Inquiry Into the Administration of the County’s In-home Supportive Services Program

Conclusions 1

• CL1 Page 5
  The IHSS Program provides needed services to the aged, blind, and disabled adults and children. It allows individuals to remain safely in their own homes as an alternative to expensive and impersonal out-of-home care. However, assuming that the number of clients continues to increase at the rate of 28% a year, the cost to the County will grow considerably from the current $23 million budget (not including administrative costs of $1.1 million). Finally, the threat of state cuts to the Residual Program leaves the County with the choice of picking up the state share (about $10 million) or cutting non-federally mandated services, such as providing meals and cleanup, protective supervision and accompanying the client to medical appointments. Finding I-A The County’s General Fund provides 25% of the funding for the IHSS program. As the total cost of this program increases, so does the County’s cost to fund this program at a time of a projected fiscal deficit. Salaries and benefits for providers in the County are the highest in the state and among the highest in the nation. Finding I-B State funding for the Residual Program may be cut or even eliminated. If so, the County will have to decide to either increase its share of IHSS costs or cut services. Recommendation I The County should limit its fiscal liability by one or more of the following: a) renegotiating total compensation for providers, b) reviewing eligibility criteria for recipients, c) consider establishing eligibility requirements for providers, d) decreasing funding for the Residual Program only commensurate with any state cuts. 5 Finding II There is currently no oversight of providers to prevent financial abuse. Recommendation II The County should support the passage and implementation of the state Quality Assurance Initiative, as proposed. PASSED and ADOPTED by the Santa Clara County Civil Grand Jury on this 1st day of June 2004. ________________________________ Richard H. Woodward Foreperson 6 References Charts A. Total authorized IHSS cases in Santa Clara County. B. IHSS population by age. C. IHSS provider wage costs. D. Providers’ wage and benefits history. E. Public authority wage increases for selected California counties (1999-2004). Interviews March 3, 2004 – meeting with Director of Adult and Aging Services, SSA Chief Financial Officer and IHSS Program Manager. Telephone conversations and email communications with Deputy County Executive and Director of Adult and Aging Services. Documents County FY 2005 Recommended Budget, www.sccgov.org. Federal Long-Term Care Insurance Program, http://www.ltcfeds.com. Governor’s Budget Proposals for The In-Home Support Services Program, http://www.savehomecare.org. Legislative Committee: FY 2004-05 Governor’s Proposed Budget, Review Impacts on Santa Clara County. Public Authority/Nonprofit Consortium RTE, IHSS, Attachment 4 and 4i, PA/NPC Hourly Rate. SCC SSA Department of Aging and Adult Services IHSS Data. Residual vs. Personal Care Service Program (PCSP) Funding, Director, Adult and Aging Services, SSA. 7 Chart A - Total Authorized IHSS Cases 10,000 8625 9,000 7674 8,000 7,000 6251 6,000 5307 4799 5,000 4259 4,000 3,000 2,000 1,000 0 1998 1999 2000 2001 2002 2003 2004 2005 8 sesaC SSHI Chart B - IHSS Population by Age 40% 35% 30% 25% 20% 15% 10% 5% 0% 0 to 6 7 to 18 19 to 44 45 to 64 65 to 79 80 + Recipient Age (as of January 2004) 9 Chart C - IHSS Provider Wage Costs ($M) $80 72 $70 $60 47 $50 $40 32 28 $30 23 $20 $10 $0 1999 2000 2001 2002 2003 2004 2005 10 )noillim $( stifeneB dna segaW redivorP Chart D - Provider Wage and Benefits History $12 $10.50 $10 $9.50 $9.25 $8.50 $8 $7.25 $6.75 $6.25 $5.75 $6 $5.15 $5.00 $4.75 $4 $2 $0 11 stifeneB dna segaW redivorP Dental & Vision Benefits VHP Health Benefits ECO Passes 1996 1997 1998 1999 2000 2001 2002 2003 2004 Chart E - Wage Increases for Providers (selected California counties) $12 $10 $8 $6 $4 $2 $0 Alameda Contra Los San San Mateo Santa Clara Costa Angeles Francisco 12 segaW redivorP 1999 2000 2001 2002

No Responses Found 2

Government entities assigned to respond to this report. No response documents have been linked in our database.