On October 8th, Governor Schwarzenegger signed into law the 2010-2011 state budget, over 100 days past its June 30th deadline. The budget, along with over 20 budget-related “trailer” bills, attempts to close an estimated $19 billion gap in funding by shifting funds, relying on additional federal money, and by implementing reductions of nearly $8.5 billion in funding for state programs including Prop 98 education funds, state employee compensation, Department of Corrections and Rehabilitation funding, and Health and Human Services funding (i.e., Medi-Cal, IHSS). No new taxes were included in the final version of the budget.
Below is a brief summary of cuts/changes that the budget imposes on the In-Home Supportive Services (IHSS) Program. It is estimated that these changes, along with a general reduction in caseload growth, will save the state nearly $300 million in program expenditures.
Reductions in IHSS Hours
Provider Background Checks
Multi-County Background Checks
Provider Fees
Cuts to Other Programs Utilized by IHSS Consumers
Reductions in IHSS Hours – effective February 1, 2011
Beginning in February, all IHSS consumers will see a 3.6% reduction in authorized hours through June 2012. The impact of this temporary reduction could be different for each consumer, depending on his/her needs and current authorized hours. Consumers who receive the average number of hours (80-85 per month) will see a reduction of 2.8-3.1 hours per month. However, any consumer receiving the maximum number of hours allowed by IHSS (283 per month) will see a reduction of approximately 10.2 hours per month. Consumers will be able to decide themselves how to apply the 3.6% reduction to their services.
This new policy will impact all IHSS consumers. No exemptions can be made. Consumers will receive a notice of action informing them of the reduction at least 30 days before the reduction goes into effect. The 3.6% reduction in service hours cannot be appealed. However, consumers maintain the right to request a reassessment of hours any time that their needs change, or if they feel that they are not receiving the hours of care that they need.
Provider Background Checks Expanded – effective January 2011
Regulations implemented in 2009 require IHSS providers to undergo a Department of Justice Criminal Background Investigation (CBI) before becoming eligible for payment through the IHSS Program. Any provider convicted of or incarcerated for crimes related to senior or dependent adult abuse, child abuse, or fraud against a government program is not eligible for payment as an IHSS provider.
Provisions in the 2010-2011 state budget expand the list of crimes that will disqualify a person from being an IHSS provider to include certain violent/serious felonies, fraud in obtaining aid, and certain felony sex offenses. These new requirements apply only to providers who undergo a background check after the implementation of this law.
Despite the expanded list of crimes, consumers will maintain their right to hire almost any provider they choose. If the provider they wish to hire is ineligible because of a crime that is on the expanded list, a consumer can apply for a waiver by completing a form stating that they are aware of the provider’s criminal history, and are willing to have that person continue to be their care provider. In addition, providers will maintain the right to appeal the county or public authority’s decision, and may request a general exemption that would allow them to provide services to any IHSS consumer. Waivers and exemptions cannot be granted when the crime is related to senior or dependent adult abuse, child abuse, or fraud against a government program.
Multi-County Background Checks – effective immediately
Under previous law, IHSS providers who worked in more than one county, or moved from one county to another, were required to pay for and undergo a separate CBI in each county. A provision in the new budget requires counties and IHSS public authorities to accept CBI clearances from other counties. Providers who clear a CBI in one county will be authorized to work in other counties without having to undergo another CBI.
Provider Fees – effective retroactive to July 1st
As part of an effort to bring additional federal funding into the IHSS Program, the new state budget imposes a reimbursable fee or sales tax on IHSS providers for the “privilege of selling support services at retail.” The fee will be deducted from a supplementary paycheck sent to providers at the end of the fiscal year and will be reimbursed to the providers in the same check. Providers will not have to pay for the fees out of pocket and should not see any net gain or loss in payment. If approved by the federal government, the payment of these fees/taxes will allow the state to bring in an additional $190 million in IHSS funding.
Cuts to Other Programs Utilized by IHSS Consumers
Over the past several months, PASC has tracked several proposed changes/cuts to other programs that could have an effect on consumers and providers. Below is a brief summary of how the final budget will impact these programs.
Medi-Cal – Pending federal approval, the 2010-2011 state budget establishes mandatory enrollment of seniors and persons with disabilities, who do not have other health coverage, into managed care programs beginning in June 2011. This policy will be phased in throughout the state on a timeline that has yet to be determined.
SSI/SSP – No cuts/changes. (The governor originally proposed to reduce payments to the lowest amount allowable under federal regulations.)
Cash Assistance Program for Immigrants (CAPI) – No cuts/changes. (The governor originally proposed elimination of the program.)
Regional Centers – Funding for regional center service providers will be reduced by an additional 1.25%. (Funds were previously lowered by 3%.)
CalWORKs – It is not known how this will impact the CalWORKs program. (The governor originally proposed elimination of the program.)
Healthy Families Program – No cuts/changes. (The governor originally proposed elimination of the program.)
Further information will be posted on this website as it becomes available.