…But Reduce General Fund Costs in 2023-24. Beginning in 2012-13, however, the historical county share-of-cost model was replaced with an IHSS county maintenance-of-effort (MOE), meaning county costs would reflect a set amount of nonfederal IHSS costs as opposed to a certain percent of nonfederal IHSS costs. PDF IHSS Wages and Bargaining Provisions Brief - Counties This Google translation feature provided on the Legislative Analyst's Office (LAO) website is for informational purposes only. It paid off! Possible Ways to Address Gap in IHSS BackUp Provider Services. County A has a wage level of $11.00 per hour, while County B has a wage level of $12.50 per hour. The MOE essentially eliminated the counties share of IHSS costs and replaced it with a set amount that each county would pay for IHSS. In some counties, IHSS provider wages are higher than the state minimum wage primarily due to locallynegotiated agreements. How Much Does Ihss Pay In California? - Inland Empire Fact Sheets Counties were responsible for 35percent of the nonfederal share of IHSS service costs and 30percent of the nonfederal share of IHSS administrative costs. The Governor's budget estimates that IHSS county MOE costs will increase by $ 83 m illion, from $1. Cost Per Hour Continues to Increase. The average number of service hours that will be provided to an estimated 642,289 IHSS recipients is projected to be 116 hours per month in 2023-24. As of December 1, 2018, nine counties have chosen to apply a local wage supplement to their IHSS wages. Provider Fraud and Elder Abuse complaint line: Based on our analysis of the proposed 2023-24 budget, we found that hourly wages are expected to continue to grow at a rate generally similar to historical levels. Below, we describe possible ways the Legislature could address this gap in backup provider services. Medi-Cal renewals begin June 2023, and mailing begins April 2023. We also found that, after a period of slowed caseload growth, the IHSS paid caseload is expected to begin to increase at rates more similar to pre-pandemic levels. (Some counties are continuing to provide backup provider services despite the expiration of the temporary COVID19 backup provider system.) The states HCBS spending plan includes two IHSSrelated enhancements: (1)provide a onetime $500incentive payment to IHSS providers who worked at least two months between March2020 and March 2021 and (2)create specialized training opportunities for IHSS providers. The growth in IHSS hourly wages in part is due to increases to the state minimum. In the nearby box, we explain the rules that dictate how the local wage supplement option would be implemented. To put this in perspective, this average is more than double what County employees received collectively during the same period. See also: Where To See Snow In Southern California? 67 m illion in 202021. The Office of Human Resources receives questions about how the General Schedule (GS . Based on our analysis of caseload data, we observe a continued trend of fewer authorized cases claiming service hours in any given month since the start of COVID-19. As inflation spikes, Social Security cost-of-living bump could reach 10 Although the trainings are relatively new, the administration indicates that as of December 2022: Over 1,100 providers had taken a training. At the start of the COVID19 pandemic, the state created a temporary backup provider system to assist IHSS recipients when their regular provider could not work due to circumstances related to COVID19. Alternatively, counties could implement local wage and benefit increases, ultimately increasing their share of IHSS costs. As shown in Figure3, due to the state participation cap, the state and county share of cost for a $1.00 wage increase is different for County A than County B. The emergency backup provider system expired on December 31, 2021. Because of this, County A would experience a wage increase that has no impact on their MOE obligation. The Office of Human Resource's compensation web page provides links to the 2023 pay tables. To apply for In-Home Supportive Services, please complete the application (PDF) and first page of the Health Care Certification (PDF).Your Licensed Health Care Professional (LHCP) will need to complete the second page of the Health Care Certification.Fax them to 916-787-8922, ATTN: IHSS Intake and call the Placer County Adult Intake number at 916-787-8860 or toll free at 888-886-5401. This increase in federal Medicaid funding is expected to offset over $1billion in baseline IHSS General Fund spending across 202021 and 202122. Starting January 1, 2022 On the date that state minimum wage reaches $15.00 per hour, currently scheduled for January 1, 2022, there will be changes to the state participation level. Budget Overview and Caseload Update The Governor's budget proposes a total of $20.5 billion (all funds) for IHSS in 2023-24, which is about $2 billion (10 percent) above estimated expenditures in 2022-23. Effect of State Participation Capa on State and County IHSS Wage Costs, Share of Nonfederal Cost for Wage Increase. The budget includes about $6. We will continue to monitor the data related to IHSS