PASC E-News, Issue #19 topJune 2009
 
New Proposed Cuts to Impact IHSS
The California State Budget for fiscal year 2009-2010, which was signed into law by Governor Schwarzenegger in February, closed a projected $42 billion deficit by increasing revenues and implementing cuts to several state-sponsored programs, including In-Home Supportive Services (IHSS). Since that time, state revenues have continued to decrease while program expenditures have continued to rise, and the state is once again facing a projected deficit of over $24 billion by the end of the 2009-2010 fiscal year.
 
Over the last few weeks, the governor has announced several additional cuts to state-sponsored programs, including over $500 million in cuts to IHSS, as part of his proposed revision to the new budget. If his proposals pass, many programs that serve children, seniors, and persons with disabilities will either see significant cuts to funding and services or face complete elimination. Some of the proposed cuts that would directly impact IHSS consumers and providers include the following:
 
The elimination of all IHSS services for consumers who have a functional index of less than 4. When being assessed for IHSS, applicants are given a functional index score, which is an average measure of their relative dependence on human assistance for performance of basic program tasks. Scores rank from 1 to 6 with 1 representing the least functional limitation and 6 representing the greatest functional limitation. This proposal was released by the governor on May 29th. Details on how many IHSS consumers this would impact are not yet available.
 
The elimination of domestic and related service hours for IHSS consumers who are not considered to have the highest level of need. Details on which consumers this would affect have not yet been released. However, in previous budget cycles the governor has proposed to eliminate domestic and related services to consumers who have a functional ranking of less than 4 for those categories. (See the June 2008 edition of PASC E-News for an explanation of functional rankings).
 
The elimination of the state's share of cost (SOC) buyout program for IHSS consumers who are not considered to have the highest level of need. The buyout program reduces the total SOC for certain IHSS consumers by paying for the difference between their IHSS SOC and their Medi-Cal SOC. Details on which consumers this would affect have not yet been released. As part of the budget passed in February, this program will no longer be available for individuals who apply for IHSS after July 1, 2009.
 
The reduction of state participation in IHSS worker wages to the minimum wage of $8.00/hour. As part of the budget passed in February, state participation in IHSS wages was reduced to $9.50/hour. This new proposal would further affect provider wages across the state, and in L.A. County would reduce wages from the current level of $9.00/hour to minimum wage unless the County is able to pay the difference out of local funds.
 
Provider health benefits in L.A. County would not be directly affected under this proposal. However, the governor's proposed cuts to services could cause many providers to lose their health benefits. For instance, if a provider who is working 85 IHSS hours per month sees a six-hour cut in his/her consumer's authorized IHSS hours, the provider would be dropped from the healthcare plan unless they begin to work for another consumer.
 
Strengthening of the IHSS Anti-Fraud Initiative. This proposal assumes a program savings of $15.8 million by strengthening the efforts to seek out cases of fraud within the IHSS Program.
 
IHSS cost containment reductions. This proposal would reduce funding for IHSS by an additional $301.5 million by cutting services to individuals who only need minimal assistance or supervision to perform certain tasks. It is unclear at this time which consumers this proposal would directly impact.
 
The permanent elimination of the Cash Assistance Program for Immigrants (CAPI) and the California Food Assistance Program. Both of these programs provide assistance to certain legal immigrants who are seniors or persons with disabilities who have been denied SSI and federal food stamp benefits because of their immigration status (i.e., those who have been in the U.S. for five years or less). This would eliminate benefits for over 30,000 legal immigrants.
 
A reduction in SSI/SSP benefit levels to the minimum level allowed by the federal government. The budget passed in February included a reduction in the SSI portion of SSI/SSP payments to levels set prior to December 2008, effective May 1st. In addition, the budget included a provision to cut the overall SSI/SSP payment rate by 2.3% effective July 1st. The governor is now proposing to lower the SSI/SSP payment a third time, effective September 1st. If passed, this would lower the benefit payments to $830/month for an individual or $1,407/month for couples. Many IHSS consumers depend on their SSI/SSP payments to pay rent and obtain the basic necessities that they need to live independently in their own homes.
 
The elimination of state-only Medi-Cal services. The governor has proposed to eliminate several Medi-Cal programs that are not mandated by Medicaid regulations, including Medi-Cal sponsored adult day health care, dialysis, non-digestive nutrition, and breast and cervical cancer treatment services. The governor has also proposed to increase funding for the Medi-Cal Anti-Fraud Initiative in hopes of reducing Medi-Cal expenditures by $47.9 million.
 
