granted by counties.

  COMMENTS  :  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.








                                                          AB 16
                                                          Page  3


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 (SEIU) represents IHSS  
individual providers in all the public authority counties.

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 share-of-cost recipients 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. This bill targets the  
county savings to partially fund wage and benefit increases in  
public authority counties.


  Analysis Prepared by  :  Sherry Novick / HUM. S. / (916) 319-2247 


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