paid hours per case and provide further comments at the time of the MayRevisionifnecessary. This lower average hours per case is likely related to the previously noted lower level of IHSS authorized cases being paid and it is something we are continuing to monitor. Under the 2017 IHSS MOE, county costs for 201718 were rebased to roughly reflect the historical county share-of-cost of IHSS as estimated in 201718 (35percent of the nonfederal share of IHSS service costs and 30percent of the nonfederal share of IHSS administrative costs). Ancillary services consisting of accompaniment to medical appointments, fittings of health-related devices, or sites where alternate resources provide care in lieu of IHSS; Questions? To the extent that the MOE growth rate is higher (or lower) than the actual growth in IHSS costs, counties will be responsible for a higher (or lower) share of total IHSS costs relative to the historical county share of cost. Because the budget assumes this enhanced federal funding ends in June 2023, the budget also assumes the General Fund will pick up this roughly $1billion in costs in 2023-24. We understand that the onetime $500 payments to IHSS providers tentatively are scheduled to occur in early 2022. In other words, the base wage is $14 per hour through the end of 2021. The LAO is unable to guarantee the accuracy of this translation and is therefore not liable for any inaccurate information resulting from the translation application tool. Which States Increased the Minimum Wage in 2023? Historically, the administration has estimated slight increases in the average hours per case on a year-over-year basis (most recently expecting year-over-year increases of around 1percent). As such, we are working with the administration to better understand (1)the assumptions they are making to project that all funds will be spent by the December 2023 deadline, (2)how many providers they expect to go through the trainings and receive the incentives in order to expend all of the funds by December 2023, (3)how the administration will wind down the program in a way that ensures providers are aware of the deadlines they must meet in order to be eligible for the various training incentive payments, and (4)whether the administration would propose to extend the IHSS Career Pathways expenditure deadline if not all funds for trainings and incentive payments are spent by December 2023. (Upcoming publications, The 202223 Budget: Analysis of the MediCal Budget and The 202223 Budget: Analysis of Health Care Access and Affordability Proposals, will provide additional details on the fullscope MediCal expansion to remaining undocumentedadults.). On January 1, 2020, the minimum wage will increase to $13 per hour. IHSS Providers are Getting a Raise on January 1, 2023 We will continue to monitor the caseload and provide updates at the May Revision. For both County A and County B, the cost for this one-time wage increase would be added to their MOE obligation, which would be adjusted every year by the MOE growth factor. We estimate that this is a net increase of about $1.9billion (24percent) above estimated General Fund costs in 2022-23. As a result, the Governors budget assumes $90million General Fund savings for the IHSSResidual program in 202122. PDF Raising the Wages of In-Home Supportive Services Home Care Workers The Governors budget proposes to further extend fullscope MediCal coverage and IHSS eligibility to incomeeligible undocumented immigrants aged 26 to 49 no sooner than January 2024. LAO Bottom Line: DSS Working Towards Implementation of IHSSRelated HCBS Spending Plan Items. In general, beneficiaries of restricted scope MediCal are not eligible for IHSS. The 2021-22 budget included legislation to raise the Medi-Cal asset limit from $2,000 to $130,000 for individuals and from $3,000 to $195,000 for couples in July 2022. All provider rates are set by individual counties. This increased federal match lowers state costs for MediCal, IHSS, and other programs that rely on federal Medicaid funding. BYJEANNE KUANG Gabriela Guerreros children are all grown and have moved out, butRead More, 2023 United Domestic Workers of America AFSCME Local 3930, AFL-CIO All Rights Reserved. Contact IHSS (661) 868-1003. MediCal redeterminations were paused during the COVID19 public health emergency. Social workers employed by county welfare departments conduct an in-home assessment of an individuals needs in order to determine the amount and type of service hours to be provided. The long and often strenuous fight to protect the basic rights of caregivers culminated in historic wage increases. Create a statewide emergency backup provider system with $2 per hour wage differential. (You can also see a list of current provider wages in our post 2023 IHSS Wages. In situations where there is no danger of COVID19 infection, the county can conduct an inperson home visit. Tentative employment agreement to raise In-Home Supportive Services wages The state implemented numerous IHSS program flexibilities and enhancements to mitigate health and safety risks associated with COVID19. Caseload growth, a rising number of paid hours per case, and hourly wage