In addition to the above, many other state-sponsored programs are facing critical cuts. These include proposals to 1) reduce by $234 million funding for regional centers, which provide services to individuals with developmental disabilities, 2) eliminate the Multipurpose Senior Services Program, which provides social and health care management to seniors who wish to remain in the community, 3) eliminate the CalWORKs Program, which is the state's welfare-to-work program that serves over 500,000 individuals, and 4) eliminate the Healthy Families Program, which provides health, dental and vision coverage for children who do not have insurance.
 
As these proposals have only recently been announced by the governor, there are still some uncertainties about how some of them will affect the IHSS community if they pass. It is now up to the state legislature to decide if they will accept or reject the governor's proposals.
 
More information on these proposals and their status in the budget process will be published in the next edition of PASC E-News. Additional information on the proposed cuts can also be found at www.ebudget.ca.gov or www.lao.ca.gov.  

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Special Election Results

On May 19th, a special election was held to vote on several ballot measures that could have impacted the state budget. Below are the results of the election:  
 
Prop 1A - State Budget (Changes California Budget Process. Limits State Spending. Increases "Rainy Day" Budget Stabilization Fund.)
 
Result: FAILED

Prop 1B - Education Funding
 
Result: FAILED 

Prop 1C - Lottery Modernization Act
 
Result: FAILED
 
Prop 1D - Children's Services Funding 

Result: FAILED
 
Prop 1E - Mental Health Services Funding 
 
Result: FAILED

Prop 1F - Elected Officials' Salaries 
 
Will prohibit members of the state legislature, the governor, or other constitutional officers from receiving pay increases in years in which there is a running budget deficit.
 
Result: PASSED

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Are you looking for training opportunities?
 
 Please contact the PASC training hotline at 818-206-8029!  PASC routinely sponsors trainings for IHSS consumers and providers on a variety of topics including Alzheimer's disease, dementia care, CPR, first aid, bloodborne pathogens, lifting and transferring, dealing with difficult behaviors, and more. We look forward to hearing from you!
IHSS Consumers See Rise in Share of Cost

A few weeks ago, many IHSS consumers began receiving letters from the Department of Public Social Services (DPSS) stating that, effective May 1st, their share of cost (SOC) would be increased. Although a change in SOC is usually seen as the result of either an increase or decrease in the consumer's income, the letter sent out reflects changes in how a consumer's SOC is calculated.  

SOCs for both IHSS and Medi-Cal are determined by comparing the consumer's monthly income to standard State Supplemental Income (SSI) benefit levels. In January, there was a cost of living adjustment (COLA) for SSI recipients, raising the payment for an individual to $907/month. On May 1st, that COLA was rescinded as part of the budget that was passed in February. This lowered the payment for an individual to $870/month and has caused some fluctuations in how SOC is determined for individuals who do not receive SSI benefits.  

For example, Mary is an IHSS consumer who has a monthly income of $1,000 that she receives from her pension plan. Prior to May 1st, her SOC was calculated as  

$1,000 - $907 (SSI benefit level) - $20 (a standard deduction) =  

$73 monthly SOC  

After May 1st, Mary's SOC is calculated as  

$1,000 - $870 (new SSI benefit level) - $20 (a standard deduction) =  

$110 monthly SOC

 
Although Mary is not a recipient of SSI and her income has not increased, her SOC has changed, because the SSI benefit levels are used to determine everyone's SOC.
 
There are several programs that will allow eligible individuals to receive Medi-Cal and IHSS benefits for a reduced or no SOC obligation, including the 250% Medi-Cal Working Disabled Program and the Aged and Disabled Federal Poverty (ADFP) Level Program. For more information regarding these programs, contact your Medi-Cal eligibility worker, or visit the Disability Benefits website at www.db101.org.
 
For questions regarding the letter you received from DPSS regarding an increase in your SOC, contact your IHSS social worker.

Verifying IHSS Employment
As an IHSS provider, you may be asked to verify your employment when you purchase a car, rent an apartment, apply for a loan, apply for an additional job, apply for school, or for a variety of other reasons. Although your employer is the IHSS consumer for whom you provide care, many times it is the verification of your wages the requesting party is seeking.
 
In L.A. County the IHSS payroll is handled at a centralized location. When you need employment verification, you should contact your consumer's provider clerk. If you cannot reach the provider clerk, you can call the IHSS Ombudsman at 888-678-4477 or the IHSS Central Help Line at 562-908-6603. You should also provide these numbers to anyone who needs to verify your employment.
 
PASC does not have access to your employment records and cannot give this information to you or anyone who calls us on your behalf.
 
