2007-2008 Santa Clara County Civil Grand Jury Report In-home Supportive Services Operating on the Edge

Findings and Recommendations 2 findings

F1

The authorization of two more payroll clerks for IHSS time card processing was badly needed and overdue. Due to projected future case load growth and ongoing budget issues, there is potential for a similar crisis to occur in the future, resulting in late paychecks for Providers.

Related Recommendations (1)

R1

The Board of Supervisors and IHSS should agree on a trigger or triggers for action so that payroll administration issues do not create undue hardship for Providers.

F2

The department has not had needed tools and technology to help track process performance and to manage change resulting from growth, funding issues, statutory changes, or new technology.

Related Recommendations (1)

R2

As funding allows, IHSS should continue to manage for growth and efficiency, including implementation of the PCG recommendations, development of operational metrics and procedures for planning and scheduling, and further utilization of available technology to improve payroll processing. . Key

Additional Recommendations 1

These recommendations are not explicitly linked to specific findings.

R40-60

minutes 13% 60 minutes+ 13% Although SEIU had been working with IHSS, SEIU decided to contact members of the County Board of Supervisors. The issue was agendized at the regular January meetings of the Board of Supervisors and the Children, Senior and Families Committee, where SEIU was joined by Providers and Clients. The result was approval of two “extra-help” payroll staff that later became permanent positions. The corrected software was reactivated on February 4, 2008. By mid-February, the department had finally eliminated the backlog and was processing time cards the day they were received. Business Process Improvement Study The County Social Services Agency diverted some time from a business process consulting group working elsewhere in the agency, to look at IHSS processes and to suggest improvements. The consultant, Public Consulting Group (PCG), completed the study in April of 2008 and provided information on how the department has functioned since the addition of the two extra staff and the improved version of the time card scanning software. PCG reported that For time cards with NO exceptions, the time frame – from the receipt of timecards by IHSS payroll to upload of time card information into CMIPS – takes 2 business days to complete. Upon input into CMIPS, the State Comptroller takes approximately 2 days to process check. Delivery of mail via USPS is estimated to take three to five business days. Total of 7 to 9 business days for Provider to receive paycheck. PCG also reported that 6000 replacement/supplemental time cards per month are still generated locally, and since they cannot be scanned by the new system, they must be manually entered. PCG recommended a number of process changes to improve accuracy and efficiency, which IHSS expects to be implementing. PCG further provided information and references regarding: - two possible methods, used in San Bernardino and Fresno Counties, to eliminate the 6000 manually entered replacement cards. - a customizable Voice Over Internet Protocol (VOIP) service to help manage call volume and to provide helpful information to callers. - an Integrated Voice Response (IVR) System to provide access to time card information. Conclusions A high growth rate under long-term budget constraints brought about the issues of late paychecks, long telephone delays, and poor customer support. Late paychecks can be devastating to Providers who frequently live from paycheck to paycheck. IHSS payroll administration has struggled through years of growth with insufficient staffing, and antiquated computer and telephone systems. Further, the agency’s newly found relief may be short-lived. At the time of this writing, the Governor of California has planned an 18% cutback in domestic and related services to IHSS clients and a 10% cutback in administrative funding. The 18% cut would be done automatically by CMIPS starting July 1, 2008. Reassessments will be moved to an 18-month schedule rather than 12 months, on the theory that less frequent reassessments will reduce the administrative load. According to a February 2008 Legislative Analyst paper, however, clients will be able to appeal the cutback, and inevitably, the processing for any related data base changes could increase the administrative burden. The Business Process Engineering study from PCG provided helpful suggestions, and their report indicates that IHSS has been moving forward productively despite a difficult situation. Automation is critical for managing growth and change with minimal staff, particularly with repeated transactions such as time cards. Findings and Recommendations Findings have been reviewed with the subject agency. Finding 1 The authorization of two more payroll clerks for IHSS time card processing was badly needed and overdue. Due to projected future case load growth and ongoing budget issues, there is potential for a similar crisis to occur in the future, resulting in late paychecks for Providers. Recommendation 1 The Board of Supervisors and IHSS should agree on a trigger or triggers for action so that payroll administration issues do not create undue hardship for Providers. Finding 2 The department has not had needed tools and technology to help track process performance and to manage change resulting from growth, funding issues, statutory changes, or new technology. Recommendation 2 As funding allows, IHSS should continue to manage for growth and efficiency, including implementation of the PCG recommendations, development of operational metrics and procedures for planning and scheduling, and further utilization of available technology to improve payroll processing. . Key

Conclusions 3

CL1 Page 8

The authorization of two more payroll clerks for IHSS time card processing was badly needed and overdue. Due to projected future case load growth and ongoing budget issues, there is potential for a similar crisis to occur in the future, resulting in late paychecks for Providers.
CL2 Page 8

The department has not had needed tools and technology to help track process performance and to manage change resulting from growth, funding issues, statutory changes, or new technology.
CL3 Page 7

