The Tulare County Board of Supervisors respectfully requests your support for AB 2262 (Calderon), which would simplify the In-Home Supportive Services Program (IHSS) annual reassessment process for certain program recipients who have stable needs.
IHSS is a critical service that enables older adults and persons with disabilities to live safely and independently in their own home with assistance of their provider. This is an alternative to institutional settings such as nursing homes. IHSS consumers receive various services including personal care services (i.e. meal preparation, meal clean up), paramedical services (i.e. administering medications, wound care) and protective supervision for individuals with cognitive impairments. County human service agencies determine eligibility and provide case management services for older adults and persons with disabilities in the IHSS Program.
California's population of persons 65 years of age or older continues to increase - by 2030, one in five Californians will be 65 or older, which is double the over 65 population today. In Tulare County, IHSS currently serves approximately 6,061 recipients, with an increase in caseload of 52% over the past five years. Additionally, in Tulare County, only 15 social workers are allocated to process the 493 reassessments that are due (on average) each month. Overworked staff and increasing workload make it extremely challenging to meet the state's 80% timely reassessment compliance rate and to be able to provide the case management needed by the program's less stable consumers.
AB 2262 addresses the growing needs in the IHSS program by simplifying the IHSS annual assessment process for recipients whose needs are determined to be more 'stable' based on several data-informed factors. This would include IHSS consumers who have undergone an initial intake assessment and one reassessment and consumers whose hours have not fluctuated more than 25 percent since their prior assessment. Qualifying consumers would then participate in a simplified reassessment process.
A consumer could opt out at any time to receive a full reassessment if they felt their needs had changed that may result in additional service hours. This data-informed process would be supplemented by social worker review to identify vulnerable consumers, including those recently referred to the adult protective services program, who may need a full re-assessment. This abbreviated re-assessment would be implemented through a stakeholder-driven input process that includes consumer representatives, provider representatives, and other stakeholders.
This alternative re-assessment would replace the current 18-month variable reassessment process, which does not benefit many "stable" IHSS consumers due to the subjectivity of the factors that must be considered. Additionally, the criteria to determine whether a consumer meets the current 18-month variable reassessment process are not currently tracked by the Case management and Payrolling System (CMIPS), making it difficult and time-consuming for IHSS workers to determine who qualifies.
Given the under-funding of the IHSS program administrative activities, AB 2262 would help Tulare County keep pace with the exponential growth of the IHSS program that we are experiencing so that individuals can access these critical services to remain safe at home. It would also significantly contribute to the fiscal sustainability of the IHSS program in Tulare County.
Finally, AB 2262 would allow our county to streamline the reassessment process for IHSS consumers with more stable needs, enabling our social workers to focus their attention to IHSS applicants and recipients with more complex needs such as those with greater mental and behavioral health needs who lack other support systems. For these reasons, Tulare County requests your support for AB 2262.
Sincerely,
Eddie Valero, Chairman
Tulare County Board of Supervisors
cc: Assembly Member Holden, Assembly Member Calderon, Assembly Appropriations Committee, Tulare County State Delegation, Paul Yoder, Shaw Yoder Antwih Schmelzer & Lange, County Welfare Directors Association of California (CWDA)