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CalWORKs Welfare-to-Work Program
The CalWORKs Welfare-to-Work Program is a comprehensive employment and training program designed to promote self-sufficiency through employment. The program provides training on topics such as basic job search skills and resume writing, and covers job-related expenses such as transportation and childcare. The program also pays for approved training or education classes as a step toward looking for employment.
 
Anyone receiving CalWORKs cash aid must participate in the Welfare-to-Work Program, unless that individual is exempt for a reason such as illness or having to care for a person with a disability. CalWORKs recipients are assessed to determine the best course of action for them, whether it is immediate placement into a job, placement into an education or training program, or both.
 
For more information on the Welfare-to-Work Program, visit the Department of Social Services website at www.dss.cahwnet.gov.
 
(Note: As part of his revised budget, Governor Schwarzenegger has proposed to eliminate the CalWORKs program.)
 
Do you have questions about PASC and the IHSS Program? Do you have suggestions for topics to be covered in the PASC E-News? Send your questions and suggestions to e-news@pascla.org. PASC E-News is designed for you to get the information you need!
 
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Upcoming Trainings and Events 
Click on event for more information
PASC/IHSS Mobile Help Desk (Woodland Hills) - June 3rd: A PASC representative will be available to answer your questions and listen to your concerns regarding the IHSS Program. 
 
PASC/IHSS Mobile Help Desk (Burbank) - June 4th: A PASC representative will be available to answer your questions and listen to your concerns regarding the IHSS Program.
 
PASC Board Meeting (L.A.) - June 8th: This meeting is open to the public and provides a forum for IHSS consumers to have their voices heard.
 
PASC/IHSS Mobile Help Desk (Lancaster) - June 26th: A PASC representative will be available to answer your questions and listen to your concerns regarding the IHSS Program. 
 
IHSS Consumer Training - June 29th: Learn important information on applying for IHSS, understanding the IHSS Notice of Action, getting the hours that you need, selecting the right homecare worker, and communicating with your provider.
 
For information on additional events, please visit the Calendar section of our website at www.pascla.org. 
 
Legislation Watch
Click on bill for more information
AB 378 (Cook) - IHSS Provider Training: This bill would require public authorities to develop and implement training standards for IHSS providers throughout the state.
 
AB 452 (Yamada) - The California Independence Act of 2009: This bill would allow individuals who are not eligible for IHSS to receive provider referrals through public authority registries for a fee set by each county.
 
AB 682 (Lowenthal) - IHSS Fraud: This bill would require the California Department of Health Care Services (DHCS) to evaluate the implementation of provisions intended to combat fraud in the IHSS Program.
 
AB 1000 (Ma and Skinner) - Paid Sick Days: This bill would change current regulations so that any employee who works in California for seven or more days in a calendar year would be entitled to paid sick days.
 
AB 1037 (Lowenthal) - Medi-Cal Managed Care: This bill would require the California Department of Health Care Services to develop a pilot project in San Bernardino and Riverside counties that would automatically assign Medi-Cal seniors and persons with disabilities to a Medi-Cal managed care plan unless they select a fee-for-service plan.
 
AB 1532 (Lieu) - IHSS Funding to Counties: This bill would make additional funding available to counties for the 2008-09 and 2009-10 fiscal years, to be used to supplement the level of county spending on IHSS in the 2007-08 fiscal year.
 
SB 141 (Maldonado) - IHSS Provider Timesheets: This bill would require IHSS timesheets, which are signed by the recipient and the provider of services, to contain a legal certification statement.
 
SB 142 (Maldonado) - IHSS Authorized Tasks: This bill would require the Department of Social Services to devise a method to ensure that an IHSS provider receives a list of approved tasks before working for an IHSS consumer.
 
SB 246 (Benoit) - Background Checks for IHSS Providers: This bill would require public authorities to add all IHSS providers to their Registries, and to conduct criminal background investigations on all IHSS providers.  
 
SB 791 (Yee) - IHSS County Responsibilities: This bill would establish that the entity who administers IHSS provider health benefits in each county be the same entity that administers the Consolidated Omnibus Budget Reconciliation Act (COBRA) and the federal American Recovery and Reinvestment Act of 2009. 
 
HR 1670 (Davis - IL) - Community Choice Act of 2009: This federal bill would amend Title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and support, and for other purposes. 
 
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In This Issue
Proposed Cuts to IHSS
Special Election Results
Share of Cost Increases
IHSS Employment Verification
Welfare-to-Work Program
Upcoming PASC Trainings/Events
Legislation Watch

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