A high growth rate under long-term budget constraints brought about the issues of late paychecks, long telephone delays, and poor customer support. Late paychecks can be devastating to Providers who frequently live from paycheck to paycheck. IHSS payroll administration has struggled through years of growth with insufficient staffing, and antiquated computer and telephone systems. Further, the agency’s newly found relief may be short-lived. At the time of this writing, the Governor of California has planned an 18% cutback in domestic and related services to IHSS clients and a 10% cutback in administrative funding. The 18% cut would be done automatically by CMIPS starting July 1, 2008. Reassessments will be moved to an 18-month schedule rather than 12 months, on the theory that less frequent reassessments will reduce the administrative load. According to a February 2008 Legislative Analyst paper, however, clients will be able to appeal the cutback, and inevitably, the processing for any related data base changes could increase the administrative burden. The Business Process Engineering study from PCG provided helpful suggestions, and their report indicates that IHSS has been moving forward productively despite a difficult situation. Automation is critical for managing growth and change with minimal staff, particularly with repeated transactions such as time cards. 7 Findings and Recommendations Findings have been reviewed with the subject agency. Finding 1 The authorization of two more payroll clerks for IHSS time card processing was badly needed and overdue. Due to projected future case load growth and ongoing budget issues, there is potential for a similar crisis to occur in the future, resulting in late paychecks for Providers. Recommendation 1 The Board of Supervisors and IHSS should agree on a trigger or triggers for action so that payroll administration issues do not create undue hardship for Providers. Finding 2 The department has not had needed tools and technology to help track process performance and to manage change resulting from growth, funding issues, statutory changes, or new technology. Recommendation 2 As funding allows, IHSS should continue to manage for growth and efficiency, including implementation of the PCG recommendations, development of operational metrics and procedures for planning and scheduling, and further utilization of available technology to improve payroll processing. . 8 Key References Documents Beall, Jim, “Budget Cuts Hit State’s Most Vulnerable,” Mercury News, February 11, 2008. California Legislative Analyst’s Office, “Improving Long-Term Care Workforce Through Tiered Wages,” Analysis of the 2006-2007 Budget, Health & Social Services, February, 2006. California Legislative Analyst’s Office, “In-Home Supportive Services (5180),” Analysis of the 2008-09 Budget Bill: Health & Social Services, February, 2008. California Legislative Analyst’s Office, Cal Facts, California’s Economy and Budget in Perspective, 2004-2005 http://www.lao.ca.gov/2004/cal_facts/cal_facts_state%20budget_2004.pdf (accessed May 23, 2008). County of Santa Clara 2003-2004 Civil Grand Jury, Final Report. “Inquiry into the Administration of the County’s In-Home Supportive Services Program,” June, 2004. County of Santa Clara, Board of Supervisors, IHSS Annual Report Presented to the Children, Seniors, and Families Committee, January 18, 2006. County of Santa Clara, IHSS Annual Report Presented to the Children, Seniors, and Families Committee, October 20, 2004. Holgate, Brandynn and Shea, Jennifer, “The Home Care Crisis in California,” New Politics Vol. XI No. 1, SEIU Confronts Summer, 2006. Local 521 Service Employees International Union, CTW-CLC, MS Excel Spreadsheet, “Home Care Workers Paycheck Survey,” January 9, 2008. Local 521 Service Employees International Union, Presentation to Santa Clara County Board of Supervisors Meeting, “Issues Affecting Home health Care Workers,” January 15, 2008. Lohse, Deborah, “Delayed Pay Hurts Santa Clara County Home-Care Workers,” San Jose Mercury News, January 29, 2008. McHugh, Pete, Transmittal to Santa Clara County Board of Supervisors, BOS3-08-006, “Referrals Relating to the In-Home Supportive Services Program,” January 15, 2008. 9 Documents - continued Public Consulting Group, County of Santa Clara, Social Services Agency, In Home Supportive Services Payroll Process Review, April, 2008. Ramoni, James, Social Services Program Manager, Department of Aging and Adult Services, In-Home Supportive Services, Keyboard Transmittal to Children, Senior and Families Committee, Board of Supervisors, Santa Clara County, “IHSS Payroll Processing Report,” January 16, 2008. RTZ Associates, The State of IHSS Health Benefits in California: A Survey of Counties, May 2005. State of California, Department of Social Services, CDSS Adult Programs Branch, In- Home Supportive Services, “Case Management, Information and Payrolling System,” CMIPS 2000 User Manual, October 1, 2007. Interviews February 28, 2008 Home Care Director, Local 521 Service Employees International Union, CTW-CLC. February 28, 2008 Internal Organizing Director for Home Care Director, Local 521 Service Employees International Union, CTW-CLC. March 11, 2008 In-Home Supportive Services Program Manager, Department of Aging and Adult Services. March 28, 2008 Employee, IHSS. May 19, 2008 Director, Fiscal and Administrative Services, County of Santa Clara Social Services Agency. 10 PASSED and ADOPTED by the Santa Clara County Civil Grand Jury on this 5th day of June, 2008. Raymond A. Blockie, Jr. Foreperson Tim Cuneo Foreperson pro tem Kathryn C. Philp Secretary 11

No Responses Found 1

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

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