increases for IHSS providers are key drivers of increasing IHSS costs. When IHSS recipients do not complete the MediCal redetermination process they can continue to receive their IHSSservices through the IHSSResidual program unless counties manually terminate them from the IHSS program. Federal COVID19related legislation effectively requires the state to suspend most MediCal eligibility redeterminations for the duration of the national public health emergency declaration, which the Governors budget assumes will last until June 30, 2022. The 2021-22 budget included $5million General Fund to create a permanent IHSS backup provider system on January 1, 2022, contingent on a policy framework being adopted in statute. The 2022-23 Budget: In-Home Supportive Services As a condition of receiving these funds, the state is required to spend an equal amount of funding on new HCBS enhancements and expansions. IHSS and APS social workers perform outbound calls and/or visits to elderly recipients to ensure atrisk recipients are receiving services they need and are safe in their homes. IHSS Fraud Hotline: 888-717-8302 After months of negotiations and a number of vigils, marches and rallies to spur public support, Californias unionized child care providers have reached a new labor deal with the state. Status of COVID19 IHSS Program Responses and Flexibilities. This yeartoyear increase in General Fund reflects a much faster rate of cost growth relative to prior budget estimates. Under the permanent backup provider system, a recipient who has an urgent need or whose health and safety will be at risk without a backup provider can receive up to 80 hours (if recipient is non-severely impaired) or 160 hours (if recipient is severely impaired) of backup provider services per state fiscal year. Automatic Increases to State Participation Cap on IHSS Wages and Benefits. February 20, 2023 Diskint Law Uncategorized. Since IHSS primarily is delivered as a Medi-Cal benefit, the federal share of cost is determined by the Medicaid reimbursement rate, which typically is 50percent. Moving forward, the IHSS MOE will be adjusted annually by a growth factor and any county costs associated with local wage and benefit increases. As shown in Figure4, many of these program flexibilities and enhancements have expired. Although the expansion of IHSS to undocumented individuals aged 26-49 will begin in the 2023-24, the administration does not assume any costs in the IHSS program for this expansion in that year. The proposed budget assumes roughly $15million in General Fund costs to support the Backup Provider System in 2022-23 and 2023-24. The administration will be updating their estimates at the May Revision. IHSS provider wages in County B, however, would remain the same given that its IHSS provider wages ($12.50 per hour) would still exceed the state minimum wage in 2019. Based on recent growth trends, we expect that the average paid hours per case will continue to grow in 202122 (as opposed to remaining roughly flat). Free Evaluation Beginning in April 2023, the enhanced rate for most services will drop from 6.2percentage points to 5percentage points, then to 2.5percentage points by July 2023, 1.5percentage points by October 2023, and will be fully eliminated by January 2024. After the 10percent option expires, the state will revert back to having no share of cost in future locally established wage or benefit increases above the state participation cap for all counties. LAO Bottom Line: Proposed FullScope MediCal Expansion to Remaining Undocumented Adults Would Increase IHSS Caseload. Temporarily suspend requirement for IHSS provider to complete fingerprintbased criminal background check. Specifically, recent state minimum wage increases and budget-related legislation adopted in 201718 instituted both temporary and permanent changes to how counties can increase IHSS provider wages and benefits with varying effects on state and county costs. In addition to the base wage provision, the IHSS worked out a $.65 pay increase for home health workers to go into effect on January 1. Additionally, counties may establish IHSS hourly wages above the state minimum wage through local wage ordinances or, more commonly, collectively bargained agreements. PDF Economic and Fiscal Impact Analysis of Wage Increases for IHSS Workers For example, the Legislature could extend the expenditure authority of any unspent funds originally provided for the temporary emergency backup provider system to June30,2022. Californias various HCBS enhancements and expansions had to be included in the states HCBS spending plan that was ultimately approved by the federal government. Submission of IHSS Provider Identification Documents. As mentioned earlier, because wages in County B already exceed the state participation cap, County B would be responsible for 100percent of the nonfederal costs for the $1.00 wage increase. Recent legislation has created various options counties can pursue to increase IHSS provider wages and benefitsall of which have different implications for state and county costs. Figure1 shows that the average share of authorized cases that are paid every month slightly