On July 28th, Governor Schwarzenegger signed into law a group of trailer bills passed by the state legislature to close a projected $26 billion budget shortfall for fiscal year 2009-2010. The bills will implement approximately $15 billion in cuts to state programs that serve children, seniors, and persons with disabilities, including In-Home Supportive Services (IHSS). Below is a summary of the cuts that will directly impact the IHSS community. There are still many uncertainties on how these cuts will be implemented and how many individuals will be affected. 
 
In-Home Supportive Services
 
Change in Eligibility Requirements (effective September 1st) - 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. Beginning September 1st, consumers who have a functional index score of less than 2 will no longer be eligible to receive services under the IHSS Program.  Exceptions will be made for any consumer who receives protective supervision, paramedical services, or who receives more than 120 hours of service per month. The exact number of consumers who will lose their eligibility for services is unknown at this time, but it is estimated to be around 10% of the IHSS population. It is also unclear at this time how these individuals will be notified of the change.
 
Reductions in Hours for Domestic and Related Services (effective September 1st) - When being assessed for IHSS, applicants are given a functional ranking for each category of service, based on their ability to complete that particular task on their own or with assistance. Beginning September 1st, consumers will lose hours for any domestic and related service (i.e., cleaning, laundry, shopping, etc.) for which they are given a ranking of less than 4.  This includes consumers with rankings of 3 (can perform the function with some human assistance, including, but not limited to, direct physical assistance from a provider), 2 (able to perform the function, but needs verbal assistance, such as reminding, guidance, or encouragement), and 1 (able to perform the function without human assistance, difficulties completing task do not pose a substantial risk to his or her safety). The exact number of consumers who will see a reduction in hours related to this measure is not yet known. It is also unclear at this time how these individuals will be notified of the change.
 
The Elimination of the Share of Cost (SOC) Buyout Program (effective October 1st) - The buyout program reduces the total SOC for certain consumers by paying for the difference between their IHSS SOC and their Medi-Cal SOC. This measure will eliminate the buyout subsidy and result in an increase in SOC for approximately 10,000 consumers. It is estimated that the average increase will be $300-$400 per month.

Strengthening of the IHSS Anti-Fraud Initiative -The bills signed into law will implement several changes to the IHSS Program designed to combat fraud and abuse.  At this time, it is uncertain how and when many of these changes will be implemented.

In addition, the bills will increase funding for local anti-fraud investigations and will provide additional positions at the Department of Social Services and the Department of Health Care Services for anti-fraud activities.
 
Reduction in State Funding for Public Authorities - Public authorities, such as PASC, are funded by a combination of state, federal, and county monies.  The state portion of funding for public authorities will be reduced by approximately 57% or $13.4 million. How this will impact the services provided by public authorities throughout the state is unknown at this time.
 
No Reductions in Provider Wages or Health Benefits - As part of the budget passed in February, state participation in IHSS wages was reduced to $9.50/hour. However, an injunction issued by a US District Court judge has suspended this reduction until further notice. No additional reductions have been made. (Wages in L.A. County are currently $9/hour.)

 

In addition, no direct cuts were made to funding for provider health benefits. However, cuts to services for consumers (see above) could cause many providers to lose their health coverage in L.A. County. For instance, if a provider who is working 85 IHSS hours per month sees a six-hour reduction 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.
 
Cuts to Other Services

All of the cuts mentioned above have been signed into law. However, there are still many questions looming regarding the implementation of many of the cuts. Additional information will be forthcoming in the next edition of PASC E-News. To subscribe to PASC E-News, click here.

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