decreased from 90percent to 88percent through July 2022. IHSS Provider Wages | sfhsa.org IHSS costs are shared by the federal government, state, and county. Counties may perform home visits for purposes of quality assurance and program integrity remotely using telehealth, including videoconferencing and telephone. Update (2/7/22): Time requirement for incentive payment to IHSS providers in the states HCBS spending plan has been updated. For instance, under the historical share-of-cost model, counties had a share of costs for all wage and benefit increases. The original IHSS program, now named IHSS-Residual (IHSS-R), began in 1974 and is a state-and-county funded program with 65% State and 35% county dollars of the non-federal share. The department has received requests for approval of 85 training incentive payments (none have been approved to date). Specifically, following the next state minimum wage increase, IHSS provider wages in County A would increase by an additional $1.00 per hour. , the average IHSS hourly wage has increased by 6, percent annually since 2014. This slowing in the growth of the IHSS caseload coincided with the start of the COVID-19 pandemic (March2020). PDF IHSS Wages and Bargaining Provisions Brief - Counties The 2023-24 budget projects the average monthly number of IHSS hours per case to remain flat between 2022-23 and 2023-24. As an alternative, counties may accept mailedin or faxed photocopies of the original identification documentation. Early 2023 the wage supplement will increase by $.75 and then again on January 1, 2024 by $.25. Future increases will go into effect if the City appropriate funds in the next budget. Asshown in Figure3, the average IHSS hourly wage has increased by 6percent annually since 2014. The 201718 budget package established provisions that changed how costs for locally established wage and benefit increases are shared between the state and counties. The state is responsible for covering the remaining nonfederal share of costs not covered by the IHSS county MOE. The 2020-21 Budget: Department of Social Services Beginning in 201718, counties and unions can collectively bargain a local wage supplement, meaning local IHSS provider wages will always exceed the state minimum wage by a fixed dollar amount. As a result, some recipients continue to receive services through the IHSSResidual program, whileothersdonot. The administration indicates this enrollment will increase further to an estimated 34,000 cases in 2024-25. Local Wage Supplement. However, under the local wage supplement model, county costs for every wage and benefit increase or supplement are not added to the IHSS MOE. Summary. This translates to roughly 14,000 fewer paid cases every month relative to preCOVID19 levels. As previously mentioned, the ARP Act temporarily increases the federal Medicaid match for HCBS services, including IHSS. Effect of State Minimum Wage Increases. …While Costs for the Expansion to those aged 26-49 Assumed to Begin in 2024-25. We describe in more detail key cost increases and cost shifts in this section. The IHSS El Monte Office is Moving!! Each county sets its own IHSS wages. Historically, income-eligible undocumented immigrants only qualified for restricted-scope Medi-Cal coverage, which covers their emergency- and pregnancy-related service costs. Pay Rate for IHSS in Los Angeles County, CA - Plus FAQs As a part of the 202122 budget, the Legislature did not approve the administrations approach to address this different treatment (which was to automatically terminate all IHSS recipients who do not complete their MediCal redetermination and require them to reinstate their MediCal eligibility before reentering the IHSS program). 2023 General Schedule Pay Tables Update | Home Page Links The Legislature could consider ways to ensure all recipients receive the same treatment, which we explain in more detail below. The Governors budget proposes a total of $20.5billion (all funds) for IHSS in 2023-24, which is about $2billion (10percent) above estimated expenditures in 2022-23. Educational Videos, IHSS Providers: Although the caseload is expected to grow at a faster rate than recent years, recent caseload data indicates that the percentage of authorized cases that are paid in any given month remains below historical averages. The main reason for the year-to-year General Fund cost increase is the anticipated end of a temporary increase to federal Medicaid funds (previously largely associated with the public health emergency) that were used to offset General Fund costs in the IHSS program in 2021-22 and 2022-23. Figure2 shows that the average share of authorized cases that are paid every month slightly decreased from 90percent to 88percent since March2020. These savings will be transferred to the HCBS ARP Fund and spent on federally approved HCBS enhancements and expansions. In-Home Supportive Services (IHSS) is a federal, state and locally funded program providing assistance to eligible aged, blind, and disabled individuals receiving Medi-Cal benefits who are unable to remain safely in their own homes without assistance. We, the members of SEIU 721, are the frontline of LA County - and we bargained hard for a contract that rewards us for the work we do. Resources In addition to the previously mentioned 6.2percent enhanced federal Medicaid match rate, under the American Rescue Plan (ARP) Act, the federal government increased the federal match rate for IHSS and other Medicaid-funded home- and community-based services (HCBS) by an additional 10percentage points from April 1, 2021 through March31, 2022. The state has expanded comprehensive, or fullscope, MediCal coverage, including IHSS eligibility, to incomeeligible undocumented children (effective May 2016), adults aged 19 through 25 (effective January 1, 2020), and older adults aged 50 and over (effective no sooner than May 2022). Currently, seniors and persons with disabilities must have assets at or below $2,000 (or $3,000 for couples) to be eligible for MediCal. Since 201617, the number of IHSS paid hours per case increased by about 2.5, percent annually, reaching 118.7 hours per case in 202021. Some of the reasons why authorized cases may not receive paid services include recipients not yet hiring an IHSS provider or being temporarily hospitalized or admitted into a licensed care facility. Allow IHSS parent provider in twoparent household to continue to be an eligible IHSS provider even if the second parent becomes a suitable care provider because the parent is not working or attending school or vocational program. However, the costs for subsequent local wage supplements are not added to a countys MOE obligation. How much will IHSS pay in 2023? While the permanent backup provider system was intended to take effect on January 1, 2022, because no program structure has been set in statute yet, the start date has been delayed to July 1, 2022. The Governors budget assumes this enhanced federal funding is in place from January 1, 2020 through June 30, 2023 and will offset over $1billion in total IHSS General Fund spending in 2022-23. Historically, incomeeligible undocumented immigrants only qualified for restrictedscope MediCal coverage, which covers their emergency and pregnancyrelated service costs. In this post, we (1)explain how the scheduled state minimum wage increases impact IHSS wages and state and county costs, (2)describe the recent temporary and permanent changes to the state and county cost-sharing structure for IHSS wage and benefit increases, and (3)explain how these changes could impact county wage decisions and costs for the state. As a result, total county costs would generally increase or decrease as total IHSS costs increased or decreased. Under the historical share-of-cost model, the county share of total IHSS program costs was the same year-to-year. The 202122 budget included $5million General Fund to create a permanent backup provider system on January 1, 2022, contingent on a policy framework being adopted in statute. As a result, the state would have no share of nonfederal costs for any locally established wage or benefit increase. Boosting hourly wages by 75 cents would cost L.A. County an additional $42.5 million annually and the added 25-cent increase the following year would cost an additional $14.7 million annually,. Lacking Statutory Structure, Permanent BackUp System Delayed. Check your BenefitsCal.com account to see the month of your renewal, . The IHSS program provides personal care and domestic services to lowincome individuals to help them remain safely in their own homes and communities. The Governors budget assumes that the cost per hour of IHSS services will increase from $18.62 in 2022-23 to $19.12 in 2023-24. In order to qualify for IHSS, a recipient must be aged, blind, or disabled and in most cases have income below the level necessary to qualify for the Supplemental Security Income/State Supplementary Payment cash assistance program (for example, about $1,135 a month for an aged and/or disabled individual living independently in 2022-23). The remaining nonfederal share of IHSS costs is covered by the state and counties. Starting June 5, 2023, the IHSS El Monte Office will be located at: Address: 588 Atlas Avenue, Monterey Park, CA 91755. Given that Omicron has become the prevailing COVID19 variant in California since the development of the Governors budget, the Legislature may want to consider whether any IHSSprogram flexibilities or temporary supports warrant an extension. PDF The 2021-22 Budget: In-Home Supportive Services The LAO is unable to guarantee the accuracy of this translation and is therefore not liable for any inaccurate information resulting from the translation application tool. Based on our analysis of caseload data, the slower growth in IHSS paid cases seems to be due, in part, to fewer authorized cases receiving paid services in any given month since the start of COVID19. We understand that the administration will continue to monitor the expansion of Medi-Cal to those aged 50 and over, and its implications for the IHSS caseload. While counties are expected to begin to transition back to inperson reassessments whenever possible, they may continue to use telephone and videoconferencing to conduct annual reassessments as needed.
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